目的:观察美沙拉秦缓释颗粒剂联合五味苦参肠溶胶囊治疗湿热内蕴型溃疡性结肠炎(ulcerative colitis,UC)的临床疗效及对T淋巴细胞亚群及血清炎症因子的影响。方法:收集2018年06月至2020年06月在我院脾胃科门诊治疗的UC患者120例为研究对象,随机分为A组(40例,口服美沙拉秦缓释颗粒剂),B组(40例,口服五味苦参肠溶胶囊),C组(40例,联合口服美沙拉秦缓释颗粒剂及五味苦参肠溶胶囊,服药剂量及方法同前)。3个组疗程均为4周,分别于治疗前后采用改良Mayo评分评估临床疗效,检测3个组患者治疗前后T淋巴细胞亚群(CD4+、CD8+)、血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)水平及不良反应发生情况。结果:C组临床疗效总有效率为95. 0%(38/40),高于A组的75. 0%(30/40)和B组的70. 0%(28/40)(P <0. 05); A、B、C各组患者治疗后Mayo评分减低(P <0. 05),C组低于A组和B组(P <0. 05); A、B、C各组患者治疗后CD4+高于治疗前(P<0. 05),CD8+低于治疗前(P <0. 05),C组治疗后CD4+水平高于A组和B组(P <0. 05),CD8+水平低于A组和B组(P <0. 05); A、B、C各组患者治疗后血清TNF-α、IL-6、IL-8均低于治疗前(P <0. 05),C组低于A组和B组(P <0. 05); 3个组不良反应发生率比较差异无统计学意义(P> 0. 05)。结论:美沙拉秦缓释颗粒剂联合五味苦参肠溶胶囊可以改善湿热内蕴型UC患者的临床疗效,其机制可能与提升UC患者免疫功能、有下调炎性因子表达有关。?

The teaching of cardiovascular surgery has always been difficult in the surgery teaching. The teaching time was short, but the content was complicated and multifarious. Furthermore, there was no clinical practice of cardiovascular surgery in Capital Medical University and thus the students paid less attention to it. The multimedia and image data are fully used and various teaching methods are combined for students to understand the overall perspective quickly, master the key diseases and remedy the shortcoming of no clinical practice.

雄黄是中医最早使用的矿物药物,也是由我国临床医生最先应用于恶性肿瘤治疗,并取得较好临床疗效的中药。然而,由于雄黄难溶于水、生物利用度低,导致临床使用剂量过大。随着纳米技术的发展,通过各种物理、化学方法制备的纳米雄黄不仅有效提高了雄黄水溶性和生物利用度,而且展示出更强和更广谱的抗肿瘤药效作用。本文对雄黄的传统应用、纳米雄黄的制备及对不同肿瘤细胞的抗肿瘤作用及机制进行文献综述,以利于广大临床科研人员更便捷地了解纳米雄黄来源、制备及抗肿瘤作用的机制等方面研究进展,更好地开发利用纳米雄黄。

This study investigates translation strategies of TCM instructions based on the theory of adaptation, and indicates that English translation of TCM instructions are continuous selections of strategies. Translators are advised to make dynamic adaptation from the perspective of cultural context and linguistic structures to render accurate descriptions of TCM. This study has extended the application of adaptation theory in scientific and technical literatures and contributed to the promotion of Chinese culture and TCM trade.

Objective: To study the effect of applying hydrocolloid dressing joint colostomy products to the protection of surrounding skin in intestinal fistula patients.Methods: 50 cases of patients with intestinal fistula hospitalized in gastrointestinal surgery from January 2014 to October 2016 were selected and randomly divided into experimental group and control group, 25 cases in each group. The experimental group was treated with hydrocolloid dressing joint colostomy products, while the control group was treated with traditional continuous washing plus pressure suction and zinc oxide coating to protect the skin.Results: In terms of objective indicators, the dermatitis incidence and severity of the fistula surrounding skin in experimental group were significantly lower than those in control group (P＜0.05); the average daily dressing change was significantly less than that in control group (P＜0.05). The subjective assessment of indicators in the Nottingham health scale (NHP) in experimental group was superior to that in control group (P＜0.05).Conclusion: Hydrocolloid dressings joint colostomy products can protect fistula surrounding skin, effectively prevent pollution of liquid leakage to abdominal incision and stimulation of liquid leakage to the surrounding skin, accelerate the fistula healing, ease the family economic burden, and at the same time reduce the workload of medical staff, which is worthy of promotion.

Objective: To evaluate the correlative factors of radiation pneumonitis ( RP) induced by radiotherapy for patients with esophageal cancer who were treated with precise radiotherapy.Methods: Clinical data of 110 patients with esophageal cancer who were treated with precise radiotherapy were retrospectively analyzed, with the incidence of radiation pneumonitis observed and correlative factors analyzed.Results: Of the 110 cases, 10 cases got complete remission(CR), accounting for 9.09 %, 66 cases got partial remission (PR), accounting for 60.00 %, 26 cases had no change (NC), accounting for 23.64 %, and 8 cases were in progressive disease ( PD), accounting for 7.27 %. The clinical benefit rate was 69.96 %. Clinical symptoms of RP were found in 22 cases(20 %) of the 110 patients. Single factor analysis showed Karnofsky performance score (KPS), chronic obstructive pulmonary disease(COPD).Conclusion: chemotherapy, the radiation dose for gross tumor volume(GTV), lung V20, mean lung dose (MLD) and target volume of radiation (PTV) were associated with RP.Conclusion: KPS.Conclusion chemotherapy, COPD, lung V20, MLD, PTV, GTV and PTV are main risk factors of RP induced by radiotherapy for patients with esophageal cancer .

Objective: To study the clinical effect of pramipexole hydrochloride combined with benserazide hydrochloride on Parkinson disease.Methods: 160 cases of patients with Parkinson disease treated in the hospital from January 2012 to December 2016 were randomly divided into observation group and control group (n=80). The control group was treated with benserazide hydrochloride. The observation group was treated with pramipexole hydrochloride combined with benserazide hydrochloride. The motor function, the UPDRS score before and after treatment, and the incidence of adverse reactions such as nausea, vomiting, switching, psychiatric symptoms and so on were compared between the two groups.Results: The effective rate in the observation group was 95.00 %, which was significantly higher than that in the control group (83.75 %) (P＜0.05). The UPDRS scores of the two groups significantly decreased (P＜0.05) and the scores in the observation group was significantly lower than those in the control group (P＜0.05). There was no significant difference in the incidence of adverse reactions such as nausea, vomiting, switching phenomenon and psychiatric symptoms in the two groups (P＞0.05).Conclusion: Pramipexole hydrochloride combined with benserazide hydrochloride is safe and effective in the treatment of Parkinson disease, which can significantly improve the motor function of patients. It is worthy of promotion.

目的:评估通过ASPECT评分筛选发病6～24 h急性颅内大血管闭塞的缺血性卒中行血管内治疗的安全性及有效性。方法:本研究回顾性分析2012年1月至2020年10月之间于包头市中心医院神经内科临床诊断为发病24 h内急性颅内大血管闭塞的缺血性卒中并行血管内治疗的患者,详细登记患者基线及血管内治疗相关信息,比较发病6～24 h患者与发病6 h内患者血管内治疗的血管开通、预后以及手术安全性的情况。血管开通成功定义为mTICI分级2b-3级,功能独立的结局定义为mRS评分0-2分,手术安全性指标为术后24 h症状性颅内出血比率,将数据进行相关统计学分析。结果:共有369例患者入组。全部入组患者按发病6 h组及发病6～24 h组经单因素分析均没有差别;在校正了所有单因素分析:90 d功能独立（OR=0.840,95%CI:0.557～1.267;P=0.405）及良好预后（OR=0.968,95%CI:0.623～1.505;P=0.887）仍没有差别,在校正了单因素年龄、性别、NIHSS评分、ASPECT评分后比较两组之间的90 d功能独立（OR=0.696,95%CI:0.439～1.104;P=0.124）及良好预后（OR=0.750,95%CI:0.453～1.241;P=0.264）依然没有差别,在校正了单因素年龄、性别、NIHSS评分,、ASPECT评分、高脂血症、心房颤动、冠心病、进展性卒中、病变部位、存在ICAS、补救支架置入、球囊扩张后比较两组之间90 d功能独立（OR=0.579,95%CI:0.300～1.116;P=0.103）及良好预后（OR=0.965,95%CI:0.482～1.932;P=0.920）没有差别。结论:ASPECT评分用于筛选发病6～24 h的急性颅内大血管闭塞的缺血性脑卒中患者行血管内治疗同样有效,为患者提供及时、安全、可行的治疗。

Objective: To explore the effect of Munro scale and ELPO scale on the risk efficacy of pressure injury in surgical patients. Methods: A case-control study was conducted to select 312 patients who were scheduled to undergo surgery as the research objects.The Munro scale and ELPO scale were used to assess the risk of pressure injury in patients during surgery, and the area under the receiver operating characteristic curve (AUC), ordon index, sensitivity, specificity, positive predictive value and negative predictive value were calculated. Results: A total of 29 patients with pressure injury, with an incidence of 9.29 %.When using the two scales for evaluation, there was a statistical difference in the scale scores between the pressure injury group and the non-pressure injury group (P<0.05).The areas under the ROC curve of Munro and ELPO scales were 0.773 and 0.878, respectively, and the optimal thresholds were 23.5 and 17.5 points,indicating that the scale had the best prediction performance. Conclusion: Both Munro and ELPO scales can assess the risk of pressure injury in surgical patients, but the predictive performance of ELPO scale is higher than that of Munro scale.

目的:探讨急性脑出血后,是否存在脑微出血（cerebral microbleed, CMB）及不同部位CMB患者的临床及影像学特征,以及预后和相关因素。方法:回顾性连续纳入2017年1月至2018年12月在神经内科住院治疗的急性脑出血患者,并完善头部MRI检查（包含SWI序列）。收集患者人口学资料、临床特征和影像学特征等资料,随访发病后3个月时神经功能结局。将影响脑出血预后的因素作为自变量,3个月时不良神经功能结局作为应变量进行Logistic回归分析。结果:总共纳入156例急性脑出血患者。CMB组与无CMB组患者相比,更年老、男性比例更低、入院时空腹血糖更高、血肿体积更大（P<0.05）。根据CMB的位置,分为脑叶CMB组、深部或幕下CMB组和混合型CMB组。三组之间,年龄、糖尿病史、吸烟史、饮酒史、血肿位置存在一定差异。有无CMB及不同部位CMB患者的三个月时不良神经功能结局未见明显统计学差异。发病年龄（OR=1.12; 95%CI为1.06-1.31）、GCS评分（OR=0.34; 95%CI为0.22-0.54）、血肿体积（OR=1.05; 95%CI为1.03-1.09）、发生侧脑室出血（OR=1.21; 95%CI为1.14-1.44）、混合性CMB（OR=1.21; 95%CI为1.09-1.33）等因素与脑出血3个月时不良神经功能独立相关。结论:在急性脑出血后,有无CMB及不同部位CMB患者其临床特征、影像学特征存在一定的差异,但两组的预后无明显差异;混合型CMB患者预后较差并且为脑出血患者预后不良的独立危险因素。

目的:利用生物信息学预测与M1型巨噬细胞参与炎症反应有关的关键基因，以及调控该基因的miRNA。方法:NCBI-GEO数据库筛选人源单核巨噬细胞表达谱，使用GEO2R筛选差异表达基因，通过WebGestalt数据库对上述基因进行GO和KEGG功能富集分析，STRING 11.0数据库构建蛋白质相互作用网络，并应用Cytoscape 3.7.2软件进行可视化分析，采用Cyto Hubba插件最终圈定HUB基因，利用mirWalk数据库和miRcode数据库预测靶向调控HUB基因的miRNA。结果:(1)GEO数据库共筛选出123个高表达差异基因，7个低表达基因；(2)经Cytoscape分析得到前20个最关键的枢纽基因，并圈定与炎症相关的基因STAT1;(3)mirWalk和mirCode数据库预测miRNAs并进行交集分析，得出STAT1受miR-23a靶向调控。结论:miR-23a靶向调控STAT1抑制M1型巨噬细胞参与的炎性反应。

Objective: To discuss the value and advantage of head and neck CT angiography (CTA) examination by spiral CT in the diagnosis of cerebral infarction.Methods: 160 cases of patients with cerebral infarction from February 2015 to February 2017 treated in the hospital were selected as the research objects. All patients were given head and neck CTA examination by spiral CT and the diagnostic effects were recorded.Results: The CBF, TTP, CBV and MTT values in the injured side were (24.38±6.42)mL/(100g·min), (3.58±1.23)mL/100g, (8.11±2.67)s and (23.19±5.99)s respectively, which had significant difference from those in the healthy side (P＜0.05). Carotid plaques were detected in the 160 patients with CTA examination, including 40 cases of soft plaque, 60 cases of mixed plaque, and 60 cases of hard plaque.Conclusion: Head and neck CTA examination by spiral CT in the diagnosis of cerebral infarction has a good application value and can reflect the degree of disease and plaque nature. It is worthy of popularization and application.

目的:搜集国内外公开发表的应用离散选择实验方法（DCE）研究中国人群对基层医疗卫生服务选择偏好的研究,为医疗服务提供者和决策者了解居民对基层医疗服务的偏好提供信息。方法:以"离散选择实验"、"偏好"、"基层医疗卫生服务"、"discrete choice experiment"、"preference"、"primary healthcare services preferences of Chinese"等为关键词,计算机检索从建库至2019年12月在PubMed、Medline、Embase、Web of Science、中国知网、万方、维普数据库公开发表的利用DCE研究中国人群在基层医疗卫生服务选择偏好中的应用的中英文文献,主要对DCE研究中属性及其水平的确定及偏好结果进行梳理。结果:本研究共纳入7篇研究,6篇发文于2019年,研究对象包括疾病人群、一般人群和基层全科医生。基层医疗服务纳入频次较高的属性包括服务类型、自付费用、医生技术水平、距最近就诊机构的时间、服务方式、医疗药品和设备的丰富程度。就诊咨询和等待时间、距就诊机构时间、医疗设备和药品丰富度、距最近医疗机构时间、医生技术水平、供给层次、预期疗效是影响人群对基层医疗服务选择偏好的最重要属性。结论:我国对特殊人群及基层医疗服务提供者偏好研究较少,离散选择实验设计尚需进一步完善,建议关注特殊人群及基层医疗服务提供者偏好研究,同时可借鉴ISPOR报告提出的开展DCE研究的十项标准,以提高设计的严谨性、保证DCE研究结果的可信性。

Objective: To explore the clinical effect of laparoscopic-assisted radical gastrectomy for distal gastric cancer.Methods:Clinical date of the gastric cancer patients who received 1aparoscopy-assisted gastrectomy (LAG) or open gastrectomy (OG) from August 2013 to August 2015 were reviewed and divided into LAG group and OG group.Results: There were no significant differences in the number of lymph node dissection and the distance of tumor margins between LAG group and OG group (P＞0.05); the intraoperative bleeding amount was (167.6 ± 34.5) mL in LAG group, which was less than (215.7 ± 42.1) mL in OG group (t=5.430,P=0.000); the operation time was longer than that in OG group (t= -2.905, P＜0.05); the complication rate was 12.8 % in LAG group and 22.2 % in OG group, which had no statistically significant difference between the two groups (χ²=1.155,P=0.283). The recovery time of gastrointestinal function in LAG group was (57.9 ±7.9) h, which was shorter than that in OG group (63.7 ± 6.5)h (t=3.455, P＜0.05); the average hospitalization time in LAG group was (11.4 ±4.3) d, shorter than that in OG group (15.6 ± 3.9) d (t=4.418, P=0.000). The local recurrence rates were 7.69 % and 8.33 % in LAG group and OG group respectively, and the difference between the two groups was not statistically significant (χ²=0.010, P=0.918); the distant metastasis rates were 5.12 % and 8.33 %, and the difference was not statistically significant (χ²=0.309, P=0.578).Conclusion: LAG has similar effects compared with OG in curing distal gastric cancer, but it has minimal trauma, less blood loss, and faster recovery.

<正>中医药是世界上最古老、独特的医学体系之一,历史悠久。中医药是包括汉族和少数民族医药在内的我国各民族医药的统称,她的发展反映了中华民族对生命、健康和疾病的认知过程,具有独特的理论、技术和方法。当前中医在中国仍是主要医疗方法之一,同时在理论和实践上均得到了发展和完善。尽管地区不同,但传统中医药使用的名称均具有汉语根源,比如阴阳,因此WHO使用传统东方医学来指代包括中医在内的多种在东方施行的传统医学,并使用3 000多种基本术语来构建数据库,?

由于牙齿实际效果和设计移动间存在一定的差异，无托槽隐形矫治技术大部分病例第一序列结束时需要进行精细化调整甚至中期重启。因此，了解隐形矫治技术牙齿移动效率及其影响因素非常重要。本文就无托槽隐形矫治效率影响因素如设计因素(附件、支抗、过矫正、牙齿移动步骤、矫治器步幅、牙齿移动量、初始牙齿角度、矫治器更换频率)、患者年龄及牙周条件、矫治器材料和药物等物理因素等作一综述，为临床选择合适适应证及设计方案提供指导。

Objective: To investigate the clinical effect of unprotected perineum delivery technique.Methods: 200 cases under natural labor were randomly divided into control group and observation group, 100 cases in each group. The control group adopted routine delivery and the observation group received unprotected perineum delivery technique. The perineal incision rate, time of labor, degree of perineal laceration, postpartum hemorrhage rate, neonatal asphyxia rate, postpartum perineal pain, maternal hospitalization time, satisfaction and hospitalization cost were compared between the two groups.Results: There was no significant difference of time of labor in the two groups (P＞0.05). The incidences of perineal laceration, incision and shoulder dystocia in observation group were significantly higher than those in control group (P＜0.05). The perineal intactness rate in observation group was significantly higher than that in control group (P＜0.05). There was no significant difference in the incidence of postpartum hemorrhage and neonatal asphyxia between the two groups (P＞0.05). The maternal satisfaction rate in observation group was significantly higher than that in control group (P＜0.05) and the hospitalization time was shorter than that in control group (P＜0.05). The score of maternal perineal pain on the 3rd day in observation group was significantly lower than that in control group (P＜0.05). There was no significant difference in the hospitalization cost between the two groups (P＞0.05).Conclusion: Unprotected perineum delivery technique can reduce the rates of shoulder dystocia, postpartum hemorrhage and perineum incision, relieve postpartum pain in the perineum, improve the satisfaction of nursing mothers, and shorten the hospitalization time. It is worthy of clinical promotion.

Objective: To explore the application effect of the Mobile Internet & Unified-Diabetes-Care model in the home management of diabetes.Methods: A total of 892 patients with type 2 diabetes who received medical treatment from March 2020 to October 2021 were selected for whole-process management by the Unified-Diabetes-Care team relying on the mobile terminal of the Internet blood glucose management platform.The questionnaire on cognition and behavior of diabetes-related knowledge and the self-management ability survey scale were used for collection and evaluation before and 6 and 12 months after management, respectively.At the same time, the changes of fasting blood glucose, blood glucose 2 hours after meals, glycosylated hemoglobin, blood lipid, urinary albumin/creatinine and other metabolic indexes before and after management were compared.Results: After 6 months and 12 months of management, the cognition and behavior of diabetes-related knowledge were improved compared with that before management, and increased with the extension of management time (P＜0.05).Diet control, regular exercise, medication compliance, blood glucose detection, complication management and scale total score were improved (P＜0.05), and the diet control, regular exercise and complication management were further improved after 12 months compared with 6 months of management (P＜0.05).The up-to-standard rates of blood glucose and blood pressure were significantly increased after management, and further increased with the passage of time (P＜0.05).Fasting blood glucose, 2 hours postprandial blood glucose, glycosylated hemoglobin, blood lipid, urinary albumin/creatinine were significantly decreased after management (P＜0.05), and fasting blood glucose, glycosylated hemoglobin, urinary albumin/creatinine were continuously improved after 12 months of management compared with 6 months of management (P＜0.05).Conclusion: Home management of type 2 diabetes patients through the Mobile Internet & Unified-Diabetes-Care model has continuously enhanced the self-management awareness and management behavior of patients, improved the metabolic indicators such as blood sugar, blood fat, urinary albumin/creatinine, and increased the standard compliance rate.The application of the new management model has greatly improved the level of chronic disease management.