简介：AbstractChronic pruritus is a very common clinical symptom that seriously affects people’s quality of life. Pruritus is associated not only with skin diseases but also with a variety of systemic diseases. It brings great challenges to clinical management. To standardize the management of chronic pruritus, experts of the Allergic Disease Committee of Chinese Dermatologist Association discussed many times and finally formed this guideline to provide reference and guidance for the clinical work of dermatologists and other physicians at all levels.

简介：取耳穴肺、风溪、神门、皮质下、肾上腺和大肠，以耳针配合常规方法治疗皮肤瘙痒症患者25例，以常规方法治疗25例为对照。结果两组疗效差别有统计意义，前者好于后者。

简介：Introduction,Chronicpericarditisisinflammationthatbeginsgradually,islonglastingandresultsinfluidaccumulationinthepericardialspaceorthickeningofthepericardium.Therearetwomaintypesofchronicpericarditisa)chroniceffusivepericarditis,fluidslowlyaccumulatesinthepericardialspacebetweenthetwolayersofthepericardium.

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简介：ObjectiveThisreviewaimedtosystematicallysummarizeandcriticallyevaluatetheclinicalevidencefororagainsttheeffectivenessofacupunctureasasymptomatictherapyforuremicpruritus(UP)inend-stagerenaldisease(ESRD)patients.Materialsandmethod:Wesearched16electronicdatabasesfromtheirinceptionstoNovember2009.Allprospectiveclinicalstudiesofneedleacupunctureforuremicpruritusinhemodialysispatientswithend-stagerenaldiseasewereincludedregardlessoftheirdesign.RiskofbiasoftheincludedstudieswereassessedusingtheCochranecriteria.ResultsOf464initiallylocatedarticles,458studieswereexcluded.Threerandomizedcontrolledtrials(RCTs),onenon-randomizedcontrolledtrial(CCT)andtwouncontrolledobservationalstudieswereincluded.InthreeRCTs,acupuncturewascomparedtosham-acupuncture(n=1),oralantihistamineplustopicalointment(n=1)andoralcalcitriol(n=1).InoneCCT,electroacupuncture(EA)wascomparedtosuperficialelectricalstimulation.Intwoobservationalstudies,EA(n=1)ormanualacupuncture(n=1)wereemployed.Fourof6includedstudiesmentionedmildornooccurrenceofadverseevents.Allofincludedtrialsreportedbeneficialeffectsofacupuncture.However,mostofthestudiesshowedhighriskofbias,whichleavetheirreportsunconvincing.ConclusionThecurrentevidenceisinsufficienttoshowthatacupunctureisaneffectivetreatmentforuremicpruritusinpatientswithend-stagerenaldiseaseduetosuboptimalqualityandlackofmethodologicalrigorofincludedstudies.Futuretrialsshouldovercomethelimitationsofthecurrentlyavailableevidence.

简介：AbstractChronic wounds have always been a tough fight in clinical practice, which can not only make patients suffer from pain physically and mentally but also impose a heavy burden on the society. More than one factor is relevant to each step of the development of chronic wounds. Along with the in-depth research, we have realized that figuring out the pathophysiological mechanism of chronic wounds is the foundation of treatment, while wound infection is the key point concerned. The cause of infection should be identified and prevented promptly once diagnosed. This paper mainly describes the mechanism, diagnosis and therapeutic strategies of chronic wound infection, and will put an emphasis on the principle of debridement.

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简介：Chronicdiseaseshavebecomeafocalpointofpublichealthworldwidewithestimatesoftrillionsofdollarsinannualhealthcarecostandcausingmorethan36milliondeathsayear.Lifestylefactorssuchasphysicalinactivityareheavilycorrelatedwiththedevelopmentofmanychronicdiseases.Newstrategiesforprimaryandsecondarydiseasepreventionaredesperatelyneededtoaidinbluntingthenegativeeconomicandsocialimpactofthesediseases.Physicalactivity(PA)andexercisearenowconsideredprincipalinterventionsforuseinprimaryandsecondarypreventionofchronicdiseases.Currently,moreemphasisinprimarypreventionofdiseaseisnecessarytoreducediseaseriskinyouthandadults;howeverwithchronicdiseaseprevalencesohigh,similaremphasisisalsonecessaryforsecondarypreventioninthosechildrenandadultsalreadyinflictedwithchronicdiseases.Conditionssuchascardiovasculardisease,type2diabetes,obesity,andcanceraredrasticallyimprovedwhenPAandexercisearepartofamedicalmanagementplan.Inaddition,thenationalPAguidelinesinconjunctionwithPApromotiontoolslikeExerciseisMedicine?areneededtopromoteincreasedPAandexerciselevelsworldwide.

简介：Coronaryarterychronictotalocclusion(CTO)isdefinedasanoccludedcoronaryarterysegmentwithoutanterogradeflowforatleastthreemonths.Itcanbeclassifiedasa“true”or“functional”CTObasedonflowcharacteristics.In“true”CTO,thereisnoanterogradeflow.In“functional”CTO,thereisminimalanterogradeflowthroughtheoccludedsegmentofthecoronaryartery.CTOisacommonfindingduringcoronaryangiographyanditsprevalencemayvarydependingonthereportedliterature.Amongpatientswithoutpreviouscoronaryarterybypassgrafting(CABG),CTOisfoundinabout20–30%ofthepatients.CTOmaydevelopinsidiouslyoveraperiodoftimeandinvolveacomplexinterplaybetweenintracellularandextracellularfactors,smoothmuscleandfoamcells,calcification,andneovascularization.ThereisagrowingbodyofevidencetosupportthatCTOrevascularizationmayimproveclinicaloutcomewhencomparedtomedicalmanagement.BoththeEuropeanandAmericancardiovascularsocietiessupportCTOrevascularizationwithaclass2arecommendation(levelofevidenceB).Historically,duetolowproceduralsuccessrate,apparentinefficientresourceutilization,potentialincreaseincomplicationratesanduncertainclinicalbenefits,onlyabout10–20%ofpatientswithCTOaretreatedwithpercutaneouscoronaryintervention(PCI).RecentadvancesusingnovelandinnovativetechniqueswithdedicatedequipmenthavesignificantlyimprovedtheproceduralsuccessrateforCTOPCItoabout90%inthehandsofexperiencedoperators.WithincreasinginterestinCTOPCIcoupledwithincreasededucationaleffort,CTOPCIlikelywillbecomemoreaccessibletopatientsinneedofCTOrevascularization.OngoingadvancementininnovativetechniquesandequipmentwillcontinuetoimproveproceduralsuccessratesandreduceproceduralcomplicationrateforCTOPCI.Furthermore,thereareanumberofprospectiveclinicaltrialsonthehorizonwhichshouldhelpdefinetheclinicalbenefitsandlimitationsofCTOPCIinthenear

简介：objectivesTodemonstratethephenomenaandexplorethecausesofanemiainpatientswithchronicheartfailure(CHF).MethodsToobservethephenomenaofanemiainpatientswithCHF,atotalof276patientswithCHFwereincludedinthisretrospectivestudy.Theclinicalcharacteristicsofthepatientsare;meanage69.2±11.0years;male151,female125;NYHAⅢandⅣ115(41.7%).Results①Amongthe276patientswithCHF,81(29.4%)hadanemia(Meanhemoglobulinconcentration101.5±13.0g/L).②PatientswithAnemiaweremorelikelytobefemaleandtohavegreaterNYHA(ⅢorⅣ)(P<0.05),higherserumcreatinine,aswellaslowerserumalbuminandlow-densitylipoproteinlevels(P<0.01).③AweaknegativecorrelationwasalsonotedbetweenthelevelofNYHAandhemoglobulin.④Therewasnosignificantdifferenceinage,theprimarycardiacetiologyoftheCHF,thehistoryofdiabetes,leftventricularenddiastolicdiameter,andleftventricularejectionfractionbetweenCHFpatientwithandwithoutanemia.ConclusionsTheprevalenceofanemiaishighamongpatientswithCHF.TheanemiapatientswithCHFtendtobefemale,havegreatercardiacandrenalfunctionalimpairment,butwithlowerserumalbuminandLDLthatsuggestssomedegreeofmalnutrition.

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简介：AbstractChronic hepatitis B virus (HBV) infection remains a global health burden. Timely and effective antiviral therapy is beneficial for patients with HBV infection. With existing antiviral drugs, including nucleos(t)ide analogs and interferon-alfa, patients can achieve viral suppression with improved prognosis. However, the rate of hepatitis B surface antigen loss is low. To achieve a functional cure and even complete cure in chronic hepatitis B patients, new antivirals need to be developed. In this review, we summarized the advantages and disadvantages of existing antiviral drugs and focused on new antivirals including direct-acting antiviral drugs and immunotherapeutic approaches.

简介：AbstractOver the last 20 years, it has become possible to use a precision medicine approach to the management of chronic obstructive pulmonary disease (COPD). Clinical and physiological features as well as a blood biomarker can be used to target treatments to patients most likely to benefit and avoid treatment in patients less likely to benefit. Future advances in a precision medicine approach to COPD will depend on more precise characterization of individual patients, possibly using quantitative imaging, new physiological techniques, novel biomarkers and genetic profiling. Precision medicine has led to significant improvements in the management of COPD and clinicians should use all available information to optimize the treatment of individual patients.

简介：AbstractChronic obstructive pulmonary disease (COPD) is a common, preventable, and treatable disease. The incidence of COPD is growing annually in China, and it is a significant and growing public health burden. Multivariate analysis showed that COPD was one of the independent risk factors for the occurrence of pulmonary embolism (PE), and the incidence of PE was significantly higher in COPD patients than in normal subjects. However, PE is often overlooked in patients with acute exacerbation of COPD (AECOPD) because there are many similarities in clinical symptoms between PE and AECOPD, which are difficult to distinguish, resulting in the failure of timely treatment and poor prognosis. Therefore, it is of great significance to understand the clinical manifestations, diagnosis, and treatment of COPD combined with PE for making a more accurate diagnosis, providing timely and effective treatment, and improving the prognosis of such patients.

简介：Chronicsubduralhematoma(CSDH)representsoneofthemostfrequenttypesofintracranialhemorrhage.ManagementofthepatientswithCSDHhasbeenevolvedthroughavastvarietyofmethodsandtechniques.Althoughthereisgeneralagreementthatsurgicaltherapyisusuallythepreferredtreatment,therearefewotherneurosurgicalconditionsthatsparksuchstrongdiscussionsanddifferencesofopinionconcerningtheoptimalsurgicaltechnique.1,2Inthispaper,wereviewadvancesinsurgicaltreatmentofCSDH.

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简介：AbstractThere is considerable epidemiological evidence indicating that air pollution has adverse effects on human health and is closely related to respiratory diseases, including chronic obstructive pulmonary disease (COPD). These effects, which can be divided into short- and long-term effects, can manifest as an exacerbation of existing symptoms, impaired lung function, and increased hospitalization and mortality rates. Long-term exposure to air with a high concentration of pollutants may also increase the incidence of COPD. The combined effects of different pollutants may become more complex in the future; hence, there is a need for more intensive research on specific at-risk populations, and formulating corresponding protective strategies is crucial. We aimed to review the epidemiological evidence on the effect of air pollution on COPD, the possible pathophysiological mechanisms underlying this effect, as well as protective measures against the effects of air pollutants in patients with COPD.

简介：Migraine,amoderatetoseverechronicheadacheoccurringononeorbothsides,isacommondiseaseaffectsyoungpeople.Althoughhearinglossinsubjectswithmigraineisnotrare,thecorrelationofmigrainewithhearinglossisnotclear.Inthisstudy,weexaminedhearinglossinyoungmigrainesubjectstodetermineifmigrainemaybeafactorincausingcochleardysfunction.Sevencollegestudentswithmigraineandthreeagematchedsubjectswithouthistoryofmigrainewereassessedusingextendedhighfrequencyaudiometryanddistortionproductotoacousticemissions(DPOAEs).Therewasnosignificantdifferenceinregularaudiomeirythresholdbetweenthemigrainegroupandthecontrolgroup.However,highfrequencyaudiometry(9-16kHz)showedthresholdsat25dBnHLorhigherinsixoutoftwentyearsinthemigrainegroup.TheamplitudeofDPOAEswerereducedformorethan10dBinthemigrainegroupincomparisonwiththecontrolgroup.ThesedatasuggestthatmigrainemayaffectcochleardysfunctionevidencedbythereducedamplitudeofDPOAEandhighfrequencypure-toneaudiometry.

简介：Chronicpancreatitisisanongoingdiseasecharacterizedbypersistentinflammationofpancreatictissues.Withdiseaseprogression,patientswithchronicpancreatitismaydeveloptroublesomecomplicationsinadditiontoexocrineandendocrinepancreaticfunctionalloss.Amongthem,apseudoaneurysm,mainlyinducedbydigestiveenzymeerosionofvesselsinproximitytothepancreas,isarareandlife-threateningcomplicationifbleedingofthepseudoaneurysmoccurs.Atpresent,noprospectiverandomizedtrialshaveinvestigatedthetherapeuticstrategyforthisrarebutcriticalsituation.Theroleofarterialembolization,thetimingofsurgicalinterventionandevensurgicalproceduresarestillcontroversial.Inthisreview,wesuggestthatdynamicabdominalcomputedtomographyandangiographyshouldbeperformedfirsttolocalizethebleedersandtoevaluatetheassociatedcomplicationssuchaspseudocystformation,followedbyarterialembolizationtostopthebleedingandtoachieveearlystabilizationofthepatient’scondition.Withadvancesandimprovementsinendoscopicdevicesandtechniques,therapeuticendoscopyforpancreaticpseudocystsistechnicallyfeasible,safeandeffective.Surgicalinterventionisrecommendedforableedingpseudoaneurysminpatientswithchronicpancreatitiswhoareinanunstablecondition,forthoseinwhomarterialembolizationofthebleedingpseudoaneurysmfails,andwhenendoscopicmanagementofthepseudocystisunsuccessful.Ifableedingpseudoaneurysmislocatedoverthetailofthepancreas,resectionisapreferentialprocedure,whereasifthelesionissituatedovertheheadorbodyofthepancreas,relativelyconservativesurgicalproceduresarerecommended.