Extended Risk Factors for Stroke Prevention

Stroke causes disability and high mortality, while it can be prevented by increasing public awareness of risk factors. The common known risk factors are hypertension, atrial fibrillation, heart failure, smoking, alcohol consumption, low physical activity, overweight and hypercholesterolemia. However, the deep understanding of risk factors is limited. Moreover, more risk factor emerges in recent years. To further increase the awareness of risk factors for stroke prevention, this review indicates the reasonable application of antihypertensive agents according to the age-dependent changes of hypertension, and some new risk factors including chronic kidney disease, obstructive sleep apnea, migraine with aura, working environment, genetic factors and air pollution. Therefore, internal risk factors (e.g. heredity, hypertension, hyperglycemia) and external risk factors (e.g. working environment, air pollution) are both important for stroke prevention. All of these are reviewed to provide more information for the pre-hospital prevention and management, and the future clinical studies.     

从病机辨证探析国医大师周仲瑛复法组方辨治肿瘤的经验

国医大师周仲瑛教授力倡中医病机辨证论治的新体系, 提出疑难病证的基本病机特征是复合病机, 并指出复法组方是治疗肿瘤等疑难病证的基本策略。紧紧围绕病机辨证, 从复法组方的理论基础、基本思路、不同肿瘤复法组方的异同三个方面, 总结周仲瑛辨治恶性肿瘤的立法遣方经验, 以期进一步拓展肿瘤等疑难病证的临床辨治及组方思路。      

周宜轩辨治高血压病的数据挖掘分析

目的：挖掘与总结周宜轩教授临床辨治高血压病的诊疗规律及学术思想。方法选取2012年12月－2013年12月周教授诊治的原发性高血压病患者149例,208诊次,将其初诊数据录入数据库,进行名词标准化,对其临床证候、治法、方药进行统计分析。结果149例高血压病患者,按照证候出现频次排序,由高到低依次为痰湿中阻证、气虚血瘀证、气阴两虚证、肝阳上亢证、肝肾阴虚证等。方剂多为参苓白术散、补阳还五汤、生脉散、天麻钩藤饮、六味地黄丸等加减。用药频次排序,由高到低依次为炙黄芪、佛手、川芎、丹参、当归、山萸肉、白芍、赤芍、炒白术、酸枣仁、枳壳、薏苡仁、党参、合欢皮、水蛭。结论高血压病是本虚标实证,临床以气虚、气阴两虚、肝肾阴虚为本,肝阳上亢、瘀血、痰浊为标。周教授善于用益气、养阴、理气、化痰、活血、安神法治疗高血压病,体现了周教授的学术思想。     

益气清利活血祛风药对治疗肾性蛋白尿临证撷英

周恩超教授从医20余载,擅长肾系疾病的中医诊治,尤其对肾性蛋白尿的治疗有较丰富的经验。他治疗肾性蛋白尿善用药对,本文介绍生黄芪-太子参,菟丝子-枸杞子,葎草-白英,桃仁-红花,桔梗-僵蚕,全蝎-地龙6组药对在治疗肾性蛋白尿中的应用。     

局部皮瓣在眼周美容整形中的应用分析

目的：探究局部皮瓣在眼周美容整形中的应用并分析。方法选择自2013年1月-2014年1月间来我院就诊的眼周皮肤受损患者41例。采取局部皮瓣疗法，根据创面的大小，部位等情况规划出一个完整的方案，最大程度的使辅助切口适应面部轮廓，尽量隐藏切口线[1]。结果本组一共有41例患者，术后皮瓣全部存活，且在术后随访几个月期间，无畸形产生，没有影响眼功能，患者很满意。结论局部皮瓣在眼周美容中能够获得效果显著的美容修复作用，值得在临床上大面积推广应用。     

《素问纠略》作者、版本考

《素问纠略》一书的作者及版本历来说法不一。《明史》记为杨慎,但考查杨慎文集《升庵全集》《升庵外集》均不见此书;丹波元胤《中国医籍考》认为此书应是朱丹溪所作。本文就此提出疑问,考查杨慎著述的主客观条件。首先,从史传及杨慎诗文中可知,他曾研习医籍,知晓医理,其医学著作《男女脉位图说》序文更反映了他欲纠辨古人的愿望,是为他著《素问纠略》的主观条件或内部条件;其次,杨慎晚年贬谪至西南地区,恶病缠身,曾学医自疗,且喜好上山采药,这为他创作《素问纠略》提供了外部条件;加之同僚何宇度、名医何时希的记载为旁证,杨慎著《素问纠略》三卷是成立的。而针对杨慎文集不见此书,一卷本著者题为朱丹溪、周木等人的事实,本文认为是版本不一所致。即:名为《素问纠略》的医书实有两个版本:其一为前述杨慎所著的三卷本,已经亡佚;其二为周木辑佚或假托元代朱震亨所作的《素问纠略》一卷本,现存抄本。由此,《素问纠略》作者及版本问题得以澄清。     

Isolated Pyridoxine Deficiency Presenting as Muscle Spasms in a Patient With Type 2 Diabetes: A Case Report and Literature Review

Pyridoxine is an important co-factor for many biochemical reactions in cellular metabolism related to the synthesis and catabolism of amino acids, fatty acids, neurotransmitters. Deficiency of pyridoxine results in impaired transcellular signaling between neurons and presents with muscular convulsions, hyperirritability, and peripheral neuropathy. Deficiency of pyridoxine is usually found in association with other vitamin B deficiencies such as folate (vitamin B9) and cobalamin (vitamin B12). Isolated pyridoxine deficiency is extremely rare. We present the case of a 59-year old female with type 2 diabetes who complained of painful muscle spasms. Her muscle spasms involved in both feet, which have spread proximally to her legs. She also experienced intermittent muscle spasms in her left arm, which is not alleviated by baclofen, cyclobenzaprine. Her plasma pyridoxal 5-phosphate confirmed pyridoxine deficiency. Vitamins B1, B3, B12, and folate were within normal limits. The patient received standard-dose intramuscular pyridoxine injections for three weeks followed by oral supplements for 3 months and her symptoms resolved. This case illustrates the rare instance of isolated pyridoxine deficiency in type 2 diabetes patient manifesting as myoclonic muscle spasms involving the legs and arms in the absence of objective polyneuropathy. Pyridoxine level should, therefore, be assessed in patients with type 2 diabetes, including newly diagnosed patients.