儿童慢性腹泻高营养风险情况及对预后的影响

目的 探讨儿童慢性腹泻高营养风险情况及对预后的影响。方法 选择2019年1～12月在我院诊断治疗的慢性腹泻患儿100例为研究对象,进行营养风险筛查,分析高营养风险患儿与非高营养风险患儿临床特征以及预后情况,分析性别、年龄、病因对慢性腹泻患儿高营养风险的影响。结果 (1)100例患儿24例患儿STAMP评分≥4分,为高营养风险组,占24.0%。(2)7～14岁患儿高营养风险发生率显著高于其他年龄段患儿(P0.05);炎症性肠病患儿高营养风险发生率显著其他病因的患儿(P0.05)。(3)炎症性肠病是慢性腹泻患儿发生高营养风险的独立危险因素(P0.05)。(4)高营养风险组白蛋白、前白蛋白水平显著低于非高营养风险组,差异有统计学意义(P0.05)。两组Hb水平比较差异无统计学意义(P0.05)。(5)非高营养风险组痊愈率显著高于高营养风险组,医院感染率显著低于高营养风险组,住院时间显著短于高营养风险组,差异均有统计学意义(P0.05)。结论 儿童慢性腹泻高营养风险发生率相对较高,病因会影响患儿高营养风险的发生,而高营养风险影响患儿的预后,延长住院时间。     

高频电针结合臭氧对膝骨关节炎患者血清IL-1及TNF-α表达的影响

目的:研究高频电针(100Hz)结合膝关节腔内注射臭氧对膝骨关节炎(KOA)患者血清IL-1及TNF-α水平的影响。方法:将195例KOA患者随机分为三组,100 Hz电针治疗组(A组,n=65); 膝关节腔内臭氧注射治疗组(B组,n=65); 100 Hz电针结合膝关节腔内臭氧注射治疗组(C组,n=65),疗程均为3周。分别于治疗前和治疗后检测患者血清IL-1及TNF-α水平,并进行WOMAC 指数评分。结果:治疗后,三组患者的血清IL-1、TNF-α含量均较治疗开始前有所降低; 且C 组改善水平优于A、B 组,B组改善水平优于A组,差异均具有统计学意义(P<0.05); 治疗后,三组患者WOMAC 指数评分均较治疗前有所降低; 且C 组WOMAC评分好于A和B 组,B 组WOMAC评分优于A 组,差异均有统计学意义(P<0.05)。结论:高频电针结合膝关节腔内注射臭氧可显著抑制KOA患者血清 IL-1、TNF-α的表达,改善患者WOMAC指数评分。     

500 Cases of High-intensity Focused Ultrasound (HIFU) Ablated Uterine Fibroids and Adenomyosis

ObjectiveClinical outcomes of 500 high-intensity focused ultrasound (HIFU)-treated uterine fibroids and adenomyosis are analyzed and presented.Materials and methodsThis is a retrospective cross-sectional analysis from a single tertiary medical center. From April 2015 to October 2018, 546 cases were enrolled for the study. After excluding 46 patients with less than 3 months of follow-up period, there were 404 fibroids, 149 adenomyosis and 53 mixed conditions entered for analysis. The patients’ uterine fibroids and adenomyosis were treated by HIFU according to Chongqing Haifu protocol, with 12 cm diameter transducer of focal length 10–16  cm at 0.8 or 1.6 MHz T2-weight MRI imaging was rendered prior to and 3 month post treatment to assess lesion volume change using non-perfusion volume, which was the primary outcome. Secondary outcomes including quality of life, subjective satisfaction, adverse events and pregnancy rate were determined using self-reported questionnaires. The mean follow up period ranged from 3 to 38 months with an average of 21 months.ResultsThree months after HIFU-treated uterine fibroids and adenomyosis, the lesion size reduced 40.2% and 46.3%, respectively. Symptoms all improved with better quality of life for the fibroid group, while those with adenomyosis or combined diseases benefit the most from pain control. Serum CA125 decreased significantly for all studied groups, and LDH only showed improvement for fibroids group. Number of adverse events is comparable to Chongqing data (approximately 10.2%), with mostly mild and self-resolving conditions. No permanent sequelae or death was documented. Twelve pregnancies are reported in this cohort.ConclusionHIFU is safe and effective in treating uterine fibroids and adenomyosis. The results are reproducible if standardized treatment schedules are followed. It is a promising treatment alternative with the advantages of precision, non-invasiveness, rapid recovery and readiness for pregnancy.     

独活寄生汤治疗骨质疏松性椎体压缩骨折的临床效果

目的：探讨独活寄生汤对骨质疏松性椎体压缩骨折（OVCF）患者高迁移率族蛋白-1（HMGB-1）、C反应蛋白（CRP）、降钙素原（PCT）的影响。方法：选取2015年4月至2016年9月广州中医药大学第二附属医院收治的OVCF患者92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46例。2组均行经皮椎体后凸成形术治疗，对照组给予常规处理，观察组在此基础上加用独活寄生汤，2组均治疗2周。比较2组术后2周的骨折愈合情况、股骨颈骨密度及日本骨科协会腰痛评价表（JOA）评分，术前、术后3 d的炎性反应递质水平，术后1、3、7 d的疼痛视觉模拟评分（VAS）。结果：与术前比较，术后2周，2组伤椎前缘高度、股骨颈骨密度及JOA评分均升高，且观察组高于对照组，差异有统计学意义（P<0.05）；2组伤椎楔变角及后凸Cobb角均降低，且观察组低于对照组，差异有统计学意义（P<0.05）；术后3 d，2组血清TNF-α、CRP、PCT及HMGB-1水平均升高，且观察组低于对照组，差异有统计学意义（P<0.05）。与术后1 d比较，术后3、7 d，2组VAS评分均降低，且观察组低于对照组，差异有统计学意义（P<0.05）。结论：采用独活寄生汤治疗OVCF，可降低患者炎性反应递质水平，减轻疼痛，并可改善患者骨质疏松症状，促进骨折愈合，疗效显著。     

Water condensation from gas outlet of oxygenator

Condensation and water loss from gas output of the cardiopulmonary bypass (CPB) oxygenator has been the study object of several research. However, little is known about the propagation of the condensation formed at the level of oxygenator and how potentially it can contaminate the surrounding environment. We aimed to document the moment of formation of the ‘gas steam’ derived from the CPB oxygenator during cardiac surgery with thermography imaging. Thermographic camera is a device that creates an image using infrared radiation, similar to a common camera that forms an image using visible light. The brightest (warmest) parts of the image are customarily colored white, the intermediate temperatures reds and yellows, and the dimmest (coolest) parts black. Thermal image captures the condensation phenomenon around the oxygenator perimeter with the same color/temperature code (yellow) of gas outlet. The use of aspiration at the level of the gas outlet could also favor the elimination of the condensation, improve gas exchanges, and potentially reduce the spread of hazardous substances in the operating room.     

Does obesity put your brain at risk?

Background and aimsThe negative impact of obesity on the brain is an issue of increasing clinical interest. Hence, this review summarized evidence linking obesity with brain morphology (gray and white matter volume), brain function (functional activation and connectivity), and cognitive function.MethodsA criticals review of the relevant published English articles between 2008 and 2022, using PubMed, Google Scholar and Science Direct. Studies were included if (1) an experimental/intervention study was conducted (2) the experiment/intervention included both high fat diet or body weight, whether it could counteract the negative effect brain morphological or functional change. Critical analysis for a supporting study was also carried out.ResultsBrain dysfunction can be recognized as result from neuroinflammation, oxidative stress, change in gut-brain hormonal functionality decrease regional blood flow or diminished hippocampal size and change in gut-brain hormonal functionality; which collectively translate into a cycle of deranged metabolic control and cognitive deficits, often obesity referred as changes in brain biochemistry and brain function. Recently, a few changes in brain structure and functions could be traced back even to obese children or adult. Evidence here suggested that obesity elicits early neuroinflammation effects, which likely disrupt the normal metabolism in hypothalamus, and hippocampus result from brain insulin resistance. The mechanisms of these robust effects are discussed herein.ConclusionBrain disease is inseparable from obesity itself and requires a better recognition to allow future therapeutic targeting for treatment of obesity. Additional research is needed to identify the best treatment targets and to identify if these changes reversible.     

中学生家庭应激源与物质主义价值观的关系:亲子依恋的中介作用

目的:考察中学生物质主义价值观与家庭应激源、亲子依恋的关系。方法:采用青少年物质主义价值观量表、家庭压力量表和青少年父母与同伴依恋问卷中的父母分问卷,对江苏某高中1344名学生进行调查。结果:家庭应激源显著正向预测中学生物质主义价值观水平,亲子依恋显著负向预测中学生物质主义价值观水平;中介回归分析结果显示,在考虑亲子依恋的影响时,家庭应激源对中学生物质主义价值水平的预测作用虽仍显著但已减弱。亲子依恋在家庭应激源与物质主义价值观之间的间接效应占总效应的13.30%,其90%置信区间为[0.003,0.024],P0.05。结论:亲子依恋在中学生家庭应激源和物质主义价值观水平之间起部分中介作用。     

功能失调性子宫出血的发病机制及治疗进展

功能失调性子宫出血(功血)是一种常见的妇科内分泌疾病,近年来其发病率逐年上升。其发病机制不明,可能包括神经内分泌功能失调和子宫内膜局部微环境异常两个方面。功血的治疗主要分为药物治疗及非药物治疗,后者包括左炔诺孕酮宫内释放系统、诊断性刮宫术、子宫内膜去除术、介入治疗及子宫切除术。其中高强度聚焦超声子宫内膜去除术是一种新兴技术,可在临床中进一步推广应用。     

Coronavirus and cardiovascular manifestations-getting to the heart of the matter

Coronavirus disease has unarguably been the largest pandemic of recent times. Over 150 million cases have occurred worldwide, and more than 3 million have succumbed to the disease. Cardiac manifestations can have varied presentations from an asymptomatic troponin rise to fulminant myocarditis. The pathogenesis of myocardial damage could be direct or indirect, including inflammation, coronary spasm, plaque rupture, and cytokine storm. Thromboembolism is also an important feature of cardiovascular affliction with both arterial and venous systems being affected. Hence, anticoagulation has also been a matter of debate. Fulminant myocarditis is the most severe form and can lead to circulatory shock with a high mortality. Management of cardiac patients with coronavirus disease 2019(COVID-19) infection is not considerably different from non-COVID-19 cardiovascular disease, but interaction between cardiovascular drugs and antiCOVID-19 therapy requires careful attention. More recently, vaccines have emerged as a ray of hope for the disease. But simultaneously, there have been reports of thromboembolism following vaccination. In this review, we discuss the various aspects of coronavirus disease affecting of heart and its management.     

磁共振结合高分辨率CT在中耳乳突炎患者术前评估中的临床应用

目的探讨磁共振结合高分辨率CT在中耳乳突炎患者术前评估中的临床应用。方法选取我院2018年11月~2020年12月接收患有中耳乳突炎的患者40例为研究对象,所有患者均采用磁共振以及高分辨率CT进行诊断检查,比较两组患者诊断后手术特征显示度。结果诊断后,磁共振联合高分辨率CT检查图像显示度高于单独使用磁共振或高分辨率CT诊断(P<0.05)。结论使用磁共振结合高分辨率CT对中耳乳突炎患者进行术前评估,显示度较高,提高诊断准确度,值得推广。