双套管在腹膜透析中的应用与Toronto管的比较

腹膜透析(简称腹透)已成为治疗慢性肾功能衰竭的主要方法之一,慢性腹透的成功主要取决于腹透管的通畅。在与腹透管有关的机械并发症中,最常见的是导管阻塞和移位,后者随着腹透管及手术方式的不断改进,发生率已明显降低,前者已成为换管的最主要原因。倘使换管无需手术而又极其简便,自较理想。双套管即能适应这一要求。1985～1988年我们使用双套管治疗12例,与同期使用的仿 Toronto 管22例进行比较,效果尚满意,报告如下。

Tea for Harmony Yaji Cultural Salon Held in Toronto

On June 23,hosted by the Consulate General of the People's Republic of China in Toronto and co-organized by the Culture and Arts Center of Guofeng Art Museum,the Tea for Harmony Yaji Cultural.Salon was successfully held in Toronto.Through this event,the Chinese and Canadian people have enhanced friendship and deepened mutual understanding in the exchange of tea culture,injecting new vitality into the stability and development of bilateral relations.

World Tai Chi Day Held in Toronto for the First Time

On April 27,with the initiative and support of the Consulate-General of the People's Republic of China in Toronto and the Chinesea Cultural Centere of Greater Toronto as a cultural partner,the Ontario Martial Arts Federation successfully hosted the event of the World Tai Chi Day for the first time in Toronto,opening a new chapter for Tai Chi in Toronto.

Clinical value of the Toronto inflammatory bowel disease global endoscopic reporting score in ulcerative colitis

BACKGROUND Endoscopic evaluation in diagnosing and managing ulcerative colitis(UC)is becoming increasingly important.Several endoscopic scoring systems have been established,including the Ulcerative Colitis Endoscopic Index of Severity(UCEIS)score and Mayo Endoscopic Subscore(MES).Furthermore,the Toronto Inflammatory Bowel Disease Global Endoscopic Reporting(TIGER)score for UC has recently been proposed;however,its clinical value remains unclear.AIM To investigate the clinical value of the TIGER score in UC by comparing it with the UCEIS score and MES.METHODS This retrospective study included 166 patients with UC who underwent total colonoscopy between January 2017 and March 2023 at the Affiliated Hospital of Qingdao University(Qingdao,China).We retrospectively analysed endoscopic scores,laboratory and clinical data,treatment,and readmissions within 1 year.Spearman’s rank correlation coefficient,receiver operating characteristic curve,and univariate and multivariable logistic regression analyses were performed using IBM SPSS Statistics for Windows,version 26.0(IBM Corp.,Armonk,NY,United States)and GraphPad Prism version 9.0.0 for Windows(GraphPad Software,Boston,Massachusetts,United States).RESULTS The TIGER score significantly correlated with the UCEIS score and MES(r=0.721,0.626,both P<0.001),showed good differentiating values for clinical severity among mild,moderate,and severe UC[8(4-112.75)vs 210(109–219)vs 328(219–426),all P<0.001],and exhibited predictive value in diagnosing patients with severe UC[area under the curve(AUC)=0.897,P<0.001].Additionally,the TIGER(r=0.639,0,551,0.488,0.376,all P<0.001)and UCEIS scores(r=0.622,0,540,0.494,and 0.375,all P<0.001)showed stronger correlations with laboratory and clinical parameters,including C-reactive protein,erythrocyte sedimentation rate,length of hospitalisation,and hospitalisation costs,than MES(r=0.509,0,351,0.339,and 0.270,all P<0.001).The TIGER score showed the best predictability for patients'recent advanced treatment,including systemic corticosteroids,biologics,or immunomodulators(AUC=0.848,P<0.001)and 1-year readmission(AUC=0.700,P<0.001)compared with the UCEIS score(AUC=0.762,P<0.001;0.627,P<0.05)and MES(AUC=0.684,P<0.001;0.578,P=0.132).Furthermore,a TIGER score of≥317 was identified as an independent risk factor for advanced UC treatment(P=0.011).CONCLUSION The TIGER score may be superior to the UCIES score and MES in improving the accuracy of clinical disease severity assessment,guiding therapeutic decision-making,and predicting short-term prognosis.

痛麻洗剂配合足底穴位按摩对糖尿病周围神经病变多伦多(Toronto)积分影响的临床研究

目的:观察痛麻洗剂(自拟配方)配合足底穴位按摩对糖尿病周围神经病变治疗的临床疗效。方法:选取2014年8月至2016年8月在我院符合糖尿病周围神经病变诊断标准的住院病人60例,在控制血糖的基础上按随机数字表法分为2组,其中对照组30例使用甲钴胺治疗2周,观察组30例使用痛麻洗剂足浴配合足底穴位按摩,疗程2周。治疗结束后比较2组患者治疗前后症状积分、反射积分和感觉检查积分的变化。结果:治疗后2组患者症状积分、反射积分和感觉检查积分均有减低,与对照组比较观察组效果更为明显,起效更快,观察组治疗总有效率90%,对照组总有效率56.7%。结论:痛麻洗剂配合足底穴位按摩对糖尿病周围神经病变疗效优于甲钴胺,可以作为一种糖尿病周围神经病变的外治方法使用。

Temporal Variability in Fine Carbonaceous Aerosol over Two Years in Two Megacities:Beijing and Toronto

Time-series of weekly total carbon （TC） concentrations of fine aerosol particles （PM2.5） in Beijing and Toronto were compared to investigate their respective levels and temporal patterns over two years from August 2001 through July 2003. In addition to this comparison, differences in the factors contributing to the observed concentrations and their temporal variations are discussed. Based upon past knowledge about the two megacities with highly contrasting air pollutant levels, it is not surprising that the average TC concentration in Belling （31.5 μg C m^-3） was greater than that in Toronto by a factor of 8.3. Despite their large concentration differences, in both cities TC comprised a similarly large component of PM2.5. TC concentrations exhibited very different seasonal patterns between the two cities. In Beijing, TC experienced higher levels and greater weekly fluctuations in winter whereas in Toronto this behavior was seen in summer. As a result, the greatest gap in TC concentrations between Beijing and Toronto （by a factor of 12.7） occurred in winter, while the smallest gap （a factor of 4.6） was in summer. In Beijing, seasonal variations in the emissions probably played a greater role than meteorology in influencing the TC seasonality, while in Toronto during the warm months more than 80% of the hourly winds were recorded from the south, along with many potential anthropogenic sources for the days with high TC concentrations. This comparison of the differences provides insight into the major factors affecting carbonaceous aerosol in each city.

Symbiosis of language testing and language teaching:The journey of the 37^(th) Language Testing Research Colloquium( LTRC 2015) in Toronto,Canada

The 37th Language Testing Research Colloquium(LTRC 2015①)was held at Eaton Chelsea Hotel in Toronto Canada during March 16-20,2015.The first two days of March 16-17 were preconference workshop days with March 18-20 as the three main conference days.More than 300 participants from 27 countries and regions joined the conference.The top numbers of the

China Tourism and Culture Week Kicks off in Toronto

The China Tourism and Culture Week kicked off in Toronto on June 15 to showcase China's landscapes, culture and food, attracting hundreds of visitors.

Is Evidence-Based Conservation Applied in Urban Forestry? A Case Study from Toronto, Canada

Evidence-based conservation seeks to incorporate sound scientific information into environmental decision making. The application of this concept in urban forest management has tremendous potential, but to date has been little applied, largely because existing scientific studies emphasize the importance of urban forests in large-scale ecological and anthropogenic processes, but in practice, scientific evidence is ostensibly incorporated into North American urban forest management only when deciding the fate of individual trees. Even under these disjunctive conditions, the degree to which evidence influences tree-level decisions remains debatable. In analyzing preliminary data from a case study from Toronto, Canada, we sought to test if and how scientific evidence factored into the decision to remove or preserve 53 trees, located in close proximity to a provincially significant area of natural and scientific interest (ANSI). We found that by far the strongest tree-level correlate of the recommendation to remove or preserve trees was whether or not an individual tree was in conflict with proposed development. In comparison, species identity, tree condition, and suitability for conservation were statistically unrelated to the final recommendation. Our findings provide the basis to expand our analysis to multiple case studies across Canada, and internationally. Furthermore, when interpreted with available research and policy, our preliminary (and future) analysis highlights clear opportunities where scientific evidence can and should be readily incorporated into urban forestry management and policy.

Algorithm Regulation Under the Framework of Human Rights Protection——From the Perspective of Toronto Declaration

The application of artificial intelligence algorithms in public services brings with it issues such as algorithmic discrimination and inequality.The discussion of the ethics and regulation of algorithms,from the legal perspective,is actually the relationship between intelligent algorithms and the protection of human rights.In response to the discrimination and prejudice of algorithmic violations of human rights,a coalition of nonprofit organizations released the Toronto Declaration on Machine Learning regulates the development and use of algorithms with the principle of"due process."The Ethics Guidelines for Trustworthy AI issued by the European Union in 2019 focus on the participants in algorithm development.While US courts that the algorithms enjoy the right to"freedom of speech".China should learn from the foreign algorithm regulation experience,and seek to establish an overall framework of government regulation that balances the need for technological innovation and commercial competition with human rights protection.

Toronto City Committee wants e-scooters barred from sidewalks

加拿大的共享电动滑板还没启动,多伦多市政厅已经开始讨论不允许这些滑板车停在人行道上了。Barring e-scooters from city sidewalks,recom mendedb yacitycom mitteeon M onday, wouldmake it impossib le to introduce the concept to Toronto,according to the CEO of Bird Canada, an e-scooter company hoping to launch here in the spring of2 0 2 0.

去多伦多旅行

Toronto is the largest city in Canada.People sometimes call it"the world in one city."Why?Because you can hear more than 180 languages onthestreetsthere.

依帕司他联合甲钴胺治疗高龄患者糖尿病周围神经病变

目的观察依帕司他联合甲钴胺治疗高龄患者糖尿病周围神经病变的疗效。方法选取100例确诊为糖尿病周围神经病变的高龄患者随机分为2组,治疗组50例给予依帕司他及甲钴胺治疗,对照组50例给予甲钴胺治疗,疗程12周,观察两组患者的TCSS(Toronto临床评分系统)评分及双侧MCV和SCV变化。结果治疗后,两组患者TCSS评分及双侧腓总神经传导速度(MCV和SCV)显著改善(P<0.05),但治疗组较对照组改善更明显(P<0.05)。结论依帕司他联合甲钴胺治疗高龄患者糖尿病周围神经病变临床疗效理想,且优于单药治疗。

温阳通络法组方汤剂治疗阳虚血瘀证型糖尿病周围神经病患者的效果评价

目的：探讨温阳通络法组方汤剂（当归四逆汤合黄芪桂枝五物汤加减）治疗阳虚血瘀证型糖尿病周围神经病（DPN）患者的效果。方法：连续选择2014年10月~2015年8月入我院门诊及住院DPN患者共60例,根据入院先后顺序将其随机分为对照组和观察组各30例,对照组给予标准医学治疗＋甲钴胺注射液（弥可保）500μg肌肉注射,1次/d;观察组给予标准医学治疗＋中药口服并沐足治疗,1剂/d,水煎400 m L,早晚各服用1次。药渣加适量水再煎30 min后泡足,水温38℃~40℃,泡25~30min,1次/d。2 w为1疗程。结果：1.2组患者的空腹血糖（FBG）和餐后2h血糖（P2h BG）比较,差异无统计学意义（P〉0.05）。2.观察组患者的Toronto临床评分和中医证候评分（包括肢体疼痛、肢体麻木、肢端发凉、感觉异常）及总积分均比治疗前降低,而对照组无变化,组内和组间比较,差异均有统计学意义（P〈0.05）。3.随访观察组的总有效率显著高于对照组,差异有统计学意义（P〈0.05）。结论：温阳通络法组方汤剂联合标准医学治疗治疗阳虚血瘀证型DPN的临床效果可能优于西药治疗,有较大的临床应用价值。

前言——加强对老年肾脏病防治的研究

最近10年来老年肾脏病学已成为肾脏病中一个引入注目的分支。1985年在Toronto举行了第一届国际老年肾脏病学讨论会,有关老年肾脏病的专著近来已不断涌现。我国肾脏病学的发展起步较晚,尽管如此,人们均已深深感到我国已存在大址迫切需要研究和解决的有关老年肾脏病的问题。这是一个待开拓的领域。肾脏作为人体的一个重要器官,随着年龄老化逐渐出现功能减退,在病理条件下更易出现功能不全。年迈者肾脏的生理变化影响到机体对药物的代谢,特别是对一些具有潜在肾毒性药物(如庆大霉素、造影剂等)的耐受性减低。老年人好发的一些系统性疾病如糖尿病、痛风、高血压、动脉硬化等都经常侵犯肾脏。

腹膜透析治疗急慢性肾衰疗效观察(附4例报告)

腹膜透析应用于临床始于Ganter,虽技术相对简单,但易合并感染,出现水电介质紊乱等,而未被普遍采用。后来由于抗生素的广泛使用及肝素的问世,且又积累了大量的经验。1975年Popovich提出了长时间留置进行腹膜透析的设想,用2升腹透液每日交换5次,连续治疗,尿毒症患者可望得到充分控制。

医学综述性文献的检索

综述一般是由专家学者在充分研究已发表文献的基础上,综述已取得的成果进展,或加评论,或预测发展趋势,它可使读者不必大量阅读一般文献,就可了解当前的研究水平、动态。医学综述对医学科研工作者和医学临床工作者都有十分重要的作用。我们在进行医学文献检索和医学文献参考咨询工作中常常会遇到读者要查或咨询如何查某一问题的综述性文献。可见医学综述性文献的检索是医学文献检索的一项重要内容。

芪藤通痹散熏洗治疗糖尿病周围神经病变临床观察

目的:探讨芪藤通痹散熏洗治疗糖尿病周围神经病变的临床疗效及安全性。方法:将60例气虚血瘀型糖尿病周围神经病变患者随机分为治疗组和对照组30例。两组均予以常规基础治疗。对照组予以甲钴胺注射液500μg肌肉注射每日1次。治疗组在基础治疗上加用芪藤通痹散熏洗。疗程均为两周。结果:两组临床疗效比较,治疗组总有效率为90.0%,对照组总有效率为76.7%,两组总有效率比较,差异具有统计学意义(P<0.05)。两组患者Toronto临床评分与治疗前相比均明显下降(P<0.05);与对照组相比,治疗组Toronto临床评分降低更显著,差异有统计学意义(P<0.05)。两组治疗后各神经传导速度均有明显改善(P<0.05),与对照组比较,治疗组的胫神经、腓总神经运动神经传导(MNCV)速度及腓总神经的感觉神经传导速度(SNCV)改善更明显,差异有统计学意义(P<0.05)。胫神经的感觉传导速度(SNCV)改善不明显,差异无统计学意义(P>0.05)。结论:芪藤通痹散熏洗能够改善症状,提高糖尿病周围神经病变患者神经传导速度,疗效肯定,安全性高,值得临床应用。

通痹活血汤治疗糖尿病周围神经病变临床观察

目的观察通痹活血汤治疗糖尿病周围神经病变的效果。方法 60例患者随机分为观察组和对照组各30例。对照组采用常规治疗,观察组在此基础上加服通痹活血汤治疗。结果治疗8周后观察组患者TCSS评分明显低于对照组,MCV和SCV测定结果明显高于对照组,观察组综合疗效优于对照组。结论通痹活血汤治疗糖尿病周围神经病变可有效提高治疗效果。