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61.
目的:探讨王友仁主任医师推拿手法治疗寒邪客胃型胃脘痛的临床经验。方法:从病因病机和治则治法方面论述王老以"呼吸按动法"为主治疗寒邪客胃型胃脘痛的学术观点和临床经验,对其基本手法及配伍予以总结。结果:王老以"呼吸按动法"为主,配合温中散寒的手法治疗寒邪客胃型胃脘痛,临床疗效佳。结论:王老认为胃脘痛多因胃腑外感寒邪或脾胃阳虚所致,呼吸按动法疗效显著。 相似文献
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心脏外科专业型硕士研究生培养模式思考 《医学教育管理》2020,6(2):146-150,155
在我国临床医学专业学位硕士研究生同住院医师规范化培训并轨政策全面落实的背景下,心脏外科专业型硕士研究生从招生到培养过程中呈现出一些问题,通过从规范化培训计划的制定、人文素养和科研素养培育3个方面,结合教学体会提出了当前培养模式下对心脏外科专业型硕士研究生综合培养的思考。 相似文献
63.
目的观察"肾脑相济"电针对阿尔茨海默病(AD)模型小鼠行为学和大脑皮质炎性因子白细胞介素-1β(IL-1b)和肿瘤坏死因子-α(TNF-α)表达的影响,探究"肾脑相济"电针疗法治疗阿尔茨海默病的作用机理。方法将7月龄雄性SAMP8小鼠随机分成模型组、西药组和电针组,每组6只;将SAMR1小鼠作为对照组。西药组给予盐酸多?哌齐灌胃,电针组电针百会、肾俞和三阴交。采用Morris水迷宫观察小鼠行为学,应用免疫组化法、Western Blot法测定大脑皮质区IL-1b、TNF-α的阳性细胞数和蛋白表达。结果与对照组比较,模型组小鼠学习记忆能力明显下降,IL-1b、TNF-α的表达升高,差异有统计学意义(P<0.05);与模型组比较,西药组和电针组小鼠学习记忆能力增强,IL-1b、TNF-α的表达降低,差异有统计学意义(P<0.05);与西药组比较,电针组小鼠学习记忆能力及IL-1b、TNF-α的表达变化不明显,差异无统计学意义(P>0.05)。结论"肾脑相济"电针疗法可以改善SAMP8模型小鼠的学习和记忆能力,降低大脑皮质区IL-1b、TNF-α的含量,从而对阿尔茨海默病达到治疗效果。 相似文献
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Milan Milojevic Patrick W. Serruys Joseph F. Sabik David E. Kandzari Erick Schampaert Ad J. van Boven Ferenc Horkay Imre Ungi Samer Mansour Adrian P. Banning David P. Taggart Manel Sabaté Anthony H. Gershlick Andrzej Bochenek Jose Pomar Nicholas J. Lembo Nicolas Noiseux John D. Puskas Arie Pieter Kappetein 《Journal of the American College of Cardiology》2019,73(13):1616-1628
Background
The randomized EXCEL (Evaluation of XIENCE versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization) trial reported a similar rate of the 3-year composite primary endpoint of death, myocardial infarction (MI), or stroke in patients with left main coronary artery disease (LMCAD) and site-assessed low or intermediate SYNTAX scores treated with percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG). Whether these results are consistent in high-risk patients with diabetes, who have fared relatively better with CABG in most prior trials, is unknown.Objectives
In this pre-specified subgroup analysis from the EXCEL trial, the authors sought to examine the effect of diabetes in patients with LMCAD treated with PCI versus CABG.Methods
Patients (N = 1,905) with LMCAD and site-assessed low or intermediate CAD complexity (SYNTAX scores ≤32) were randomized 1:1 to PCI with everolimus-eluting stents versus CABG, stratified by the presence of diabetes. The primary endpoint was the rate of a composite of all-cause death, stroke, or MI at 3 years. Outcomes were examined in patients with (n = 554) and without (n = 1,350) diabetes.Results
The 3-year composite primary endpoint was significantly higher in diabetic compared with nondiabetic patients (20.0% vs. 12.9%; p < 0.001). The rate of the 3-year primary endpoint was similar after treatment with PCI and CABG in diabetic patients (20.7% vs. 19.3%, respectively; hazard ratio: 1.03; 95% confidence interval: 0.71 to 1.50; p = 0.87) and nondiabetic patients (12.9% vs. 12.9%, respectively; hazard ratio: 0.98; 95% confidence interval: 0.73 to 1.32; p = 0.89). All-cause death at 3 years occurred in 13.6% of PCI and 9.0% of CABG patients (p = 0.046), although no significant interaction was present between diabetes status and treatment for all-cause death (p = 0.22) or other endpoints, including the 3-year primary endpoint (p = 0.82) or the major secondary endpoints of death, MI, or stroke at 30 days (p = 0.61) or death, MI, stroke, or ischemia-driven revascularization at 3 years (p = 0.65).Conclusions
In the EXCEL trial, the relative 30-day and 3-year outcomes of PCI with everolimus-eluting stents versus CABG were consistent in diabetic and nondiabetic patients with LMCAD and site-assessed low or intermediate SYNTAX scores.(Evaluation of XIENCE versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization [EXCEL]; NCT01205776) 相似文献68.
69.
Sonia Moreno-Grau Itziar de Rojas Isabel Hernández Inés Quintela Laura Montrreal Montserrat Alegret Begoña Hernández-Olasagarre Laura Madrid Antonio González-Perez Olalla Maroñas Maitée Rosende-Roca Ana Mauleón Liliana Vargas Asunción Lafuente Carla Abdelnour Octavio Rodríguez-Gómez Silvia Gil Miguel Ángel Santos-Santos Agustín Ruiz 《Alzheimer's & dementia》2019,15(10):1333-1347
IntroductionLarge variability among Alzheimer's disease (AD) cases might impact genetic discoveries and complicate dissection of underlying biological pathways.MethodsGenome Research at Fundacio ACE ([email protected]) is a genome-wide study of dementia and its clinical endophenotypes, defined based on AD's clinical certainty and vascular burden. We assessed the impact of known AD loci across endophenotypes to generate loci categories. We incorporated gene coexpression data and conducted pathway analysis per category. Finally, to evaluate the effect of heterogeneity in genetic studies, [email protected] series were meta-analyzed with additional genome-wide association study data sets.ResultsWe classified known AD loci into three categories, which might reflect the disease clinical heterogeneity. Vascular processes were only detected as a causal mechanism in probable AD. The meta-analysis strategy revealed the ANKRD31-rs4704171 and NDUFAF6-rs10098778 and confirmed SCIMP-rs7225151 and CD33-rs3865444.DiscussionThe regulation of vasculature is a prominent causal component of probable AD. [email protected] meta-analysis revealed novel AD genetic signals, strongly driven by the presence of clinical heterogeneity in the AD series. 相似文献
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