Objective To analyze the basic characteristics,drug features,prescription rules,and drug-symptom relationships of patients in the splenic deficiency and impairment stage,by data mining of medical records under the New...Objective To analyze the basic characteristics,drug features,prescription rules,and drug-symptom relationships of patients in the splenic deficiency and impairment stage,by data mining of medical records under the New Theory on Spleen Dampness Syndrome(Pi Dan Xin Lun,《脾瘅新论》).Methods Medical records listed in the“New Theory on Spleen Dampness Syndrome-Under-standing and Treatment of Metabolic Syndrome from the Perspective of Traditional Chinese Medicine”,and which were diagnosed with the spleen dampness syndrome at the splenic de-ficiency and impairment stage,during January 2004 and December 2016 were selected.These patients’data,including basic information,clinical symptoms,laboratory examination res-ults,traditional Chinese medicine(TCM)and western medicine diagnoses,treatment meth-ods,prescriptions,etc.,were collected.The collected data were subsequently compiled into a medical record database using the Epidata 3.1 data management software,followed by the use of Apriori algorithm provided in the SPSS Modeler 14.2 statistical software to investigate the association rules between drug-drug,drug-symptom,and drug-western medicine indices.Results(i)A total of 51 medical records were included,involving 17 types of syndromes.Among them,the top three with frequency≥3 included“Phlegm and blood stasis,and thoracic obstruction”“Deficiency-weakness of the spleen Qi,and static blood blocking collat-erals”,and“Deficiency-weakness of the spleen Qi,and static blood blocking collaterals”.Al-ternatively,of the 14 treatment methods,the top three treatments with frequency of≥3 in-cluded“Activating Yang and eliminating turbidity,and removing phlegm and dredging chan-nel blockage”“Strengthening the spleen and benefiting Qi,and eliminating phlegm to activ-ate the channels”,and“Warming Yang and benefiting Qi,and expelling cold to remove ob-structions”.Among the 15 prescriptions,the top three used with frequency≥3 included Huangqi Guizhi Wuwu Tang(黄芪桂枝五物汤),Gualou Xiebai Banxia Tang(瓜蒌薤白半夏汤),and Ganjiang Huangqin Huanglian Renshen Tang(干姜黄芩黄连人参汤).Lastly,of the 83 drugs used for a total of 476 times,those with frequency≥15 included Huanglian(Coptid-is Rhizoma),Huangqi(Astragali Radix),Jiudahuang(Wine-processed Rhei Radix et Rhizoma),Jixueteng(Spatholobi Caulis),Shengjiang(Zingiberis Rhizoma Recens),Huangqin(Scutellariae Radix),and Guizhi(Cinnamomi Ramulus).(ii)For the drug-drug associations,under the criteria of support≥15%and confidence=100%,seven second-order association rules,seven third-order rules,and six fourth-order roles were identified.The top-ranking rule of each was“Huangqin(Scutellariae Radix)→Huanglian(Coptidis Rhizoma)”“Ganjiang(Zingiberis Rhizoma)+Huangqin(Scutellariae Radix)→Huanglian(Coptidis Rhizoma)”,and“Baishao(Paeoniae Radix Alba)+Guizhi(Cinnamomi Ramulus)+Jixueteng(Spatho-lobi Caulis)→Huangqin(Scutellariae Radix)”,respectively.Alternatively,the drug-symptom associations were analyzed under the criteria of support≥5%and confidence=100%,which derived eight second-order association rules,31 third-order rules,and 30 fourth-order rules.The top-ranking association rule of each order was“Huangqi(Astragali Radix)→Limb ed-ema”“Guizhi(Cinnamomi Ramulus)+Jixueteng(Spatholobi Caulis)→Limb numbness and pain”,and“Guizhi(Cinnamomi Ramulus)+Jixueteng(Spatholobi Caulis)+Huangqi(As-tragali Radix)→Limb numbness and pain”,respectively.Similarly,the drug-western medi-cine index associations were investigated under the criteria of support≥5%and confidence=100%,and five second-order association rules,16 third-order rules,and 16 fourth-order rules were identified.In this category,the top-ranking association rule of each order was“Qinpi(Fraxini Cortex)→Uric acid”“Huanglian(Coptidis Rhizoma)+Ganjiang(Zingiberis Rhizoma)→Glycated hemoglobin”,and“Huanglian(Coptidis Rhizoma)+Ganjiang(Zing-iberis Rhizoma)+Huangqin(Scutellariae Radix)→Glycated hemoglobin”,respectively.Conclusion Through association rule mining,this study objectively and quantitatively demonstrated the drug-drug,drug-symptom,and drug-physicochemical index associations of patients with the spleen dampness syndrome at the splenic deficiency and impairment stage treated by Academician TONG Xiaolin.The results indicated that treatment for these patients adopted the“state-target”syndrome differentiation method.The drug combination was characterized by“small prescriptions”,targeting both the patient’s symptoms and signs(syndrome target)and western medicine indices(treatment target).This study could provide references for future research on the academic thoughts and medical experience of Academi-cian TONG Xiaolin.展开更多
Dear Editor,I am Dr.Soraya Mediero,from Department of Ophthalmology of La Paz University Hospital,Madrid,Spain.I write to present a case report of keratoconus associated with Williams-Beuren syndrome（WBS）.
Irritable bowel syndrome (IBS) is an intestinal functional disorder with the highest prevalence in the industrialized world. The intestinal microbiota (IM) plays a role in the pathogenesis of IBS and is not merely a c...Irritable bowel syndrome (IBS) is an intestinal functional disorder with the highest prevalence in the industrialized world. The intestinal microbiota (IM) plays a role in the pathogenesis of IBS and is not merely a consequence of this disorder. Previous research efforts have not revealed unequivocal microbiological signatures of IBS, and the experimental results are contradictory. The experimental methodologies adopted to investigate the complex intestinal ecosystem drastically impact the quality and significance of the results. Therefore, to consider the methodological aspects of the research on IM in IBS, we reviewed 29 relevant original research articles identified through a PubMed search using three combinations of keywords: “irritable bowel syndrome + microflora”, “irritable bowel syndrome + microbiota” and “irritable bowel syndrome + microbiome”. For each study, we reviewed the quality and significance of the scientific evidence obtained with respect to the experimental method adopted. The data obtained from each study were compared with all considered publications to identify potential inconsistencies and explain contradictory results. The analytical revision of the studies referenced in the present review has contributed to the identification of microbial groups whose relative abundance significantly alters IBS, suggesting that these microbial groups could be IM signatures for this syndrome. The identification of microbial biomarkers in the IM can be advantageous for the development of new diagnostic tools and novel therapeutic strategies for the treatment of different subtypes of IBS.展开更多
AIMTo compare predictive ability of Budd-Chiari syndrome (BCS) prognostic indices (PIs) for one-year survival and Transjugular intrahepatic portosystemic shunt (TIPS) patency.METHODSThis retrospective study enrolled 1...AIMTo compare predictive ability of Budd-Chiari syndrome (BCS) prognostic indices (PIs) for one-year survival and Transjugular intrahepatic portosystemic shunt (TIPS) patency.METHODSThis retrospective study enrolled 194 Egyptian patients with primary BCS who presented to the Budd-Chiari Study Group of Ain Shams University Hospital. Calculation of the available PIs was performed using Child-Pugh and model for end-stage liver disease scores, BCS-specific PIs (Clichy, New Clichy and Rotterdam) for all patients, and BCS-TIPS PI only for patients who underwent TIPS. The overall one-year survival rate and the one-year shunt patency rate for TIPS were reported.RESULTSThe overall one-year survival rate was 69.6%, and the New Clichy PI revealed the best validity for its prediction at a cut-off value of 3.75, with sensitivity and specificity of 78% and 73.3%, respectively [area under receiver operating characteristic curve (AUC) = 0.806]. The one-year survival rate post-TIPS was 89.7%, and the BCS-TIPS score demonstrated validity for its prediction at a cut-off value of 3.92 (sensitivity and specificity were 71.4% and 64.5%, respectively) (AUC = 0.715). Logistic regression analysis revealed that the New Clichy PI (P = 0.030), high serum total bilirubin (P = 0.047) and low albumin (P < 0.001) were independent factors for predicting mortality within one year. The one-year shunt patency rate in TIPS was 80.2%, and none of the PIs exhibited significant validity for its prediction.CONCLUSIONThe New Clichy score could independently predict the one-year survival in Egyptian BCS patients.展开更多
Severe fever with thrombocytopenia syndrome (SFTS), a new disease of zoonotic natural foci has been increasing in recent years. In this review, the disease of human granulocytic anaplasmosis infection due to tick-born...Severe fever with thrombocytopenia syndrome (SFTS), a new disease of zoonotic natural foci has been increasing in recent years. In this review, the disease of human granulocytic anaplasmosis infection due to tick-borne and new Bunia virus infection, have similar clinical symptoms. Total of 11 articles were retrieved. The emergence, etiology, nomenclature and pathogenic mechanisms, clinical diagnosis and genotyping of SFTS were summarized, and the current situation of treatment was also evaluated. In conclusion, early detection, identiifcation and treatment are the key points to SFTS, but how to reduce the mortality of critically ill patients is still the focus in the future.展开更多
目的:观察新三期中药外治方案治疗急性外踝韧带损伤的临床疗效。方法:将2023年7月至2023年12月期间招募的64例急性外踝韧带损伤患者,按照治疗方法不同分为观察组和对照组,每组32例。观察组男17例,女15例;年龄25~36(30.59±3.10)岁;...目的:观察新三期中药外治方案治疗急性外踝韧带损伤的临床疗效。方法:将2023年7月至2023年12月期间招募的64例急性外踝韧带损伤患者,按照治疗方法不同分为观察组和对照组,每组32例。观察组男17例,女15例;年龄25~36(30.59±3.10)岁;采用新三期中药外治方案联合“POLICE”治疗方案即保护(protect)、适当负重(optimal loading)、冰敷(ice)、加压包扎(compression)和抬高患肢(elevation)。对照组男14例,女18例;年龄24~37(30.03±3.19)岁;采用“POLICE”治疗方案。分别在初次入组和治疗第1、6周后采用视觉模拟评分(visual analogue scale,VAS)评估和Figure of 8测量法评估受试者踝关节疼痛和肿胀程度。同时采用美国足踝外科踝功能评分(American Orthopaedic Foot and Ankle Society,AOFAS)和Karlsson踝关节功能评分系统评价各阶段患者踝关节功能改善情况。通过MRI特定图像观察距腓前韧带生物愈合程度,通过计算信噪比(signal to noise ratio,SNR)评估,信噪比越低代表韧带含水量越低,愈合越好。结果:所有患者获得6周随访。治疗前两组VAS、AOFAS和Karlsson评分差异无统计学意义(P>0.05),治疗1周和6周后,两组VAS、AOFAS评分和Karlsson评分均较治疗前显著改善(P<0.05)。治疗1周后,观察组VAS(3.21±0.87)分,低于对照组(4.21±1.50)分(P<0.05)。治疗1周后,观察组AOFAS和Karlsson评分[(50.84±4.70)分,(49.97±4.00)分],高于对照组[(46.91±5.56)分,(46.66±5.36)分],P<0.05。MRI图像显示,治疗6周后,观察组SNR值75.25±16.59,低于对照组的85.81±15.55(P<0.05)。结论:与对照组相比,新三期中药外治方案早期临床疗效显著,能够明显减轻急性外踝韧带损伤患者踝关节的疼痛和肿胀程度,提高韧带修复质量,促进患者踝关节功能的恢复。展开更多
Objective: This study was conducted to explore what media exactly do when disease is emerging and furthermore, to infer the role and the responsibility that media should play. Method: A content analysis with 0.81 inte...Objective: This study was conducted to explore what media exactly do when disease is emerging and furthermore, to infer the role and the responsibility that media should play. Method: A content analysis with 0.81 inter-rater reliability was adopted to categorize SARS-related events shown on the three major newspapers in 117 days, dated from March 13th (the date before the first probable case of SARS in Taiwan was identified) to July 7th (the date after Taiwan was removed from the list of SARS-affected countries by the bulletin of World Health Organization), 2003. Results: There were totally 8923 SARS events related news found in the observed newspapers during the study period. When the epidemic situation is more serious, the media will also lay out more coverage on reporting the related contents. In the reporting contents, the three most influential newspapers in Taiwan mainly emphasized the impact dimension (34.27%). Only 2.16% of the coverage was on the topic of health communication and prevention education. Overall, the opinions of general public are the primary sources of news (46.57%). Health authority was not the main and typical sources information of the press (9.42%). Conclusion: Media is a double-edged sword in the communicable disease control. We suggest that the health authority should take advantage of media to transmit message rapidly to convey related information to public.展开更多
基金The Construction of First-class Integrated Traditional Chinese and western Medicine Disciplines in Guangxi(Scientific Research Project No.12 of Guangxi Ministry of Education[2018])Qihuang High-level Talent Team Training Projects of Guangxi University of Chinese Medicine−Application of Systems Biology in Chinese Medicine Research(2021005).
文摘Objective To analyze the basic characteristics,drug features,prescription rules,and drug-symptom relationships of patients in the splenic deficiency and impairment stage,by data mining of medical records under the New Theory on Spleen Dampness Syndrome(Pi Dan Xin Lun,《脾瘅新论》).Methods Medical records listed in the“New Theory on Spleen Dampness Syndrome-Under-standing and Treatment of Metabolic Syndrome from the Perspective of Traditional Chinese Medicine”,and which were diagnosed with the spleen dampness syndrome at the splenic de-ficiency and impairment stage,during January 2004 and December 2016 were selected.These patients’data,including basic information,clinical symptoms,laboratory examination res-ults,traditional Chinese medicine(TCM)and western medicine diagnoses,treatment meth-ods,prescriptions,etc.,were collected.The collected data were subsequently compiled into a medical record database using the Epidata 3.1 data management software,followed by the use of Apriori algorithm provided in the SPSS Modeler 14.2 statistical software to investigate the association rules between drug-drug,drug-symptom,and drug-western medicine indices.Results(i)A total of 51 medical records were included,involving 17 types of syndromes.Among them,the top three with frequency≥3 included“Phlegm and blood stasis,and thoracic obstruction”“Deficiency-weakness of the spleen Qi,and static blood blocking collat-erals”,and“Deficiency-weakness of the spleen Qi,and static blood blocking collaterals”.Al-ternatively,of the 14 treatment methods,the top three treatments with frequency of≥3 in-cluded“Activating Yang and eliminating turbidity,and removing phlegm and dredging chan-nel blockage”“Strengthening the spleen and benefiting Qi,and eliminating phlegm to activ-ate the channels”,and“Warming Yang and benefiting Qi,and expelling cold to remove ob-structions”.Among the 15 prescriptions,the top three used with frequency≥3 included Huangqi Guizhi Wuwu Tang(黄芪桂枝五物汤),Gualou Xiebai Banxia Tang(瓜蒌薤白半夏汤),and Ganjiang Huangqin Huanglian Renshen Tang(干姜黄芩黄连人参汤).Lastly,of the 83 drugs used for a total of 476 times,those with frequency≥15 included Huanglian(Coptid-is Rhizoma),Huangqi(Astragali Radix),Jiudahuang(Wine-processed Rhei Radix et Rhizoma),Jixueteng(Spatholobi Caulis),Shengjiang(Zingiberis Rhizoma Recens),Huangqin(Scutellariae Radix),and Guizhi(Cinnamomi Ramulus).(ii)For the drug-drug associations,under the criteria of support≥15%and confidence=100%,seven second-order association rules,seven third-order rules,and six fourth-order roles were identified.The top-ranking rule of each was“Huangqin(Scutellariae Radix)→Huanglian(Coptidis Rhizoma)”“Ganjiang(Zingiberis Rhizoma)+Huangqin(Scutellariae Radix)→Huanglian(Coptidis Rhizoma)”,and“Baishao(Paeoniae Radix Alba)+Guizhi(Cinnamomi Ramulus)+Jixueteng(Spatho-lobi Caulis)→Huangqin(Scutellariae Radix)”,respectively.Alternatively,the drug-symptom associations were analyzed under the criteria of support≥5%and confidence=100%,which derived eight second-order association rules,31 third-order rules,and 30 fourth-order rules.The top-ranking association rule of each order was“Huangqi(Astragali Radix)→Limb ed-ema”“Guizhi(Cinnamomi Ramulus)+Jixueteng(Spatholobi Caulis)→Limb numbness and pain”,and“Guizhi(Cinnamomi Ramulus)+Jixueteng(Spatholobi Caulis)+Huangqi(As-tragali Radix)→Limb numbness and pain”,respectively.Similarly,the drug-western medi-cine index associations were investigated under the criteria of support≥5%and confidence=100%,and five second-order association rules,16 third-order rules,and 16 fourth-order rules were identified.In this category,the top-ranking association rule of each order was“Qinpi(Fraxini Cortex)→Uric acid”“Huanglian(Coptidis Rhizoma)+Ganjiang(Zingiberis Rhizoma)→Glycated hemoglobin”,and“Huanglian(Coptidis Rhizoma)+Ganjiang(Zing-iberis Rhizoma)+Huangqin(Scutellariae Radix)→Glycated hemoglobin”,respectively.Conclusion Through association rule mining,this study objectively and quantitatively demonstrated the drug-drug,drug-symptom,and drug-physicochemical index associations of patients with the spleen dampness syndrome at the splenic deficiency and impairment stage treated by Academician TONG Xiaolin.The results indicated that treatment for these patients adopted the“state-target”syndrome differentiation method.The drug combination was characterized by“small prescriptions”,targeting both the patient’s symptoms and signs(syndrome target)and western medicine indices(treatment target).This study could provide references for future research on the academic thoughts and medical experience of Academi-cian TONG Xiaolin.
文摘Dear Editor,I am Dr.Soraya Mediero,from Department of Ophthalmology of La Paz University Hospital,Madrid,Spain.I write to present a case report of keratoconus associated with Williams-Beuren syndrome（WBS）.
文摘Irritable bowel syndrome (IBS) is an intestinal functional disorder with the highest prevalence in the industrialized world. The intestinal microbiota (IM) plays a role in the pathogenesis of IBS and is not merely a consequence of this disorder. Previous research efforts have not revealed unequivocal microbiological signatures of IBS, and the experimental results are contradictory. The experimental methodologies adopted to investigate the complex intestinal ecosystem drastically impact the quality and significance of the results. Therefore, to consider the methodological aspects of the research on IM in IBS, we reviewed 29 relevant original research articles identified through a PubMed search using three combinations of keywords: “irritable bowel syndrome + microflora”, “irritable bowel syndrome + microbiota” and “irritable bowel syndrome + microbiome”. For each study, we reviewed the quality and significance of the scientific evidence obtained with respect to the experimental method adopted. The data obtained from each study were compared with all considered publications to identify potential inconsistencies and explain contradictory results. The analytical revision of the studies referenced in the present review has contributed to the identification of microbial groups whose relative abundance significantly alters IBS, suggesting that these microbial groups could be IM signatures for this syndrome. The identification of microbial biomarkers in the IM can be advantageous for the development of new diagnostic tools and novel therapeutic strategies for the treatment of different subtypes of IBS.
文摘AIMTo compare predictive ability of Budd-Chiari syndrome (BCS) prognostic indices (PIs) for one-year survival and Transjugular intrahepatic portosystemic shunt (TIPS) patency.METHODSThis retrospective study enrolled 194 Egyptian patients with primary BCS who presented to the Budd-Chiari Study Group of Ain Shams University Hospital. Calculation of the available PIs was performed using Child-Pugh and model for end-stage liver disease scores, BCS-specific PIs (Clichy, New Clichy and Rotterdam) for all patients, and BCS-TIPS PI only for patients who underwent TIPS. The overall one-year survival rate and the one-year shunt patency rate for TIPS were reported.RESULTSThe overall one-year survival rate was 69.6%, and the New Clichy PI revealed the best validity for its prediction at a cut-off value of 3.75, with sensitivity and specificity of 78% and 73.3%, respectively [area under receiver operating characteristic curve (AUC) = 0.806]. The one-year survival rate post-TIPS was 89.7%, and the BCS-TIPS score demonstrated validity for its prediction at a cut-off value of 3.92 (sensitivity and specificity were 71.4% and 64.5%, respectively) (AUC = 0.715). Logistic regression analysis revealed that the New Clichy PI (P = 0.030), high serum total bilirubin (P = 0.047) and low albumin (P < 0.001) were independent factors for predicting mortality within one year. The one-year shunt patency rate in TIPS was 80.2%, and none of the PIs exhibited significant validity for its prediction.CONCLUSIONThe New Clichy score could independently predict the one-year survival in Egyptian BCS patients.
文摘Severe fever with thrombocytopenia syndrome (SFTS), a new disease of zoonotic natural foci has been increasing in recent years. In this review, the disease of human granulocytic anaplasmosis infection due to tick-borne and new Bunia virus infection, have similar clinical symptoms. Total of 11 articles were retrieved. The emergence, etiology, nomenclature and pathogenic mechanisms, clinical diagnosis and genotyping of SFTS were summarized, and the current situation of treatment was also evaluated. In conclusion, early detection, identiifcation and treatment are the key points to SFTS, but how to reduce the mortality of critically ill patients is still the focus in the future.
文摘目的:观察新三期中药外治方案治疗急性外踝韧带损伤的临床疗效。方法:将2023年7月至2023年12月期间招募的64例急性外踝韧带损伤患者,按照治疗方法不同分为观察组和对照组,每组32例。观察组男17例,女15例;年龄25~36(30.59±3.10)岁;采用新三期中药外治方案联合“POLICE”治疗方案即保护(protect)、适当负重(optimal loading)、冰敷(ice)、加压包扎(compression)和抬高患肢(elevation)。对照组男14例,女18例;年龄24~37(30.03±3.19)岁;采用“POLICE”治疗方案。分别在初次入组和治疗第1、6周后采用视觉模拟评分(visual analogue scale,VAS)评估和Figure of 8测量法评估受试者踝关节疼痛和肿胀程度。同时采用美国足踝外科踝功能评分(American Orthopaedic Foot and Ankle Society,AOFAS)和Karlsson踝关节功能评分系统评价各阶段患者踝关节功能改善情况。通过MRI特定图像观察距腓前韧带生物愈合程度,通过计算信噪比(signal to noise ratio,SNR)评估,信噪比越低代表韧带含水量越低,愈合越好。结果:所有患者获得6周随访。治疗前两组VAS、AOFAS和Karlsson评分差异无统计学意义(P>0.05),治疗1周和6周后,两组VAS、AOFAS评分和Karlsson评分均较治疗前显著改善(P<0.05)。治疗1周后,观察组VAS(3.21±0.87)分,低于对照组(4.21±1.50)分(P<0.05)。治疗1周后,观察组AOFAS和Karlsson评分[(50.84±4.70)分,(49.97±4.00)分],高于对照组[(46.91±5.56)分,(46.66±5.36)分],P<0.05。MRI图像显示,治疗6周后,观察组SNR值75.25±16.59,低于对照组的85.81±15.55(P<0.05)。结论:与对照组相比,新三期中药外治方案早期临床疗效显著,能够明显减轻急性外踝韧带损伤患者踝关节的疼痛和肿胀程度,提高韧带修复质量,促进患者踝关节功能的恢复。
文摘Objective: This study was conducted to explore what media exactly do when disease is emerging and furthermore, to infer the role and the responsibility that media should play. Method: A content analysis with 0.81 inter-rater reliability was adopted to categorize SARS-related events shown on the three major newspapers in 117 days, dated from March 13th (the date before the first probable case of SARS in Taiwan was identified) to July 7th (the date after Taiwan was removed from the list of SARS-affected countries by the bulletin of World Health Organization), 2003. Results: There were totally 8923 SARS events related news found in the observed newspapers during the study period. When the epidemic situation is more serious, the media will also lay out more coverage on reporting the related contents. In the reporting contents, the three most influential newspapers in Taiwan mainly emphasized the impact dimension (34.27%). Only 2.16% of the coverage was on the topic of health communication and prevention education. Overall, the opinions of general public are the primary sources of news (46.57%). Health authority was not the main and typical sources information of the press (9.42%). Conclusion: Media is a double-edged sword in the communicable disease control. We suggest that the health authority should take advantage of media to transmit message rapidly to convey related information to public.
