Efficacy and safety of herbal medicines for idiopathic Parkinson's disease: a systematic review.

The objective of this study is to assess the efficacy and safety of herbal medicines (HMs), as a monotherapy or adjunct therapy, compared to placebo or conventional approaches in the treatment of idiopathic Parkinson's disease (PD). We conducted a systematic review of randomized controlled trials from both conventional and alternative medicine sources. Outcome measures were overall improvement, quality of life, reduction of levodopa dose, and adverse events. Nine studies were included, each testing a different HM. Six of the trials had limited internal validity due to major flaws in design, including the lack of proper randomization; insufficient blinding; unclear inclusive criteria in terms of diagnostic criteria, baseline staging, and duration of disease; lack of proper sample size calculation; and insufficient data analysis. Imbalances in gender and ethnicity among the patients in the included trials were observed. No major adverse events emerged, and no specific pattern was detected from the trials describing such data. In addition to major methodological defects, heterogeneity in (1) HM tested, (2) control treatment, and (3) outcome measure hindered in-depth data analysis and synthesis. Current evidence is insufficient to evaluate the efficacy and safety of various HMs. Further studies with improved trial design and reporting, with assessment on cost-effectiveness, quality of life, and qualitative data are warranted.     

后囊连续环形撕囊在儿童人工晶体植入术的应用

后发障是儿童白内障最常见的并发症，是导致术后视力下降的主要原因，故降低后发障的发生率对提高术后视力及减少弱视的发生非常重要，以往文献报道大多是术后行ND-YAG激光后囊切开术来治疗后发障。笔者近年对儿童白内障采用白内障摘除人工晶体植入联合后囊连续环形撕囊术预防人工晶体术后后囊混浊，效果肯定，报告如下。     

心脾综合征的多普勒超声心动图诊断

目的:探讨多普勒超声心动图对心脾综合征的诊断价值,分析其心脏伴随畸形漏诊及误诊原因,提高对心脾综合征诊断的准确率。方法:本文总结了221例心脾综合征患儿的超声检测结果,并与其心血管造影或磁共振检查结果进行对照。结果:超声心动图诊断为心脾综合征与心导管或磁共振结论符合者199例(占90.0%),诊断不符合者22例(占10.0%)。结论:多普勒超声心动图可以较准确地诊断心脾综合征,但对其心脏伴随畸形检出的准确率尚待进一步提高。     

Pain levels experienced with activities after cardiac surgery.

BACKGROUND: Acute pain is common after cardiac surgery and can keep patients from participating in activities that prevent postoperative complications. Accurate assessment and understanding of pain are vital for providing satisfactory pain control and optimizing recovery. OBJECTIVES: To describe pain levels for 5 activities expected of patients after cardiac surgery on postoperative days 1 to 6 and changes in pain levels after chest tube removal and extubation. METHODS: Adults who underwent cardiac surgery were asked to rate the pain associated with various types of activities on postoperative days 1 to 6. Pain levels were compared by postoperative day, activity, and type of cardiac surgery. Pain scores before and after chest tube removal and extubation also were analyzed. RESULTS: Pain scores were higher on earlier postoperative days. The order of overall pain scores among activities (P < .01) from highest to lowest was coughing, moving or turning in bed, getting up, deep breathing or using the incentive spirometer, and resting. Changes in pain reported with coughing (P = .03) and deep breathing or using the incentive spirometer (P = .005) differed significantly over time between surgery groups. After chest tubes were discontinued, patients had lower pain levels at rest (P = .01), with coughing (P = .05), and when getting up (P = .03). CONCLUSIONS: Pain relief is an important outcome of care. A comprehensive, individualized assessment of pain that incorporates activity levels is necessary to promote satisfactory management of pain.     

Immunological responses to pneumococcal vaccine in frail older people

Advanced age has been associated with a wide range of defects in both the innate and adaptive immune systems including diminished specific antibody responses that increase the risk of invasive pneumococcal disease (IPD) and limit the effectiveness of vaccines. However, the elderly are a heterogeneous group and measures of overall frailty may be a better indicator of disease susceptibility (or vaccine response) than chronological age alone.     

五白散胶囊治疗慢性消化道溃疡出血15例观察

目的:观察五白散胶囊治疗慢性消化道出血的疗效.方法:治疗组15例用五白散胶囊治疗,对照组15例用维霉素、果胶铋、止血敏治疗.结果:治疗组总有效率100%,对照组总有效率86.6%,两组比较有显著性差异(P<0.05).结论:五白散胶囊治疗消化道溃疡出血止血功效良好.     

小切口股骨近端解剖钢板治疗股骨转子间骨折

目的 探讨股骨转子间骨折的治疗方法和疗效。方法小切口微创股骨近端解剖钢板内固定治疗股骨转子间骨折17例。结果 随访时间8个月～3年，平均1.6年，优良16例，占94%（16/17）。结论 小切口微创股骨近端解剖钢板内固定治疗股骨转子间骨折具有切口小、出血少等优点，是一种微创手术。     

血管紧张素转换酶2与糖尿病肾病

The identification of angiotensin-converting enzyme (ACE)2 opened new recognition of renin-angiotensin system (RAS). ACE2 degrades Ang Ⅱ to Ang (1-7), maintains homeostasis of RAS with ACE. Studies have revealed that ACE2 has important functions in diabetic nephropathy. It may be a target for drug and is used as gene therapy for diabetic nephropathy. Amplifying ACE2 activity may have a potential therapeutic role for diabetic nephropathy.