基于四季六气探讨天津市过敏性鼻炎滞后发病与气象因素相关性的研究

目的:从四季六气角度分析过敏性鼻炎滞后发病与气象因素的相关性,为防治过敏性鼻炎提供一定的依据。方法:收集天津市2006至2013年过敏性鼻炎病例及气象资料,通过Nonparametric Correlations分析筛选与过敏性鼻炎四季六气滞后发病相关的气象因素。结果:过敏性鼻炎滞后1月2月发病与秋季平均气压、四季平均风力呈负相关,与秋季最低气温、平均气温,夏季平均气温、平均降水量呈正相关;六气滞后1月发病与三之气平均气温、平均降水量呈正相关;与六气平均风力均呈负相关。四季滞后2月发病与全年平均风力、夏季平均气压、秋季平均相对湿度呈负相关;与夏季最低气温、最高气温、平均气温、平均降水量呈正相关;六气滞后2月发病与初之气、二之气、四之气、五之气、六之气平均风力呈负相关;与三之气平均降水量、六之气日照时数及日照百分数均呈正相关。结论:天津市过敏性鼻炎滞后发病时间主要集中在7～11月,以8、9月高发,与平均风力呈负相关。

冠心病痰瘀互结证SAQ与生化指标相关研究

目的:旨在对冠心病稳定型心绞痛痰瘀互结证和气阴两虚证患者不同时点的SAQ和生化指标进行相关性分析并探究二者的相关性。方法:采用多中心、小样本、精细化的研究方法记录冠心病患者SAQ积分,并检测脂质代谢、炎症介质、金属蛋白酶、同型半胱氨酸等7类28项指标,检测时点为0、8、12周,对SAQ进行聚类分析并与生化指标进行相关性分析。结果:聚类与主成分分析得出,痰瘀互结证以躯体活动受限程度、脂质代谢和炎症介质指标为主要参考标准,气阴两虚证以治疗满意程度和疾病认知程度、炎症介质和凝血功能指标为主要参考标准。结论:SAQ与生化指标的联合应用,对于临床冠心病痰瘀互结证和气阴两虚证的判定具有一定的指导作用。

《中医健康状态精辨识问卷》实施效果评价

目的:基于中医精辨识理论,编制《中医健康状态精辨识问卷》,并对其实施效果进行评价。方法:通过专家调查法进一步精简和完善前期研究得出的中医健康状态精辨识条目,结合专家意见形成辨识问卷,并在1 564名健康体检人群中开展应用,评价问卷的可行性、信度、效度。结果:经过两轮专家咨询形成的精辨识问卷共包含14个条目。效果评价显示,问卷可行性高,Cronbach’sα为0.776。验证性因子分析显示,GFI为0.945,RMSEA为0.068。结论:《中医健康状态精辨识问卷》具有较满意的信度和效度,可进一步推广应用,为中医临床健康辨识提供参考依据。

银屑病患者的复发情况及影响因素分析

目的:探讨银屑病复发的影响因素。方法:选取2018年11月—2020年5月在长春中医药大学附属第三临床医院进行治疗的银屑病患者347例,统计患者在随访期间银屑病的复发情况,探讨影响银屑病治疗后复发的危险因素。结果:本次研究纳入病例347例,完成1年随访的患者有338例,而在随访期间有153例银屑病患者出现复发情况,复发率高达45.27%。经单因素分析,银屑病复发与银屑病家族史、饮酒史、精神状态异常、感染、环境潮湿、不规范用药等有关。经多因素logistic回归分析显示,银屑病家族史、饮酒史、精神状态异常、感染、环境潮湿、不规范用药为银屑病复发的独立危险因素。结论:银屑病患者在治疗后有较高的复发率,患者的复发主要受到银屑病家族史、饮酒史、精神状态异常、感染、环境潮湿、不规范用药等危险因素的影响。

The Efficacy of Escitalopram Combined with Olanzapine in Depression:A Systematic Review and Meta-analysis

Background:Depression will become the second most common disease after coronary heart disease(CHD).Escitalopram and olanzapine are commonly used to treat depression.Some studies indicated that escitalopram combined with olanzapine is effective in treating depression,however,there is no evidence to support these results.Our objective was to study the efficacy of escitalopram combined with olanzapine on depression by conducting a systematic review and meta analysis,and to provide reference for doctors.Methods:Relevant evidence were searched from PubMed,SinoMed,the Cochrane Library,Web of Science,Embase,China Knowledge Resource Integrated(CNKI),Wanfang Data Knowledge Service Platform databases(WANFANG)and VIP dating from inception to July 2020.The randomized controlled trials(RCTs)of escitalopram and olanzapine for the treatment of depression was obtained.According to inclusion and exclusion criteria,two researches(Sun Wu and Wang Zhe)independently screened the literature,extracted data,and evaluated the quality of included studies.Rev Man 5.3 software was used to conduct statistical analyze.Results:A total of 39 studies involving 3,267 patients were identified.These studies were finally included into the meta-analysis.Pooled results showed that there was a significant difference in efficiency(RR=1.18,95%CI:1.14 to 1.12,P<0.00001),HAMD(MD=-4.54,95%CI:-5.09 to-3.99,P<0.00001),and HAMA(MD=-3.94,95%CI:-5.57 to-2.12,P<0.0001).There was no significant difference in adverse reactions(MD=0.07,95%CI-0.03 to 0.17,P=0.19).Heterogeneity test showed that due to the high heterogeneity of HAMD(P<0.00001,12=86%)and HAMA(P<0.00001,I2=91%),after removing the items with high heterogeneity,there were also statistically significant in HAMD(MD=-5.22,95%CI:-5.53 to-4.91,P<0.00001)and HAMA(MD=-5.46,95%CI:-6.15 to-4.77,P<0.00001).Conclusion:Based on this study,the combination of escitalopram and olanzapine was more effective in treating depression than the control group.It is suggested that clinical and scientific researchers carry out more high-quality,large-sample,multi-center RCTs to provide more evidence-based medical evidence for the future study of escitalopram combined with olanzapine in the treatment of depression.

营养与食品安全知识调查研究的可视化分析

目的 使用文献计量学方法对近33年营养与食品安全知识调查研究的文献进行可视化分析,梳理总结该领域研究现状、热点方向及发展趋势。方法 以中国知网文献数据库为数据源,以主题“营养知识”OR“食品卫生知识”OR“食品安全知识”AND“调查”为主题检索词,时间设定为1990年1月1日—2022年5月31日。借助CiteSpace可视化分析软件对领域内文献的发文量、研究机构、核心作者以及关键词分布进行分析。结果 共纳入2 280篇文献,年发文量逐步增多,2007年后平均年发文量超过100篇;发文量最高的是高校[四川大学(30篇)],政府机构是中国疾病预防控制中心(15篇),研究者是曾果(13篇);该领域重点关注营养、食品安全、知识、态度、行为、饮食行为、健康教育、kap、食品从业人员等方面;研究前沿围绕知识、态度、行为调查、食品相关人群、干预措施3个方面。结论 作者之间、机构之间存在合作但联系并不紧密,各个调查研究之间无法实现有效链接。可视化分析可清晰了解营养与食品安全知识水平调查研究领域内热点与前沿,但研究者还需结合时代变化继续深入研究,以更好促使大众形成良好认知和生活方式。

冠心病稳定型心绞痛痰瘀互结证中医证候量表与生化指标相关性

目的:对严格筛选冠心病稳定型心绞痛痰瘀互结证患者的中医证候量表和生化指标进行分析,探究中医证候与临床生化指标之间的相关性。方法:本试验采用了多中心、小样本、精细化的研究方法收集38例冠心病稳定型心绞痛痰瘀互结证患者,对患者0、8、12周中医证候以及各时点的生化指标进行相关性分析。结果:①冠心病痰瘀互结证因子分析结果:第0周主成分一以脂代谢相关指标为主,主成分二、三、四以炎性因子为主,主成分五以凝血功能为主,主成分六到十以临床症状和部分炎性因子为主。经过治疗后,第8周及第12周中医证候逐渐以血瘀和炎性因子为主,痰浊症状及脂代谢相关指标逐渐减少。②冠心病痰瘀互结证聚类结果:第0周聚为10类,其中第一、二类以炎性因子为主,第三、四类以脂代谢相关为主,第五类以凝血功能为主,第六至十类以中医证候为主。结论:冠心病痰瘀互结证主要症状以舌质紫暗、舌下络脉青紫、舌有瘀斑瘀点、身重和口黏腻为主,主要表现在炎性因子、血脂、凝血功能三方面,其中痰和瘀的相互作用可能与炎性因子的高表达有关。

Association between Genetic Variants and Characteristic Symptoms of Type 2 Diabetes:A Matched Case-Control Study

Objective： To examine the association of genetic variants with characteristic symptoms of type 2 diabetes mellitus （T2DM）. Methods： A matched case-control study was performed to investigate the association between common variants in four genes （CDKAL1, GLIS3, GRK5, and TCFTL2） and symptoms of T2DM. Symptoms were examined with questionnaire for 710 subjects. Genomic DNA was extracted from peripheral blood mononuclear cell by salting-out procedure. Genotyping was carried out by direct sequencing of the unpurified polymerase chain reaction products. Result： Most of the T2DM patients pressented characteristic symptoms, such as feeling weak in limbs （P=0.0057）, hand tremor （P=0.0208）, bradymasesis （P=0.0234）, and polyuria （P=0.0051）. Some of the T2DM patients shared characteristic symptoms, such as desire for cold drinks （P=0.0304）, polyphagia （P=0.0051）, and furred tongue （P=0.028）. The impaired glucose regulation （IGR） cases took only one characteristic symptom of frequent micturition （P=0.0422）. GLIS3 rs7034200 and GRK5 rs10886471 were significantly associated with increased T2DM risk （GLIS3 rs7034200 under dominant model： P=0.0307; GRK5 rs 10886471 under recessive model： P=0.0092）. However, only the rs10886471 polymorphism in GRK5 showed a significant effect on both differentiated symptoms and T2DM risk. The C-allele was involved in both dampness-heat encumbering Pi （Spleen） syndrome （P=0.047） and qi-yin deficiency syndrome （P=0.002） via increased GRK5 expression. Conclnsions： Both T2DM and IGR exhibited its corresponding characteristic symptoms. The variants of GRK5 were involved with both qi-yin deficiency syndrome and dampness-heat encumbering Pi syndrome.