临床3例处方联合配伍用药分析

根据各类药物的不同作用特点,将临床3例不合理联合配伍用药,进行具体分析及详细介绍。     

多节段布鲁菌性脊柱炎与脊柱结核MRI特征分析

目的 探讨多节段布鲁菌性脊柱炎(BS)及脊柱结核(ST)在MRI中的不同影像特点,从而提高早期诊断及鉴别诊断水平.方法 回顾性分析33例由临床或病理确诊为多节段BS患者、30例多节段ST患者,根据两者MRI表现,分析其发生部位、椎体形态、周围组织情况及伴随征象.结果 多节段BS患者的椎体形态、椎间盘受累、后凸畸形、死骨...     

A sewing needle in the liver in children: A case report and literature review

Rationale:In clinical practice, foreign bodies (FBs) in the digestive tract are more common in children, but intrahepatic FBs are rare, especially those that can cause infection, bleeding, bile leakage, and other complications. However, there is no consensus on its diagnosis and treatment due to the lack of large-scale cohort studies.Patient concerns:Case 1 is a 4-years 8-months-old girl, who at the age of 10 months, showed an X-ray finding of a striped FB in her liver, with no symptoms. However, the patient’s parents refused surgery. After nearly 4 years of active surveillance, the patient visited our hospital for surgery. Case 2, a 2-year-old male, reported a sewing needle that completely pierced into the right upper abdomen due to an accidental fall that took place half-a-day before admission. He only had right upper abdominal pain. CT showed a striped FB in the liver.Diagnosis:FB in the liver (sewing needle).Interventions:Both the patients were injected with human tetanus immunoglobulin and underwent surgical removal.Outcomes:Both patients recovered smoothly and had no complications during follow-up.Lessons:Active surveillance might be considered for cases with no symptoms or complications and no displacement of the FB, but surgery should be the first choice. If the patient’s condition is complicated, it is recommended to use ultrasound or X-ray to help decision-making during the operation. Additionally, tetanus, child safety, and family education are important supportive measures.     

产后早期甲状腺激素、肾上腺皮质激素与产后抑郁的关系研究

目的 探讨产后早期甲状腺激素、肾上腺皮质激素与产后抑郁的关系。方法 选择2019年2月～2021年2月108例产妇为研究对象,产后4～6周采用爱丁堡产后抑郁量表（EPDS）评估抑郁情况,并设为抑郁组与非抑郁组。检测血清甲状腺素水平,包括甲状腺素（T4）、三碘甲状腺原氨酸（T3）以及促甲状腺激素（TSH）,同时检测肾上腺皮质激素,即皮质醇（Cor）。采用Pearson相关分析甲状腺激素、肾上腺皮质激素与EPDS评分的相关性。结果 108例产妇产后4～6周检出抑郁36例,检出率33.33%。抑郁组血清T4、T3、TSH水平显著低于非抑郁组,差异具有统计学意义（P<0.05）;抑郁组血清Cor水平显著高于非抑郁组,差异具有统计学意义（P<0.05）;血清T4、T3、TSH水平与EPDS评分呈负相关,血清Cor与EPDS评分呈正相关。结论 产后早期甲状腺激素、肾上腺皮质激素与抑郁程度有一定关联,前者与抑郁呈负相关,后者呈正相关。     

Association of AGTR1 gene methylation and its genetic variant in Chinese farmer with hypertension: A case-control study

The objective was to determine the potential associations of the angiotensin II receptor type 1 (AGTR1) gene polymorphism, methylation, and lipid metabolism in Chinese farmers with hypertension.A case-control study was conducted in Wuzhi county of Henan province in China in 2013 to 2014. A total of 1034 local residents (35–74 years, 386 hypertensive cases, and 648 normotensive subjects) were enrolled in this study. Triglyceride (TG), total cholesterol (TC), high-density lipoprotein, and low-density lipoprotein were measured using automatic chemistry analyzer. The AGTR1 gene promoter methylation level was measured using quantitative methylation-specific polymerase chain reaction method. The single nucleotide polymorphism rs275653 was genotyped with TaqMan probe assay at an applied biosystems platform.The gender, body mass index (BMI), TG, TC, and family history of hypertension in the hypertension group were significantly higher than those in control group (P < .05). No significant difference was observed in the distribution of AGTR1 rs275653 polymorphism in the hypertension and controls (P > .05). The AGTR1 gene methylation in subjects carrying different genotypes was not significantly observed (P > .05). The logistic regression analysis found the AGTR1 gene methylation level was negative correlation with hypertension in the present study (odds ratio, 0.946, 95% confidence interval, 0.896–0.999) through adjusting for age, gender, BMI, education, smoking, alcohol drinking, fruit and vegetable intake, pickles intake, and family history of hypertension.The association of AGTR1 gene hypomethylation and essential hypertension was observed in Chinese farmers; no significant difference was observed in the distribution of AGTR1 rs275653 polymorphism.     

基于数据挖掘的魏连波教授治疗慢性肾衰的临床用药规律分析

目的 探究魏连波教授治疗慢性肾衰的临床用药规律。方法 基于中医传承辅助平台V2.5软件构建数据库,采用软件集成的数据挖掘方法,对处方中方剂的证候、药物频次、组方规律等进行分析。结果 符合纳入标准的处方有396张,涉及125味中药。药物四气主要为温、寒、平和热;药物五味主要为苦、甘、辛和酸;药物归经主要为脾、胃、肝、肺和肾。证候以脾肾亏虚为本,湿浊毒瘀为标。丹参、白术、大黄、川芎、姜半夏、砂仁、党参、陈皮、黄连、干姜、牛膝、杜仲是核心药物群,以健脾和胃、活血化瘀、补益肝肾药为主。结论 魏连波教授治疗慢性肾衰遵循扶正祛邪、标本兼治的法则,温寒平热药并用,多应用健脾活血、补益肝肾药,各药配伍共奏补脾益肾、清利湿热、化浊的效果。     

Prevalence of and factors associated with sarcopenia among elderly individuals with hypertension

PurposeSarcopenia is a major health problem in community-dwelling elderly individuals. Hypertension is postulated to aggravate sarcopenia. The present study was performed to estimate the prevalence of and factors associated with sarcopenia among elderly individuals with hypertension.MethodsThis study involved 165 Chinese individuals with hypertension aged ≥60 years who were evaluated for sarcopenia using the Asian Working Group for Sarcopenia criteria. Data on their sociodemographic information, physical illnesses, and clinical and functional status were collected.ResultsThe overall prevalence of sarcopenia among elderly individuals with hypertension was 20.2%. The factors significantly associated with sarcopenia were an age of ≥70 years (adjusted odds ratio (OR), 3.01; 95% confidence interval (CI), 1.17–5.39), diabetes (OR, 4.45; 95% CI, 1.32–11.16), osteoporosis (OR, 2.52; 95% CI, 1.13–5.37), drinking (OR, 3.28; 95% CI, 1.26–7.85), and a body mass index of 24.0 to 27.9 kg/m² (OR, 0.74; 95% CI, 0.59–0.91).ConclusionsThis study revealed a very high prevalence of sarcopenia among elderly individuals with hypertension (20.2%). Sarcopenia may be associated with advanced age, drinking, diabetes, the body mass index, and osteoporosis. The longitudinal relationship between clinic visits and sarcopenia should be further evaluated.     

薇诺娜舒敏保湿特护霜对新冠疫情防控期间医护人员佩戴医用口罩后皮肤屏障的修复

目的 观察使用薇诺娜舒敏保湿特护霜对疫情期间医护人员佩戴医用口罩后皮肤屏障修复作用及皮肤敏感改善情况.方法 采用自身前后对照研究,选取受试者佩戴口罩后的右侧面颊为受试区.入组当天晨起及佩戴口罩4h后检测经表皮水分流失(transepidermal waterloss,TEWL)及角质层含水量,随后发放受试品(薇诺娜舒敏...     

不同缝合方法在Sanders Ⅲ型跟骨骨折患者术中的应用比较

目的 比较三层紧密缝合法与Allgower-Donati缝合法在SandersⅢ型跟骨骨折患者术中的应用价值。方法 选取2017年6月至2020年6月东南大学附属中大医院溧水分院的83例SandersⅢ型跟骨骨折患者为研究对象,根据手术缝合方法的不同分为观察组（43例）与对照组（40例）。观察组采用三层紧密缝合法,对照组采用Allgower-Donati缝合法。比较两组的手术疗效、手术相关指标、术后恢复情况及术后切口并发症总发生率,观察两组患者术后的Maryland评分、视觉模拟评分法（VAS）评分及切口皮肤温度变化情况。结果 两组的手术优良率比较,差异无统计学意义（P>0.05）;观察组术后1个月的Maryland评分高于对照组,术后3 d的VAS评分低于对照组,差异有统计学意义（P<0.05）;两组的手术时间及术后引流时间比较,差异无统计学意义（P>0.05）;观察组的皮肤切口缝合时间长于对照组,切口周围皮肤炎症反应面积小于对照组,切口愈合时间短于对照组,差异有统计学意义（P<0.05）;两组的骨折愈合时间比较,差异无统计学意义（P>0.05）;观察组...