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1.
目的探讨叶天士治疗便闭病用药规律,以供临床参考和借鉴。方法收集《临证指南医案》“肠痹门”“便闭门”处方中药,运用Excel、SPSS 22.0、SPSS Modeler软件进行证型、药物频次、属性统计及关联规则分析。结果叶氏治疗便闭病主要辨证为湿热内蕴、肾阳虚、阴虚火旺、肝肾阴虚、肺失宣肃等证型。药性以温、寒、平为主,药味以甘、辛、苦为主,归经以胃、脾、肺、肝、肾、心为主,常使用苦杏仁、当归、茯苓、柏子仁、瓜蒌皮等药物,根据关联规则分析得到常用药对配伍,如苦杏仁-瓜蒌皮、苦杏仁-郁金、当归-柏子仁等。结论叶天士治疗便闭病是以调理脾胃为中心,注重湿热在致病过程中的重要地位,注重肺气宣肃、肝气疏泄、膀胱气化作用。叶天士为后世医家提供了新的治疗思路与方法,具有临床指导意义。  相似文献   
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AIM: To compare the ciliary body thickness between eyes with primary angle closure (PAC) and primary angle-closure glaucoma (PACG) with the normal eyes, and to investigate the association between ciliary body thickness and ciliary processes situation. METHODS: In this cross-sectional study, 57 patients with PAC/PACG were matched to 57 normal subjects after propensity score matching (PSM) adjusting for age and gender. All subjects underwent conventional ocular examinations and ultrasound biomicroscopy (UBM) examination, among which the patients with PAC/PACG performed the examinations one month after laser peripheral iridotomy (LPI). Quantitative parameters were measured, which included ciliary body thickness at the position of 1 mm posterior to the scleral spur (CBT1), trabecular-ciliary process distance (TCPD) and trabecular-ciliary process angle (TCA). RESULTS: Eyes with PAC/PACG presented significantly thinner CBT1, shorter TCPD and smaller TCA (P<0.001) than the normal eyes, both in comparison of the means of four quadrants and in comparisons of each quadrant. After removing images with peripheral anterior synechia (PAS), the same results were also found in comparisons between the two groups. Significant correlations were found between TCPD (R2=0.537, P<0.001) and TCA (R2=0.517, P<0.001) with CBT1. CONCLUSION: Eyes with PAC/PACG have thinner ciliary body thickness and more anteriorly situated ciliary processes. Thinner ciliary body thickness is associated with anterior situation of the ciliary processes.  相似文献   
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ObjectivesThis study sought to better understand out-of-hospital 30-day mortality following transfemoral transcatheter aortic valve replacement (TAVR) and identify factors associated with poor outcomes.BackgroundDespite improvements in outcomes with TAVR for severe aortic stenosis, out-of-hospital 30-day mortality has not been evaluated.MethodsThis study examined patients in the Society of Thoracic Surgeons/American College of Cardiology TVT (Transcatheter Valve Therapy) Registry undergoing TAVR for severe aortic stenosis from January 2015 to March 2018. Primary and secondary endpoints were 30-day out-of-hospital all-cause mortality and out-of-hospital cardiovascular mortality, respectively. Logistic regression models were used to assess association between pre-specified factors and endpoints.ResultsA total of 106,749 patients underwent TAVR and were eligible for analysis. Transfemoral TAVR was performed in 92.3% of patients. A total of 2,137 (2.2%) transfemoral patients died within 30 days of the procedure, and 623 (29%) patients of these patients experienced out-of-hospital 30-day mortality. Cardiovascular and pulmonary etiologies accounted for the majority of observed mortality. Multivariable regression analysis identified older age, gender, lower body surface area, lower left ventricular ejection fraction, lower hemoglobin, atrial fibrillation or flutter, severe lung disease, home oxygen use, lack of moderate-to-severe aortic insufficiency, urgent TAVR, lower Kansas City Cardiomyopathy Questionnaire score, longer hospital length of stay, and in-hospital complications as being independently associated with the primary endpoint. New onset or pre-existent atrial fibrillation or flutter was also independently associated with 30-day out-of-hospital cardiovascular mortality in the transfemoral population.ConclusionsWe identified 30-day all-cause mortality rate for TAVR of 2.2%. Approximately one-third of patients experienced out-of-hospital mortality at 30 days. Several factors were identified as being independently associated with 30-day out-of-hospital all-cause and cardiovascular mortality. Further work is needed to understand how best to improve out-of-hospital mortality following TAVR.  相似文献   
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Mechanical intravascular hemolysis is frequently observed following procedures on heart valves and uncommonly observed in native valvular disease. In most cases, its severity is mild. Nevertheless, it can be clinically significant and even life threatening, requiring multiple blood transfusions and renal replacement therapy. This paper reviews the current knowledge on mechanical intravascular hemolysis in valvular disease, before and after correction, focusing on pathophysiology, approach to diagnosis, and impact of other hematological conditions on the resultant anemia. The importance of a multidisciplinary management is underscored. Laboratory data are provided about subclinical hemolysis that is commonly observed following the implantation of surgical and transcatheter valve prostheses and devices. Finally, clinical scenarios are reviewed and current medical and surgical treatments are discussed, including alternative options for inoperable patients.  相似文献   
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《Indian heart journal》2021,73(5):637-639
We herein report our single center experience of safety and efficacy of device closure of large sized ostium secundum atrial septal defects (OS ASD) in small children with less than 2 years of age performed over the period of 10 years from 2009 to 2019.148 symptomatic children with ASD size of more than 8 mm were included in our study. We obtained a high rate of successful deployment (98 %) with no major complications.  相似文献   
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