目的:观察补肾活血安胎汤联合低分子肝素钠治疗抗磷脂综合征型复发性流产临床疗效.方法:选取2016年1月—2017年10月在青岛市中医医院(市海慈医院)收治的抗磷脂综合征合并复发性流产患者60例为研究对象,随机分观察组和对照组,各30例.观察2组患者治疗前后症状、实验室指标的变化情况以及妊娠结局.结果:补肾活血安胎汤联合低分子肝素钠治疗抗磷脂综合征型复发性流产,总有效率达 93.33%,高于对照组86.67%,差异具有统计学意义(P＜0.05);与对照组相比,对照组治疗后实验室指标改善明显,具有统计学意义(P＜0.01);对照组妊娠12周流产率(13.33%)明显低于对照组(23.33%),具有统计学意义(P＜0.05).结论:补肾活血安胎汤联合低分子肝素钠治疗抗磷脂综合征型复发性流产疗效显著.

AIMS AND OBJECTIVES:To investigate and analyse the prevalence of depression among patients with lung cancer, identify risk factors of depression, and develop a visual, non-invasive, and straightforward clinical prediction model that can be used to predict the risk probability of depression in patients with lung cancer quantitatively.BACKGROUND:Depression is one of the common concomitant symptoms of patients with lung cancer, which can increase the risk of suicide. However, the current assessment tools cannot combine multiple risk factors to predict the risk probability of depression in patients.DESIGN:A cross-sectional study.METHODS:The clinical data from 297 patients with lung cancer in China were collected and analysed in this cross-sectional study. The clinical prediction model was constructed according to the results of the Chi-square test and the logistic regression analysis, evaluated by discrimination, calibration, and decision curve analysis, and visualised by a nomogram. This study was reported using the TRIPOD checklist.RESULTS:130 patients with lung cancer had depressive symptoms with a prevalence of 43.77%. A visual prediction model was constructed based on age, disease duration, exercise, stigma, and resilience. This model showed good discrimination at an AUC of 0.842. Calibration curve analysis indicated a good agreement between experimental and predicted values, and the decision curve analysis showed a high clinical utility.CONCLUSIONS:The visual prediction model developed in this study has excellent performance, which can accurately predict the occurrence of depression in patients with lung cancer at an early stage and assist the medical staff in taking targeted preventative measures.RELEVANCE TO CLINICAL PRACTICE:The visual, non-invasive, and simple nomogram can help clinical medical staff to calculate the risk probability of depression among patients with lung cancer, formulate personalised preventive care measures for high-risk groups as soon as possible, and improve the quality of life of patients.

目的:观察自拟滋阴化瘀汤联合硫酸羟氯喹治疗阴虚血瘀型干燥综合征的临床疗效.方法:选取70例原发性干燥综合征患者为研究对象,且均符合阴虚血瘀型燥痹,随机分为实验组35例,对照组35例.对照组患者采用硫酸羟氯喹(0.2 g,2次/日,口服)治疗;实验组患者在对照组治疗方法基础上加用中药自拟滋阴化瘀汤(每日2次,两组连续治疗12周)治疗.观察患者临床症状缓解情况、免疫学指标、泪液分泌情况、唾液流率,以及干燥综合征疾病活动指数的改善情况.结果:自拟滋阴化瘀汤联合硫酸羟氯喹治疗阴虚血瘀型干燥综合征,实验组患者总有效率达85.71％,高于对照组的74.28％,差异有统计学意义(P<0.05),与对照组比较,实验组患者在治疗后,ESR、IgG、RF显著改善,差异有统计学意义(P<0.05);治疗后两组患者Schirmer I评分、SFR评分均提高,ESSDAI评分均降低,且实验组患者治疗后,ESSDAI评分低于对照组患者,Schirmer I评分、SFR评分高于对照组患者,差异有统计学意义(P<0.05).结论:自拟滋阴化瘀汤联合硫酸羟氯喹治疗阴虚血瘀型干燥综合征的临床疗效显著,值得推广.

The syndrome of dampness stagnancy due to spleen deficiency (DSSD) is relatively common globally. Although the pathogenesis of DSSD remains unclear, evidence has suggested that the gut microbiota might play a significant role. Radix Astragali , used as both medicine and food, exerts the effects of tonifying spleen and qi. Astragalus polysaccharide (APS) comprises a macromolecule substance extracted from the dried root of Radix Astragali , which has many pharmacological functions. However, whether APS mitigates the immune disorders underlying the DSSD syndrome via regulating gut microbiota and the relevant mechanism remains unknown. Here, we used DSSD rats induced by high-fat and low-protein (HFLP) diet plus exhaustive swimming, and found that APS of moderate molecular weight increased the body weight gain and immune organ indexes, decreased the levels of interleukin-1β (IL-1β), IL-6, and endotoxin, and suppressed the Toll-like receptor 4/nuclear factor-κB (TLR4/NF-κB) pathway. Moreover, a total of 27 critical genera were significantly enriched according to the linear discriminant analysis effect size (LEfSe). APS increased the diversity of the gut microbiota and changed its composition, such as reducing the relative abundance of Pseudoflavonifractor and Paraprevotella , and increasing that of Parasutterella , Parabacteroides , Clostridium XIVb , Oscillibacter , Butyricicoccus , and Dorea . APS also elevated the contents of short-chain fatty acids (SCFAs). Furthermore, the correlation analysis indicated that 12 critical bacteria were related to the body weight gain and immune organ indexes. In general, our study demonstrated that APS ameliorated the immune disorders in DSSD rats via modulating their gut microbiota, especially for some bacteria involving immune and inflammatory response and SCFA production, as well as the TLR4/NF-κB pathway. This study provides an insight into the function of APS as a unique potential prebiotic through exerting systemic activities in treating DSSD.

The accumulating evidence revealed that gut microbiota plays an important role in pathological process of disease including obesity, type 2 diabetes mellitus, heart failure, and non-alcoholic fatty liver disease. Polysaccharides extracted from Chinese medicine (CM) can not only alleviate pathological status but also promote health by anti-inflammatory, regulating immunity, lowering blood glucose and lipids, anti-cancer, and anti-oxidation. The alterations of gut microbiota composition and metabolism pathways are the potential mechanisms of CM polysaccharides treatment. In addition, they exert functions through gut-organ axis or play an indirect role by synergistic actions with other drugs or components mediated by gut microbiota. This review summarizes the molecular mechanisms of CM polysaccharides interacted with intestinal microbial inhabitants as potential prebiotics for promoting health.

It reviewed the application status quo of precision health concept in the field of nursing symptomatology，and introduced the nursing science precision health model.The roles of bionomics，big data analysis technology and mHealth devices in the research of precision nursing symptomatology were emphasized.And the challenges facing the development of precision nursing in China were discussed，in order to provide ideas and references for the development of precision health in nursing field in China.