温病学教学中的“三全育人”战略

温病学是中医学四大经典课程之一,是基础理论向临床实践过渡的桥梁课程,对于中医药高校学生具有重要意义。“三全育人”战略是高校思想政治工作的重点,新时期,我们应把“三全育人”战略贯穿温病学教育教学全过程和各环节,全员全过程全方位为培养具有坚实的温病理论知识和技能、医德高尚的现代化应用型中医药人才服务。     

中西医不同角度对儿童新型冠状病毒肺炎(COVID-19)的认识

2019年12月以来,以湖北省武汉市为中心陆续发现了多例新型冠状病毒肺炎(COVID-19)患者。人群普遍易感,儿童亦有感染病例出现,感染波及新生儿、婴幼儿,并且已出现儿童重症病例。儿童感染病例引起了社会高度重视。目前COVID-19病理机制尚不清楚,治疗亦缺乏特效药,这些问题都给疫情防控和临床救治带来极大困难。尝试从中西医不同角度认识儿童COVID-19,分析儿童COVID-19病因、流行特点、病情发展特点及治疗措施,同时从中医角度探讨儿童COVID-19病因病机、辨证及治疗方法,能更好地通过中西医结合对此次儿童COVID-19进行深入了解,理解其病理之基础,分析目前疫情发展之趋势,并在此基础上寻找安全有效的防治措施,以期对临床更好地防治儿童COVID-19提供参考。     

Infections at the bottom end of the gastrointestinal tract

This article concentrates on specific infections of the distal gastrointestinal (GI) tract, particularly those that are transmitted sexually, by anal intercourse. Syphilis, gonorrhoea and lymphogranuloma venereum (LGV) are age old and well known diseases, but the features may be unfamiliar to GI histopathologists. Every histopathology trainee will have seen Herpes simplex virus (HSV) infection of squamous epithelium (e.g. oesophagus, vulva and anus), but the HSV pseudotumour of the anus/perineum can present a pitfall to those who have not previously encountered this entity. Another, more recently described, entity that has a predilection for the ano-rectal region is Epstein–Barr Virus (EBV) positive mucocutaneous ulcer, and this also presents a diagnostic trap to the unwary.     

Caliber-persistent labial artery: report of 3 cases

The caliber-persistent labial artery is a vascular anomaly in which a primary arterial branch penetrates into the submucosal tissue without reduction in diameter. Most lesions are benign and do not require treatment, except for complications and/or on patient demands. In this way, noninvasive diagnostic tools are preferred such as high-resolution and color Doppler ultrasonography which allow direct observation of the lesion, assessing its exact location and diameter at every axis, as well as the blood flow velocity. An excisional biopsy of these lesions or even their surgical extirpation could have a fatal outcome with profuse bleeding.     

Cognitive impairment in patients with rheumatoid arthritis: A systematic review and meta-analysis

ObjectiveAn increasing number of studies have demonstrated cognitive impairment in patients with rheumatoid arthritis (RA). The literature indicates many factors play an important role in this clinical problem, such as the severity of depressive symptoms and the treatment used. The aim of this study was to systematically review studies comparing cognitive functioning between healthy participants and RA patients and to determine both the severity and potential moderators of cognitive impairment.MethodsFor this purpose, 16 studies that fulfilled all selection criteria were carefully selected. Altogether, 921 patients with RA (812 women and 109 men) and 700 controls participated in these studies. Due to the inability to perform a network meta-analysis, it was decided to determine the effect sizes for studies which used the same measurement methods.ResultsThe analysis demonstrated greater impairment of cognitive functioning in patients with RA than in healthy controls, with effect sizes ranging from small to large, depending on the assessment method used in the study.ConclusionsThe study pinpoints potential biases, lack of replication, and inconsistencies in reporting data as possible confounding factors and suggests further recommendations for assessment methods, research directions and clinical implications.Clinical trial registrationNot applicable.     

基于单中心的恶性肿瘤患者合并心血管及代谢疾病的调查

目的:探讨恶性肿瘤、心血管病变和代谢疾病三者之间的关联。方法:搜索2018年9月1日至2018年10月31日期间在复旦大学附属中山医院心脏超声诊断科进行心脏超声心动图检查的患者，根据病史资料统计恶性肿瘤患者例数，并分析其合并心脏疾病和代谢疾病情况。结果:搜索行心脏超声心动图检查的患者共计26 698例，其中经病理检查或经影像学检查明确证实的恶性肿瘤患者1 992例，男性1 084例，女性908例，平均年龄（62.62±11.42）岁。左室射血分数平均值为（65.35±4.94）%。合并心脏疾病共220例，占11.04%。合并代谢疾病共1 052例，占52.81%。结论:恶性肿瘤患者在心脏超声心动图检查的患者中比例较高，合并心脏疾病、代谢疾病情况也不在少数；恶性肿瘤及相关治疗既能造成心脏疾病的发生又可导致代谢疾病的出现，故需对恶性肿瘤患者进行早期预防和干预治疗，以减少心脏疾病和代谢疾病的发生或加重。     

阴道微生态菌群与宫颈疾病相关性的研究进展

宫颈疾病包括宫颈炎症、宫颈鳞状上皮内病变及宫颈癌,近年研究发现阴道微生物菌群产生的细胞因子及局部免疫系统与宫颈疾病的发生、发展有关。正常女性的阴道微生态环境由多种微生物构成,其中乳杆菌对维持阴道微生态平衡发挥着重要作用。宫颈癌在女性恶性肿瘤中发生率位居第一,其发生与人乳头瘤病毒(HPV)持续感染密切相关,但并非所有感染HPV者均患宫颈癌,其病因为多因素综合作用。因乳杆菌变化导致的阴道疾病与HPV感染相互作用,共同参与宫颈疾病的发生、进展,系统有效的阴道微生态环境检测对及时调节阴道微生态平衡非常重要。阴道微生物菌群与宫颈疾病之间的关系成为许多学者的研究热点,综述阴道微生态与宫颈疾病发生、发展的相关性,为宫颈疾病尤其是宫颈癌的预防、治疗及预后提供理论依据。     

Engineered glove to evaluate hand disability in rheumatoid arthritis: A pilot-study

ObjectiveThe Hand Test System (HTS) is an engineered-sensorized glove that has been originally developed in the neuroscientific field for the evaluation of hand fingers’ speed movement. This pilot-study aimed to evaluate the reproducibility of HTS analysis in rheumatoid arthritis (RA), correlating glove-derived parameters with clinical disease activity indexes, self-reported disability-related questionnaires and hand strength.MethodsFifty-five RA patients and fifty age and sex matched healthy controls (HCs) performed HTS analysis. The glove recognized the touch speed between the finger tips during standard sequences of movements, providing three quantitative parameters: touch duration (TD), inter-tapping interval (ITI) and movement rate (MR). These variables were correlated with Health Assessment Questionnaire (HAQ), Health Assessment Questionnaire-Disease Index (HAQ-DI), Hand Disability Index (HDI), Hand Grip Strength (HGS), DAS28-CRP, CDAI and SDAI.ResultsIntraclass correlation coefficient was 0.93 (CI: 0.92, 0.95). RA patients showed significantly slower TD, ITI and MR than HCs, for all classes of disease activity (P < 0.001). All HTS parameters correlated significantly with HAQ, HAQ-DI, HDI, HGS, DAS28-CRP, SDAI, CDAI (between P < 0.05 and P < 0.001). Of note, also RA patients in clinical remission showed a significantly higher TD compared with HCs (P < 0.001).ConclusionHTS seems a new safe and fast tool to evaluate rheumatoid hand's functionality, measuring the speed of finger movements. Furthermore, the HTS parameters significantly correlate with quality of life, disease activity, hand strength and perceived hand disability, evaluating also potential hand motor impairment in RA clinical remission.