ABSTRACT
[Objective] To introduce the experience of Professor ZHANG Biao in the treatment of infantile dyspepsia. [Methods] Through the long-term study with Professor ZHANG, large amounts of medical records are collected and generalized, so that the experiences concerning infantile dyspepsia are summarized, when and how to choose activation, tonification or digestion depends on excess and deficiency,and proven cases are presented. [Results] It is thought that infantile dyspepsia mostly belongs to excess syndrome, or excess syndrome combined with deficiency syndrome, so the treatment is heiping digestion, tonifying spleen and harmonizing stomach. Professor ZHANG thinks that the cause of children's dyspepsia is the weakness in spleen and stomach eventually. It is characterized by excess in syndromes and deficiency in root causes. Its clinical manifestations are concurrence of excess and deficiency. As for the treatment, there's no need to wait for the pathogenic qi to disappear. The basic principle of treatment is always to activate the spleen, regulate qi and help digestion. Professor ZHANG raises that syndromes with more deficicency than excess are treated by activating spleen, which is complemented by tonification. That is to say, activation and tonification are combined, while helping digestion is considered, also. But as to syndromes with more excess than deficiency, the treatment will be activating spleen combined with helping digestion, also with regulating qi. He also cares for children 's regulating and giving reasonable advice. [Conclusion]According to the children's characteristics of physiology and pathology, we should pay more attention to excess and deficiency to choose better method, at the same time, proper feeding and teaching are also important.
ABSTRACT
Objective To evaluate the clinical significance of chronic hepatitis B (CHB) with concurrent hepatitis e antigen (HBeAg) and antibody (anti-HBe) during antiviral therapy. Methods A total of 115 CHB patients with concurrent HBeAg and anti-Hbe detection during antiviral therapy were enrolled in this retrospective study. All patients received pegylated-IFN-alpha-2a (Peg-IFNα-2a, n = 50) or entecavir (ETV, n = 65) for antiviral treatment. Their biochemical virological and serological response and clinical outcome were detected and analyzed. Results Among the patients treated with Peg-IFNα-2a, 31 (62.0%) achieved HBeAg seroconversion and 6 (12.0%) achieved HBsAg seroconversion at the end of treatment. About 35.4% of patients, who received ETV, achieved HBeAg seroconversion and none of them achieved HBsAg seroconversion at the end of treatment (P < 0.05). Conclusion High rates of HBeAg seroconversion and HBsAg loss could be achieved in CHB patients, with co-existence of HBeAg and anti-HBe, who received Peg-IFNα-2a, but not ETV therapy.
ABSTRACT
La Organización Mundial de la Salud ha establecido que hay una reducción de años de vida útil en aquellos pacientes que tienen trastornos mentales. La concurrencia de uno de dichos trastornos con un síndrome coronario agudo empeora el pronóstico de éste. Este artículo presenta los resultados de un estudio de la relación de los trastornos mentales con la evolución del síndrome coronario agudo en 97 pacientes de dos hospitales, en Barquisimeto, Venezuela. Se administró individualmente, la entrevista clínica estructurada del eje 1 del manual diagnóstico y estadístico de trastornos mentales IV, de la Asociación Psiquiátrica Americana, durante la primera semana de hospitalización y seis meses más tarde. Se estudiaron las variables: Trastorno mental, edad, sexo, nuevo evento cardíaco, impresión global clínica, riesgo TIMI, y evolución cardiovascular. 28 pacientes (28,8%) tuvieron diagnóstico de trastorno mental al ingreso. Se presentó un nuevo evento coronario en 50% de los 10 pacientes en quienes persistió el trastorno mental. por el contrario, los 15 pacientes en quienes se controló el trastorno mental mostraron mejoría del síndrome coronario agudo. Hubo diferencia, con significación estadística, entre estos dos últimos grupos. (P<0,05). La tasa de trastorno mental en esta población fue mayor a la que estima la organización Mundial de la Salud para cualquier estudio transversal (10%). Hubo empeoramiento, estadísticamente significativo, en la evolución del síndrome coronario agudo cuando éste ocurrió con un trastorno mental. Tal hallazgo acentúa la necesidad de un despistaje precoz (y eventual tratamiento) de trastornos mentales en todos los pacientes que se admiten que se admiten a la unidad de cuidados coronarios.
The world health Organization has established that there is a reduction of useful years of life in those subjects who present mental disorders. Concurrence of one of such disorders with an Acute Coronary Syndrome worsens its prognosis. This article presents the results of a study of the relationship between mental disorders and the clinical course of Acute Coronary Syndrome in 97 patients of two hospitals in Barquisimeto, Venezuela. The Structured Clinical Interview for Axis 1, of the American Psychiatric Associations Diagnostic and Statistical Manual of Mental Disorders IV, was conducted, individually, during the first week of hospitalization, and six months later. the following variables were studied: mental disorder, age, sex, new cardiac event, Clinical Global Impression, TIMI Risk and cardiovascular clinical course. 28 patients (28.8%) were diagnosed with a mental disorder on admission; a new coronary event ensued in 50% of the 10 patients whose mental disorder persisted. Conversely, those 15 patients whose mental disorder was controlled showed improvement of their Acute Coronary Syndrome. There was statistically significant difference between the latter two groups. (P<0,05). The rate of mental disorders in this population was higher than the Word Health Organizations estimation for any cross-sectional study (10%). There was a statistically significant worsening of the clinical course of the Acute Coronary Syndrome when it concurred with a mental disorder. Such a finding a accentuates the need for early detection (and eventual treatment) of mental disorders in all patients who are admitted to CCUs.