简介：Graves眼病是Graves病的常见并发症,其病因主要包括先天禀赋不足、情志损伤、饮食劳倦、环境因素等,对病机的认识总属本虚标实。在治疗方面,中医辨证论治的观点主要包括活动期与非活动期分期辨治、早中后三期分期辨治、抓主症顾兼症等,针灸治疗主要包括针药结合、整体辨证综合取穴等。中医药对Graves眼病的研究仍有待进一步发展。

简介：Chronicheartfailureisincreasinglyprevalentworldwideandisassociatedwithsignificantmorbidityandmortality.TheCochranereviewdemonstratedthatcardiacrehabilitation(CR)resultedinimprovementsinQOLandareductioninlong-termmortality.Chronickidneydisease(CKD)isanotherworldwidepublichealthproblem.ThisreviewfocusesontheimportanceandefficacyofrehabilitationforCKDpatientsasanewtargetofCR.PatientswithCKDonhemodialysis(HD)haveahighmortalityrate,withcardiovasculardiseases,suchaschronicheartfailure.Anewsystematicreviewandmeta-analysisofrandomizedcontrolledtrialsreportedthatexercise-basedrenalrehabilitationimprovedaerobiccapacity,muscularfunctioning,cardiovascularfunction,walkingcapacity,andQOLinCKDpatientswithHD.Moreover,exercisetrainingmayhaverenalprotectiveeffects,notonlyinsomeanimalmodelsofpre-HDCKD,butalsoinpre-HDCKDpatients.Exercisetherapycouldbeaneffectiveclinicalstrategyinimprovingrenalfunction,loweringtheneedforrenalreplacementtherapy,suchasHD,andreducingrenaltransplantriskinpre-HDCKDpatients.ThisledtheMinistryofHealth,LaborandWelfareofJapantoextendrenalrehabilitationpartialcoveragetostage4pre-HDCKDpatientsforthefirsttimeintheworldin2016.

简介：Theinflammatoryprocessplaysacentralroleinthedevelopmentandprogressionofnumerouspathologicalsituations,suchasinflammatoryboweldisease(IBD),autoimmuneandneurodegenerativediseases,metabolicsyndrome,andcardiovasculardisorders.IBDsinvolveinflammationofthegastrointestinalareaandmainlycompriseCrohn’sdisease(CD)andulcerativecolitis(UC).Bothpathologicalsituationsusuallyinvolverecurringorbloodydiarrhea,pain,fatigueandweightloss.ThereisatpresentnopharmacologicalcureforCDorUC.However,surgerymaybecurativeforUCpatients.Theprescribedtreatmentaimstoamelioratethesymptomsandpreventand/ordelaynewpainfulepisodes.Flavonoidcompoundsarealargefamilyofhydroxylatedpolyphenolicmoleculesabundantinplants,includingvegetablesandfruitswhicharethemajordietarysourcesofthesecompoundsforhumans,togetherwithwineandtea.Flavonoidsarebecomingverypopularbecausetheyhavemanyhealth-promotinganddisease-preventiveeffects.Mostinteresthasbeendirectedtowardstheantioxidantactivityofflavonoids,evidencingaremarkablefree-radicalscavengingcapacity.However,accumulatingevidencesuggeststhatflavonoidshavemanyotherbiologicalproperties,includinganti-inflammatory,antiviral,anticancer,andneuroprotectiveactivitiesthroughdifferentmechanismsofaction.ThepresentreviewanalyzestheavailabledataaboutthedifferenttypesofflavonoidsandtheirpotentialeffectivenessasadjuvanttherapyofIBDs.

简介：ThisarticlereviewstheeffectivenessofintratympaniccorticosteroidsforvertigocontrolinM_eni_ere'sdiseaseat2-yearsfollow-upaccordingtotheguidelinesexpressedbytheAmericanAcademyofOtolaryngology-Head&NeckSurgery.DespitetheincreaseduseofintratympaniccorticosteroidsforvertigocontrolinM_eni_ere'sdiseasethereisdebateastotheireffectiveness,particularlycomparedtogentamicin.Evenso,afterjustasinglecourseofinjections,corticosteroidscanreliablyprovidecompletevertigocontrol(ClassA)at2-yearsinabout50%ofcasesasindicatedinarecentdouble-blindrandomizedcontrolledclinicaltrial(Pateletal.,2016).Buttheeffectivenessofintratympaniccorticosteroidstrulyincreaseswhentreatmentisprovided'as-needed',wherebycompletevertigocontrolisestablishedinupto91%ofcases.Onthebasisofavailableliterature,thereisgoodevidencetorecommendtheuseofintratympanicsteroidtreatmentforvertigocontrolinM_eni_ere'sdisease,butpatientsmustbemonitoredfornon-response.Therationalefortreatingpatientsas-neededandthepossiblereasonsforcorticosteroidnonresponsearediscussed.

简介：Cardiovasculardisease(CVD)anddepressionandanxietycontributesubstantiallytothecurrentdiseaseburdenworldwideaswellasinChina.BothdepressionandanxietyarehighlyprevalentamongpatientswithCVD.WesystematicallyreviewedtheliteraturetodisentangletheroleofdepressionandanxietydisordersintheonsetandprognosisofCVDwithanemphasisoncohortstudiesconductedintheChinesepopulation.Despitethelackoflarge-scaleprospectivestudiesinChina,theavailableevidenceimpliesthatbothdepressionandanxietyarecloselyassociatedwiththeonsetandprognosisofCVD,includingischemicheartdiseaseandstroke,inChineseadults.Putativebehavioralandbiologicalmechanismsareimplicatedinthelinkbetweendepression/anxietyandCVD.TimelyscreeninganddiagnosisfollowedbypropertreatmentshouldbeimplementedfordepressionandanxietyinboththegeneralpopulationandpatientswithCVD.CurrentstandardtreatmentssuchasselectiveserotoninreuptakeinhibitorsandpsychotherapiesarerecommendedforCVDpatientswithdepression,althoughtheirefficacyforreducingCVDmorbidityandmortalityremainsuncertain.Inconclusion,prospectivestudiesonthelinkbetweendepression/anxietyandtheonsetandprognosisofCVDareurgentlyneededintheChinesepopulation,andmoreeffortsarewarrantedtoexaminetheefficacyofdepressionandanxietytreatmentsforCVDpatients,particularlytheintegratedcaremodelofincludingpsychiatristsinamultidisciplinaryclinicalgroup.

简介：Background:Thehospitalizationburdenofcongenitalheartdisease(CHD)atthenationalorregionallevelinChinaremainsunknown.WeaimedtoevaluatetherecentpatientcharacteristicsandtemporaltrendsofhospitalizationsforCHDinBeijing.Methods:PatientshospitalizedforCHDinBeijingfrom2007to2011wereidentifiedfromtheHospitalDischargeInformationSystem.Patientcharacteristicswererecorded,andtrendsinhospitalizationrateswereanalyzedbyPoissonregressionafteradjustmentforageandsex.Results:Atotalof53,064patientswereadmittedforCHDinBeijingduringthestudyperiod,amongwhom50.5%werechildrenyoungerthan5years,30.0%wereadults,18.5%hadsevereCHD,86.9%werenonpermanentBeijingresidents,and81.3%wereadmittedtocardiac-specifictertiaryhospitals.Thehospitalizationrateincreasedfrom10.2per100,000populationin2007to12.4per100,000populationin2011,representingasignificantincreaseafteradjustmentforageandsex(P=0.009).However,thetrendsvariedindifferentgroups.Therateshalvedin2011forbothnonsevereCHDandsevereCHDcomparedwiththeratesin2010,whereasincreasingtrendswerenoticedinchildrenaged1–4yearsandadultsfornonsevereCHDacrossthestudyperiod.Conclusions:TheoverallrateofCHDhospitalizationhasbeenincreasinginBeijing,whereasnotallpatientgroupshavethesametrend.Thehospitalizationratedecreasedamonginfants,whiletheratefornonsevereCHDincreasedsignificantlyamongadults.Thesefindingswillbeofimportanceforfutureallocationofhealthresources.

简介：摘要目的研究Graves病应用碘131核素联合甲基泼尼松龙的临床效果。方法抽选符合相关纳入标准的86例Graves病患者为此次研究的观察对象，参照随机双盲法将其分为对照组（43例）与研究组（43例），对照组仅应用碘131核素治疗，研究组同时还配合甲基泼尼松龙口服治疗，治疗期间各组还依据病情需要给予甲巯咪唑片及比索洛尔片对症处理，在完成为期6周的治疗后，以治愈率、治愈所需时间、甲巯咪唑片与比索洛尔片使用剂量以及复发情况等为标准来评析两组疗效。结果研究组的治愈率、复发率分别为83.7%、4.7%，相比于对照组的79.1%、9.3%均无明显差异（P＞0.05）；研究组治愈病例的甲巯咪唑使用量与比索洛尔使用量相比于对照组均明显更少（P＜0.05），且FT3恢复正常时间相比于对照组显著更短（P＜0.05）。结论Graves病应用碘131核素联合甲基泼尼松龙治疗可获得较高的治愈率，并能缩短病程，减少甲巯咪唑片与比索洛尔片的使用剂量，具有较高的临床推广价值。

简介：摘要目的观察不同初始剂量甲巯咪唑治疗Graves病的临床效果，研究治疗Graves病最合适的甲巯咪唑初始剂量。方法选取我院2015年1月-2016年6月收治的70例Graves病患者为研究对象，分为治疗方式不同的两组，常规剂量组患者服用甲巯咪唑10mg/次，3次/d，低剂量组患者服用甲巯咪唑15mg/次/d，治疗后比较两组患者的临床疗效。结果经过治疗后小剂量组治疗总有效率为94.29%，常规组治疗总有效率为88.57%，两组比较差异不明显，p＞0.05认为差异不具有统计学意义。小剂量组患者并发症总发生率为17.14%，常规组患者并发症总发生率为28.57%，小剂量组并发症发生率明显低于对照组，两组比较差异明显，p＜0.05认为差异具有统计学意义。结论对于Graves病的治疗，应用小剂量甲巯咪唑能够有效的降低TSH水平，对疾病治疗疗效显著，具有安全性高的优点，值得在临床上推广应用。

简介：摘要目的评价TPOAb检测对I131治疗Graves甲亢病的临床价值。方法2014年2月～2016年7月，医院核医学科收治Graves病患者94例，采用I131治疗。结果6个月后，患者FT3、FT4、TPOAb、峡部厚度低于治疗前，TPOAb低于治疗前，差异有统计学意义（P＜0.05）。TPOAb与峡部厚度治疗前与6个月变化幅度存在相关性（P＜0.05）。症状完全控制者治疗前、治疗后TPOAb水平低于未获得控制者，控制者治疗后TPOAb水平低于治疗前，差异有统计学意义（P＜0.05）。结论TPOAb水平可作为I131治疗Graves甲亢病的疗效预测指标。

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简介：IL-33/ST2轴在几织物特定的自体免疫的疾病的致病被含有。腹的疾病(CD)是主要基因因素(HLA-DQ2/DQ8)和为危险性的etiologic(饮食的面筋)在被知道的唯一的自体免疫的疾病。我们测量了浆液层次和IL-33和它的受体的坚定的肠的织物表示在病人与的可溶的ST2与疾病活动调查他们的协会的CD。没有CD，IL-33和sST2的浆液和织物层次与在控制病人的那些相比在有CD的病人是显著地更高的。我们证明显著地从大麦和小麦麦胶蛋白质提取的有毒的肽从腹的病人在有教养的外部血mononuclear房间刺激IL-33和ST2的生产，强烈含有在CD的致病的IL-33/ST2轴。在织物和浆液的IL-33和它的受体ST2的高水平反映一个活跃煽动性的状态并且可以为疾病活动代表潜在的biomarker。IL-33/ST2版本，行动的模式，和规定的更好的理解将是关键的开发治疗学指向IL-33/ST2小径到对待CD。

简介：DearEditor,Vogt-Koyanagi-Harada(VKH)diseaseisacell-mediatedautoimmunesyndromedirectedagainstmelanocytes.Itisconsideredamultisystemdisordercharacterizedbygranulomatouspanuveitisoftenassociatedwithneurologicandcutaneousmanifestations.Thechoroidisthemainsiteof

简介：传染疾病爆发在过去多次发生了并且是更可能的以后发生。在这份报纸，分配并且安排的问题限制了多重、相同或非相同，当有几时，在平行采用的资源感染了区域，被考虑。一个启发式的算法，基于Shihs(1974)(2010)和Pappis和Rachaniotis算法，作为答案方法论被建议。在特定的疾病爆发的上下文实现建议方法论的一个数字例子，也就是流行性感冒，被介绍。建议方法论能具有到那些起草的意外事故计划和保健政策议程的重要价值。

简介：摘要目的对甲巯咪唑与丙硫氧嘧啶治疗Graves甲状腺机能亢进症（甲亢）的临床疗效进行比较，为临床上合理的选择用药提供依据。方法将我院2014年1月-2016年3月收治的128例Graves甲亢患者按照随机数字表法分为A组和B组，每组64例，分别采用甲巯咪唑、丙硫氧嘧啶进行治疗。3个月后，检测两组治疗前后游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）、促甲状腺素（TSH）、甲状腺过氧化物酶抗体（TPOAb）以及促甲状腺素受体抗体（TRAb）的水平。结果与治疗前比较，治疗后两组的FT3、FT4、TSH、TPOAb以及TRAb的水平均显著降低，差异有统计学意义（P<0.05）；与B组比较，A组FT4以及FT3水平明显升高，差异有统计学意义（P<0.05）；两组TPOAb以及TRAb水平之间比较，差异无统计学意义（P>0.05）。结论甲巯咪唑治疗Graves甲亢较丙硫氧嘧啶的临床疗效更加显著，值得进行广泛的临床应用。

简介：摘要目的观察左旋甲状腺素与甲巯咪唑联合治疗Graves病的疗效及预后。方法选取本院2014年1月至2015年1月收治的Graves病患者60例，随机分为对照组及观察组，各30例。患者均给予甲巯咪唑，观察组在此基础上加用左旋甲状腺素。观察两组临床疗效及复发情况。结果观察组治疗总有效率为90%，高于对照组的63.33%，差异有统计学意义（P＜0.05）；观察组复发率为16.67%，低于对照组的40%，差异有统计学意义（P＜0.05）；观察组甲状腺体积小于对照组，差异有统计学意义（P＜0.05）。结论对Graves病患者给予左旋甲状腺素联合甲巯咪唑治疗，治疗有效率高，复发情况少，预后好。

简介：摘要目的分析比较不同初始剂量的甲巯咪唑治疗Graves病的疗效与安全性。方法从本院接收的Grzves病患者中随机的抽取60例参与研究，将60例患者按照给药剂量的不同分为常规剂量组和低剂量组，比较两组患者用药治疗后临床疗效以及不良反应发生率。结果经过一段时间治疗后两组患者的临床疗效相差无几，但是低剂量组患者的不良反应发生率明显低于常规组（10.00%36.67%），且差异明显（P<0.05）。结论低剂量与常规剂量不同的甲巯咪唑治疗Graves病疗效确切，但是低剂量的甲巯咪唑并发症较低，值得推荐。

简介：摘要目的观察131碘治疗Graves病（GD）后对甲状腺相关性眼病（TAO）的发生、发展及转归，分析影响转归的因素。方法收集了我院自2015年1月至2017年1月因GD于内分泌科住院行131碘治疗的患者356例，剔除资料不全者37例，纳入研究319例，于131碘治疗后3月和6月随访患者TAO的发生、发展及转归情况同时通过统计学的方法探讨TAO发生以及恶化的危险因素。结果1、同位素治疗后3月甲亢的治愈率为47.0％，6月的治愈率为74.9%；甲状腺功能减退的发生率分别为3.8％和9.1％；2、同位素之后后3月时伴与不伴TAO的患者眼病恶化和新发率差异无统计学意义（x2=0.511，p>0.05），单纯性突眼组与浸润性突眼组间患者的恶化率差异具有统计学意义（x2=7.336，p<0.05），其好转率差异亦有统计学意义（x2=3.89，p<0.05）；3、同位素治疗后6月时伴与不伴TAO的患者眼病恶化和新发率差异无统计学意义（x2=0.232，p>0.05），单纯性突眼组与浸润性突眼组间患者的恶化率差异有统计学意义（x2=17.687，p<0.05），其好转率差异亦有统计学意义（x2=9.297，p<0.05）。4、对131碘治疗后新发或恶化的TAO患者进行危险因素的Logistic回归分析显示，治疗前吸烟、TSH的大幅度变异、浸润性突眼的严重程度、高滴度的TR-Ab，是131碘治疗后引起或加重TAO的危险因素。结论1、131碘治疗前伴TAO的患者，治疗后眼病大部分好转，部分恶化；不伴TAO的患者可新发TAO；2、131碘治疗不加重或增加Graves病患者眼病的发生、发展；3、131碘治疗前吸烟、严重的浸润性突眼患者、高滴度的TR-Ab水平以及碘疗前后TSH变异幅度大的患者同位素治疗后其TAO的结局较差。

简介：BackgroundChronickidneydisease(CKD)patientsareathighriskofatherosclerosis.Structuralandelasticchangesofcarotidarterywallreflecttherangeanddegreeofatherosclerosisinperipheralarteries,whichcanbeacquiredbyultrasoundradiofrequency-datatechniqueautomaticallyandprecisely.MethodsAtotalof66CKDpatientswithnegativeresultsonroutinecarotidarteryultrasoundexaminationwereenrolled,and30healthyphysicalexamineeswereselectedascontrols.Patientsweredividedinto3groupsaccordingtoCKDstage:stage1-2,stage3-4andstage5.Clinicalcharacteristicsandthelaboratoryresultswereacquired.Intima-mediathickness(IMT)andcompliancecoefficient(CC)ofcommoncarotidarteryweremeasuredbyultrasoundradiofrequencydatatechnique(QIMTandQAS).PredictorsofIMTandCCwereanalyzedrespectively.ResultsAmongthe66patients,15wereonstage1-2,15onstage3-4and36onstage5accordingtoeGFR.ThecommoncarotidarteryIMT(CCIMT)ofalltheCKDgroupsexceptpatientsonstage1-2wassignificantlyincreasedwhencomparedwithcontrols.TheCCofcarotidarterysignificantlywasdecreasedineveryCKDgroupcomparedwithcontrols.AgeandCKDstageweresignificantpredictorsofCCIMTandCCinCKDpatients(P<0.05).AgingandadvancedCKDstagewereassociatedwithincreasedCCIMT(OR=4.855and4.969)anddecreasedCC(OR=32.178and14.068).ConclusionsRadiofrequency-datatechniquecandetectthesmallchangesofstructureandelasticityofcarotidarterywallinCKDpatients.CKDpatientshaveincreasedIMTanddecreasedelasticityofcarotidarterycomparedwithhealthysubjects.AgingandadvancedCKDstageareassociatedwithincreasedCCIMTanddecreasedCC.

简介：Alzheimer’sdisease(AD)isthemostcommontypeofdementiainelderlypopulation.WithagrowingagingpopulationnotonlyintheUnitedStatesbutalsointheworldwide,ADconstitutesanemergentpublichealthproblem.Overdecades,theprevailinghypothesiswasthatneurodegenerationmightresultfromoneortwoofthespecificlesions