Hospital admission for neurologic disorders among 5-year survivors of noncentral nervous system tumors in childhood: A cohort study within the Adult Life after Childhood Cancer in Scandinavia study

Large, comprehensive studies of the risk for neurologic disorders among long-term survivors of noncentral nervous system (CNS) childhood cancers are lacking. Thus, the aim of our study was to assess the lifetime risk of Nordic non-CNS childhood cancer survivors for neurologic disorders. We identified 15,967 5-year survivors of non-CNS childhood cancer diagnosed in Denmark, Iceland, Finland and Sweden in 1943–2008, and 151,118 matched population comparison subjects. In-patient discharge diagnoses of neurologic disorders were used to calculate relative risks (RRs) and absolute excess risks (AERs). A neurologic disorder was diagnosed in 755 of the survivors while 370 were expected, yielding a RR of 2.0 (95% confidence interval (CI) 1.9–2.2). The highest risks were found among survivors of neuroblastoma (4.1; 95% CI 3.2–5.3) and leukemia (2.8; 95% CI 2.4–3.2). The AER decreased from 331 (278–383) excess neurologic disorders per 100,000 person-years 5–9 years after diagnosis to 82 (46–118) ≥ 20 years after diagnosis. Epilepsy was the most common diagnosis (n = 229, 1.4% of all survivors), and significantly increased risks were seen among survivors of eight out of 12 types of childhood cancer. Survivors of neuroblastoma had remarkably high risks (RR ≥ 10) for hospitalization for paralytic syndromes and hydrocephalus, while survivors of leukemia had additional high risks for dementia and encephalopathy. In conclusion, survivors of non-CNS childhood cancer are at high risk for neurologic disorders, especially within the first decade after diagnosis. Therefore, intensive follow-up to identify those who require close management is needed.     

The introduction of BCG vaccination to neonates in Northern Sweden, 1927–31: Re-analysis of historical data to understand the lower mortality among BCG-vaccinated children

BackgroundFollowing the introduction of oral Bacille Calmette-Guérin (BCG) a century ago, Albert Calmette suggested that BCG both provided protection against death from tuberculosis (TB) and other causes. The findings were not pursued. Today, there is considerable evidence that intradermal BCG have beneficial non-specific effects (NSEs). We re-analyzed data from BCG’s introduction 1927–1931 in Sweden hypothesizing that BCG reduced infectious deaths.MethodsIn three papers published by Dr Carl Näslund, the progress of oral neonatal BCG rollout provided free-of-charge and the effects on child mortality in the highly TB-prevalent region Norrbotten was sequentially updated. We analyzed cause-specific post-neonatal mortality by vaccination status excluding deaths from congenital conditions. Due to apparent differences in effects during study years, effects were assessed overall and separately in two periods (1927–1929, 1930–1931).ResultsAccording to Näslund, TB households were slightly more likely to accept vaccination; fewer newborns that were sick or had congenital problems were vaccinated. BCG coverage was 28.3% (5659/20,012); 8.7% (1746/20,012) died. The BCG/unvaccinated Risk Ratio (RR) of post-neonatal childhood death was 0.53 (0.45–0.62). BCG was associated with 80% (49–92%) reduced mortality from TB. From 1927 to 29, BCG appeared to protect strongly against deaths from all diseases, including the non-infectious, RR = 0.09 (0.02–0.36), presumably reflecting selection bias. From 1930 to 1931, there was no protection against non-infectious deaths, RR = 0.92 (0.49–1.70) indicating less bias (p = 0.004 for same effect). During 1930–1931, BCG was associated with reductions in non-TB infectious deaths (RR = 0.75 (0.58–0.97)); 2/3 were caused by respiratory infections, against which the BCG/unvaccinated RR was 0.61 (0.43–0.84). Other causes of death were less frequent and provided no clear pattern, except that BCG was associated with more meningitis deaths, RR = 6.85 (2.20–21.4).ConclusionHealthy vaccinee bias, particularly in 1927–1929, resulted in strongly beneficial overall BCG effects. However, the 1930–1931 data provided some support that BCG both protected against TB deaths and deaths from respiratory infections.     

国产沉香化学成分及药理作用研究进展

根据国内外有关国产沉香化学成分及药理作用的文献报道,国产沉香的主要化学成分为倍半萜类和色酮类成分,除此之外,还包括芳香族类、脂肪酸类、三萜类等成分。国产沉香具有多种生物活性,其药理作用包括催眠镇静、缓解肠道平滑肌痉挛、止咳平喘、抗心肌缺血、降血糖等。根据当前研究情况,今后应对国产沉香中2-(2-苯乙基)色酮类多聚体成分进行系统研究,探索沉香化学成分与药理药效的关系,以清楚地了解各成分在各种药理作用中的具体作用机制。参考文献46篇。     

高龄老年骨折患者手法固定后使用补气活血方的临床价值研究

目的:研究高龄老年骨折患者手法固定后使用补气活血方的临床价值。方法:纳入我院2017年1-12月收治的骨折患者共100例为研究对象,按照住院号单双数分组法分为观察组与对照组各50例,对照组实施手法固定后使用常规药物干预,观察组在对照组治疗方案基础上给予补气活血方,对比不同药物方案对患者骨折愈合时间、C反应蛋白(C-reactive Protein,CRP)及红细胞沉降率(Erythrocyte Sedimentation Rate,ESR)水平、疼痛评分差异。结果:①两组治疗前CRP、ESR、白细胞介素(Interleukin,IL)-6及肿瘤坏死因子-α(Tumor Necrosis Factor,TNF-α)水平无统计差异(P>0.05),治疗后观察组患者指标水平优于对照组(P<0.05);②两组患者的疼痛评分治疗前无明显差异(P>0.05),治疗后疼痛评分均下降,但观察组显著低于对照组(P<0.05),且观察组的骨折愈合时间短于对照组(P<0.05)。结论:对高龄老年骨折患者使用手法固定联合补气活血方口服能够改善患者的骨折康复效果。     

补气养阴降糖饮联合二甲双胍治疗老年2型糖尿病的疗效观察

目的:观察补气养阴降糖饮加减联合二甲双胍治疗老年2型糖尿病(气阴两虚证)的效果。方法:选取2018年4月至2019年10月北京市和平里医院收治的老年2型糖尿病(气阴两虚证)患者84例作为研究对象,随机分为对照组和观察组,每组42例。2组均予以基础治疗,对照组予以二甲双胍口服,观察组予以补气养阴降糖饮加减联合二甲双胍治疗。比较2组治疗前后主症、次症及总评分、糖代谢水平、临床疗效、胰岛素抵抗指数水平及不良反应。结果:治疗后2组主症、次症及总评分,糖代谢水平、胰岛素抵抗指数水平均下降,且观察组较对照组降低的更为明显,差异均有统计学意义(P0.05);治疗后观察组总有效率高于对照组,差异有统计学意义(P0.05);观察组不良反应发生率与对照组比较,差异无统计学意义(P0.05),且不良反应均轻微。结论:对老年2型糖尿病气阴两虚证予以补气养阴降糖饮加减联合二甲双胍可有效控制症状,改善糖代谢,增强临床疗效,减轻胰岛素抵抗,且安全。     

新癀片用于口腔种植牙术后肿胀疼痛中的治疗效果观察

目的：探析口腔种植牙术后肿胀疼痛采取新癀片进行治疗的效果及对炎性因子的影响。方法：选取2015年1月至2019年12月北京中医药大学东直门医院收治的口腔种植牙术后肿胀疼痛患者300例作为研究对象，按照随机数字表法随机分为对照组和观察组，每组150例，对照组采用红霉素治疗，观察组采用新癀片联合红霉素治疗，比较2组患者术后肿胀和术后疼痛持续时间、牙槽骨吸收量、种植牙功能、种植体唇侧骨厚度、周围边缘骨吸收量、炎性反应因子水平、治疗优良率等指标。结果：与对照组比较，观察组术后肿胀持续时间、术后疼痛持续时间明显较短（P<0.05）；观察组种植牙功能评分等明显高于对照组（P<0.05）；观察组种植体唇侧骨厚度、周围边缘骨吸收量与对照组比较有明显差别（P<0.05）；观察组CPR、IL-6、PCT等炎性反应因子水平明显较低（P<0.05）；观察组治疗总有效率明显高于对照组（P<0.05）。结论：口腔种植牙术后肿胀疼痛应用新癀片进行治疗，能获得较为理想的效果，改善炎性反应因子水平，有着极大的推广价值。     

Medical masks’ and respirators’ pattern of use,adverse effects and errors among Portuguese health care professionals during the COVID-19 pandemic: A cross-sectional study

BackgroundDuring COVID-19 pandemic, a shortage of surgical masks (Mask) and respirators (Resp) was experienced worldwide. We aimed to assess its pattern of use, adverse effects and user errors by Portuguese health care professionals (HCP).MethodsA cross-sectional study was conducted through snowball convenience sample, collected by email/ social media to health care organizations. Participants answered an online anonymous survey in March 2021.ResultsMean age of 3052 respondents was 42.1 years old, 83.6% were female and 77.8% provided direct health care to COVID-19 patients. Mean time of use per shift was 6-8 hours in 40.8% of the participants. 28.0% reported never changing it during their shift. Resp use (vs Mask) was more associated with discomfort (58.2% vs 26.8%), affecting task performance (41.5 vs 18.9%) and communication (55.0 vs 40.9%), dyspnea (36.0 vs 14.4%), skin rash (37.5 vs 19.4%) and headache (37.5 vs 19.4%). Frequent user errors included touching the front while in use (70.1% Mask vs 66.3% Resp) and omitting hand hygiene before (61.8% Mask vs 55.0% Resp) or after use (61.3% Mask vs 57.0% Resp). Average number of errors was higher for Mask (4.3), than for Resp (3.2) (all: P < .001).ConclusionsMost HCP admitted an extended use of Mask/ Resp. Resp were more prone to adverse effects and Mask more prone to errors. Strategies to reinforce good practices should be considered.     

益母草属萜类化学成分及其药理作用研究进展

益母草属植物中的化合物类型多样、结构丰富,其中萜类化合物是目前发现数量最多的一类,同时具有广泛的生物活性。因此,作者对益母草属萜类化合物及其药理活性进行总结归纳,为该属萜类化合物的进一步研究提供参考。     

微型种植体支抗与口外弓支抗对安氏Ⅱ类1分类错牙合畸形患者的矫治效果对比分析

目的:分析比较微型种植体支抗与口外弓支抗对安氏Ⅱ类1分类错牙合畸形患者的矫治效果。方法:收集笔者医院95例安氏Ⅱ类1分类错牙合畸形患者临床资料,根据其治疗方法将之分为口外弓支抗(MIA组)46例和微型种植体支抗组(HGA组)49例,比较其矫正前后头影测量结果和模型测量结果,矫治时间和不良反应。结果:治疗后,MIA组牙合平面与SN平面夹角(OP-SN)、上颌中切牙牙长轴与SN平面夹角(U1-SN)、上唇突度、下唇突度、上唇最凸点至E线垂直距离(E line-UL)、下唇最凸点至E线垂直距离(E line-LL)、覆牙合(OB)、覆盖(OJ)均小于HGA组(P<0.05),矫治时间短于HGA组(P<0.05),总不良反应发生率与HGA组差异无统计学意义(P>0.05)。结论:对比HGA,MIA对安氏Ⅱ类1分类错牙合畸形患者的矫治效果更佳,且能够缩短矫治时间。     

丹红注射液联合氢氯吡格雷用于脑梗死恢复期的临床观察

目的：探析脑梗死恢复期患者采取丹红注射液联合氢氯吡格雷口服进行治疗对改善神经功能的效果。方法：选取2017年5月至2019年11月马鞍山十七冶医院收治的脑梗死恢复期患者66例作为研究对象，按照随机数字表法随机分为对照组与观察组，每组33例。对照组采取氢氯吡格雷口服治疗，观察组采取丹红注射液联合氢氯吡格雷口服治疗，比较2组患者治疗有效率、神经功能缺损评分（NIHSS）、日常生活能力评分（ADL）、运动功能、不良反应发生率、洼田饮水试验等指标。结果：与对照组比较，观察组治疗有效率明显较高，差异有统计学意义（P<0.05）；与对照组比较，观察组的NIHSS评分较低，ADL评分较高，差异有统计学意义（P<0.05）；观察组的不良反应发生率明显低于对照组，差异有统计学意义（P<0.05）；2组Ⅱ级、Ⅲ级比较，差异有统计学意义（P<0.05）；2组用药后洼田饮水试验分级比较，差异有统计学意义（P<0.05）。结论：脑梗死恢复期患者采取丹红注射液联合氢氯吡格雷口服进行治疗能够提升治疗效果、改善神经功能，安全性高，可加快患者康复速度。