Effects of working memory training in patients with Parkinson's disease without cognitive impairment: A randomized controlled trial

ObjectiveTo determine the feasibility and evaluate effects of a computerized working memory (WM) training (WMT) in patients with Parkinson's Disease (PD) on cognitive and clinical outcomes.Methods76 patients with PD without cognitive impairment were randomized to either the WMT group (n = 37), who participated in a 5-week adaptive WMT, or a passive waiting-list control group (CG, n = 39). Patients underwent clinical and neuropsychological examination at baseline, after training, and at 3-months follow-up, with verbal WM and non-verbal WM as primary outcomes. Outcome assessors were blinded for group allocation.ResultsAll WMT participants completed the training successfully and reported high levels of motivation for and satisfaction with the training. Repeated-measures, linear mixed-effects models revealed positive training effects for the WMT group compared to the CG in verbal working memory with a small relative effect size 0.39 [95%CI 0.05; 0.76] for the 3-months follow-up only. No other reliable training effects in cognitive and clinical variables were found for either point of time.ConclusionsIn this randomized controlled trial, WMT was feasible and yielded some evidence for 3-months follow-up training gains in patients with PD. WMT might be an effective intervention to prevent cognitive decline in this patient group, however, more longitudinal studies with longer follow-up periods and more sensitive assessment tools will have to proof this concept.Trial registrationGerman Clinical Trials Register (DRKS00009379).     

血液透析治疗尿毒症顽固性高血压的疗效比较

〔摘 要〕 目的：分析在尿毒症顽固性高血压患者治疗过程中使用血液透析所取得的临床效果。方法：选取 2019 年 1 月 至 2020 年 3 月期间江门市人民医院血透室在透的 80 例尿毒症顽固性高血压患者作为研究对象，采用随机列表将 其分为对照组和观察组，各 40 例。观察组患者选取血液透析的方式进行治疗，对照组患者选取血液灌流的方式进 行治疗，对两组患者临床治疗效果进行分析。结果：观察组患者治疗总有效率高于对照组，差异具有统计学意义 （P ＜ 0.05）。治疗前，两组患者血压比较，差异无统计学意义（P ＞ 0.05）；治疗后，两组患者收缩压与舒张压均降低， 且观察组低于对照组，差异具有统计学意义（P ＜ 0.05）。两组患者均未出现严重不良反应，组间比较，差异无统计学意义 （P ＞ 0.05）。结论：在尿毒症顽固性高血压患者治疗过程中，通过血液透析疗法的应用，有利于提升患者治疗质量，对 于患者健康具有积极作用。     

Efficacy of Curcumin in Combination with Intralesional Dexamethasone with Hyaluronidase in the Treatment of Oral Submucous Fibrosis: A Randomized Controlled Trial

Objective: The objective of this study was to determine the efficacy of curcumin in combination with  intralesional dexamethasone with hyaluronidase in the treatment of oral submucous fibrosis (OSF). Methods: This randomized, double blind, parallel design, clinical trial was conducted at B.P. Koirala Institute of Health Sciences, Nepal. Thirty-four patients with clinically diagnosed OSF were randomized into two groups (17 participants in each) with baseline treatment of intralesional dexamethasone with hyaluronidase for 6 weeks for the both. Curcumin (2gm/day) was provided to Group A (Test) and Group B (Control) received placebo. Interincisal mouth opening, tongue protrusion, cheek flexibility and visual analogue scale (VAS) scoring of burning sensation of oral mucosa was recorded at baseline, 6, 8 and 12 weeks follow-up and independent t-test was used to compare the improvements in two groups. Results: On comparing the 6 weeks and baseline values, in Group A and B the mean difference in mouth opening was 8.82±1.33 mm and 5.53±1.17 mm respectively (p<0.001), in cheek flexibility was 2.94±1.02 mm and 1.94±1.24 mm respectively (p=0.02) and in tongue protrusion was 6.23±1.48 and 3.65±1.37 mm respectively (p<0.001). The findings were consistent in the 8 weeks follow-up. In 12 weeks follow-up, on comparing with the baseline values, in Group A and B, the mean difference in mouth opening was 8.71±1.16 mm and 5.35±1.22 mm respectively (<0.001), ), in cheek flexibility was 2.81±1.01 mm and 1.76±1.35 mm respectively (p=0.02) and in tongue protrusion was 6.06±1.48 and 3.35±1.50 mm respectively (p<0.001). Both the arms showed 100% improvement in burning sensation in 6, 8 and 12 weeks follow-up. Conclusion: Curcumin in combination with intralesional dexamethasone with hyaluronidase is efficacious in the treatment of OSF.     

妊娠合并肺动脉高压的管理

妊娠合并肺动脉高压为严重的妊娠合并症，文章从肺动脉高压的诊断、临床分类、妊娠风险评估、妊娠常见类型的孕期管理等方面对该疾病进行了综合介绍。在相应级别的医疗机构进行规范评估及治疗，有助于改善妊娠合并肺动脉高压患者的母儿预后。     

Une cause rare d’hypertension artérielle pulmonaire : l’amylose thoracique

Isolated thoracic involvement in amyloidosis is a rare and serious condition. Its association with pulmonary arterial hypertension (PAH) usually weakens the prognosis. We report the case of a 40-year-old man with a smoking history, hospitalized for chest pain, abdominal pain and acute respiratory distress. The cardiac ultrasound revealed a circumferential pericardial effusion as well as a pulmonary artery systolic pressure (PAPS) at 80 mmHg. Chest imaging (computed tomography scan and magnetic resonance imaging) showed a tissue process developed in the pericardial sheath (60 × 45 mm) sheathing the ascending aorta and infiltrating the trunk of the pulmonary artery and its right branch. Anatomopathological and immunohistochemical study of the process revealed AL amyloidosis. Note that the patient had no signs of extrathoracic amyloidosis. Blood and urine electrophoresis and immunoelectrophoresis as well as bone marrow mylogram and biopsy were normal. The patient was put on oral anticoagulant as he presented with PAH. A therapeutic protocol with thalidomide and dexamethasone has been initiated. The course of the disease was marked by total regression of the clinical signs, a marked decrease in the amyloid process on imaging and a normalization of the PAPS; our follow-up being three years.     

高血压合并冠心病患者血浆致动脉硬化指数与同型半胱氨酸表达水平的相关性分析

目的探究高血压合并冠心病患者血浆致动脉硬化指数(AIP)与同型半胱氨酸(Hcy)表达水平的相关性。方法采用机械随机抽样法选择2018年1月至2019年3月本院收治的142例高血压患者作为研究对象,依据是否合并冠心病将其分为对照组(单纯高血压,67例)和研究组(高血压合并冠心病,75例)。比较两组的TG、LDL-C、HDL-C、AIP、Hcy、UA、Cr、BUN、IMT,采用Pearson相关性法分析AIP与Hcy、UA及Cr的相关性。结果研究组TG、Hcy、UA、Cr水平明显高于对照组,HDL-C水平明显低于对照组,AIP值和IMT明显大于对照组(P<0.05)。相关性分析显示,高血压合并冠心病患者AIP值与血浆Hcy、UA、Cr水平呈显著正相关(P<0.05)。结论高血压合并冠心病患者血浆Hcy水平与AIP呈正相关,可作为高血压合并冠心病早期预测因子。     

强化健康教育及心理干预对老年高血压患者健康行为及生活质量的影响

目的探讨强化健康教育及心理干预的健康管理模式对老年高血压患者健康行为及生活质量的影响。方法选取我院收治的210例老年高血压患者,随机将其分为对照组(105例,常规综合护理)与观察组(105例,对照组基础上强化健康教育及心理干预)。比较两组的护理效果。结果护理后,两组的生活方式均改善,且观察组优于对照组(P<0.05)。护理后,两组HK-LS评分均升高,SBP、DBP水平均下降,且观察组优于对照组(P<0.05)。护理后,两组自我健康管理行为评分均升高,且观察组高于对照组(P<0.05)。护理后,两组的HAMA、HAMD评分均降低,生活质量评分均升高,且观察组优于对照组(P<0.05)。结论强化健康教育及心理干预能明显提高老年高血压患者自我健康管理行为,降低血压,改善生活方式、心理状态和生存质量。     

中药防治肺动脉高压研究现状及创新药物研发＊

肺动脉高压为恶性肺血管疾病或临床综合征，发病机理涉及复杂的生物学过程和多种分子机制，临床仍缺乏有效治疗药物。尽管单靶点药物的联合应用可有效改善其临床症状，但不能阻止病程进展，且价格昂贵，药物不良反应问题一直未能解决。中药因多成分协同作用、多靶点发挥药效、多途径整合调节疾病的特点，在肺动脉高压的治疗中发挥独特优势，具有良好应用前景和创新药物开发潜力。本文旨在全面系统地梳理近30年中药防治肺动脉高压的研究进展，分析创新药物研发的瓶颈及策略，以期为肺动脉高压的创新药物研发提供有益参考。