温通膏外敷联合中频电疗治疗冻结肩的疗效观察

目的:观察温通膏外敷联合中频电疗对冻结肩的临床疗效。方法:选取90例冻结肩病例,随机分为温通膏组、中频组,联合组。温通膏组使用温通膏外敷患者患处,中频组使用中频电疗,联合组则同时给予温通膏外敷及中频电疗治疗,三组均连续治疗10天。观察患者治疗前后的Constant-Murley肩关节评分中的疼痛评分、活动度评分,并于3个月后随访患者,记录复发情况。结果:治疗后,三组患者的肩关节Constant-Murley疼痛评分、活动度评分均高于治疗前(P<0.05);联合组患者的肩关节Constant-Murley疼痛评分、活动度评分明显优于温通膏组及中频组(P<0.05);治疗3个月后联合组的复发率(6.67%)明显低于其它两组。结论:温通膏联合中频电疗可以有效缓解冻结肩患者的疼痛,改善活动度,临床效果较单独使用温通膏外敷或中频电疗更优。     

中药配方颗粒的发展现状及国际化对策探讨

近年来,世界各国对天然药物日益重视,而中药配方颗粒既能在中医理论指导下随证加减,又有服用便捷、适宜工业生产等优点,成为推动中药"走出去"的有力助力。通过回顾中药配方颗粒的发展历程、分析相关数据和国内外发展形势,对中药配方颗粒的研究现状、市场情况及国际化发展面临的主要挑战进行探讨,提出利用政府间交往推进中药国际贸易、充分发挥海外资源平台作用、帮助监管部门建立符合中药配方颗粒特点和审批国政策的合理化国际审批方案、争取国际标准主导权的建议,为推动中药配方颗粒产业在世界范围内高质量发展提供参考。     

How Picky Eating Becomes an Illness—Marketing Nutrient-Enriched Formula Milk in a Chinese Society

The essential adaptive food selection behavior of young children has become increasingly medicalized as a kind of disease—the “picky-eating” syndrome in Hong Kong. The researcher used the multiple case studies approach with data collected from in-depth interviews and advertisements to examine the process of the medicalization of picky-eating disorder, which demonstrates how an essential adaptive human behavior can be redefined by the market and medical system as a deviant, abnormal behavior that needs to be eliminated and how the resulting health risks can be resolved by modern medicine produced by this pharmaceutical nexus.     

Should sleep laboratories have their own predictive formulas for continuous positive airway pressure for patients with obstructive sleep apnea syndrome?

BackgroundSeveral formulas predicting optimal continuous positive airway pressure (CPAP) for obstructive sleep apnea treatment have been developed and diverse parameters selected as predictive factors in different sleep laboratories using different ethnic groups. This study aimed to validate a constructed predictive formula for the study laboratory and to test the hypothesis that sleep laboratories should have their own predictive formulas.MethodsFifty-seven adult subjects with obstructive sleep apnea syndrome (OSAS) were enrolled in the model-building set and underwent two polysomnography (PSG) studies to diagnose OSAS and titrate for optimal CPAP. A predictive formula, derived from anthropometric and polysomnographic variables, was validated together with two other predictive formulas in 30 subjects by comparing the mean predictive CPAP values, rates of successful prediction, and agreements.ResultsRegression analysis showed that apnea–hypopnea index (AHI), SaO_2nadir (nadir of arterial oxyhemoglobin saturation by pulse oximetry), and body mass index (BMI) strongly correlated with optimal CPAP. The derived predictive formula for the study laboratory was: CPAPpred (predictive CPAP) = 6.380 + 0.033 × AHI – 0.068 × SaO_2nadir + 0.171 × BMI (R² = 0.335, adjusted R² = 0.298). In Taiwan, different predictive formulas used by different sleep laboratories with different independent predictors led to similar mean predictive CPAP values to the mean observed optimal CPAP values, rates of successful prediction, and agreements with the observed optimal CPAP. There were significant differences between the mean predictive CPAP values and mean observed optimal CPAP values, lower rates of successful prediction, and negatively skewed 95% confidence interval (CI) when using a predictive formula derived from different ethnic populations.ConclusionA sleep laboratory may not need to have its own predictive formula for determining the optimal effective CPAP but should adopt the one derived from the same ethnicity of OSAS patients as the reference formula.     

Promoting safe infant feeding practices – the importance of structural,social and contextual factors in Southern Africa

There has been significant progress towards the goal of eliminating vertical transmission of HIV by 2015. However, a question that remains is how we can most effectively prevent late postnatal transmission of HIV through infant feeding. Guidelines published by the World Health Organization in 2010 have been widely adopted. These guidelines place strong emphasis on exclusive breastfeeding, in some countries over‐turning a prior emphasis on formula feeding. Where available, provision of antiretroviral treatment for HIV‐positive mothers or prophylaxis for infants offers additional protection against vertical transmission through infant feeding. However, merely changing guidelines is not sufficient to change practice, particularly with regard to culturally sanctioned forms of feeding, such as mixed feeding. This commentary highlights structural, social and contextual barriers to effective implementation of the guidelines and suggests ways to address some of these barriers.     

Accuracy of the Common Predictive Equations for Estimating Resting Energy Expenditure among Normal and Overweight Girl University Students

Objective: The aim of the present study was to determine the accuracy of commonly used predictive formulas of resting metabolic rate (RMR) compared to measured RMR in normal and overweight young females.

Methods: In this cross-sectional study, 98 female university students aged 18–30 years with body mass index 18 to 30 kg/m² were recruited. Anthropometric indices and body compositions were measured. RMR was measured by indirect calorimetry (FitMate, Cosmed, Rome, Italy) and estimated by 11 predictive formulas. The accuracy of the RMR formulas and mean percentage differences between estimated and measured values were calculated. Paired t test was used to compare estimated and measured RMRs.

Result: There were no significant differences between measured and estimated RMR by the 4 commonly used formulas (Mifflin, Cunningham, and World Health Organization [WHO]/Food and Agriculture Organization [FAO]). Among all of the equations, the Mifflin formula showed the lowest bias (?2.97 ± 116.43 kcal/day) at the group level and was the most accurate formula (80.23%) in normal and overweight participants. The over- and underestimated values were about 14% and 5.5%, respectively. In normal and overweight females, Mifflin was the most accurate formula, with 75.51% and 84.61% accuracy, respectively.

Conclusion: Given the current lack of a standardized formula that consistently delivers accurate results, the Mifflin formula can be recommended for estimating energy requirements in normal and overweight females in clinical practice.