踝肱指数和肱踝动脉脉搏波速度与血管舒张功能联合载脂蛋白B与载脂蛋白A-1比值对中青年冠心病血瘀证的预测价值研究

背景 冠心病属中医“胸痹心痛”范畴,其证候分布以血瘀证最为多见,与老年人相比,中青年血瘀证的发生率更高。本研究在团队前期研究基础上进行拓展,首次运用动脉弹性和血管内皮功能检测联合载脂蛋白比值诊断中青年冠心病血瘀证,旨在为早期发现中青年冠心病血瘀证提供新思路,也可为优化补充冠心病血瘀证的诊断标准提供参考。目的 探讨踝肱指数(ABI)、肱踝动脉脉搏波速度(baPWV)、血管舒张功能(FMD)联合载脂蛋白B与载脂蛋白A-1比值(apoB/apoA-1)与中青年冠心病血瘀证的关系及其预测价值。方法 选取2016年12月至2021年12月于中日友好医院中西医结合心脏内科住院治疗的中青年(<50岁)冠心病患者,并根据《冠心病血瘀证诊断标准》分为血瘀证组和非血瘀证组。收集患者首次冠状动脉造影前的ABI、baPWV、FMD和apoB/apoA-1等临床资料。采用多因素Logistic回归分析构建中青年冠心病患者血瘀证的预测模型,并采用受试者工作特征(ROC)曲线进行预测价值评价。结果 本研究共纳入中青年冠心病患者206例,其中血瘀证组127例,非血瘀证组79例。多因素Logistic回归分析结果...     

Th17细胞分化调控及其治疗自身免疫性疾病的研究进展

辅助性T细胞17(Th17)作为CD4＋T细胞的一个亚群,对包括自身免疫性疾病在内的某些炎性疾病的发生和发展起着重要作用。越来越多证据显示,在多种自身免疫性疾病患者血液中,Th17细胞数量及其相关细胞因子明显上升,靶向Th17细胞分化可能成为一种新的自身免疫性疾病临床治疗方案。本文讨论了Th17细胞与自身免疫性疾病的关系,并总结了调控Th17细胞分化的几个重要因素,以及一些以Th17细胞分化为靶点的自身免疫性疾病的治疗新策略。     

鼻咽癌放化疗患者味嗅觉改变及自我报告症状的相关性

目的 基于鼻咽癌放化疗患者自我报告症状进行分析,探讨症状困扰与味嗅觉改变(taste and smell alterations, TSAs)的相关性,为症状评估和管理策略的制定提供依据。方法 采用横断面调查,于2021年6—12月,采用一般资料调查表、味嗅觉调查表(the Taste and Smell Survey, TSS)、安德森症状量表-头颈部模块(M.D.Anderson Symptom Inventory-Head and Neck, MDASI-HN)对142例鼻咽癌放化疗患者进行问卷调查。结果 TSS总分为10.00(6.00,13.00),味觉维度7.00(5.00,9.00),嗅觉维度3.00(0.00,5.00)。MDASI-HN量表核心症状困扰个数为11.00(7.75,13.00),头颈症状困扰个数为7.00(4.00,9.00),生活干扰个数为5.00(2.00,6.00),其中核心症状困扰、头颈症状困扰与TSAs程度分级呈正相关(P<0.05)。MDASI-HN量表条目睡眠不安、发音/讲话困难、食物或饮水呛咳、工作(包含家务劳动)与TSAs程度分级...     

超声心动图评价急性心肌梗死Ⅱ期心脏康复前后心功能及同步性

目的： 应用超声心动图评价急性心肌梗死患者行Ⅱ期心脏康复前后心功能及同步性改变。方法: 对20例急性心肌梗死患者Ⅱ期心脏康复前后使用脉冲多普勒结合心电图计算主肺动脉射血前时间差,即心室间机械延迟时间(IVMD)。于心尖四腔心切面,使用M型超声心动图,计算出三尖瓣环收缩期位移(TAPSE)。使用实时三维超声心动图获取心尖四腔心全容积图像,在Qlab 9.0软件下获得心率、左室射血分数(LVEF)、左室舒张末容积(LVEDV)、左房最大容积(LAVmax)和左房射血分数(LAEF)。软件自动计算出左室16节段达收缩期最小容积点时间最大时间差(Tmsv16 Dif)心率校正值,即LVTmsv16 Dif/R R(%),以及左房16节段达收缩期最小容积点时间最大时间差(Tmsv16 Dif)心率校正值,即LATmsv16 Dif/R R(%)。结果: 急性心肌梗死患者Ⅱ期心脏康复后心率、LATmsv16 Dif/R R(%)明显低于康复前(P<0.001和P<0.05),LVEF、LAEF明显高于康复前(P<0.001和P<0.05),康复前后IVMD、TAPSE、LVEDV、LAVmax、LVTmsv16 Dif/R R(%)比较差异无统计学意义(P均>0.05)。结论: 急性心肌梗死患者行Ⅱ期心脏康复后左心收缩功能及左房同步性较康复前改善。     

“90增血剂”对特发性血小板减少性紫裥患者的T细胞亚群的作用

作者根据现代免疫学观点,自1989年起采用自制中药“90增血剂”治疗ITP46例。期间,应用间接免疫荧光技术检测了患者外周血T淋巴细胞亚群,结果表明病例组全T细胞(CD_3)、T辅助/诱导细胞(CD_4)降低,T抑制/细胞毒细胞(CD_8)增高,CD_4/CD_8比值明显降低。治疗后,患者T亚群恢复常态,血小板数上升,骨髓产板型巨核细胞数增加,临床总有效率达91.2%,明显优于激素组(71.4%)。提示中药具有显著的疗效和良好的免疫调节作用。同时,动态观察ITP患者T细胞亚群的变化,对帮助临床判断治疗反应和预后有很大意义。     

A report on a feasibility test of "community control of epilepsy" proposed by WHO

According to a protocol proposed by the Division of Mental Health, WHO, a feasibility test for "Community Control of Epilepsy" was carried out in rural areas of Beijing and Sichuan. This project means to detect, control and follow-up patients with generalized tonic-clonic seizures using primary health care workers 40 patients were chosen to be administrated phenobarbital and divided randomly into two groups. 20 in community "A" treated by primary health care workers who were trained by a three-day course, 20 in community "B" treated by neurologists. Patients in both communities were compliant and the curative effects were no difference between the two groups. The primary health care workers could master the fixed method and manage patients conveniently. This present study revealed that the "Community Control of Epilepsy" is a feasible project in the rural areas of China.     

Cerebral blood flow and metabolism in severely head-injured children. Part 1: Relationship with GCS score, outcome, ICP, and PVI

The literature suggests that in children with severe head injury, cerebral hyperemia is common and related to high intracranial pressure (ICP). However, there are very few data on cerebral blood flow (CBF) after severe head injury in children. This paper presents 72 measurements of cerebral blood flow ("CBF15"), using the 133Xe inhalation method, with multiple detectors over both hemispheres in 32 children aged 3 to 18 years (mean 13.6 years) with severe closed head injury (average Glasgow Coma Scale (GCS) score 5.4). In 25 of the children, these were combined with measurements of arteriojugular venous oxygen difference (AVDO2) and of cerebral metabolic rate of oxygen (CMRO2). In 30 patients, the first measurement was taken approximately 12 hours postinjury. In 18 patients, an indication of brain stiffness was obtained by withdrawal and injection of ventricular cerebrospinal fluid and calculation of the pressure-volume index (PVI) of Marmarou. The CBF and CMRO2 data were correlated with the GCS score, outcome, ICP, and PVI. Early after injury, CBF tended to be lower with lower GCS scores, but this was not statistically significant. This trend was reversed 24 hours postinjury, as significantly more hyperemic values were recorded the lower the GCS score, with the exception of the most severely injured patients (GCS score 3). In contrast, mean CMRO2 correlated positively with the GCS score and outcome throughout the course, but large standard deviations preclude making predictions based on CMRO2 measurements in individual patients. Early after injury, there was mild uncoupling between CBF and CMRO2 (CBF above metabolic demands, low AVDO2) and, after 24 hours, flow and metabolism were completely uncoupled with an extremely low AVDO2. Consistently reduced flow as found in only four patients; 28 patients (88%) showed hyperemia at some point in their course. This very high percentage of patients with hyperemia, combined with the lowest values of AVDO2 found in the literature, indicates that hyperemia or luxury perfusion is more prevalent in this group of patients. The three patients with consistently the highest CBF had consistently the lowest PVI: thus, the patients with the most severe hyperemia also had the stiffest brains. Nevertheless, and in contrast to previous reports, no correlation could be established between the course of ICP or PVI and the occurrence of hyperemia, nor was there a correlation between the levels of CBF and ICP at the time of the measurements. The authors argue that this lack of correlation is due to: 1) a definition of hyperemia that is too generous, and 2) the lack of a systematic relationship between CBF and cerebral blood volume     

Clinical and experimental study of the effect of compound five-shen herbal drink in the treatment of acute febrile diseases with damage to the yin and reddened tongue syndrome

Based on the experience of the late Beijing traditional medicine professor Zhao Bingnan in treating acute infectious febrile disease and its complications, compound herbal drink composed of five kinds of shen. Six hundred cases of febrile disease with damage to Yin and reddened tongue syndrome and hypokalemia. Patients were randomly divided into groups I, II and control. The perspective study of treatment results and experiments were carried out. The results showed that group I and II who received the compound five-Shen herbal drink (CFSHD) showed good therapeutic effects, the rates of significant effectiveness were 65.5% and 73.1% respectively (P greater than 0.05). The total rates of effectiveness were 97.2% and 96.2% respectively. The rate of significant effectiveness of the control group was 11%, total rate of effectiveness was 43%. There was significant statistical difference between the control group and group I or II (P less than 0.001). Authors of present paper are the first to propose the "Reddened Tongue" to be the main diagnostic criterion of syndrome of "Damage both to the Qi and Yin". Laboratory examination of 344 cases of "Reddened Tongue" revealed that 317 cases with hypokalemia (blood potassium less than 3.5 mEq/L) were 92.15% of the entire group. The authors point out that most of the patients with "damage to both the Qi and Yin" besides hypokalemia can be also low in calcium, magnesium and trace elements. After treatment with CFSHD restoration of normal blood potassium was parallel with the improvement of the reddened tongue.(ABSTRACT TRUNCATED AT 250 WORDS)     

抑菌防霉剂—噻苯哒唑的合成

本文介绍了噻苯哒唑的新用途和采用“一锅煮”工艺制备噻唑酸进而制得该防霉剂的合成方法。