Objective To investigate the medication rule of Professor Liang Xiaochun in the treatment of diabetic microvas-cular complications.Methods A retrospective real-world study method was used,with the electronic medical records from the hospital information system of Peking Union Medical College Hospital as the carrier.Clinical information of patients treated for diabetic microvascular complications by Professor Liang Xiaochun from January 2021 to December 2022 was col-lected to construct a database,which was then entered into the Traditional Chinese Medicine Inheritance Platform(V 3.5).Techniques such as association rule mining and cluster analysis were used to analyze the frequency of medication usage,the nature,flavour,and channel tropism of the medicines,and common drug combinations,the treatment principles and medica-tion patterns of Professor Liang Xiaochun for diabetic microvascular complications were summarized.Results A total of 301 effective prescriptions for treating diabetic microvascular complications by Professor Liang Xiaochun were collated,involving 211 Chinese herbal medicines.The most frequently used medicines were Mori Cortex,Cuscutae Semen,Commelina com-munis,Fructus Ligustri Lucidi,Euonymus alatus,Achyranthes aspera,etc.The four natures were mostly cold,and the five flavours were mostly sweetness.The channel tropism belonged to the liver,spleen,and kidney.The core combinations of medicines identified through correlation analysis were Cuscutae Semen-Fructus Ligustri Lucidi,Cuscutae Semen-Achyranthes aspera,Cuscutae Semen-Commelina communis,Cuscutae Semen-Mori Cortex,Fructus Ligustri Lucidi-Achyranthes aspera,Achyranthes asp era-Smilacis Glabrae Rhixoma,Fructus Ligustri Lucidi-Mori Cortex,Fructus Ligustri Lucidi-Commelina communis.The four core prescrip-tions were obtained by cluster analysis:Fructus Ligustri Luci-di-Cuscutae Semen-Mori Cortex-Commelina communis-Eu-onymus alatus-Achyranthes aspera,Commelina communis-Mori Cortex-Radix Puerariae-Salvia miltiorrhiza-Cuscutae Semen-Fructus Ligustri Lucidi,Fructus Ligustri Luci-di-Commelina communis-Cuscutae Semen-Mori Cortex-Chuanxiong Rhizoma-Spatholobus Suberectus Dunn,Mori Cor-tex-Cuscutae Semen-Folium Nelumbinis-Commelina communis-Fructus Ligustri Lucidi-Chuanxiong Rhizoma.Conclu-sion Professor Liang Xiaochun treats diabetic microvascular complications with the main therapeutic principles of invigorat-ing blood circulation to remove blood stasis,clearing away phlegm to eliminate turbidity,and supplementing deficiencies to support the body's vital energy.
Abstract Background Older patients (aged ≥ 60 years) with severe brain injury have a high mortality and disability rate. The objective of this retrospective study was to assess the clinical risk factors of prognosis in older patients with severe brain injury after surgical intervention and to analyze the prognosis of the surviving group of patients 1 year after discharge. Methods Clinical data of older patients with severe brain injury who were admitted to two neurosurgical centers between January 2010 and December 2020 were collected. Patient age, sex, Glasgow Coma Scale (GCS) score at admission, underlying disease, mechanisms of injury, abnormal pupillary reflex, head computed tomography imaging findings (such as hematoma type),intraoperative brain swelling and other factors were reviewed. All the patients were categorized into a good prognosis (survival) group and a poor prognosis (death) group by the Glasgow Outcome Score (GOS); also, the related factors affecting the prognosis were screened and the independent risk factors were identified by the Binary logistic regression analysis. GOS was used to evaluate the prognosis of the surviving group of patients 1 year after discharge. Results Out of 269 patients, 171 (63.6%) survived, and 98 (36.4%) died during hospitalization. Univariate analysis showed that age, GCS score at admission, underlying diseases, abnormal pupillary reflex, the disappearance of ambient cistern, the midline structure shift, intraoperative brain swelling, oxygen saturation < 90%, and cerebral hernia were risk factors for the prognosis of older patients with severe brain injury after surgical intervention. Multivariate analysis showed that age, underlying diseases, disappearance of ambient cistern, Oxygen saturation < 90% and intraoperative brain swelling were independent risk factors of the prognosis in the population. The effect of surgical intervention differed among various age groups at 1-year follow-up after surgery. Conclusions The results of this retrospective study confirmed that age, underlying diseases, disappearance of ambient cistern, intraoperative brain swelling, and oxygen saturation < 90% are associated with poor prognosis in older postoperative patients with severe brain injury. Surgical intervention may improve prognosis and reduce mortality in older patients (age < 75 years). But for those patients (age ≥ 75 years), the prognosis was poor after surgical intervention.
Objective To investigate the risk factors of colorectal polyps＜10 mm in diameter with high-risk adenoma.Methods Patients who underwent colonoscopy in the First Medical Center of Chinese People's Liberation Army General Hospital and Hainan Hospital of Chinese People's Liberation Army General Hospital from October 2019 to March 2021 were selected as study objects.According to the number of adenomas and pathological features,the patients were divided into high-risk adenoma group and non-high-risk adenoma group.The risk factors of high-risk adenoma were analyzed.Results A total of 1 267 patients were included in the study,including 341 patients(26.9％)in the high-risk adenoma group and 926 patients(73.1％)in non-high-risk adenoma group.The proportion of age(45-＜75 years old),male,drinking history,smoking history,frequent consumption of pickled food,high salt diet,chronic history,history of colorectal polyp,and maximum polyp diameter(＞5-＜10 mm)in high-risk adenoma group was higher than those in non-high-risk adenoma group(P＜0.05).Age(45-＜75 years),male,high salt diet,occasional anal distention,chronic history,and maximum polyp diameter(＞5-＜10 mm)were risk factors for high-risk adenomas(OR＞1,P＜0.05).Conclusion Age(45-＜75 years),male,high salt diet,occasiontal anal distention,chronic history,and maximum polyp diameter(＞5-＜10 mm)are risk factors for colorectal polyps＜10 mm with high-risk adenomas,providing a basis for endoscopists to assess the risk and apply targeted"resect and discard strategy".
目的 基于VOSviewer对当下媒体与心理交叉领域的研究进展进行计量分析.方法 在Scopus上收集2018年 1 月至 2022 年 6 月所有媒体与心理交叉领域的文献,筛选后基于VOSviewer从作者和关键词两个角度进行连接强度、时间、词团聚块等维度上的计量分析.结果 筛选得 3 233 篇文献,发现 2022 年 2 月研究主体由Griffiths MD为核心的学者集团转移到以Li为核心的中国学者团,中国学者间总体连接数大、但个体连接强度较弱,总发文量大、但单篇被引量较低;40%的作者关键词聚焦于受媒体影响的大众心理健康状态;存在以性别和年龄阶段命名的词团聚块;信息流行病学被广泛提及.结论 国内学界对于该领域的研究基础规模大但影响力还需提升;受媒体影响产生的抑郁与焦虑及所属的心理健康大类是目前的主流研究方向;二分性别和年龄是当下主要使用的人群分类研究方式;信息流行病学有潜力作为新兴学科进一步发展.
目的 基于p38 丝裂原活化蛋白激酶(p38MAPK)通路探讨瑶医除闷汤药浴治疗膝骨关节炎(KOA)模型大鼠的效果与作用机制.方法 在 60 只 8 周龄雄性SPF级SD大鼠(体重 200～220 g)中随机选取 10 只作为空白组,在实验第 1、4 天,于空白组右膝关节腔内注射 0.1 ml生理盐水,其余大鼠注射 0.1 mlⅡ型胶原蛋白酶与弗氏完全佐剂的混合乳剂(质量浓度为0.5 mg/ml).第 7天根据大鼠膝关节情况评估造模结果,将 50只造模成功的大鼠按照随机数字表法分为模型组、双氯芬酸钠组及除闷汤高、中、低剂量组,每组 10 只.实验第 8 天,对除闷汤高、中、低剂量组进行药浴干预(浓度分别为 49.00、24.50、12.25 g/L),模型组进行温水泡浴,双氯芬酸钠组于造模部位予 0.01 g的 1%双氯芬酸钠凝胶,空白组常规饲养,连续干预 4周,干预期间观察各组一般情况.干预后观察各组膝关节解剖学情况,测量膝关节直径,采用苏木精-伊红(HE)染色观察膝关节软骨组织形态学改变.采用酶联免疫吸附试验检测各组血清中白细胞介素-1β(IL-1β)、IL-6、IL-10 含量;采用免疫组织化学染色检测各组软骨组织中p38MAPK、磷酸化p38MAPK(p-p38MAPK)、基质金属蛋白酶-13(MMP-13)的表达水平.结果 药物干预期间,空白组一般情况正常;模型组强迫运动时跛行,伴膝关节屈伸功能障碍;除闷汤各剂量组膝关节屈伸功能与步态逐渐恢复,双足跛行状态减少.干预后,空白组膝关节解剖可见滑膜平滑半透明,软骨透明光滑,关节面完整,HE染色可见软骨细胞排列规则清晰;模型组膝关节解剖可见滑膜增厚糜烂,软骨表面粗糙磨损,色泽灰暗,HE染色可见软骨基质减少甚至消失,软骨细胞大量减少,形态不规则;除闷汤各剂量组膝关节解剖及HE染色可见膝关节软骨有不同程度改善.模型组膝关节直径大于空白组,血清IL-1β、IL-6 及软骨p38MAPK、p-p38MAPK、MMP-13表达均高于空白组,血清IL-10低于对照组(P＜0.05).除闷汤各剂量组膝关节直径小于模型组,血清IL-10高于模型组,软骨p-p38MAPK、MMP-13表达均低于模型组(P＜0.05).除闷汤高、中剂量组血清IL-1β、IL-6及软骨p38MAPK低于模型组和除闷汤低剂量组,IL-10高于除闷汤低剂量组(P＜0.05).除闷汤高剂量组膝关节直径小于除闷汤低、中剂量组,软骨p-p38MAPK、MMP-13 表达低于除闷汤低剂量组,血清IL-10高于除闷汤低、中剂量组,软骨MMP-13 表达低于除闷汤中剂量组(P＜0.05).结论 瑶医除闷汤可能通过靶向抑制p38MAPK通路表达,减轻KOA大鼠的炎症反应,改善软骨退变.
