不同年龄非特异性腰痛患者腰椎曲度相关因素分析

目的 分析不同年龄段非特异性腰痛患者人口学因素、临床特征及竖脊肌形态与腰椎曲度的相关性.方法 选取2016年1月—2019年12月首都医科大学附属北京安贞医院和国家电网北京电力医院收治的临床影像学资料完整的非特异性腰痛患者99例,记录患者年龄、性别、体质量指数(BMI)、腰痛持续时间、腰痛视觉模拟量表(VAS)评分.于腰椎侧位X线片测量腰椎前凸角,于腰椎横断面MRI测量L4,5节段去除脂肪信号后的双侧竖脊肌横截面积(CSA)及L4 CSA.依据患者年龄分为≥65岁组(16例)和<65岁组(83例),比较2组人口学因素、腰痛持续时间、VAS评分、竖脊肌参数和腰椎前凸角的差异,并分析腰椎前凸角与其他指标的相关性.结果 <65岁组L4,5节段竖脊肌CSA/L4 CSA高于≥65组,差异有统计学意义(P<0.05).2组性别、BMI、VAS评分、腰痛持续时间及腰椎前凸角差异无统计学意义(P>0.05).在<65岁组中,相关性检验显示性别和L4,5节段竖脊肌CSA/L4 CSA与腰椎前凸角存在相关性,多元线性回归分析显示腰椎前凸角与L4,5节段竖脊肌CSA/L4 CSA呈正线性相关.在≥65岁组中,相关性检验显示腰椎前凸角与年龄和L4,5节段竖脊肌CSA/L4 CSA存在相关性,多元线性回归分析显示年龄与腰椎前凸角呈负线性相关、与L4,5节段竖脊肌CSA/L4 CSA呈正线性相关.结论 非特异性腰痛患者性别、年龄、L4,5节段竖脊肌CSA/L4 CSA与腰椎曲度均存在相关性,<65岁的患者腰椎曲度与性别相关,≥65岁的患者腰椎曲度与年龄相关,而腰椎曲度与L4,5节段竖脊肌CSA/L4 CSA的相关性不依赖于年龄.     

How do the Growth and Metabolic Activity of Aquatic fungi Geotrichum Candidum and Aspergillus Niger Respond to Nanoplastics?

In this study, exposure experiments were conducted to assess the effects of polystyrene nanoparticles (PS) and amine-modified polystyrene nanoparticles (APS) at environmental concentrations (1, 10, and 100 µg L^??1) on two fungal species (Geotrichum candidum and Aspergillus niger), isolated from leaf litter in streams, concerning their growth and metabolic activity. Results showed that PS at 1 and 10 µg L^??1 have hormesis effects on G. candidum growth. Compared with G. candidum, A. niger had higher sensitivity to nanoplastic exposure. Besides, the peroxidase and cellobiohydrolase activities of A. niger were significantly inhibited by nanoplastics (except 1 µg L^??1 PS), which would weaken its metabolic activity in carbon cycling. These results provided a new thought on how the growth and functions of aquatic fungi cope with the stress induced by nanoplastics. Overall, the study provided evidence for the different responses of aquatic fungi to nanoplastics in streams.

     

Clinical Characteristics and Controllable Risk Factors of Osteoporosis in Elderly Men with Diabetes Mellitus

ObjectiveTo analyze the clinical characteristics and controllable risk factors of osteoporosis in elderly men with type‐2 diabetes mellitus (T2DM).MethodsA total of 250 elderly OP patients with T2DM were included in the present study. Patients with one or more common chronic diseases (including hypertension, coronary heart disease, heart failure, chronic bronchitis, chronic nephrosis, and cirrhosis), and a course of more than 3 years were defined as complicated with chronic diseases. Blood glucose, cholesterol, triglyceride, low‐density lipoprotein, high‐density lipoprotein, calcium, phosphorus, glycosylated hemoglobin, urea nitrogen, creatinine, fasting insulin, liver function, and 25‐hydroxy vitamin D3 levels were measured. Bone mineral density was also measured.ResultsA total of 16 patients (6.4%) had severe osteoporosis. Furthermore, 66 patients (26.4%) had blood glucose control that reached the standard, while 176 patients (70.4%) used more than two anti‐diabetic drugs. The serum testosterone level was lower than the median in 87 patients (34.8%) and in 56 smokers (22.4%). Furthermore, 138 patients (55.2%) were overweight and obese, six patients (2.4%) were underweight, 197 patients (78.8%) had chronic diseases, 88 patients (35.2%) were sticking to exercise, and 117 patients (46.8%) had less exercise. In addition, 92 patients (36.8%) were treated with osteotrophy‐protective agents, and 24 patients (9.6%) received anti‐osteoporosis therapy. Smoking, poor glycemic control, low testosterone levels, less exercise, and complications with chronic diseases were the most relevant controllable risk factors.ConclusionFor elderly male osteoporosis patients with type‐2 diabetes, smoking cessation, blood sugar control up to the standard, regular exercise, active prevention and treatment of complications, and appropriate testosterone supplementation are necessary for preventing and curing osteoporosis.     

"健康中国"战略下临床医学专业本科生职业医学教育的实践与探索

临床医学专业学生是职业病的诊断、治疗、康复和预防的未来主干力量,因而在"健康中国"战略下采用多元化教学方式培养学生解决问题的能力,提高临床医学生学习职业医学的积极性,推进职业医学专业人才队伍建设,对维护全体劳动者身体健康、促进经济社会协同发展具有重要意义。     

Efficacy and tolerability of anti-asthma herbal medicine intervention in adult patients with moderate-severe allergic asthma

BACKGROUND: Chinese herbal medicine has a long history of human use. A novel herbal formula, anti-asthma herbal medicine intervention (ASHMI), has been shown to be an effective therapy in a murine model of allergic asthma. OBJECTIVE: This study was undertaken to compare the efficacy, safety, and immunomodulatory effects of ASHMI treatment in patients with moderate-severe, persistent asthma with prednisone therapy. METHODS: In a double-blind trial, 91 subjects underwent randomization. Forty-five subjects received oral ASHMI capsules and prednisone placebo tablets (ASHMI group) and 46 subjects received oral prednisone tablets and ASHMI placebo capsules (prednisone group) for 4 weeks. Spirometry measurements; symptom scores; side effects; and serum cortisol, cytokine, and IgE levels were evaluated before and after treatment. RESULTS: Posttreatment lung function was significantly improved in both groups as shown by increased FEV(1) and peak expiratory flow findings (P<.001). The improvement was slightly but significantly greater in the prednisone group (P<.05). Clinical symptom scores, use of beta(2)-bronchodilators, and serum IgE levels were reduced significantly, and to a similar degree in both groups (P<.001). T(H)2 cytokine levels were significantly reduced in both treated groups (P<.001) and were lower in the prednisone-treated group (P<.05). Serum IFN-gamma and cortisol levels were significantly decreased in the prednisone group (P<.001) but significantly increased in the ASHMI group (P<.001). No severe side effects were observed in either group. CONCLUSION: Anti-asthma herbal medicine intervention appears to be a safe and effective alternative medicine for treating asthma. In contrast with prednisone, ASHMI had no adverse effect on adrenal function and had a beneficial effect on T(H)1 and T(H)2 balance.     

儿童臀肌挛缩症免疫发病机理的研究

本文对４１例儿童臀肌挛缩症患者外周血及３２例儿童臀肌挛缩症臀肌进行了系统的免疫学研究。结果表明：儿童臀肌挛缩症患者免疫调节功能紊乱，红细胞免疫功能低下，臀肌组织免疫复合物沉积，臀肌小血管数目减少及管壁损伤。由此认为免疫病理因素是儿童臀肌挛缩症的主要发病机理。     

Management of hemangiopericytomas in the central nervous system

目的　血管外皮细胞瘤是少见的中枢神经系统肿瘤 ,由于其易复发和转移而预后不良。本文介绍 2 6例血管外皮细胞瘤的处理经验并结合文献复习其诊治要点。方法　回顾性分析 1993年 1月至 1999年 6月华山医院收治的 2 6例血管外皮细胞瘤 ,其中 5例为复发肿瘤 ,1例为术后残留。结果　 2 6例中 2 4例病灶全切除 ,2例次全切除。术后 2 1例症状好转或不变 ,4例加重 ,1例手术后死于并发症。18例术后放疗。 18例获随访 ,随访期 1- 5 8个月 ,其中 15例恢复良好 ,2例发现转移肿瘤 ,1例复发再次手术后死亡。结论　手术全切是主要治疗方法 ,术后放疗可延缓肿瘤复发。