Papillary Cystadenoma of Minor Salivary Glands: Report of 11 Cases and Review of the English Literature

Papillary cystadenoma is a rare, benign salivary gland tumor which is well-circumscribed, containing cystic cavities with intraluminal papillary projections. Only 19 cases arising within minor salivary glands (MnSG) from the oral cavity sites have been reported in the English literature (PubMed 1958–2014). We report 11 new cases of MnSG papillary cystadenomas in conjunction with a review of the literature. Demographic information, clinical and histologic features, treatment and prognosis are compiled and discussed for all 30 cases reported in the English literature.     

A comparison of the epidemiology of ice hockey injuries between male and female youth in Canada

BACKGROUND:

Hockey is played by youth across Canada, and its popularity has increased dramatically among females in the past decade. Despite this, there has been little epidemiological research comparing the injury patterns of young female and male hockey players.

OBJECTIVE:

To describe and compare injuries sustained by female and male youth hockey players using the Canadian Hospitals Injury Reporting and Prevention Program database.

METHODS:

In the present cross-sectional, retrospective comparison study, the Canadian Hospitals Injury Reporting and Prevention Program database was used to identify all hockey-related injuries sustained by children seven to 17.5 years of age over a 15-year period (January 1995 to December 2009). Exclusion criteria included paid professional players and children with injuries sustained while playing road hockey.

RESULTS:

Inclusion criteria were met by 33,233 children (2637 [7.9%] females and 30,596 [92.1%] males). Compared with males, females reported proportionately more soft tissue injuries (39.8% versus 32.6%; P<0.01) and sprains/strains (21.1% versus 17.6%; P<0.01). Males experienced more fractures (27.1% versus 18.2%; P<0.01) and were most often injured through body checking (42.8% versus 25.7%; P<0.01). Females showed a trend toward increased concussion with age, and were most often injured through collisions (28.6% versus 24.6%; P<0.01).

CONCLUSION:

Compared with males, female hockey players sustained proportionately more soft tissue injures and sprains/strains, and showed a trend toward concussions in late adolecence. Males experienced more fractures, shoulder injuries and injuries due to body checking. Further research is required to identify risk factors for injury in female youth hockey players and to target injury prevention.     

小承气汤敷神阙穴治疗中风后便秘40例

目的:观察小承气汤敷神阙穴治疗中风后便秘的临床疗效。方法:将80例中风后便秘患者随机分为两组各40例,对照组采用常规治疗,治疗组在对照组治疗的基础上采用小承气汤敷神阙穴治疗,两组均以1个月为1个疗程。结果:对照组有效率为75.0%,治疗组有效率为90.0%,两组有效率比较,差异有统计学意义(P0.05);两组患者治疗后临床症状积分均较治疗前明显改善(P0.05),且组间比较差异有统计学意义(P0.05)。结论:小承气汤敷神阙穴治疗中风后便秘简便易行,疗效显著。     

Rapid detection of the hepatitis B virus YMDD mutant using TaqMan-minor groove binder probes

BACKGROUND: TaqMan-minor groove binder (MGB) probes were used in a real-time PCR-based assay for the rapid and accurate detection of hepatitis B virus (HBV) YMDD mutants. METHODS: TaqMan-MGB probes were designed to distinguish between wild-type (YMDD) and mutant (YVDD and YIDD) strains of HBV. The detection limit and sensitivity of the assay were determined using a dilution series of a mixture of wild-type and mutant plasmids. Serum samples collected from four patients with chronic mutant HBV infections during lamivudine therapy were analyzed using this method. RESULTS: The detection limit for YVDD and YIDD was 10 and 50 copies, respectively, whereas the sensitivity was 10% within a mixed virus population. In the clinical samples, mutant strains of HBV could be detected at levels <2.6 log copies/ml of HBV DNA. While 15 of the 21 samples tested by this method were positive for the YMDD mutant, direct sequencing and a reverse hybridization line probe assay (INNO-LiPA HBV DR v2) detected the mutant strain in only 11 and 9 samples, respectively. Moreover, the data for 6 samples analyzed by TA cloning were fully consistent with our TaqMan PCR results. CONCLUSIONS: We successfully established a sensitive and accurate assay for the YMDD mutant of HBV. This method may be useful for monitoring patients treated with lamivudine.     

酸枣仁汤合小柴胡汤治疗甲状腺功能亢进症50例

目的:观察酸枣仁汤合小柴胡汤治疗甲状腺功能亢进症的临床疗效。方法:选取甲状腺功能亢进症患者100例,按照随机平行分组法分为治疗组与对照组各50例,对照组给予西药甲硫咪唑治疗,治疗组给予中药酸枣仁汤合小柴胡汤治疗,两组疗程均为8周。结果:治疗8周后,两组主要中医证候及血清TT3、TT4、FT3、FT4、TSH水平均明显改善(P0.05),且治疗组均优于对照组(P均0.05)。结论:酸枣仁汤合小柴胡汤治疗甲状腺功能亢进症疗效显著。     

加味小青龙汤联合舒利迭治疗喘息性哮喘40例

目的:观察加味小青龙汤联合舒利迭治疗喘息性哮喘的临床疗效.方法:选取2012年1月-2013年6月本院收治的喘息性哮喘患者80例,随机分为对照组和治疗组各40例,对照组单用舒利迭治疗,治疗组在对照组治疗的基础上采用小青龙汤治疗,观察治疗前后相应指标和临床疗效.结果:治疗1月后,两组FEV1、PEF、呼出气PH均较治疗前有显著升高(P＜0.05),EO及FeNO含量均较治疗前有显著降低(P＜0.05),两组治疗前后指标差值比较,差异有显著性(P＜0.05).结论:加味小青龙汤联合舒利迭可以改善患者通气障碍,缓解气道炎症,疗效显著.     

Mineurs non accompagnés accueillis au centre psychiatrique d’orientation et d’accueil de l’hôpital Sainte-Anne,Paris

Since its creation, the Psychiatric Guidance and Reception Centre (CPOA) has received and cared for patients aged 16 to 18. Among them, the rate of Unaccompanied Minor Refugees (UMR) has steadily increased, from 10% in 2016 to 12% in 2018. Meeting UMR patients most often occurs at the peak of their crisis, when their personal resources are overwhelmed and when they experience a severe state of psychological suffering. Our objective was to understand who UMR are concerning the particularities and the similarities they could share at clinical and therapeutic levels with other adolescents. We conducted a retrospective and observational cohort study of the 52 UMR received at the CPOA in 2018 in order to draw a portrait of them, to identify the specificities of their care, their guidance and their access to care, and to compare them with other young non UMR patients. UMR we met at CPOA in 2018 were most often boys aged 16 to 17, with limited resources and in great psychological distress. UMR had more suicidal behaviors (19%) than other minor patients (13%), and our results showed more prolonged consultations for UMR than non UMR at the CPOA (44% versus 41%), indicating that the isolated situation of UMRs complicates their ambulatory support. This study also allowed us to question the existence of emergency care specially dedicated to UMR. Although there are few recommendations to date, it seems important to reintroduce time into their care, in order to recreate a unit, which has sufficient place and time for these young patients whose lives are marked by many breakdowns.     

论《伤寒论》柴胡剂临床应用

柴胡剂主要见于《伤寒论》少阳病篇,是在小柴胡汤的基础上进行加减,包括小柴胡汤、大柴胡汤、柴胡加芒硝汤、柴胡桂枝汤、柴胡桂枝干姜汤以及柴胡加龙骨牡蛎汤在内的六首方剂。通过对《伤寒论》中的柴胡剂进行归纳,论述各个方剂的方证研究及临床应用。由于少阳居于半表半里,为三阴三阳之枢机,故柴胡剂具有和解少阳,疏通内外,调畅全身气机的作用,其临床应用十分广泛。在临床上辨证论治时,须审慎详察其病机和主症,切中病机,方能取得良好疗效。     

从难治性病例谈经方的运用

经方大家胡希恕先生与冯世纶教授对《伤寒论》的六经进行了重新解读,认为六经来自八纲,系表、里、半表半里各分阴阳,即三阴三阳.提出辨证施治是于患病机体一般的规律反应的基础上,讲求疾病的通治方法.通过先辨八纲,再辨六经,最后辨方证,合理运用经方以提高临床疗效.验证于临床,应用经方小青龙汤治哮喘、厚朴生姜甘草半夏人参汤治脾虚腹胀、乌梅丸治慢性结肠炎等疑难杂症,均取得了满意疗效.