出血性脑梗死危险因素的Logistic回归分析

目的探讨出血性脑梗死的危险因素。方法根据专业知识确定与出血性脑梗死有关的因素,采用非条件Logistic回归确定危险因素。结果大面积梗死灶、使用抗凝剂或溶栓治疗、糖尿病史是出血性脑梗死的独立危险因素,与年龄、高血压史、高血脂关系不大。结论大面积脑梗死、使用抗凝剂或溶栓、糖尿病患者发生梗死后出血的几率增大,及时行影像学检查可以早期发现。     

Feasibility of treating hyperfibrinogenemia with intermittently administered batroxobin in patients with ischemic stroke/transient ischemic attack for secondary prevention.

This study evaluated the safety and efficacy of batroxobin in treating hyperfibrinogenemia for secondary stroke prevention. Patients with ischemic stroke or transient ischemic attack (TIA) were measured for plasma fibrinogen levels. Selected participants had concomitant hyperfibrinogenemia (plasma fibrinogen > or = 3.0 g/l). Patients enrolled between 1 July 2003 and 31 December 2004 were treated with batroxobin; patients enrolled between 1 January 2002 and 30 June 2003 were treated without batroxobin. Batroxobin was administered intermittently via intravenous injection at 3-monthly intervals. Patients in both groups were followed for 1 year. Any cerebrovascular events and suspected adverse events were recorded. In total, 112 ischemic stroke/TIA patients with concomitant hyperfibrinogenemia were enrolled, 52 being treated with batroxobin and 60 without batroxobin. Six patients (11.5%) with batroxobin and 16 patients (26.7%) without batroxobin had recurrent cerebral ischemic events during follow-up. Stroke/TIA recurrence in patients without batroxobin was higher than that in patients with batroxobin (P < 0.05). Two patients with batroxobin and two patients without batroxobin developed hemorrhagic stroke during follow-up. There were five deaths (9.6%) in the batroxobin group, and seven deaths (11.7%) in the nonbatroxobin group during follow-up (P > 0.05). Intermittent intravenous injection of batroxobin can efficiently reduce the risk for stroke/TIA recurrence in patients with concomitant hyperfibrinogenemia.     

两种微创方法治疗股骨颈骨折的临床对照试验

目的分别应用三针锁针加压器外固定和空心拉力钉内固定疗法治疗股骨颈骨折,探讨股骨颈骨折最佳治疗方法.方法应用三针锁针加压器外固定治疗股骨颈骨折63例,其中男24例,女39例;年龄55～89岁,平均(64.5±3.2)岁;Garderl Ⅰ型2例,Ⅱ型15例,Ⅲ型38例,Ⅳ型8例.应用空心拉力钉内固定治疗63例,其中男29例,女34例;年龄45～76岁,平均(62.2±2.9)岁;Garden Ⅰ型4例,Ⅱ型24例,Ⅲ型28例,Ⅳ型7例.对其疗效进行分析.结果126例除2例死亡外均得到随访.115例愈合,其中10例股骨头坏死.外固定组愈合58例,股骨头坏死4例,死亡1例;内固定组愈合57例,股骨头坏死6例,死亡1例.根据Harris功能评定标准评价疗效,外固定组62例中优24例,良26例,可8例,差4例,优良率80.65%;内固定组62例中优23例,良27例,可6例,差6例,优良率80.65%.Harris评分外固定组平均(80.40±1.21)分,内固定组平均(79.14±1.47)分,两组Harris评分比较差异无统计学意义(P＞0.05).结论采用内外固定治疗股骨颈骨折疗效无明显差异,但外固定创伤小、费用低、可早期离床;而采用拉力钉内固定器医疗成本高,卧病时间相对较长,且需二次手术取内固定钉.     

寰枢椎椎弓根内固定技术的解剖学与临床研究进展

1910年,Mixter等[1]用丝线固定寰椎后弓和枢椎棘突,开创了寰枢椎内固定技术的先河.此后,学者们创建了一系列寰枢椎内固定技术,按入路分为前路技术和后路技术.     

环戊硫酮治疗干眼的临床疗效评价

Objective To investigate anethol trithione therapic efficiency on dry eye. Methods It was a prospective random double-blind controlled study. Eighty cases diagnosed dry eye in Ocular Surface Out-patient Clinic of Xiamen University Affiliated Xiamen Eye Center from 2006 to 2008 were divided into two groups: anethol trithione group and control group, 40 cases in each group. Every group was then divided into two subgroups: weak dry eye subgroup, middle and severe dry eye subgroup. All groups had been added with 0.05% refresh drops. All patients had been detected and evaluated by subjective symptoms of dry eye, visual acuity,corneal fluorescent staining(F1), break-up time(BUT) and Schirmer Ⅰ test (SⅠT) at pre-therapy and 3,7,28 d of post-therapy. All groups had been compared and analyzed by F test and sample mean difference (SMD) or median difference (MD) comparison between pre-therapy and post-therapy. Results Except of tear and red eye, the other subjective symptoms of dry eye, F1, BUT and SⅠT of weak dry eye subgroup of both groups had been improved at 7 d after therapy. Only those of middle and severe dry eye subgroup of anethol trithione group had been improved at 7 d after therapy compared with those of pre-therapy: SMD=0.96 (visual tiredness), 1.26 (dry and unsmooth sensation), 0.82 (foreign body sensation), 1.28 (burning sensation), 1.05 (photophobia), 1.48 ( pain ) ; MD=0.30 (visual acuity), 4.00 (F1) ,5.00 (BUT), 5.00 (SⅠT) [F=15.30 (visual tiredness), 15.68 (dry and unsmooth sensation ), 13.56 (foreign body sensation), 20. 91 ( burning sensation ), 18.90 (photophobia), 27.22 ( pain ), 10.54 (visual acuity), 188.21 (F1) ,261.76 (BUT) ,269.05 (SⅠT) ;P<0. 05]. Those of middle and severe dry eye subgroup of control group hadn't significantly been improved at 28 d after therapy: SMD=0.10 (visual tiredness) ,0.16 (dry and unsmooth sensation) ,0.09 (foreign body sensation) ,0.38 ( burning sensation ), 0.24(photophobia) ,0.36 (pain) ,0.23 (red eye) ; MD=0.10 (visual acuity) ,0.50(F1) ,0.50(BUT), 0.50(SⅠT) [F=1.76 (visual tiredness), 1.61 (dry and unsmooth sensation), 1.02 (foreign body sensation),2.39 (burning sensation), 2.42 (photophobia), 2.73 ( pain ), 2.55 ( red eye ), 1.46 ( visual acuity) ,2.35 (F1) ,2.90 (BUT) ,2.76 (SⅠT) ; P>0.05]. SⅠT of anethol trithione group had been improved more significantly after therapy (F=13.77, P<0.05). Conclusion Anethol trithione could significantly improve middle and severe dry eye patients' symptoms and signs whose lacrimal gland function survival and it has clinical application value.     

无名异冲剂促进去卵巢大鼠骨质疏松性骨折愈合的机制研究

为探讨无名异冲剂促进去卵巢 SD大鼠骨质疏松性骨折愈合的机制 ,用 48只 6月龄雄性 SD大鼠建立骨质疏松性骨折模型 ,随机分为模型组、跳骨片组、仙灵骨葆组、无名异冲剂组 ,于灌胃后 2周、4周取材 ,观察 X线片、骨密度、光镜 ,骨痂钙、磷、胶原含量 ,结果显示灌胃第 2周时 ,各组动物各项指标均无显著性差异 ;第4周时 ,无名异冲剂组的骨密度 ,骨痂钙、磷、胶原含量的检测结果与模型组有显著性差异 ( P<0 .0 5 ) ,X线及光镜观察骨痂的生长情况 ,无名异冲剂组也优于模型组 ,说明无名异冲剂能够通过提高骨密度 ,改善骨骼钙、磷、胶原的代谢 ,促进骨折端骨痂的生长 ,达到治疗骨质疏松性骨折的目的。     

早期脑室置管行颅内压监护对中型颅脑损伤患者的预后影响

目的　探讨早期脑室置管行颅内压 (ICP)和脑灌注压 (CPP)监护在中型颅脑损伤中的临床应用价值。方法　将 12 5例伤后 2 4h入院无手术指征的中型颅脑损伤 (GCS 9～ 12分 )患者 ,随机分为ICP监护组 :入院后即经恻脑室内穿刺置管行ICP与CPP连续监测 ,根据颅内压变化调整治疗方案 ;对照组 :入院后不做ICP监测 ,依据临床观察的意识及生命体征变化 ,进行治疗。结果　颅内压监护组脱水剂剂量、应用时间均低于对照组 ,疗效优于对照组 ,两组差异有显著意义 (P <0 0 5 )。结论　中型颅脑损伤病情极不稳定 ,早期行ICP监护能及早发现病情变化 ,对及时采取有效治疗措施 ,降低死残率 ,改善预后有重要意义。     

奥沙利铂为主的静脉化疗联合腹腔温热灌注和体外高频透热治疗晚期大肠癌的临床观察

目的 探讨奥沙利铂为主的化疗联合腹腔温热灌注治疗晚期肠癌的临床效果.方法 对42例晚期大肠癌患者,予腹腔温热灌洗化疗及体外高频透热治疗,联合以奥沙利铂为主的静脉化疗,至少2个周期,观察疗效及不良反应.结果 全组患者完成169个周期治疗,CR 5例,PR 22例,SD 8例,PD 7例,总有效率66.3%.完全缓解率11.9%.不良反应以白细胞下降及消化道反应多见,少数患者出现周围性神经毒性,以I-Ⅱ 度为主.结论 以奥沙利铂为主的静脉化疗联合腹腔温热灌注和体外高频透热治疗,对晚期大肠癌具有一定的疗效,毒副作用小;腹腔局部化疗是一种值得关注的治疗途径.     

Analysis of the Surface Ozone During Summer and Autumn at a Coastal Site in East China

The levels and temporal variations of surface ozone at a coastal site in East China during summer and autumn were analyzed and the influences of meteorological parameters on ozone were investigated. An inland city was chosen as a comparison site. The main results and conclusions of this study are: (1) ozone pollution, with a maximum 1 h concentration of 150.98 ppbv, was severe during summer and autumn at the coastal site; (2) the ozone level was obviously higher at the coastal site than that at the inland site in September; (3) besides temperature and solar radiation, sea-land breeze circulation is an important factor influencing the ozone level at the coastal site, and sea breeze often induce high ozone levels (the average ozone concentration for sea breeze was about 13 ppbv higher than that for land breeze).     

改良低压回肠代膀胱术的疗效评价

目的 总结改良原位低压回肠代膀胱术的疗效及患者生活质量。方法 膀胱癌患者53例，平均年龄61岁，均施行根治性膀胱全切术。截取末端35—45cm回肠，“U”形缝合形成代“膀胱”，并与输尿管形成抗返流的“乳头”缝合。结果 术后所有患者血生化及电解质均正常，随访3—6个月，51例患者白天完全可控排尿，完全夜间可控制排尿25例。47例无残余尿，5例有残余尿20-35mL。结论 改良低压回肠代膀胱术，膀胱容量大、压力低、无返流、效果好、无吸收性酸中毒，患者白天均能够控制尿液，夜间需定时排尿，生活质量高，多数患者满意。