分析比较等离子刀与机械刨削在治疗膝关节类风湿性关节炎中的临床作用

目的:分析比较等离子刀与机械刨削在治疗膝关节类风湿性关节炎中的临床作用。方法:将57例患者随机分为两组,等离子刀治疗组29例,记为观察组。机械刨削治疗组28例,记为对照组。7~36个月随访中,比较两组患者Lysholm膝关节功能评分。结果:根据美国风湿病学会的RA分期,RA分期处于Ⅰ期和Ⅱ期,观察组Lysholm膝关节功能评分优于对照组。而对于Ⅲ期的病人,两组无明显的差别(P>0.05),无统计学意义。结论:关节镜下等离子刀治疗是Ⅰ期和Ⅱ期风湿性关节炎患者首选治疗方法。     

关节镜治疗膝关节类风湿性关节炎

目的　探讨关节镜下实施膝关节滑膜切除术治疗膝关节类风湿性关节炎 (RA)的方法。方法　 34例RA患者根据美国风湿病学会 (ARA)进行分期 ,按Lysholm标准评分〔1〕。采用关节镜下滑膜切除的方法进行治疗 ,术后随访 6个月后 ,按Lysholm标准评分 ,判断手术疗效。结果　所有随访患者Lysholm评分增加 ,以Ⅰ、Ⅱ期疗效显著。结论　关节镜下治疗膝关节类风湿性关节炎是一种方便可行的微创治疗方法 ,尤其适合于Ⅰ、Ⅱ期患者。     

等离子刀与机械刨削在治疗膝骨性关节炎性滑膜炎中的作用分析

目的：比较等离子刀与机械刨削在治疗膝骨性关节炎性（OA）滑膜炎中的作用。方法：采用随机对照前瞻性研究,等离子刀治疗组90例,机械刨削对照组96例,全部病例获得6～36个月(平均19.4个月)随访。术后分别比较两组患者的Lysholm评分,术后康复时间及关节积液发生情况。结果：等离子刀组康复时间较常规器械组明显缩短,关节积液发生率明显减少,术后2周Lysholm评分显著优于同期的常规器械组(P＜0.05）。结论：等离子刀对于OA滑膜炎的病例是首选治疗方法。     

类风湿性关节炎合并膝关节骨坏死的MRI与病理学对照研究

目的 研究无激素应用史的类风湿性关节炎(RA)合并膝关节骨坏死(ONK)的MRI表现和病理学变化特点,并与膝关节特发性骨坏死(SONK)比较,为深入RA骨坏死的发病机制提供线索.方法 筛选需全膝关节置换术治疗的无激素应用史的RA合并ONK患者共11例(13膝),根据MRI检查定位截取股骨髁远坏骨标本并制作病理切片.采用双人双盲法分别描述病理切片和MRI图像资料,并应用SONK的MRI分期系统观察评价无激素应用史RA并发ONK的MRI期与病理学分期的一致性.结果 本组病例的MRI表现与其病理学表现具有高度一致性.其中MRI分期Ⅱ期者10膝,其中病理学分期Ⅱ期者9膝,Ⅲ期1;MRI分与病理学分期均为Ⅲ期者2膝,均为Ⅰ期者1膝.结论 无激素应用史的RA合并的膝关节骨坏死与膝关节特发性骨坏死具有相似的病理分期变和对应的RI表现,且SONK的MRI分期系统及病理分期标准同样适用于无激素应用史的RA合并的膝关节骨坏死.     

胸腺肽治疗类风湿性关节炎的临床价值

<正>大剂量胸肽治疗类风湿性关炎的临床观察.结果发现胸腺肽对RA的疗效尚为满意.特总结报道如下:1 资料与方法1.1 临床资料 按美国风湿病协会1987年诊断标准.从1995年8月随机选定患者92例.其中男8例.女81例.年龄23岁～76岁.平均年龄19.6±12.9岁.病程11个月～28年.平均5.8±6.6年.作胸腺肽治疗前患者发病的x线分期.Ⅰ期18例.Ⅱ期25例.Ⅲ期13例.Ⅳ期6例.所有患者随机分为治疗组和对照组.治疗组48例,对照组44例.两组年龄,性别.病情无显著性差异.具有可比性.类风湿性关节炎(RA)是一种常见的慢性多关节破坏性疾病.在病程中容易出现骨关节的侵蚀、破坏.以致最后丧失功能,对病员的身心健康造成较大影响,目前国内外尚无特效的针对治疗方法.为此我院开展了应用     

类风湿关节炎活动期膝关节超声检查的价值

目的:探讨超声检查在类风湿性关节炎(RA)患者活动期膝关节病变中的价值。方法:48例RA(病程1~8年)患者与26例健康人分别做超声检查,分析两组膝关节超声图像,比较滑膜厚度、关节腔积液深度及血流情况。结果:RA组患者滑膜厚度、积液深度较对照组增多(P0.01),RA组滑膜血流较对照组增多(P0.05),均有统计学意义。结论:超声检查RA活动期膝关节病变,可作为临床诊断RA活动期依据。     

奇正消痛贴与复方倍他米松联合使用治疗膝关节骨性关节炎的临床观察

目的 观察奇正消痛贴与复方倍他米松联合使用在治疗膝关节骨性关节炎中的治疗效果.方法 选择VAS评分4～7分,Lysholm膝关节评分标准评分在40～60分之间的骨性关节炎患者60例.随机分为复方倍它米松组(Ⅰ)组及消痛贴组(Ⅱ)组,Ⅰ组采用复方倍它米松膝关节腔注射,Ⅱ组在Ⅰ组基础上加奇正消痛贴痛点外敷.观察并比较两组患者治疗前及治疗后1周、2周、8周时的VAS评分及Lysholm膝关节评分.结果 Ⅰ组及Ⅱ组患者在治疗后疼痛及膝关节功能恢复均较治疗前有明显缓解,有统计学意义(P＜0.05),且Ⅱ组Ⅰ组近期及远期疗效更好(P＜0.05).结论 奇正消痛贴与复方倍他米松联合使用在治疗膝关节骨性关节炎中有良好的治疗效果.     

中药熏蒸联合推拿手法治疗膝关节类风湿关节炎的临床疗效观察

目的探讨中药熏蒸联合推拿手法治疗膝关节类风湿关节炎(RA)的临床疗效。方法选取2017年3月至2018年3月上海市光华中西医结合医院收治的84例膝关节RA患者为研究对象,依据随机数字法分为观察组和对照组,各42例。对照组患者入院后予以基础治疗联合温水熏蒸治疗;观察组患者予以基础治疗联合中药熏蒸及推拿手法治疗,两组患者均治疗20 d。观察两组患者的临床疗效,比较治疗前后红细胞沉降率、C反应蛋白、视觉模拟评分、Lysholm膝关节功能评分,以及磁共振成像(MRI)及B超下滑膜厚度。结果观察组治疗总有效率明显高于对照组[90. 5%(38/42)比71. 4%(30/42)](P <0. 05)。治疗后3周、3个月、6个月,两组患者的红细胞沉降率、C反应蛋白、视觉模拟评分呈下降趋势,观察组低于对照组(P <0. 05);两组Lysholm膝关节功能评分呈升高趋势,观察组高于对照组(P <0. 05)。通过MRI及B超检查,治疗后3周、3个月、6个月观察组患者髌上囊滑膜厚度均小于对照组(P <0. 01)。两组患者治疗期间均未见明显不良反应发生。结论中药熏蒸联合推拿手法治疗膝关节RA具有较好的临床疗效,能最大限度地减轻患者膝关节疼痛肿胀,促进关节功能恢复,安全性高。     

人工全膝关节置换术治疗类风湿性关节炎患者的临床疗效

目的探讨人工全膝关节置换术治疗类风湿性关节炎患者的临床疗效及术后膝关节功能的影响。方法本文选择我院2012年4月～2017年3月收治的73例患者随机分为观察组(n=37)和对照组(n=36)。两组均进行常规基础药物治疗,对照组给予玻璃酸钠膝关节腔局部注射治疗,观察组给予人工全膝关节置换术治疗。比较两组ROM评分、HSS评分及SF-36评分。结果治疗后,两组ROM评分明显高于治疗前,差异有统计学意义(t=-15.308,P=0.000;t=2.205,P=0.032);而且,观察组ROM评分明显高于对照组,差异有统计学意义(t=2.205,P=0.032)。两组HSS评分较治疗前均显著升高,差异均有统计学意义(P0.05);而且,观察组HSS评分明显高于对照组,差异有统计学意义(P0.05)。两组SF-36评分与治疗前比较均显著升高,差异有统计学意义(P0.05);观察组SF-36评分显著高于对照组,差异有统计学意义(P0.05);但观察组GH评分与对照组比较无明显差异,差异无统计学意义(P0.05)。结论 TKA治疗RA临床疗效显著,可有效根除患者疼痛症状,改善患者膝关节功能,提高患者生活质量,值得推广应用。     

关节镜下低温等离子刀微创治疗膝关节骨性关节炎的效果分析

目的评价分析关节镜下低温等离子刀治疗膝关节骨性关节炎的临床疗效与安全性。方法选取2014年7月至2016年4月南阳市中心医院膝关节骨性关节炎患者56例,按照Holden膝关节骨性关节炎放射学评价系统对其进行分级,然后行关节镜下低温等离子刀手术治疗,术后随访6~12个月,记录患者术前术后VAS评分和改良Lysholm膝关节评分情况进行统计分析。结果入组患者56例,术前VAS评分为(6.84±1.34)分,术后末次随访时VAS评分为(2.33±0.77)分,术前术后比较差异有统计学意义(P<0.05);Lysholm膝关节评分由术前(35.67±12.30)分增加至术后(80.74±8.20)分,差异有统计学意义(P<0.05)。结论关节镜下低温等离子刀治疗膝关节骨性关节炎,疗效确切,损伤小,恢复快,值得临床推广应用。     

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…