Facet Joint Versus Transforaminal Epidural Steroid Injections in Patients With Cervical Radicular Pain due to Foraminal Stenosis: A Retrospective Comparative Study

BackgroundA cervical transforaminal epidural (TFE) steroid injection is a useful treatment option for cervical radicular pain, but it carries a small risk of catastrophic complications. Several studies have reported that cervical facet joint (FJ) steroid injection can reduce cervical radicular pain through an indirect epidural spread. The aim of this retrospective comparative study was to evaluate the pain scores and functional disability in subjects receiving cervical FJ or TFE steroid injection for the treatment of cervical radicular pain due to foraminal stenosis (FS).MethodsWe selected 278 patients 18 years of age and older who underwent cervical FJ (n = 130) or TFE (n= 148) steroid injection for cervical radicular pain. The primary outcomes included pain scores and functional disability during hospital visits one, three, and six months after the initial injection. Secondary outcomes were the proportion of responders and Medication Quantification Scale (MQS) scores. Adverse events and variables correlating with effectiveness one month after the initial injection were also evaluated.ResultsThe Numeric Rating Scale and Neck Disability Index scores showed a significant improvement one, three, and six months after the initial injection in both groups, with no significant differences between the groups. No significant differences were observed in the success rates of the procedure one, three, and six months after the initial injection for either group. There were no significant differences in MQS between the groups during the follow-up period. Univariate and multivariate logistic regression analyses revealed that the injection method, age, sex, number of injections, FS severity, MQS, pain duration, and the presence of cervical disc herniation were not independent predictors of treatment success.ConclusionThe efficacy of FJ steroid injection may not be inferior to that of TFE steroid injection in patients with cervical radicular pain due to FS.     

Intralymphatic Histiocytosis Associated with Osteoarthritis: A Case Report

Intralymphatic histiocytosis (ILH) is a rare cutaneous condition with uncertain pathogenesis. It is characterized by dilated lymphatic vessels that contain histiocytes within their lumina. Although the etiology of ILH remains unknown, it has been associated with various inflammatory and neoplastic diseases, such as rheumatoid arthritis (RA), reaction to metal joint implants and Merkel cell carcinoma, breast cancer and colon cancer. An 83-year-old female presented with an erythematous patch on the left forearm that had appeared six months previous. She had suffered from osteoarthritis (OA) and the cutaneous lesion was located in the vicinity of the affected joint. Skin biopsy from the lesion showed dilated dermal vessels and some ectatic vessels that contained many mononuclear histiocytes. Based on the clinical and histopathological findings, we diagnosed her with ILH with OA. Two sessions of intralesional triamcinolone acetonide injection (5 mg/ml) were administered to treat the skin lesion, which gradually improved over a period of a few months. We here report a rare case of ILH associated with degenerative OA.     

磷酸氯喹致飞蚊症和腹泻的文献复习

目的 通过1例飞蚊症和腹泻的药物不良反应,探索磷酸氯喹治疗新型冠状肺炎的药学监护要点.方法 询问患者和医生,查阅文献,对照不良反应因果关系.结果 磷酸氯喹治疗新冠肺炎的日剂量大于不良反应文献报道及美国眼科学会推荐的视网膜安全剂量,磷酸氯喹的眼毒性与单次剂量和疗程有关.结论 建议治疗前行眼部基线检查,治疗中加强监测.     

补体C3、补体C4联合甲状腺自身抗体检测对桥本甲状腺炎诊断和预后的意义

目的探讨补体C3、补体c4、抗甲状腺球蛋白抗体（TGAb）、甲状腺过氧化物酶抗体（TPOAb）和促甲状腺激素受体刺激抗体（TSAb）检测对桥本甲状腺炎（HT）的诊断价值和病情发展判定的意义。方法选择HT患者120例作为HT组,同期就诊的Graves病患者110例作为Graves’病组,30例健康体检者作为对照组。3组患者分别检测补体C3、补体C4、TGAb、TPOAb和TSAb,并进行比较。结果HT组和Graves病组TGAb、TPOAb和TSAb水平和阳性率较对照组明显升高,HT组TGAb和TPOAb的水平和阳性率升高较Graves病组升高更为明显,而TSAb的水平和阳性率Graves病组较HT组更为明显。HT组的补体C3和补体C4水平较对照组和Graves病组明显降低,而对照组和Graves病组无显著性差异。HT组中甲减亚组补体C3和补体C4水平的变化较甲功正常亚组和甲功亢进亚组明显降低。结论HT是最常见的自身免疫性甲状腺疾病之一,因其血清学诊断标准不具特异性,联合检测补体C3、补体C4和甲状腺自身抗体对提高HT的临床诊断以及判断病情发展具有较重要的临床意义。     

饮红茶对大鼠慢性缺氧性肺动脉高压的影响

慢性缺氧过程中，饮红茶的大鼠（HT组）平均肺动脉压（Ppa）为2.50±0.20kPa，肺血管阻力（PVR）为2824.80±658.69kPa·s~(-1)／L，均显著低于缺氧对照组（Ppa为2.97±0.25kPa，PVR为3763.46±529.62kPa·s~(-1)／L），而HT组肺血管对急性缺氧的反应性（22.50±6.16％）则显著强于缺氧对照组（10.65±3.80％）。结果表明，长期饮红茶可防止大鼠慢性缺氧性肺动脉高压的形成。     

高危人群踝臂指数影响因素的多元回归分析

目的探讨影响外周动脉病(PAD)高危人群的踝臂指数(ABI)的重要危险因素。方法选取心内科、内分泌科等住院患者为研究对象,对851例PAD易患者测定ABI,并收集相关影响因素的资料,进行多元线性回归分析。结果851例高危人群中,242例ABI异常,PAD患病率为28.44%(242/851例),平均ABI为0.74±0.14。其中影响ABI的危险因素有性别(男性)、年龄、吸烟年数、脑血管意外史、心肌梗死史、高脂血症史、血脂水平以及服用利尿剂、降糖药物史等。结论ABI值受多种因素综合影响。     

CD44在不同肿瘤细胞表面阳性表达率的实验研究

目的 检测CD44在肿瘤细胞表面的阳性表达率,为以CD44为靶点的肿瘤靶向治疗提供新的理论依据.方法 采用流式细胞术检测HCT116人结肠癌细胞,SGC-7901、MGC-803胃癌细胞,A549人肺腺癌细胞,HepG2人肝癌细胞,CNE-2人鼻咽癌细胞,U87MG恶性胶质瘤等肿瘤细胞表面CD44表达情况.结果 各肿瘤细胞表面均表达CD44.其中胃癌SGC-7901、MGC-803、肝癌HepG2、鼻咽癌CNE-2细胞表面CD44细胞的阳性率分别为17.90％±1.67％、18.36％±9.27％、24.61％±4.0％和19.03％ ±1.52％,呈高表达状态.结论 SGC-7901、MGC-803、HepG2、CNE-2细胞与HCT116、A549和U87MG细胞表面CD44阳性表达率相比有显著性差异（P＜0.05）.     

针灸治疗压力性尿失禁的临床研究进展

目的了解针灸治疗压力性尿失禁的现状和存在的问题。方法总结和分析近十五年来针灸治疗压力性尿失禁的文献。结果针灸治疗压力性尿失禁疗效确切．但辨证和疗效评价的标准不一致。结论今后应运用循证医学的方法,建立完善的针灸治疗压力性尿失禁规范化诊疗体系。     

流行病学以问题为基础学习教学效果的分析与评价

目的：对医学院本科生流行病学以问题为基础学习（problem-based learning,PBL）教学方法的授课效果进行分析和评价,探讨 PBL 教学方法在流行病学教学中的优点和不足,为进一步提高流行病学的教学效果提供理论依据。方法设计信度、效度较好的 PBL 教学质量评价问卷,选取某大学医学院参与流行病学 PBL 课程的本科生开展问卷调查分析及授课反馈。结果流行病学PBL 教学方法在临床医学本科生的教学过程中取得良好的教学效果,学生可以很好地掌握本次课程的重要知识点,而且大部分学生对 PBL 教学予以支持。结论 PBL 教学方法能够有效提高学生的学习动力和兴趣,有助于学生掌握基础知识,能够增强学生分析和解决实际问题的能力。     

新模式下病理学教学改革初探

为适应现代医学教育新模式,培养高质量的实用性医学人才,对传统的病理学教学进行了全方位、多层次、综合性探索、改革。从改革教学内容、教学方法及手段等方面入手,教学质量得到改善,学生对病理知识的掌握和主动学习、独立思考能力都有明显提高。