【摘要】 目的 評價臨床心血管系統藥物的利用情況與趨勢。 方法 利用excel表格對四川省建筑醫院2008年1月－2010年12月全部心血管系統藥物處方的種類、銷售金額、用藥頻度值（DDDs）等進行統計分析。 結果 3年中，心血管系統藥物的銷售金額呈逐年上升趨勢。在銷售金額和DDDs的前10名排名中主要包括鈣通道阻滯類藥物、調血脂藥物和中成藥等。 結論 臨床心血管系統藥物應用基本合理，對于療效顯著、不良反應輕微、價格合理的藥物患者依從性好，臨床使用廣泛。【Abstract】 Objective To investigate the use of cardiovascular drugs in our hospital (Sichuan Architecture Hospital) from 2008 to 2010, and evaluate its future tendency. Methods Excel was used to analyze the variety, consumption, defined daily dose (DDDs) of cardiovascular drugs used during 2008 to 2010 statistically in our hospital. Results During these three years, the consumption of cardiovascular drugs increased from year to year. The calcium channel blockers, lipid-modulating drugs and traditional Chinese medicines ranked high in the sum and DDDs column in Excel. Conclusion The use of cardiovascular drugs is rational in our hospital. The safe and effective drugs with reasonable price and better compliance are widely applied.
目的:評價益生菌在預防和治療兒童喘息性疾病中的效果。方法:將393例喘息性疾病患兒分為觀察組206例,對照組187例,對照組187例常規治療,觀察組206例在對照組187例常規治療的基礎上給予口服雙歧桿菌三聯活菌腸溶膠囊。結果:觀察組治愈時間明顯少于對照組,兩組比較差異有顯著性(Plt;005),觀察組總復發率為342%,對照組總復發率為433%,兩組比較差異有顯著性(Plt;005)。結論:添加益生菌對預防和治療兒童喘息性疾有積極的效果。
Objective To summarize the optimal evidence for improving the management of chronic wounds exudate, so as to provide evidence-based references for medical professionals, therapists, patients, and their caregivers. Methods PubMed, Wanfang, CNKI, Medlive, UpToDate, etc., were searched by computer for literature about chronic trauma exudate management. The retrieval time limit was from 1998 to 2023. Two researchers trained in evidence-based practice evaluated the quality of the included literature and finally extracted evidence from the literature that met the quality evaluation criteria. Results A total of 11 articles were included, including 2 expert consensuses, 7 systematic reviews, 1 randomized controlled trial, and 1 guideline, covering 7 aspects of the assessment of the nature of chronic wounds exudate, selection of exudate assessment tools, management of antimicrobial concerns, selection and application of wound dressings, negative pressure wound drainage therapy, wound drainage bags, and affected limb elevation or compression therapy for patients with venous leg ulcers. A total of 13 best evidences were extracted. Conclusions When applying evidence, medical professionals should fully evaluate and combine the individual circumstances of the patient, make full use of existing resources, new treatment concepts and technologies, and carry out comprehensive integrated management. This can optimize the management of chronic wounds exudate and improve the quality of life of patients.
ObjectiveTo investigate the clinical features, differential diagnosis and treatment for chromophobe cell renal carcinoma (CRCC) and renal oncocytoma. MethodsFrom December 2009 to May 2013, we selected 41 cases of CRCC and 22 cases of renal oncocytoma, retrospectively analyzed their clinical features, ultrasonography and CT findings and performed immunohistochemical staining for CK7, CD10, PAX-2, and Ksp-cadherin. ResultsCRCC could be associated with lower back pain or hematuria, and renal oncocytoma generally did not have clinical symptoms. Ultrasonography and CT examination were not specific for the differentiation between the two diseases. The expression rates of CK7, CD10, PAX-2, and Ksp-cadherin in CRCC were 66% (21/32), 22% (7/32), 23% (3/13) and 93% (14/15), respectively. In patients with oncocytoma, 7% (1/15) were positive for CK7, 7% (1/15) were positive for CD10, 86% (13/15) were positive for PAX-2, and 31% (4/13) were positive for Ksp-cadherin. Pearson chi-square analysis was performed with a significant P value set at <0.05. The results of CK7(-)CD10(-)PAX-2(+) and CK7(-)CD10(-)Ksp-cadherin(-) immunohistochemistry were integrated, which also showed the differences. ConclusionThe combination of CK7(-)CD10(-)PAX-2(+) and CK7(-)CD10(-)Ksp-cadherin(-) immunohistochemistry may be useful for differentiating between CRCC and oncocytoma. Combined with imaging examination, it can further improve the differential diagnosis of the two diseases.
With the rapid advancement of artificial intelligence (AI), its application in the rehabilitation of patients undergoing hip and knee arthroplasty has been increasingly emphasized. AI has the potential to enhance the precision and individualization of rehabilitation training, improve patient adherence, and optimize overall outcomes. This review summarizes the current progress of AI in postoperative rehabilitation following hip and knee arthroplasty, focusing on its roles in rehabilitation assessment, intelligent training, and remote rehabilitation. Furthermore, the advantages of AI in improving efficiency, accuracy, and patient engagement are highlighted, while existing challenges, including insufficient clinical evidence, high technological costs, and ethical concerns, are critically discussed. Finally, potential future directions, such as the integration of AI with virtual reality and wearable devices, are proposed. This review aims to provide valuable insights for clinical practice and future research in the rehabilitation of hip and knee arthroplasty.
Objective To systematically search for evidence related to the prevention and management of kinesiophobia in patients undergoing total knee arthroplasty at home and abroad, evaluate and integrate the evidence, and to provide reference for clinical nursing practice. Methods Domestic and international evidence-based resource databases, including UpToDate, BMJ (British Medical Journal) Best Practice, National Institute for Health and Clinical Excellence guidelines network, JBI (Joanna Briggs Institute) evidence-based healthcare center database, Cochrane Library, Registered Nurses’ Association of Ontario website, China guidelines network, Web of Science, PubMed, SinoMed, China National Knowledge Infrastructure, and Wanfang were searched. Evidence related to the prevention and management of kinesiophobia after total knee arthroplasty was collected, and the search period was until June 30, 2023. The evidence extraction and integration were conducted on the literature that meets the requirements. Results A total of 10 papers were ultimately included, including 1 guideline, 1 expert consensus, 2 systematic evaluations, 4 randomized controlled studies, and 2 cohort studies. A total of 17 pieces of evidence were extracted from 5 aspects, including risk assessment, health education, intraoperative pain management, rehabilitation exercise, and patient participation. Conclusion The prevention and management of kinesiphobia after total knee arthroplasty include evidence from multiple aspects, which can provide evidence-based basis for orthopedic and rehabilitation medical staff to develop intervention plans for kinesiphobia and promote rapid recovery of patients with total knee arthroplasty.
Objective To investigate the effectiveness of tibial transverse transport (TTT) in treating Wagner grade 3-4 type 2 diabetic foot ulcers and analyze dynamic changes in immunoglobulin levels. Methods The clinical data of 68 patients with Wagner grade 3-4 type 2 diabetic foot ulcers treated with TTT between May 2022 and September 2023 was retrospectively analyzed. The cohort included 49 males and 19 females, aged 44-91 years (mean, 67.3 years), with 40 Wagner grade 3 and 28 grade 4 ulcers. The duration of type 2 diabetes ranged from 5 to 23 years, with an average of 10 years. The number of wound healing cases, healing time, amputation cases, death cases, and complications were observed and recorded. Serum samples were collected at 6 key time points [1 day before TTT and 3 days, 7 days (the first day of upward transverse transfer), 14 days (the first day of downward transverse transfer), 21 days (the first day after the end of transfer), 36 days (the first day after the removal of the transfer device)], and the serum immunoglobulin levels were detected by flow cytometry including immunoglobulin G (IgG), IgA, IgM, IgE, complement C3 (C3), C4, immunoglobulin light chain κ (KAP), immunoglobulin light chain λ (LAM). Results All the 68 patients were followed up 6 months. Postoperative pin tract infection occurred in 3 cases and incision infection in 2 cases. Amputation occurred in 5 patients (7.4%) at 59-103 days after operation, and 8 patients (11.8%) died at 49-77 days after operation; the wounds of the remaining 55 patients (80.9%) healed in 48-135 days, with an average of 80 days. There was no recurrence of ulcer, peri-osteotomy fracture, or local skin necrosis during follow-up. The serum immunoglobulin levels of 55 patients with wound healing showed that the levels of IgG and IgM decreased significantly on the 3rd and 7th day after operation compared with those before operation (P<0.05), and gradually returned to the levels before operation after 14 days, and reached the peak on the 36th day. IgA levels continued to decrease with time, and there were significant differences at all time points when compared with those before operation (P<0.05). The level of IgE significantly decreased at 21 days after operation compared with that before operation (P<0.05), while it was higher at other time points than that before operation, but the difference was not significant (P>0.05). The level of C3 showed a clear treatment-related increase, which was significantly higher on the 7th, 14th, and 21st days after operation than that before operation (P<0.05), and the peak appeared on the 14th day. The change trend of C4 level was basically synchronous with that of C3, but the amplitude was smaller, and the difference was significant at 7 and 14 days after operation compared with that before operation (P<0.05). There was no significant difference in KAP/LAM between different time points before and after operation (P>0.05). Conclusion TTT can accelerate wound healing, effectively treat diabetic foot ulcer, and reduce amputation rate, and has definite effectiveness. The potential mechanisms of TTT in the treatment of diabetic foot ulcers include the dynamic regulation of IgG, IgA, IgM, and IgE levels to balance the process of inflammation and repair, and the periodic increase of C3 and C4 levels may promote tissue cleaning, angiogenesis, and anti-infection defense.