股骨转子间骨折是最常见的髋部骨折,内固定手术为其目前治疗的首选方式。头颈钉位置是评估手术效果和判断治疗预后的重要因素,合适的置钉位置有利于稳定骨折、加速康复以及改善预后。目前头颈钉位置最经典的评估方式为尖顶距(TAD),但TAD至今仍存在较多争议。近年来提出的轴刀角、尖颈距离比、偏心距(ED)以及标准化TAD(STAD)为临床实践拓展了新视野。文章通过对上述头颈钉位置的评估方法及局限性进行文献综述,旨在为临床手术置钉时提供相应的参考。ED和STAD的提出,为未来人工智能评估头颈钉位置提供了可能。
Femoral intertrochanteric fracture is one of the most common hip fractures, and the internal fixation is the preferred treatment. The position of cephalic fixator is an important factor to evaluate the effect of operation and the prognosis of treatment. Tip-apex-distance(TAD)is the most classical method to evaluate the position of cephalic fixator, but it is still controversial. In recent years, the axis-blade angle,tip-neck distance ratio, eccentric distance(ED)and standardized TAD(STAD)have been proposed,though with limitations, they also provide a new perspective for clinical practice. In this study, we reviewed the literature on the evaluation of the position of cephalic fixator in order to provide the corresponding references and guidance for the clinical operation of internal fixation. Both STAD and ED may be the theoretical possibility of artificial intelligence evaluation of the position of cephalic fixator in the future.
胃食管反流病是一种以烧心和反流为主要症状的胃食管动力障碍性疾病,现有的常规治疗存在药物依赖,手术风险高且易复发等局限性,而经皮电刺激作为一种新兴疗法,在治疗动力障碍性疾病时具有非侵入性、可逆性及调节生理功能的优势。因此本研究为了探讨经皮电刺激治疗胃食管反流病的进展,现从胃食管反流病的神经调控生理、不同经皮电刺激对治疗胃食管反流病的研究以及应用效果等方面进行综述,以期为胃食管反流病提供新的诊断思路和方法。
In order to discuss the progress of transcutaneous electrical stimulation for the treatment of gastroesophageal reflux disease(GERD),the physiology of neuromodulation of GERD,the research on different transcutaneous electrical stimulation for the treatment of GERD,and the application effect were reviewed,with the aim of providing new diagnostic ideas and methods for GERD.
先天性血管瘤(CH)是一种较为罕见的良性血管肿瘤,出生前瘤体已经存在,按照出生后瘤体的生长特征可分为4类:不消退型CH、部分消退型CH、快速消退型CH以及迟发性扩张型CH。不同类型的CH其临床特征及治疗方式不同。结合近年CH的研究进展报道,文章对CH的发病机制、临床特征、诊断及治疗着重进行综述,以期更好地为临床诊治提供指导。
Congenital hemangioma(CH)is a relatively rare benign vascular tumor that is present before birth.Based on the growth characteristics of CH after birth,CH can be classified into four types:non-involuting congenital hemangioma,partially involuting congenital hemangioma,rapidly involuting congenital hemangioma,and delayed expanding congenital hemangioma.Different types of CH exhibit distinct clinical features and require different treatment approaches.This review focuses on recent research advances in CH,including its pathogenesis,clinical characteristics,diagnosis,and treatment,aiming to provide better guidance for clinical practice.
糖尿病肾病(DN)是指由糖尿病所致的慢性肾脏疾病,是目前我国和全球范围内慢性肾脏疾病和终末期肾脏疾病的首位病因。DN发病率逐年攀升,且预后不良,已成为我国重大的公共卫生问题之一。DN不仅明显降低了患者的生活质量,还增加了心血管疾病的风险。随着对DN发病机制的深入研究,近十余年来在DN治疗手段方面取得了显著进展,包括新型药物的研发、生活方式的干预及各种新兴疗法的探索。本文旨在系统性综述近年来DN领域的重要治疗进展,阐明这些进展在临床应用中的有效性和适用性,并展望未来的研究方向,以期为临床实践提供参考和指导。
Diabetic nephropathy(DN)is a form of chronic kidney disease(CKD)induced by diabetes.Diabetic nephropathy represents the leading cause of CKD and end-stage renal disease both in China and globally.The incidence of DN has been steadily increasing and its prognosis remains unfavorable.Diabetic nephropathy has become a major public health concern.Diabetic nephropathy not only significantly affects patients’ quality of life but also increases the risk of cardiovascular diseases.Recent advancements in our understanding of the pathogenesis of DN have facilitated significant progress in treatment options over the past decade.These developments include the introduction of novel pharmacological agents,the implementation of lifestyle modifications,and the exploration of various emerging therapeutic approaches.This review aims to systematically expound the significant therapeutic advancements in the field of DN in recent years,evaluate the efficacy and applicability of these advancements in clinical practice,and explore potential future research directions,thereby providing valuable insights andguidance for clinical practice.
无创正压通气的使用是患者发生鼻面部压力性损伤的重要原因之一,随着我国防控政策的放开,新增老年新冠感染患者急剧增加。文章对使用无创正压通气发生相关压力性损伤现状进行综述,介绍老年患者使用无创正压通气发生鼻面部压力性损伤的主要影响因素、评估方法以及预防措施现状,旨在为临床医务人员预防其相关压力性损伤提供参考。
The use of non-invasive positive pressure ventilation is one of the important reasons for nasal and facial pressure injuries in patients.With the release of China's epidemic prevention policy,the number of new elderly patients with COVID-19 has increased dramatically.This paper summarizes the current situation of stress injuries caused by noninvasive positive pressure ventilation,introduces the main influencing factors,evaluation methods and prevention measures of nasal and facial stress injuries in elderly patients with noninvasive positive pressure ventilation,aiming to provide a reference for clinical medical personnel to prevent their related stress injuries.
放射治疗(放疗)可以提高妇科恶性肿瘤患者的总体生存率,降低复发率,增加手术机会。但肿瘤周围的健康组织不可避免地会进入电离辐射区域从而导致阴道狭窄、缩短和失去弹性,文章结合近年来国内外的放疗后阴道损伤治疗方式进行综述,总结分析治疗的优缺点,旨在为放疗后阴道损伤的临床治疗提供帮助。
Radiotherapy can improve the overall survival rate,reduce the recurrence rate and increase the chance of surgery in patients with gynecological malignant tumors.However,the healthy tissue around the tumor can inevitably be included the ionizing radiation area,resulting in vaginal stenosis,shortening and loss of elasticity.This paper reviews the treatment methods of post-radiotherapy vaginal injury at home and abroad in recent years,to summarize and analyze theadvantages and disadvantages of treatment,aiming to provide help for the clinical treatment of post-radiotherapy vaginal injury.
运动可以调节机体代谢,预防和治疗由糖脂代谢紊乱所引发的心血管疾病。运动因子是在运动过程中,由肌肉、脂肪以及肝脏等多个组织合成和分泌的一系列生物活性物质,包括蛋白质和多肽类分子、小分子代谢物以及核酸等。诸多研究证实,运动因子是运动调节机体代谢的重要因素之一,也是机体从运动中获益的关键分子机制。近年来,随着蛋白质组学、代谢组学以及高通量测序等相关技术的飞速发展,越来越多的运动因子被陆续发现和证实。这不仅拓宽了人们对机体从运动中获益相关机制的认知,还激发了人们对运动因子在健康领域应用前景的浓厚兴趣。文章系统地阐述了运动因子对机体心血管系统的影响,旨在揭示运动因子在促进心血管健康以及治疗心血管疾病等方面的积极效用。
Exercise can prevent and treat cardiovascular diseases resulting from the metabolic disorders of glucose and lipid.Exerkines are defined as a series of bioactive substances in response to exercise including proteins,peptides,small molecular metabolites and nucleic acids.Multiple tissues can produce exerkines,such as skeletal muscle,adipose tissue,and liver.Many studies indicate that exerkines play essential roles in improving glucose and lipid metabolism,which are crucial to harness the health-related benefits mediated by exercise.In recent years,with the progression of proteomics,metabolomics and high-throughput sequencings,an increasing number of exerkines are discovered.These findings expand the research on beneficial effects of exercise and draw attention to the clinical implications of exerkines.This review aims to explore the influence of exerkines on cardiovascular system and reveal their potential roles in the prevention and treatment of cardiovascular disease.
受现代人们生活、饮食习惯改变、心理压力增加和睡眠质量下降等因素影响,胃食管反流病的发病率逐渐增加,对患者的工作生活和情绪造成了极大的影响。自我管理能够以患者为中心,提高患者在疾病治疗中的参与度,节约医疗资源,被广泛应用在慢性病管理中。而胃食管反流病患者的自我管理仍处于初步发展阶段,缺少科学、系统的评估工具和能够广泛实行的干预流程。文章通过对胃食管反流病患者的自我管理的概念、评估工具、干预方案等方面进行综述, 旨在为胃食管反流病患者自我管理的干预提供参考。
As modern lifestyles and dietary habits change,psychological stress increases,and sleep quality declines,the prevalence of gastroesophageal reflux disease(GERD)has been rising.This condition significantly impacts patients' work,daily life,and emotional well-being.Self-management,which centers on patient involvement,enhances participation in disease treatment,conserves medical resources,and is widely used in managing chronic diseases.However,self-management for GERD patients is still in its early stages,lacking scientifically systematic assessment tools and broadly applicable intervention protocols.This study reviews the concepts,assessment tools,and intervention programs of self-management GERD patients,aiming to provide reference for the intervention of self-management of GERD patients.
戊型肝炎病毒(HEV)是导致急性肝炎的重要病原体,部分HEV感染者可进展为肝衰竭,此外,慢性感染和肝外表现可也在HEV感染者中发生。全球每年感染HEV的患者数达2000万,其中330万例患者有肝炎相关的临床症状,年死亡例数约为4.4万(2015年数据)。在我国,HEV以散发流行为主。近年来由于对其研究的重视,HEV病原学、流行病学、临床诊疗和预防取得较大的进展,文章拟对目前HEV防治热点以及新进展进行总结和分析。
Hepatitis E virus(HEV)is an important pathogen that causes acute hepatitis.Some HEV-infected individualsmay progress to liver failure.In addition,chronic infection(including liver fibrosis and cirrhosis)and extrahepatic manifestations can also occur in HEV infection.Worldwide,there are 20 million cases of HEV infection each year,with 3.3 million cases presenting clinical symptoms related to hepatitis,and an annual death toll of approximately 44,000(data from 2015).In China,HEV mainly present as sporadic outbreaks.In recent years,there has been significant progress in the pathogenesis,epidemiology,clinical diagnosis and treatment,and prevention of HEV.This review aims to summarize and analyze the current hotspots and new developments in the prevention and treatment of HEV.
人工智能(AI)这一新兴技术的出现和应用给炎症性肠病(IBD)的诊断带来了巨大的变革。越来越多的研究着手于开发基于机器学习(ML)和深度学习(DL)的诊断模型,并获得了良好的诊断性能,尤其是在IBD的图像诊断,卷积神经网络(CNN)等模型由于其出色的图像分析能力,在内镜检查和组织病理检查等方面具有十分可观的发展前景。近年来AI诊断模型的应用越发广泛,但与此同时,关于算法、数据库及其应用方面仍存在一些难以忽视的局限性。本文将主要就图像识别方面对AI在IBD诊断中的应用进行综述,以期为IBD精准图像诊断领域下步研究提供参考。
As an emerging technology,artificial intelligence(AI)has brought great changes to the precise diagnosis of inflammatory bowel disease(IBD).More and more researches have developed diagnostic models which are based on machine learning(ML)and deep learning(DL)and obtained satisfactory diagnostic performance.Especially in the image diagnosis of IBD,convolutional neural network(CNN)and other models have considerable development prospects in endoscopy and histopathology due to their excellent image analysis capabilities.In recent years,the application of AI diagnostic models has become more and more widespread,but at the same time,there are still some limitations about algorithms,databases and their applications that cannot be ignored.This review mainly focused on the application of AI in IBD diagnosis from the aspect of image recognition,to provide a reference for IBD diagnosis towards precision medicine.