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[目的] 探究钩藤饮子合小青龙汤辨证治疗咳嗽变异性哮喘(风邪犯肺证)的效果及对外周血白三烯D4(LTD4)、C4(LTC4)及尿白三烯E4(LTE4)水平的影响。[方法] 选取海口市人民医院100例咳嗽变异性哮喘患者为研究对象,按照简单随机法分为对照组和观察组,对照组(50例)给予孟鲁司特钠片和沙美特罗替卡松粉吸入剂治疗,观察组(50例)在对照组基础上加用钩藤饮子合小青龙汤治疗,比较治疗2个月后两组患者的临床疗效、中医症状积分改善情况、肺功能[第1秒用力呼气容积(FEV1)、呼气高峰流速(PEF)、用力肺活量(FVC)]、外周血炎症因子水平[LTD4、LTC4、LTE4、血清嗜酸性粒细胞(EOS)、免疫球蛋白(IgE)]、药物不良反应及治疗结束6个月内预后。[结果] 治疗2个月后,观察组疗效优于对照组(P<0.05);两组中医症状积分降低(P<0.05),且治疗后观察组中医症状积分低于对照组(P<0.05);两组FEV1、PEF、FVC水平升高(P<0.05),外周血LTD4、LTC4、LTE4、血清EOS、IgE水平降低(P<0.05),且治疗后上述指标组间比较差异有统计学意义(P<0.05);治疗期间,两组不良反应发生率比较差异无统计学意义(P>0.05);治疗结束后6个月内随访,对照组有13例复发,复发率26.00%,观察组出现4例复发,复发率8.00%,组间比较差异有统计学意义(P<0.05)。[结论] 钩藤饮子合小青龙汤治疗咳嗽变异性哮喘(风邪犯肺证)临床有效、安全,可改善症状,提高肺功能,抑制炎症因子水平,且复发率较低。 相似文献
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Yu Shi Jiachuan Xiong Yan Chen Junna Deng Hongmei Peng Jinghong Zhao Jing He 《International urology and nephrology》2018,50(2):301-312
Aim
To assess the efficacy of the multidisciplinary care (MDC) model for patients with chronic kidney disease (CKD).Background
The MDC model has been used in clinical practice for years, but the effectiveness of the MDC model for patients with CKD remains controversial.Methods
Embase, PubMed, Medline, the Cochrane Library, and China National Knowledge Infrastructure databases were used to search for relevant articles. Only randomized controlled trials and cohort studies were pooled. Two independent authors assessed all articles and extracted the data. The efficacy was estimated from the odds ratios and corresponding 95% confidence intervals. A random effects model was used according to the heterogeneity.Results
Twenty-one studies including 10,284 participants were analyzed. Compared with the non-MDC group, MDC was associated with a lower risk of all-cause mortality and lower hospitalization rates for patients with CKD. In addition, MDC also resulted in a slower eGFR decline and reduced temporary catheterization for patients receiving dialysis. However, according to the subgroup analysis, the lower rates of all-cause mortality in the MDC group were observed only in patients in stage 4–5 and when the staff of the MDC consisted of nephrologists, nurse specialists and professionals from other fields. The most prominent effect of reducing the hospitalization rates was also observed in patients with stage 4–5 but not in patients with stage 4–5 CKD.Conclusions
MDC can lower the all-cause mortality of patients with CKD, reduce temporary catheterization for patients receiving dialysis, decrease the hospitalization rate, and slow the eGFR decline. Moreover, the reduction in all-cause mortality crucially depends on the professionals comprising the MDC staff and the stage of CKD in patients. In addition, the CKD stage influences the hospitalization rates.5.
封闭负压引流技术结合组织瓣移植治疗胫腓骨严重开放性骨折 总被引:1,自引:0,他引:1
目的探讨封闭负压引流技术结合组织瓣移植,治疗胫腓骨严重开放性骨折的临床疗效。方法自2009年8月至2012年8月,对21例严重胫腓骨开放性骨折,行一期清创,骨折采用外固定架固定,应用封闭负压引流技术结合组织瓣移植治疗。结果术后随访10~36个月,所有患者骨折愈合良好,均无骨髓炎发生,功能恢复满意。结论封闭负压引流技术能改善创面软组织条件,结合组织瓣移植修复,是治疗胫腓骨严重开放性损伤的有效方法。 相似文献
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Wang Fan Zhou Zhuochao Teng Jialin Sun Yue You Yijun Su Yutong Hu Qiongyi Liu Honglei Cheng Xiaobing Shi Hui Yang Chengde Ye Junna 《Clinical rheumatology》2022,41(11):3439-3449
Clinical Rheumatology - Patients with infective endocarditis (IE) may present rheumatic manifestations concurrent with various autoantibodies and thus mimic antineutrophil cytoplasmic antibody... 相似文献
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De Novo Mutations in the Motor Domain of KIF1A Cause Cognitive Impairment,Spastic Paraparesis,Axonal Neuropathy,and Cerebellar Atrophy 下载免费PDF全文
Jae‐Ran Lee Myriam Srour Doyoun Kim Fadi. F. Hamdan So‐Hee Lim Catherine Brunel‐Guitton Jean‐Claude Décarie Elsa Rossignol Grant A. Mitchell Allison Schreiber Rocio Moran Keith Van Haren Randal Richardson Joost Nicolai Karin M.E.J. Oberndorff Justin D. Wagner Kym M. Boycott Elisa Rahikkala Nella Junna Henna Tyynismaa Inge Cuppen Nienke E. Verbeek Connie T.R.M. Stumpel Michel A. Willemsen Sonja A. de Munnik Guy A. Rouleau Eunjoon Kim Erik‐Jan Kamsteeg Tjitske Kleefstra Jacques L. Michaud 《Human mutation》2015,36(1):69-78
KIF1A is a neuron‐specific motor protein that plays important roles in cargo transport along neurites. Recessive mutations in KIF1A were previously described in families with spastic paraparesis or sensory and autonomic neuropathy type‐2. Here, we report 11 heterozygous de novo missense mutations (p.S58L, p.T99M, p.G102D, p.V144F, p.R167C, p.A202P, p.S215R, p.R216P, p.L249Q, p.E253K, and p.R316W) in KIF1A in 14 individuals, including two monozygotic twins. Two mutations (p.T99M and p.E253K) were recurrent, each being found in unrelated cases. All these de novo mutations are located in the motor domain (MD) of KIF1A. Structural modeling revealed that they alter conserved residues that are critical for the structure and function of the MD. Transfection studies suggested that at least five of these mutations affect the transport of the MD along axons. Individuals with de novo mutations in KIF1A display a phenotype characterized by cognitive impairment and variable presence of cerebellar atrophy, spastic paraparesis, optic nerve atrophy, peripheral neuropathy, and epilepsy. Our findings thus indicate that de novo missense mutations in the MD of KIF1A cause a phenotype that overlaps with, while being more severe, than that associated with recessive mutations in the same gene. 相似文献
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Sasha Taleban Nima Toosizadeh Shilpa Junna Todd Golden Sehem Ghazala Rita Wadeea Coco Tirambulo Jane Mohler 《Digestive diseases and sciences》2018,63(12):3272-3280
Background
Colonoscopy is associated with multiple adverse outcomes. With an aging population undergoing colorectal cancer screening, few modalities exist to assess the patient risk prior to colonoscopy. Frailty, the age-related decline in reserve and function across multiple organ systems, predicts poor surgical outcomes, but its role in endoscopy is unclear.Aims
This prospective cohort study assesses the efficacy of frailty in predicting acute colonoscopy outcomes.Methods
Participants aged ≥?50 years undergoing screening colonoscopy at a tertiary care center were recruited over 2 months ending in July 2017. Frailty was assessed using a validated 20-s upper-extremity frailty test, which measures the capacity of muscle performance. Demographic data, American Society of Anesthesiologists (ASA) status, and Charlson comorbidity index (CCI) were evaluated. Procedure-related adverse events and cardiopulmonary changes during and in the immediate post-procedure period were recorded. Adverse events were stratified into minor and major events. Chi-square and ANCOVA models were used in the analysis.Results
Ninety-nine adults (mean age 62.8 years) were enrolled, among which 49 were non-frail and 50 were pre-frail/frail; 50 were female. Overall, 55 participants experienced a total of 87 adverse events. Frailty and ASA status were significantly associated with colonoscopy adverse events (p?=?0.01 and p?=?0.02, respectively). Age and CCI did not predict colonoscopy outcomes.Conclusions
Compared to age and CCI, frailty status better predicts colonoscopy outcomes in older adults. Among adults undergoing colonoscopy, routine frailty screening should be considered for risk stratification. Additional prospective studies evaluating frailty measurements in endoscopy will further clarify its role in forecasting adverse events.9.
Meredith McKean Junna Oba Junsheng Ma Katherine G Roth Wei-Lien Wang Mariana P. Macedo Fernando C.L. Carapeto Lauren E. Haydu Alan E. Siroy Phuong Vo David S. Hong Agda K. Eterovic Keyur Pravinchandra Patel Roland L Bassett Elizabeth A. Grimm Alexander J. Lazar Scott E. Woodman 《The Journal of investigative dermatology》2019,139(3):728-731
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