搭建平台甘为人梯 繁荣学科造就人才——《中国医学伦理学》杂志的杰出贡献

《中国医学伦理学》杂志为医学伦理学、生命伦理学发展,为改善医德医风、和谐医患关系等做出了贡献,为医学伦理学工作者成长成才提供了平台。在现代医学高技术化而人文精神尚显不足的当前,更需医学伦理学发挥作用,以使医学人文精神回归,使医学科学技术能够真正造福人类。     

牵张性成骨术在口腔颌面外科的应用进展

牵张性成骨术 (Distraction Osteogenesis,DO)是通过骨切开后 ,应用特制的牵引装置 ,缓慢牵拉使截骨间隙中形成新骨从而达到骨骼延长的目的。这一技术最初用于四肢骨的延长 ,近年来引入口腔颌面外科及整形外科领域 ,它的出现和应用为常规技术难以矫正的牙颌畸形提供了新的方法和思路 ,并取得了优于传统方法的疗效 ,世界各国学者们都在关注着这一技术的应用和发展。1　牵张性成骨术的发展概况　　早在 190 5年 ,意大利人 Codivilla[1 ] 首次应用牵张成骨术试图延长股骨 ,并发现截骨间隙有新生骨增生现象。 2 0世纪5 0年代 ,苏联学者 Gavri…     

26例肢体延长术X线观察

本文报告26例脊髓灰质炎后遗症致下肢短缩,应用胫骨干骺端截骨延长和胫骨骨骺牵开延长术的X线表现。年龄11～26岁,其中干骺端截骨延长19例,骨骺牵开延长6例,平均延长长度为5cm。X线主要观察延长区是否被牵开、延长长度、各期的骨痂形成、有无并发症等。     

Ilizarov技术修复胫腓骨创伤性长段骨缺损

目的总结应用Ilizarov技术延长方法修复下肢创伤性长段胫腓骨缺损经验。方法应用"针锯"潜行截骨Ilizarov技术延长方法修复下肢创伤性长段胫腓骨缺损15例,骨缺损长度6~11cm。均伴有皮肤软组织缺损,面积5cm×8cm~13cm×21cm。在骨折端穿入骨圆针,在截骨处与骨平纵轴垂直穿入圆形针锯,安装双轨外固定延长器。术后7天始以1.0~1.25mm速度每天延长截骨端至骨缺损长度后停止。修复创面。延长骨段骨性愈合后拆除延长器。结果全部病例均获随访,时间18~48个月,平均24个月,骨缺损修复良好,骨感染治愈,皮肤软组织缺损修复。结论"针锯"潜行截骨Ilizarov延长方法修复胫腓骨外伤性长段骨缺损,安全有效,是治疗胫腓骨创伤性长段骨缺损较理想的方法之一。     

改进骨延长术的临床应用体会

骨“再生”延长术是在总结既往骨延长术经验基础上[1]结合临床实践，根据骨再生原理提出的一种改进的术式[2,3]．1995年～1996年应用这一技术成功地为26例骨伤病（骨缺损、骨不连、骨短缩及身材矮小等）病人进行了骨再生肢体延长，收到满意效果。由于骨“再生”延长术更符合人体骨再生生理，因而相对减少或避免了以往骨延长出现的血管、神经、肌肉牵拉性损伤；延长期间肢体疼痛；力线改变（肢体畸形愈合）；原解剖位置变异；骨迟缓愈合或骨不愈合；再发骨折等并发症．骨“再生”延长术发展了骨延长技术，并为治疗某些骨缺损、骨短缩、骨不连、肢体不等长、侏儒症等提供了一种更加安全。可靠而积极的方法．     

重组成骨生长肽对兔截骨延长区骨愈合的影响

目的观察重组成骨生长肽（recombinant osteogenic growth peptide,rOGP）对兔截骨延长区骨愈合的影响。方法取42只健康兔随机分成实验组和对照组,每组21只,左胫骨结节下1cm处截骨制成骨延长动物模型。从术后第1天至取材的前1天实验组动物每日经耳缘静脉注射rOGP0．5μg／kg,对照组注射同等剂量的生理盐水。于延长后第10、30、60天取材分别行大体、放射线和HE染色组织学观察愈合情况。结果放射线学显示,延长后第60天实验组髓腔形成延长区已接近正常骨皮质。对照组骨皮质较薄,髓腔形成不完全。实验组自延长30天后组织学检查骨延长区修复组织的成熟度及新生骨小梁均优于对照组（P〈0．05）。结论全身静脉应用rOGP能促进兔截骨延长区骨愈合。     

颅外支架式牵引成骨治疗重度上颌后缩的研究进展

牵引成骨（Distraction Osteogenesis,DO）是通过切开骨皮质,仍保留骨膜及软组织附着与血供,施加特定的牵引力,以延长或重建骨组织及软组织的一项外科技术[1]。McCarthty[2]首次应用牵引成骨延长发育不足的下颌骨,开创了口腔颌面外科牵引成骨的先河。Polley[3]最早应用颅外支架式牵引成骨（Rigid External Distraction,RED）治疗唇腭裂术后继发上颌后缩,从而使牵引成骨技术被广泛应用于矫治各种颌面部先天性与获得性畸形。     

牵张性成骨术在口腔颌面外科的应用进展

牵张性成骨术(Distraction Osteogenesis, DO) 是通过骨切开后,应用特制的牵引装置,缓慢牵拉使截骨间隙中形成新骨从而达到骨骼延长的目的。这一技术最初用于四肢骨的延长,近年来引入口腔颌面外科及整形外科领域,它的出现和应用为常规技术难以矫正的牙颌畸形提供了新的方法和思路,并取得了优于传统方法的疗效,世界各国学者们都在关注着这一技术的应用和发展。     

骨搬移技术治疗下肢感染性骨缺损

目的探讨应用骨搬移技术治疗严重下肢感染性骨不连的临床疗效。方法按照牵拉组织再生原理,对26例四肢高能量损伤后下肢感染性骨不连患者采取病灶彻底切除+干骺端截骨搬移术。术后7 d以0.25 mm/6 h速度延长,固定延长至骨缺损端会合,于骨缺损处两断端加压并继续维持外同定支架至骨愈合。结果 26例全部获随访,平均随访56(20~92)个月。骨延长2~14 cm,平均5.5 cm,骨性感染全部治愈。带支架时间6~24个月,平均13个月。23例骨缺损处及延长部位骨生长良好,达到了骨性愈合;3例断端骨接触后6个月无明显骨愈合,其中2例行自体髂骨植骨,1例拆除支架后行自体髂骨植骨内固定,4~6个月达到骨性愈合。截骨延长部位及骨缺损对合处对位对线良好。结论骨搬移技术治疗下肢感染性骨不连,术后感染控制良好,骨愈合率高。     

保留部分松质骨的肢体延长术

为探索行之有效的截骨延长手术方法，总结了5例保留骨膜及松质骨应用外固定架的防骨延长术。结果表明前臂延长，均在延长过程中形成絮状骨化，较常规截骨延长术形成骨化早。5例患者延长4～7cm，80d内完成，全部病例无神经、血管损伤，无患肢水肿、骨延迟连接等并发症，随访1～4年，患肢肩、肘关节功能正常，感觉、肌力、血循环无异常，无畸形愈合。     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Analysis of CK-19,PDX-1,Nestin,Ngn3 in different donor islet purity in rats

Objective: To investigate if there are the CK-19, PDX-1, Nestin, Ngn3 positive cells in the donor islets of different purity in rats. Methods: Thirty male adult SD rats were randomly divided into 3 groups. Islets were isolated using digestion by ductal injection of collagenase. Group Ⅰ (n=10): Separating cell preparations were not purified, Group Ⅱ(n=10): Islet sediment was purified with 25% Ficoll400 ,Group Ⅲ (n=10): Islet sediment was purified with 25% and 11% Ficoll-400. The levels of protein of CK-19, PDX-1, Nestin and Ngn3 were detected by immunohistochemistry and the mRNA of CK-19, PDX-1, Nestin, Ngn3 was amplified by RT-PCR. Results: After two different purification methods applied, three islet preparations of different purities were obtained. The difference of islet purity was significant among various groups (P＜0.05). Compared with group Ⅱ and group Ⅲ,the protein and mRNA of CK-19, PDX-1, Nestin,Ngn3 were both higher in group Ⅰ; group Ⅲ was poorly expressed. Conclusions: The three different islet purity donor islet have different CK-19, PDX-1, Nestin, Ngn3 positive cells within them, indicating that there are some islet stem cells in the purified donor islet.     

Dr.Zhang Ren''''s Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

Luo Lingjie''''s Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.