简介：Inthepresentpaper,theauthorputsforwardsixkeypointsforacupuncturetreatmentofdiseases,namely,①carefulexamination,②definitediagnosis,③preciseandappropriateidentificationofsyndromes,④accuratelocationoftheacupoint,⑤flexibleapplicationofneedlingmanipulations,and⑥“Deqi”.Thefirstthreeaspactsarethefoundation,accuratelocationandflexibleneedlingmanipulationsarealsotheprerequisiteforeffectivetreatmentofdiseases.Inaddition,soundtheoreticalbasicknowledgeofbothtraditionalChinesemedicine(TOM)andmodemmedicine,andflexiblyapplyingsuitableneedlingmaneuvers,stimulatingquantityanddurationofneedleretaininginaccordancewiththeconcretestateofdiseaseandthepatient'sconditionsarealsoveryimportantinclinicalpracticeofacupuncture.

简介：LedbyfourgenerationsofleadershipfromlateProf.JIANGSichang(academician,ChineseAcademyofEngineering),Prof.YANGWeiyan(HonoraryPresident,DivisionofOtolaryngologyHeadandNeckSurgery,ChineseMedicalAssociation),Prof.HANDongyi(PresidentElected,DivisionofOtolaryngologyHeadandNeckSurgery,ChineseMedicalAssociation)tonowProf.YANGShiming(President,DivisionofOtolaryngologists,

简介：AbstractMandibular condylar fractures are among the most common facial fractures and some of the most difficult to manage. Opinions about the management of mandibular condylar fractures differ among surgeons. With the implementation of new technology, an increased understanding of fracture management, and better functional and morphological outcomes reported in the literature, open reduction and internal fixation is becoming many surgeons’ preferred choice for the treatment of condylar fractures. Because surgical treatment of such fractures is complex, certain factors must be considered to achieve satisfactory outcomes. In this article, we summarise six key points in the management of mandibular condylar fractures: virtual evaluation of condylar fracture, a suitable surgical approach, good reduction, stable internal fixation, repair of the articular disc, and restoration of the mandibular arch width. We believe that these points will help to improve the prognosis of mandibular condyle fractures.

简介：AbstractObjective:To measure the prevalence of depression in patients with psoriasis and to evaluate the relationship between the severity of psoriasis and depression and its effect on patients’ quality of life.Methods:A total of 154 patients with a confirmed diagnosis of psoriasis were assessed to determine the severity of psoriasis based on the psoriasis area and severity index score, presence, and severity of depression using the patient health questionnaire 9, and quality of life using the dermatology life quality index 10. Pearson correlation coefficient was used to demonstrate the relationship between continuous variables with 95% confidence intervals (CIs); P < 0.00001 was taken to indicate statistical significance.Results:The severity of psoriasis was mild in 36.36% of patients, moderate in 25.97%, severe in 32.47%, and very severe in 5.20%. Of the 154 patients, 139 (90.3%) had depression; the severity of depression was mild in most affected patients (46.7%) and severe in 2.6% of patients. Psoriasis had a moderate effect on the quality of life in 37.01% of patients and a very large effect in 33.77% of patients. The severity of psoriasis was positively correlated with depression (Pearson correlation coefficient, r= 0.42, P < 0.00001, 95% CI: 0.28-0.54) and quality of life (r= 0.43, P < 0.00001, 95% CI: 0.29-0.55).Conclusion:Depression is a common comorbidity in patients with psoriasis. The severity of psoriasis is positively correlated with the severity of depression and is associated with poor quality of life.

简介：AbstractParotidectomy is the mainstay treatment for tumors of the parotid gland. In an effort to improve clinical outcomes, several modern surgical techniques and perioperative interventions have been evaluated and refined. This review discusses current and actively debated perioperative interventions aimed at improving patient safety and the quality of parotidectomy. Relevant high-impact literature pertaining to preoperative diagnostic modalities, intraoperative surgical techniques, and postoperative care will be described.

简介：Objective:tostudytheclinicalinfluenceoffemoralqualityoncementlesshipreplacementandtoevaluatecorticalindex(CI)forfemoralqualityinordertoguideprosthesischoiceandrehabilitation.Methods:forth-ninecasesofcementlesshipreplacementwerefollowedupforaverage3.5years,42ofwhonhadX-rayfilmsonpreoperationoroperationday.Results:Harrisscoresandpatients'satisfactionwerelowbutpainwassignificantandprolongedwhencorticalindiceswerelow.Conclusions:CIisareliablesemi-quantityparameterforclinicalevaluationoffemoralquality.Osteoporosispatientspredisposetothighpain.Lagforfull-weightloadingandavoidancefortorsionmotioncancontributetolesspainwhenCI≤2.2.

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简介：BACKGROUND:ResearchfocusedonthequalityoflifeofepilepticpatientsbeganonlyveryrecentlyinChina;inparticular,mostresearchhasfocusedonchildren,butlessonepilepticadults.OBJECTIVE:Tosurveyandanalyze11influentialfactorsforqualityoflifeinadultswithepilepsybyusingqualityoflifeepilepsy-31scale.DESIGN:Cross-sectionalstudy.SETTING:DepartmentofNeurology,FirstHospitalAffiliatedtoJinanUniversity;DepartmentofNeurology,FirstAffiliatedHospitalofWenzhouMedicalCollege.PARTICIPANTS:Atotalof107adultswithepilepsyforlongerthanoneyearwereselectedfromDepartmentofNeurology,FirstHospitalAffiliatedtoJinanUniversitybetweenMarch2004andDecember2006.TheincludedpatientsmettheClassificationandDiagnosticCriteriaofEpilepticAttackpublishedbyInternationalAnti-EpilepsyLeaguein1981,andtheyprovidedinformedconsent.METHODS:Generalstates,includingcourse,attackfrequency,marriagestatus,educationallevel,occupationaltypes,economicstatus,attacktypes,drugtypes,anddrugamount,wererecorded.ThereweresevenaspectsintheQualityofLifeEpilepsy-31scale,includingattackworry,lifesatisfaction,emotion,vigor/tiredness,druginfluence,cognitivefunction,andsocialfunction.Thescorespositivelycorrelatedwiththequalityoflife.Possibleinfluentialfactorsforqualityoflifewereanalyzedbyone-wayANOVAandmultivariateregressionanalysis.MAINOUTCOMEMEASURES:Course,attackfrequency,marriagestatus,educationallevel,occupationaltypes,economicstatus,attacktypes,drugtypes,drugamount,age,andsex.RESULTS:Atotalof107epilepticpatientswereincludedinthefinalanalysis.Influentialfactorsforqualityoflifeinepilepticadultsincludedattackfrequency,educationallevel,economicstatus,attacktypes,drugamount,age,andcourseofdisease(P<0.05).Amongthem,attackfrequencynegativelycorrelatedwithattackworry,lifesatisfaction,emotion,vigor/tiredness,cognitivefunc

简介：Objectives:Thisstudyexaminedthequalityoflife(QoL)oftheparentsandsiblingsofhearing-impairedchildrenwithcochlearimplants(CIs).Design:Thisisacross-sectional,questionnaire-basedstudy.Thequestionnaireconsistsofthreesub-domains-interaction,emotionalwell-beingandsupportforthehearing-impairedchildandtheoverallQoL-andtwoopen-endedquestionsforparticipantstoprovidecommentsandsuggestionstoenhancetheirfamily'sQoL.Atotalof63questionnairesweree-mailedormailedtofamilieswhomettheinclusioncriteria.Setting:ThestudywasconductedundertheCenterforRehabilitation&SpecialNeeds,FacultyofHealthSciences,UniversitiKebangsaanMalaysia,KualaLumpur.Participants:Atotalof79parentsand23siblingsfrom44familiesofchildrenwithCIparticipatedinthisstudy.Mainoutcomemeasures:Themeanscoreforeachofthesub-domainandtheoverallQoLforbothsubjectgroupswerecomputed.Theanswersfortheopen-endedquestionswerelistedandorganizedintothemes.Results:ThereweresignificantcorrelationsbetweentheoverallQoLscoreandeachofthetestdomainsfortheparents'group(p<0.01).Forthesiblings'group,onlytheinteractionandsupportdomainsweresignificant.Interactionwasthemainsub-domainaffectingtheparents'QoLbutforsiblings,thiscouldnotbedetermined.Atotalof60%ofthepooledcommentswereclassifiedas‘concerns’.Asforthesuggestions,38.7%requestedsomeformofsupport,mainlyfinancial(41.7%).Conclusions:FamilieswithhearingimpairedchildrenwithCIhavenumerousconcernsthatneedtobeaddressed,eventhough,onaverage,theyweresatisfiedwiththeiroverallQoL.

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简介：为了比较在在medication.METHODSA上有选择激光trabeculoplasty(SLT)和那些的病人之间的生活和治疗满足的质量，收到了SLT和用反绿内障药继续的一个控制组的143个绿内障病人上的未来的临床的试用被进行。眼泪分散时间(，但是)，标点角膜炎，对帮助的需要，人工的眼泪的使用和intraocular压力(IOP)的治疗满足调查在基线被测量，6并且12mo.RESULTSSLT能减少从1.56需要的药的吝啬的数字

简介：<正>1.IntroductionThegoalofthepresentstudywastodevelopnon-in-vasivetechniquesfortheassessmentofvoicedisordersandformonitoringtheeffectsofvoice.However,beforeacous-ticalgorithmscanbeusedinclinicalapplications,itisimportanttounderstandtherelationshipbetweenclinicalperceptionsofvoicequalityandtheacousticmeasuresob-

简介：胆囊疾病在发达国家是很普通的。复杂胆石疾病代表外科定期为被倡导的胆汁的混乱最经常。关于，胆囊炎代表普通腹的外科的干预；它能作为选任的干预或紧急情况外科被执行，在坏疽，穿孔，腹膜炎或败血的情况中。现在，laparoscopic途径被喜欢甚于开的剖腹术。全球性，众多的胆囊炎每天被执行；然而，小证据都不关于对跟随这些干预的生活(QOL)的surgical以后质量的评价存在。为了估计胆囊炎以后的QOL，事实上，高质量的照顾的文档服从于报导病人的结果满足的扩大讨论，和使用因为优秀改进被倡导几年了。然而，几乎没有很少研究，关于跟随胆囊炎的QOL结果出版；另外，许多当前的文学在以病人为中心的结果上缺乏系统的数据。然后，尽管几个工具被用来在胆囊炎以后测量QOL，困难留在选择有意义的参数以便获得可再现的数据反映手术后的QOL。这研究的目的是在QOL上为胆囊疾病考察外科的影响。这评论在QOL后面的胆囊炎上包括当前的文学的Medline搜索。大多数研究证明征兆的病人比收到选任的干预的病人从外科更获利。因此，在没有症状的外科，和病人少些获利或可以甚至在QOL有减小以前，在QOL的获得取决于一般条件。

简介：AbstractMucormycosis is a lethal human disease caused by fungi of the order Mucorales. Mucormycosis is caused by fungi mainly belonging to the genera Mucor, Rhizopus, and Lichtheimia, all of which belong to the order Mucorales. The number of individuals with mucormycosis-causing disorders has increased in recent years, hence, leading to the spread of mucormycosis. Throughout the coronavirus disease 2019 (COVID-19) pandemic, numerous cases of mucormycosis in COVID-19-infected patients have been reported worldwide, and the illness is now recognized as COVID-19-associated mucormycosis, with most of the cases being reported from India. Immunocompromised patients such as those with bone marrow sickness and uncontrolled diabetes are at a greater risk of developing mucormycosis. Genes, pathways, and other mechanisms have been studied in Mucorales, demonstrating a direct link between virulence and prospective therapeutic and diagnostic targets. This review discusses several proteins such as high-affinity iron permease (FTR1), calcineurin, spore coat protein (CotH), and ADP-ribosylation factors involved in the pathogenesis of mucormycosis that might prove to be viable target(s) for the development of novel diagnostic and therapeutic methods.

简介：AbstractBackground:The End Tuberculosis (TB) Strategy of the World Health Organization highlights the need for patient-centered care and social protection measures that alleviate the financial hardships faced by many TB patients. In China, TB treatments are paid for by earmarked government funds, social health insurance, medical assistance for the poor, and out-of-pocket payments from patients. As part of Phase III of the China-Gates TB project, this paper introduces multi-source financing of TB treatment in the three provinces of China and analyzes the challenges of moving towards universal coverage and its implications of multi-sectoral engagement for TB care.Main text:The new financing policies for TB treatment in the three provinces include increased reimbursement for TB outpatient care, linkage of TB treatment with local poverty alleviation programs, and use of local government funds to cover some costs to reduce out-of-pocket expenses. However, there are several challenges in reducing the financial burdens faced by TB patients. First, medical costs must be contained by reducing the profit-maximizing behaviors of hospitals. Second, treatment for TB and multi-drug resistant TB (MDR-TB) is only available at county hospitals and city or provincial hospitals, respectively, and these hospitals have low reimbursement rates and high co-payments. Third, many patients with TB and MDR-TB are at the edge of poverty, and therefore ineligible for medical assistance, which targets extremely poor individuals. In addition, the local governments of less developed provinces often face fiscal difficulties, making it challenging to use of local government funds to provide financial support for TB patients. We suggest that stakeholders at multiple sectors should engage in transparent and responsive communications, coordinate policy developments, and integrate resources to improve the integration of social protection schemes.Conclusions:The Chinese government is examining the establishment of multi-source financing for TB treatment by mobilization of funds from the government and social protection schemes. These efforts require strengthening the cooperation of multiple sectors and improving the accountability of different government agencies. All key stakeholders must take concrete actions in the near future to assure significant progress toward the goal of alleviating the financial burden faced by TB and MDR-TB patients.

简介：Historically,mastcellswereknownasakeycelltypeinvolvedintypeIhypersensitivity.Untillasttwodecades,thiscelltypewasrecognizedtobewidelyinvolvedinanumberofnon-allergicdiseasesincludinginflammatoryboweldisease(IBD).MarkedlyincreasednumbersofmastcellswereobservedinthemucosaoftheileumandcolonofpatientswithIBD,whichwasaccompaniedbygreatchangesofthecontentinmastcellssuchasdramaticallyincreasedexpressionofTNFα,IL-16andsubstanceP.TheevidenceofmastcelldegranulationwasfoundinthewallofintestinefrompatientswithIBDwithimmunohistochemistrytechnique.ThehighlyelevatedhistamineandtryptaselevelsweredetectedinmucosaofpatientswithIBD,stronglysuggestingthatmastcelldegranulationisinvolvedinthepathogenesisofIBD.However,littleisknownoftheactionsofhistamine,tryptase,chymaseandcarboxypeptidaseinIBD.Overthelastdecade,heparinhasbeenusedtotreatIBDinclinicalpractice.Thelowmolecularweightheparin(LMWH)waseffectiveasadjuvanttherapy,andthepatientsshowedgoodclinicalandlaboratoryresponsewithnoseriousadverseeffects.TherolesofPGD2,LTC4,PAFandmastcellcytokinesinIBDwerealsodiscussed.Recently,aseriesofexperimentswithdispersedcolonmastcellssuggestedthereshouldbeatleasttwopathwaysinmanformastcellstoamplifytheirownactivation-degranulationsignalsinanautocrineorparacrinemanner.Thehypothesisisthatmastcellsecretogoguesinducemastcelldegranulation,releasehistamine,thenstimulatetheadjacentmastcellsorpositivelyfeedbacktofurtherstimulateitshostmastcellsthroughH1receptor.Whereasreleasedtryptaseactssimilarlytohistamine,butactivatesmastcellsthroughitsreceptorPAR-2.Theconnectionsbetweencurrentanti-IBDtherapiesorpotentialtherapiesforIBDwithmastcellswerediscussed,implicatingfurtherthatmastcellisakeycelltypethatisinvolvedinthepathogenesisofIBD.Inconclusion,whilepathoge

简介：LongbeforethediscoveryofHelicobacterpylori,thereweremanyexcellentobservationalstudiesthatdocumenteddifferencesinthepatternsofgastroduodenaldisease.Itwasclearthatinthedevelopingworld,gastriculcerandgastriccancerweremorecommonthaninthedevelopedworldwhereduodenalulcerpredominated.Thiscorrelatedwiththedistributionofgastritisinduodenalulcerpatientswheretheinflammationwasantralpredominantwhileingastriculcerpatientsthegastritiswasmoreevenlydistributedthroughthestomach.Gastriculcersusuallyappearedinafairlyrestricteddistributioninthestomachneartheangulusandclosetothetransitionalzonebetweenantrumandbodymucosa.Asasocietydevelopedsothesepatternsofdiseasechanged.

简介：AbstractBackground:It is crucial to improve the quality of care provided to ICU patient, therefore a national survey of the medical quality of intensive care units (ICUs) was conducted to analyze adherence to quality metrics and outcomes among critically ill patients in China from 2015 to 2019.Methods:This was an ICU-level study based on a 15-indicator online survey conducted in China. Considering that ICU care quality may vary between secondary and tertiary hospitals, direct standardization was adopted to compare the rates of ICU quality indicators among provinces/regions. Multivariate analysis was performed to identify potential factors for in-hospital mortality and factors related to ventilator-associated pneumonia (VAP), catheter-related bloodstream infections (CRBSIs), and catheter-associated urinary tract infections (CAUTIs).Results:From the survey, the proportions of structural indicators were 1.83% for the number of ICU inpatients relative to the total number of inpatients, 1.44% for ICU bed occupancy relative to the total inpatient bed occupancy, and 51.08% for inpatients with Acute Physiology and Chronic Health Evaluation II scores ≥15. The proportions of procedural indicators were 74.37% and 76.60% for 3-hour and 6-hour surviving sepsis campaign bundle compliance, respectively, 62.93% for microbiology detection, 58.24% for deep vein thrombosis prophylaxis, 1.49% for unplanned endotracheal extubations, 1.99% for extubated inpatients reintubated within 48 hours, 6.38% for unplanned transfer to the ICU, and 1.20% for 48-hour ICU readmission. The proportions of outcome indicators were 1.28‰ for VAP, 3.06‰ for CRBSI, 3.65‰ for CAUTI, and 10.19% for in-hospital mortality. Although the indicators varied greatly across provinces and regions, the treatment level of ICUs in China has been stable and improved based on various quality control indicators in the past 5 years. The overall mortality rate has dropped from 10.19% to approximately 8%.Conclusions:The quality indicators of medical care in China’s ICUs are heterogeneous, which is reflected in geographic disparities and grades of hospitals. This study is of great significance for improving the homogeneity of ICUs in China.