Postoperative seizure and memory outcome of temporal lobe epilepsy with hippocampal sclerosis: A systematic review

We conducted a systematic review and meta-analysis to evaluate postoperative seizure and memory outcomes of temporal lobe epilepsy with different hippocampal sclerosis (HS) subtypes classified by International League Against Epilepsy (ILAE) Consensus Guidelines in 2013. Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and MOOSE (Meta-Analysis of Observational Studies in Epidemiology) guidelines, we searched PubMed, Embase, Web of Science, and Cochrane Library from January 1, 2013 to August 6, 2023. Observational studies reporting seizure and memory outcomes among different HS subtypes were included. We used the Newcastle–Ottawa scale to assess the risk of bias and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach to grade the quality of evidence. Seizure freedom and improved outcome (Engel 1 or ILAE class 1–2) ≥1 year after surgery were defined as the primary and secondary seizure outcome. A random-effects meta-analysis by DerSimonian and Laird method was performed to obtain pooled risk ratio (RRs) with 95% confidence interval (CIs). The memory impairment was narratively reviewed because of various evaluation tools. Fifteen cohort studies with 2485 patients were eligible for the meta-analysis of seizure outcome. Six cohorts with detailed information on postoperative memory outcome were included. The pooled RRs of seizure freedom, with moderate to substantial heterogeneity, were .98 (95% CI = .84–1.15) between HS type 2 and type 1, 1.11 (95% CI = .82–1.52) between type 3 and type 1, and .80 (95% CI = .62–1.03) between the no-HS and HS groups. No significant difference of improved outcome was found between different subtypes (p > .05). The quality of evidence was deemed to be low to very low according to GRADE. The long-term seizure outcome (≥5 years after surgery) and memory impairment remained controversial.     

不同历史时期中医胸痹的定义和病机认识变迁

胸痹是以胸膺部疼痛、痹阻不通为主要特点的疾病，自胸痹病名创始以来，各时代医家都对其定义和病机有不同见解。通过梳理历代医书古籍，探讨名医学术思想，以追溯胸痹的学术源流。古代胸痹的内涵范围较广，涵盖了冠心病等心系疾病和其他胸膺部疾病。古籍中胸痹的因机理论亦颇为丰富，不仅有张机提出“阳微阴弦”的重要理论影响后世，还有各医家从风、寒、饮食、痰、瘀、清阳等角度阐述胸痹成因，为现代治疗胸膺部疾病提供更夯实的理论基础和更广泛的治疗思路。     

张定华主任医师治疗亚急性甲状腺炎临证浅析

随着社会压力、生活习惯的改变, 亚急性甲状腺炎的发病率逐渐升高。张定华主任认为亚急性甲状腺炎主因外感邪毒、情志不畅致使热邪内生, 热毒内盛, 炼液灼津, 阻滞气血, 故本病主要发病病机为热毒壅盛, 痰热互结, 蕴于颈前。张定华主任提出对该病应分期论治, 自拟亚甲康方, 分期加减治疗该病, 临床疗效显著。     

2016—2020年中国麻风病流行病学特征分析

目的分析2016—2020年中国麻风病的流行病学特征, 为进一步消除麻风危害提供科学依据。方法对2016—2020年全国(未包括香港、澳门和台湾地区)麻风病疫情监测年度报表进行数据整理和统计分析。结果 2016—2020年, 全国共累计报告新发麻风病患者2 697例, 其中儿童46例(1.71%)、女性894例(33.15%)、流动人口374例(13.87%)、多菌型2 443例(90.58%)和2级畸残患者546例(20.24%);发现复发患者203例。到2020年底, 全国登记现症麻风病患者1 893例, 较2010年(6 032例)减少68.62%;36(1.2%)个县(市)患病率大于1/10万, 新发麻风病患者中2级畸残患者72例(17.73%)。结论 2016—2020年我国麻风病报告发病率和患病率逐年稳步下降, 麻风病继续保持整体低流行状态。     

RBM7在乳腺癌细胞BT474中的表达及其与P21的关系

目的：探索RNA结合蛋白7（RNA binding protein 7，RBM7）在人源性乳腺癌细胞BT474中的过表达及干扰后的表达改变，并研究其与P21之间的关系。方法：在人源性乳腺癌细胞BT474中分别转染RBM7过表达、干扰慢病毒（实验组）和相应对照慢病毒（对照组），从而构建稳定转染的细胞株，用qRT?PCR和Western blot实验分别验证转染后的RBM7的表达情况。用CCK?8实验、流式细胞周期实验分别评估RBM7表达改变后对乳腺癌细胞增殖能力和细胞周期分布的影响。通过qRT?PCR和Western blot实验观察BT474细胞中RBM7表达改变后对P21表达的影响。进一步通过RNA结合蛋白免疫共沉淀（RIP）实验来研究RBM7与P21之间的关系。结果：在乳腺癌细胞BT474中分别转染RBM7过表达、干扰慢病毒48 h后，通过荧光显微镜检测细胞的绿色荧光表达情况；经嘌呤霉素稳定筛选后，获得RBM7过表达及干扰的稳转细胞株。CCK?8和流式细胞周期实验显示，过表达RBM7后可促进乳腺癌细胞的增殖，而干扰RBM7后能抑制乳腺癌细胞的增殖。qRT?PCR和Western blot实验显示，过表达RBM7能下调P21的mRNA（P < 0.05）及蛋白的表达，干扰RBM7能上调P21的mRNA（P < 0.05）及蛋白的表达。RNA结合蛋白免疫共沉淀（RIP）实验显示，RBM7能直接结合P21的mRNA从而发挥其对P21的调节作用。结论：RBM7在人乳腺癌细胞BT474中通过结合P21的mRNA从而下调P21的表达。     

荷兰养老护理模式对我国老年护理发展的思考

2012年4月至5月,笔者作为中荷社区卫生合作项目第五期学员赴荷兰进行为期两周的考察和学习,了解荷兰社会概况、福利政策、健康保健体系等。学习期间我们参观了全科医生工作站、医院、学校、康复中心、老年公寓、老年护理中心和养老院,跟随当地护士到患者家中开展家庭护理(home care)。现将荷兰卫生保健体系、家庭护理特点及对我国老年护理发展的启示,介