冠心病心绞痛患者冠脉介入治疗前后生存质量及其相关因素分析

目的分析冠心病心绞痛患者冠脉介入治疗前后的生存质量及其影响因素。 方法选择2015年1月至2017年6月内蒙古赤峰市医院行冠脉介入治疗且治疗成功的1 608例冠心病心绞痛患者,对其临床资料进行回顾性分析,比较患者介入治疗前后的生存质量评分。将治疗前后的生存质量评分作为因变量,将年龄、性别、冠脉病变血管支数、吸烟、血脂水平等作为自变量,对影响冠脉介入治疗前后生存质量的危险因素进行Logistic线性回归分析。 结果治疗后,患者的生存质量评分各维度得分均高于治疗前(P<0.05)。经Logistic线性回归分析,影响冠心病心绞痛患者冠脉介入治疗前生存质量的危险因素主要为性别、吸烟、冠脉病变血管支数,影响冠心病心绞痛患者冠脉介入治疗后生存质量的危险因素主要为年龄、血脂水平。 结论冠脉介入治疗可有效改善冠心病心绞痛患者的生存质量,但其生存质量还受到吸烟、血脂水平等因素的影响,为保证疗效,需对患者加强管理。     

曹志群治疗慢性萎缩性胃炎伴躯体化障碍验案1则

正慢性萎缩性胃炎(Chronic Atrophic Gastritis,CAG)是以胃黏膜固有腺体数量减少或消失,或肠上皮化生为病理特点的消化系统常见慢性疾病[1]。躯体化障碍是一种以持久地担心或相信各种躯体症状的优势观念为特征的一组神经症[2],最常见的症状是胃肠道感觉异常,包括疼痛、呃逆、反酸、恶心等。躯体化障碍与CAG相互影响。西医治疗主要采用药物治疗和心理疗法,但存在疗程长、费用高、不良反应等问题,与之相比,中医药因其疗效显     

女性无先兆偏头痛的流行病学及临床表现探讨

目的 通过流行病学调查,分析女性无先兆偏头痛的相关因素,为女性无先兆偏头痛的防治提供理论依据。方法 将女性原发性头痛的96例患者分为无先兆的月经相关性偏头痛(MRM)组、无先兆的单纯月经性偏头痛(PMM)组、月经性无先兆偏头痛(NMM)组共3个组,观察患者的一般资料,包括年龄、病程(年)、家族史(直系亲属);头痛性质:头痛的严重程度、发作频率、持续时间;共病(情绪改变)及伴随症状。所得数据用SPSS15.0软件包进行统计,计数资料行χ2检验,计量资料行t检验,多个组间比较采用单因素方差分析。结果 ⑴MRM组、PMM组患者家族史阳性率高于NMM组,差异有统计学意义(χ2=10.541,P<0.01),MRM组、PMM组患者重度疼痛阳性率高于NMM组,差异有统计学意义(χ2=9.264,P<0.05);⑵MRM组和PMM组头痛程度VAS评分、持续时间均高/长于NMM组(P<0.05),NMM组患者发作频率低于MRM组发作频率(P<0.01)。结论 女性月经性偏头痛患者家族史、重度疼痛阳性率及疼痛程度、发作频率,持续时间高/长于非月经性头痛,对指导女性无先兆偏头痛的防治有重要意义。     

胆道闭锁肝脏CX3CR1^(+)T淋巴细胞的比例与肝纤维化及预后的相关性研究北大核心CSCD

Objective: To explore the frequencies of CX3CR1 expressing T lymphocytes (CX3CR1+ T cell) in different liver diseases in children and to examine the relationship between proportion of CX3CR1-expressing T cells in liver and liver function parameters, fibrosis score and prognosis of children with biliary atresia (BA). Methods: From January 2019 to June 2020, liver biopsies were harvested from BA children undergoing Kasai Procedure. And liver biopsies from children with choledochal cyst (CC), portal hypertension (PH) and neonatal cholestasis were set as controls. Liver fibrosis (LF) scores were performed on 24 liver specimens of BA children. The infiltrating T lymphocyte subpopulations in liver were analyzed by flow cytometry. The expression differences were examined for T lymphocyte subsets in liver of children with different diseases. Spearman's test was utilized for examining the correlation between the proportion of CX3CR1+ CD8+ T lymphocytes in liver of BA children, liver function parameters and LF score. During a follow-up period of 2 years, the proportion of T lymphocytes expressing CX3CR1 in liver was compared between children with good and poor prognosis. Results: The proportion of CD69- CX3CR1+ CD8+ T lymphocytes in liver of BA group was (7.91±8.81)%. It was lower than that of CC children (21.53±13.85)% and PH children (13.82±7.75)% and the difference was statistically significant (P<0.001, P=0.016). The proportion of CD69- CX3CR1+ CD4+ T lymphocytes in liver of BA group was (3.96±5.39)%. It was lower than that of CC children (8.76±9.16)% and PH children (7.68±5.98)% and the difference was statistically significant (P=0.020, P=0.003). The proportion of CX3CR1+ CD8+ T lymphocytes in liver of BA children were correlated negatively with the levels of gamma-glutamyl transpeptidase (GGT) and direct bilirubin (P=0.002, P=0.048). LF score was correlated negatively with the proportions of CX3CR1+ CD8+ T and CX3CR1+ Ki67+ CD8+ T lymphocytes in liver (P=0.025, P=0.030). The proportion of CX3CR1+ T lymphocytes in liver of children with good prognosis was higher than that of counterparts with poor prognosis (P<0.05). Conclusions: Proportion of CX3CR1+ CD4+ T and CX3CR1+ CD8+ T cells in liver may be an important prognostic predicator of BA children through maintaining immune homeostasis of liver and inhibiting LF. © 2023 Authors. All rights reserved.     

针刺治疗抑郁症研究进展

抑郁症作为一种常见的精神障碍,近年来逐渐成为危害人类身心健康的重要疾病。因其发病广泛,病程长久,治疗困难,容易复发等特点,每年越来越多的人遭受抑郁症的困扰,针对抑郁症治疗的研究也一直备受医学界关注,然而,现行治疗手段因自杀、5-羟色胺综合征、性功能障碍、代谢综合征、心血管副作用、消化道副作用、狂躁等副反应图穷匕见。这些不良反应不仅仅引起用药依从性的降低,甚至会导致严重的药物不良事件或药源性疾病。因此,积极探寻更多副反应低、疗效确切的抗抑郁治疗方案变得迫在眉睫。而中医针刺穴位治疗,因其独特优势,也逐渐在抑郁症治疗领域绽放光彩,本文旨在结合近5年中医针刺治疗抑郁症领域的学术进展,分析中医针刺治疗抑郁症的发展现状及相关问题,以求为该方向的进一步研究提供参考。     

胆道闭锁肝脏CX3CR1+T淋巴细胞的比例与肝纤维化及预后的相关性研究

目的探讨表达CX3C趋化因子受体1(CX3C chemokine receptor 1, CX3CR1)的T淋巴细胞(即CX3CR1+T淋巴细胞)在不同儿童肝脏疾病中的表达情况, 以及胆道闭锁肝组织浸润的表达CX3CR1的T淋巴细胞亚群与胆道闭锁患儿临床指标以及预后之间的关系。方法回顾性分析2019年1月至2020年6月在广州市妇女儿童医疗中心接受手术的24例胆道闭锁患儿临床资料, 同时选取同期进行手术的胆总管囊肿20例(接受胆总管囊肿根治手术)、胆汁淤积症4例(术中胆道造影排除BA)、门静脉高压9例(行门静脉高压治疗手术)作为对照组。对24例胆道闭锁患儿肝脏标本进行肝纤维化评分。利用流式细胞技术对所有患儿肝脏中浸润的T淋巴细胞亚群进行分析。比较T淋巴细胞亚群在不同疾病患儿肝脏中的表达差异。采用Spearman检验对BA患儿肝脏中CX3CR1+CD8+T淋巴细胞比例与肝功能指标、BA肝纤维化评分分别进行相关性分析。对BA患儿随访2年, 比较预后良好及预后不良患儿肝脏表达CX3CR1的T淋巴细胞比例。结果胆道闭锁组肝脏CD69-CX3CR1+CD8+T淋巴细胞比例为(7.91±8.81)...