穿刺技术的改进和创新是穴位埋线疗法的第三次飞跃

穴位埋线是长效针灸,是在传统针具和针法基础上建立和发展起来的,是针灸技术的发展和延伸,穴位埋线的核心技术是穿刺技术,穴位埋线的三大要素中,针具、埋藏物、穿刺技巧之间是互相影响、互相促进的。针具的改进成功实现了穴位埋线疗法的第一次飞跃,埋藏物的改进成功实现了穴位埋线疗法的第二次飞跃,穿刺技术的改进和创新是穴位埋线疗法的第三次飞跃。     

2型糖尿病中个性化综合饮食护理的应用效果

目的观察2型糖尿病患者中个性化综合饮食护理的应用效果。方法选择本院2018年1月—2018年12月接收的80例2型糖尿病患者实施此次研究,根据随机数字表法分为观察组(40例)和对照组(40例)。观察组使用个性化综合饮食护理,对照组使用常规护理措施,比较两组患者临床效果。结果观察组依从性为95.00%,对照组为80.00%(P<0.05)。两组护理前餐后2 h后血糖含量、糖化血红蛋白水平及空腹血糖含量比较差异无统计学意义(P>0.05)。观察组护理后餐后2 h后血糖含量、糖化血红蛋白水平及空腹血糖含量均低于对照组(P<0.05)。结论将个性化综合饮食护理用于2型糖尿病患者治疗中。     

TLC法对众生丸中蒲公英成分的快速鉴别

目的为建立众生丸中蒲公英成分的快速定性鉴别方法,采用薄层色谱法(TLC),基于样品与标准品对照,实现快速定性鉴别。方法通过参考有关文献,经过实验,对众生丸中蒲公英成分的提取方法、提取时间、提取溶剂、展开剂的选择、显色剂的选择对实验结果的影响进行研究。结果以乙酸乙酯为溶剂经超声提取、以三氯甲烷为展开剂,喷以10%硫酸乙醇溶液作为显色剂。薄层色谱鉴别斑点清晰,阴性对照无干扰。结论所建立方法操作简单,具有速度快,分离效果、专属性和重现性好的优点,应用于众生丸中蒲公英成分的快速定性鉴别,可加强对众生丸的质量控制。     

Bladder Cancer Stage Development, 2004-2014 in Europe Compared With the United States: Analysis of European Population-based Cancer Registries,the United States SEER Database,and a Large Tertiary Institutional Cohort

BackgroundThe purpose of this study was to analyze trends of bladder cancer (BC) stages and incidence in Europe and the United States (US).Materials and MethodsTumor stages after radical cystectomy were assessed in a monocentric cohort from 2006 to 2016. BC incidence was assessed between 2004 and 2014 based on the German Center for Cancer Registry Data dataset at the Robert Koch Institute (n = 111,002), the Netherland Cancer Registry (n = 64,226), cancer registration statistics of England (n = 179,883), and the pooled data from the Scandinavian cancer registries, NORDCAN (n = 77,585) and the SEER (Surveillance, Epidemiology, and End Results) database (n = 184,519) for the complete populations and gender-specific subgroups. The average annual percent changes (AAPC) were used for statistical evaluation.ResultsNon–muscle-invasive BC (NMIBC) and muscle-invasive BC (MIBC) did not change in the institutional cohort at the point of radical cystectomy. The incidence of total BC (AAPC, −0.3), NMIBC (AAPC, −0.1), and non-metastasized MIBC (AAPC, 0.1) did not change in Germany during the time period under survey. BC total incidence in the Netherlands did not change significantly. In England and the Nordic countries, the incidence of total BC increased (AAPC, 0.8 and 0.5, respectively). In contrast, both the incidence of total BC (AAPC, −1.4), NMIBC (AAPC, −1.6), and non-metastasized MIBC (AAPC, −1.6) significantly decreased in the US.ConclusionsBetween 2004 and 2014 the incidence of BC was significantly sinking in the US, was stable in Germany and the Netherlands, and increased in England and the Nordic countries. Predominantly, differences in the smoking prevalence within the last decades but also gender-specific factors might be responsible for this discrepancy.     

评价消风散合黄连解毒汤治疗湿疹效果及价值

目的:探讨评价消风散合黄连解毒汤治疗湿疹效果及价值。方法:选择2017年5—12月治疗湿疹的患者54例作为对象,随机数字表分为对照组(27例)和观察组(27例)。对照组给予常规盐酸西替利嗪片治疗的方法,观察组采用消风散合黄连解毒汤治疗,15 d后对两组治疗方法的患者血清白细胞介素(Interleukin,IL)-4、γ-干扰素(γ-Interferon,IFN-γ)水平和临床治疗效果进行评估,比较两组湿疹患者体内的血清IL-4、IFN-γ含量以及患者治愈、显效、好转、无效以及总有效率的情况。结果:治疗前后两组患者IL-4、IFN-γ差异无统计学意义(P>0.05)。经15 d治疗后,观察组血清IL-4、IFN-γ水平相较于对照组有明显改善,差异有统计学意义(P<0.05),观察组患者总有效率高于对照组,临床治疗效果显著优于对照组(P<0.05)。结论:将消风散合黄连解毒汤治疗用于湿疹,相较于盐酸西替利嗪片治疗,患者血清水平更佳,临床疗效更好,值得推广应用。     

从调节免疫力谈中医药防治新型冠状病毒肺炎

从中医扶正祛邪、调和阴阳的防治大法,审证求因、辨证论治的指导原则,以及未病先防、既病防变的"治未病"核心内涵3个方面阐释中医药通过调节人体免疫力来防治新型冠状病毒肺炎的作用及意义。认为中医药可有效防治该疫病归因于其独具特色的"正气"理论,这一学术思想与现代免疫学的内涵有异曲同工之处。     

Facteurs de récidive après radiothérapie stéréotaxique des cancers bronchiques non à petites cellules

Lung cancer is the fourth most common cancer in France with a prevalence of 30,000 new cases per year. Lobectomy surgery with dissection is the gold standard treatment for T1-T2 localized non-small cell lung carcinoma. A segmentectomy may be proposed to operable patients but fragile from a respiratory point of view. For inoperable patients or patients with unsatisfactory pulmonary function tests, local treatment with stereotactic radiotherapy may be proposed to achieve local control rates ranging from 85 to 95% at 3–5 years. Several studies have examined prognostic factors after stereotaxic pulmonary radiotherapy. We conducted a general review of the literature to identify factors affecting local control.     

刘晓鹰教授“扶中”外治法治疗儿科疾病临床经验浅析

小儿"脾常不足",脾胃之体成而未全,脾胃之气全而未壮,脾胃不足在儿科疾病发生发展、病机转归中占有相当重要的地位。刘晓鹰教授在继承全国名老中医倪珠英学术思想基础上,提出"扶中"外治法,立法取穴方面强调时时顾护小儿中焦脾胃,采用小儿推拿、扶阳罐(含温推、温灸和温刮痧)、针刺(含腹针、揿针)等外治手段治疗儿科脾、肺、肾等系列疾病,取得满意疗效。     

New evidence supporting lung cancer screening with low dose CT & surgical implications

IntroductionLung cancer is the leading cause of cancer-death worldwide. The U.S. Preventative Services Task Force (USPTSF) approved screening for current or former smokers aged 55–80 based on the results of the National Lung Screening trial (NLST). Following the NLST, new evidence has emerged from clinical trials and updates to previous trials prior to the anticipated update to the USPSTF guideline. We review the new evidence on lung cancer screening with low dose computed tomography (LDCT) and the surgical implications.MethodsA review of new literature was performed pertaining to lung cancer screening since implementation of UPSTF guidelines. Articles for inclusion were identified by both authors’, then search of the Pubmed and Cochrane database was performed from January 1st, 2013 through February 4th, 2020 using the MeSH search terms: “lung cancer”; “screening”; “low dose CT”. The results of these studies are summarized.ResultsWe identified multiple prospective randomized control trials and meta-analysis since the NLST supporting lung cancer-specific mortality with screening. We identified new nodule classification systems and the development of risk-models which may reduce false positive rates and identify high risk patients not currently eligible for screening. Finally, we discussed the surgical implications of screening.ConclusionNew data supports NLST findings and show ongoing benefit to LDCT for lung cancer screening. Standardized LDCT screening classification has been shown to reduce harm and lower false positive rates. Further study is needed regarding use of risk-modeling. Screening will require an increase in the thoracic workforce to accommodate the amount of surgically operable cancers.     

Racialized Risk in Clinical Care: Clinician Vigilance and Patient Responsibility

Racial/ethnic identity is contingent and arbitrary, yet it is commonly used to evaluate disease risk and treatment response. Drawing on open-ended interviews with patients and clinicians in two US clinics, we explore how racialized risk is conceptualized and how it impacts patient care and experience. We found that racial/ethnic risk was a common but poorly defined construct for both patients and clinicians, who intermingled concepts of genetics, biology, behavior, and culture, while disregarding historical or structural context. We argue that racializing risk embodies social power in marked and unmarked bodies, reinforcing inequality along racial lines and undermining equitable health care.