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1.
目的 了解我国老年人中医证候分布特征,为中医药辨治老年人提供参考依据。方法 系统检索中国知识基础设施(CNKI)、中文科技期刊数据库(CCD)、万方数据资源系统数据库(CSPD),纳入研究对象为老年人的临床流行病学调查研究文献,对其调查目的、调查疾病及调查结果等进行描述统计。结果 ①最终纳入168篇文献,其中2010至2020年之间发表138篇(82.14%);调查地区涵盖全国28个省市自治区,共纳入43948例老年人,累计覆盖340个研究中心;②主要研究结果显示,老年人中医证候阴虚阳亢证(10.05%)>血瘀证(9.5%)>痰浊(湿)证(8.91%)>阴阳两虚证(4.98%)>痰瘀互结证(4.96%);单元证分布阴虚证(14.70%)>痰证(11.22%)>气虚证(7.15%)>肾虚证(4.72%)>血瘀证(4.18%);涉及病变脏腑肾>肝>脾>肺>心。结论 根据统计结果,可以看出老年人证候分布虚证多于实证,虚证中又以阴虚证、气虚证最为多见,实证常见血瘀证、痰浊(湿)证等,且多见痰瘀互结证;老年人五脏皆损,其中又以肾、肝、脾功能失调最为突出。 相似文献
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中医学古籍中罕有关于“胰腺”的明确记载,缺乏直观、系统的理论论述。本文试图通过对各个时期具有代表性的医学典籍所记载内容的分析,结合现代解剖学相关理论,梳理中医学对胰腺实体解剖的认识过程。通过分析,笔者认为中医学对胰腺实体解剖的认识具有阶段性:①先秦两汉时期,存在胰腺实体解剖,但并非认为胰腺是脏器;②唐宋时期,胰腺实体解剖更加清晰,在医学上胰腺附属于脾,并非为独立的脏器;③明清时期,胰腺实体解剖明确,部分医家以独立脏器论之,出现“脾”、“胰”之争。中医学理论缺少对胰腺的单独论述,目前学界的主流观点多为“胰属脾”,线性归属以脾笼统代之略显单薄,不利于理论的丰富与发展。笔者认为胰腺藏象应独立于脾单独讨论,现代解剖学对胰腺命名同一,形态结构清楚,位置描述明确,可直接补充进中医学胰腺藏象(藏)理论中,为完善胰腺藏象理论搭建解剖学基础。 相似文献
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目的 探讨右美托咪定联合综合体温保护对腔镜手术治疗老年恶性肿瘤患者苏醒期质量及免疫功能的影响。方法 选择择期行腔镜手术治疗的老年恶性肿瘤患者90例,随机均分为3组:对照组(C组)、体温保护组(T组)和体温保护联合右美托咪定组(T-D组),每组30例。C组常规体温保护,T组和T-D组综合体温保护;T-D组麻醉诱导前10 min泵注右美托咪定0.5 μg/kg。记录3组患者麻醉诱导开始时(T0)、手术开始30 min(T1)、60 min(T2)、90 min(T3)、120 min(T4)以及手术结束时(T5)的鼻咽温度;于T0、术后2 h(T6)、24 h(T7)和48 h(T8)时抽取静脉血标本,测定T淋巴细胞亚群(CD3+、CD4+和CD8+)和自然杀伤细胞(NK cell)水平;记录患者术中麻醉药物用量及苏醒期质量指标。结果 与T0比较,C组T2~T5时点鼻咽温度均明显降低(P < 0.05);与C组比较,T组和T-D组T2~T5时点鼻咽温度明显升高(P < 0.05)。与T0时点比较,C组、T组和T-D组T6、T7和T8时点CD3+和NK cell活性均明显降低(P < 0.05);C组在T6、T7和T8时点,T组和T-D组在T6和T7时点,CD4+活性均明显降低(P < 0.05)。与C组比较,T组和T-D组T6和T7时点CD3+细胞活性均明显升高(P < 0.05);T组在T7时点,T-D组在T6和T7时点,CD4+细胞活性均明显升高(P < 0.05);T组在T7时点,T-D组在T6、T7和T8时点,NK cell活性均明显升高(P < 0.05)。结论 采用体温保护措施联合右美托咪定能够维持老年恶性肿瘤患者的体温稳定,减少围手术期意外低体温(IPH)的发生,并有效提高患者苏醒期质量,减轻免疫抑制程度,加速患者早期恢复。 相似文献
5.
Mette Nissen Tiina‐Mari Ikheimo Jukka Huttunen Ville Leinonen Henna‐Kaisa Jyrkknen Mikael von und zu Fraunberg 《Neuromodulation》2021,24(1):102-111
ObjectiveSpinal cord stimulation (SCS) is an effective treatment in failed back surgery syndrome (FBSS). We studied the effect of preimplantation opioid use on SCS outcome and the effect of SCS on opioid use during a two-year follow-up period.Materials and methodsThe study cohort included 211 consecutive FBSS patients who underwent an SCS trial from January 1997 to March 2014. Participants were divided into groups, which were as follows: 1) SCS trial only (n = 47), 2) successful SCS (implanted and in use throughout the two-year follow-up period, n = 131), and 3) unsuccessful SCS (implanted but later explanted or revised due to inadequate pain relief, n = 29). Patients who underwent explantation for other reasons (n = 4) were excluded. Opioid purchase data from January 1995 to March 2016 were retrieved from national registries.ResultsHigher preimplantation opioid doses associated with unsuccessful SCS (ROC: AUC = 0.66, p = 0.009), with 35 morphine milligram equivalents (MME)/day as the optimal cutoff value. All opioids were discontinued in 23% of patients with successful SCS, but in none of the patients with unsuccessful SCS (p = 0.004). Strong opioids were discontinued in 39% of patients with successful SCS, but in none of the patients with unsuccessful SCS (p = 0.04). Mean opioid dose escalated from 18 ± 4 MME/day to 36 ± 6 MME/day with successful SCS and from 22 ± 8 MME/day to 82 ± 21 MME/day with unsuccessful SCS (p < 0.001).ConclusionsHigher preimplantation opioid doses were associated with SCS failure, suggesting the need for opioid tapering before implantation. With continuous SCS therapy and no explantation or revision due to inadequate pain relief, 39% of FBSS patients discontinued strong opioids, and 23% discontinued all opioids. This indicates that SCS should be considered before detrimental dose escalation. 相似文献
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Zongzhang Huang Qigu Yao Jianping Zhu Ying He Yanghao Chen Feng Wu Teng Hua 《Diagnostic and interventional imaging》2021,102(5):279-285
PurposeThe purpose of this study was to make a systematic review and meta-analysis to determine the stent diameter (8 mm vs. 10 mm) that conveys better safety and clinical efficacy for transjugular intrahepatic portosystemic shunt (TIPS).Materials and methodsFour databases were used to identify clinical trials published from inception until March 2020. Data were extracted to estimate and compare one-year and three-year overall survivals, hepatic encephalopathy, variceal rebleeding, and shunt dysfunction rates between patients with 8 mm covered stents and those with 10 mm covered stents.ResultsFive eligible studies were selected, which included 489 patients (316 men, 173 women). The 8 mm covered stent group had higher efficacy regarding one-year or three-year overall survival (odds ratio [OR], 2.88; P = 0.003) and (OR, 1.81; P = 0.04) and lower hepatic encephalopathy (OR, 0.69; P = 0.04) compared with 10 mm covered stent group. There were no significant differences in variceal rebleeding rate (OR 0.80; P = 0.67). However, shunt dysfunction was lower in 10 mm covered stent group (OR, 2.26; P = 0.003).ConclusionsOur results suggest that the use of 8 mm covered stents should be preferred to that of 10 mm covered stents for TIPS placement when portal pressure is frequently monitored. 相似文献
9.
Yuxiang Ma Wenfeng Fang Hongyun Zhao Sai Praneeth Bathena Amol Tendolkar Jennifer Sheng Li Zhang 《The oncologist》2021,26(4):e549-e566
Lessons Learned
- The overall safety profiles of ipilimumab 3 mg/kg and 10 mg/kg administered every 3 weeks, were consistent between Chinese patients with solid tumors in the current study and patients from previous U.S. ipilimumab monotherapy studies. No new safety signals were identified.
- The mean systemic exposures to ipilimumab (assessed by first dose area under the curve during the dosing interval and maximum serum concentration) were numerically lower in the Chinese patient population than in U.S. patients for both 3 mg/kg and 10 mg/kg doses; however, the range of serum concentrations in the Chinese and U.S. populations overlapped (3 mg/kg and 10 mg/kg), suggesting that ipilimumab pharmacokinetics was ethnically insensitive in this study.
10.
Near-infrared diffuse correlation spectroscopy/tomography (DCS/DCT) has recently emerged as a noninvasive measurement/imaging technology for tissue blood flow. In DCT studies, the high-dense collection of light temporal autocorrelation curves (g2(τ)) via fiber array are critical for image reconstruction of blood flow. Previously, the camera-based fiber array limits the field of view (FOV), precluding its applications on large-size human tissues. The line-shape fiber probe based on lens combination, which is predominantly used in current DCT studies, requires rotated-scanning over the surface of target tissue, substantially prolonging the measurement time and increasing the system instability. In this study, we design a noncontact optical probe for DCT based on collimating micro-lens fiber array, termed as FA-nc-DCT system. For each source/detector fiber, a single optical path was collimated by coupling with one micro-lens in the fiber array that is integrated in a square-shape base. Additionally, an 8×8 optical switch is used to share the hardware laser and detectors without spatial scanning. The FA-nc approach for the precise collection of g2(τ) curves was validated through a speed-varied phantom experiment and the human experiments of cuff occlusion, from which the expected value of the blood flow index (BFI) was obtained. Furthermore, the flow anomaly in the phantom and the ischemic muscle in human were accurately reconstructed from the FA-nc-DCT system, which is combined with the imaging framework based on the Nth-order linear algorithm that we recently created. Those outcomes demonstrated the great potential of FA-nc-DCT technology for fast and robust imaging of various diseases such as human breast cancers. 相似文献