石炭酸甲床切除术治疗嵌甲37例

目的：探讨石炭酸甲床切除术在嵌甲治疗中的效果。方法：采用石炭酸甲床切除术对37例嵌甲患者进行治疗，后将效果进行总结评价。结果：全组获随访5个月～2年，均无复发。接受手术的37例患者于术后7～10d恢复正常工作，14d恢复正常训练。结论：石炭酸甲床切除术在嵌甲治疗中效果较好，值得临床应用。     

甲床损伤传统处理法与甲床原位缝合法疗效观察

目的比较甲床原位缝合法与甲床损伤传统处理法治疗甲床损伤的优缺点。方法80例甲床损伤患者,其中40例采用传统处理法,另40例为甲床原位缝合法。结果临床治疗效果比较发现:采用甲床原位缝合法效果满意,无肉组织及瘢痕形成,新生长的指甲光滑无畸形,附着完全且手术简单易行,有效率94.9%;传统处理法为15.8%。结论甲床原位缝合法治疗甲床损伤,手术简单,术后后遗症少,是比较理想的治疗方法。     

5-0铬制肠线用于急诊修复甲床裂伤

目的探讨5-0铬制肠线用于急诊修复甲床裂伤的效果。方法选择43例甲床裂伤患者,使用5-0铬制肠线急诊修复甲床并甲板原位缝合,随访3-6个月,观察临床治疗效果。结果术后随访3-6个月,以最后一次评定结果为疗效。43例45指疗效评定,优39指,良4指,可2指,总优良率95.6%。结论应用5-0铬制肠线用于急诊修复甲床裂伤手术简单有效,适用于急诊科急诊治疗甲床裂伤。     

102例甲床损伤的急诊修复

目的：介绍甲床损伤的急诊修复方法。方法：对于102例120指甲床损伤的患者进行显微修复,分别使用单纯缝合、断层甲床游离移植及全甲床游离移植。结果：术后随访3～6个月,以最后一次评定结果为疗效,120指疗效评定,优67指,良32指,可17指,差4指,总优良率82．5％。结论：应用显微无创技术进行甲床的修复与重建．可以减少后期畸形．有利于美观和功能。     

手指甲床损伤修复术的护理

目的总结手指甲床损伤修复术围手术期的护理方法。方法对167例手指甲床损伤患者进行术前心理护理,术前准备,术后进行观察及护理。结果 167例甲床全部成活,无感染等并发症的发生。结论甲床修复术围手术期周全的健康指导、密切的病情观察、及时有效的专科护理、积极预防感染等并发症是决定手术成功的必要条件。     

一期部分甲床切除甲沟重建术治疗嵌甲性甲沟炎

目的探讨甲沟成形术治疗嵌甲性甲沟炎的方法及临床疗效,提高其临床治愈率。方法对121例嵌甲性甲沟炎病例,采用一期部分甲床切除甲沟成形手术治疗,观察远期疗效。结果经过平均33个月临床随访,无复发病例;1例单侧部分复发,再次处理甲床残余物后痊愈,满意率97.5%。结论手术彻底切除患侧部分甲床是治疗并预防手术后复发的关键;一期手术治疗能有效缩短病程、降低医疗费用及减少患者的痛苦;术前充分准备及术后规范处置能保证切口一期愈合。     

甲癣与药物治疗

指(趾)甲分为甲板和甲根两部分,所露出的部分为甲板,被皮肤覆盖的部分为甲根.其中,甲板近端半月形白色区称为甲半月,深面是甲床,相当于棘细胞层和基底层.以甲半月的远端为分界线,甲床后部为甲母,是甲的发生区,围绕甲板两侧和后部的皮肤皱褶为甲皱襞.指甲的生长速度较趾甲快.     

125例部分拔甲加甲床切除术治疗趾甲沟炎临床研究

目的：探讨趾甲沟炎患者行部分拔甲加甲床切除术治疗的临床效果。方法125例趾甲沟炎患者,分析其发病原因,行部分拔甲加甲床切除术治疗患趾,观察治疗效果。结果125例患者中,甲床基本修复、干燥需12~14 d左右。随访6个月~3年,123例痊愈,创面愈合良好,新生趾甲顺利长出,外观基本良好,感觉运动功能正常,复发者2例。结论部分拔甲加甲床切除术可以有效地治愈趾甲沟炎,提高患者的生活质量。     

甲床黑色素瘤5例报告

我院自1989～1993年共收治5例甲床黑色素瘤（subungualmelanoma，SM），现就其临床表现及诊断报道如下。临床资料一、一般资料5例均经病理检查确诊，男4例，女1例；平均年龄56岁（42～68岁）；其中拇指3例，食指1例，姆趾1例；左侧3例，右侧2例；3例有外伤史，1例有感染史。4例当作甲沟炎、甲下血肿行拉甲术，局部病灶刮除术；1例误诊血管球瘤入院，术后经病理检查确诊。二、临床表现5例均未能在早期作出诊断，从症状开始到确诊SM时间平均为18个月（4～22个月）。3例在出现症状前甲下有纵行黑线，长者5年，短者1年。早期表现：4例外伤或感…     

甲板甲床部分切除术治疗嵌甲症36例分析

目的分析甲板甲床部分切除术治疗嵌甲症的手术治疗方法和疗效。方法2004年4月～2007年10月采取甲板甲床部分切除术治疗嵌甲症36例,术后予以口服抗生素3～5日及门诊换药处理。结果本组全部36例病例于术后5-7天即可穿宽松软帮鞋恢复日常工作及生活,10-14天创面痊愈,局部红肿、疼痛消失。全部36例病例获得随访,最短12个月,最长27个月,平均16个月,复发2例,复发率5%,治愈率95%。结论甲板甲床部分切除术治疗嵌甲症效果良好,操作简单,患者恢复迅速,值得推广。     

可吸收线联合海肤康急诊修复甲床损伤效果观察

目的 探讨医用可吸收线与海肤康指套联合应用急诊修复甲床损伤的可行性,安全性及疗效.方法 指根阻滞麻醉,常规刷洗消毒、清创、仔细对合甲床创缘,用4-0可吸收线无张力缝合甲床,止血,套上海肤康指套.结果 46例57指除1例因碾压伤严重而缺血坏死外其余均自行愈合满意,其中优41指,占71.93%,良13指,占22.81%,差3指,占5.26%.结论 医用可吸收线与海肤康指套联合应用急诊修复甲床损伤操作简单,并发症少,疗效确切,适合大多数甲床损伤患者.     

Potential of bone marrow stromal cells in applications for neuro-degenerative, neuro-traumatic and muscle degenerative diseases

Cell transplantation is a promising strategy for the treatment of neurodegenerative and muscle degenerative diseases. Many kinds of cells, including embryonic stem cells and tissue stem cells, have been considered as candidates for transplantation therapy. Bone marrow stromal cells (MSCs) have great potential as therapeutic agents since they are easy to isolate and can be expanded from patients without serious ethical or technical problems. We discovered a new method for the highly efficient and specific induction of functional Schwann cells, neurons and skeletal muscle lineage cells from both rat and human MSCs. These induced cells were transplanted into animal models of neurotraumatic injuries, Parkinson's disease, stroke and muscle dystrophies, resulting in the successful integration of transplanted cells and an improvement in behavior of the transplanted animals. Here we focus on the respective potentials of MSC-derived cells and discuss the possibility of clinical application in degenerative diseases.     

Enhancing the nail permeability of topically applied drugs

The topical therapy of nail diseases, especially of onychomycosis, and to a smaller extent, of nail psoriasis, is desirable to avoid the side effects associated with their systemic therapy, to increase patient compliance and reduce the cost of treatment. Systemic therapy is however the mainstay of treatment due to the poor permeability of the nail plate to topically applied drugs. For effective topical therapy, ungual drug permeation must be enhanced. This can be achieved by disrupting the nail plate using physical techniques or chemical agents. Alternatively, drug permeation into the intact nail plate may be encouraged, for example, by iontophoresis or by formulating the drug within a vehicle which enables high drug partition out of the vehicle and into the nail plate. The physical techniques (manual and electrical nail abrasion, acid etching, ablation by lasers, microporation, application of low-frequency ultrasound and electric currents) and chemicals (thiols, sulphites, hydrogen peroxide, urea, water, enzymes) that have shown ungual enhancer activity are discussed in this review. Optimal drug formulation, while crucial to ungual drug delivery, is only briefly reviewed due to the limited literature.     

Enhancing the nail permeability of topically applied drugs

The topical therapy of nail diseases, especially of onychomycosis, and to a smaller extent, of nail psoriasis, is desirable to avoid the side effects associated with their systemic therapy, to increase patient compliance and reduce the cost of treatment. Systemic therapy is however the mainstay of treatment due to the poor permeability of the nail plate to topically applied drugs. For effective topical therapy, ungual drug permeation must be enhanced. This can be achieved by disrupting the nail plate using physical techniques or chemical agents. Alternatively, drug permeation into the intact nail plate may be encouraged, for example, by iontophoresis or by formulating the drug within a vehicle which enables high drug partition out of the vehicle and into the nail plate. The physical techniques (manual and electrical nail abrasion, acid etching, ablation by lasers, microporation, application of low-frequency ultrasound and electric currents) and chemicals (thiols, sulphites, hydrogen peroxide, urea, water, enzymes) that have shown ungual enhancer activity are discussed in this review. Optimal drug formulation, while crucial to ungual drug delivery, is only briefly reviewed due to the limited literature.     

Emerging Topical Onychomycosis Therapies – Quo Vadis?

Introduction: Onychomycosis, a common chronic fungal infection affecting fingernails and toenails, globally may affect 10 – 30% of the population. This chronic disease is difficult to eradicate. The goal of developing a highly effective and safe topical treatment has not yet been reached as it depends on the type of onychomycosis and the variety of invaders.

Areas covered: Topical drug delivery to the nail is highly desirable in treating nail disorders. However, efficacy of topical therapies is low due to their limited permeability across the nail plate. Advances have especially been made by the development of new therapeutic options including new drug entities, new formulations and reformulations. This overview updates emerging topical treatments for onychomycosis, research progress and future perspectives.

Expert opinion: Development of novel effective noninvasive topical therapy for treating onychomycosis and other nail diseases such as psoriasis is long overdue. Previously there was a lack of basic knowledge about nail and its barrier properties, but with the recent increased interest in this field both from industry and academia, we hope extensive research will continue in this field to bring about successful and safe treatments for such chronic diseases.     

Therapeutic potential of TDT 067 (terbinafine in Transfersome®): a carrier-based dosage form of terbinafine for onychomycosis

Introduction: Current topical treatments for onychomycosis are unsatisfactory. New topical agents that offer efficacy without the potential adverse effects of oral antifungal therapy would benefit patients with this condition and encourage a greater treatment rate. Areas covered: Currently available topical therapies are reviewed, and new approaches for enhancing delivery of the established antifungal terbinafine through the nail are summarized. We focus on the use of ultra-deformable lipid vesicles to facilitate delivery of terbinafine to the nail and surrounding tissue. TDT 067 (terbinafine in Transfersome?) is the only such therapy in development for onychomycosis, and we review published preclinical and clinical studies on this formulation. Expert opinion: TDT 067 offers the use of new technology to deliver an established antifungal, terbinafine. Preclinical data suggest that the Transfersome? accelerates entry of terbinafine released from TDT 067 into fungi and potentiates its antifungal effects, resulting in enhanced activity, compared with conventional terbinafine. This translated into high rates of mycological cure and evidence of clinical effect in a study of TDT 067 administered twice daily for 12 weeks in patients with onychomycosis. An ongoing Phase-III trial involving more than 700 patients treated for 48 weeks is investigating the efficacy and safety of TDT 067.     

小切口椎板开窗联合自制环锯治疗腰椎间盘突出对疗效和血清 TNF-α及 LDH 水平的影响

目的：探讨臭氧联合射频靶点热凝与小切口椎板开窗联合自制环锯治疗腰椎间盘突出的疗效及对患者血清肿瘤坏死因子-α（TNF-α）及乳酸脱氢酶（LDH）水平的影响。方法回顾分析2012年2月—2014年11月我院就诊的208例腰椎间盘突出患者临床资料，按照治疗方法不同分为观察组和对照组，每组104例。观察组给予小切口椎板开窗联合自制环锯治疗，对照组给予臭氧联合射频靶点热凝治疗，分析比较两组患者的治疗效果及血清 TNF-α和 LDH 水平变化。结果观察组的治疗总有效率明显高于对照组，而治疗后血清 TNF-α和 LDH 水平低于对照组，差异均有统计学意义（P ﹤0.05）。结论小切口椎板开窗联合自制环锯治疗腰椎间盘突出具有更好的疗效，可有效降低患者血清 TNF-α和 LDH 水平。     

微创术和小骨窗开颅术治疗高血压脑出血的疗效观察(附34例临床分析)

目的探讨采用CT引导下立体定向置管加尿激酶溶凝块(微创术)和小骨窗开颅手术治疗高血压脑出血(HICH)病人的疗效。方法对高血压脑出血病人,分别采用微创术和小骨窗开颅手术治疗,观察治疗前后存活优良率、中重病残率、病死率、神经功能缺损评分。结果采用微创术治疗高血压脑出血组病人存活优良率高于小骨窗开颅手术组,病死率及病残率低于小骨窗开颅手术组,但无明显差异。而生存质量、格拉斯哥计分(GCS)、神经功能缺损评分明显改善,与小骨窗开颅手术组有显著性差异。结论采用微创术和小骨窗开颅手术均是较好的治疗高血压脑出血的手术途径,而术式的选择对患者的预后较为重要。     

三种不同方法治疗输卵管妊娠对生育能力影响的探讨

目的 比较3种方法治疗未生育的年轻女性输卵管妊娠后对其生育能力的影响.方法 回顾性分析我院2006至2011年收治,并能够系统随访的274例有生育要求的输卵管妊娠患者,其中55例行开腹输卵管切除术(切除组),120例行开腹输卵管开窗术(开窗组),99例行全身应用氨甲蝶呤保守治疗(药物组).治疗后平均随访4年.结果 180例(65.7％)治疗后自然宫内妊娠,16例(5.8％)再次异位妊娠.其中切除组的白然宫内妊娠37例(67％),再次异位妊娠1例(2.2％);开窗组宫内妊娠96例(80％),再次异位妊娠2例(1.7％);药物组宫内妊娠47例(47.4％),再次异位妊娠13例(13.1％).治疗后进行宫腔输卵管造影共55例,其中切除组13例,显示双侧输卵管不通3例(24％);开窗组20例,双侧输卵管不通1例(5％);药物组22例,双侧输卵管不通9例(43％).切除组和开窗组的宫内妊娠率较药物组高,再次异位妊娠率低.结论 开腹输卵管开窗术在保留生育能力最好,其次是开腹输卵管切除术.而全身应用甲氨蝶呤治疗不仅保留生育能力较低,再次异位妊娠的发生率也高.     

清除小部分甲母质治疗甲沟炎的临床效果

目的 探讨拔甲术加部分甲母质清除术治疗甲沟炎的临床效果。方法 将在本院门诊就诊的122例甲沟炎患者随机分为A、B组,A组实行单纯部分或全甲拔除术,B组在A组手术的基础上切除患侧小部分甲母质．并用刮匙刮除、用碘酊烧灼去除残留部分甲母质。结果 A组甲沟炎的复发率为55．73％,B组为4．92％,B组甲沟炎的复发率明显低于A组（P〈0．005）。结论 拔甲术加部分甲母质清除术创伤小,复发率低,基本不影响新甲的外形美观,值得推广应用。