儿童频繁瞬目征的病因及综合治疗

[目的]探讨儿童频繁瞬目征的发病原因及其治疗措施。[方法]随机抽取148例门诊频繁瞬目征患儿，对其生活习惯、眼部情况进行详细询问并进行病因分析及综合治疗。[结果]通过克服不良生活习惯、去除谤因、调节心理和综合治疗措施，148例频繁瞬目征惠患儿经2周～5周的治疗，115例患儿治愈，28例好转，5例无效。[结论]频繁瞬目征与玩电脑、看电视及偏食有一定关系，针对性综合治疗可获得较满意的疗效。     

Pre-vaccination vulnerability and suspected adverse events following HPV vaccination. A case-control study nested in the Danish national birth cohort

Previous studies have indicated that girls experiencing suspected adverse events (AE) following HPV vaccination were more vulnerable prior to vaccination. However, no study has previously investigated differences in vulnerability using prospectively collected self-reported measures of vulnerability. The objective of this study therefore was to describe the distribution of biological and psychosocial indicators of vulnerability in girls referred to a hospital setting due to suspected adverse events and compare it with a sample of non-referred HPV vaccinated girls.The study was conducted as a case control study based within the Danish National Birth Cohort. Cases were defined as HPV vaccinated girls referred to a hospital setting between 2015 and 2017 due to suspected adverse events (n = 80), and 5 controls were randomly selected from the remaining source population, matched to cases on age at vaccination, region of residence and year of vaccination. The final study population consisted of 480 girls. Prior exposures were based on information gathered from an 11 year follow up of the DNBC and included information on self-rated health, frequent health complaints, medication use, bullying, stressful life events and physical activity. Conditional logistic regression analysis was used to estimate the association between each exposure and referral.The percentage of individuals in the exposed category of each exposure was generally higher for cases than controls. Particularly, the odds of being referred were higher for those with low self-rated health compared to high (OR [95%-CI] 2.43 [1.07–5.5]1), those being bullied (OR 3.19 [1.17–8.73]), and those who had taken medication (OR 2.22 [1.32–3.67]).Overall, these results indicated that girls experiencing suspected AE following HPV vaccination were more vulnerable prior to vaccination.     

基于隐结构模型联合频繁项集的针灸治疗弱精子症不育患者的辨证取穴规律

目的：探讨针灸治疗弱精子症不育患者的辨证取穴规律,为临床治疗弱精子症不育患者提供帮助。方法：检索国家知识基础设施数据库（CNKI）、中国生物医学文献数据库（CBM）、中国学术期刊数据库（CSPD）及中文科技期刊数据库（CCD）等数据库有关针灸治疗弱精子症的相关文献,提取症状、取穴处方信息构建医案数据库,采用隐结构模型、频繁项集的数据挖掘方法,分析针灸治疗弱精子症的辨证取穴规律。结果：纳入文献35篇,涉及症状62种,穴位49个。高频症状包括腰酸、神疲乏力等,高频腧穴包括关元、肾俞等。对症状、腧穴、证型进行频繁项集分析,挖掘出症状-腧穴频繁项集4项,包括耳鸣+头晕+腰酸+关元+肾俞等;证型-症状频繁项集4项,包括肾精亏虚证+健忘+性欲淡漠+神疲乏力+脉细等;证型-症状-腧穴频繁项集4项,包括肾精亏虚证+性欲淡漠+神疲乏力+头发易脱+关元等。结论：针灸治疗弱精子症多以关元、肾俞、足三里为主穴。     

呼出气一氧化氮测定在COPD频繁急性加重表型患者中的临床意义

目的 探讨中央和外周气道呼出气一氧化氮(FeNO)在慢性阻塞性肺病(COPD)频繁急性加重表型患者中的临床意义。方法 收集2019年1月至2021年6月安徽医科大学第四附属医院呼吸与危重症医学科收治的90例COPD患者作为研究对象,在一年内因急性加重次数≥2次的患者纳入频繁急性加重组(n=23),急性加重次数≤1次的患者纳入非频繁急性加重组(n=67)。测定两组中央气道一氧化氮(FeNO₅₀)浓度和外周气道呼出气一氧化氮(FeNO₂₀₀)浓度、肺泡气一氧化氮(CaNO)浓度并收集白细胞计数、血嗜酸粒细胞百分比、血清总免疫球蛋白E(IgE)、慢性阻塞性肺疾病评估测试(CAT)评分及肺功能等相关指标,对进行对比分析。结果 COPD频繁急性加重组FeNO₂₀₀、CaNO、C反应蛋白(CRP)、血清总IgE、CAT评分均高于非频繁急性加重组,第一秒用力呼气容积占预计值百分比(FEV1%)低于非频繁急性加重组(P＜0.05)。在COPD急性加重患者中,FeNO₂₀₀、CaNO与FEV1%呈负相关(r=-0.305、-0.439,P＜0.05),与血清总IgE呈正相关(r=0.523、0.514,P＜0.05),其中CaNO还与CRP呈正相关(r=0.321,P=0.023)。结论 COPD频繁急性加重表型患者中央和外周FeNO浓度存在差异,FeNO₂₀₀、CaNO均可作为COPD患者外周小气道炎症指标。     

基于隐结构模型和频繁项集的针刺治疗慢性前列腺炎辨证取穴规律

目的：探讨针刺治疗慢性前列腺炎的辨证取穴规律,为临床治疗慢性前列腺炎提供帮助。方法：检索国家知识基础设施数据库（CNKI）、中文科技期刊数据库（CCD）等数据库中关于针刺辨证论治慢性前列腺炎的文献,构建包含症状、证型、穴位处方的慢性前列腺炎病历数据库,运用隐结构模型分析、频繁项集等方法,分析针刺治疗慢性前列腺炎的辨证取穴规律。结果：共纳入文献64篇,涉及穴位91个,症状248项。高频穴位如三阴交、中极等;高频症状包括舌体瘀点瘀斑、苔黄腻、滴白、尿急等;构建隐结构模型,得出慢性前列腺炎主要证型有湿热下注、肾阳不足等;挖掘出症状-穴位频繁项集、症状-证型-穴位频繁项集各4项。症状-穴位频繁项集如“尿急+滴白+阳痿+早泄+肾俞+足三里”,症状-证型-穴位频繁项集如“尿频+尿急+苔黄腻+滴白+舌体瘀点瘀斑+湿热瘀阻+三阴交+会阴”,提示治疗时可根据相应症状判定证型及选择对应穴位。结论：针刺治疗慢性前列腺炎多以三阴交、中极、关元等为主要穴位,穴位配伍依据临床情况辨证选穴,此可为临床治疗慢性前列腺炎提供参考。     

全局频繁闭项目集挖掘算法研究

频繁闭项目集挖掘是数据挖掘研究中的一个重要研究课题.目前已有的频繁闭项目集挖掘算法主要针对单机环境,有关分布式环境下的全局频繁闭项目集挖掘算法的研究尚不多见.为此,本文提出了一种快速挖掘全局频繁闭项目集算法,并对其更新问题进行了研究;提出了一种相应的频繁闭项目集增量式更新算法,该算法将充分利用先前的挖掘结果来节省发现新的全局频繁闭项目集的时间开销.实验结果表明算法是有效的.     

Levamisole in steroid-sensitive nephrotic syndrome of childhood: the lost paradise?

Among the different drugs used for sparing steroids in steroid-sensitive nephrotic syndrome (SSNS) with frequent relapses and steroid dependency, levamisole is the least toxic and the least expensive. However, it is neither approved for this indication nor widely used in Europe. This may be explained by the difficulty in obtaining levamisole in some countries and the lack of good quality evidence for its effectiveness. Evidence is limited to three clinical trials that all suffered from methodological limitations. Statistical synthesis of these trials showed that levamisole reduces the risk of a relapse during treatment (relative risk 0.60, 95% confidence interval 0.45–0.79). From the available information, no conclusions can be drawn on the steroid-sparing effect, the long-term efficacy, and safety, as well as possible differences in efficacy in different subgroups of SSNS patients. The confirmation of a favorable effect of levamisole on the reduction of the frequency of relapses and on sparing steroids in an adequately powered, double-blind, placebo-controlled, randomized, multi-center clinical trial will promote consensus on the place of levamisole in the treatment of SSNS of childhood. Follow-up should be at least 1 year to evaluate long-term efficacy and side effects. If the results of such a clinical trial confirm the beneficial effects of levamisole in nephrotic syndrome, this may allow registration for this indication and interest companies other than Jansen-Cilag, which only recently has decided to stop its production.     

Characteristics of frequent attenders in different age and sex groups in primary health care

Objective. To explore depression from a gender perspective, by capturing depressed women's and men's formulations of their experiences and understanding of their situation. Design. Qualitative interview study. Setting. A healthcare centre in northern Sweden. Subjects. Eighteen patients who had been diagnosed with depression and treated for at least 6 months were interviewed in depth, both women and men of different ages and social status. Open questions were posed around the themes of Malterud's key questions, focusing especially on how the informants conveyed their experiences. Interviewing and qualitative data analysis went on simultaneously. Results. The experience of depression held similarities for men and women, but the outward manifestations differed by gender as well as socioeconomic status. Though experiences of high demands underlay the narratives of all informants, home or work had different priority. Men talked more easily about physical distress – often the heart – than about emotions. Women verbalized more readily emotional distress – shame and guilt – while physical symptoms often revolved around the stomach. Men dealt with insecurity by aggrandizing their previous competence, women by self-effacement. Conclusion. As clinicians we must listen attentively not only to the manifest but to the avoided or unarticulated. By doing so we might counteract normative gender patterns that highlight the depression of women and conceal that of men.     

Carto系统与常规方法指导消融频发右室流出道室性早搏的比较

目的通过对应用Carto电解剖标测系统(Carto系统)与常规方法指导射频消融治疗频发右室流出道室性早搏(RVOT-PVCs)的比较,评价其临床应用。方法 68例频发RVOT-PVCs患者,其中Carto组36例,运用Carto系统重建右室流出道三维电解剖图后行电解剖标测靶点并予冷盐水灌注电极进行消融;另32例在X线下常规标测和消融,为常规组。比较两组的手术时间、靶点标测时间、X线曝光时间、总放电次数及有效放电率、消融成功率、并发症和随访复发结果。结果手术时间、即时成功率两组无差别(P0.05)。与常规组相比,Carto组靶点标测时间明显缩短(50.8±10.2minvs71.9±20.9min),X线曝光时间缩短(15.5±3.8minvs27.0±7.1min),总放电次数减少(5.8±1.2次vs9.4±1.8次),有效放电率增高(48.1%±12.2%vs31.5%±7.9%),复发率降低(2.8%vs9.4%),P均0.05。两组均无并发症。结论两种标测方法消融频发RVOT-PVCs均有效,安全。但Carto系统对复杂的多源多形早搏有明显的优势。     

半导体激光照射配合重组人IL-2治疗复发性生殖器疱疹

【目的】研究半导体激光照射骶神经节配合重组人IL-2治疗复发性生殖器疱疹的临床疗效及复发率。【方法】将160例确诊的复发生殖器疱疹患者随机分为2组,每组各80例。对照组仅口服伐昔洛韦。治疗组在此基础上加用半导体激光照射骶神经节配合重组人IL-2。【结果】治疗组痊愈率和总有效率均显著高于对照组（P〈0.01）,而复发率显著低于对照组（P〈0.01）。【结论】在常规抗病毒的基础上,加用半导体激光照射骶神经节配合重组人IL-2治疗复发性生殖器疱疹,具有较好的临床疗效,并能明显降低复发率,值得临床进一步研究探讨。