Non-motor signs and symptoms in Parkinson’s disease

Motor symptoms are cardinal clinical features of Parkinson’s disease (PD). Progress in drug therapy and rehabilitation has been presenting beneficial effect for motor symptoms. However, non-motor symptoms and signs in PD have been accumulated growing attentions and its amelioration may also give beneficial effect for PD patients’ and their care givers’ quality of life. In this mini-review, I overviewed non-motor symptoms and signs in PD.

Oral and peri-oral signs and symptoms of herbal dentifrices in patients in two oral medicine clinics in Lagos—A preliminary study

Background: Herbal dentifrices appear to have become an attractive alternative for some consumers and its use has gained appreciable acceptance in Nigeria. This could be partly due to the perception that herbal toothpastes like other herbal products are “natural”, devoid of chemicals and therefore superior to regular toothpastes. Aggressive advertisement of the products may also contribute to this new trend. Mucosal symptoms such as glossitis and intolerance to spicy foods seen in patients attending the oral diagnosis clinic are usually associated with anaemia and nutritional deficiency states. The disturbing trend of an increasing number of patients presenting with such oral mucosal symptoms associated with the use of herbal dentifrices prompted this study. This trend was observed in two isolated oral medicine clinics. Objective: To sensitize oral health, allied professionals and consumers on the possible adverse effects of regular use of some herbal dentifrices sold in Nigeria. Materials and Methods: Routine patients of two oral medicine clinics in Lagos, namely the Randle General Hospital and the Lagos University Teaching Hospital who complained of some adverse mucosal signs and symptoms following the regular use of two identified herbal toothpastes made up the study population. The study was conducted between April 2010-April 2011. A detailed history and examination was carried out on these patients and clinical photographs of oral signs observed was taken in consenting patients. Data analysis was done using the Epi-info 6 software. P values ≤ 0.05 was considered statistically significant and data was presented in table format. Results: A total of 45 patients, 9 (20%) males and 36 (80%) fe-males were seen. The age range of patients was 14 - 78 years;mean age 45.5 ± 14.9 years. The duration of use of herbal dentifrices ranged from 2 weeks - 84 months (mean 24 ± 11.5 months). Oral signs and symptoms seen include, burning mouth and peppery sensation, mucosal erythema, lichenoid reaction, xerostomia, loss of taste sensation, angio-oedema and oral and peri-oral pigmentation. In many patients, resolution of symptoms was progressive within 2 weeks of withdrawal of the herbal toothpaste and its replacement with a conventional fluoride toothpaste. Most of the patients however required further treatment. A statistically significant association was found between the use of the identified herbal dentifrices and the following mucosal signs and symptoms namely, burning mouth and peppery sensation ,loss of taste sensation, soreness, erythema and lichenoid straie (p value ≤ 0.05). There was no statistically significant association between the use of herbal toothpaste and mucosal signs and symptoms of xerostomia, angular cheilitis, mucosal itching, angio-oedema and numbness (p value > 0.0.5) Conclusion: The regular use of the herbal dentifrices identified in this study can result in oral signs and symptoms affecting taste , nutrition, aesthetics and general oral physiology in some consumers. These findings suggest that further long term clinical trials need to be conducted on the herbal dentifrices to identify the noxious agents causing these symptoms. The formulation and use of these dentifrices need to be standardized and regulated. There is also a need to formulate a treatment protocol for these patients.

Symptoms and signs of acute alcoholic hepatitis

Although there is not one specific sign or symptom related to alcoholic hepatitis(AH),a constellation of symptoms and signs can help make the diagnosis of AH with reasonable accuracy.Documentation of chronic and active alcohol abuse is paramount in making a diagnosis of AH.Clinical presentation after abstinence for more than 3 m should raise doubts about the diagnosis of AH and dictate the need for considering other causes of liver disease,decompensation of alcoholic cirrhosis,sepsis and malignancy as the cause of patient's clinical profile.

ACUPUNCTURE TREATMENT OF 40 CASES OF SEVERE HICCUP BASED ON DIFFERENTIATION OF SYMPTOMS AND SIGNS

In the present study, the authors selected points according to differentiation of symptoms and signs and applied filiform needles to treating 40 cases of hiccup who had tried treatment with Western and Chinese drugs but without any effect and achieved satisfactory results. After acupuncture treatment, 34 cases (85 %) were cured, 4 (10 %) improved markedly and 2(5 %) improved, with total effective rate of 100 %.

Signs and syndromes in acute appendicitis:A pathophysiologic approach

Physical examination signs have not been well studied,and their accuracy and reliability in diagnosis remain unknown.The few studies available are limited in that the method of performing the sign was not stated,the technique used was not standardized,and the position of the appendix was not correlated with imaging or surgical findings.Some appendiceal signs were written in a non-English language and may not have been appropriately translated(e.g.,Blumberg-Shchetkin and Rovsing).In other cases,the sign described differs from the original report(e.g.,Rovsing,Blumberg-Shchetkin,and Cope sign,Murphy syndrome).Because of these studies limitations,gaps remain regarding the signs’utility in the bedside diagnosis of acute appendicitis.Based on the few studies available with these limitations in mind,the results suggest that a positive test is more likely to be found in acute appendicitis.However,a negative test does not exclude the diagnosis.Hence,these tests increase the likelihood of ruling in acute appendicitis when positive but are less helpful in ruling out disease when negative.Knowledge about the correct method of performing the sign may be a valuable adjunct to the surgeon in further increasing their pretest probability of disease.Furthermore,it may allow surgeons to study these signs further to better understand their role in clinical practice.In the interim,these signs should continue to be used as a tool to supplement the clinical diagnosis.

Digestive Pathologies during Chronic Renal Failure in the Nephrology and Haemodialysis Department at the University Hospital Center of Point G in Mali

Introduction: Chronic kidney disease (CKD) is the progressive and irreversible loss of kidney function. It exposes to many complications, among which, digestive complications. In Mali, we do not have data on the prevalence of digestive pathologies in people with chronic renal failure, hence the interest of this study. Objective: To determine the prevalence of digestive pathologies and to describe their manifestations during chronic renal failure. Patients and Methods: This was a prospective cross-sectional study conducted from September 2016 to August 2017, a period of 12 months. Included were patients hospitalized in our department with CKD who received digestive endoscopy and/or liver serology. Results: Seventy-one patients underwent digestive endoscopy with oesogastroduodenal fibroscopy (60 patients), rectoscopy (6 patients) and anoscopy (5 patients), i.e. 15.9% of those hospitalized. The mean age of the patients was 48 ± 14 years with extremes of 15 and 84 years. The sample consisted of 59.2% men versus 40.8% women, for a sex ratio of 1.5. The functional signs are in order of frequency: vomiting (72.4%), anorexia (51.3%) and epigastralgia (48.7%). Terminal CKD by creatinine clearance accounted for 88.2% of cases, of which 47.4% were monitored by hemodialysis. Hepatitis C virus infection was present in 21.3% of cases, hepatitis B (18%) and HIV (7.5%). Endoscopic examinations were represented by fibroscopy (84.5%), rectoscopy (8.5%) and anuscopy (7%). The fibroscopic lesions were respectively gastric (96.8%), duodenal (14.1%) and esophageal (12.5%). They were dominated by gastritis (40.5%), duodeno-gastric reflux (16.4%), pyloric gap (12.6%). Rectoscopy found 4 cases of hemorrhoids, 2 cases of rectitis and no lesions were observed at anuscopy. Conclusion: The prevalence of these digestive manifestations and the endoscopic lesions encountered indicate the importance of digestive endoscopy and the performance of hepatic serologies in chronic renal failure patients with digestive symptoms and/or treated by hemodialysis.

Effectiveness of Xiangsha Liujun pills(香砂六君丸)on decreased digestive function in convalescent patients of coronavirus disease 2019:a randomized,double blind,placebo controlled clinical trial

OBJECTIVE:To evaluate the effectiveness and safety of Xiangsha Liujun pills(香砂六君丸) on the decreased digestive function in patients in the recovery phase of the Coronavirus disease 2019(COVID-19).METHODS:A randomized,double blind,placebo controlled clinical trial was conducted.A total of 200 COVID-19 patients in the recovery phase were included in our study in Ezhou Hospital of Traditional Chinese Medicine.Totally 200 subjects were randomly divided into a treatment group(Xiangsha Liujun pills) and a control group(placebo),with 100 in each group.Subjects took Xiangsha Liujun pills or placebo orally three times a day for two weeks.Three visits were scheduled at week 0(baseline),week 1(the middle of the intervention) and week 2(the end of the intervention) for each eligible patient.The total efficacy rates for improving the Traditional Chinese Medicine(TCM) symptoms(fatigue,poor appetite,abdominal distension and loose stools) and the disappearance rates of symptoms were observed and compared in the treatment and control groups.Adverse events were recorded during the study period.SAS 9.4 was used to analyze the data.RESULTS:A total of 200 patients were included in this study,among which 4 participants withdrew because the drugs did not work.Three patients were excluded for age.Before the treatment,there was no significant difference between the TCM symptoms scores of subjects.After 1 week of treatment,the full analysis set(FAS) showed that the efficacy rates for abdominal distension and loose stools in the treatment group were significantly higher than the control group(P < 0.05).There were no significant differences in the efficacy rates for fatigue and poor appetite between the two groups(P > 0.05).In addition,the disappearance rate of fatigue in the treatment group was significantly higher than the control group(P < 0.05);there were no significant differences between the two groups after treatment in the rates of poor appetite,abdominal distension,and loose stools(P > 0.05).After 2 weeks of treatment,the efficacy rates for fatigue,poor appetite,abdominal distension,and loose stools in the treatment group were significantly higher than the control group(P < 0.05).The disappearance rate of loose stools in the treatment group was significantly higher than the control group(P < 0.05).However,there were no significant differences in the disappearance rates of fatigue,poor appetite,and abdominal distension between the two groups(P > 0.05).No severe adverse events were reported by subjects during the study.CONCLUSIONS:This clinical study confirmed that Xiangsha Liujun pills can effectively improve the symptoms related to the decreased digestive function in COVID-19 convalescent patients.

Clinical Observations on the Effects of a Dietary Supplement (GI Regenerate^TM) on Patients’ Gastrointestinal Symptoms and Quality of Life Assessments

Background: Different treatments have been developed and used to control symptoms and improve quality of life in patients with digestive diseases and disorders. Although the use of drugs or alternative approaches has improved symptom severity in some but not all patients, often these improvements were not sustainable. Objectives: An open label clinical study was initiated to determine if oral capsules containing a dietary supplement of herbs and oils (GI RegenerateTM) could reduce self-reported gastrointestinal symptoms and improve quality of life (QOL) indicators in patients with gastrointestinal conditions. Methods: Participants included 50 patients (40 females and 10 males) of mean age of 51.1 ± 12.7 years (range, 24 - 77 years) with a diagnosis of a gastrointestinal disorder or gastrointestinal symptoms. These patients consumed five soft-gels containing the test supplement 30 minutes before each meal for 90 days. Symptoms were evaluated by medical staff, and patient health status was self-reported using a validated quality of life questionnaire (Quality of Life Digestive Survey) designed for functional digestive disorders. Exit interviews (Patient Global Impression of Change, PGIC) were conducted by the medical staff. Results: Participants in the study responded with improved symptom severities and QOL scores to the test dietary supplement within the 90 day period;most improvements occurred within 20 days on the test dietary supplement. By the end of the study there were significant overall global improvements in the symptoms and QOL health surveys (p = 0.0183), with significant improvements in symptom discomfort (p = 0.0004), daily activities (p = 0.029) and anxiety (p = 0.018). In contrast, there were insignificant improvements in diet (p = 0.398), sleep (p = 0.136), health perception (p = 0.686), coping with the disease (p = 0.309) and impact of stress (p = 0.785). Using the PGIC exit interview that measured each patient’s impression of overall global change in symptoms and QOL these data also indicated overall significant improvements in symptoms and in satisfaction with the test supplement (moderately better improvements in symptoms and QOL or score of 4.8 ± 0.169, p 50 years) versus younger (Conclusions: The GI RegenerateTM natural dietary supplement safely and significantly reduced gastrointestinal symptoms and improved quality of life in subjects with a broad spectrum of gastrointestinal disorders and symptoms.

Routine diagnosis of intestinal tuberculosis and Crohn's disease in Southern India

AIM:To investigate whether routinely measured clinical variables could aid in differentiating intestinal tuberculosis(ITB)from Crohn’s disease(CD).METHODS:ITB and CD patients were prospectively included at four South Indian medical centres from October 2009 to July 2012.Routine investigations included case history,physical examination,blood biochemistry,ileocolonoscopy and histopathological examination of biopsies.Patients were followed-up after 2 and 6 mo of treatment.The diagnosis of ITB or CD was re-evaluated after 2 mo of antituberculous chemotherapy or immune suppressive therapy respectively,based on improvement in signs,symptoms and laboratory variables.This study was considered to be an exploratory analysis.Clinical,endoscopic and histopathological features recorded at the time of inclusion were subject to univariate analyses.Disease variables with sufficient number of recordings and P<0.05 were entered into logistic regression models,adjusted for known confounders.Finally,we calculated the odds ratios with respective confidence intervals for variables associated with either ITB or CD.RESULTS:This study included 38 ITB and 37 CD patients.Overall,ITB patients had the lowest body mass index(19.6 vs 22.7,P=0.01)and more commonly reported weight loss(73%vs 38%,P<0.01),watery diarrhoea(64%vs 33%,P=0.01)and rural domicile(58%vs 35%,P<0.05).Endoscopy typically showed mucosal nodularity(17/31 vs 2/37,P<0.01)and histopathology more frequently showed granulomas(10/30vs 2/35,P<0.01).The CD patients more frequently reported malaise(87%vs 64%,P=0.03),nausea(84%vs 56%,P=0.01),pain in the right lower abdominal quadrant on examination(90%vs 54%,P<0.01)and urban domicile(65%vs 42%,P<0.05).In CD,endoscopy typically showed involvement of multiple intestinal segments(27/37 vs 9/31,P<0.01).Using logistic regression analysis we found weight loss and nodularity of the mucosa were independently associated with ITB,with adjusted odds ratios of 8.6(95%CI:2.1-35.6)and 18.9(95%CI:3.5-102.8)respectively.Right lower abdominal quadrant pain on examination and involvement of≥3 intestinal segments were independently associated with CD with adjusted odds ratios of 10.1(95%CI:2.0-51.3)and 5.9(95%CI:1.7-20.6),respectively.CONCLUSION:Weight loss and mucosal nodularity were associated with ITB.Abdominal pain and excessive intestinal involvement were associated with CD.ITB and CD were equally common.

Symptom distress and interference among cancer patients with osteoradionecrosis of jaw: A cross-sectional study

Objective:Osteoradionecrosis of the jaws(ORNJ)is among the most serious oral complications of head and neck cancer treatment with radiation therapy.This study aimed to examine the level of symptom distress and interference of ORNJ in head and neck cancer patients in China.Methods:A cross-sectional study was conducted to profile patient reported symptom severity.Ninetyfive hospitalized ORNJ patients were recruited.Participants completed the MD Anderson Symptom Inventory-Head and Neck Module-Chinese version.Results:The percentage of participants who reported that they experienced at least one type of symptom was 97.9%,and 85.2%patients reported interference.The 10 most severe symptoms were as follows:limited mouth opening,problem with teeth/gums,difficulty swallowing/chewing,dry mouth,oral malodor,difficulty with voice/speech,dental ulcer,tinnitus/ear obstruction,skin pain/burning/rash,and difficulty hearing.The problem of limited mouth opening was more severe in patients with longer time to onset of ORNJ after radiotherapy.The interference of patients positively correlated with core symptoms(r=0.612),head and neck symptoms(r=0.709),and ORNJ symptoms(r=0.440)(P<0.01).The longer time to the onset of ORNJ after radiotherapy was positively and significantly correlated with symptom distress(r=0.479,P<0.001),and mouth opening correlated negatively with symptom distress(r=-0.298,P=0.003).Conclusions:ORNJ patients suffered mainly from limited mouth opening and other maxillofacial symptoms.The problem of limited mouth opening was more severe in patients with longer time to onset of ORNJ after radiotherapy.ORNJ patients commonly had symptom distress,which influenced their quality of life.

Identifying barriers to early diagnosis of breast cancer and perception of women in Malwa region of Punjab,India

Objective:The aim of present study is to identify the breast cancer screening barriers among the women with breast cancer of Malwa region of Punjab,India.The study was conducted at three government hospitals representing almost all districts of Malwa region.Methods:The quantitative research design was followed using empirical research methods.Study was carried out by one-to-one interview by the field investigator and research assistant.Total of 363 breast cancer patient has been interviewed through the scheduled questionnaire and results has been recorded for further analysis.In this study,five barriers are described namely as personal barriers,socio-cultural barriers,economic barriers,health­system barriers,and treatment barriers which contains various questions regarding barriers to breast cancer screening.Univariate analysis methods have been used for the analysis to access the socio-demographic profile of women.Data has been obtained with the help of 5-point liker scale.Binary logistic model was chosen.Results:Majority of participants were in the age groups 50-<60 years(3&6%,140/363)and>60 years(31.1%,112/363).Majority of these women(47.4%,171/363)were illiterate and most of them were housewives.The major barriers to breast cancer screening faced by most of the women were having no knowledge about screening services(90.9%,329/363),the importance of early diagnosis(90.9%,329/363),different screening methods(95.5%,347/363)and place of availing screening services(91.2%,330/363)misguided belief in God and fate(81.5%,295/363)and preferring duties than taking care of health(70.2%,254/363).Education qualification(odds ratio[OR]0.74,β'=-0.309,t=-5.357,P=0.000)and socioeconomic class(OR 1.43,β’=0.354,t=3.399,P=0.001)were found to be significant determinant of the barriers among women.Conclusion:The survey was conducted in the women between the age 40-60 years and as an outcome,the unawareness about screening services,fatalistic attitude,fear of being diagnosed with the cancer,low per capita income was found out significant factors that restricted the women for early check-up for the breast cancer.

Sheehan’s syndrome and anterior hypopituitarism

A case of Sheehan’s syndrome and anterior hypopituitarism was collected in Geriatric department of the third clinical college of Inner Mongolia medical university.Due to atypical clinical symptoms,it is easy to be delayed in its diagnosis and treatment.The paper aims to investigate the difference of clinical characteristics and treatment outcome of anterior hypopituitarism through case analysis.

Liposarcoma of the stomach: Report of two cases and review of the literature

Liposarcoma of the stomach is extremely rare, and only 37 cases have been reported worldwide. We herein report two cases of liposarcoma of the stomach. The first patient was referred to our hospital with upper abdominal discomfort. The endoscopic examination revealed a tumor mass about 3 cm in diameter. The patient underwent a partial gastrectomy and had an uneventful recovery. The histopathological examination revealed a welldifferentiated liposarcoma. The second patient had symptoms of upper abdominal discomfort combined with nausea and anorexia. Several palpable masses were found with endoscopy. Endoscopic submucosal dissection was the treatment used, and the postoperative course was uneventful. The histopathological diagnosis was a well-differentiated liposarcoma. The two patients did not undergo any adjuvant therapy. They are both currently in good condition without recurrence. Therefore, we believe that the outcome of liposarcoma of the stomach is positive, and surgical resection may be the first choice for treatment at present.

17例耳硬化症患者的临床与影像学分析

目的分析17例耳硬化症患者的临床特征、影像学表现及手术治疗效果。方法收集2020年5月~2023年5月在湖州市中心医院接受手术治疗的17例(17耳)耳硬化症患者临床、影像学资料,分析其临床表现、颞骨CT影像学表现及手术前后纯音测听结果变化。结果17例(17耳)患者中,11耳(64.71%)为前庭窗型,表现为进行性传导性听力损失,其中9耳有耳鸣,3耳有轻微平衡问题;混合型6耳(35.29%)显示混合性听力损失,5耳有耳鸣,3耳有偶发性平衡障碍。影像学上,前庭窗型显示镫骨底板区域骨质增厚、前庭窗密度增加;混合型则显示镫骨底板增厚及耳蜗周围密度减低,1耳可见“双环征”,两种类型耳硬化症患者骨密度差异无统计学意义(P>0.05)。术后均未见耳鸣加重或其他严重并发症,仅2例(11.76%)出现暂时性头晕,术后随访显示术区恢复良好,无感染或其他迟发性并发症;术后听力测试显示气导阈值、气骨导差较术前显著改善(P均<0.05)。结论前庭窗型和混合型耳硬化症的影像学和临床表现各有特点,镫骨成形术可显著改善听力,降低气导阈值和气骨导差,且手术安全、并发症少。

Clinical Predictors for Diagnosing Pandemic (H1N1) 2009 and Seasonal Influenza (H3N2) in Fever Clinics in Beijing,China

Objective Symptomatic predictors of influenza could assess risks and improve decisions about isolation and outpatient treatment. To develop such predictors, we undertook a prospective analysis of pandemic （HIN1） 2009 and seasonal influenza （H3N2） in patients attending fever clinics. Methods From 1 May 2009 to 1 January 2010, all adult patients admitted to fever clinics for suspected influenza, confirmed by real time RT-PCR, were enrolled. Predictors of influenza virus infection were selected with logistic regression models. Measures of sensitivity, specificity, positive and negative likelihood ratios （LRs） were calculated to identify the best predictors. Results The clinical features and routine blood test results of influenza （H1N1） 2009 and seasonal influenza were similar. The positive and negative LRs of current US CDC influenza-like illness （ILl） criteria were modest in predicting influenza infection. Our modified clinic predictors improved the ability of the positive and negative LRs to recognize pandemic （HIN1） 2009 and seasonal influenza. The revised criteria are： fever ~ 38 ~C accompanied by at least one of the following--cough, arthralgia or relative iymphopenia. Conclusion Patients with symptoms and signs that meet the new criteria are likely to have influenza and timely antiviral therapy may be appropriate. In addition, physicians should ascertain if influenza is circulating within the community or if there is a contact history of influenza and combine this information with the newly developed criteria to clinically diagnose influenza.

Factors that contribute to delay in seeking cervical cancer diagnosis and treatment among women in Malawi

Cervical cancer is a curable disease if diagnosed early. However, many women in Malawi seek treatment when the disease has reached inoperable stage. This study was conducted to explore factors that contribute to delay in seeking early diagnosis and treatment of cervical cancer among women in Malawi. The study was exploratory and utilized qualitative data collection and analysis method. In-depth interviews were conducted using a semi-structured interview guide on a purposive sample of 24 women who were diagnosed of cervical cancer at the gynaecological wards of Zomba and Queen Elizabeth Central Hospitals in Malawi between July and September, 2011. Thematic content analysis was used to analyze the qualitative data. Two major themes (individual and health facility) emerged from the participants’ narratives as factors that contributed to their delay in seeking early diagnosis and treatment. The individual factors included;limited knowledge on symptoms and signs and limited financial resources. The health facilities factors included;limited accessibility and unavailability of cancer screening facilities in the health centres. Results show that there is a need to strengthen the screening of cervical cancer among women in the country. In addition, there is a need to create community awareness on the signs and symptoms of cervical cancer and the merits of seeking early diagnosis and treatment.

不同类型剖宫产瘢痕妊娠的病例特点与诊治分析

背景现行剖宫产瘢痕妊娠(CSP)分型依据仅参照超声影像特点,目前尚缺乏该分型标准下不同类型CSP病例临床特点的分析总结。目的探讨不同类型CSP的病例特点及诊治差异。方法纳入北京大学第三医院妇产科2014年7月—2022年6月收治的CSP患者共862例为研究对象,根据超声分型标准分为Ⅰ型、Ⅱ型、Ⅲ型组,并对其临床特点及诊治指标进行回顾性分析。结果本研究CSP患者中Ⅰ型组占36.5%(315/862),Ⅱ型组占53.1%(458/862),Ⅲ型组占10.3%(89/862)。3组患者的年龄、孕产史、既往宫腔手术史比例比较,差异均无统计学意义(P>0.05)。CSP患者中腹痛发生率为24.2%(209/862),阴道出血发生率为65.0%(560/862)。3组CSP患者腹痛及阴道出血发生率比较,差异均无统计学意义(P=0.261、0.062)。Ⅲ型组患者诊断时停经时间为55(46,64)d,妊娠物中位径线长29.6(19.1,43.3)mm,术前血β-人绒毛膜促性腺激素(β-HCG)水平为60673(17164,122203)mU/mL,需辅助药物杀胚治疗、腹腔镜监视下手术、子宫动脉阻断率分别为27.0%(24/89)、33.7%(30/89)、32.6%(29/89),手术时长101(67,125)min,住院时间4(3,7)d,治疗花费11933.7(8760.7,15250.6)元,术后24 h累计出血量、出血≥200 mL发生率及输血率分别为83(33,178)mL、24.7%(22/89)、7.9%(7/89),均高于其他两组(P<0.001)。所有患者持续性CSP发生率为3.1%(27/862),3组持续性CSP发生率比较,差异无统计学意义(χ^(2)=3.353,P=0.187)。结论不同类型CSP患者的年龄、孕产史、既往宫腔手术史及腹痛、阴道出血等临床特点无明显差异。Ⅰ型和Ⅱ型患者治疗侵入性较小,Ⅲ型患者的医疗资源消耗较多,对多学科团队及个体化管理有较高要求。不同类型患者经规范管理,其治疗预后均较理想。

Jejunum and ileum

930134 Chronic intestinal pseudo-obstruc-tion:An analysis of 8 cases.WANG Xiuling(王秀玲),et al.Dept Med,Xinhua Hosp,Shanghai2nd Med Univ.Chin J Digest 1992;12(3):148-150.This report describes 8 cases of chronic in-testinal pseudoobstruction.Among them 6 pa-tients underwent exploratory laparotomy,and nomechanical obstructive lesions could be found.The remaining two cases had a clinical syndromecharacterized by symptoms and signs of intesti-nal pseudo-obstruction and a typical

感染性心内膜炎急诊手术经验总结

目的总结急诊手术治疗感染性心内膜炎(IE)的临床经验。方法回顾性分析2019年1月至2022年8月在苏州大学附属第一医院心脏大血管外科诊治的76例IE患者的临床资料,总结并分享急诊手术治疗IE的经验。结果76例IE患者中男性55例(72.4%),女性21例(27.6%),男性和女性比例为2.6∶1;年龄17~76岁,平均(52.1±15.6)岁;血培养阳性率25.0%(19例);治愈57例(75.0%),自动出院8例(10.5%),好转9例(11.8%),术前死亡2例(2.6%)。患者行二尖瓣手术30例(39.5%),主动脉瓣置换手术24例(31.6%),二尖瓣+主动脉瓣手术12例(15.7%);合并先天性心脏病15例(19.7%),风湿性心脏病69例(90.8%);左心系统赘生物66例(93.0%),右心系统4例(5.6%);行急诊手术13例(17.1%),且无死亡病例。结论IE病死率较高,目前有效的治疗方法仍然是外科手术,但手术时机仍有争议。本研究经过多例急诊手术总结经验,认为只要患者情况允许,尽早手术可提高患者的存活率,改善预后。

腰痛活血胶囊对强直性脊柱炎患者M1、M2型炎症因子的影响

目的探讨腰痛活血胶囊对强直性脊柱炎(AS)患者疗效及M1、M2型炎症因子的影响。方法选取2020年1月至2023年11月安徽中医药大学第一附属医院风湿科收治的60例AS患者,采用随机数字表法分为研究组、对照组各30例。研究组予腰痛活血胶囊(1.2 g,3次/d)联合沙利度胺口服(50 mg,每晚1次),对照组予沙利度胺口服(50 mg,每晚1次),2组均治疗4周。观察治疗前后疼痛视觉模拟评分法(VAS)评分、强直性脊柱炎疾病活动指数(BASDAI)评分、Bath强直性脊柱炎功能指数(BASFI)评分、Bath强直性脊柱炎计量学指数(BASMI)、Bath强直性脊柱炎总体指数(BAS-G)、中医临床证候积分及血清红细胞沉降率(ESR)、C反应蛋白(CRP)、M1型炎症细胞因子[肿瘤坏死因子(TNF)-α、白细胞介素(IL)-6]、M2型炎症细胞因子(IL-4、IL-10)的表达。结果2组治疗后,研究组和对照组的总有效率分别为90%及70%,研究组总有效率高于对照组,差异有统计学意义(P<0.05)。与治疗前相比较,研究组治疗后VAS、BASDAI、BASFI、BAS-G、BASMI、ESR、CRP、TNF-α、IL-6降低,腰骶脊背僵痛积分、腰脊活动受限积分、晨僵积分、夜间疼痛积分、关节肿痛积分及中医证候总积分降低,IL-4、IL-10表达升高(P<0.01)。与对照组治疗后相比较,研究组治疗后VAS、BASDAI、BASFI、CRP、IL-6、腰骶脊背僵痛、腰脊活动受限、夜间疼痛、中医证候总积分降低,IL-10表达升高(P<0.01)。结论腰痛活血胶囊联合沙利度胺可显著改善AS患者临床症状,通过上调M2型炎症因子表达,降低AS患者免疫炎症水平,改善患者临床症状且临床疗效安全。