Chestnut Lodge: 1948–1951

The author of the acclaimed novel, I Never Promised You a Rose Garden, a fictionalized account of her 3-year in-patient treatment at Chestnut Lodge, shares her personal memories and impressions of the experience. Treated by Frieda Fromm-Reichmann at the Lodge from 1948 to 1951, the author mines her memories of the facility, staff, fellow patients, and the treatment itself (including cold packs for sedation). She reflects on an earlier time in the history of treatment for the mentally ill.     

Liquefied petroleum gas cold burn sustained while refueling a car

There have been few cases of cold burn related to the exposure of liquid petroleum gas (LPG). We present the case of a young woman exposed to LPG while refueling her car who sustained partial thickness burns to the dorsum of her hand. Contact with LPG leaking from a pressurized system causes tissue damage because of cold injury. Immediate management of LPG is extrapolated from the management of frostbite. The increasing use of LPG mandates an awareness of prevention strategies and management principles in the setting of adverse events.     

寒区军人功能性腹泻患者菌群失调临床研究

目的分析寒区军人功能性腹泻(FD)的菌群失调诊治情况,为该疾病卫勤保障提供参考依据。方法回顾性分析2011年1月至2015年12月沈阳军区总医院消化内科收治的84例FD军人患者临床资料,分析患者肠道菌群失调情况。根据菌群失调情况分为菌群失调组与非菌群失调组,比较两组患者住院时间、应用微生态制剂情况。结果 FD伴发菌群失调者66例,占78.6%。其中,Ⅰ度菌群失调24例,占36.4%;Ⅱ度菌群失调12例,占18.2%;Ⅲ度菌群失调30例,占45.4%。菌群失调组患者中位住院时间为11.9 d,显著高于无菌群失调组(5.0 d),差异有统计学意义(P<0.05);无菌群失调组患者83.3%应用微生态制剂治疗;菌群失调组患者100.0%应用微生态制剂治疗。Ⅰ度、Ⅱ度、Ⅲ度菌群失调患者住院时间分别为8.8、10.4、17.5 d,与菌群失调程度呈正相关。结论寒区FD军人患者菌群失调发生率较高,且影响住院时间,需微生态制剂等更加系统的治疗。因此,仍需进一步完善现有针对寒区军人FD的卫勤保障措施。     

评价舒洛地特联合辛伐他汀治疗糖尿病下肢血管病变的疗效

目的评价舒洛地特联合辛伐他汀治疗糖尿病下肢血管病变的疗效。方法选取我院50例糖尿病下肢血管病变患者,使用舒洛地特联合辛伐他汀进行治疗,三个月后观察其下肢血管病变状况以及各项指标的改善情况,并与治疗前进行对比,分析其临床疗效。结果治疗后患者的症状明显改善,且各项指标显著优化(P0.05)。结论使用舒洛地特联合辛伐他汀治疗糖尿病下肢血管病变,具有显著疗效。     

悟透寒热说辨证医案连载（一）

古人说“大道至简”，最精辟、最伟大的学问，往往有一个最简明的内核，简明到一两句话就能说明白，叫“真传一句话，假传万卷书”。一门学问显得深奥是因为没有看穿实质，貌似复杂是因为没有抓住关键。中医这个“大道”的“至简”能简到什么程度呢？就是一个关于“寒热”的大道！关于“阴阳”的大道！就是一门研究人体寒热阴阳的大学问。     

Beyond冷光美白术联合祛氟剂治疗氟牙症的效果分析

目的观察Beyond冷光美白与祛氟剂联合治疗氟牙症的临床治疗效果。方法将60例氟牙症患者完全随机分为试验组和对照组，各30例。试验组患者用Beyongd冷光美白仪配合祛氟剂进行美白，对照组仅用Beyond冷光美白仪美白。治疗结束后采用Vita比色板比色，计算各组色阶提高值和有效率，并进行统计学分析。结果治疗后，试验组有效率和总有效率均高于对照组[43．3％（13／30）比16．7％（5／30），83．3％（25／30）比43．4％（13／30）]，差异均有统计学意义（均P〈0．05）。试验组和对照组治疗期间均无不良反应发生。结论Beyond冷光美白术联合祛氟剂脱色协同治疗氟牙症有良好临床效果。     

Equestrian chilblain: another outdoor recreational hazard

Herein, we describe two cases and review 14 cases of equestrian chilblain or ‘equestrian cold panniculitis’ in the literature. The first, a 23‐year‐old healthy female horse trainer, presented with burning nodular swelling on her lateral thighs. The second was a 34‐year‐old healthy woman with recurrent nodular eruption on the lateral thighs after horseback riding in the winter. Physical examination of both patients revealed erythematous to violaceous nodules with eczema craquelé‐like changes. Laboratory workup for systemic and autoimmune connective tissue disease was negative. Punch biopsies from both patients showed a superficial and deep perivascular and periadnexal lymphocytic infiltrate with focal extension into the subcutaneous fat. Parakeratosis, subtle spongiosis and increased pandermal interstitial mucin were also present. Previously reported cases generally showed a similar clinical course and similar histopathologic findings. In contrast, our cases revealed increased pandermal interstitial mucin, resembling tumid lupus erythematosus. We aim to better characterize the histopathologic findings of equestrian chilblain and discuss its relationship to other cold‐induced skin injuries and autoimmune connective tissue disease, namely lupus erythematosus.     

张纾难教授治疗肺结节的用药规律分析

目的：分析总结张纾难教授治疗肺结节的用药经验与规律。方法：收集整理张纾难教授近4年来治疗肺结节的中药处方，利用中医传承辅助平台多维度分析处方药物的四气五味、归经、核心处方及药物群组。结果：对221首处方进行中药频次统计，共涉及171味中药，常用药物性味分别是温、寒，苦、辛；最常用归脾经、肝经、肺经药物；最常使用的药味为黄芪、桂枝、川贝母；常用药对是“生黄芪，桂枝”“生黄芪，川贝母”。关联规则分析得出由“黄芪、桂枝、川贝母、夏枯草、陈皮、郁金、生龙骨、生牡蛎、山慈菇”9味核心药物组成的关联网络，聚类分析得到4首新方。结论：张纾难教授在治疗肺结节时注重扶正以祛邪，寒温并用，清补共施，善用脾经、肝经、肺经药物，补脾益气，化痰散结，疗效确切。     

宫颈上皮内瘤变锥切术后HPV检测的阴性预测价值

目的评定宫颈上皮内瘤变锥切术后高危型人乳头瘤病毒(HPV)检测的阴性预测价值。方法收集宫颈上皮内瘤变CINⅡ～CINⅢ的110患者并进行回顾性分析,宫颈锥切后定期行液基细胞学宫颈TCT及宫颈HPV检测,对子宫颈锥切术后切缘状态(切缘阳性)和高危型HPV状态与随后切除的子宫标本的残留病变进行相关性比较。高危型HPV检测应用二代杂交捕获(HC2)分析。结果在分析的110例患者中,47例(42.7%)宫颈锥切术后切缘为阳性,其中37例(78.7%)患者锥切后高危型HPV阳性,10例(21.3%)HPV阴性。这47例中,31例(66.0%)患者锥切后切除的子宫标本中有残留病变。宫颈锥切后63例(57.3%)切缘阴性的患者中,49例(77.8%)患者高危型HPV阴性患者均无残留病变,14例(22.2%)阳性患者中4例(6.3%)有残留病变。结论宫颈锥切术后进行HPV DNA检测具有很高的阴性预测价值。与之相伴的优点是能够预测CIN宫颈锥切患者术后残存病变的发生或复发。