疏风宣肺止嗽汤对咳嗽变异性哮喘患儿肺功能及睡眠质量的影响

目的:观察疏风宣肺止嗽汤对咳嗽变异性哮喘患儿肺功能及睡眠质量的影响。方法:将70例咳嗽变异性哮喘患儿按照随机数字表法分为对照组和观察组,每组各35例。对照组给予常规西医治疗,观察组在对照组的基础上加用自拟疏风宣肺止嗽汤治疗。比较两组患儿的临床疗效、症状消失时间、住院时间、不良反应发生率、复发率及治疗前后中医证候积分、匹兹堡睡眠质量指数(pittsburgh sleep quality index,PSQI)、肺功能指标变化情况。结果:观察组有效率为94.29%,对照组有效率为77.14%,两组患儿有效率比较,差异具有统计学意义(P<0.05)。观察组复发率低于对照组,差异具有统计学意义(P<0.05)。两组患儿治疗后中医证候评分及PSQI评分低于本组治疗前,且观察组治疗后低于对照组治疗后,差异具有统计学意义(P<0.05)。两组患儿治疗后肺功能指标高于本组治疗前,且观察组治疗后高于对照组治疗后,差异具有统计学意义(P<0.05)。观察组患儿症状消失时间及住院时间短于对照组,差异具有统计学意义(P<0.05)。结论:自拟疏风宣肺止嗽汤治疗咳嗽变异性哮喘,能够改善患儿的临床症状、肺功能及睡眠质量。     

祛风导痰汤加减治疗支气管哮喘临床观察

目的：观察祛风导痰汤加减治疗支气管哮喘的临床疗效。方法：治疗组36例服用祛风导痰汤加减方，对照组30例用氨茶碱、感染者用青霉素治疗，1周为一疗程，治疗2个疗程。结果：总有效率治疗组为91．67％、对照组为73．33％，两组比较有显著性差异（P〈0．05）。结论：祛风导痰汤加减治疗支气管哮喘有显著效果。     

Bicycle helmet ventilation and comfort angle dependence

Five modern bicycle helmets were studied to elucidate some of the variations in ventilation performance, using both a heated manikin headform and human subjects (n=7). Wind speed and head angle were varied to test their influence on the measured steady-state heat exchange (cooling power) in the skull section of the headform. The cooling power transmitted by the helmets varied from about 60% to over 90% of that of the nude headform, illustrating the range of present manufacturer designs. Angling the head forward by 30° was found to provide better cooling power to the skull (up to 25%) for three of the helmets and almost equal cooling power in the remaining two cases. Comparisons of skull ventilation at these angles with human subjects strongly supported the headform results.     

中医"中风"概念的演变

中风是临床常见病证,历代医家在长期临床实践中积累了丰富的经验,留下了大量的文献.从这些文献来看,历代医家对中风,尤其是中风概念的认识并不统一,在不同时期,中风一词的内涵并不相同,而是经历了外感病、真中、类中,再到脑卒中这样一个逐渐演变的过程.     

CLINICAL OBSERVATION ON 50 CASES OF WIND STROKE TREATED MAINLY BY ACUPUNCTURE AT 13 POINTS ALONG THE DU MERIDIAN

Windstrokeisoneofthecommonly-en-counteredandfrequentlyoccurringdiseases,withhighincidenceofmortalityanddisability.Since1992,theauthorhastreated5ocasesofwindstrokeusingacupunctureatthe13pointsalongDumeridian,anempiricalrecipeoriginat-edbytheseniorintheacupuncturecircles,DrWangLeting.Andthetherapeuticeffectwascomparedwiththatinthecontrolgroup.Itisreportedasfollows.CLIN1CALDATATheobservationwasmadeon5oin-patientsinthedepartmentofacupunctureinourhospitalfrom()ctober,1992toFebruary,1995.They…     

风能胜湿理论在泄泻中的应用

泄泻病情复杂,易于反复,中医独特的辨证及治疗方法在治疗泄泻中有着明显的优势,通过对风能胜湿理论的阐述,探讨风能胜湿的理论依据,并证实祛风胜湿法在临床治疗泄泻中的作用,以期对泄泻的治疗提供新的思路。     

Clinical utility of plain-film abdominal radiographs for inpatients outside standard working hours in a large university teaching hospital

IntroductionPlain film abdominal radiographs (PFAs) are frequently the initial investigation ordered for patients with abdominal symptoms. However, increasing use of emergency ultrasound and availability of emergency CT raises the question of whether PFA remains an appropriate first line investigation. We investigated the impact of out of hours (OOH) PFAs on inpatient management.MethodsAll consecutive PFAs over an 8-week period were included to determine the impact on patient management. OOH was classified as from 5pm to 9am Monday to Friday, weekends and bank-holidays. PACS and hospital records were accessed to determine patient pathways. The institution is a tertiary referral centre with 850 acute beds and serves a population of 950,000.ResultsA total of 758 consecutive PFAs were performed in total (58.3% male, mean age 58.1 (range 0–93)). 310 (40.9%) were requested from the emergency department (ED) and 382 (50.4%) were requested from wards. 160 (21.1%) met the criteria of OOH, of these 120 (72.2%) were from ED and 28 were on adult inpatients. Of these 28, none had a change in management based on the PFA result.ConclusionOur study suggests that OOH PFAs of inpatients are of limited clinical utility. These patients are exposed to extra radiation.Implications for practiceWe propose that OOH PFAs of inpatients should be questioned as a viable investigation due to the limited contribution they offer in managing patients, the deleterious effects they confer on the patient and the associated economic cost. Further studies are needed to assess if these results are generalizable to other large hospitals.     

Epidemiological Features of 105 Patients Infected with the COVID-19

ObjectiveTo investigate and evaluate the clinical features of patients infected with the 2019 novel coronavirus (COVID-19) outside of Wuhan.Methods105 patients admitted to our hospital with clinical- and laboratory-confirmed COVID-19 infection were studied. Data were collected from January 17, 2020 to March 5, 2020.Results105 patients (57 male and 48 female) were confirmed to have COVID-19 infection. Among the 105 patients, 55 (52%) had made short trips to Wuhan during the two weeks before the onset of illness, and these were the first-generation confirmed cases. An exact date of close contact with someone in Wenzhou with confirmed or suspected COVID-19 infection from Wuhan (the second-generation confirmed cases) could be provided by 38 (36%) patients. Of the remaining patients, six (6%; the third-generation confirmed cases) were familial clusters of the second-generation confirmed cases, three (3%) had no definite epidemiological features, and 16 (15%) were from the same location as for the case report.ConclusionDue to the infectiousness of COVID-19, patients with infections should be diagnosed and treated as early as possible after developing fever symptoms or showing other clinical characteristics or imaging features. With respect to high-risk cases, we must focus on any complications that arise and take effective measures to treat them immediately. This will significantly improve the prognosis of patients with severe infections.     

Adaptor regulation of LFA‐1 signaling in T lymphocyte migration: Potential druggable targets for immunotherapies?

The integrin lymphocyte function associated antigen‐1 (LFA‐1) plays a key role in leukocyte trafficking and in adaptive immune responses through interactions with adhesive ligands, such as ICAM‐1. Specific blockade of these interactions has validated LFA‐1 as a therapeutic target in many chronic inflammatory diseases, however LFA‐1 antagonists have not been clinically successful due to the development of a general immunosuppression, causing fatal side effects. Growing evidence has now established that LFA‐1 mediates an array of intracellular signaling pathways by triggering a number of downstream molecules. In this context, a class of multimodular domain‐containing proteins capable of recruiting two or more effector molecules, collectively known as “adaptor proteins,” has emerged as important mediators in LFA‐1 signal transduction. Here, we provide an overview of the adaptor proteins involved in the intracellular signaling cascades by which LFA‐1 regulates T‐cell motility and immune responses. The complexity of the LFA‐1‐associated signaling delineated in this review suggests that it may be an important and challenging focus for future research, enabling the identification of “tunable” targets for the development of immunotherapies.     

从五运六气辨识与防治新型冠状病毒肺炎

从五运六气理论推演天时气化,据实际气候指标拟定全国16方域六气气化数值。参合两者,提示本次新型冠状病毒何以发于己亥岁末之鄂,并据患者易见症状表现,辨识此肺炎乃风温夹湿之疫厉。然后分析其易感之地,以鄂湘赣为最,次则浙闽两广江苏,以其气化相近也;好发之人,以肺脾气虚湿盛者为甚,次则肝气失调、素体孱弱者,以其正虚邪凑也。进而推测疫情演化趋势,庚子岁半之前,疫情正烈;岁半而后,当衰减而泯灭。中医防治,当以出具防治方药为本,参考古今医家治疫理法,结合自家经验,拟定防治方药八帧。