论著

基于 Python 语言探析《圣济总录》中腰痛病用药规律研究

Study on medication rule of low back pain in Shengji Zonglu based on Python language

:99-105
 
      目的   应用 Python语言对《圣济总录》中腰痛病篇中的中药进行用药规律分析,提取腰痛病治疗方法及用药特色指导临床腰痛病治疗思路。方法   运用 Python语言中的语言提取对《圣济总录》中腰痛篇章中的所有中药方剂识别,提取方剂组成,统计并分析方剂中中药的规律并将其结果可视化呈现。结果   最终共纳入62首方剂,包含药物86味。其中使用频次≥7次、频率≥1.6%的药物共20味,频次频率最高的为桂枝;所用中药四气以温性为主,占56.74%;五味以辛、甘、苦为主,共约占90%,归经以肝肾经为主;药物功效以补虚类为主,占27.13%;关联规则分析显示提升度最高的组合为麻黄-独活,置信度最高的组合为巴戟天-牛膝、牵牛子-牛膝,支持度最高的组合为川芎-当归、川芎-杜仲;通过聚类分析得到3个聚类结果。结论   《圣济总录》治疗腰痛病方面善用通法和补法,强调活血通络,补益肝肾,尤擅长治疗肝肾亏虚或风寒所客等腰痛病证。
       Objective Python language was used to analyze the rules of traditional Chinese medicine in the chapter of low back pain in Shengji Zonglu,and to extract the treatment methods and medication characteristics of low back pain to guide the clinical treatment of low back pain.Methods The language extraction in Python language was used to identify all the Chinese medicine prescriptions in the chapter of low back pain in Shengji Zonglu,extract the composition of the prescription,and analyze the rules of Chinese medicine in the prescription to visually present the results.Results A total of 62 prescriptions were included,including 86 drugs.Among them,with there were 20 kinds of drugs,the frequency of use ≥7 times,the frequency ≥1.6%,and cmnamomi Mmulus highest frequency.Four gas used in traditional Chinese medicine is given priority to with warm,accounted for 56.74%.The five flavors were mainly pungent,sweet and bitter,accounting for about 90%,and the liver and kidney meridians were the main meridians.The drug efficacy was mainly deficiency tonic,accounting for 27.13%.The association  rule analysis showed that the combination with the highest improvement was Ephedrae Herba- Angelicae Pubescentis Radix,the combination with the highest confidence was Morindae Officinalis Radix- Achyranthis Bidentatae Radix,Pharbitidis Semen- Achyranthis Bidentatae Radix.and the combination with the highest support was Chuanxiong Rhizoma- Angelicae Sinensis Radix,Chuanxiong Rhizoma- Eucommiae Cortex.Three clustering result is obtained by cluster analysis.Conclusions In the treatment of low back pain,Shengji Zonglu is good at using both blocking methods and reinforcing methods,emphasizing circulating blood and unblocking meridians supplementing liver and kidney,especially in the treatment of low back pain syndrome caused by liver and kidney deficiency or wind and cold.
论著

不同湿化方法对喉癌患者术后气道湿化效果的网状 Meta 分析

Effects of airway humidification for postoperative with laryngeal cancer:A network Meta-analysis

:89-98
 
       目的   评估多种气道湿化方法对喉癌患者术后气道湿化的效果。方法   检索PubMed、Cochrane、Embase、Web of Science、Ovid、中国知网、万方、CBM、Google Scholar等数据库和网站,检索时限为建库至2023年2月。搜集关于喉癌患者术后不同气道湿化方法的随机对照试验,采用JBI2016年随机对照试验RCT评价标准评价文献质量。使用ADDIS1.16.5软件进行网状Meta分析。结果   纳入18篇研究,共1 596例患者。结果显示,镇痛泵持续泵入与注射器间断滴入、喷雾瓶间断喷雾在痰痂形成方面比较差异有统计学意义[OR(95%CI)=537.70(4.18,124 511.88)、0(0,0.52),P<0.05];湿化满意度方面,注射器间断滴入与喷雾瓶间断喷雾比较差异有统计学意义[OR(95%CI)=8.55(1.40,73.35),P<0.05];其余比较差异无统计学意义(P>0.05)。概率排序显示,降低肺部感染、黏膜出血和痰痂形成、痰液黏稠度、咳嗽和湿化不满意的发生,最优方法分别为湿化泵持续泵入、镇痛泵持续泵入、MR400湿化器和输液器持续泵入。结论   综合网状Meta分析及概率排序结果,考虑到喉癌患者术后早期下床活动,推荐便携式持续湿化方法。
       Objective  To access the effects of multiple airway humidification methods for postoperative patients with laryngeal cancer.Methods  PubMed,Cochrane Library,EMbase,Web of Science,Ovid,China National Knowledge Infrastructure,Wanfang database,CBM and Google Scholar were searched systematically from establishment to February 2023,respectively.Related  randomized controlled trials on airway humidification for postoperative patients with laryngeal cancer was analyzed and the quality of the literature was assessed using the JBI 2016 RCT evaluation.The network Meta analysis was performed using ADDIS 1.16.5 softwares.Results  A total of 18 articles and 1596 patients were inciuded.The results showed that the analgesia pump continued to pump into the airway compared with the syringe intermittently drip and the spray bottle intermittent spray was statistically different in the formation of sputum[OR(95%CI)=537.70(4.18,124 511.88),0(0,0.52),P<0.05].In terms of satisfaction of wetness,the difference between the intermittent drop of the syringe and the intermittent spray of the spray bottle was statistically different[OR(95%CI)=8.55(1.40,73.35),P<0.05],the others were not statistically different(P0.05).Probability ranking table shows that the optimal methods were the humidification pump continues to pump into the airway,the analgesia pump continued to pump into the airway,the MR400 humidifier and the infusion set continuously pumped into the airway,which were beneficial to the reduction in pulmonary infection,tracheal mucosal hemorrhage and formation of phlegm callus,the degree of sputum viscosity,cough and unsatisfactory wetness.Conclusions  Based on the comprehensive mesh meta-analysis and probability ranking results,a portable continuous humidification method is  recommended considering the early post-operative activities of laryngeal cancer patients.
论著

Ki-67、MCM2、p16 在宫颈鳞状上皮内病变中表达及意义

Analysis of the expression and significance of Ki-67、MCM2 and p16 in cervical intraepithelial lesions

:82-88
 
       目的   探讨Ki-67、微小染色体维持蛋白2(MCM2)、p16在宫颈鳞状上皮内病变中的表达及其临床意义。方法   采用免疫组化检测Ki-67、MCM2、p16在宫颈炎症组14例、低级别鳞状上皮内病变(LSIL)组47例、高级别鳞状上皮内病变(HSIL)组49例中的表达情况,以病理结果作为金标准,对结果进行统计分析。结果  HSIL组中Ki-67、MCM2、p16阳性率均高于炎症组和LSIL组(均P<0.017)。HSIL组中Ki-67、MCM2过表达率均显著高于炎症组和LSIL组(均P<0.017)。随着宫颈病变级别增加,Ki-67及MCM2阳性范围从基底层至表层逐渐扩大。MCM2及Ki-67在LSIL组中表达模式多为基底层的非过表达模式,HSIL组多为中层及以上的过表达模式。Spearman相关性分析显示,MCM2和Ki-67在宫颈鳞状上皮内病变中的表达强度之间呈正相关(r=0.801,P<0.05);p16与MCM2在宫颈鳞状上皮内病变中的表达呈正相关(r=0.559,P<0.05);p16与Ki-67在宫颈鳞状上皮内病变中的表达呈正相关(r=0.478,P<0.05)。结论  p16阳性提示宫颈高级别鳞状上皮内病变。MCM2与Ki-67在宫颈鳞状上皮内病变中的表达具有较高一致性,MCM2可作为宫颈鳞状上皮内病变新的增殖标志物。
       Objective  To investigate the expression and significance of Ki-67,MCM2 and p16 in cervical intraepithelial lesions.Methods  The expressions of Ki-67,MCM2 and p16 in cervicitis group(14 cases),low-grade squamous intraepithelial lesion(LSIL) group(47 cases)and high-grade squamous intraepithelial lesion(HSIL) group(49 cases)were detected by immunohistochemistry.The pathological results were used as the gold standard for statistical analysis.Results  The positive  rates of Ki-67,MCM2 and p16 in HSIL group were significantly higher than those in cervicitis group and LSIL group(P<0.017).The over-expression rates of Ki-67,MCM2 in HSIL group were significantly higher than those in cervicitis group and LSIL grou(P<0.017).With the increase of cervical lesion grade,the positive range of Ki-67 and MCM2 gradually expanded from basallayer to surface layer.The expression patterns of MCM2 and Ki-67 in LSIL group were mostly non-overexpressed in the basal layers,while those in HSIL group were mostly overexpressed in the middle layer and above.Spearman correlation analysis showed that the expression intensity of MCM2 and Ki-67 in cervical squamous intraepithelial lesions was positively correlated(r=0.801,P<0.05).There was a positive correlation between the expression of p16 and MCM2 in cervical squamous intraepithelial lesions(r=0.559,P<0.05).There was a positive correlation between the expression of p16 and Ki-67 in cervical squamous intraepithelial lesionsr=0.478,P<0.05).Conclusions  Positive p16 indicates high-grade squamous intraepithelial lesion.The expression of MCM2 and Ki-67 in cervical intraepithelial lesions is highly consistent.MCM2 can be used as a new proliferative marker for cervical intraepithelial lesions.
论著

癌症患者生命质量测定量表体系之肾癌量表(QLICP-REV2.0)的条目筛选

Items selection on the Specific Module of Quality of Life Instruments for patients with renal cancer (QLICP-REV2.0)

:77-81
 
       目的   开发适合中国肾癌患者的生命质量测定量表的特异模块。   采用议题小组和核心小组的程序化决策方式,提出条目池,形成初步量表,采用医生及患者重要性评分法、相关系数法、变异度法、因子分析法和克朗巴赫系数α对20例肾癌患者和20名医护人员进行的数据进行统计分析。结果   经过上述方法进行筛检,结合专家小组的建议,最终得到含有11个条目的肾癌生命质量测定量表的特异模块。结论 肾癌的生命质量测定量表特异模块严格按照程序执行,具有较好的内容效度。
      Objective  To develop the specific module of the quality of life instruments for patients with renal cancer(QLICP-RE).Methods  With the structured group(nominal group and focus group)methods,the item pool was put forward and a preliminary instrument was formed.The data from 20 renal cancer patients and 20 doctors/nurses were analyzed by statistical procedures.Doctors and patients’ importance rating procedure,correlation analysis,method of coefficient of variation,factor analysis,and Cronbach’s α.Results  By above statistical procedures and advises of expert panel,11-items of the specific module were formed finally.Conclusions  The specific module of QLICP-RE developed on the strict procedures has good content validity and representativeness.
论著

SUZ12 通过调控肝癌细胞及人脐静脉内皮细胞的血管生成发 挥抑癌作用

Anti-cancer role of SUZ12 by regulating angiogenesis of liver cancer cells and human umbilical vein endothelial cells

:71-76
 
       目的   探讨多梳蛋白SUZ12对肝细胞肝癌(HCC)细胞增殖、血管生成拟态形成和人脐静脉内皮细胞(HUVECs)血管生成的影响。方法 分别利用MTT比色法及体外血管生成实验检测SUZ12表达水平改变对HCC细胞SMMC-7721、Hep3B增殖、血管生成拟态形成和HUVECs血管生成的影响。结果  MTT结果显示,在HCC细胞中分别敲低或过表达SUZ12均对HCC细胞的增殖能力无明显影响。将SUZ12低表达HCC细胞与HUVECs共培养后,HCC细胞的血管生成拟态管样结构形成增多。此外,将SUZ12敲低组HCC细胞的培养上清用于培养HUVECs后,HUVECs的血管生成拟态管样结构形成也明显增多。结论  SUZ12对HCC细胞的增殖无影响,其在HCC中可抑制HCC细胞和HUVECs的血管生成拟态管样结构形成。上述结果提示SUZ12可能通过调控HCC细胞及HUVECs的血管生成发挥抑癌作用。
      Objective  To investigate the effects of SUZ12 on cell proliferation of hepatocellular carcinoma(HCC),vasculogenic mimicry formation and human umbilical vein endothelial cells(HUVECs)angiogenesis.Methods  MTT assay was performed to detect the proliferation of SMMC-7721 and Hep3B cells.The effects of SUZ12 on the angiogenesis of HCC cells and HUVECs cells were studied by in vitro angiogenesis experiment.Results  The result of MTT assay showed that SUZ12 knockdown or overexpression in HCC cells had no significant effect on the proliferation of HCC cells.We found that when HCC cells with low SUZ12 expression were co-cultured with HUVECs cells,the formation of vasculogenic mimicry tubular structures in HCC cells increased.In addition,we also found that after the culture supernatant of HCC cells in the SUZ12 knockdown group was used to culture HUVECs cells,the formation of vasculogenic mimicry tubular structures in HUVECs cells also increased significantly.Conclusions  SUZ12 has no effect on the proliferation of HCC cells,but it can inhibit the formation of vasculogenic mimicry tubular structures in HCC cells and HUVECs cells.These results suggest that SUZ12 plays a role in cancer inhibition by regulating the angiogenesis of HCCcells and HUVECs cells.
综述

浅析音乐疗法在儿童发育障碍疾病中的应用

Analysis of the application of music therapy in childhood developmental disorders

:62-70
 
       患有发育障碍类疾病的儿童数量庞大,给社会造成了严重的影响。这类疾病难以预防和治愈,同时缺乏特效药物,因此治疗主要依赖于行为和教育干预,药物治疗只是辅助手段。然而,目前临床相关治疗均有一定的不足,如存在不良反应、治疗周期相对较长、专业性要求相对较高等缺点。与之相比,音乐疗法具有操作简便、不良反应少等优势,因此可应用于儿科多种慢性疾病的治疗。文章旨在通过研究现代音乐治疗,探讨结合古代五音疗法、现代知识以及中医理论,为儿童临床治疗提供一定的方法指导。
      The number of children suffering from developmental disorders is substantial,causing significant impact on society.These diseases are difficult to prevent and cure,with a lack of specific medications,thus treatment primarily  relies on behavioral and educational interventions,with medication being only an auxiliary measure.However,current clinical treatments have certain drawbacks,such as potential toxic side effects,relatively long treatment periods,and high demands for specialization.In contrast,music therapy offers significant advantages such as easy operation and minimal side effects,making it suitable for the treatment of various chronic pediatric disease.This paper aims to explore the integration of ancient pentatonic therapy,modern knowledge,and traditional Chinese medicine theory through the study of modern music therapy,providing guidance for clinical treatment of children.
综述

浆细胞性乳腺炎的中西医结合治疗进展

Progress of integrated traditional Chinese and Western medicine treatment of plasma cell mastitis

:56-61
 
       近年来浆细胞性乳腺炎的发病率逐渐升高,已占乳腺疾病的4%~5%,该病易反复发作,经久不愈,抗生素、糖皮质激素、抗结核药、他莫昔芬等治疗效果不明显,单纯手术切除如切除范围小极易复发,而切除范围大则乳腺外形变化较大,严重者甚至需要切除乳腺。乳腺外形的缺损改变对患者身心健康造成伤害。随着研究不断深入,采用中西医结合治疗浆细胞性乳腺炎,可取得较好的治疗效果,降低复发率,而且对乳腺外观无影响。该文通过对文献的整理,对中西医结合治疗浆细胞性乳腺炎进行论述。
       In recent years,the incidence of plasma cell mastitis has gradually increased,accounting for 4 % ~ 5 % of breast diseases.The disease is prone to repeated attacks and unhealed for a long time.The treatment effect of antibiotics,glucocorticoids,anti-tuberculosis drugs and tamoxifen is not obvious.Simple surgical  resection is easy to  relapse if the  resection range is small,while the shape of the breast changes greatly,if the resection range is large.And even the breast needs to be removed in severe cases.The defect change of breast shape is harmful to the physical and mental health of patients.With the deepening of research,the combination of traditional Chinese and Western medicine in the treatment of plasma cell mastitis can achieve better therapeutic effect,reduce the recurrence rate,and has no effect on the appearance of breast.This article discusses the treatment of plasma cell mastitis with integrated traditional Chinese and Western medicine by sorting out the literature.
综述

评价药源性心脏毒性生物标志物的研究进展

Research progress in evaluating biomarkers of pharmacogenic cardiotoxicity

:48-55
 
       药源性心脏毒性是临床常见的药物不良反应,是药物研发和临床治疗需面临的严峻考验。对药源性心脏毒性的评价是目前研究的重点,基于其机制复杂多样、临床表现不一、影响因素多,早期评价具有困难。生物标志物是评价心脏毒性的重要指标之一,文章总结了目前已经报道的多种心脏毒性标志物及其潜在的生物标志物,希望能从中找到特异性强、敏感性高的标志物,以贡献于药物心脏安全性评价工作。
    As a common clinical adverse reaction,pharmacogenic cardiotoxicity is a severe challenge for drug development and clinical treatment.The evaluation of pharmacogenic cardiotoxicity is the focus of current research,and early evaluation is difficult with its complex and diverse mechanisms,varying clinical manifestations,and numerous influencing factors.Biomarker is an important index to evaluate cardiotoxicity.This article summarizes a variety of cardiotoxicity biomarkers and other potential biomarkers that have been reported so far,hoping to find  biomarkers with strong specificity and high sensitivity,so as tocontribute to the evaluation on cardiac safety of drugs.
综述

机器学习算法在术后谵妄风险评估中的应用进展

Progress in the application of machine learning algorithms in the risk assessment of postoperative delirium

:42-47
 
      近年来,人工智能技术(AI)的发展正在逐渐改变传统的医疗行业,机器学习作为人工智能技术中的主流被越来越多地应用于分析复杂的医学数据,为疾病的诊断、预后风险评估、诊疗决策的制定等方面提供了便利。文章对国内外机器学习算法在术后谵妄中的应用进行综述,以期为术后谵妄预测模型的构建提供新的思路,为临床早期评估术后谵妄提供新的依据。
    In recent years,the development of artificial intelligence(AI)is gradually changing the traditional medical industry.Machine learning,as the mainstream of artificial intelligence technology,is increasingly applied to analyze complex data in medical research.It provides convenience for disease diagnosis,risk assessment and diagnosis and treatment decision making.This paper reviews the application of machine learning algorithms in postoperative delirium at home and abroad,in order to provide a new idea for the construction of postoperative delirium prediction model and a new basis for early clinical evaluation of postoperative delirium.
眼科专题:近视防控

西藏林芝市 3 ~ 6 年级学生屈光状态及参数相关性研究

Analysis of refractive status and parameter correlations among three to six grade students in Nyingchi,Tibet

:32-41
 
      目的   分析高原地区3~6年级学生屈光状态及屈光参数之间的关系。方法  2023年9月,采用随机抽样方法选取林芝市波密县某两所小学3~6年级535名学生进行校园筛查。计算并记录裸眼远视力(UCVA),非睫状肌麻痹电脑验光下散光及其轴位、等效球镜(SE)、眼轴(AL)、角膜曲率半径(CR)和眼轴/角膜曲率半径轴率比(AL/CR)。采用SPSS 22.00统计软件分析数据。结果  3~6年级学生AL和AL/CR大体趋势为随年级升高而增长,SE随年级升高而降低。3~6年级学生总体筛查性近视患病率为29.91%,且3~6年级筛查性近视患病率分别为20.35%、25.53%、30.53%和51.38%。总体散光患病率为51.59%,其中顺规散光、逆规散光及斜轴散光分别占90.22%、7.61%及2.17%。视力不良者约40.37%。以非睫状肌麻痹验光SE≤-0.50 D同时UCVA<5.0作为筛查性近视的诊断,AL/CR诊断筛查性近视的灵敏度为0.656、特异度为0.887和Youden指数为0.534,曲线下面积(AUC)为0.802,优于AL评估(AUC=0.764)。结论   高原地区3~6年级学生的筛查性近视患病率随年级升高而快速增长,且散光患病率较高,视力不良者较多。AL/CR值对筛查性近视监测具有一定的临床意义。
      Objective  To analyze the  relationship  between  refractive  status and  refractive  parameters of  students in grades three-six in plateau area.Methods  In September,2023,a random sampling method was used to select 535 students from grades three-six of two primary schools in Bomi County,Nyingchi City,for school screening.Distance uncorrected visual acuity(UCVA),astigmatism and its axis position,equivalent spherical(SE),axial length(AL),corneal radius(CR),and axial length/corneal radius ratio(AL/CR)were calculated and recorded.The data was analyzed using the statistical software SPSS 22.00.Results  The general trend of AL and AL/CR for grade three-six students was increased with grade increasing,while SE decreased with grade increasing.The overall prevalence of screening myopia was 29.91%,and the prevalence of screening myopia in grades three to six was 20.35%,25.53%,30.53% and 51.38%,respectively.The overall prevalence rate of astigmatism was 51.59%,including 90.22%,7.61% and 2.17% for astigmatism with the rule,astigmatism against the rule and oblique astigmatism,respectively.About 40.37% of the students had poor vision.Screening myopia was diagnosed using non-cycloplegic optometry with SE ≤-0.50 D combined with UCVA<5.0.The sensitivity and specificity of AL/CR for screening myopia were 0.656 and 0.887,respectively,with a Youden index of 0.534 and an area under the curve(AUC)of 0.802.This was superior to the AL evaluation,which had an AUC of 0.764.Conclusions  The prevalence of screening myopia increased rapidly with the increase of grade in grade 3 to 6 in plateau area.And there were high prevalence of astigmatism and more poor vision.AL/CR value has a certain clinical significance in the monitoring of screening myopia.
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