复方中药制剂对食管癌术后患者免疫功能及血液流变学影响的临床研究

目的:观察扶正抑瘤颗粒(FYG)对食管癌术后患者免疫功能及全血粘度的影响.方法:选食管癌术后患者129例,根据临床需要分为化疗组和未化疗组,每组又随机分为对照组与服FYG组.服用FYG一月后,各组病人分别测定T细胞亚群、NK细胞活性、全血粘度.结果:服FYK组患者,CD4、CD4/CD8、NK值均明显高于对照组(P＜0.05);CD8明显下降(P＜0.05);全血粘度明显下降(P＜0.05).结论:FYG能够改善食管癌术后患者免疫低下状态,提高患者免疫功能,改善高粘血症,对肿瘤的转移有抑制作用.     

Development of acute lymphoblastic leukemia following treatment for acute myeloid leukemia in children with Down syndrome: A case report and retrospective review of Children's Oncology Group acute myeloid leukemia trials

Children with Down syndrome have a 150‐fold increased risk of developing acute myeloid leukemia (AML) and 20‐fold increased risk of developing acute lymphoblastic leukemia (ALL). Although the risk of developing AML and ALL is significantly increased in children with Down syndrome, the development of both malignancies in the same patient is very rare. We describe a patient with Down syndrome who developed ALL 6 years after being diagnosed with AML. We performed a literature review and Children's Oncology Group query and discovered eight published cases and five cases of ALL following AML in pediatric patients with Down syndrome, as well as six cases of ALL following AML in non‐Down syndrome patients. There was a similar cumulative incidence of ALL after treatment for AML in the Down syndrome and non‐Down syndrome populations. Overall survival in patients with Down syndrome who developed ALL after treatment for AML was comparable to overall survival for patients with Down syndrome with de novo ALL with an average follow‐up of 7 years after ALL diagnosis. Clinical data collected were used to discuss whether this phenomenon represents a secondary leukemia, second primary cancer, or mixed‐lineage leukemia.     

胃食管反流病证型研究

为研究中医治疗胃食管反流病的辨证分型标准。对120例胃食管反流病患者主症，次症以及舌象，脉象等进行辨证分析。结果：各主要证型为胆热犯胃型9.17%，肝胃郁热刑51.67%，中虚气逆型25.83%，气郁痰阻型3.33%，提示胃食管反流病的辨证分型以肝胃郁热，中虚气逆，胆热犯胃，气郁痰阻四型为主。     

子宫内膜异位症的中医证型分布与相关因素的研究

目的探讨子宫内膜异位症（EMs）的中医证型分布特点及相关因素。方法对152例EMs患者进行辨证分型,并分析其年龄、病变程度、流产次数,及对中医证型分布的影响。结果152例EMs患者证型分布为气滞血瘀型（43．4％）、肾虚血瘀型（27．1％）、湿热血瘀型（16．4％）、寒凝血瘀型（13．1％）;22岁-28岁、29岁-35岁和36岁-42岁3个年龄段均以气滞血瘀型最多（P〈0．05）;病情轻度者气滞血瘀型居多,病情重度者肾虚血瘀型居多（P〈0．05）;从未流产患者气滞血瘀型较多,流产3次以上者肾虚血瘀型较多（P〈0．05）。结论EMs证型出现频率由高至低为气滞血瘀型、肾虚血瘀型、湿热血瘀型、寒凝血瘀型;中医证型分布与年龄、病变程度、流产次数有一定相关性。     

葛根素的心血管系统药理作用及机理研究

纵观近年来对葛根素在心血管系统药理作用及机理研究方面的进展发现，葛根素对心血管系统具有抗心律失常、降血压、扩张冠状动脉、抗心肌缺血、抗过氧化、抗缺血-再灌注损伤、影响血液动力学和血小板聚集、保护血管等作用。其临床应用前景良好，其药效机制研究及临床应用有待更深一步的探究。     

周永明辨治恶性淋巴瘤经验

介绍周永明教授辨治恶性淋巴瘤的经验。认为恶性淋巴瘤多由正气亏虚,痰毒结滞所致;病理特点为本虚标实,以“脾肾亏虚”为本,以“痰毒瘀结”为标,而脾肾亏虚在恶性淋巴瘤的发病中尤显重要;病理因素可以归结为“虚、痰、毒、瘀”;治疗上始终立足于扶正祛邪,以健脾补肾治其本,化痰祛瘀解毒治其标;临证宜在辨证论治的基础上结合化疗、放疗及手术治疗的不同时期随证加减治疗,以达到增效减毒、优势互补、促进康复的目的。     

中西医结合治疗膝骨关节炎（膝痹）专家共识

随着我国老龄化进程的加快,膝骨关节炎（KOA）成为严重影响患者生命质量的一种慢性退行性疾病,给社会和家庭带来沉重的经济负担。目前,KOA的中西医诊疗策略尚待完善和规范,如能中西医结合诊疗、优势互补,则将更好地提升KOA临床诊疗水平。因此,本共识经各学科专家组商议、问卷测评及牵头人团队综合评价,优化了以往共识内容,并将各种KOA治疗方法的使用建议按照KOA不同分期对应不同的推荐等级,旨在为从事KOA防治的中医、西医及中西医结合专业的医务工作者提供指导性意见,推动KOA的中西医结合诊疗规范化发展。     

朱生樑运用藿苏散辨治脾胃病验案举隅

通过食管瘅、胃痞、胃脘痛、泄泻验案分析,介绍朱生樑教授运用藿苏散辨治脾胃病的临证经验。     

Shoulder magnetic resonance imaging findings in manual wheelchair users with spinal cord injury

Objective: To investigate the prevalence of rotator cuff and long head of the biceps pathologies in manual wheelchair (MWC) users with spinal cord injury (SCI).Design: Cross-sectional study.Setting: Outpatient clinic at a tertiary medical center.Participants: Forty-four adult MWC users with SCI (36 men and 8 women) with an average age (SD) of 42 (13) years. SCI levels ranged from C6 to L1; complete and incomplete SCI.Outcome Measures: Participants’ demographic and anthropometric information, presence of shoulder pain, Wheelchair User’s Pain Index (WUSPI) scores, and magnetic resonance imaging findings of shoulder pathologies including tendinopathy, tendon tears, and muscle atrophy.Results: Fifty-nine percent of the participants reported some shoulder pain. The prevalence of any tendinopathy across the rotator cuff and the long head of biceps tendon was 98%. The prevalence of tendinopathy in the supraspinatus was 86%, infraspinatus was 91%, subscapularis was 75%, and biceps was 57%. The majority of tendinopathies had mild or moderate severity. The prevalence of any tears was 68%. The prevalence of tendon tears in the supraspinatus was 48%, infraspinatus was 36%, subscapularis was 43%, and biceps was 12%. The majority of the tears were partial-thickness tears. Participants without tendon tears were significantly younger (P < 0.001) and had been wheelchair user for a significantly shorter time (P = 0.005) than those with tendon tears.Conclusion: Mild and moderate shoulder tendinopathy and partial-thickness tendon tears were highly prevalent in MWC users with SCI. Additionally, the findings of this study suggest that strategies for monitoring shoulder pathologies in this population should not be overly reliant on patient-reported pain, but perhaps more concerned with years of wheelchair use and age.     

Nursing Case Management Strategies for Adults with Serious Mental Illness Seeking Dental Services

A university-community partnership initiated a dental screening and nursing case management program for Medicaid-insured adults with serious mental illness (SMI). Forty-three adults with SMI participated in dental screening; 72% participated in case management. Per client, an average of six case management contacts was made. After 6 months, 87% (27/31) had attended at least one dental appointment, with a 13% no-show rate; 8 completed treatment, 4 had ongoing treatment, 12 had interrupted care, and 3 were lost to follow-up. Adults with SMI experienced high unmet dental needs; nursing case management strategies aided clients to initiate and complete dental care.