简介:Inthepresentpaper,theauthorputsforwardsixkeypointsforacupuncturetreatmentofdiseases,namely,①carefulexamination,②definitediagnosis,③preciseandappropriateidentificationofsyndromes,④accuratelocationoftheacupoint,⑤flexibleapplicationofneedlingmanipulations,and⑥“Deqi”.Thefirstthreeaspactsarethefoundation,accuratelocationandflexibleneedlingmanipulationsarealsotheprerequisiteforeffectivetreatmentofdiseases.Inaddition,soundtheoreticalbasicknowledgeofbothtraditionalChinesemedicine(TOM)andmodemmedicine,andflexiblyapplyingsuitableneedlingmaneuvers,stimulatingquantityanddurationofneedleretaininginaccordancewiththeconcretestateofdiseaseandthepatient'sconditionsarealsoveryimportantinclinicalpracticeofacupuncture.
简介:慢性阻塞性肺病(COPD)是一种以气流受限为特征的疾病,通常呈进行性发展,不完全可逆.多与肺部对有害颗粒和气体的异常炎性反应相关,主要是吸烟.近年来国内外对COPD的研究及临床诊治日益重视.2004年美国胸科协会和欧洲呼吸协会,提出了COPD的治疗目标:防止病情进展,缓解症状,提高运动耐量,改善生活质量,防治合并症,防治急性发作以及降低病死率.主要的目标是提高COPD患者的生活质量,主要由两部分组成,一方面专业医师要不断提高COPD认识,了解COPD的病理、诊断、治疗和监控,宣传COPD是能治疗的疾病的观念.另一方面,为COPD患者提供所有的这一方面的信息,提倡健康的生活方式,大力倡导戒烟,避免职业和环境污染,除宣传教育外,诊治方面有以下进展[1].
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:目的探讨慢性阻塞性肺部疾病(COPD)患者家庭氧疗的应用状况及氧疗知识,提供合理的指导措施.方法采用自行设计的家庭氧疗应用状况及氧疗知识调查表对60例实施家庭氧疗的COPD患者进行调查,资料采用百分构成法进行分析.结果被调查者在氧疗过程中存在许多不合理之处,其中,无1例患者真正了解氧疗的目的,54例患者每日平均吸氧时间<15h,38例患者吸氧流量不正确,48例患者未采取合理的消毒措施,54例患者存在着安全隐患.结论指导COPD患者家庭氧疗不容忽视,护理人员在患者出院指导时,应加强家庭氧疗的指导;社区医疗科的护士可利用随访时间给予现场检查和指导,保证家庭氧疗的正确实施.
简介:无创通气是指不经人工气道(气管切开或气管内插管)进行的机械通气,患者通过鼻罩、口鼻面罩或头罩等与呼吸机相连进行辅助通气,与绕开上气道的气管插管、喉罩、气管切开等有创方式存在显著区别。与有创通气相比,无创通气具有以下优点:①无须建立人工气道,避免了相应的并发症,如咽喉部损伤、出血、水肿、皮下气肿等。②不破坏上气道的防御和保护机制,患者可以交谈、咳痰,呼吸机相关性肺炎的发生率大大下降。③上机、撤机操作容易,技术简单,患者容易接受。④费用较低,亦可于家庭中使用。自20世纪80年代中期以来,无创性通气因其上述特点越来越受到人们的重视,按类型又可分为以下三种:正压通气、负压通气及高频通气。其中无创正压通气(noninvasivepositivepressureventilation,NPPV)在COPD急性加重期(AECOPD)中最常用。相比常规治疗而言,多项RCT及荟萃分析均显示,NPPV可降低AECOPD的气管插管需求率(28%)、住院时间(4.57天)以及院内病死率(10%)。