Background and objectives: Hip dislocation is a prevalent occurrence among children afflicted with spastic cerebral palsy. It has the potential to induce impairment of function, and a decline in the quality of life. Early prevention and management of hip dislocation remains an intricate problem. Our objective is to elucidate the risk factors influencing hip dislocation in children with spastic cerebral palsy. Methods: We included children with spastic cerebral palsy who were admitted to Dongzhimen Hospital, Beijing University of Chinese Medicine between January 2016 and January 2023. Participants' comprehensive clinical information, encompassing aspects such as gender, age, gestational age, birth weight, Gross Motor Function Classification System (GMFCS) level, and age of first standing, could be meticulously retrieved from medical records. All participants underwent pelvic X-ray examination. The severity of hip dislocation was assessed through the meticulous calculation of the Migration Percentage (MP) of the femoral head. Meanwhile, Acetabular Index (AI) and Neck-Shaft Angle (NSA) were obtained. Correlation analysis and multiple linear regression analysis were performed in the subsequent process. Results: A total of 291 patients (206 males and 85 females) fulfilled the inclusion criteria and were subsequently included in the analytical scope. The mean age was 8.3 years, ranging from 2 to 16 years. Correlation analysis showed that gender, age, gestational age, and birth weight were not related to MP ( p > 0.05). Multiple linear regression analysis revealed that GMFCS level ( p < 0.001), AI ( p < 0.001), NSA ( p < 0.001), and age of first standing ( p < 0.001) bore the stature of independent risk factors for MP. Conclusions: Our finding has revealed that GMFCS level, AI, NSA, and age of first standing are independent risk factors for the progression of MP in spastic cerebral palsy children. This study provided a new insight for the anticipation of hip dislocation.

We aimed to study the effects of a methyltransferase 3 (METTL3) inhibitor on osteomyelitis. Bone marrow cells (BMs) and peripheral blood mononuclear cells (PBMCs) were isolated from osteomyelitis patients at our hospital. Primary BM-derived macrophages (BMDMs) were incubated with lipopolysaccharide (LPS), poly(I:C), or PAM3CSK4 after pretreatment with STM2457. S. aureus was injected into the intramedullary canal to construct an osteomyelitis C57BL/6 mice model, which was then treated with STM2457. Body weights, μCT three-dimensional analyses, and bacterial burdens of the mice were obtained. Up-regulated METTL3 expression was found in both BMs and PBMCs of osteomyelitis patients. LPS and PAM3CSK4-induced IL-6 and TNF-α secretion in BMDMs could be inhibited by STM2457 pretreatment, while STM2457 pretreatment did not affect the relative expression of NOS2, IL-6, and TNF-α after incubation with poly(I:C). STM2457 alleviated the symptoms of osteomyelitis in mice with increased body weights, diminished reactive bone formation and cortical bone loss, increased bacterial burdens, and decreased IL-6 and TNF-α secretion. STM2457 pretreatment down-regulated the relative expression of myeloid differentiation factor 88 (MyD88), p-TAK, and p-IKKα/β in LPS-stimulated BMDMs, while it did not show any effect on poly(I:C)-stimulated BMDMs. STM2457 alleviates the onset of osteomyelitis in mice by down-regulating the relative expression of MyD88 and NF-κB relevant inflammation molecules in macrophages.

目的 探讨经皮电刺激疗法联合手术治疗促进长管骨骨折愈合的临床效果.方法 选取2021年2-12月北京中医药大学东直门医院收治的60例长管骨骨折的患者作为研究对象,采用随机数字表法分为对照组与电刺激组,各30例.比较术后第4～6周两组患者Lane-Sandhu X线评分、视觉模拟评分法(visual analogue scale,VAS)疼痛评分、肿胀程度与并发症发生情况.结果 电刺激组治疗后Lane-Sandhu X线评分高于对照组,差异有显著性(P＜0.01).在术后第7天、第14天时,电刺激组VAS评分均低于对照组,差异有显著性(P＜0.01).随着时间推移,两组肿胀指数均呈现递减趋势,肿胀程度均减轻,在术后第1天、第4天、第7天、第14天时,电刺激组肿胀指数低于对照组,差异有显著性(P＜0.01).两组术后均未发生愈合不良、切口感染、骨不连等并发症.结论 电刺激疗法可显著促进长管骨骨折患者的愈合进程,缓解患者疼痛程度,改善患肢的肿胀程度.

Background Venous thromboembolism (VTE) is one of the leading causes of mortality in hospitalized patients. However, whether the coagulation-related parameters of the hospitalized patients could be used to predict the occurrence of VTE in patients with spinal injury surgery remained unclear. Method The patients with spinal fractures who met the inclusion and exclusion criteria were enrolled to be analyzed using a retrospective analysis approach. The association of risk factors of enrolled patients and operations to VTE occurrence were analyzed. The activated partial thromboplastin time, prothrombin time, thrombin time, D-dimer (D-D), fibrinogen (FIB) and fibrinogen degradation products (FDP) were detected. ROC and HR analysis were applied to evaluate the correlation of coagulation-related parameters and other parameters to VTE occurrence. Result The indicators of D-D, FIB and FDP were significantly elevated in VTE patients compared to non-VTE patients. The multivariate analysis of OR showed that six risk factors, including age ≥ 60, spinal cord injury, postoperative bedtime over 5 days, plasma D-dimer ≥ 0.54 mg/L, plasma fibrinogen ≥ 3.75 g/L and plasma FDP ≥ 5.19 mg/L, were positively correlated to VTE. Conclusion The six risk factors, including D-D, FIB, FDP, age ≥ 60, spinal cord injury, and postoperative bedtime over 5 days, could be used to predict the occurrence of VTE.

目的:脑性瘫痪因其高发病率及高致残率,严重影响儿童身心健康.佩戴踝足矫形器是该病一项重要治疗措施,但关于其改善脑性瘫痪儿童运动功能的效果方面还不十分确切.为此,文章系统评价了踝足矫形器改善脑瘫儿童运动功能的效果.方法:第一作者检索PubMed、EMbase、Web of Science、Cochrane Library、CBM、中国知网、万方和维普数据库,检索时限从建库至2020-09-09.根据制定的入组标准,纳入有关踝足矫形器治疗脑性瘫痪儿童的随机对照试验.至少2名评价员独立提取数据,使用Cochrane 5.1.0偏倚风险评估工具对纳入研究的质量进行评估,采用RevMan 5.3软件进行数据分析.结果:①纳入12项质量较高的随机对照试验,共480例脑性瘫痪儿童,其中踝足矫形器组239例为佩戴踝足矫形器,对照组241例不佩戴踝足矫形器,治疗疗程0-48周;②Meta分析结果显示,踝足矫形器组在GMFM-88-D/E区评分(MD=6.26,95％C/:3.54-8.98,P＜0.00001)、MAS评分(MD=-0.60,95％C/:-0.80至-0.40,P＜0.00001)、摆动位平均踝背屈角度(MD=14.96,95％CI:12.03-17.90,P＜0.00001)、运动功能改善有效率(MD=2.99,95％CI:1.19-7.50,P=0.02)和步幅(MD=0.06,95％C/:0.04-0.09,P＜0.00001)的改善方面均优于对照组.结论:现有的12项随机对照试验证据表明,脑性瘫痪患儿无论是佩戴踝足矫形器行走,亦或是佩戴一定时间后解除踝足矫形器行走,其短期内(治疗0-48周)运动功能恢复效果均显著,但长期运动功能的恢复情况还有待进一步研究.

不少人都有过早晨起床后脚底痛的经历,除了早晨起床以后,有时休息后刚开始站立或行走时也会出现明显疼痛,但行走一段时间后疼痛反而减轻.跟痛症和足底跖筋膜炎都会出现这种"启动"时疼痛加重,活动后反而减轻的表现.

过敏性鼻炎的发生与脏腑阳气的虚损密切相关,阳气输布障碍,不能防御外邪,上犯鼻窍,致该病发生.从阳气对过敏性鼻炎发病的影响及阳气激发的方式入手,阐明其作用机理及相应的效应,为临床治疗过敏性鼻炎提供理论依据和临床参考.

膝骨关节炎(KOA)即膝关节骨性关节炎,临床以膝关节僵硬、肿痛、畸形、功能障碍为主要表现.KOA是中老年人高发的骨关节病,且该病缠绵难愈.目前西医对该病的治疗效果并不理想,且治疗费用较高,因此临床急需一种简便廉验的治疗方法.中医的某些特色疗法则在改善KOA症状方面疗效较为显著,灸法即是一种常用中医疗法.结合相关文献,从艾条灸、艾炷灸、温针灸、温灸器灸和其他灸法等方面,比较不同灸法治疗膝骨关节炎的临床疗效,从而为探求治疗膝骨关节炎的最佳灸治方法提供参考.

从中、西医角度探讨膝骨关节炎的病因病机及艾灸疗法治疗该病的作用机制.从中医角度来说,艾灸有扶阳祛邪之效.从西医角度来说,艾灸疗法的作用机制包括抗炎、改善血液循环及调节免疫3个方面.

目的:探讨当归通痹汤联合中药热敷治疗膝关节骨性关节炎的疗效及对白细胞介素(IL)-1β、基质金属酶(MMP)-3和肿瘤坏死因子(TNF)-α水平的影响.方法:选取我院收治的膝关节骨性关节炎患者140例,随机分为两组各70例.对照组给予中药热敷治疗,治疗组在对照组基础上给予当归通痹汤,对比两组治疗后的临床疗效、VAS评分、WOMAC指数和ADL评分,以及IL-1β、MMP-3和TNF-α水平.结果:治疗后,治疗组的总有效率为94.29％,高于对照组的81.43％,差异有统计学意义(P<0.05);两组ADL评分明显升高,WOMAC指数、VAS评分明显降低(P<0.05);且治疗组比对照组明显改善(P<0.05);两组患者治疗后的IL-1β、MMP-3和TNF-α水平均显著低于治疗前(P<0.05);且治疗组低于对照组,差异有统计学意义(P<0.05).两组患者不良反应发生率差异无统计学意义(P>0.05).结论:膝关节骨性关节炎患者采用当归通痹汤联合中药热敷治疗,具有较好的临床疗效,能够改善患者膝关节功能,值得在临床上推广应用.

目的 探讨益智开窍针刺法结合穴位注射对脑性瘫痪(简称脑瘫)患儿语言障碍、脑血流灌注、脑葡萄糖代谢的影响.方法 选取2015年1月—2018年12月北京中医药大学东直门医院收治的100例脑瘫患儿,随机分为观察组及对照组,每组50例.对照组采用常规语言疗法治疗,观察组采用益智开窍针刺法结合穴位注射治疗,时间3个月.治疗结束后对患儿的语言障碍功能、脑血流灌注及脑葡萄糖代谢改善情况进行评估.结果 观察组治疗后的临床有效率高于对照组(P<0.05),脑血流灌注改善患儿多于对照组(P<0.05),额叶、顶叶、颞叶及枕叶部葡萄糖代谢水平高于对照组(P<0.05).结论 采用益智开窍针刺法结合穴位注射治疗后可显著提高脑瘫患儿临床疗效,并改善患儿脑血流灌注情况,提高脑葡萄糖代谢水平.

癌症是现在医疗、科技手段最难攻克的疾病之一.一旦罹患癌症,不仅给家庭带来巨大的经济负担,而且治愈几率渺茫.即便能够继续维持生命,也意味着将终生与药物、医院相伴.其实,预防癌症,我们生活中就可以做到.食物中的八大癌症“克星”,你都知道多少?

谚语是我国劳动人民几千年来生活经验的总结,在各地有许多谚语源于中医理论,与疾病相关.进入夏天,经常听到有人说“千金难买六月泻”.这句谚语源于闽南“千金难买六月漏”. “千金难买六月泻”意思是在暑湿较大的农历六月里拉肚子难得,期望通过夏天的适当腹泻,而获得“祛湿”、养生和保健的效果,对于养身的意义价值千金. 时至今日,老祖宗传下来的谚语,还有用吗?

中医常说 “气生百病”,也就是说:生气会导致许多疾病的产生.这里的气是气滞,通俗一点说也就是生闷气,或者是情绪压抑、抑郁的意思. 中医认为,乳腺结节和甲状腺结节的病因与情志,以及生活环境有很大关系.长期的情绪压抑或波动较大,使肝气难以抒发,造成结节的产生.心情抑郁、爱发脾气,极容易导致肝郁气滞.肝气郁结、气滞血瘀是百病之源.

腰椎间盘突出症主要是因为不同程度的退行性改变后,腰椎间盘在外力因素的作用下,椎间盘的纤维环破裂,髓核组织从破裂之处突出(或脱出),导致相邻脊神经根遭受不同程度的压迫,从而产生腰部疼痛或伴一侧下肢甚至双下肢麻木、疼痛等一系列临床症状.体格检查可见到,腰椎侧弯,根据髓核突出的部位与神经根之间的位置关系,可表现为髓核突出于脊神经根内侧,因脊柱向患侧弯曲,可使脊神经根的张力减低,所以腰椎弯向患侧;髓核突出于脊神经根外侧,则腰椎多向健侧弯曲;腰部压痛、叩痛;直腿抬高试验及加强试验阳性.在阳性病人中,缓慢降低患肢高度,待放射痛消失,被动背伸患侧踝关节,再次诱发放射痛称为加强试验阳性.根据神经根受压的范围而出现该神经支配区感觉异常.结合病史、查体和影像学检查,尤其是根据腰椎CT与磁共振可以详细诊断.

人们常说的关节炎是指反复发作、久治不愈的腿部(多指膝关节)酸麻疼痛,也常称为老寒腿.关节炎多在气候转冷、天阴下雨时疼痛加重.老年人肝肾不足,精亏血少,更容易患膝关节炎,所以老寒腿患者多以老年人为主,老寒腿的病名也由此而来. 其实,老百姓常说的关节炎、老寒腿是多种疾病的一个症状,如骨关节炎、腰椎管狭窄症、腰椎间盘突出症,风湿性关节炎、类风湿关节炎等.

通过查阅中国知网发表的手三里穴治疗急性腰扭伤的相关文献并结合临床实践,对针刺手三里穴治疗急性腰扭伤的临床效应进行总结并对其治疗机理进行分析.急性腰扭伤是一种突发性疾病,发病后患者非常痛苦,因此临床急需一种简便快捷、安全有效的治疗方法.而针刺具有疏通经脉,调和气血的作用,治疗急性疼痛效果显著.临床上医者取单穴手三里治疗急性腰扭伤,可以达到针出痛止,从而使患者腰部活动基本恢复正常.

目的:探讨丹红注射液治疗绝经期骨质疏松性腰腿痛的临床效果.方法:用随机分配法将绝经期骨质疏松症患者74例分为两组,各37例.对照组采用口服双氯芬酸钠缓释胶囊治疗,观察组采用口服双氯芬酸钠缓释胶囊加静脉静脉滴注丹红注射液治疗,对比两组患者的治疗效果.结果:观察组患者治疗总有效率(89.19％)明显高于对照组(70.27％),差异有统计学意义(P＜0.05).结论:丹红注射液在治疗绝经期骨质疏松症上有一定的临床疗效,可有效缓解患者腰腿疼痛的症状,值得推广.

生活中,我们常常听到或看到身边有的人在转动脖子时,总是发出“咔咔”的响声.当然,我们自己有时也会有. 一、脖子“咔咔”的响是什么情况 我们先来对响声进行鉴别.有三种情况会造成颈椎扭动时有响声:①生理性弹响.生理性弹响是由于关节腔内的气体震动造成的,关节腔里有起润滑作用的关节液,腔内呈负压,从而保持关节结构的稳定.

腰椎术后硬膜外血肿(spinal epidural hematomas,SHE)是后路腰椎术后一种常见的并发症,但大部分无临床症状,少数情况下血肿压迫硬膜囊和神经导致马尾神经功能受损,需急诊手术清除血肿.腰椎术后出现SEH的原因众多,多发生在术后72 h内,J.Kou等将术后3d以后发生的SHE定义为迟发性硬膜外血肿[1].本文报道1例79岁男性患者,后路腰椎术后2周突发腰骶部剧烈疼痛、进行性神经功能丧失,根据症状体征及MRI结果诊断为硬膜外血肿,急诊行探查血肿清除手术,术中发现腰肌穿支动脉活动性出血,术后患者神经功能恢复较为满意.结合此病例,复习相关文献,分析腰椎术后迟发性SHE的原因、治疗策略及手术时机的选择.现将病例的诊治过程及文献结果报告如下.