肩关节镜下喙锁韧带重建术与切开改良Weaver-Dunn手术治疗肩锁关节脱位的疗效比较

目的比较肩关节镜下喙锁韧带重建术与切开改良Weaver-Dunn手术治疗肩锁关节脱位的效果。方法选取肩锁关节脱位患者93例,根据患者手术方法不同分为A组(行肩关节镜下喙锁韧带重建术)、B组(行切开改良Weaver-Dunn手术)。结果两组患者术后12个月肩关节前屈上举角度、体侧外旋角度及加州大学洛杉矶分校评分、美国肩肘外科医师评分比较,差异均无统计学意义(P>0.05)。A组患者肩关节复位丢失率(1.92%)低于B组(14.63%),差异有统计学意义(P<0.05)。两组并发症发生率比较,差异无统计学意义(P>0.05)。结论肩关节镜下喙锁韧带重建术与切开改良Weaver-Dunn手术治疗肩锁关节脱位,均可获得显著疗效,但关节镜下喙锁韧带重建术可降低患者术后肩关节复位丢失率,减轻对患者的创伤。     

改良微创穿刺血肿清除术在治疗基底节脑出血的临床应用

目的评价改良微创血肿清除术在治疗基底节脑出血的临床应用价值。方法将2009年9月至2012年9月我院收治基底节脑出血178例患者随机分为A、B两组,其中A组88例采用传统微创穿刺粉碎清除术;B组90例采用改良微创穿刺血肿清除术治疗;术后随访1年,对比分析两组患者手术时间、术后再出血发生率、病死率、存活患者神经功能缺损评分、Barthel指数日常生活活动(ADL)量表评分之间的差异。结果 A组平均手术时间(55.2±3.4)min,B组平均手术时间(40.3±3.2)min,两组间比较,差异具有统计学意义(P<0.05);术后再出血发生率A组22.7%(20/88),B组23.3%(21/90),术后病死率A组17.0%(15/88),B组17.8%(16/90),两组间比较,差异无统计学意义(P>0.05),存活患者神经功能缺损评分、Barthel指数日常生活活动(Activity of Daily Living Scale,ADL)量表评分之间差异无统计学意义(P>0.05)。结论改良微创血肿清除术能显著降低手术时间,并不增加术后病死率及再出血发生率,近期神经功能缺损与远期疗效(日常生活活动能力)与传统术式无显著差别。     

改良后路椎间融合结合椎弓根螺钉系统治疗腰椎滑脱疗效分析

目的 探讨改良后路椎间融合结合椎弓根螺钉系统治疗腰椎滑脱的临床疗效.方法 腰椎滑脱症患者60例,按治疗方法不同分为:临床传统手术治疗(A组)30例和改良后路椎间融合结合椎弓根螺钉系统治疗(B组)30例A组采用临床传统手术治疗;B组患者采用改良后路椎间融合结合椎弓根螺钉系统治疗方法.观察2组患者的临床治疗效果、并发症和不良反应.结果 B组患者的有效率93.3%,明显高于A组70.0%(χ2=3.86,P<0.05);B组患者的手术出血量和手术时间明显少于A组(χ2=3.78,χ2=3.8547,P均<0.05);2组患者的并发症和不良反应均无显著性差异(P>0.05).结论 改良后路椎间融合结合椎弓根螺钉系统治疗腰椎滑脱是一种安全有效的方法,临床疗效满意.     

改良白内障超声乳化吸除联合人工晶体植入术治疗白内障患者的近期随访研究

目的探究改良白内障超声乳化吸除(Phaco)+人工晶体植入术(IOL)治疗白内障患者的效果。方法收集淇县人民医院98例(98眼)白内障患者(2019年2月至2022年3月),按手术方案不同分成A组(n=49)、B组(n=49)。B组接受常规Phaco+IOL治疗,A组接受改良Phaco+IOL治疗。对比两组手术前后视力情况、眼压、中央前房深度(ACD)、角膜内皮计数及地形图散光、血清核苷酸结合寡聚化结构域样受体蛋白3(NLRP3)炎症小体、白细胞介素-6(IL-6)、转化生长因子-β(TGF-β)、肿瘤坏死因子-α(TNF-α)水平及并发症发生率。结果A组术后7 d、30 d视力(LogMAR值)低于B组(P<0.05);两组术后7 d、30 d眼压均较术前降低,ACD均较术前升高(P<0.05),组间比较差异无统计学意义(P>0.05);两组术后7 d、30 d角膜内皮计数较术前降低,A组高于B组,术后7 d、30 d A组角膜散光较术前降低,B组较术前升高,A组低于B组(P<0.05);A组术后7 d、30 d血清NLRP3炎症小体、IL-6、TGF-β、TNF-α水平低于B组(P<0.05);A组并发症总发生率为[2.04%(1/49)],B组为[20.41%(10/49)],A组低于B组(P<0.05)。结论与常规Phaco+IOL治疗白内障患者相比,应用改良Phaco+IOL治疗于提升视力、减少机体应激反应、降低并发症发生率、稳定角膜内皮计数、改善角膜散光方面更具优势。     

无张力补片修补法治疗疝气的效果观察

目的:研究无张力补片修补法在疝气中的应用价值。方法:以2014年3月至2016年3月本院接诊的76例疝气病患为研究对象,采用投掷子法,对76例病患进行分组:A组和B组均有38例。A组行无张力补片修补治疗,B组行传统手术治疗。观察比较两组的临床疗效。结果:A组并发症发生率为5.26%,和B组的31.58%比较显著降低,组间差异明显(P0.05)。A组的手术费用、手术时间、术后下床时间和住院天数均明显优于B组,组间差异显著(P0.05)。A组的术后1年复发率为2.63%,明显比B组的18.42%低,组间差异显著(P0.05)。A组的治疗满意度为100.0%,明显高于B组的81.58%,组间差异显著(P0.05)。结论:对疝气病患施以无张力补片修补治疗,可降低手术费用,促进病情恢复,减少并发症。     

改良Stoppa入路手术方法治疗骨盆髋臼骨折的临床疗效分析

目的:探讨改良Stoppa入路手术方法用于治疗骨盆髋臼骨折的临床疗效。方法:将40例手术治疗的骨盆与髋臼骨折患者随机分为两组,A组20例给予改良Stoppa入路手术治疗;B组20例给予髂腹股沟入路治疗。对比两组患者手术时间、术中出血量及随访效果。结果:A组患者手术时间和术中出血量明显少于B组(P<0.05);A、B两组在骨折的复位效果和术后最后一次随访时的髋关节功能方面无明显差异(P>0.05);A组仅有1例患者出现切口的浅表感染,并发症发生率为5%(1/20)。B组出现2例切口感染,1例深静脉血栓,1例尿路感染,1例腹股沟疝,1例股外侧神经麻痹,并发症发生率为30%(6/20)。A组并发症发生率明显低于B组(P<0.05)。结论:改良Stoppa入路应用于骨盆髋臼骨折的治疗效果确切,相比传统髂腹股沟入路手术方式,可以明显缩短手术时间,减少术中出血,降低并发症的发生率。     

显微镜辅助与传统开窗手术治疗腰椎间盘突出症的临床对比研究

目的比较显微镜辅助与传统后路开窗手术治疗腰椎间盘突出症的疗效,探讨显微镜辅助下椎间盘手术的临床优势。方法选取2010年1月至2010年12月行单节段髓核摘除术的病例60例,随机分为两组,每组各30例,A组在显微镜下手术,B组采用传统后路开窗手术。术后记录两组的手术相关指标评价结果。采用腰痛疾患疗效评定标准及改良Macnab标准评价两组术后1年的临床疗效。结果 60例患者均获得12个月的临床随访。在切口长度及术中出血量方面,A组显著优于B组,组间比较差异有统计学意义(P<0.05)。在末次随访时,A组与B组的腰痛疾患疗效评定标准及改良Macnab标准评价结果,差异无统计学意义(P>0.05)。结论显微镜辅助椎间盘手术可获得满意疗效,具有视野清晰,创伤小的优点。     

高频电刀术联合外用溃疡散治疗重度宫颈糜烂320例观察

目的探讨外用溃疡散与高频电刀联合治疗重度慢性宫颈糜烂的应用价值。方法将320例重度慢性宫颈糜烂患者随机分为两组,观察组(A组)168例于术毕及术后创面应用外用溃疡散喷涂,对照组(B组)152例。结果阴道排液持续时间A组为(24.27±1.83)天,B组为(33.92±4.75)天,A组显著缩短(P<0.05);A组一次手术治愈率96.17%,B组93.05%(P<0.05);A组术后并发症3.57%,B组为7.24%(P<0.05)。结论高频电刀联合外用溃疡散治疗重度慢性宫颈糜烂可缩短阴道排液持续时间,降低手术并发症,提高一次手术治愈率。     

改良右半结肠切除术治疗结肠癌的临床效果评价

目的 分析和评价改良右半结肠切除术治疗结肠癌的临床效果.方法 方便选择该院于2012年6月—2016年6月间收治的109例结肠癌患者为研究对象.按入院顺序分A组和B组,分别是55例与54例.A组给予改良右半结肠切除术治疗,B组给予传统手术治疗.对比治疗相关指标、并发症情况、复发几率和临床疗效.结果 A组的术中出血量(83.35±15.32)mL、手术时间(61.42±12.33)min和住院时间(12.40±2.63)d均短于B组[(159.32±25.61)mL、(122.41±20.13)min、(17.25±3.51)d];淋巴结清除数量(6.58±2.44)个多于B组(3.27±1.25)个,对比差异有统计学意义(P<0.05).A组的并发症发生率为3.64％,B组为14.81％;A组的复发率是1.82％,B组是11.11％,对比差异有统计学意义(P<0.05).A组的治疗总有效率是98.18％,B组是85.19％,对比差异有统计学意义(P<0.05).结论 为结肠癌患者采取改良右半结肠切除术治疗可显著改善其相关指标,降低其复发几率和并发症发生率,值得推广.     

精子DNA碎片对IVF-ET结局的影响

目的:探讨精子DNA碎片化率(DFI)对体外受精结局的影响。方法:采用改良精子染色质扩散实验(SCD)对139例接受体外受精(IVF)的男方进行精子DFI检测,并根据精子DFI值将上述IVF患者分为:A组(DFI<17.6%)、B组(17.6%≤DFI≤30%)、C组(DFI>30%),根据单因素方差分析统计方法分析各组IVF受精率、卵裂率、优质胚胎率和妊娠结局的差异。结果:与A组比较,B组和C组正常形态精子率、精子前向活动力([a+b)%]、卵裂率、优质胚胎率均降低(P>0.05 vs B组,P<0.05 vs C组);与B组比较,C组正常形态精子率、精子前向活动力([a+b)%]、卵裂率、优质胚胎率均降低(P<0.05);与A组比较,B组和C组受精率均降低(P<0.05 vs B组,P<0.05 vs C组);与B组比较,C组受精率降低(P<0.05);A、B、C 3组间生化妊娠率、临床妊娠率差异无统计学意义(P>0.05)。结论:精子DNA碎片率升高不仅会导致精子前向活动力下降,还可导致IVF受精率、卵裂率、优质胚胎率下降,但对临床妊娠结局无明显影响。     

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…