因气候与生活习惯影响,广东地区老年性肩周炎临床特点及康复需求具有独特性,亟待制定规范、具有当地特色的康复方案。为制订适合地区差异化的康复方案,广东省中西医结合学会康复专业委员会联合广东省康复医学发展研究会疼痛康复发展研究分会牵头发起,省内多家机构专家学者共同制订《老年性肩周炎中医全周期康复广东专家共识(2026年版)》。该共识以ICF框架为基础,立足肩周炎康复循证医学证据,结合多学科专家产教研实践经验,对肩周炎 ICF评定、中医适宜技术及康复治疗技术运用、阶梯式干预性措施制定和中西医全周期康复协同等方面形成共识性意见。本共识的发布,将为老年性肩周炎中医全周期康复提供规范化、本土化的“广东方案”。
Due to climatic and lifestyle influences,the clinical characteristics and rehabilitation needs of senile periarthritis of the shoulder in Guangdong region exhibit unique features,necessitating the development of standardized and locally tailored rehabilitation protocols.To formulate regionally differentiated rehabilitation plans,the Rehabilitation Professional Committee of Guangdong Association of Integrative Medicine and the Pain Rehabilitation Development Research Branch of Guangdong Rehabilitation Medicine Development Research Association jointly initiated the development of the “Guangdong Expert Consensus on TCM Full-Cycle Rehabilitation for Senile Periarthritis of the Shoulder(2026 Edition)” through collaboration with multiple provincial institutions and experts.Based on the International Classification of Functioning,Disability and Health(ICF)framework and evidence-based rehabilitation medicine for periarthritis of the shoulder,this consensus integrates multidisciplinary expertise from industry,academia,and research to establish unified guidelines on ICF assessment,application of appropriate TCM techniques and rehabilitation therapies,implementation of stepwise intervention measures,and integrated TCM-Western medicine full-cycle rehabilitation approaches.The publication of this consensus will provide a standardized and localized “Guangdong Solution” for TCM-based full-cycle rehabilitation of senile periarthritis of the shoulder.
目的:探讨司美格鲁肽联合二甲双胍对2型糖尿病合并周围神经病变(DPN)患者神经传导和炎症因子的影响。方法:选取64例DPN患者,分为研究组(n=32)和对照组(n=32)。对照组口服二甲双胍,研究组司美格鲁肽皮下注射联合口服二甲双胍。对比两组空腹血糖(FPG)、餐后2h血糖(2hPG)、糖化血红蛋白(HbA1c)、腓总神经运动神经传导速度(CPN-MCV)、腓总神经感觉神经传导速度(CPN-SCV)、正中神经运动神经传导速度(MN-MCV)、正中神经感觉神经传导速度(MN-SCV)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)及临床疗效。结果:治疗后,研究组FPG(7.47±1.16mmol/L vs. 8.20±1.22mmol/L)、2hPG(9.75±1.50mmol/L vs. 10.82±1.69mmol/L)及HbA1c(5.76±0.70% vs. 7.11±0.79%)较对照组降低(P<0.05)。研究组CPN-MCV(51.18±4.02m/s vs. 48.01±4.56m/s)、CPN-SCV(46.69±4.40m/s vs. 43.51±4.66m/s)、MN-MCV(46.79±3.53m/s vs. 43.42±4.68m/s)及(41.97±4.08m/s vs. 38.56±3.50m/s)较对照组升高(P<0.05)。研究组血清IL-6及TNF-α水平较对照组降低(P<0.05)。 研究组有效率高于对照组(96.87% vs. 78.12%,P<0.05)。结论:司美格鲁肽联合二甲双胍治疗DPN患者疗效确切,有助于改善神经传导功能,降低炎症因子表达。
目的 探讨益生菌辅助治疗儿童过敏性哮喘的临床疗效,分析其对Th1/Th2免疫失衡、炎症反应、免疫功能及复发风险的影响。方法 选取2022年1月至2023年12月本院收治的80例过敏性哮喘患儿,按随机数字表法分为对照组和观察组,各40例。对照组接受常规抗哮喘治疗(布地奈德雾化吸入+孟鲁司特钠),观察组结合益生菌进行辅助治疗。比较两组肺功能[第1秒用力呼气容积占预计值百分比(FEV1%)、最大呼气峰流速占预计值百分比(PEF%)]、Th1/Th2细胞因子[干扰素-γ(IFN-γ)、白细胞介素-4(IL-4)、白细胞介素-13(IL-13)]以及治疗总有效率、治疗后6个月内复发率。结果 治疗后,观察组FEV1%、PEF%分别为(87.35±5.21)%、(85.62±4.93)%,高于对照组的(78.44±5.67)%、(76.18±5.20)%(P<0.05)。观察组IFN-γ为(32.58±4.12)pg/mL,高于对照组的(24.36±3.89)pg/mL(P<0.05);IL-4、IL-13分别为(18.27±3.06)pg/mL、(22.14±3.51)pg/mL,低于对照组的(25.63±3.74)pg/mL、(31.05±4.02)pg/mL(P<0.05)。观察组治疗总有效率为92.50%(37/40),高于对照组的75.00%(30/40)(P<0.05)。随访6个月,观察组哮喘复发率为10.00%(4/40),低于对照组的27.50%(11/40)(P<0.05)。结论 益生菌辅助治疗儿童过敏性哮喘可显著改善肺功能及临床症状,调节Th1/Th2免疫失衡,提高临床疗效,并降低复发风险,值得临床推广。
目的:探讨维生素B2(VB2)联合蓝光照射对新生儿黄疸康复进程及肝脏功能的影响。方法:选取2024年5月—2025年10月收治的150例黄疸患儿,应用随机数字表法分为常规组和试验组,每组75例。常规组接受蓝光照射治疗,试验组在常规组基础上口服VB2治疗。比较两组患儿的氧化应激反应[谷胱甘肽过氧化物酶(GSH-Px),8羟基脱氧鸟苷(8-OHdG)、晚期蛋白氧化产物(AOPP)、超氧阴离子(O2-)]、肝脏微循环[血管性血友病因子(vWF)、可溶性血栓调节蛋白(sTM)、肝动脉阻力指数(HA-RI)、门静脉血流速度(PVV)]、胆红素排泄[总胆红素(TBil)、间接胆红素(IBil)]、肝脏功能[丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)]、康复进程[光疗时间、胆红素恢复正常时间、黄疸消退时间、住院康复时间]及治疗安全性。结果:治疗后,试验组的GSH-Px高于常规组,8-OHdG、AOPP、O2-均低于常规组(P<0.05);试验组的vWF、sTM、HA-RI均低于常规组,PVV高于常规组(P<0.05)。试验组的TBil、IBil、ALT、AST分别为(80.52±5.47)μmol/L、(68.52±5.49)μmol/L、(30.25±5.48)U/L、(32.14±5.22)U/L,均低于常规组[(85.19±6.44)μmol/L、(74.37±6.52)μmol/L、(35.29±6.17)U/L、(38.55±6.48)U/L],差异有统计学意义(P<0.05)。试验组的光疗时间、胆红素恢复正常时间、黄疸消退时间、住院康复时间分别为(3.05±0.33)d、(4.22±1.39)d、(5.41±1.27)d、(5.12±0.49)d,均低于常规组[(3.68±0.36)d、(5.36±1.45)d、(6.28±1.33)d、(6.51±0.54)d],差异有统计学意义(P<0.05)。试验组的不良反应发生率与常规组比较,差异无统计学意义(P>0.05)。结论:VB2联合蓝光照射可减轻黄疸患儿的氧化应激反应并改善肝脏微循环,对促进胆红素排泄、改善肝脏功能均有积极影响,在促进患儿康复同时未显著增加治疗风险。其安全性较高,可进一步推广。
Objective: To investigate the effects of vitamin B2 (VB2) combined with blue light irradiation on the recovery process and liver function of neonatal jaundice. Method: 150 children with jaundice admitted from May 2024 to October 2025 were selected and randomly divided into a control group and an experimental group using a random number table method, with 75 cases in each group. The conventional group received blue light irradiation treatment, while the experimental group received oral VB2 treatment on the basis of the conventional group. Compare the oxidative stress response of two groups of children [glutathione peroxidase (GSH Px) higher than the control group, 8-hydroxydeoxyguanosine (8-OHdG), advanced protein oxidation products (AOPP), superoxide anion (O2-)], liver microcirculation [von Willebrand factor (vWF), soluble thrombomodulin (sTM), hepatic artery resistance index (HA-RI), portal vein blood flow velocity (PVV)], bilirubin excretion [total bilirubin (TBil), indirect bilirubin (IBil)], liver function [alanine aminotransferase (ALT), aspartate aminotransferase (AST)], rehabilitation process [phototherapy time, bilirubin recovery time to normal, jaundice regression time]. Hospitalization rehabilitation time and treatment safety. Result: After treatment, the GSH Px levels in the experimental group were higher than those in the control group, while 8-OHdG, AOPP, and O2- levels were lower than those in the control group (P<0.05); The vWF, sTM, and HA-RI of the experimental group were lower than those of the control group, while PVV was higher than that of the control group (P<0.05). The TBil, IBil, ALT, and AST of the experimental group were (80.52 ± 5.47) μ mol/L, (68.52 ± 5.49) μ mol/L, (30.25 ± 5.48) U/L, and (32.14 ± 5.22) U/L, respectively, which were lower than those of the conventional group [(85.19 ± 6.44) μ mol/L, (74.37 ± 6.52) μ mol/L, (35.29 ± 6.17) U/L, (38.55 ± 6.48) U/L], and the difference was statistically significant (P<0.05). The phototherapy time, bilirubin recovery time, jaundice resolution time, and hospital rehabilitation time of the experimental group were (3.05 ± 0.33) days, (4.22 ± 1.39) days, (5.41 ± 1.27) days, and (5.12 ± 0.49) days, respectively, which were lower than those of the conventional group [(3.68 ± 0.36) days, (5.36 ± 1.45) days, (6.28 ± 1.33) days, and (6.51 ± 0.54) days], and the difference was statistically significant (P<0.05). The incidence of adverse reactions in the experimental group was not significantly different from that in the control group (P>0.05). Conclusion: VB2 combined with blue light irradiation can alleviate oxidative stress response and improve liver microcirculation in children with jaundice. It has a positive effect on promoting bilirubin excretion and improving liver function, and does not significantly increase treatment risk while promoting the recovery of children. It has high safety and can be further promoted.
目的 探讨吗替麦考酚酯联合醋酸泼尼松对视神经脊髓炎(NMO)患者白细胞介素-23(IL-23)/IL-17A轴相关因子、复发的影响。设计 前瞻性设计。研究对象 选取我院90例NMO患者,简单随机化法分组,各30例。方法 所有患者术前均行矫正视力、Kurtzke功能评定量表(EDSS)、实验室指标检查。A组采取吗替麦考酚酯+醋酸泼尼松,B组采取吗替麦考酚酯,C组采取醋酸泼尼松,观察患者治疗3个月后、6个月后矫正视力、Kurtzke功能评定量表(EDSS)、实验室指标变化。主要指标 IL-23/IL-17A轴相关因子、矫正视力、EDSS评分、复发。结果 (1)治疗前,3组ApoE、AQP4、GFAP、IL-23、IL-17A、IL-6、TNF-α及矫正视力、EDSS评分比较差异无统计学意义(P>0.05);治疗3个月后、6个月后A组血清ApoE水平高于B组、C组,AQP4、GFAP、IL-23、IL-17A、IL-6、TNF-α水平低于B组、C组(P<0.05),治疗3个月后、6个月后A组矫正视力、EDSS评分低于B组、C组(P<0.05);(2)3组不良反应比较差异无统计学意义(P>0.05);(3)3组治疗后随访12个月,A组、B组、C组各有3、3、3例失访,年复发率比较差异无统计学意义(P>0.05)。结论 免疫抑制剂联合醋酸泼尼松可调节NMO患者神经递质、IL-23/IL-17A轴相关因子表达,改善视力,降低复发率。
目的 分析2024年2月至2026年2月郑州人民医院收治的急性下呼吸道感染(ALRTI)患儿的病原体分布情况及其流行病学特征。方法 选取2024年2月—2026年2月于郑州人民医院就诊的193例ALRTI患儿为研究对象,采集患儿咽拭子样本,统计患儿病原体检测结果,比较不同性别、不同年龄段、不同发病季节患儿病原体分布情况。结果 193例患儿中,经病原体检测出阳性患儿165例,总阳性检出率85.49%,检出率最高的前三位为RSV(20.73%)、MP(19.69%)、HRV(15.54%);婴儿期患儿RSV感染占比(44.83%)最高,其次为HRV感染(20.69%),幼儿期患儿RSV、HRV、MP感染占比(17.31%、17.31%、19.23%)均较高,学龄前、学龄期患儿MP感染占比(33.33%、26.32%)最高,婴儿期患儿混合感染占比(6.90%)较低,学龄前患儿混合感染占比(20.00%)较高;春季时,各病原体分布较均衡,HRV、MP、SP感染占比(14.58%、12.50%、14.58%)均较高,夏季、秋季时,MP感染率(31.82%、28.85%)较高,冬季时,RSV感染率(55.10%)较高,四个季节中混合感染患儿占比较接近,其中秋季感染率(17.31%)相对较高。结论 2024年至2026年郑州人民医院收治的急性下呼吸道感染患儿病原体中,RSV、MP为主要病原体,各呼吸道病原体随患儿年龄段、季节变化存在不同发病高峰,临床应结合实际情况早期鉴别病原体,以指导临床制定针对性治疗方案,改善患儿预后。
Objective To analyze the distribution of pathogens and the epidemiological characteristics of children with acute lower respiratory tract infections (ALRTI) admitted to Zhengzhou People’s Hospital from February 2024 to February 2026. Methods: A total of 193 pediatric patients with ALRTI who visited Zhengzhou People’s Hospital between February 2024 and February 2026 were selected as study subjects. Throat swab samples were collected from the patients, and pathogen testing results were compiled to compare the distribution of pathogens across different genders, age groups, and seasons of onset. Results: Among the 193 children, 165 tested positive for pathogens, resulting in an overall positive detection rate of 85.49%. The top three most frequently detected pathogens were RSV (20.73%), MP (19.69%), and HRV (15.54%); RSV infection had the highest prevalence (44.83%) among infants, followed by HRV infection (20.69%). Among preschoolers, the prevalence of RSV, HRV, and MP infections (17.31%, 17.31%, and 19.23%, respectively) was relatively high. MP infections were most common among preschool and school-age children (33.33% and 26.32%, respectively); the proportion of mixed infections was lower among infants (6.90%) but higher among preschoolers (20.00%); In spring, the distribution of pathogens was relatively balanced, with high proportions of HRV, MP, and SP infections (14.58%, 12.50%, and 14.58%, respectively). In summer and fall, the MP infection rate was high (31.82% and 28.85%, respectively). In winter, the RSV infection rate (55.10%) was high. The proportion of children with mixed infections was relatively similar across the four seasons, with a relatively higher infection rate (17.31%) in autumn. Conclusion: Among the pathogens identified in children with acute lower respiratory tract infections admitted to Zhengzhou People’s Hospital from 2024 to 2026, RSV and MP were the primary pathogens. The incidence peaks of various respiratory pathogens varied according to the children’s age groups and seasons. Clinicians should conduct early pathogen identification based on actual conditions to guide the development of targeted treatment plans and improve patient outcomes.