跟痛症的分型与治疗

目的　讨论跟痛症的分型方法与治疗。方法　根据患者的临床症状和体征将跟痛症分为Ⅰ型 (跖筋膜型 )、Ⅱ型(骨内压增高型 )、Ⅲ型 (神经卡压型 ) ,并对这三种跟痛症分别给予跖筋膜切断、跟骨钻孔减压、局部封闭治疗。结果　经过10 0例 134跟的治疗 ,并经 12～ 18个月的随访 ,效果满意。结论　跟痛症是某一种疾病的临床表现 ,不能用单一的发病机制解释和单一的方法治疗 ,应根据患者的临床表现分型 ,结合其发病机制给予针对性的治疗     

跟痛症的分型与治疗

目的 讨论跟痛症的分型方法与治疗。方法 根据患者的临床症状和体征将跟痛症分为I型（跖筋膜型），Ⅱ型（骨内压增高型），Ⅲ型（神经卡压型），并对这三种跟痛症分别给予跖筋膜切断、跟骨钻孔减压、局部封闭治疗。结果 经过100例134跟的治疗，并经12－18个月的随访，效果满意。结论 跟痛症是某一种疾病的临床表现，不能用单一的发病机制解释和单一的方法治疗，应根据患者的临床表现分型，结合其发病机制给予针对性的治疗。     

中西医结合微创技术治疗拇外翻术后转移性跖痛症危险因素的Logitstic回归分析

目的探讨拇外翻术后转移性跖骨痛的危险因素,为拇外翻术后前足底疼痛的预防及治疗提供理论参考依据。方法采用回顾性研究方法,对2010年5月～2012年8月在笔者所在科室住院治疗的47例拇外翻患者(67足)进行术后随访,20例术后出现转移性跖骨痛足为观察组,47例术后未出现转移性跖骨痛足为对照组,随访时间平均(17.74±6.23)个月,研究人员按研究方案填写回访表,内容包括年龄、随访时间、拇趾外翻角、第一至二跖骨间角、第一跖骨短缩度、第一跖骨近端关节固定角,足内侧纵弓角,第一跖趾关节活动度、第一跖楔关节矢状面活动度、推进期第一跖骨头下压力及拇趾下压力。对可能影响拇外翻术后转移性跖骨痛的高危因素进行单因素分析与Logistic多元回归分析。结果 Logistic回归分析结果显示,术后拇趾跖趾关节活动度,第一跖楔关节活动度,第一跖骨(相对第二跖骨短缩)为拇外翻患者出现转移性跖骨痛的危险因素。结论术前针对每一只拇外翻患足的具体病理变化进行细致的分析,选择相应的手术方法,注意尽可能避免第一跖骨过度短缩、第一跖楔关节过度活动,而且要注意术后拇趾功能的恢复,只有这样才能有效降低患足出现转移性跖骨痛的机率,提高手术的疗效。     

硬膜囊内型腰椎间盘突入出症的诊治并文献复习

目的通过1例腰椎间盘突入硬膜内患者探讨其发病机制、影像学表现和临床治疗方法。方法患者术前接受体检及多种影像学检查;确诊后施以椎管探查减压术及椎间盘切除手术;然后笔者结合文献复习讨论。结果患者治愈,出院。结论既往手术可导致硬膜囊内型椎间盘突出症的发病,但其发病机制目前还不明确。GDDTPA加强MRI可用于硬膜囊内型椎间盘突出症的诊断,其他影像学方法诊断硬膜囊内型椎间盘突出症目前还存在争议。硬膜囊内型椎间盘突出症的临床治疗主要通过手术的方法,应尽早治疗。     

小针刀松解跖腱膜治疗跟痛症临床观察

目的观察针刀松解跖腱膜治疗跟痛症的疗效。方法将60例跟痛症患者随机分为治疗组和对照组30例,观察治疗前后跟痛的改善情况。结果治疗组在远期疗效上优于对照组,近期疗效两组无显著性差异。结论针刀松解跖腱膜适合于跟痛症的治疗。     

军事训练期间跟痛症原因分析与治疗

目的探讨由军事训练导致的跟痛症的原因与治疗措施。方法对37例新兵训练中发生跟痛症患者的病例资料进行回顾性分析。结果 2007年1月至2010年12月间,共收治新兵训练期间发生跟痛症患者37例,全部得到随访,其中跖腱膜炎33例,占89.2%,全部经保守治疗,均痊愈。结论军事训练期间导致的跟痛症,大多是由跖腱膜炎所致,急性发病,经保守治疗效果可靠。     

癌痛的发病机制及治疗研究进展

癌痛作为癌症患者的一种常见症状,其发生率呈逐年上升趋势。疼痛不仅影响患者的生活质量,对患者的后期康复也可造成一定影响。目前,癌痛的临床治疗效果参差不齐,一方面是由于临床对癌痛的病因及发病机制认识不足,另一方面,癌痛的治疗也未引起临床医生和患者的足够重视。本文旨在对癌痛的发病机制及目前临床常用的治疗方法进行综述,以期为癌痛的临床治疗和用药提供参考。     

临床常见跟痛症的治疗体会

跟痛症是骨科常见病之一,其病因至少有50种。临床常见的跟痛症多为跟骨骨刺及跟底滑囊炎。加据报道,跖筋膜的大部分及拇展肌的牵拉也是跟痛的主要原因。跟痛症的治疗方法较多,其疗效优劣差异亦较大,我们自1987年9月至1991年9月,诊治跟痛症42例,对其中38例随访3～23个月,疗效满意,现就有关问题讨论如下1 一般资料:本组42例,男18例,女24倒;年龄22～61岁,平均47.3岁。以站立行走工     

药源性血小板减少症的发病机制和临床表现及防治

目的分析并研究药源性血小板减少症的发病机制,同时对于其临床表现进行分析和调查,研究其防治措施。方法本研究所有选择的研究对象为我院收治的药源性血小板减少症患者,所有患者的入院时间为2016年10月至2017年12月,本研究选择其中的58例患者作为研究对象,对于所有患者的临床资料进行回顾性分析,总结并调查患者药源性血小板减少症的发病机制,分析患者的临床表现,并且总结有效的防治措施。结果通过对于患者的临床资料分析总结得出,药源性血小板减少症的发病机制主要为骨髓抑制性血小板减少症、免疫性血小板减少症和非免疫性血小板减少症,从临床表现来说,患者存在有出血症状,而且存在有全身的症状。为患者在进行治疗的时候,应该尽可能的选择对于血小板影响较小或者没有影响的药物。本研究所有患者治疗以后,全部得到恢复,采用自制的量表对于所有患者的满意度进行评分,满意度评分为(92.5±3.4)分。结论临床药源性血小板减少症的发病机制主要为骨髓抑制性血小板减少症、免疫性血小板减少症和非免疫性血小板减少症等,根据患者的临床表现对患者进行治疗,尽量为患者选择采用对血小板影响较小或者没有影响的药物进行干预可有效的促进患者临床症状的缓解。     

1例转移性骨癌骨痛行153sm-EDTMP治疗的护理干预

报告1例因肿瘤所致的转移性骨癌引起骨痛的治疗,在临床上推广应用153sm-EDTMP（153钐-乙二胺四亚甲基磷酸）治疗转移性骨癌骨痛,探索有效的临床治疗方法,减轻患者的痛苦,通过密切的观察和护理减少并发症,提高患者的生存质量。     

Pathophysiology of saphenous vein graft failure: a brief overview of interventions

Coronary artery bypass graft surgery (CABG) is widely used for the treatment of atheromatous stenosis of coronary arteries. However, as many as 50% of grafts fail within 10 years after CABG due to neointima (NI) formation, a process involving the proliferation of vascular smooth muscle cells (VSMCs) and superimposed atherogenesis. To date no therapeutic intervention has proved successful in treating late vein graft failure. However, several diverse approaches aimed at preventing neointimal formation have been devised which have yielded promising results. In this review, therefore, we will summarise the pathophysiology of vein graft disease and then briefly consider interventional approaches to prevent late vein graft failure which include surgical technique, conventional pharmacology, external sheaths, cytostatic drugs and gene transfer.     

妇产科专业发展趋势与设想

目的综述国内外妇产科疾病诊断和治疗的最新进展及发展趋势,为军区妇产科专业发展提供方向及理论依据。方法通过PubMed及CNKI检索近年来妇产科专业相关中文及英文文献,对妇产科疾病诊断和治疗的最新进展进行分析、归纳及总结。结果近年来妇科腹腔镜、宫腔镜、阴式手术等微创手术日益成熟,妇科盆底功能障碍发病机制新理论促进了盆底重建手术的改进。产科危重症病房的建立有利于危重症产妇得到及时监护和救治,孕妇外周血中胎儿游离DNA及RNA的发现为无创产前诊断提供了新途径,健康与疾病的胚胎发育起源学说受到重视。保留女性生育能力及辅助生殖技术不断发展。军队妇产科专业在妇科机器人系统辅助下手术、精准妇科肿瘤手术、经基因芯片试管婴儿助孕技术等方面处于领先地位。北京军区妇产科专业处于临床发展阶段,需紧跟最新研究前沿开展新业务、新技术。结论随着科技水平的不断提高,妇产科专业将会持续蓬勃发展。军区妇产科应加强科研力量,促进基础研究和临床研究同步发展,建立知识创新机制,使学科整体水平达国内领先。     

Canadian Neuro-Oncology '98--Eighth Biennial Meeting. 7-9 May 1998, Niagara-on-the-Lake, Ontario, Canada

The purpose of this meeting was to review the progress made in the treatment of human brain tumors using a variety of modalities. Unlike many cancers which have shown marked improvements in terms of patient survival with the advent of new techniques and drugs, the majority of patients with the most malignant form of a primary brain tumor (glioblastoma multiforme), continue to do poorly, and have a median survival of approximately 12 months. The meeting was appropriately organized into morning scientific sessions, in which experimental neuro-oncology studies were presented, and afternoon sessions which were comprised of more clinically relevant presentations covering the latest advances in surgery, radiation therapy and chemotherapeutic agents. This review covers the highlights of this meeting in terms of the utility of accepted and novel chemotherapeutic agents for human brain tumors.     

腹腔镜胆囊切除术后黄疸的诊治体会

目的探讨腹腔镜胆囊切除(LC)后黄疸的原因、预防措施及处理方法。方法回顾分析性本院4362例LC后发生黄疸的36例临床资料并结合文献进行总结。结果内科性黄疸16例,梗阻性黄疸20例(包括胆道损伤7例,胆总管结石9例,胆道蛔虫2例,原因不明2例)。开腹手术中1例患者继发腹腔脓肿转上级医院治疗,其余治愈。结论 LC后黄疸与许多因素有关,十分复杂,我们必须详细全面的检查以明确诊断,区分梗阻性黄疸与内科性黄疸。梗阻性黄疸以胆管损伤和胆道结石为主要原因,内科性黄疸与术前患者的肝功能状况、中气腹压力大小、手术时间长短密切相关,当诊断不明确时,处理应更为谨慎,强调对发生黄疸病例的处理采用个体化原则。     

Review article: maintenance treatment with H2-receptor antagonists for peptic ulcer disease

In recent years a number of different strategies for managing patients with peptic ulcer disease have become available. The present review discusses the relative merits of each form of treatment. Intermittent treatment (whether given in response to symptoms or as a prophylactic regimen prescribed seasonally or at weekends) fails to prevent ulcer recurrence and leaves patients at risk of haemorrhage and perforation. Anti-Helicobacter pylori therapy, although useful in certain circumstances, cannot be recommended for all patients with ulcer disease because of side effects and, in any case, requires further assessment of efficacy. Gastric surgery reduces ulcer recurrence and complications, but operations which have a low incidence of side effects are associated with higher rates of ulcer recurrence, particularly when patients are followed up for more than 10 years. Long-term continuous maintenance treatment with H2-receptor antagonists for 5 or more years effectively prevents ulcer recurrence in the majority of patients and significantly reduces the risk of ulcer complications. In addition, maintenance treatment has proved to be safe and is well tolerated by patients. Maintenance treatment with H2-receptor antagonists is the preferred option for the management of patients with peptic ulcer disease.     

Pharmacoeconomics of voriconazole

Importance of the field: The recent increase in the use of antineoplastic and immune suppressive agents and the use of broad-spectrum antibiotics, prosthetic interventions, organ transplants and more aggressive surgery have been related to a greater prevalence of invasive fungal infections (IFI). Over the past few years, several new antifungal therapies have become available for these patients. Pharmacoeconomic data can play a useful role in comparing the relative benefits of treatment.

Areas covered in this review: This review summarizes all the available evidence regarding the pharmacoeconomics of voriconazole. A systematic review of pharmacoeconomic analyses through a non-restricted literature search was conducted (until May 2009).

What the reader will gain: The reader will gain a greater understanding of the pharmacoeconomics role of voriconazole.

Take home message: The majority of economic analyses have shown that voriconazole is a more cost-effective alternative in the treatment of invasive fungal infections than the antifungal drugs with which it was compared.     

The pharmacological management of childhood anxiety disorders: a review

Rationale Pediatric anxiety is a prevalent psychiatric disorder that may have important implications for school, social, and academic function. Psychopharmacological approaches to the treatment of pediatric anxiety have expanded over the past 20 years and increasing empirical evidence helps guide current clinical practice. Objective To review studies which examine the pharmacological treatment of pediatric anxiety disorders, including obsessive–compulsive disorder and to summarize treatment implications. Methods All relevant studies were searched using MEDLINE and PsycINFO search engines, supplemented by a manual bibliographical search; studies published between 1985 and 2006 that met inclusion criteria were examined. Results This article provides a systematic review of the psychopharmacological treatment of pediatric anxiety disorders based on available empirical evidence, with a focus on randomized controlled trials. General treatment principles and pharmacological management of specific pediatric anxiety disorders are also reviewed. Conclusion There is good evidence to support the efficacy of several pharmacological agents including the selective serotonin reuptake inhibitors to treat pediatric anxiety and obsessive–compulsive disorder, although there are still many unanswered questions.     

Upcoming therapeutic advances in diabetic macular edema: an intravitreal dexamethasone drug delivery system

INTRODUCTION: Diabetes mellitus, through its ophthalmic complications diabetic retinopathy and diabetic macular edema (DME), is a leading cause of vision loss in industrialized countries. AREAS COVERED: This review covers laser treatment, which is a standard treatment strategy that has proven efficacy and safety through large clinical trials in DME. Several intravitreal drug applications currently being investigated are also discussed. EXPERT OPINION: First results suggest that the administration of anti-VEGF compounds is effective for DME. However, frequent injections may compromise safety. In order to enhance patient compliance, sustained delivery systems are being evaluated as potential treatment approaches. So far, only steroids have been included as active in such non-biodegradable or biodegradable delivery systems. Non-biodegradable systems are more complicated to administer as surgery is required and they need to be retrieved at the end of treatment. Also, in some cases safety issues have arisen, especially around intraocular pressure control. A new biodegradable dexamethasone delivery system seems to show promising efficacy results in addition to a more favorable safety profile, which will potentially improve patient compliance. All new therapeutic approaches, alone and in combination, will need to demonstrate their efficacy and safety in DME in future trials.     

Psychopharmacology of pediatric bipolar disorder: a review

Rationale Pediatric bipolar disorder (PBD) is a chronic and debilitating psychiatric illness. It is associated with many short-term and long-term complications including poor academic and social performance, legal problems and increased risk of suicide. Moreover, it is often complicated by other serious psychiatric disorders including attention deficit hyperactivity disorder, oppositional defiant disorder, conduct disorder and substance use disorders. For these reasons, there is a need for effective treatment for PBD. Objectives To review available data from published reports of the treatment of PBD, highlighting those treatment practices for which there is scientific evidence. To suggest directions for future research. Materials and methods A comprehensive Medline search was performed to identify published reports from 1995 to 2006. Reports with the greatest methodological stringency received greater focus. Results There is limited evidence from double-blind, placebo-controlled trials regarding the treatment of PBD. Available data suggests that lithium, some anticonvulsants and second-generation antipsychotics may be equally beneficial in the acute monotherapy for youth with mixed or manic states. However, because of limited response to acute monotherapy, there is increased justification for combination therapy. There is very limited data on the treatment of the depressed phase of bipolar illness in the youth. Also, very few studies have addressed the treatment of comorbidities and maintenance/relapse prevention in PBD. Conclusion Although significant progress was made in the treatment of youth with bipolar disorder, there is a need for more methodologically stringent research to more precisely define evidence-based treatment strategies for PBD.