经皮椎体成形术治疗椎体压缩性骨折128例

目的:评价经皮椎体成形术(PVP)治疗骨质疏松性椎体压缩性骨折(OVCF)的临床疗效。方法:128例OVCF患者,共计165节椎体,在C型臂X线机下行PVP术,骨黏合剂注入量为2.7～9.5 ml。结果:165节椎体全部穿刺成功,其中146节行单侧椎弓根穿刺,临床疼痛缓解总有效率为95.3%,无严重并发症。结论:PVP治疗OVCF疗效好、创伤小、适应证广。     

C臂导向下椎体成形术治疗椎体压缩性骨折

目的:评估C臂导向下椎体成形术(PVP)治疗椎体压缩性骨折的疗效.方法:对近年来腰椎压缩性骨折适于PVP的32例椎体压缩性骨折患者共38个椎体在C臂导向下施行PVP治疗,术中采取小剂量、较低浓度骨水泥加压注入病变椎体,术后定期随访评价疗效.结果:32例全部顺利完成,其中27例术后疼痛次日减轻,1例3天后疼痛减轻,3例1周后疼痛缓解,1例症状改善不明显;均未发生严重并发症.结论:C臂导向下PVP治疗椎体压缩性骨折是比较安全的微创治疗技术,远期疗效均较肯定.     

经皮椎体成形术治疗骨质疏松性椎体压缩性骨折的护理干预

目的 探讨经皮椎体成形术(PVP)治疗骨质疏松性椎体压缩性骨折的护理干预效果.方法 24例老年患者在“C”型臂X线机透视下行PVP治疗椎体压缩性骨折,对患者进行术前、术后护理干预和康复指导.结果 术后患者较术前临床症状改善,均康复出院.结论 PVP是治疗骨质疏松性椎体压缩行骨折的有效方法,重视术前、术后护理及康复指导是治疗成功的关键.     

骨质疏松性骨折经皮椎体成形术围手术期护理

目的 探讨经皮椎体成形术(PVP)治疗骨质疏松性骨折的围手术期护理方式.方法 32例高龄患者在"C"型臂X线机透视下行PVP治疗椎体压缩性骨折,对患者进行术前、术后护理和康复指导.结果 所有患者临床症状明显改善,康复出院.结论 PVP是治疗骨质疏松性椎体骨折的有效方法,重视围手术期护理及康复指导是治疗成功的保障.     

经皮椎体成形术治疗骨质疏松症合并压缩性骨折疗效分析

目的:探讨经皮椎体成形术(Percutaneousvertebroplasty,PVP)治疗骨质疏松性椎体压缩骨折疗效。方法:应用PVP治疗12例陈旧性老年性骨质疏松性压缩性骨折,术前均保守治疗,6周以上疼痛无缓解。在C型臂X光透视机监视下注射PMMA粉(克)誜液誜造影剂=3誜2誜1。结果:12例成功施术,有2例骨水泥外漏椎体侧方,但无临床症状,无并发症。施术后1个月疼痛完全缓解8例,显著缓解4例,止痛效果100%,术后9个月随访,非常满意8例,满意3例,较满意1例。结论:手术安全,操作简单,能有效缓解骨质疏松性椎体压缩骨折引起的疼痛,疗效满意。     

C型臂X线机引导下经皮球囊扩张椎体成形术的护理

经皮椎体成形术(PVP)主要用于骨质疏松引起的椎体压缩性骨折的治疗,PVP是在C型臂X线机引导下经皮将骨水泥注入椎体内,以恢复其高度,增加病变椎体抗压程度,防止椎体进一步坍塌和变形,减轻患者疼痛,改善其功能,提高其生活质量[1].我院2010年10月至2011年7月共对20例腰椎压缩性骨折患者进行了PVP治疗,通过精心医疗和护理,疗效显著,现报道如下.     

椎体成型术治疗骨质疏松性椎体压缩性骨折临床分析

目的探讨经皮穿刺椎体成型术（PVP）治疗老年骨质疏松性椎体压缩性骨折的疗效。方法对45例老年患者的57个骨质疏松性压缩性骨折椎体,在双C臂X光机透视下,经皮向椎体内穿刺并注入骨水泥,并对止痛效果和椎体恢复高度进行评估。结果患者术后腰背部疼痛明显好转,24 h后可离床活动,术后X线片确认压缩性骨折基本复位。随访1-15个月,腰背痛无复发,椎体高度无丢失。结论PVP治疗老年骨质疏松性椎体压缩性骨折有显著的止痛效果,能较好地恢复椎体高度,操作方便,疗效满意。     

经皮椎体成形术治疗椎体良恶性病变13例

目的经皮椎体成形术治疗椎体良恶性病变。方法应用经皮椎体成形术治疗13例椎体良恶性病变,共14个椎体,其中骨质疏松性压缩性骨折9例、椎体血管瘤2例、转移瘤2例,C形臂透视下,经皮穿刺到椎体病变后注入(3～7ml)平均4.8ml骨水泥,术后观察24h,抗感染1～3d,复查平片和CT后出院观察疗效及并发症。结果穿刺全部获得成功,共治疗13例患者14个椎体,13例疼痛者有12例不同程度的减轻,1例无明显改善,随访6～12个月,所有患者疼痛无复发,有效率达92.5%,无严重的并发症。结论创伤小,操作简单,并发症少,能有效缓解骨质疏松性压缩性骨折,椎体血管瘤及椎体转移瘤引起的疼痛症状。     

骨质疏松性骨折经皮椎体成形术围手术期护理

目的探讨经皮椎体成形术（PVP）治疗骨质疏松性骨折的围手术期护理方式。方法32例高龄患者在＂C＂型臂X线机透视下行PVP治疗椎体压缩性骨折,对患者进行术前、术后护理和康复指导。结果所有患者临床症状明显改善,康复出院。结论PVP是治疗骨质疏松性椎体骨折的有效方法,重视围手术期护理及康复指导是治疗成功的保障。     

经皮椎体成形术治疗椎体压缩性骨折128例

目的探讨经皮椎体成形术(PVP)治疗椎体压缩性骨折的效果及并发症。方法PVP治疗骨质疏松并椎体压缩性骨折、转移瘤及血管瘤共128例、196个椎体。操作于C形臂X线机监视下进行,经皮穿刺并经过椎弓根进入病椎,灌注骨水泥。结果128例术后疼痛均消失或缓解,不再需要应用镇痛剂治疗,按照WHO的评价标准,有效率为91.4%。本组发生骨水泥渗漏9例,发生率7.0%,未发生感染、肺栓塞等并发症。结论PVP治疗椎体压缩性骨折方法简单、效果可靠。骨水泥渗漏是常见并发症,椎体骨皮质破裂、椎体后壁及椎弓遭肿瘤破坏、骨水泥过稀或注射时机掌握不当、影像质量差等是引起外漏的危险因素。     

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…     

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.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.     

TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.     

IMPROVING P-gp EXPRESSION IN HUMAN MONONUCLEAR CELLS IN VITRO TRANSFECTED BY MULTIDRUG RESISTANCE-1 mRNA

CHEMOTHERAPY playsa greatrolein the treat- ment of malignanttumors,especiallyingynecolo- gicalones.But inanticancerchemotherapy,leuko-cytopeniaisfrequentlytheprimarydose-limitingsideeffect factor.Moreover,cancersarefrequentlychemoresistantbe-causeof overexpressionof P-glycoprotein(P-gp), which isencodedby multidrugresistancegene (MDR1 ) and detectableinup to50% ofhuman cancersand renderscellsresistancetoanticancerdrugs.The safetyand potentialtherapeuticbenefitof mdr1 gene transferredto h…