中药熏洗(浴)疗法临床外用技术规范(草案)

熏洗(浴)疗法临床应用广泛,但方法各异。基于对熏洗(浴)疗法已有临床应用的数据挖掘与分析,结合临床应用实际和相关现代研究,经相关领域专家多次论证,形成中药熏洗(浴)疗法临床应用技术规范(草案)。该规范(草案)包括适应症、禁忌症、用药前评估、用药前准备、药液制备、熏洗温度、熏洗时间、熏洗频率、熏洗疗程、操作方法、用药后处理及评估、注意事项、常见不良反应及应对措施等,以期规范中药熏洗(浴)疗法的临床应用,提高临床疗效,减少不良反应。     

Cognitive interviewing to improve women's empowerment questions in surveys: Application to the health and nutrition and intrahousehold relationships modules for the project‐level Women's Empowerment in Agriculture Index

In 2015, the United Nations adopted the Sustainable Development Goals, which include fostering gender equality and women's empowerment and ending hunger and malnutrition. To monitor progress and evaluate programmes that aim to achieve these goals, survey instruments are needed that can accurately assess related indicators. The project‐level Women's Empowerment in Agriculture Index (pro‐WEAI) is being developed to address the need for an instrument that is sensitive to changes in empowerment over the duration of an intervention. The pro‐WEAI includes new modules with previously untested survey questions, including a health and nutrition module (focused on women's agency in this area) and an intrahousehold relationships module. This study uses cognitive interviewing to identify how new survey questions might be misinterpreted and to understand what experiences women are referencing when they respond to these questions. This was undertaken with the goal of informing revision to the modules. The study was conducted in Bangladesh with women from nuclear, extended, and migrant‐sending households and from two regions of the country to identify difficulties with interpretation and response formulation across these groups. Findings revealed that questions were generally understood, but participants occasionally responded to the wrong part of the question, did not understand key phrases, or were uncomfortable with questions. The findings also suggested ways to revise the modules and strengthen the pro‐WEAI. The revised pro‐WEAI health and nutrition and intrahousehold relationships modules will advance the ability to measure changes in these domains and their relationship with the health and nutritional status of women and their children.     

盐酸氨溴索治疗小儿支气管肺炎的临床分析

目的分析研究盐酸氨溴索用于小儿支气管肺炎的临床效果。方法将本院2017年12月—2018年12月期间收治的小儿支气管肺炎患儿88例按照随机双盲法均分为对照组和治疗组,予以对照组44例患儿常规治疗,予以治疗组44例患儿常规治疗联合氧气驱动雾化吸入盐酸氨溴索治疗,对两组患儿的临床疗效和临床症状缓解时间进行对比。结果与对照组相比,治疗组患儿咳嗽、咳痰、胸片改善时间及肺部干湿啰音缓解时间均显著短于对照组,组间差异具有统计学意义(P<0.05),治疗组的临床总有效率为95.45%(42/44),明显高于对照组77.27%(34/44),组间差异具有统计学意义(P<0.05)。结论小儿支气管肺炎在临床常规治疗的基础上加用盐酸氨溴索治疗有助于患儿临床症状的缓解,效果明显。     

A loxoscelism case received therapeutic apheresis and hyperbaric oxygen therapy

Loxosceles reclusa (L.reclusa) is known to bite humans, and its venom includes several enzymes that cause clinical symptoms. Loxoscelism, a condition due to being bitten by Loxosceles spiders, commonly known as recluses, can involve a range of clinical conditions, from local cutaneous lesions to severe systemic involvement. The diagnosis of loxoscelism is usually made by anamnesis and clinical findings. Magnetic resonance imaging is recommended for patients at high risk of necrotizing fasciitis. Treatment modalities are still controversial and there is no standardized treatment approach. Reported here, our case of loxoscelism involved a 24-year-old man presenting with a Loxosceles spider bite, dermonecrotic lesion, vomiting, diarrhea, acute renal injury, and rhabdomyolysis, who was successfully treated with hyperbaric oxygen therapy, therapeutic apheresis, hemodialysis, wound debridement, and cutaneous autografting. Early diagnosis and multidisciplinary approach can be life-saving in spider bites that can cause systemic involvement. Loxoscelism should be considered in patients with skin necrosis, acute renal injury, and rhabdomyolysis.