Objective: Zinc has been studied for its antioxidant and anti-inflammatory properties and also for its immune function in end stage renal disease patients. The aim of this review is to clarify whether there is a relat...Objective: Zinc has been studied for its antioxidant and anti-inflammatory properties and also for its immune function in end stage renal disease patients. The aim of this review is to clarify whether there is a relationship between zinc levels and ESRD patients in hemodialysis. Methodology: A search through LILACS and MEDLINE database using the keywords “zinc”, “chronic kidney disease” and “hemodialysis” was performed. Articles in English and Portuguese performed in humans with the previous words were selected. Studies with subjects younger than 18 years of age were excluded. Moreover, exclusion criteria included patients with absence of diagnosis of end stage renal disease and not in hemodialysis;patients treated with peritoneal dialysis, absence of abstract available, absence of clear association between zinc deficiency and worse prognosis. Results: The search found a total of 214 articles. A total of 44 publications were selected after appliance of exclusion criteria. Conclusion: Zinc deficiency is highly prevalent, and it not only showed influence on inflammatory and immunological processes, but also interfered with metabolism and other systems. Zinc supplementation was considered positive. In summary, lower zinc levels are related to end stage renal disease patients in hemodialysis and supplementation seems to be a promising approach in such cases.展开更多
Objective To understand general practice(GP)residents’attitudes about their residency training in China.Design Mixed methods survey administered cross-sectionally.Setting Two GP training programmes similar in most re...Objective To understand general practice(GP)residents’attitudes about their residency training in China.Design Mixed methods survey administered cross-sectionally.Setting Two GP training programmes similar in most regards according to current GP training policy of 5 years’undergraduate degree in medicine and 3 years of postgraduate GP residency training-but differing as the Beijing programme has adopted educational innovations beyond the nationally prescribed standard curriculum used by the second Shenzhen programme.Participants 105(85%)of eligible GP trainees,35(90%)in the innovative Beijing programme and 70(83%)in the standard training Shenzhen programme.Results Overall,residents felt discrimination because of specialty choice,and that they lacked competency as a general practitioner.Many residents commented faculty had negative teaching attitudes.Beijing residents were more satisfied than Shenzhen residents with their training(p=0.001),and felt teaching faculty had sufficient knowledge(p<0.001),and appropriate attitudes towards teaching(p=0.004).Beijing residents more strongly agreed on five items about good future job prospects(all p<0.05).Conclusion These Chinese GP residents identify areas for improvement in their training as well as strengths.Higher satisfaction with faculty teaching and job optimism in Beijing where GP residents receive training from specifically qualified faculty,and can earn special certification,suggest that the educational innovations enhance training and promote positivity about job prospects.These findings imply that GP residents in China face many training challenges that are similar to other international reports,while also implicating benefits of using an innovative curricular approach.展开更多
Objective:This study was undertaken to investigate the association between maternal age at the first and last delivery,and urinary incontinence later in life. Study design:In the Norwegian EPINCONT study (a substudy o...Objective:This study was undertaken to investigate the association between maternal age at the first and last delivery,and urinary incontinence later in life. Study design:In the Norwegian EPINCONT study (a substudy of HUNT 2),crosssectional data on incontinence from 11,397 women aged 20 to 64 years was linked with prospectively obtained data on exposures from the Medical Birth Registry of Norway. Bivariate and multivariate methods were applied. Results:Women 25 years or younger at their first delivery had a lower risk of incontinence than their older counterparts (23%vs 28%,P < .01). No significant effect of maternal age at the first delivery was found in women with actual age 50 to 64 years. Adjusting for confounders did not change any results. Age at the last delivery was less associated with incontinence. Conclusion:Being older than 25 years at the first delivery was associated with incontinence. The effect attenuated with actual age.展开更多
Hereditary lymphoedema type I is a congenital onset primary lymphoedema with autosomal dominant inheritance, which is characterized by the swelling of the lower body. In this article, the authors report a case of a 32...Hereditary lymphoedema type I is a congenital onset primary lymphoedema with autosomal dominant inheritance, which is characterized by the swelling of the lower body. In this article, the authors report a case of a 32-year-old woman with repeating episodes of swollen limbs. Imaging studies and genetic study were carried out and a Milroy’s syndrome diagnosis was established. The patient started sintomatic treatment of the edema, with fitting stockings and descompressive massage, with symptomatic benefit.展开更多
Multiple Symmetric Lipomatosis (MSL) is a rare condition characterized by a symmetrical pattern of massive fatty deposits. This condition predominates in males, between 30 and 60 years. In this article, the authors pr...Multiple Symmetric Lipomatosis (MSL) is a rare condition characterized by a symmetrical pattern of massive fatty deposits. This condition predominates in males, between 30 and 60 years. In this article, the authors present a case report of a 47-year-old man that resorted to consultation to perform routine medical exams, without any complaint associated. Physical examination shows multiple bilateral swellings in the proximal region of the upper limbs and analytically presents hyperuricemia, hypertriglyceridemia, hypercholesterolemia and changes in hepatic tests. CT revealed the presence of non-encapsulated homogeneous masses of adipose tissue in the proximal region of the limbs. Currently the patient is asymptomatic, being monitoring in consultation.展开更多
General Practice is a comprehensive subject with a wide spectrum of diseases. It is challenging to make a more correct diagnosis timely and reasonable treatment with the least instrument examination for the diagnosis ...General Practice is a comprehensive subject with a wide spectrum of diseases. It is challenging to make a more correct diagnosis timely and reasonable treatment with the least instrument examination for the diagnosis of medically unexplained physical symptoms (MUPS). This article reviews the case report of a patient who presented to a community hospital with a one-month history of constant diffuse abdominal pain and underwent eight weeks of examinations, finally experienced deterioration of their condition. Based on this case, this article discusses the problems in the diagnosis of abdominal pain in a community hospital, and according to the clinical thinking mode and checklist of abdominal pain, the diagnostic process of abdominal pain can be improved, and the diagnosis of non-differentiated diseases can be done better, the harm caused by delayed diagnosis may be reduced.展开更多
IntroduCtIon As the World Health Organisation calls for urgent,aggressive actions to combat COVID-19,China has been making positive contri-butions in the fight against the pandemic during the past few months.General p...IntroduCtIon As the World Health Organisation calls for urgent,aggressive actions to combat COVID-19,China has been making positive contri-butions in the fight against the pandemic during the past few months.General practi-tioners(GPs)in China are at the forefront of tackling the spread of the virus.While the health sector in China has been under scrutiny globally,many articles have been disseminated within the country about the response.GPs in China hope that by sharing their experiences,international colleagues could benefit from what worked well and what went less well.展开更多
BACKGROUND： Although cupping remains a popular treatment modality worldwide, its efficacy for most diseases, including hypertension, has not been scientifically evaluated. OBJECTIVE： We aimed to determine the effica...BACKGROUND： Although cupping remains a popular treatment modality worldwide, its efficacy for most diseases, including hypertension, has not been scientifically evaluated. OBJECTIVE： We aimed to determine the efficacy of wet-cupping for high blood pressure, and the incidence of the procedure＇s side effects in the intervention group. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS： This is a randomized controlled trial conducted in the General Practice Department at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, between May 2013 and February 2014. There were two groups （40 participants each）： intervention group undergoing wet-cupping （hijama） in addition to conventional hypertension treatment, and a control group undergoing only conventional hypertension treatment. Three wet-cupping sessions were performed every other day. MAIN OUTCOME MEASURE： The mean systolic and diastolic blood pressures were measured using a validated automatic sphygmomanometer. The follow-up period was 8 weeks. RESULTS： Wet-cupping provided an immediate reduction of systolic blood pressure. After 4 weeks of follow-up, the mean systolic blood pressure in the intervention group was 8.4 mmHg less than in the control group （P = 0.046）. After 8 weeks, there were no significant differences in blood pressures between the intervention and control groups. In this study, wet-cupping did not result in any serious side effects. CONCLUSION： Wet-cupping therapy is effective for reducing systolic blood pressure in hypertensive patients for up to 4 weeks, without serious side effects. Wet-cupping should be considered as a complementary hypertension treatment, and further studies are needed.展开更多
Metal halide perovskites have attracted much attention in biomedicine because of their excellent fluorescence energy conversion properties;however,poor water-stability and cytotoxicity limit its applications as a biom...Metal halide perovskites have attracted much attention in biomedicine because of their excellent fluorescence energy conversion properties;however,poor water-stability and cytotoxicity limit its applications as a biomedical tracer,especially in cellular imaging.Herein,water-ultrastable perovskites C sPbBr_(3):Cs_(4)PbBr_(6)nanocrystals(NCs)encapsulated in chitosan are fabricated successfully using a water-triggered method.The as-synthesized CsPbBr_(3):Cs_(4)PbBr_(6)@CS(chitosan,CS)nanoparticles in water display enhanced fluorescence emission for 35 days.Further,the viability of glioma cells(U87 cells)incubated with different concentrations of CsPbBr_(3):Cs_(4)PbBr_(6)@CS nanoparticles(0-20μg·ml^(-1))for24 h is found to be higher than 90%.In artificial body fluid,analyses using laser confocal microscopy,the standard Cell Counting Kit-8(CCK-8)method,and flow cytometry demonstrated the good water ultrastability and high biocompatibility performance of CsPbBr_(3):Cs_(4)PbBr_(6)@CS nanoparticles in cellular imaging.Overall,the water-ultrastable halide perovskites support promising perspectives in biological cell tracing and intelligent medical technology.展开更多
那么，好的东西会嫌太多吗？——《皆大欢喜》（As You Likeh）莎士比亚（公元1600年）罗莎琳德在要嫁给奥兰多时提出的这个问题仅仅是一种反问——她认为不能对好东西过度享用。然而，尽管俗套，一个人有时候就是会过度享用。在医疗保...那么，好的东西会嫌太多吗？——《皆大欢喜》（As You Likeh）莎士比亚（公元1600年）罗莎琳德在要嫁给奥兰多时提出的这个问题仅仅是一种反问——她认为不能对好东西过度享用。然而，尽管俗套，一个人有时候就是会过度享用。在医疗保健领域更是如此，目前已被称为“过度医疗”。尽管它容易和“过度用药”相混淆，更好的说法应该是“过度医疗保健”。展开更多
文摘Objective: Zinc has been studied for its antioxidant and anti-inflammatory properties and also for its immune function in end stage renal disease patients. The aim of this review is to clarify whether there is a relationship between zinc levels and ESRD patients in hemodialysis. Methodology: A search through LILACS and MEDLINE database using the keywords “zinc”, “chronic kidney disease” and “hemodialysis” was performed. Articles in English and Portuguese performed in humans with the previous words were selected. Studies with subjects younger than 18 years of age were excluded. Moreover, exclusion criteria included patients with absence of diagnosis of end stage renal disease and not in hemodialysis;patients treated with peritoneal dialysis, absence of abstract available, absence of clear association between zinc deficiency and worse prognosis. Results: The search found a total of 214 articles. A total of 44 publications were selected after appliance of exclusion criteria. Conclusion: Zinc deficiency is highly prevalent, and it not only showed influence on inflammatory and immunological processes, but also interfered with metabolism and other systems. Zinc supplementation was considered positive. In summary, lower zinc levels are related to end stage renal disease patients in hemodialysis and supplementation seems to be a promising approach in such cases.
基金This study was funded by University of Michigan Medical School.
文摘Objective To understand general practice(GP)residents’attitudes about their residency training in China.Design Mixed methods survey administered cross-sectionally.Setting Two GP training programmes similar in most regards according to current GP training policy of 5 years’undergraduate degree in medicine and 3 years of postgraduate GP residency training-but differing as the Beijing programme has adopted educational innovations beyond the nationally prescribed standard curriculum used by the second Shenzhen programme.Participants 105(85%)of eligible GP trainees,35(90%)in the innovative Beijing programme and 70(83%)in the standard training Shenzhen programme.Results Overall,residents felt discrimination because of specialty choice,and that they lacked competency as a general practitioner.Many residents commented faculty had negative teaching attitudes.Beijing residents were more satisfied than Shenzhen residents with their training(p=0.001),and felt teaching faculty had sufficient knowledge(p<0.001),and appropriate attitudes towards teaching(p=0.004).Beijing residents more strongly agreed on five items about good future job prospects(all p<0.05).Conclusion These Chinese GP residents identify areas for improvement in their training as well as strengths.Higher satisfaction with faculty teaching and job optimism in Beijing where GP residents receive training from specifically qualified faculty,and can earn special certification,suggest that the educational innovations enhance training and promote positivity about job prospects.These findings imply that GP residents in China face many training challenges that are similar to other international reports,while also implicating benefits of using an innovative curricular approach.
文摘Objective:This study was undertaken to investigate the association between maternal age at the first and last delivery,and urinary incontinence later in life. Study design:In the Norwegian EPINCONT study (a substudy of HUNT 2),crosssectional data on incontinence from 11,397 women aged 20 to 64 years was linked with prospectively obtained data on exposures from the Medical Birth Registry of Norway. Bivariate and multivariate methods were applied. Results:Women 25 years or younger at their first delivery had a lower risk of incontinence than their older counterparts (23%vs 28%,P < .01). No significant effect of maternal age at the first delivery was found in women with actual age 50 to 64 years. Adjusting for confounders did not change any results. Age at the last delivery was less associated with incontinence. Conclusion:Being older than 25 years at the first delivery was associated with incontinence. The effect attenuated with actual age.
文摘Hereditary lymphoedema type I is a congenital onset primary lymphoedema with autosomal dominant inheritance, which is characterized by the swelling of the lower body. In this article, the authors report a case of a 32-year-old woman with repeating episodes of swollen limbs. Imaging studies and genetic study were carried out and a Milroy’s syndrome diagnosis was established. The patient started sintomatic treatment of the edema, with fitting stockings and descompressive massage, with symptomatic benefit.
文摘Multiple Symmetric Lipomatosis (MSL) is a rare condition characterized by a symmetrical pattern of massive fatty deposits. This condition predominates in males, between 30 and 60 years. In this article, the authors present a case report of a 47-year-old man that resorted to consultation to perform routine medical exams, without any complaint associated. Physical examination shows multiple bilateral swellings in the proximal region of the upper limbs and analytically presents hyperuricemia, hypertriglyceridemia, hypercholesterolemia and changes in hepatic tests. CT revealed the presence of non-encapsulated homogeneous masses of adipose tissue in the proximal region of the limbs. Currently the patient is asymptomatic, being monitoring in consultation.
文摘General Practice is a comprehensive subject with a wide spectrum of diseases. It is challenging to make a more correct diagnosis timely and reasonable treatment with the least instrument examination for the diagnosis of medically unexplained physical symptoms (MUPS). This article reviews the case report of a patient who presented to a community hospital with a one-month history of constant diffuse abdominal pain and underwent eight weeks of examinations, finally experienced deterioration of their condition. Based on this case, this article discusses the problems in the diagnosis of abdominal pain in a community hospital, and according to the clinical thinking mode and checklist of abdominal pain, the diagnostic process of abdominal pain can be improved, and the diagnosis of non-differentiated diseases can be done better, the harm caused by delayed diagnosis may be reduced.
文摘IntroduCtIon As the World Health Organisation calls for urgent,aggressive actions to combat COVID-19,China has been making positive contri-butions in the fight against the pandemic during the past few months.General practi-tioners(GPs)in China are at the forefront of tackling the spread of the virus.While the health sector in China has been under scrutiny globally,many articles have been disseminated within the country about the response.GPs in China hope that by sharing their experiences,international colleagues could benefit from what worked well and what went less well.
基金funded by King Abdulaziz University(Jeddah,Saudi Arabia)Kashef Diagnostics Factory(Jeddah,Saudi Arabia)
文摘BACKGROUND： Although cupping remains a popular treatment modality worldwide, its efficacy for most diseases, including hypertension, has not been scientifically evaluated. OBJECTIVE： We aimed to determine the efficacy of wet-cupping for high blood pressure, and the incidence of the procedure＇s side effects in the intervention group. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS： This is a randomized controlled trial conducted in the General Practice Department at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, between May 2013 and February 2014. There were two groups （40 participants each）： intervention group undergoing wet-cupping （hijama） in addition to conventional hypertension treatment, and a control group undergoing only conventional hypertension treatment. Three wet-cupping sessions were performed every other day. MAIN OUTCOME MEASURE： The mean systolic and diastolic blood pressures were measured using a validated automatic sphygmomanometer. The follow-up period was 8 weeks. RESULTS： Wet-cupping provided an immediate reduction of systolic blood pressure. After 4 weeks of follow-up, the mean systolic blood pressure in the intervention group was 8.4 mmHg less than in the control group （P = 0.046）. After 8 weeks, there were no significant differences in blood pressures between the intervention and control groups. In this study, wet-cupping did not result in any serious side effects. CONCLUSION： Wet-cupping therapy is effective for reducing systolic blood pressure in hypertensive patients for up to 4 weeks, without serious side effects. Wet-cupping should be considered as a complementary hypertension treatment, and further studies are needed.
基金financially supported by the National Natural Science Foundation of China(Nos.U2130128,11772207)the Natural Science Foundation of Hebei Province(Nos.A2019210204,H2022205047)+4 种基金the Central Government Guiding Local Science and Technology Development Project(No.216Z4302G)the Natural Science Foundation of Hebei Education Department(No.ZD2020192)the Youth Top-notch Talents Supporting Plan of Hebei ProvinceNational Key Research and Development Program of China(No.2016YFC0904503)Hebei Administration for Market Supervision Science and Technology Project List(2023ZC03)。
文摘Metal halide perovskites have attracted much attention in biomedicine because of their excellent fluorescence energy conversion properties;however,poor water-stability and cytotoxicity limit its applications as a biomedical tracer,especially in cellular imaging.Herein,water-ultrastable perovskites C sPbBr_(3):Cs_(4)PbBr_(6)nanocrystals(NCs)encapsulated in chitosan are fabricated successfully using a water-triggered method.The as-synthesized CsPbBr_(3):Cs_(4)PbBr_(6)@CS(chitosan,CS)nanoparticles in water display enhanced fluorescence emission for 35 days.Further,the viability of glioma cells(U87 cells)incubated with different concentrations of CsPbBr_(3):Cs_(4)PbBr_(6)@CS nanoparticles(0-20μg·ml^(-1))for24 h is found to be higher than 90%.In artificial body fluid,analyses using laser confocal microscopy,the standard Cell Counting Kit-8(CCK-8)method,and flow cytometry demonstrated the good water ultrastability and high biocompatibility performance of CsPbBr_(3):Cs_(4)PbBr_(6)@CS nanoparticles in cellular imaging.Overall,the water-ultrastable halide perovskites support promising perspectives in biological cell tracing and intelligent medical technology.
文摘那么，好的东西会嫌太多吗？——《皆大欢喜》（As You Likeh）莎士比亚（公元1600年）罗莎琳德在要嫁给奥兰多时提出的这个问题仅仅是一种反问——她认为不能对好东西过度享用。然而，尽管俗套，一个人有时候就是会过度享用。在医疗保健领域更是如此，目前已被称为“过度医疗”。尽管它容易和“过度用药”相混淆，更好的说法应该是“过度医疗保健”。
