单纯心脏超声引导下儿童房间隔缺损的介入治疗

目的 探讨单纯心脏超声引导下儿童房间隔缺损（Atrial Septal Defect, ASD）的介入治疗安全性、有效性、可行性。方法 收集2018年3月至2019年12月间收治房间隔缺损患儿92例,其中男38例,女54例,年龄（4.82?3.24）岁,体重（18.61?9.12）kg,心脏畸形均为房间隔缺损（其中1例合并动脉导管未闭,直径约1.8mm,未予特殊处理）,均行单纯心脏超声引导下房间隔缺损封堵术,其中81例患儿行经皮超声引导下房间隔缺损封堵术,7例患儿行经胸房间隔缺损封堵术,4例患儿经麻醉后食道心脏超声评估无需行手术治疗。术后常规予口服阿司匹林抗凝治疗6个月,每日3mg/kg,预防血栓形成。术后即刻、1个月、3-6个月复查心脏超声及心电图,评估治疗效果。结果 手术患儿均封堵成功,无封堵器脱落、心脏穿孔、外周血管损伤等并发症。术后随诊心脏彩超及心电图提示封堵器位置好,各房室内径基本正常,未见残余分流、心包积液、心律失常等并发症。结论 单纯心脏超声引导下儿童房间隔缺损应用介入治疗是安全有效的,且具有创伤小、恢复快、并发症少等优点。     

骨科患者术后死亡及并发症相关因素分析与护理对策

目的：探讨分析骨科患者术后死亡及并发症发生的危险因素。方法回顾性分析935例骨科住院接受手术治疗的患者,统计术后死亡及并发症发生情况,对导致严重结局的危险因素行多因素logistic回归分析,针对危险因素提出预防性护理措施。结果935例患者中,围手术期内发生术后并发症82例,占8．77％;32例死亡,占3．42％。经logistic多元回归分析,术前肾功能不全、呼吸系统慢性疾病、心功能不全、房颤、心肌供血不足、脑血管病史是导致骨科患者术后死亡及并发症的独立危险因素（P＜0．05）。结论术前肾功能不全、呼吸系统慢性疾病、心功能不全、房颤、心肌供血不足、脑血管病史6个因素为骨科术后死亡及并发症发生的独立危险因素,护理人员应针对危险因素给予积极预防和干预。     

《针灸临床实践指南》国际需求的调查:一项横断面研究

ObjectiveThis study aims to get the medical management of acupuncture and moxibustion in the countries and regions where the society members of World Federation of Acupuncture-Moxibustion Societies (WFAS) are located, including the educational background of acupuncture and moxibustion practitioners and the local clinical practice of acupuncture and moxibustion, and the demands of the content and evidence types of Clinical Practice Guidelines (CPGs) of acupuncture and moxibustion in accordance with WFAS standards, so as to provide requirements and reference principles for the development of CPGs of acupuncture and moxibustion in accordance with WFAS standards.MethodsThe convenient sampling method was used to collect the questionnaires, and the WFAS secretariat distributed the questionnaires to 294 contacts of society members from 70 countries and regions in the form of Questionnaire Star four times in April 2020, July 2020, March 2021, and April 2021 respectively. They were then distributed to individual members of acupuncture-moxibustion societies by the contacts. The study content involved the basic information of respondents, including their nationality, occupation, educational background of acupuncture and moxibustion, their local clinical practice and medical management of acupuncture and moxibustion, as well as their demand for CPGs of acupuncture and moxibustion, etc. After the questionnaires were collected, the data were analyzed and described by quantitative research method.ResultsIn all, 302 respondents from 37 countries of six continents responded. The 302 respondents were members of the WFAS society members. (1) Basic information of respondents. They all had acupuncture and moxibustion learning experience, among which, 76.5% (231/302) had the education background of acupuncture and moxibustion professional college training, and 88.4% (267/302) had experience of acupuncture and moxibustion clinical practice. Acupuncturists or traditional Chinese medicine doctors accounted for 63.9% (193/302), western medicine doctors, nurses, and pharmacists accounted for 18.2% (55/302), and researchers and teachers accounted for 6.3% (19/302). (2) Local clinical practice and medical management of acupuncture and moxibustion. The level of clinical practice of acupuncture and moxibustion varies greatly among the regions where the WFAS society members lived. Among them, more countries in Europe have not included acupuncture and moxibustion in medical insurance than those in other continents (x²=26.049, P < 0.01), and more countries have not included acupuncture and moxibustion in public hospital treatment system than those in other continents (x²=113.488, P < 0.01). (3) Demand for CPGs of acupuncture and moxibustion. A total of 93.0% (281/302) respondents believed that WFAS CPGs of acupuncture and moxibustion would be helpful for their local practice. The order of their demand and concern for WFAS CPGs was: acupuncture manipulation > latest progress of acupuncture treatment > choice of acupuncture therapies > safety of acupuncture and moxibustion > combination of acupuncture and other programs. A total of 87.4% (264/302) respondents believed that ancient classics could guide clinical practice, and the ancient literature should be used as evidence for the development of guidelines.ConclusionThe respondents are those future practitioners of CPGs of acupuncture and moxibustion conforming to WFAS standards. Commonly they have clinical practice experience and professional education background. They believe that guidelines will be of help to the clinical practice of acupuncture and moxibustion, hope that WFAS CPGs would recommend effective guidelines for acupuncture manipulation and provide the latest progress in acupuncture treatment and so on, and they believe that classical ancient books can guide their clinical practice. It indicates the necessity and feasibility of formulating the WFAS CPGs of acupuncture and moxibustion. In view of the results of this study, it is suggested that the formulation process of WFAS CPGs of acupuncture and moxibustion should take into account the clinical practice level of acupuncture and moxibustion in each region, as well as its legislation and management situation of acupuncture and moxibustion, so as to meet the needs of users as much as possible.     

基于数据挖掘方法分析曹志群治疗慢性萎缩性胃炎的用药规律

目的探讨曹志群教授治疗慢性萎缩性胃炎（CAG）的用药规律。方法收集曹志群教授2016 年11 月至 2020 年1 月治疗CAG 的门诊病案,筛选、整理后建立数据库。使用Microsoft Excel 2019 进行药物频数及性味 归经分析,利用IBM SPSS 23.0 软件进行因子分析和系统聚类分析。结果根据纳入、排除标准共收集处方 191 首,涉及中药162 味。高频药物有砂仁、半夏、炒白术、丹参、党参、黄芪、枳壳、香附等;药物功效以 补虚、理气、化湿为主;药性以温性为主,药味以苦、辛、甘为主,归经以脾、胃经为主;因子分析共提取公 因子7 个;系统聚类分析得到新处方5 首。结论曹志群教授围绕CAG“中焦虚损”的基本病机,治疗从 脾、胃出发,以补虚祛实、虚实兼顾为治疗准则,重视补益脾胃,同时注意调节脏腑气机升降,辅以运脾化 湿、行气活血、消食化积等治法。     

补肾促卵泡颗粒治疗肾虚型排卵障碍性不孕的疗效观察

目的:观察补肾促卵泡颗粒治疗肾虚型排卵障碍性不孕的临床疗效,探讨治疗肾虚型排卵障碍性不孕疗效显著的治疗方式。方法:将60例符合入选条件的排卵障碍性不孕的患者随机分为观察组和对照组。观察组予补肾促卵泡颗粒,对照组予克罗米芬。疗程均为3个月经周期,比较两组最大卵泡直径和子宫内膜厚度的变化,并评价临床疗效。结果:治疗后两组间子宫内膜厚度与最大卵泡直径比较,差异均有统计学意义(P0.05);两组治疗后的总有效率分别为86.7%、66.7%,差异有统计学意义(P0.05)。结论:补肾促卵泡颗粒治疗肾虚型排卵障碍性不孕疗效显著,值得临床推广。     

莫西沙星110例不良反应及其神经/精神毒性的危险因素分析

目的:分析莫西沙星药物不良反应(Adverse Drug Reaction,ADR)发生的规律及特点,并对其神经/精神毒性进行危险因素分析,为临床安全用药提供参考.方法:回顾性分析2018年1月至2019年12月新疆医科大学第一附属医院上报的全部莫西沙星ADR,并对其神经/精神毒性进行单因素及多因素Logistic回归...     

婴幼儿混合型完全性肺静脉异位引流的外科治疗

目的:探讨混合型完全性肺静脉异位引流(TAPVC)的形态学特点及手术方式,并分析可能导致术后死亡的危险因素。方法:2011年1月至2019年1月在首都医科大学附属北京儿童医院心脏外科行手术治疗的混合型TAPVC患儿17例。男10例,女7例;年龄(4.4±3.8)个月(1～15个月);体质量(5.6±1.7) kg(3....     

黄芪不同有效成分对电离辐射致BMSCs DNA损伤防护作用的比较研究

目的:比较黄芪不同有效成分对电离辐射致人骨髓间充质干细胞(BMSCs)DNA损伤的防护作用。方法:采用2 Gy X射线直接辐照BMSCs建立辐射细胞模型。采用CCK-8法检测不同质量浓度(25、50、75、100μg/m L)黄芪多糖、黄芪皂苷、黄芪黄酮辐射前干预1 d+辐射后干预1～5 d对辐射BMSCs增殖的影响,筛选给药浓度和辐射后继续干预时间。将辐射BMSCs分为辐射组、黄芪多糖组、黄芪皂苷组、黄芪黄酮组,后3组辐射前后均使用适宜的相应药物进行干预,另设空白组进行比较;采用胞浆分裂阻滞微核法检测辐射后干预适宜时间的微核细胞率和细胞微核率,免疫荧光法检测辐射后干预适宜时间细胞中53BP1焦点簇数量,并对不同时间点(0.5、2、12、24 h)的53BP1焦点簇数量进行比较。结果:与空白组比较,辐射组BMSCs的OD值显著降低(P<0.05或P<0.01);与辐射组比较,50μg/m L黄芪多糖、黄芪皂苷、黄芪黄酮继续干预2～3 d时BMSCs的OD值均显著升高,其余剂量组仅部分时间点有显著差异(P<0.05或P<0.01);综合考虑确定给药浓度为50μg/...     

曹志群辨治溃疡性结肠炎用药规律分析

目的：运用数据挖掘方法总结曹志群教授治疗溃疡性结肠炎（UC）的用药规律。方法：收集167例曹志群治疗UC的门诊病案，使用Microsoft Excel 2016建立规范化数据库，进行频数分析，运用IBM SPSS 23.0、IBM SPSS Modeler 14.1对出现频率>20%的中药进行因子分析、关联规则分析。结果：167首临床处方共涉及中药107味，高频药物有黄芪、薏苡仁、败酱草、乌梅、仙鹤草、当归、木香、黄连等，功效以补虚、清热、止血为主，药性以温、寒为主，药味以苦、辛、甘为要，归经以肝、脾、胃为最；关联规则主要为薏苡仁、黄芪、败酱草、当归、乌梅与其他药物的配伍，因子分析共得到8个公因子。结论：曹志群根据UC脾虚湿蕴-湿热瘀阻-奇经虚损的病机演变过程，以健脾祛湿作为基本治则，辅以清热利湿、凉血止血、益气养血、祛瘀导滞等治法，疗效良好。     

虎杖利胆退黄药理作用机制的研究进展

虎杖已被证实具有利胆退黄的药理作用，且在临床上被用于治疗胆汁淤积性肝病和黄疸型肝炎，探究虎杖利胆退黄药理作用机制对拓展其在临床上的应用以及开展后续研究都至关重要。目前对于虎杖利胆退黄的药理机制已有部分研究，主要是从胆汁酸代谢和胆红素代谢这两条代谢通路作为切入点进行。本文通过调研有关文献，从虎杖的活性成分和复方制剂两个层面出发，发现目前的研究多聚焦于影响体内胆汁酸和胆红素稳态的酶或受法尼醇X受体调控的转运蛋白上，另外也有研究发现炎症和氧化应激也与胆汁淤积有关，所以从这些角度综述了虎杖利胆退黄药理作用机制研究进展，以期为后续虎杖进一步研究奠定基础。