A handy review of carpal tunnel syndrome:From anatomy to diagnosis and treatment

Carpal tunnel syndrome(CTS) is the most commonly diagnosed disabling condition of the upper extremities. It is the most commonly known and prevalent type of peripheral entrapment neuropathy that accounts for about 90% of all entrapment neuropathies. This review aims to provide an outline of CTS by considering anat-omy, pathophysiology, clinical manifestation, diagnostic modalities and management of this common condition, with an emphasis on the diagnostic imaging evaluation.

Application value analysis of magnetic resonance imaging and computed tomography in the diagnosis of intracranial infection after craniocerebral surgery

BACKGROUND Intracranial infection is a common clinical disease.Computed tomography(CT)and magnetic resonance imaging(MRI)have certain sensitivity and have good diagnostic efficacy.AIM To study the application value of MRI and CT in the diagnosis of intracranial infection after craniocerebral surgery.METHODS We selected 82 patients who underwent craniocerebral surgery(including 40 patients with intracranial infection and 42 patients without infection)during the period from April 2016 to June 2019 in our hospital.All 82 patients received CT and MRI examinations,and their clinical data were reviewed.A retrospective analysis was performed,and the coincidence rate of positive diagnosis and the overall diagnosis coincidence rate of different pathogenic infection types were measured with the two examination methods.The diagnostic sensitivity and specificity as well as the positive and negative predictive values of the two examination methods were compared.RESULTS For all types of pathogenic infections(Staphylococcus aureus,Staphylococcus hemolyticus,Staphylococcus epidermidis,and others),MRI scans had higher positive diagnostic coincidence rates than CT scans;the overall diagnostic coincidence rate,sensitivity,specificity,positive predictive value,and negative predictive values were significantly higher with MRI examinations than with CT examinations,and the differences were statistically significant(P<0.05).CONCLUSION MRI examination can accurately diagnose intracranial infection after clinical craniocerebral surgery.Compared with CT,MRI had higher diagnostic efficiency.The diagnostic sensitivity and specificity,the diagnostic coincidence rate,and the positive and negative predictive values were significantly higher with MRI than with conventional CT,which can be actively promoted.

Albendazole versus metronidazole treatment of adult giardiasis:An open randomized clinical study

AIM:To investigate the efficacy and tolerability of albendazole and metranidazole treatment in giardiasis. METHODS:The open comparative randomized trial was carried out prospectively from December 1999 to July 2001 in Duzce City of Turkey.The diagnosis was based on the presence of signs and symptoms compatible with giardiasis including a positive stool examination of giardia cysts or trophozoite.Metranidazole group consisted of 29 patients and was given metranidazole 500 mg,three times a day for 5 d and albendazole group was consisted of 28 patients and was given albendazole 400 mg/d for 5 d. RESULTS:There were no significant differences in demographical and therapeutical effects and patient's compliance between both groups.But side effects were seen more in metranidazole group than in albendazole group. CONCLUSION:Albendazole is as effective as metranidazole in adults' giardiasis.Albendazole has less side effect potentials than metranidazole in the treatment of giardiasis.

A Comparative Study of Genetic Algorithm Parameters for the Inverse Problem-based Fault Diagnosis of Liquid Rocket Propulsion Systems

Fault diagnosis of liquid rocket propulsion systems （LRPSs） is a very important issue in space launch activities particularly when manned space missions are accompanied, since the safety and reliability can be significantly enhanced by exploiting an efficient fault diagnosis system. Currently, inverse problem-based diagnosis has attracted a great deal of research attention in fault diagnosis domain. This methodology provides a new strategy to model-based fault diagnosis for monitoring the health of propulsion systems. To solve the inverse problems arising from the fault diagnosis of LRPSs, GAs have been adopted in recent years as the first and effective choice of available numerical optimization tools. However, the GA has many control parameters to be chosen in advance and there still lack sound theoretical tools to analyze the effects of these parameters on diagnostic performance analytically. In this paper a comparative study of the influence of GA parameters on diagnostic results is conducted by performing a series of numerical experiments. The objective of this study is to investigate the contribution of individual algorithm parameter to final diagnostic result and provide reasonable estimates for choosing GA parameters in the inverse problem-based fault diagnosis of LRPSs. Some constructive remarks are made in conclusion and will be helpful for the implementation of GA to the fault diagnosis practice of LRPSs in the future.

A COMPARATIVE OBSERVATION ON TREATMENT OF HEART FAILURE DUE TO DIASTOLIC INSUFFICIENCY OF THE LEFT VENTRICLE -A Report of 43 Cases

43 cases of heart failure due to diastolic insufficiency of the left ventricle were treated with TCM differential treatment as the treatment group, the total effective rate being 86.0%. Statistically significant difference (P

Treatment responses in Asians and Caucasians with chronic hepatitis C infection

AIM：To conduct a multicentre retrospective review of virological response rates in Asians infected with genotype 1 chronic hepatitis C（CHC） treated with combination interferon and ribavirin and then to compare their responses to that among Caucasians.METHODS：Asian patients infected with genotype 1 CHC treated at 4 Australian centres between 2001 to 2005 were identified through hospital databases.Baseline demographic characteristics,biochemical,virological and histological data and details of treatment were collected.Sustained virological responses（SVR） in this cohort were then compared to that in Caucasian subjects,matched by genotype,age,gender and the stage of hepatic fibrosis.RESULTS：A total of 108 Asians with genotype 1 CHC were identified.The end of treatment response（ETR） for the cohort was 79% while the SVR was 67%.Due to the relatively advanced age of the Asian cohort,only sixty-four subjects could be matched with Caucasians.The ETR among matched Asians and Caucasians was 81% and 56% respectively（P=0.003）,while the SVR rates were 73% and 36%（P 〈0.001） respectively.This difference remained significant after adjusting for other predictive variables. CONCLUSION： Genotype 1 CHC in Asian subjects is associated with higher rates of virological response compared to that in Caucasians.

Epidemiology and outcome of Crohn's disease in a teaching hospital in Riyadh

AIM: To know the epidemiology and outcome of Crohn's disease at King Khalid University Hospital, Riyadh, Saudi Arabia and to compare the results from other world institutions.METHODS: A retrospective analysis of patients seen for 20 years (between 1983 and 2002). Individual case records were reviewed with regard to history, clinical, findings from colonoscopy, biopsies, small bowel enema, computerized tomography scan, treatment and outcome.RESULTS: Seventy-seven patients with Crohn's disease were revisited, 13% presented the disease in the first 10 years and 87% over the last 10 years. Thirty-three patients (42.9%) were males and 44 (57.1%) were females. Age ranged from 11-70 years (mean of 25.3+11.3 years). Ninety-two (92%) were Saudi. The mean duration of symptoms was 26+34.7 mo. The mean annual incidence of the disease over the first 10 years was 0.32:100 000 and 1.66:100 000 over the last 10 years with a total mean annual incidence of 0.94:100 000 over the last 20 years. The chief clinical features included abdominal pain, diarrhea, weight loss,anorexia, rectal bleeding and palpable mass. Colonoscopic findings were abnormal in 58 patients (76%) showing mostly ulcerations and inflammation of the colon. Eighty nine percent of patients showed nonspecific inflammation with chronic inflammatory cells and half of these patients revealed the presence of granulomas and granulations on bowel biopsies. Similarly, 69 (89%) of small bowel enema results revealed ulcerations (49%), narrowing of the bowel lumen (42%), mucosal thickening (35%) and cobblestone appearance (35%). CT scan showed abnormality in 68 (88%) of patients with features of thickened loops (66%) and lymphadenopathy (37%). Seventy-eight percent of patients had small and large bowel disease, 16% had small bowel involvement and only 6% had colitis alone. Of the total 55 (71%) patients treated with steroids at some point in their disease history, a satisfactory response to therapy was seen in 28 patients (51%) while 27 (49%) showed recurrences of the condition with mild to moderate symptoms of abdominal pain and diarrhea most of which were due to poor compliance to medication. Seven patients (33%) remained with active Crohn's disease. Nine (12%) patients underwent surgery with resections of some parts of bowel, 2 (2.5%) had steroid side effects, 6 (8%) with perianal Crohn's disease and five (6.5%) with fistulae.CONCLUSION: The epidemiological characteristics of Crohn's disease among Saudi patients are comparable to those reported from other parts of the world. However the incidence of Crohn's disease in our hospital increased over the last 10 years. The anatomic distribution of the disease is different from other world institutions with less isolated colonic affection.

Undifferentiated embryonal sarcoma of the liver:Clinical characteristics and outcomes

BACKGROUND Undifferentiated embryonal sarcoma of the liver(UESL)is a rare liver malignancy originating from primary mesenchymal tissue.The clinical manifestations,laboratory tests,and imaging examinations of the disease lack specificity and the preoperative misdiagnosis rate is high.The overall prognosis is poor and survival rate is low.AIM To investigate the diagnosis,treatment,and prognosis of UESL.METHODS We performed a retrospective,single-center cohort study in Shengjing Hospital of China Medical University,which is a central hospital in northeast China.From 2005 to 2017,we recruited 14 patients with pathologically confirmed UESL.We analyzed the clinical manifestations,laboratory tests,imaging examinations,pathological examinations,therapy,and prognosis of these patients.RESULTS There were nine males and five females aged 2-60 years old included in the study.The major initial symptoms were abdominal pain(71.43%)and fever(57.14%).Preoperative laboratory tests revealed that seven patients had increased leukocyte levels,four showed a decrease in hemoglobin levels,seven patients had increased glutamyl transpeptidase levels,nine had increased lactate dehydrogenase levels,and three showed an increase in carbohydrate antigen 199.There was no difference in the rate of misdiagnosis in preoperative imaging examinations of UESL between adults and children(6/6 vs 5/8,P=0.091).The survival rate after complete resection was 6/10,while that after incomplete resection was 0/4(P=0.040),suggesting that complete resection is important to improve survival rate.In total,five out of the eight children achieved survival.During the follow-up,the maximum survival time was shown to be 11 years and minimum survival time was 6 mo.Six adult patients relapsed late after surgery and all of them died.CONCLUSION Preoperative imaging examination for UESL has a high misdiagnosis rate.Multidisciplinary collaboration can improve the diagnostic accuracy of UESL.Complete surgical resection is the first choice for treatment of UESL.

Factors Influencing Subjective Orthodontic Treatment Need and Culture-related Differences among Chinese Natives and Foreign Inhabitants

Aim The aim of this survey was to compare Chinese natives and foreign inhabitants in Chengdu, China, with respect to： （1） attitudes towards dental appearance, （2） subjective orthodontic treatment need, and （3） the main factors influencing orthodontic treatment need. Methodology A total of 522 subjects, including 227 foreign inhabitants and 295 Chinese natives in Chengdu participated in the survey. A simple random sampling method was adopted and a face-to-face interview was conducted at some public sites using a questionnaire. Data was entered by two persons synchronously using Epidata 3.0, and SPSS 13.0 was used to analyze these data. Results 89.0% of foreign inhabitants were satisfied with their teeth compared to only 46.8% of Chinese natives. Females were more dissatisfied with their teeth than males. Chinese natives put improving appearance as the top priority （55.9%） for seeking orthodontic treatment; however, in foreign inhabitants, the main reason for seeking treatment was to improve masticatory function（44.1%）, followed by ＂to be pretty＂ （35.2%）. The importance of well-aligned teeth and self-perception of psychosocial impact of malocclusion were the same two main factors influencing subjective orthodontic treatment need （P〈0.05） in foreign inhabitants and Chinese natives. Sub- jective orthodontic treatment need between the two target groups was significantly different （P〈0.05）. Conclusion （1） It was very common that Chinese natives were dissatisfied with their dental appearance, and their subjective orthodontic treatment needs were high. （2） There were some differences in orthodontic treatment motives between the two target groups. （3） There were differences in subjective orthodontic treatment needs between foreign inhabitants and Chinese natives. However, the prominent influential factors were almost the same. There may be benefit to understanding subjective orthodontic needs of different races.

Low eradication rate of Helicobacterpyloriwith triple 7-14 days and quadriple therapy in Turkey

AIM:The eradication rate of Helicobacter pylori (H pylori) shows variation among countries and regimens of treatment. We aimed to study the eradication rates of different regimens in our region and some factors affecting the rate of eradication. METHODS:One hundred and sixty-four H pylori positive patients (68 males,96 females;mean age:48±12 years) with duodenal or gastric ulcer without a smoking history were included in the study.The patients were divided into three groups according to the treatment regimens.Omeprazole 20mg,clarithromycin 500mg,amoxicillin 1g were given twice daily for 1 week (Group Ⅰ) and 2 weeks (Group Ⅱ). Patients in Group Ⅲ received bismuth subsitrate 300mg, tetracyline 500mg and metronidazole 500mg four times daily in addition to Omeprazole 20mg twice daily.Two biopsies each before and after treatment were obtained from antrum and corpus,and histopathologically evaluated. Eradication was assumed to be successful if no H pylorus was detected from four biopsy specimens taken after treatment.The effects of factors like age,sex,H pylori density on antrum and corpus before treatment,the total H pylori density,and the inflammation scores on the rate of H pylori eradication were evaluated. RESULTS:The overall eradication rate was 42%.The rates in groups Ⅱ and Ⅲ were statistically higher than that in group Ⅰ (P<0.05).The rates of eradication were 24.5%, 40.7% and 61.5% in groups Ⅰ,Ⅱ and Ⅲ,respectively.The eradication rate was negatively related to either corpus H pylori density or total H pylori density (P<0.05).The median age was older in the group in which the eradication failed in comparison to that with successful eradication (55 yr vs 39 yr,P<0.001).No correlation between sex and H pylori eradication was found. CONCLUSION:Our rates of eradication were significantly lower when compared to those reported in literature.We believe that advanced age and high H pylori density are negative predictive factors for the rate of H pylori eradication.

Comparison of six human anti-transglutaminase ELISA-tests in the diagnosis of celiac disease in the Saharawi population

AIM: Celiac disease (CD) is an enteropathic disorder very prevalent in Saharawi people. Our aim was to investigate the diagnostic accuracy of six human tissue transglutaminase (tTG) based ELISA tests in Saharawi CD patients. METHODS: Fifty-two CD patients and 23 controls were selected from the Saharawi refugee camps in Tinduf. CD patients were divided into two groups according to their anti-endomysium (EmA) status: 41 EmA positive and 11 EmA negative. Sera from patients and controls were tested for human tTG using six commercial ELISA kits. We used receiver operating characteristics (ROC) curves and areas under the curve to compare the diagnostic accuracies of the six assays. RESULTS: In general, there are differences in the sensitivity and specificity of the human tTG ELISA assays used. Diagnostic accuracy of tests was significantly improved by adjusting the cut-off thresholds according to ROC plot analysis; the correction of the cut-off with the employment of the ROC curve analysis modifies the decision limit in more than 50% in five of the six kits evaluated. CONCLUSION: Some of the human tTG ELISAs used in this study have a diagnostic accuracy similar to EmA determination for diagnosis of CD in Saharawi people. However, it is necessary to select the assay with a higher sensitivity and specificity, and recalculate the cut-off threshold using samples from the referral population.

Contribution of Cytology for the Diagnosis of Gallbladder Carcinoma to Avoid Misdiagnosis in This Commonly Resected Organ

The cytological study of gallbladder bile is a diagnostic tool used very often in the treatment of gallbladder cancer. The diagnosis of gall bladder cancer is done by morphological examinations such as ultrasound, computed tomography in 80% of cases, but in some difficult cases, benign lesions associated with malignant lesions, such as pseudo-tumoral cholecystitis, adenomyosis or adenoma and cancers requiring medical treatment by chemotherapy or radiotherapy, is without the possibility of surgical treatment. Cytology can help resolve a number of difficult situations, such as the presence of an intra-gallbladder lesion in the form of a polyp or nodule. Some studies have reported very interesting results from gallbladder cytology to cancer diagnosis with results up to 85% sensitivity. The purpose of this study is to analyze the contribution of the cytological study of gallbladder bile to the positive diagnosis of gallbladder cancer.

Is laparoscopy an advantage in the diagnosis of cirrhosis in chronic hepatitis C virus infection?

AIM:To evaluate the potential of laparoscopy in the diagnosis of cirrhosis and outcome of interferon treatment in HCV-infected patients. METHODS:In this retrospective study,diagnostic laparoscopy with laparoscopic liver biopsy was performed in 72 consecutive patients with chronic HCV infection.The presence or absence of drrhosis was analyzed macroscopically by laparoscopy and microscopically by liver biopsy specimens.Clinical and laboratory data and outcome of interferon-alfa treatment were compared between cirrhotic and noncirrhotic patients. RESULTS:Laparoscopically,cirrhosis was seen in 29.2 % (21/72)and non-cirrhosis in 70.8 %(51/72)of patients. Cirrhotic patients were significantly older with a significant longer duration of HCV infection than noncirrhotic patients. Laboratory parameters(AST,y-GT,y-globulin fraction)were measured significantly higher as well as significantly lower (prothrombin index,platelet count)in cirrhotic patients than in non-cirrhotic patients.Histologically,cirrhosis was confirmed in 11.1%(8/72)and non cirrhosis in 88.9 %(64/72).Patients with macroscopically confirmed cirrhosis(n=21)showed histologically cirrhosis in 38.2 %(8/21)and histologically non- cirrhosis in 61.9 %(13/21).In contrast,patients with macroscopically non-cirrhosis(n=51)showed histologically non cirrhosis in all cases(51/51).Thirty-nine of 72 patients were treated with interferon-alfa,resulting in 35.9 %(14/39) patients with sustained response and 64.1%(25/39)with non response.Non-responders showed significantly more macroscopically cirrhosis than sustained responders.In contrast,there were no significant histological differences between non-responders and sustained responders. CONCLUSION:Diagnostic laparoscopy is more accurate than liver biopsy in recognizing cirrhosis in patients with chronic HCV infection.Liver biopsy is the best way to assess inflammatory grade and fibrotic stage.The invasive marker for staging,prognosis and management,and treatment outcome of chronic HCV-infected patients need further research and dinical thals.Laparoscopy should be performed for recognition of drrhosis if this parameter is found to be of prognostic and therapeutic relevance in patients with chronic HCV infection.

The Comparison of Clinical analysis of Chinese and German Patients with Obstructive Sleep Apnea Syndrome

Objective:To compare the sex ratio,age distribution,severity of the illness,comorbidities,and the treatment of the patients with obstructive sleep apnea syndrome in China and Germany.Methods:A retrospective study of the data was conducted,and a total of 200 patients diagnosed with obstructive sleep apnea syndrome in Germany and China from March 2013 to October 2015 were analyzed.The sex ratio,age distribution,severity of the illness,comorbidities and treatment methods were analyzed.Results:There was no significant difference in the severity of disease,sex ratio,and age distribution between the patients with obstructive sleep apnea syndrome in China and Germany(P>0.05).In terms of comorbidities,the combination of moderate and severe patients in the German group,compared with the moderate and severe patients in the Chinese group,except for cerebrovascular disease,the comorbidities were less than those in the Chinese group(P<0.05),the difference was statistically significant.In terms of treatment,the patients in the German group were compared with the patients in the Chinese group with light,moderate,and severe patients.Except for the German patients who received oral appliances and surgical treatment,more patients were treated than Chinese patients(P<0.05),the difference is statistically significant.Conclusion:The two country(Germany and China)are basically the same in the diagnosis and treatment of obstructive sleep apnea syndrome,but Germany pays more attention to details and individualization in treatment.

Comparative Study on Distributed Waste Pyrolysis Cold Emission Energy Station and Incineration Power Generation

The proper terminal disposal of organic solid waste such as domestic waste is a worldwide issue.Landfill covers a large area,with limited capacity,and a single landfill will be filled one day;incineration is costly to build and operate.These methods all need to transfer and centralized treatment,and secondary pollution is difficult to control,against the purification law of the nature."NIMBY effect"is very serious,and the social cost of treatment is increasing,becoming a heavy financial burden."The Distributed Waste Pyrolysis Cold Emission Energy Station"developed by Hunan Zhongzhou Energy-Saving Technology Co.,Ltd.overcomes these disadvantages and constructs a more appropriate environmental economic industrial chain for the treatment of organic solid waste such as urban and rural household waste.Based on its technical characteristics,this paper compares it with waste incineration power generation project in the aspects of secondary pollution control,treatment effect,energy utilization,investment and operation economy,etc.

Current understanding and management of aggressive posterior retinopathy of prematurity

Aggressive posterior retinopathy of prematurity(ROP), previously referred to as "Rush disease", is a rapidly progressive form of ROP. This form of ROP typically presents in very low birth weight babies of early gestational age. Historically, anatomical and functional outcomes have been poor with standard treatment. This review is designed to discuss current knowledge and treatment regarding this aggressive form of ROP. Recommendations regarding management of these difficult cases are detailed.

鼻内镜下低温等离子腺样体消融术治疗小儿腺样体肥大疗效观察

目的探讨鼻内镜下低温等离子腺样体消融术治疗小儿腺样体肥大的临床效果。方法回顾性分析2020年2月至2023年2月湖南省儿童医院耳鼻咽喉头颈外科收治的100例(按样本计算公式得出最少样本量为96例)腺样体肥大患儿临床资料,依据所采取手术方法的不同分为鼻内镜下低温等离子腺样体消融术组(简称低温等离子消融术组)和鼻内镜下腺样体切除术组(简称常规切除术组),每组各50例。收集并对比分析两组患儿手术相关指标、疼痛程度、创伤应激指标、CC类趋化因子中CCL2和CCL21、通气功能指标、生活质量、术后并发症及复发情况。结果低温等离子消融术组患儿术中出血量及手术时间少于常规切除术组(P<0.05),咽痛持续时间、恢复鼻腔通气时间以及白膜完全消退时间均短于常规切除术组(P<0.05);手术后第1、2、3天,患儿疼痛视觉模拟评分法(visual analogue scale for pain,VAS)评分以及前列腺素F2α(prostaglandin F2α,PG F2α)、前列腺素E2(prostaglandin E2,PGE2)、皮质醇(cortisol hydrocortisone,Cor)、降钙素原(procalcitonin,PCT)、CCL21水平、血氧饱和度<90%时间占睡眠时间百分比(percentage of time with oxygen saturation<90%during sleep,SLT 90%)、血氧饱和度下降指数(oxygen desatura tion indes,ODI)、最长呼吸暂停时间(longest apnea time,LAT)、呼吸暂停通气指数(apnea and hypopnea index,AHI),均低于常规切除术组(P<0.05);CCL2水平、最低夜间血氧饱和度(lowest oxygen saturation,LSaO_(2))以及生活质量评分均高于常规切除术组(P<0.05)。低温等离子消融术组患儿治疗总有效率为92.00%(46/50),高于常规切除术组(38/50,76.00%),差异有统计学意义(χ^(2)=4.762,P<0.05);术后并发症发生率(2/50,4.00%)低于常规切除术组(9/50,18.00%),差异有统计学意义(χ^(2)=5.005,P<0.05),而复发率[(1/50,2.00%)比(2/50,4.00%)]差异无统计学意义(χ^(2)=0.000,P>0.05)。结论鼻内镜下低温等离子腺样体消融术治疗小儿腺样体肥大,与鼻内镜下腺样体切除术相比,手术时间更短,术中出血量更少,并发症更少,复发率无差异,可有效改善患儿通气功能。

2018—2022年某三级口腔专科医院工作人员职业暴露情况调查

目的:探讨口腔专科工作人员职业暴露危险因素和职业伤害情况,为制定针对性职业防护措施提供依据。方法:回顾性分析2018年1月1日—2022年12月31日某三级口腔专科医院工作人员的职业暴露现状,探讨口腔专科医护工作人员职业暴露的风险因素。结果:5年职业暴露率分别为9.65%、6.54%、4.96%、5.38%、3.96%。151名职业暴露人员中,84.77%的职业暴露源不明;以女性[128人(84.77%)]、护士[63人(41.72%)]为主;暴露科室主要以综合门诊科/部(21.85%)和牙周黏膜科(17.22%)为主;主要发生于口腔诊疗操作(48.34%);08:00~11:59(51.66%)是1 d中发生职业暴露次数最多的时间;手部(87.42%)是最主要的暴露部位;暴露器械多为根管锉、牙科钻、洁治器头(38.41%)及注射针头(33.11%);2020年后工作人员职业防护考核得分有大幅度提升(P<0.05)。结论:口腔专科职业暴露风险较综合医院有其专科特色,建议在推广安全器具使用的基础上,进行喷溅操作多、诊疗次数多的操作之前开展病人血源性检测,同时在进行职业安全防护、标准操作规程、职业暴露处置等相关培训时要结合人群特点,培训形式应与受训者群体特征相适应。

小动物肠道异物性梗阻和出血性胃肠炎诊治的比较研究

小动物肠道异物引起犬肠道梗阻是犬常见肠道疾病之一。在临床上容易和出血性胃肠炎发生混淆。本试验通过一例患犬的病史,结合血常规检查、CRP检查、内窥镜检查,并与出血性胃肠炎鉴别诊断,确定为犬肠道异物性梗阻,并对患犬尝试使用剖腹探查术治疗,术后以消炎、补充营养和体液、修复胃肠道粘膜为主,取得明显的治疗效果。研究结果可为宠物犬肠道异物性梗阻和出血性胃肠炎的鉴别诊治提供可参考的诊治方案。

基于区域健康医疗大数据脑卒中专病库的构建在中医药研究中的应用

目前国内基于区域诊疗数据构建的单病种数据库在中医药领域应用较少,本研究依托天津健康医疗大数据平台建立脑卒中专病库,探讨区域诊疗数据从形成专病库到深入挖掘临床问题所具有的独特优势和缺陷,为后续中医药领域区域诊疗数据下专病库的构建和应用提供参考。专病库构建需要经过跨机构数据采集、整合和治理,同时需兼顾数据安全,以此作为研究开展基础。建设完成后通过描述人群现状和预后情况,总结专病库概况和可开展的研究方向。最后对研究中数据治理、分析时存在的问题和解决方案进行梳理,从方法学角度讨论专病库应用与中医药研究的适配性。专病库覆盖天津市81家医院2016~2020年24万首发脑卒中患者诊疗数据,并链接公卫系统死亡登记数据,可进行人群特征分析、发病影响因素探查、诊疗路径优化、预测模型构建和卫生经济学研究。但也存在数据覆盖度不全和记录不完善的问题,并伴随真实世界研究中常出现的各种偏倚,需要在研究设计及方法学应用上加以调整。真实世界下的诊疗数据应用是探索和提升中医药疗效的必由之路,但正如脑卒中专病库展现出的研究优势和不足,数据挖掘是循序渐进的过程,需要通过将研究需求反哺于临床电子病历的记录以提升专病库质量,为承载后续更多高质量的中医药研究奠定基础。