论著

超声引导下针刺蝶腭神经节治疗过敏性鼻炎的随机对照研究

Ultrasound-guided acupuncture at the sphenopalatine ganglion for the treatment of allergic rhinitis:A randomized controlled study

:105-110
 
       目的   观察超声引导下针刺蝶腭神经节治疗过敏性鼻炎的临床疗效。方法   将80例过敏性鼻炎患者随机分成干预组(40例)和对照组(40例),干预组采用超声引导针刺蝶腭神经节,对照组采用常规方法针刺蝶腭穴,每周2次,持续4周。结果   治疗4周后,干预组和对照组均显示出良好疗效。干预组的总有效率为92.50%,对照组的总有效率为82.50%,差异有统计学意义(P<0.05);干预组在鼻症状总分(TNSS)、非鼻症状总分(TNNSS)、视觉模拟量表(VAS)和鼻结膜炎生活质量问卷(RQLQ)等指标上的改善均优于对照组(P<0.05)。结论   超声引导下针刺蝶腭神经节治疗过敏性鼻炎能有效改善患者的临床症状。
   Objective  To investigate the main clinical effect of acupuncture of pterygopalatine ganglion on patients with allergic rhinitis under the guidance of ultrasound.Methods  A total of 80 patients with allergic rhinitis were randomly divided into intervention group and control group.The intervention group was treated with ultrasound guided acupuncture of the sphenopalatine 
ganglion,the control group was treated with conventional acupuncture at sphenopalatine point.The clinical efficacy was determined after the course of treatment.Results  The total effective rate was 92.50% in the intervention group and 82.50% in the control group.The improvement of total nasal symptom score,total non-nasal symptom score,VAS and Arhinoconjunctivitis Quality of Life Questionnaire scores in the treatment group was significantly better the control group Conclusions  Ultrasound-guided acupuncture of the sphenopalatine ganglion can improves clinical symptoms of patients with allergic rhinitis.
论著

LAMP3 基因表达与肾癌之间的因果关系:一项基于孟德尔随机化分析的研究

Causal relationship between LAMP3 gene expression and renal cancer:A Mendelian randomization analysis

:88-94
 
       目的   探讨溶酶体相关膜蛋白3(LAMP3)与肾癌发病风险之间的因果关系,为肾癌的分子致病机制提供新的理论依据。方法   基于全基因组关联研究(GWAS)数据,采用孟德尔随机化分析方法,评估LAMP3基因表达与肾癌的因果关系。并通过GEPIA2分析LAMP3表达对肾癌总体生存期(OS)及无病生存期(DFS)的关系。结果  LAMP3基因变异与肾癌风险呈正相关,提示LAMP3的表达可能增加肾癌的发病风险。此外,GEPIA2分析进一步显示,LAMP3的高表达与肾癌患者的低总体生存期(OS)及无病生存期(DFS)显著相关。结论   本研究通过孟德尔随机化分析探讨了LAMP3基因表达与肾癌的因果关系,结果表明LAMP3可能是肾癌的潜在致病因子,并与肾癌预后相关。这为肾癌的分子致病机制研究提供了重要的理论依据,并为未来的生物标志物和靶向治疗策略的开发提供了新的思路。
        Objective  To investigate the causal  relationship  between LAMP3 expression and  renal cancer  risk  using Mendelian randomization analysis,providing a theoretical basis for understanding the molecular mechanisms underlying renal cancer.Methods  This study utilized data from genome-wide association studies(GWAS)and employed Mendelian randomization analysis to assess the causal relationship between LAMP3 gene expression and renal cancer.Additionally,GEPIA2 was used to examine the association between LAMP3 expression and overall survival(OS)and disease-free survival(DFS)in renal cancer patients.Results  Variants in the LAMP3 gene were positively correlated with renal cancer risk,suggesting that LAMP3 expression may increase the likelihood of developing renal cancer.Furthermore,GEPIA2 analysis  revealed that high expression of LAMP3 was significantly associated with lower OS and DFS in renal cancer patients.Conclusions  This study explored the causal  relationship between LAMP3 gene expression and renal cancer through Mendelian randomization analysis.The results indicate that LAMP3 may be a potential pathogenic factor in renal cancer and is associated with poor prognosis.These findings provide important theoretical insights into the molecular mechanisms of  renal cancer and offer new perspectives for the development of biomarkers and targeted therapeutic strategies in the future.
论著

孕中晚期口腔二维轴向切面超声诊断唇腭裂类型的价值研究

The value of two-dimensional axial sectional ultrasonography in the diagnosis of cleft lip and palate in the second and third trimesters of pregnancy

:83-87
 
       目的   探讨孕中晚期口腔二维轴向切面超声在产前诊断胎儿唇腭裂中的应用价值,评估其对唇裂、唇腭裂及继发腭裂的检出率和准确性。方法   本研究为前瞻性研究,共纳入2020年3月—2023年12月在我院超声科行产前超声诊断的3 666例孕中晚期胎儿,其中经超声检查诊断出111例唇腭裂,这些病例归为唇腭裂组,其余3 555例归入正常对照组。所有受试者均通过口腔二维轴向切面超声进行评估,诊断结果经产后随访确认。结果   在正常对照组中,上唇及上牙槽突的评估成功率为100%,软硬腭分界线显示率为99%,软腭显示率为85%。在唇腭裂组中,超声对唇裂、唇腭裂及继发腭裂的检出率分别为45%、48%和7%,且超声诊断的灵敏度、特异度和预测值均超过98%。结论   孕中晚期口腔二维轴向切面超声在产前诊断胎儿唇腭裂中具有较高的准确性和可靠性,为早期干预和临床管理提供了重要的影像学依据。
       Objective  To explore the application value of two-dimensional axial section ultrasound in prenatal diagnosis of fetal cleft lip and palate in the second and third trimesters of pregnancy,and to evaluate its detection rate and accuracy for cleft lip,cleft lip and palate,and secondary cleft palate.Methods  This study is a prospective study that included 3 666 fetuses in the second and third trimesters of pregnancy.Among them,111 cases of cleft lip and palate were diagnosed by ultrasound examination.These cases were classified as the cleft lip and palate group,and the remaining 3 555 cases were classified as the normal control group.All subjects were evaluated by oral two-dimensional axial section ultrasound,and the diagnostic  results were confirmed by postpartum follow-up.Results  In the normal control group,the success rates of evaluating the upper lip and upper alveolar process were 100%.The present rate of the soft hard palate boundary was 99%,and the present rate of the soft palate was 85%.In the cleft lip and palate group,the detection rates of cleft lip,cleft lip and palate,and secondary cleft palate by ultrasound were 45%,48% and 7% respectively,and the sensitivity,specificity,and predictive value of ultrasound diagnosis exceeded 98%.Conclusions  Two dimensional axial section ultrasound of the oral cavity in second and third trimesters of pregnancy has high accuracy and reliability in prenatal diagnosis of fetal cleft lip and palate,providing strong imaging evidence for early intervention and clinical management.
论著

基于图卷积神经网络的孤独症谱系障碍多模态数据融合与诊断模型研究

Development of an interpretable graph convolutional neural network for multimodal evidence integration and quantitative diagnosis of autism spectrum disorder

:39-45
 
       目的   针对孤独症多模态证据融合与定量化辨识的关键问题,本研究提出基于图卷积神经网络(GCN)的孤独症谱系障碍(ASD)诊断模型研究思路。方法  通过对来源于ABIDE的ASD儿童脑部fMRI数据进行整理和筛选,提取脑区功能连接矩阵作为图结构的邻接矩阵,并融合临床表型数据,构建了ASD多模态关联网络。通过网络特征比较分析,识别出了ASD与典型发育组的脑功能连接网络组间差异。进一步地构建一个端到端的GCN模型,并尝试引入注意力机制,提高模型决策的可解释性。结果  该模型在诊断性能指标优于传统机器学习方法(准确率=0.710,精确率=0.709,召回率=0.780,F1=0.743,曲线下面积=0.746)。背侧注意网络与边缘系统-颞极枢纽的功能连接减弱是模型做出判断的最主要依据。结论  以异质图为多模态数据整合的基本架构,本模型为ASD的潜在病理机制探索提供了新的方法学范例。
      Objective   To develop a quantitative model for autism spectrum disorder(ASD)integration multimodal evidences.Methods The fMRI  dataset from ABIDE was  used for extracting connectivity function  network of ASD after  data preprocessing.Difference between ASD and typical development about their brain connectivity function was evaluated with t-test.Integrating phenotypic data and fMRI dataset,an graph convolutional neural network (GCN)with attention module was estimated and compared against benchmark models about their efficiency and interpretability.Results  The GCN model was evaluated outperformed other models with better accuracy indices.And regions from Dorsal Attention Network and Limbic-Temporal Pole were ranked as the highest weights for the differentiation in the model.Conclusions  This study provided a novel paradigm for quantitative diagnosis and exploring pathogenesis of ASD.
综述

青少年群体述情障碍的研究进展

Advances in the study of alexithymia among adolescent populations

:30-38
 
       述情障碍(alexithymia)是一种主要表现为难以识别和描述情绪情感、社交依附和人际交往能力匮乏的人格特质与心理特征。近年来,述情障碍的发生在青少年群体中日益普遍,这不仅对青少年的身心健康造成威胁,还给家庭与社会带来沉重负担。因此,本研究通过系统回顾国内外相关文献,综述青少年述情障碍的评估工具、影响因素及干预方式,旨在为青少年述情障碍的早期识别与预防,以及干预措施的制定与应用提供参考依据。
    Alexithymia is a psychological trait characterized by difficulty in identifying and describing emotional feelings,as well as deficits in social attachment and interpersonal communication skills.In recent years,the prevalence of alexithymia among adolescents has become increasingly common,posing significant threats to their physical and mental health and imposing a heavy burden on families and society.This study conducts a systematic review of relevant literature from domestic and international databases to examine the influencing factors,assessment tools,and intervention strategies for adolescent alexithymia.The findings aim to provide a reference for early identification,prevention,and the development and application of targeted interventions for adolescent 
alexithymia.
综述

中医药调控 CD4+ T 细胞亚群防治动脉粥样硬化的研究进展

Research progress on the regulation of CD4+ T cell subsets by traditional Chinese medicine for the prevention and treatment of atherosclerosis

:24-29
 
       动脉粥样硬化(AS)是一种起始于炎症介导的内皮损伤的慢性血管疾病,其本质是免疫炎症驱动的病理过程,是众多心血管疾病的病理基础。CD4+  T细胞亚群[包括辅助性T细胞1型(T helper 1 cell,Th1)、Th2、Th17、调节性T细胞等]通过分泌特异性细胞因子参与AS的炎症反应,其中促炎性CD4+  T细胞与抗炎性CD4+  T细胞的抗炎功能失衡是推动斑块进展的关键环节,在AS斑块形成与发展中起关键作用。近年来,多项研究表明某些中药单体、经典复方及其有效成分,具有多靶点、多层次机制调控CD4+  T细胞分化及功能,这些作用共同减轻血管内皮炎症反应、抑制巨噬细胞泡沫化及平滑肌细胞迁移等,延缓AS斑块形成与发展,为AS防治提供了新思路,展现了中医药在该领域的研究展现出独特优势与广阔前景,本文综述了中医药通过干预CD4+  T细胞亚群平衡防治AS的最新研究进展,及其影响相关细胞因子网络及关键信号通路的作用机制,为开发具有多靶点协同优势的创新中药与中西医结合治疗方案提供了关键理论依据与实践方向。
       Atherosclerosis(AS)is a chronic vascular disease that originates from inflammation mediated endothelial 
damage.Its essence is a pathological process driven by immune inflammation,and it is the pathological basis of many cardiovascular diseases.CD4+  T cell subsets(including Th1,Th2,Th17,Treg,etc.)participate in the inflammatory response of AS by secreting specific cytokines.The imbalance of anti-inflammatory function between pro-inflammatory CD4+  T cells and anti-inflammatory CD4+T cells is a key link in promoting plaque progression and playing a crucial role in the formation and development of AS plaques.In recent years,a number of studies have shown that the monomers,classic prescriptions and their effective ingredients of Chinese herbs have the effect of multi-target,multi-level mechanism to regulate the differentiation and function of CD4+  T cells.These effects together reduce the inflammatory reaction of vascular endothelium,inhibit the foam formation of macrophages and smooth muscle cell migration,delay the formation and development of AS plaque,provide new ideas for the prevention and treatment of AS,and make the research of Chinese medicine show unique advantages and broad prospects in this field.This article  reviews the latest  research progress of Chinese medicine in the prevention and treatment of AS by intervening in the balance of CD4+  T cell subsets,as well as the mechanism of its effects on related cytokine networks and key signal pathways.This provides a key theoretical basis and practical direction for the development of innovative traditional Chinese medicine and integrated traditional Chinese and Western medicine treatment plans with multi-target synergistic advantages.
综述

缺氧诱导因子调控的铁死亡及其在胃肠道疾病中的作用研究进展

Research progress in hypoxia-inducible factor regulated ferroptosis and its implications in gastrointestinal disease

:16-23
 
       铁死亡是一种以铁依赖性脂质过氧化为特征的程序性细胞死亡形式。近年来研究表明,铁死亡与缺氧应答的关键调控因子——缺氧诱导因子(HIF)存在密切关联。HIF(包括HIF-1α、HIF-2α、HIF-3α三种亚型)调控的铁死亡在结直肠癌、胃癌、溃疡性结肠炎及其他胃肠黏膜损伤性疾病中发挥作用,影响疾病的发生发展。但目前关于HIF-铁死亡通路在不同胃肠道疾病中的差异化作用及调控机制尚未完全阐明。因此,本文对HIF各亚型调控铁死亡的分子机制及其在胃肠道疾病中的作用进行综述,以期为靶向HIF-铁死亡通路治疗相关疾病提供新的思路。
       Ferroptosis is a form of regulated cell death characterized by iron-dependent lipid peroxidation.Recent 
studies have demonstrated a close association between ferroptosis and hypoxia-inducible factor(HIF),the key  regulator of the hypoxic response.Ferroptosis regulated by HIF(comprising three isoforms:HIF-1α,HIF-2α,and HIF-3α)plays a  role in colorectal cancer,gastric cancer,ulcerative colitis,and other gastrointestinal mucosal injury diseases,impacting their initiation and progression.However,the differential roles and regulatory mechanisms of the HIF-ferroptosis pathway in various gastrointestinal diseases remain incompletely elucidated.Therefore,this  review  summarizes the molecular mechanism networks through which individual HIF isoforms regulate ferroptosis and their roles in gastrointestinal diseases,with the aim of providing new perspectives for targeting the HIF-ferroptosis pathway to treat relevant diseases.
医院管理

我国华东五省市紧密型城市医疗集团建设现状与对策研究

Study on the present situation and countermeasures of the construction of compact city medical groups in five provinces in east China

:9-15
 
       目的   通过总结分析我国华东五省市紧密型城市医疗集团的实践经验,为全面推进紧密型城市医疗集团建设,促进区域内医疗资源的优化整合和高效利用提供借鉴和参考。方法   采用内容分析法从责权协同、资源协同、业务协同和机制协同四个维度对上海闵行、浙江湖州、江苏淮安、安徽铜陵、山东青岛五个紧密型医疗集团建设的实践经验进行梳理和对比分析。结果   各地区医疗集团建设总体具备政府主导,集团共建,一体化管理、同质化服务等紧密型医疗集团特点,但存在权责归属失配、利益分配机制缺失、信息化建设不均衡、基层服务能力不足、一体化管理不全面、机制协同有待加强等问题。结论   建议通过完善治理体系、均衡利益分配、强化数字赋能、推进强基提能、落实配套政策等措施,切实推动紧密型城市医疗集团高质量发展。
       Objective  To  summarize  and  analyze the  practical  experience  of  compact  city medical  groups in five provinces and cities in East China,for reference of promoting the construction of compact city medical groups,and promoting the optimization,integration and efficient utilization of medical resources in the region.Methods  The content analysis method was used to sort out and compare the practical experience of building such compact medical groups in Shanghai Minhang,Zhejiang Huzhou,Jiangsu Huai’an,Anhui Tongling and Shandong Qingdao from the four dimensions of responsibility and power synergy,resource synergy,business synergy and mechanism synergy.Results  Such medical groups are characterized by government-led,group co-construction,integrated management,and homogeneous services.However,there are such problems as mismatched ownership of rights and responsibilities,lack of interest distribution mechanism,unbalanced information construction,insufficient primary service capacity,incomplete integrated management,and mechanism coordination to be strengthened.Conclusions  It is recommended to effectively promote the high-quality development of compact city medical groups by improving the governance system,balancing the distribution of interests,strengthening digital empowerment,promoting the strengthening of energy,and implementing supporting policies.
论著

综合性医院门诊幽门螺杆菌感染及耐药情况研究

Investigation of Helicobacter pylori infection and antibiotic resistance in outpatients at a general hospital

:1669-1676
 
       目的  调查深圳地区综合性医院门诊幽门螺杆菌(Hp)对8种常见抗菌药物的耐药情况。方法  采集13C呼气试验阳性的患者胃黏膜标本313例,进行Hp分离培养及抗菌药物敏感性试验。结果  313例患者分离培养得到247例Hp菌株,培养阳性率78.91%,不同性别、不同年龄患者Hp分离培养阳性率比较差异无统计学意义(P>0.05)。Hp对甲硝唑、克拉霉素、左氧氟沙星、利福平、阿莫西林、四环素、呋喃唑酮、庆大霉素耐药率依次为88.66%(219/247)、38.46%(95/247)、38.06%(94/247)、4.05%(10/247)、1.21%(3/247)、0.40%(1/247)、0.40%(1/247)、0(0/247)。双重耐药率为38.46%(95/247),其中Hp对克拉霉素+甲硝唑组合耐药率最高(18.62%,46/247),对甲硝唑+左氧氟沙星耐药率居其次(17.00%,42/247)。多重耐药率为19.84%(49/247)。不同年龄、性别患者双重耐药率、多重耐药率比较差异均无统计学意义(P>0.05)。结论  深圳地区分离的Hp菌株对甲硝唑、克拉霉素、左氧氟沙星耐药率相对更高,且双重耐药、多重耐药情况严重。
        Objective  To investigate the antibiotic resistance of Helicobacter pylori(Hp)to eight commonly  used antibiotics in outpatients of general hospitals in Shenzhen.Methods  Gastric mucosal samples were collected from 313 patients who tested positive for the  13C breath test,and Hp strains were isolated and cultured.Antibiotic susceptibility testing was performed on the isolated Hp strains.Results  Of the 313 patients,247 Hp strains were isolated,with a culture-positive rate of 78.91%.There was no significant difference in culture-positive rates between different genders and age groups(P>0.05).The resistance rates to metronidazole,clarithromycin,levofloxacin,rifampicin,amoxicillin,tetracycline,furazolidone,and gentamicin were 88.66%(219/247),38.46%(95/247),38.06%(94/247),4.05%(10/247),1.21%(3/247),0.40%(1/247),0.40%(1/247),0(0/247),respectively.The dual resistance rate was 38.46%(95/247),with the highest combination  resistance observed in clarithromycin + metronidazole(18.62%,46/247),followed by metronidazole + levofloxacin(17.00%,42/247).The multi-drug resistance rate was 19.84%(49/247).There were no significant differences in dual resistance rates(P>0.05)or multiple resistance rates(P>0.05)between different age groups and genders.Conclusions  The Hp strains isolated in Shenzhen exhibited relatively higher resistance rates to metronidazole,clarithromycin,and levofloxacin,with substantial dual and multi-drug resistance.
论著

新型穿戴式气压治疗仪预防深静脉血栓的非劣效性临床研究

Evaluation of new type of wearable pneumatic compression pump in prevention of deep vein thrombosis:A non-inferiority study

:1663-1668
 
       目的   评价新型穿戴式气压治疗仪预防深静脉血栓的临床疗效及安全性。方法   将156例脑梗死患者随机分为对照组和试验组,各78例。试验组使用新型穿戴式气压治疗仪(邦普医疗/VW100)进行气压治疗。对照组使用韩国元金压力治疗仪进行气压治疗。两组疗程均为10 d,观察临床疗效及安全性,比较两组深静脉血栓形成率、医护人员和患者的使用满意度。结果   治疗10 d后,试验组与对照组深静脉血栓未发生率差值为1.2%,相应的95%置信区间为–5.3%~7.9%,下限高于–10%,医护人员和患者对试验组的评价优于对照组(P<0.001)。结论   新型穿戴式气压治疗仪预防深静脉血栓形成的临床疗效不劣于市面上已有的气压治疗仪,治疗过程中未见明显不良反应,临床使用安全有效。
        Objective  To  evaluate the  effectiveness  and  safety  of  new wearable  pneumatic  compression  pump in preventing deep vein thrombosis.Methods  One hundred and fifty-six patients with cerebral infarction were randomly divided into control and study group with 78 cases in each group.Study group was treated with the new wearable pneumatic compression pump(Bangpu Medical / VW100).Control group was treated with pneumatic compression pump(Wonjin-POWER).The course of both groups was 10 days,comparing the deep vein thrombosis  rate and useage satisfaction of patients and staffs between the two groups.Results  After 10 days of treatment,the difference between the incidence of deep venous thrombosis in the study and control group was 1.2%.The corresponding 95% confidence interval was(-5.3%,7.9%),and the lower limit was greater than -10%.The appraisal from medical staffs and the patients of study group was better than that of the control group(P<0.001).Conclusions  The clinical effect of the new wearable pneumatic compression pump to prevent deep vein thrombosis is not inferior to the existing pneumatic compression pump,which clinical practice experience is better.There is no obvious adverse reactions in the treatment process,and the clinical practice is also safe and effective.
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