占永立教授从咽论治IgA肾病的理论与实践探析

本文从理论与临床实践2方面总结了占永立教授从咽论治IgA肾病的经验。占教授将Ig A肾病分为3型进行辨证论治:1)肺气不足,热毒扰咽证; 2)脾气虚弱,热邪客咽证; 3)肾阴亏虚,余热留咽证。治疗上以清热解毒利咽为主,兼以扶正,根据病情灵活选方用药,取得较好的临床疗效。     

亮氨酸氨基肽酶在妊娠妇女血清中的水平变化及其意义

目的:探讨血清亮氨酸氨基肽酶(LAP)在妊娠妇女不同时期血清中的变化规律及其临床意义。方法:选取2011年1月~2013年12月在该院产检的正常妊娠妇女180例,根据孕周分为早期组、中期组和晚期组,每组各60例,另选取60例健康未孕妇女为未孕组;同时选取该院收治的妊娠期高血压疾病妇女33例为妊娠期高血压疾病组、早产孕妇22例为早产组,采用速率法分别检测各组孕妇血清LAP水平并进行比较。结果:未孕组、早期组、中期组、晚期组妇女的血清LAP、血清肝胆酸(CG)、碱性磷酸酶(ALP)、α-L-岩藻糖苷酶(AFU)水平比较,差异有统计学意义(P均<0.05)。妊娠期高血压疾病组的CG、ALP、AFU、LAP水平显著高于早期组、中期组和晚期组(P均<0.05);早产组的CG、ALP、AFU、LAP水平显著高于早期组、中期组(P均<0.05),仅CG水平高于晚期组(P<0.05)。结论:随着妊娠周期的增加,妊娠妇女的血清LAP水平逐步升高,在合并妊娠期高血压疾病时LAP升高更加显著,结合CG、ALP、AFU水平的变化能够对妊娠期高血压疾病的发病情况进行动态监测。     

Fertility Outcome After Renal Transplantation: A Single-Center Experience

BackgroundWomen suffering from kidney disease are more prone to fertility problems, due to uremia. Fortunately, their fertility rate increases dramatically after renal transplantation. This study analyzes the predictors/risk factors of successful pregnancy with live birth outcome while presenting an overview of the 7-year experience of a single center.MethodsThis retrospective cohort study includes 239 women of reproductive age (18–40 years) who underwent renal transplantation in a tertiary Turkish clinic between October 1, 2011, and August 24, 2017. The subjects were invited to take part in a survey questioning their obstetric characteristics and they were assessed in 2 groups: fertile and infertile. Multivariable linear regression analysis was conducted to determine the predictors of a successful pregnancy.ResultsThirty-five 35 patients wished to become pregnant: 12 got pregnant spontaneously, while 21 failed to become pregnant (spontaneously). The mean age of the patients at the survey was 34 ± 7. Regular menstrual cycles after renal transplantation, tacrolimus-mycophenolate mofetil maintenance protocol, and age at transplantation were found to be predictors of spontaneous pregnancy. The duration of peritoneal dialysis was significantly longer in the infertile group (48 vs 12 months).ConclusionEnd-stage renal disease's negative impacts, including menstrual abnormality and fertility problems, can be overcome by successful kidney transplantation with appropriate immunosuppression. Minimizing the duration of peritoneal dialysis, particularly in patients who desire future fertility, may be accepted as a logical management strategy.     

工作相关肌肉骨骼疾患与人体工效学负荷研究进展

工作相关肌肉骨骼疾患(WMSDs)是常见的慢性非传染性疾病。WMSDs已成为影响工人健康、降低工人生命质量和造成经济损失的重要因素,可见于多个行业、工种。本文对WMSDs流行现状及人体工效学负荷相关研究进行综述,以期找到职业人群保护的可行方法。