原发性睾丸淋巴瘤(PTL)是一种罕见且具有侵袭性的结外淋巴瘤,可分为原发和继发两类。1) 原发性:以睾丸肿块为原发症状或主要症状,无其他结外器官受累,经病理确诊为DLBCL。2) 继发性:系统性累及睾丸的DLBCL为继发睾丸DLBCL,以原发性常见...原发性睾丸淋巴瘤(PTL)是一种罕见且具有侵袭性的结外淋巴瘤,可分为原发和继发两类。1) 原发性:以睾丸肿块为原发症状或主要症状,无其他结外器官受累,经病理确诊为DLBCL。2) 继发性:系统性累及睾丸的DLBCL为继发睾丸DLBCL,以原发性常见。目前PTl-DLBCL的相关文献报道较少且发病机制未明,推荐的综合治疗方案仍存在较高的结外复发风险。Primary Testicular Lymphoma (PTL) is a rare and invasive extranodal lymphoma, which can be divided into primary and secondary types. 1) Primary: Testicular mass is the primary symptom or the main symptom without other extranodal organ involvement, which is pathologically diagnosed as DLBCL. 2) Secondary: DLBCL with systemic involvement of the testis is secondary testicular DLBCL, which is common in primary. At present, there are few reports on PTl-DLBCL and the pathogenesis is unknown. The recommended comprehensive treatment still has a high risk of extranodal recurrence.展开更多
玫瑰痤疮作为面部损容性皮肤病,面部的持续性红斑、阵发性潮红的体征和症状严重影响患者的日常生活,总体发病率已高达5.1%。针刺疗法种类多样、疗效确切、副作用小,现已有大量文献证明针刺治疗玫瑰痤疮效果较佳。本文通过综述近年来针...玫瑰痤疮作为面部损容性皮肤病,面部的持续性红斑、阵发性潮红的体征和症状严重影响患者的日常生活,总体发病率已高达5.1%。针刺疗法种类多样、疗效确切、副作用小,现已有大量文献证明针刺治疗玫瑰痤疮效果较佳。本文通过综述近年来针刺疗法治疗玫瑰痤疮的临床研究和可能发挥的机制,以期为针刺疗法用于玫瑰痤疮治疗提供一些参考。As a facial disfiguring skin disease, rosacea, with the signs and symptoms of persistent facial erythema and paroxysmal flushing, seriously affects patients’ daily lives. The overall incidence rate has reached as high as 5.1%. There are various types of acupuncture therapies, which have definite curative effects and few side effects. A large body of literature has already proved that acupuncture has a better effect on treating rosacea. This article reviews the clinical research on acupuncture treatment of rosacea and the possible mechanisms in recent years, aiming to provide some references for the use of acupuncture in the treatment of rosacea.展开更多
中医外治法作为中医中药治疗的一大法宝,在皮肤科中的应用范围甚广,疗效显著。古往今来,对中医外治法的研究、革新从未停止过,到了现在医学如此发达的今天,还出现了现代医学与传统中医外治法相结合的外治方法,例如穴位注射法。而瘙痒性...中医外治法作为中医中药治疗的一大法宝,在皮肤科中的应用范围甚广,疗效显著。古往今来,对中医外治法的研究、革新从未停止过,到了现在医学如此发达的今天,还出现了现代医学与传统中医外治法相结合的外治方法,例如穴位注射法。而瘙痒性皮肤病,囊括了大部分皮肤科常见病,瘙痒也是困扰大多数患者的临床症状之一。本文将从中医外治法入手,讲述外治法在瘙痒性皮肤病中的优势。Traditional Chinese medicine external treatment, as one of the great treasures of traditional Chinese medicine treatment, has a wide range of applications in dermatology and has significant therapeutic effects. Research and innovation in traditional Chinese medicine external treatment have never stopped from ancient times to the present day, even in today’s highly developed medical field, there are now external treatment methods combining modern medicine and traditional Chinese medicine external treatment, such as acupoint injection. Pruritic skin diseases, including the most common skin diseases in dermatology, and pruritus is also one of the clinical symptoms that trouble most patients. In this article, we will start with traditional Chinese medicine external treatment and discuss the advantages of external treatment in pruritic skin diseases.展开更多
早发性卵巢功能不全是指女性40岁之前出现的卵巢功能衰退,严重危害女性生育力。随着现代生活方式的转变,该病发病率逐年上升,且有年轻化趋势。益经汤是中医临床常用方剂,古往今来常用于治疗“年未老经水断”,即卵巢早衰。药理学研究表明...早发性卵巢功能不全是指女性40岁之前出现的卵巢功能衰退,严重危害女性生育力。随着现代生活方式的转变,该病发病率逐年上升,且有年轻化趋势。益经汤是中医临床常用方剂,古往今来常用于治疗“年未老经水断”,即卵巢早衰。药理学研究表明,益经汤通过多靶点、多层面抑制卵巢炎症反应,激活卵巢细胞生长代谢,改善实验室指标,能有效缓解临床症状、提高卵巢功能。本文从中医和西医角度分别探讨益经汤的作用机制,总结益经汤治疗早发性卵巢功能不全的研究进展。Premature ovarian insufficiency refers to the decline of ovarian function in women before the age of 40, which seriously endangers female fertility. With the transformation of modern lifestyles, the incidence of this disease has been increasing year by year, and there is a trend of younger onset. Yijing Decoction is a commonly used traditional Chinese medicine formula, which has been used for treating “menstruation cessation before old age”, that is, premature ovarian failure, since ancient times. Pharmacological studies have shown that Yijing Decoction can effectively alleviate clinical symptoms and improve ovarian function by inhibiting ovarian inflammatory responses through multiple targets and multiple levels, activating the growth and metabolism of normal ovarian cells, and improving laboratory indicators. This article discusses the mechanism of action of Yijing Decoction from both traditional Chinese medicine and Western medicine perspectives and summarizes the research progress of Yijing Decoction in the treatment of premature ovarian insufficiency.展开更多
原发性痛经是妇科常见病之一,表现为月经期或月经期前后周期性小腹疼痛或伴有腰骶部疼痛、恶心、呕吐、腹泻等症状,严重者出现晕厥,影响正常的工作及生活状态。目前西医在临床上治疗此病常使用非甾体抗炎药物,此类药物副作用较大,不宜...原发性痛经是妇科常见病之一,表现为月经期或月经期前后周期性小腹疼痛或伴有腰骶部疼痛、恶心、呕吐、腹泻等症状,严重者出现晕厥,影响正常的工作及生活状态。目前西医在临床上治疗此病常使用非甾体抗炎药物,此类药物副作用较大,不宜长期服用,且不能从根本上解决问题。祖国医学治疗原发性痛经方面具有独特的优势,该文结合2则病案,论述针药联合治疗在寒凝血瘀型痛经中的应用,扩展了临床治疗寒凝血瘀型痛经的思路,发挥了针药联合治疗原发性痛经的优势。Primary dysmenorrhea is one of the common gynecological diseases, which is manifested as periodic lower abdominal pain or lumbosacral pain, nausea, vomiting, diarrhea and other symptoms during or around menstruation. In severe cases, syncope occurs, affecting normal work and life status. At present, Western medicine often uses non-steroidal anti-inflammatory drugs in clinical treatment of this disease, such drugs have large side effects, should not be taken for a long time, and can not fundamentally solve the problem. Chinese medicine has unique advantages in the treatment of primary dysmenorrhea. Combining two cases, this paper discusses the application of combination of acupuncture and medicine in the treatment of cold coagulation and blood stasis dysmenorrhea, expands the idea of the clinical treatment of cold coagulation and blood stasis dysmenorrhea, and gives full play to the advantages of combination of acupuncture and medicine in the treatment of primary dysmenorrhea.展开更多
目的:探讨利多卡因联合地塞米松对甲状腺手术患者术后恶心呕吐(Postoperative Nausea and Vomiting, PONV)的影响。方法:选择2023年9月~2024年8月在右江民族医学院附属医院住院并择期行单侧甲状腺次全切除术的女性患者120例,随机分为L ...目的:探讨利多卡因联合地塞米松对甲状腺手术患者术后恶心呕吐(Postoperative Nausea and Vomiting, PONV)的影响。方法:选择2023年9月~2024年8月在右江民族医学院附属医院住院并择期行单侧甲状腺次全切除术的女性患者120例,随机分为L (利多卡因)组、D (地塞米松)组、LD (利多卡因联合地塞米松)组和N (生理盐水)组四组,每组30例。对比四组术后T1 (0~2 h)、T2 (2~6 h)、T3 (6~12 h)、T4 (12~24 h)时间段PONV发生情况和术后24 h内PONV的级别;患者一般情况、麻醉时间、手术时间和输液量;术后2 h、6 h、12 h和24 h的静息VAS疼痛评分;入室时(t0)、气管插管时(t1)及拔除气管导管时(t2)的平均动脉压(MAP)和心率(HR);术中阿片类药物用量、术后首次排气时间、术后24 h氟比洛芬酯(凯纷)补救镇痛和补救止吐胃复安的例数及患者总体满意率;围术期发生的不良反应。结果:四组患者在年龄、BMI、麻醉时间和输液量等一般资料比较上,无统计学差异(P > 0.05);与其他三组相比,LD组术后24 h内的恶心和呕吐程度最低(P 0.05);在T1、T2、T3和T4各时间段,与其他三组相比,LD组恶心发生率明显降低(P 1、T2和T3各时间段,与L组和D组相比,LD组呕吐发生率明显降低(P 0.05);与其他三组相比,LD组术后2 h、6 h、12 h和24 h VAS评分最低(P 0.05);组间比较:t0时刻,四组患者MAP和HR之间的差异无统计学意义(P > 0.05);在t1、t2时刻,与其他三组相比,LD组的MAP和HR显著低(P 0.05);组内比较:与t0时刻比,N组在t1和t2时刻的MAP、HR明显增高(P 1和t2时刻的MAP、HR与t0时刻之间的差异无统计学意义(P > 0.05);舒芬太尼用量在各组之间的差异无统计学意义(P > 0.05),与其他三组相比,LD组的瑞芬太尼用量最少、术后首次排气时间缩短、补救镇痛和止吐的例数最少及总体满意率最高(P 0.05),L组和D组的瑞芬太尼用量和术后各指标之间的差异无统计学意义(P > 0.05);各组不良反应发生率之间的差异无统计学意义(P > 0.05)。结论:1) 利多卡因联合地塞米松能显著降低甲状腺手术患者PONV的发生率。2) 利多卡因联合地塞米松能增强术后镇痛效果,增加血流动力学的稳定性,减少补救镇痛和止吐药物的使用,促进术后康复。Objective: To investigate the effects of lidocaine combined with dexamethasone on postoperative nausea and vomiting (PONV) in patients undergoing thyroid surgery. Methods: A total of 120 female patients hospitalized in the Affiliated Hospital of Youjiang Medical University for Nationalities from September 2023 to August 2024 who underwent unilateral subtotal thyroidectomy were selected and randomly divided into four groups: L (lidocaine) group, D (dexamethasone) group, LD (lidocaine combined with dexamethasone) group and N (normal saline) group, with 30 cases in each group. We compared the occurrence of PONV at T1 (0~2 h), T2 (2~6 h), T3 (6~12 h), and T4 (12~24 h) and the grade of PONV within 24 h after surgery among the four groups;patient’s general condition, anesthesia time, operation time and infusion volume;resting VAS pain scores at 2 h, 6 h, 12 h and 24 h after surgery;Mean Arterial Pressure (MAP) and Heart Rate (HR) at entry (t0), tracheal intubation (t1), and tracheal catheter removal (t2);intraoperative opioid dosage, the first postoperative exhaust time, the number of cases of flurbiprofen axetil (Kefon) for analgesia and metoclopramide for emetic relief 24 h after surgery, and the overall satisfaction rate of patients;adverse reactions occurred during perioperative period. Results: There were no significant differences in age, BMI, anesthesia time and infusion volume among the four groups (P > 0.05). Compared with the other three groups, LD group had the lowest degree of nausea and vomiting within 24 h after surgery (P 0.05). In each time period of T1, T2, T3 and T4, the incidence of nausea in LD group was significantly decreased compared with the other three groups (P 1, T2 and T3 time periods, the incidence of vomiting in LD group was significantly lower than that in L and D groups (P 0.05). Compared with the other three groups, the LD group had the lowest VAS scores at 2 h, 6 h, 12 h and 24 h after surgery (P 0.05). Inter-group comparison: at t0, there was no significant difference in MAP and HR among the four groups (P > 0.05). At t1 and t2, compared with the other three groups, MAP and HR in LD group were significantly lower (P 0.05). Intra-group comparison: Compared with t0 moment, MAP and HR in group N were significantly increased at t1 and t2 moments (P 0 in L, D and LD groups at t1 and t2 (P > 0.05). There was no statistically significant difference in the dosage of sufentanil among all groups (P > 0.05). Compared with the other three groups, the dosage of remifentanil in LD group was the least, the first postoperative exhaust time was shortened, the number of cases of relief analgesia and antiemetics was the least, and the overall satisfaction rate was the highest (P 0.05). There was no statistically significant difference between the dosage of remifentanil and postoperative indexes in groups L and D (P > 0.05). There was no significant difference in the incidence of adverse reactions among all groups (P > 0.05). Conclusion: 1) Lidocaine combined with dexamethasone can significantly reduce the incidence of PONV in patients undergoing thyroid surgery. 2) Lidocaine combined with dexamethasone can enhance postoperative analgesia, increase hemodynamic stability, reduce the use of remedial analgesia and antiemetic drugs, and promote postoperative rehabilitation.展开更多
糖尿病肾病(Diabetic Kidney Disease, DKD)随着糖尿病患者数量的增加,其发病率逐年上升。近些年来,中药灌肠在治疗DKD的症状及减少蛋白尿、保护肾功能、预后改善等方面发挥着重要作用,且具有较好的安全性和可行性。故而通过文献检索,...糖尿病肾病(Diabetic Kidney Disease, DKD)随着糖尿病患者数量的增加,其发病率逐年上升。近些年来,中药灌肠在治疗DKD的症状及减少蛋白尿、保护肾功能、预后改善等方面发挥着重要作用,且具有较好的安全性和可行性。故而通过文献检索,本文从经方、经验方、辨证选方用药、中药灌肠联合中医外治法治疗DKD等方面的治疗进展,进而说明中药灌肠在治疗DKD方面取得的确切临床疗效,以及中药灌肠治疗DKD的临床推广价值。Diabetic Kidney Disease (DKD) has been increasing in incidence with the increasing number of diabetes patients. In recent years, Traditional Chinese Medicine Enema (TCME) has played an important role in alleviating symptoms, reducing proteinuria, protecting kidney function, and improving prognosis of DKD, and it has good safety and feasibility. Therefore, by conducting a literature search, this paper explores the progress of TCME treatment for DKD, including classical prescriptions, experience prescriptions, prescriptions selected according to syndrome differentiation, and TCME combined with traditional Chinese medicine external treatment, to further illustrate the definite clinical efficacy of TCME in treating DKD and the clinical promotion value of TCME in treating DKD.展开更多
哮喘异质性强,随着对哮喘机制与治疗手段的认识要求提高,现有的哮喘诊断体系亟需随之更新。生物标志物是可以反映生理、病理机制与治疗效果的指标,理想的生物标志物应具有敏感性、特异性,能够提供阳性和阴性预测值,同时测量简单且具有...哮喘异质性强,随着对哮喘机制与治疗手段的认识要求提高,现有的哮喘诊断体系亟需随之更新。生物标志物是可以反映生理、病理机制与治疗效果的指标,理想的生物标志物应具有敏感性、特异性,能够提供阳性和阴性预测值,同时测量简单且具有成本效益。目前已有许多着眼于哮喘生物标志物的研究,但尚未获得更多经过验证可供于投入临床的生物标志物。本文就典型与新兴哮喘诊断相关生物标志物的研究进展进行综述。Asthma is highly heterogeneous, and as the understanding of asthma mechanisms and therapeutic means increases, there is an urgent need to update the existing asthma diagnostic system accordingly. Biomarkers are indicators of physiologic and pathologic mechanisms and therapeutic efficacy. Ideally, biomarkers should be sensitive, specific, providing positive and negative predictive values, and be simple and cost-effective to measure. There have been many studies focusing on asthma biomarkers, but more validated biomarkers are not yet available. This article provides a review of the progress of research on typical and emerging biomarkers relevant to asthma diagnosis.展开更多
目的:采用两样本孟德尔随机化分析法,探讨EPAS1与2型糖尿病(T2DM)的因果关联,以期为T2DM的防治提供新思路。方法:利用全基因组关联研究(GWAS)的数据,将EPAS1作为暴露因素,以T2DM为结局变量,进行孟德尔随机化分析。本研究以逆方差加权(I...目的:采用两样本孟德尔随机化分析法,探讨EPAS1与2型糖尿病(T2DM)的因果关联,以期为T2DM的防治提供新思路。方法:利用全基因组关联研究(GWAS)的数据,将EPAS1作为暴露因素,以T2DM为结局变量,进行孟德尔随机化分析。本研究以逆方差加权(IVW)法作为主要的MR分析手段,将单核苷酸多态性(SNP)的因果效应估计进行汇总合并,同时结合MR-Egger回归、加权中位数、加权模式作为补充方法分析二者之间的潜在因果关联。利用Cochran’s Q检验、MR-Egger回归截距、留一法进行敏感性分析。结果:IVW分析结果显示,EPAS1与T2DM之间存在显著的正向因果关联(OR: 1.055, 95% CI: 1.044~1.067, P = 6.96e−22)。敏感性分析显示不存在多效性,但异质性显著,结果相对可靠。结论:EPAS1与T2DM之间存在显著的正向因果关联,但需进行进一步验证。Aim: To explore the cause-and-effect relationship between EPAS1 and Type 2 Diabetes Mellitus (T2DM), a two-sample Mendelian randomization analysis was used to provide new ideas for the prevention and treatment of T2DM. Method: Using data from the Genome-Wide Association Study (GWAS), mendelian randomization analysis was performed with EPAS1 as an exposure factor and T2DM as an outcome variable. In this paper, Inverse Variance Weighting (IVW) was used as the primary analysis method to pool and combine the causal effect estimates of Single Nucleotide Polymorphisms (SNPs), and MR-Egger regression, weighted median, and weighted model were used as supplementary methods to analyze the potential causal association between the two. Cochran’s Q test, MR-Egger regression intercept, and leave-one-out method were used for sensitivity analysis. Results: IVW analysis showed that EPAS1 and T2DM had a significant positive causal relationship (OR: 1.055, 95% CI: 1.044~1.067, P = 6.96e–22). Sensitivity analysis showed no pleiotropy but significant heterogeneity, and the results were relatively reliable. Conclusion: EPAS1 and T2DM have a significant positive causal relationship, but further verification is needed.展开更多
阿尔茨海默病(Alzheimer’s Disease, AD)是老年人群中最常见的痴呆类型,其特点是认知功能下降、记忆力下降、严重者出现语言障碍,最终丧失独立生活能力,给患者和社会带来了沉重的负担。其潜在病理改变在症状出现前的几十年就已经存在,...阿尔茨海默病(Alzheimer’s Disease, AD)是老年人群中最常见的痴呆类型,其特点是认知功能下降、记忆力下降、严重者出现语言障碍,最终丧失独立生活能力,给患者和社会带来了沉重的负担。其潜在病理改变在症状出现前的几十年就已经存在,因此AD的早诊断、早干预对于高风险人群具有重要意义,能够大幅度提高患者预后并有效改善生活质量。本文将回顾当前AD在生物标记物方面的相关前沿文章,通过综述其研究进展寻找潜在标记物,为AD的早期诊断提供帮助。Alzheimer’s Disease (AD) is the most common type of dementia among the elderly, characterized by cognitive decline, memory impairment, and, in severe cases, language disorders, ultimately leading to the loss of independent living abilities. This condition imposes a substantial burden on both patients and society. The underlying pathological changes of AD may exist for decades before the onset of clinical symptoms. Therefore, early diagnosis and intervention are of significant importance for high-risk populations, as they can substantially improve patient prognosis and quality of life. This paper will review the current cutting-edge articles related to AD in terms of biomarkers, search for potential markers for early diagnosis of AD by summarizing their research progress, and provide insights into the early diagnosis of Alzheimer’s disease.展开更多
嗜酸性肉芽肿性血管炎(EGPA)是一种罕见的多系统性小血管炎,膜性肾病(MN)是导致肾病综合征的常见病因,其特点是肾小球基底膜出现免疫复合物沉积。尽管EGPA合并MN的病例较为罕见,但其潜在的病理机制可能涉及免疫系统的异常激活和自身免...嗜酸性肉芽肿性血管炎(EGPA)是一种罕见的多系统性小血管炎,膜性肾病(MN)是导致肾病综合征的常见病因,其特点是肾小球基底膜出现免疫复合物沉积。尽管EGPA合并MN的病例较为罕见,但其潜在的病理机制可能涉及免疫系统的异常激活和自身免疫反应。本文报道1例嗜酸性肉芽肿性血管炎合并膜性肾病典型病例,总结其诊治要点,并复习相关文献。Eosinophilic Granulomatosis with Polyangiitis (EGPA) is a rare multi-systemic small-vessel vasculitis. Membranous Nephropathy (MN) is a common cause of nephrotic syndrome, characterized by immune complex deposition in the glomerular basement membrane. Although cases of EGPA combined with MN are rare, the underlying pathological mechanism may involve abnormal activation of the immune system and autoimmune reactions. This article reports a typical case of EGPA combined with MN, summarizes the key points of diagnosis and treatment and reviews relevant literature.展开更多
目的:从文献年度发表量、核心作者、研究内容分析国内遗尿症的研究现状、热点及未来发展趋势,为后续相关研究提供参考。方法:从中国知网数据库中检索与遗尿有关的文献,时间为建库~检索日(2022年10月3日),并用Zotero软件查重、筛选后将...目的:从文献年度发表量、核心作者、研究内容分析国内遗尿症的研究现状、热点及未来发展趋势,为后续相关研究提供参考。方法:从中国知网数据库中检索与遗尿有关的文献,时间为建库~检索日(2022年10月3日),并用Zotero软件查重、筛选后将所得数据导入CiteSpace和VOSviewer软件进行可视化分析。结果:共纳入文献2177篇,文献发表量整体呈上升趋势;根据普赖斯定律,以4篇发文量为界限,国内儿童遗尿症领域核心作者共80名;共形成14个关键词聚类,聚类方向涉及研究方法、干预措施及伴随症;目前国内的研究热点主要与临床干预措施有关,中医外治联合药物治疗、中药现代化、医案经验循证化可能成为未来研究趋势。结论:我国遗尿症研究总体呈上升趋势,目前仍保持着积极稳定的发展状态,未来遗尿研究可关注药物治疗联合中医外治、传统医学的现代化发展以及多团队、多学科合作创新。Objective: To analyze the current status, hot spots and future development trend of domestic research on enuresis (Nocturnal Enuresis, NE) from the annual publication volume, core authors and research content of literature, and provide a reference for subsequent related research. Methods: The literature related to enuresis was retrieved from the China Knowledge Network database from the date of library construction to the date of retrieval (October 3, 2022), and the data obtained were checked and screened by Zotero and then imported into CiteSpace and VOSviewer for visual analysis. Results: A total of 2177 publications were included, and the overall trend of literature publication was on the rise. According to Price Law, there are 80 core authors in the field of childhood enuresis in China, using the volume of 4 publications as the threshold;a total of 14 keyword clusters were formed, and the clustering directions involved research methods, interventions and concomitant disorders;current domestic research hotspots are mainly related to clinical interventions, external Chinese medicine combined with pharmacological treatment, modernization of Chinese medicine, and medical case experience evidence-based may become the future research trend. Conclusion: Research on enuresis in China is generally on the rise and is still actively and steadily developing. Future research on enuresis can focus on pharmacological treatment combined with external Chinese medicine, modernization and development of traditional medicine, and multi-team and multidisciplinary cooperation and innovation.展开更多
胰腺炎是经内镜逆行胰胆管造影术(ERCP)术后最常见的并发症,在ERCP发展的几十年中一直有着较高的发病率,严重影响患者的术后恢复。本文综述了术后胰腺炎的发病机制、危险因素以及用于预防及术后胰腺炎的各种药物和手术方法,以改善内窥...胰腺炎是经内镜逆行胰胆管造影术(ERCP)术后最常见的并发症,在ERCP发展的几十年中一直有着较高的发病率,严重影响患者的术后恢复。本文综述了术后胰腺炎的发病机制、危险因素以及用于预防及术后胰腺炎的各种药物和手术方法,以改善内窥镜逆行胰胆管造影术后患者的预后。Pancreatitis is the most common complication after Endoscopic Retrograde Cholangiopancreatography (ERCP). It has a high incidence rate in the decades of ERCP development, which seriously affects the postoperative recovery of patients. This article reviews the pathogenesis, risk factors, and various drugs and surgical methods used for the prevention and treatment of postoperative pancreatitis, to improve the prognosis of patients after endoscopic retrograde cholangiopancreatography.展开更多
脱肛为临床常见病和多发病证,各年龄阶段的人群皆可患病。中医关于脱肛的研究由来已久,在病因和治疗的探讨上颇有特色。考究古代名家诸书,总结诸医治疗经验,认为脱肛之因不独脾虚下陷,更与肺、肝、肾三脏之气不足,湿热下注,气机阻滞,血...脱肛为临床常见病和多发病证,各年龄阶段的人群皆可患病。中医关于脱肛的研究由来已久,在病因和治疗的探讨上颇有特色。考究古代名家诸书,总结诸医治疗经验,认为脱肛之因不独脾虚下陷,更与肺、肝、肾三脏之气不足,湿热下注,气机阻滞,血虚、血热有密切联系。本文基于诸代名家对脱肛的阐述,在分析脱肛病因病机的同时,探讨了脱肛的中医治法,以期臻善其理。Anal prolapse is a common and frequently occurring clinical disease, which can be found in people of all ages. The research of anal prolapse in traditional Chinese medicine has a long history, which has its own characteristics in etiology and treatment. After studying the ancient famous books and summarizing the treatment experience of various doctors, it is considered that the cause of anal prolapse is not only spleen deficiency and depression, but also closely related to the deficiency of Qi in the lung, liver and kidney, the downpour of damp heat, Qi block, blood deficiency and blood heat. Based on the elaboration of famous experts in various dynasties on prolapse of anus, this paper analyzes the etiology and pathogenesis of prolapse of anus and discusses the traditional Chinese medicine treatment of prolapse of anus, in order to improve its theory.展开更多
表里双解法是解表与清里同施,适用于表里同病。陈明岭教授在临床实践中,秉持整体观念和辨证论治的原则,强调外损皮肤,亦关脏腑,认为寻常型银屑病虽为外在皮肤疾病,但其根源在于内在脏腑失调,治疗此病需内外兼顾,不可仅局限于外部治疗。...表里双解法是解表与清里同施,适用于表里同病。陈明岭教授在临床实践中,秉持整体观念和辨证论治的原则,强调外损皮肤,亦关脏腑,认为寻常型银屑病虽为外在皮肤疾病,但其根源在于内在脏腑失调,治疗此病需内外兼顾,不可仅局限于外部治疗。在诊断湿热证寻常型银屑病时,陈教授会综合考虑患者皮损、地域、生活习惯等特点,常用外解表邪、内清湿热之麻黄连翘赤小豆汤使阴阳调和,疾病得愈。The dual solution of exterior and interior is releasing the exterior and consolidating the interior simultaneously. It is indicated for both superficial syndrome and interior syndrome. Prof. Mingling Chen’s clinical treatment of diseases is based on holistic concept and syndrome differentiation-based treatment. He emphasizes that external damage to the skin is also related to the internal organs. He believes that psoriasis vulgaris, although manifested on the exterior, is rooted in the interior and that treating this disease requires both external and internal treatments and should not be confined to external treatments only. He focuses on the characteristics of the patient’s skin lesions, geography, and lifestyle habits when diagnosing psoriasis vulgaris with damp-heat syndrome. He often uses the dual solution of exterior and interior of Modified Mahuang Lianqiao Chixiaodou Decoction to harmonize yin and yang, the disease is cured.展开更多
目的:探讨Th17细胞、血清白细胞介素-17 (IL-17)、基质金属蛋白酶(MMP2)在评估胃癌(GC)淋巴结转移中的临床应用价值。方法:选取2023年1月~2024年10月入住于天津市武清中医院的36例胃癌患者(GC组)及38例胃良性病变患者(对照组),采用流式...目的:探讨Th17细胞、血清白细胞介素-17 (IL-17)、基质金属蛋白酶(MMP2)在评估胃癌(GC)淋巴结转移中的临床应用价值。方法:选取2023年1月~2024年10月入住于天津市武清中医院的36例胃癌患者(GC组)及38例胃良性病变患者(对照组),采用流式细胞术检测各组外周血Th17细胞水平,采用酶联免疫吸附法(ELISA)测定血清中IL-17和MMP2水平,评估这三个检测指标在GC淋巴结转移中的应用价值及三者联合检测的诊断效能。结果:与对照组对比,GC组患者外周血Th17细胞水平明显增高,血清IL-17和MMP2水平也明显较高,差异均有统计学意义(均p Objective: To explore the clinical application value of Th17 cells, serum Interleukin-17 (IL-17), and Matrix Metalloproteinases (MMP2) in assessing the lymph node metastasis of Gastric Cancer (GC). Methods: 36 GC patients (GC group) and 38 patients with benign gastric lesions (control group) admitted to Tianjin Wuqing Hospital of Traditional Chinese Medicine from January 2023 to October 2024 were selected. Flow cytometry was used to detect peripheral blood Th17 cell amount in each group, and Enzyme-Linked Immunosorbent Assay (ELISA) was used to measure IL-17 and MMP2 levels in the serum. The application value of these three detection indicators in the lymph node metastasis of GC, as well as the diagnostic efficacy of their combined detection, were evaluated. Results: Compared with control group, patients in the GC group showed a significant increase in Th17 cell levels in peripheral blood and prominently higher serum IL-17 and MMP2 levels, with statistical significance (all p < 0.05). In the GC group, the amount of Th17 cells, serum IL-17, and MMP-2 was significantly higher in patients with lymph node metastasis compared to those without metastasis, and the differences were statistically significant (all p < 0.05). The accuracy, specificity, and sensitivity of the combined detection of Th17, IL-17, and MMP2 were 95.82%, 94.21% and 97.69%, respectively. Compared with single detection, they were significantly higher, and the differences were statistically significant (all p < 0.05). Conclusion: Th17 cells, IL-17, and MMP2 are associated with lymph node metastasis in GC, and their combined detection can help in the differential diagnosis of GC.展开更多
偏头痛是一种常见的慢性神经血管性疾病,其主要特点是反复发作的头痛,疼痛可以局限于单侧或双侧,通常伴随有恶心、呕吐以及对光线的敏感等症状。通窍活血汤是中医经典的方剂,主要用于活血化瘀,尤其在疏通经络和止痛方面表现突出,同时也...偏头痛是一种常见的慢性神经血管性疾病,其主要特点是反复发作的头痛,疼痛可以局限于单侧或双侧,通常伴随有恶心、呕吐以及对光线的敏感等症状。通窍活血汤是中医经典的方剂,主要用于活血化瘀,尤其在疏通经络和止痛方面表现突出,同时也具有调和阴阳的作用。为全面了解通窍活血汤在偏头痛治疗中的研究进展,笔者检索了知网、万方和维普等数据库中关于该方剂的中英文文献,从中医理论、药理学及临床应用等多个角度进行归纳分析。Migraine is a common chronic neurovascular disease, which is mainly characterised by recurrent headaches. Pain can be confined to unilateral or bilateral, usually accompanied by nausea, vomiting and sensitivity to light. Tongqiao Huoxue Decoction is a classic formula in Chinese medicine, which is mainly used for activating blood circulation and removing blood stasis, especially in clearing the meridians and relieving pain. And also has the effect of harmonising yin and yang. In order to comprehensively understand the research progress of Tongqiao Huoxue Decoction in the treatment of migraine, the author searched the Chinese and English literature on this formula in the databases of CNKI, Wanfang Data, and VIP, summarised and analysed it from the perspectives of Chinese medicine theory, pharmacology and clinical application.展开更多
文摘原发性睾丸淋巴瘤(PTL)是一种罕见且具有侵袭性的结外淋巴瘤,可分为原发和继发两类。1) 原发性:以睾丸肿块为原发症状或主要症状,无其他结外器官受累,经病理确诊为DLBCL。2) 继发性:系统性累及睾丸的DLBCL为继发睾丸DLBCL,以原发性常见。目前PTl-DLBCL的相关文献报道较少且发病机制未明,推荐的综合治疗方案仍存在较高的结外复发风险。Primary Testicular Lymphoma (PTL) is a rare and invasive extranodal lymphoma, which can be divided into primary and secondary types. 1) Primary: Testicular mass is the primary symptom or the main symptom without other extranodal organ involvement, which is pathologically diagnosed as DLBCL. 2) Secondary: DLBCL with systemic involvement of the testis is secondary testicular DLBCL, which is common in primary. At present, there are few reports on PTl-DLBCL and the pathogenesis is unknown. The recommended comprehensive treatment still has a high risk of extranodal recurrence.
文摘玫瑰痤疮作为面部损容性皮肤病,面部的持续性红斑、阵发性潮红的体征和症状严重影响患者的日常生活,总体发病率已高达5.1%。针刺疗法种类多样、疗效确切、副作用小,现已有大量文献证明针刺治疗玫瑰痤疮效果较佳。本文通过综述近年来针刺疗法治疗玫瑰痤疮的临床研究和可能发挥的机制,以期为针刺疗法用于玫瑰痤疮治疗提供一些参考。As a facial disfiguring skin disease, rosacea, with the signs and symptoms of persistent facial erythema and paroxysmal flushing, seriously affects patients’ daily lives. The overall incidence rate has reached as high as 5.1%. There are various types of acupuncture therapies, which have definite curative effects and few side effects. A large body of literature has already proved that acupuncture has a better effect on treating rosacea. This article reviews the clinical research on acupuncture treatment of rosacea and the possible mechanisms in recent years, aiming to provide some references for the use of acupuncture in the treatment of rosacea.
文摘中医外治法作为中医中药治疗的一大法宝,在皮肤科中的应用范围甚广,疗效显著。古往今来,对中医外治法的研究、革新从未停止过,到了现在医学如此发达的今天,还出现了现代医学与传统中医外治法相结合的外治方法,例如穴位注射法。而瘙痒性皮肤病,囊括了大部分皮肤科常见病,瘙痒也是困扰大多数患者的临床症状之一。本文将从中医外治法入手,讲述外治法在瘙痒性皮肤病中的优势。Traditional Chinese medicine external treatment, as one of the great treasures of traditional Chinese medicine treatment, has a wide range of applications in dermatology and has significant therapeutic effects. Research and innovation in traditional Chinese medicine external treatment have never stopped from ancient times to the present day, even in today’s highly developed medical field, there are now external treatment methods combining modern medicine and traditional Chinese medicine external treatment, such as acupoint injection. Pruritic skin diseases, including the most common skin diseases in dermatology, and pruritus is also one of the clinical symptoms that trouble most patients. In this article, we will start with traditional Chinese medicine external treatment and discuss the advantages of external treatment in pruritic skin diseases.
文摘早发性卵巢功能不全是指女性40岁之前出现的卵巢功能衰退,严重危害女性生育力。随着现代生活方式的转变,该病发病率逐年上升,且有年轻化趋势。益经汤是中医临床常用方剂,古往今来常用于治疗“年未老经水断”,即卵巢早衰。药理学研究表明,益经汤通过多靶点、多层面抑制卵巢炎症反应,激活卵巢细胞生长代谢,改善实验室指标,能有效缓解临床症状、提高卵巢功能。本文从中医和西医角度分别探讨益经汤的作用机制,总结益经汤治疗早发性卵巢功能不全的研究进展。Premature ovarian insufficiency refers to the decline of ovarian function in women before the age of 40, which seriously endangers female fertility. With the transformation of modern lifestyles, the incidence of this disease has been increasing year by year, and there is a trend of younger onset. Yijing Decoction is a commonly used traditional Chinese medicine formula, which has been used for treating “menstruation cessation before old age”, that is, premature ovarian failure, since ancient times. Pharmacological studies have shown that Yijing Decoction can effectively alleviate clinical symptoms and improve ovarian function by inhibiting ovarian inflammatory responses through multiple targets and multiple levels, activating the growth and metabolism of normal ovarian cells, and improving laboratory indicators. This article discusses the mechanism of action of Yijing Decoction from both traditional Chinese medicine and Western medicine perspectives and summarizes the research progress of Yijing Decoction in the treatment of premature ovarian insufficiency.
文摘原发性痛经是妇科常见病之一,表现为月经期或月经期前后周期性小腹疼痛或伴有腰骶部疼痛、恶心、呕吐、腹泻等症状,严重者出现晕厥,影响正常的工作及生活状态。目前西医在临床上治疗此病常使用非甾体抗炎药物,此类药物副作用较大,不宜长期服用,且不能从根本上解决问题。祖国医学治疗原发性痛经方面具有独特的优势,该文结合2则病案,论述针药联合治疗在寒凝血瘀型痛经中的应用,扩展了临床治疗寒凝血瘀型痛经的思路,发挥了针药联合治疗原发性痛经的优势。Primary dysmenorrhea is one of the common gynecological diseases, which is manifested as periodic lower abdominal pain or lumbosacral pain, nausea, vomiting, diarrhea and other symptoms during or around menstruation. In severe cases, syncope occurs, affecting normal work and life status. At present, Western medicine often uses non-steroidal anti-inflammatory drugs in clinical treatment of this disease, such drugs have large side effects, should not be taken for a long time, and can not fundamentally solve the problem. Chinese medicine has unique advantages in the treatment of primary dysmenorrhea. Combining two cases, this paper discusses the application of combination of acupuncture and medicine in the treatment of cold coagulation and blood stasis dysmenorrhea, expands the idea of the clinical treatment of cold coagulation and blood stasis dysmenorrhea, and gives full play to the advantages of combination of acupuncture and medicine in the treatment of primary dysmenorrhea.
文摘目的:探讨利多卡因联合地塞米松对甲状腺手术患者术后恶心呕吐(Postoperative Nausea and Vomiting, PONV)的影响。方法:选择2023年9月~2024年8月在右江民族医学院附属医院住院并择期行单侧甲状腺次全切除术的女性患者120例,随机分为L (利多卡因)组、D (地塞米松)组、LD (利多卡因联合地塞米松)组和N (生理盐水)组四组,每组30例。对比四组术后T1 (0~2 h)、T2 (2~6 h)、T3 (6~12 h)、T4 (12~24 h)时间段PONV发生情况和术后24 h内PONV的级别;患者一般情况、麻醉时间、手术时间和输液量;术后2 h、6 h、12 h和24 h的静息VAS疼痛评分;入室时(t0)、气管插管时(t1)及拔除气管导管时(t2)的平均动脉压(MAP)和心率(HR);术中阿片类药物用量、术后首次排气时间、术后24 h氟比洛芬酯(凯纷)补救镇痛和补救止吐胃复安的例数及患者总体满意率;围术期发生的不良反应。结果:四组患者在年龄、BMI、麻醉时间和输液量等一般资料比较上,无统计学差异(P > 0.05);与其他三组相比,LD组术后24 h内的恶心和呕吐程度最低(P 0.05);在T1、T2、T3和T4各时间段,与其他三组相比,LD组恶心发生率明显降低(P 1、T2和T3各时间段,与L组和D组相比,LD组呕吐发生率明显降低(P 0.05);与其他三组相比,LD组术后2 h、6 h、12 h和24 h VAS评分最低(P 0.05);组间比较:t0时刻,四组患者MAP和HR之间的差异无统计学意义(P > 0.05);在t1、t2时刻,与其他三组相比,LD组的MAP和HR显著低(P 0.05);组内比较:与t0时刻比,N组在t1和t2时刻的MAP、HR明显增高(P 1和t2时刻的MAP、HR与t0时刻之间的差异无统计学意义(P > 0.05);舒芬太尼用量在各组之间的差异无统计学意义(P > 0.05),与其他三组相比,LD组的瑞芬太尼用量最少、术后首次排气时间缩短、补救镇痛和止吐的例数最少及总体满意率最高(P 0.05),L组和D组的瑞芬太尼用量和术后各指标之间的差异无统计学意义(P > 0.05);各组不良反应发生率之间的差异无统计学意义(P > 0.05)。结论:1) 利多卡因联合地塞米松能显著降低甲状腺手术患者PONV的发生率。2) 利多卡因联合地塞米松能增强术后镇痛效果,增加血流动力学的稳定性,减少补救镇痛和止吐药物的使用,促进术后康复。Objective: To investigate the effects of lidocaine combined with dexamethasone on postoperative nausea and vomiting (PONV) in patients undergoing thyroid surgery. Methods: A total of 120 female patients hospitalized in the Affiliated Hospital of Youjiang Medical University for Nationalities from September 2023 to August 2024 who underwent unilateral subtotal thyroidectomy were selected and randomly divided into four groups: L (lidocaine) group, D (dexamethasone) group, LD (lidocaine combined with dexamethasone) group and N (normal saline) group, with 30 cases in each group. We compared the occurrence of PONV at T1 (0~2 h), T2 (2~6 h), T3 (6~12 h), and T4 (12~24 h) and the grade of PONV within 24 h after surgery among the four groups;patient’s general condition, anesthesia time, operation time and infusion volume;resting VAS pain scores at 2 h, 6 h, 12 h and 24 h after surgery;Mean Arterial Pressure (MAP) and Heart Rate (HR) at entry (t0), tracheal intubation (t1), and tracheal catheter removal (t2);intraoperative opioid dosage, the first postoperative exhaust time, the number of cases of flurbiprofen axetil (Kefon) for analgesia and metoclopramide for emetic relief 24 h after surgery, and the overall satisfaction rate of patients;adverse reactions occurred during perioperative period. Results: There were no significant differences in age, BMI, anesthesia time and infusion volume among the four groups (P > 0.05). Compared with the other three groups, LD group had the lowest degree of nausea and vomiting within 24 h after surgery (P 0.05). In each time period of T1, T2, T3 and T4, the incidence of nausea in LD group was significantly decreased compared with the other three groups (P 1, T2 and T3 time periods, the incidence of vomiting in LD group was significantly lower than that in L and D groups (P 0.05). Compared with the other three groups, the LD group had the lowest VAS scores at 2 h, 6 h, 12 h and 24 h after surgery (P 0.05). Inter-group comparison: at t0, there was no significant difference in MAP and HR among the four groups (P > 0.05). At t1 and t2, compared with the other three groups, MAP and HR in LD group were significantly lower (P 0.05). Intra-group comparison: Compared with t0 moment, MAP and HR in group N were significantly increased at t1 and t2 moments (P 0 in L, D and LD groups at t1 and t2 (P > 0.05). There was no statistically significant difference in the dosage of sufentanil among all groups (P > 0.05). Compared with the other three groups, the dosage of remifentanil in LD group was the least, the first postoperative exhaust time was shortened, the number of cases of relief analgesia and antiemetics was the least, and the overall satisfaction rate was the highest (P 0.05). There was no statistically significant difference between the dosage of remifentanil and postoperative indexes in groups L and D (P > 0.05). There was no significant difference in the incidence of adverse reactions among all groups (P > 0.05). Conclusion: 1) Lidocaine combined with dexamethasone can significantly reduce the incidence of PONV in patients undergoing thyroid surgery. 2) Lidocaine combined with dexamethasone can enhance postoperative analgesia, increase hemodynamic stability, reduce the use of remedial analgesia and antiemetic drugs, and promote postoperative rehabilitation.
文摘糖尿病肾病(Diabetic Kidney Disease, DKD)随着糖尿病患者数量的增加,其发病率逐年上升。近些年来,中药灌肠在治疗DKD的症状及减少蛋白尿、保护肾功能、预后改善等方面发挥着重要作用,且具有较好的安全性和可行性。故而通过文献检索,本文从经方、经验方、辨证选方用药、中药灌肠联合中医外治法治疗DKD等方面的治疗进展,进而说明中药灌肠在治疗DKD方面取得的确切临床疗效,以及中药灌肠治疗DKD的临床推广价值。Diabetic Kidney Disease (DKD) has been increasing in incidence with the increasing number of diabetes patients. In recent years, Traditional Chinese Medicine Enema (TCME) has played an important role in alleviating symptoms, reducing proteinuria, protecting kidney function, and improving prognosis of DKD, and it has good safety and feasibility. Therefore, by conducting a literature search, this paper explores the progress of TCME treatment for DKD, including classical prescriptions, experience prescriptions, prescriptions selected according to syndrome differentiation, and TCME combined with traditional Chinese medicine external treatment, to further illustrate the definite clinical efficacy of TCME in treating DKD and the clinical promotion value of TCME in treating DKD.
文摘哮喘异质性强,随着对哮喘机制与治疗手段的认识要求提高,现有的哮喘诊断体系亟需随之更新。生物标志物是可以反映生理、病理机制与治疗效果的指标,理想的生物标志物应具有敏感性、特异性,能够提供阳性和阴性预测值,同时测量简单且具有成本效益。目前已有许多着眼于哮喘生物标志物的研究,但尚未获得更多经过验证可供于投入临床的生物标志物。本文就典型与新兴哮喘诊断相关生物标志物的研究进展进行综述。Asthma is highly heterogeneous, and as the understanding of asthma mechanisms and therapeutic means increases, there is an urgent need to update the existing asthma diagnostic system accordingly. Biomarkers are indicators of physiologic and pathologic mechanisms and therapeutic efficacy. Ideally, biomarkers should be sensitive, specific, providing positive and negative predictive values, and be simple and cost-effective to measure. There have been many studies focusing on asthma biomarkers, but more validated biomarkers are not yet available. This article provides a review of the progress of research on typical and emerging biomarkers relevant to asthma diagnosis.
文摘目的:采用两样本孟德尔随机化分析法,探讨EPAS1与2型糖尿病(T2DM)的因果关联,以期为T2DM的防治提供新思路。方法:利用全基因组关联研究(GWAS)的数据,将EPAS1作为暴露因素,以T2DM为结局变量,进行孟德尔随机化分析。本研究以逆方差加权(IVW)法作为主要的MR分析手段,将单核苷酸多态性(SNP)的因果效应估计进行汇总合并,同时结合MR-Egger回归、加权中位数、加权模式作为补充方法分析二者之间的潜在因果关联。利用Cochran’s Q检验、MR-Egger回归截距、留一法进行敏感性分析。结果:IVW分析结果显示,EPAS1与T2DM之间存在显著的正向因果关联(OR: 1.055, 95% CI: 1.044~1.067, P = 6.96e−22)。敏感性分析显示不存在多效性,但异质性显著,结果相对可靠。结论:EPAS1与T2DM之间存在显著的正向因果关联,但需进行进一步验证。Aim: To explore the cause-and-effect relationship between EPAS1 and Type 2 Diabetes Mellitus (T2DM), a two-sample Mendelian randomization analysis was used to provide new ideas for the prevention and treatment of T2DM. Method: Using data from the Genome-Wide Association Study (GWAS), mendelian randomization analysis was performed with EPAS1 as an exposure factor and T2DM as an outcome variable. In this paper, Inverse Variance Weighting (IVW) was used as the primary analysis method to pool and combine the causal effect estimates of Single Nucleotide Polymorphisms (SNPs), and MR-Egger regression, weighted median, and weighted model were used as supplementary methods to analyze the potential causal association between the two. Cochran’s Q test, MR-Egger regression intercept, and leave-one-out method were used for sensitivity analysis. Results: IVW analysis showed that EPAS1 and T2DM had a significant positive causal relationship (OR: 1.055, 95% CI: 1.044~1.067, P = 6.96e–22). Sensitivity analysis showed no pleiotropy but significant heterogeneity, and the results were relatively reliable. Conclusion: EPAS1 and T2DM have a significant positive causal relationship, but further verification is needed.
文摘阿尔茨海默病(Alzheimer’s Disease, AD)是老年人群中最常见的痴呆类型,其特点是认知功能下降、记忆力下降、严重者出现语言障碍,最终丧失独立生活能力,给患者和社会带来了沉重的负担。其潜在病理改变在症状出现前的几十年就已经存在,因此AD的早诊断、早干预对于高风险人群具有重要意义,能够大幅度提高患者预后并有效改善生活质量。本文将回顾当前AD在生物标记物方面的相关前沿文章,通过综述其研究进展寻找潜在标记物,为AD的早期诊断提供帮助。Alzheimer’s Disease (AD) is the most common type of dementia among the elderly, characterized by cognitive decline, memory impairment, and, in severe cases, language disorders, ultimately leading to the loss of independent living abilities. This condition imposes a substantial burden on both patients and society. The underlying pathological changes of AD may exist for decades before the onset of clinical symptoms. Therefore, early diagnosis and intervention are of significant importance for high-risk populations, as they can substantially improve patient prognosis and quality of life. This paper will review the current cutting-edge articles related to AD in terms of biomarkers, search for potential markers for early diagnosis of AD by summarizing their research progress, and provide insights into the early diagnosis of Alzheimer’s disease.
文摘嗜酸性肉芽肿性血管炎(EGPA)是一种罕见的多系统性小血管炎,膜性肾病(MN)是导致肾病综合征的常见病因,其特点是肾小球基底膜出现免疫复合物沉积。尽管EGPA合并MN的病例较为罕见,但其潜在的病理机制可能涉及免疫系统的异常激活和自身免疫反应。本文报道1例嗜酸性肉芽肿性血管炎合并膜性肾病典型病例,总结其诊治要点,并复习相关文献。Eosinophilic Granulomatosis with Polyangiitis (EGPA) is a rare multi-systemic small-vessel vasculitis. Membranous Nephropathy (MN) is a common cause of nephrotic syndrome, characterized by immune complex deposition in the glomerular basement membrane. Although cases of EGPA combined with MN are rare, the underlying pathological mechanism may involve abnormal activation of the immune system and autoimmune reactions. This article reports a typical case of EGPA combined with MN, summarizes the key points of diagnosis and treatment and reviews relevant literature.
文摘目的:从文献年度发表量、核心作者、研究内容分析国内遗尿症的研究现状、热点及未来发展趋势,为后续相关研究提供参考。方法:从中国知网数据库中检索与遗尿有关的文献,时间为建库~检索日(2022年10月3日),并用Zotero软件查重、筛选后将所得数据导入CiteSpace和VOSviewer软件进行可视化分析。结果:共纳入文献2177篇,文献发表量整体呈上升趋势;根据普赖斯定律,以4篇发文量为界限,国内儿童遗尿症领域核心作者共80名;共形成14个关键词聚类,聚类方向涉及研究方法、干预措施及伴随症;目前国内的研究热点主要与临床干预措施有关,中医外治联合药物治疗、中药现代化、医案经验循证化可能成为未来研究趋势。结论:我国遗尿症研究总体呈上升趋势,目前仍保持着积极稳定的发展状态,未来遗尿研究可关注药物治疗联合中医外治、传统医学的现代化发展以及多团队、多学科合作创新。Objective: To analyze the current status, hot spots and future development trend of domestic research on enuresis (Nocturnal Enuresis, NE) from the annual publication volume, core authors and research content of literature, and provide a reference for subsequent related research. Methods: The literature related to enuresis was retrieved from the China Knowledge Network database from the date of library construction to the date of retrieval (October 3, 2022), and the data obtained were checked and screened by Zotero and then imported into CiteSpace and VOSviewer for visual analysis. Results: A total of 2177 publications were included, and the overall trend of literature publication was on the rise. According to Price Law, there are 80 core authors in the field of childhood enuresis in China, using the volume of 4 publications as the threshold;a total of 14 keyword clusters were formed, and the clustering directions involved research methods, interventions and concomitant disorders;current domestic research hotspots are mainly related to clinical interventions, external Chinese medicine combined with pharmacological treatment, modernization of Chinese medicine, and medical case experience evidence-based may become the future research trend. Conclusion: Research on enuresis in China is generally on the rise and is still actively and steadily developing. Future research on enuresis can focus on pharmacological treatment combined with external Chinese medicine, modernization and development of traditional medicine, and multi-team and multidisciplinary cooperation and innovation.
文摘胰腺炎是经内镜逆行胰胆管造影术(ERCP)术后最常见的并发症,在ERCP发展的几十年中一直有着较高的发病率,严重影响患者的术后恢复。本文综述了术后胰腺炎的发病机制、危险因素以及用于预防及术后胰腺炎的各种药物和手术方法,以改善内窥镜逆行胰胆管造影术后患者的预后。Pancreatitis is the most common complication after Endoscopic Retrograde Cholangiopancreatography (ERCP). It has a high incidence rate in the decades of ERCP development, which seriously affects the postoperative recovery of patients. This article reviews the pathogenesis, risk factors, and various drugs and surgical methods used for the prevention and treatment of postoperative pancreatitis, to improve the prognosis of patients after endoscopic retrograde cholangiopancreatography.
文摘脱肛为临床常见病和多发病证,各年龄阶段的人群皆可患病。中医关于脱肛的研究由来已久,在病因和治疗的探讨上颇有特色。考究古代名家诸书,总结诸医治疗经验,认为脱肛之因不独脾虚下陷,更与肺、肝、肾三脏之气不足,湿热下注,气机阻滞,血虚、血热有密切联系。本文基于诸代名家对脱肛的阐述,在分析脱肛病因病机的同时,探讨了脱肛的中医治法,以期臻善其理。Anal prolapse is a common and frequently occurring clinical disease, which can be found in people of all ages. The research of anal prolapse in traditional Chinese medicine has a long history, which has its own characteristics in etiology and treatment. After studying the ancient famous books and summarizing the treatment experience of various doctors, it is considered that the cause of anal prolapse is not only spleen deficiency and depression, but also closely related to the deficiency of Qi in the lung, liver and kidney, the downpour of damp heat, Qi block, blood deficiency and blood heat. Based on the elaboration of famous experts in various dynasties on prolapse of anus, this paper analyzes the etiology and pathogenesis of prolapse of anus and discusses the traditional Chinese medicine treatment of prolapse of anus, in order to improve its theory.
文摘表里双解法是解表与清里同施,适用于表里同病。陈明岭教授在临床实践中,秉持整体观念和辨证论治的原则,强调外损皮肤,亦关脏腑,认为寻常型银屑病虽为外在皮肤疾病,但其根源在于内在脏腑失调,治疗此病需内外兼顾,不可仅局限于外部治疗。在诊断湿热证寻常型银屑病时,陈教授会综合考虑患者皮损、地域、生活习惯等特点,常用外解表邪、内清湿热之麻黄连翘赤小豆汤使阴阳调和,疾病得愈。The dual solution of exterior and interior is releasing the exterior and consolidating the interior simultaneously. It is indicated for both superficial syndrome and interior syndrome. Prof. Mingling Chen’s clinical treatment of diseases is based on holistic concept and syndrome differentiation-based treatment. He emphasizes that external damage to the skin is also related to the internal organs. He believes that psoriasis vulgaris, although manifested on the exterior, is rooted in the interior and that treating this disease requires both external and internal treatments and should not be confined to external treatments only. He focuses on the characteristics of the patient’s skin lesions, geography, and lifestyle habits when diagnosing psoriasis vulgaris with damp-heat syndrome. He often uses the dual solution of exterior and interior of Modified Mahuang Lianqiao Chixiaodou Decoction to harmonize yin and yang, the disease is cured.
文摘目的:探讨Th17细胞、血清白细胞介素-17 (IL-17)、基质金属蛋白酶(MMP2)在评估胃癌(GC)淋巴结转移中的临床应用价值。方法:选取2023年1月~2024年10月入住于天津市武清中医院的36例胃癌患者(GC组)及38例胃良性病变患者(对照组),采用流式细胞术检测各组外周血Th17细胞水平,采用酶联免疫吸附法(ELISA)测定血清中IL-17和MMP2水平,评估这三个检测指标在GC淋巴结转移中的应用价值及三者联合检测的诊断效能。结果:与对照组对比,GC组患者外周血Th17细胞水平明显增高,血清IL-17和MMP2水平也明显较高,差异均有统计学意义(均p Objective: To explore the clinical application value of Th17 cells, serum Interleukin-17 (IL-17), and Matrix Metalloproteinases (MMP2) in assessing the lymph node metastasis of Gastric Cancer (GC). Methods: 36 GC patients (GC group) and 38 patients with benign gastric lesions (control group) admitted to Tianjin Wuqing Hospital of Traditional Chinese Medicine from January 2023 to October 2024 were selected. Flow cytometry was used to detect peripheral blood Th17 cell amount in each group, and Enzyme-Linked Immunosorbent Assay (ELISA) was used to measure IL-17 and MMP2 levels in the serum. The application value of these three detection indicators in the lymph node metastasis of GC, as well as the diagnostic efficacy of their combined detection, were evaluated. Results: Compared with control group, patients in the GC group showed a significant increase in Th17 cell levels in peripheral blood and prominently higher serum IL-17 and MMP2 levels, with statistical significance (all p < 0.05). In the GC group, the amount of Th17 cells, serum IL-17, and MMP-2 was significantly higher in patients with lymph node metastasis compared to those without metastasis, and the differences were statistically significant (all p < 0.05). The accuracy, specificity, and sensitivity of the combined detection of Th17, IL-17, and MMP2 were 95.82%, 94.21% and 97.69%, respectively. Compared with single detection, they were significantly higher, and the differences were statistically significant (all p < 0.05). Conclusion: Th17 cells, IL-17, and MMP2 are associated with lymph node metastasis in GC, and their combined detection can help in the differential diagnosis of GC.
文摘偏头痛是一种常见的慢性神经血管性疾病,其主要特点是反复发作的头痛,疼痛可以局限于单侧或双侧,通常伴随有恶心、呕吐以及对光线的敏感等症状。通窍活血汤是中医经典的方剂,主要用于活血化瘀,尤其在疏通经络和止痛方面表现突出,同时也具有调和阴阳的作用。为全面了解通窍活血汤在偏头痛治疗中的研究进展,笔者检索了知网、万方和维普等数据库中关于该方剂的中英文文献,从中医理论、药理学及临床应用等多个角度进行归纳分析。Migraine is a common chronic neurovascular disease, which is mainly characterised by recurrent headaches. Pain can be confined to unilateral or bilateral, usually accompanied by nausea, vomiting and sensitivity to light. Tongqiao Huoxue Decoction is a classic formula in Chinese medicine, which is mainly used for activating blood circulation and removing blood stasis, especially in clearing the meridians and relieving pain. And also has the effect of harmonising yin and yang. In order to comprehensively understand the research progress of Tongqiao Huoxue Decoction in the treatment of migraine, the author searched the Chinese and English literature on this formula in the databases of CNKI, Wanfang Data, and VIP, summarised and analysed it from the perspectives of Chinese medicine theory, pharmacology and clinical application.
