针灸联合龙胆泻肝汤对子宫脱垂患者血清TGF-β1、MMP-2、TIMP-2表达的影响

目的观察针灸联合龙胆泻肝汤治疗子宫脱垂的临床疗效及对患者血清TGF-β1、MMP-2、TIMP-2表达水平的影响。方法 296例子宫脱垂患者随机分为研究组和对照组,每组148例。对照组采用龙胆泻肝汤治疗,研究组在对照组的基础上采用针灸治疗。观察两组治疗前后的盆底功能障碍评分变化、盆底肌力评分变化及血清转化生长因子-β1 (TGF-β1)、基质金属蛋白酶-2(MMP-2)、基质金属蛋白酶抑制剂-2(TIMP-2)表达水平变化,并比较两组临床疗效。结果研究组愈显率优于对照组(P<0.05)。两组治疗后盆底功能障碍评分较同组治疗前降低,研究组低于对照组,差异有统计学意义(P<0.05)。研究组治疗后盆底肌力评分高于对照组(P<0.05)。两组治疗后血清TGF-β1、MMP-2、TIMP-2表达水平与同组治疗前比较,差异有统计学意义(P<0.05);研究组治疗后血清TGF-β1、TIMP-2表达水平高于对照组(P><0.05),MMP-2表达水平低于对照组(P<0.05)。结论针灸联合龙胆泻肝汤能显著提高PDF患者的临床疗效,缓解患者的临床症状,改善患者血清TGF-β1、MMP-2、TIMP-2的表达水平。     

儿童反复呼吸道感染合理用药

反复呼吸道感染是儿童常见的临床现象，病情反复发作，影响了儿童的生长发育。由于反复呼吸道感染病因繁杂，儿科医生对本组疾病认识不足，治疗上也常存在一些误区。早期识别导致儿童反复呼吸道感染的潜在病因是正确治疗的前提，同时儿科医生也应合理用药，正确管理本病患儿。     

急诊青年胸痛患者的超声心动图表现及临床特点

目的 探讨急诊青年胸痛患者超声心动图表现及临床特点.方法 选取我院2013年1月至2014年1月急诊室收治的年龄＜40岁的胸痛患者200例,分析其临床表现、超声心动图表现、冠脉造影资料.结果 200例患者中男性150例,女性50例,年龄均＜40岁,最小20岁,平均32.5岁.能明确诊断并为临床提供重要帮助者130例,阳性率为65％,其中冠心病34例(26.2％)、急性心力衰竭20例(15.4％)、心包积液3例(2.3％)、肺栓塞8例(6.2％)、非心源性胸痛50例(38.5％),其他15例(11.5％).结论 超声心动图对心血管危重症急诊协助除外心血管性病因等提供了重要的临床应用价值,对指导临床治疗起着其他影像检查无法替代的作用.     

The association of psychiatric medication use with adherence in patients with HIV

Over two million new cases of HIV infection will occur annually, worldwide. Triple drug anti-retroviral therapy (ART) decreases the viral load in patients with HIV, helping to stop progression of HIV infection to AIDs. Our study assessed how pharmacologic treatment for mental health issues affects medication adherence and viral load in patients with HIV. We conducted a retrospective chart review of 163 patients with HIV who had at least 2 visits at the HIV-clinic at Ascension St. John Hospital. Data were collected on demographics, medications, CD4 counts and viral loads. Data were analyzed using Student’s t-test, the χ² test, the Mann–Whitney U test and logistic regression. “Poor Compliance” was defined as at least 2 consecutive visits with a CD4 count <200?µL and/or with viral load ≥100?IU/ml. Patients taking antidepressants were less likely to have poor compliance than those not on anti-depressants (6.3% vs. 22.3%, p?=?0.04). A similar association was found for patients taking any psychiatric drug (7.0% vs. 23.5%, p?=?0.02). On multivariable analysis, the odds of poor compliance were 6.3 times higher in patients who stopped HIV therapy for greater than one week between visits (p?=?0.004) and 3.6 times lower in patients taking any psychiatric medication (p?=?0.05).     

Pre-existing mental health disorders and pregnancy

Mental health conditions are independent risk factors for poor obstetric and neonatal outcomes therefore obstetricians need to be able to manage them well. This review will summarize the management of pre-existing mental health disorders in pregnancy. Explanations will be given as to which women are managed in primary care for their mental health conditions and which women are managed in specialist Perinatal Mental Health Services. When women should be referred to perinatal mental health services is described. The article provides recommendations on the obstetric management of these women as well as information on psychotropic medication in pregnancy and lactation.