Analysis thrombolysis with anticoagulation treatment for early stage of deep vein thrombosis in the lower extremities

Objective:To explore the effect of thrombolysis with anticoagulation treatment forearly stage of deep vein thrombosis of lower extremity.Methods:The clinical data of 10 patients at the early stage of deep vein thrombosis(DVT)in the lower extremuites treated by thrombolysis with anticoagulation and dispersion drugs were analyzed retrospectively.Results:The thrombolytic effect was significant.After treatment,the deep veins were recanalized without regurgitation in 75.3% of the patients.The total effective rate was 100%.Only three patients had hemorrhagic complication,but none of the patients died.Conclusion:Thrombolysis with anticoagulation treatment is an effective and safe method for DVT at the early stage.     

小儿骶管麻醉中不同镇静方法镇静效果的研究

目的　评价不同镇静方法在小儿骶管麻醉术中镇静的优缺点 ,从而找到一种较为理想的镇静方法。方法　选择 45例ASAⅠ～Ⅱ级在骶管麻醉下行择期下腹部、会阴短小手术的患儿 ,体重 9～ 2 4kg。随机分为氟芬合剂对照组 (I)组、咪唑安定 (M )组和异丙酚 (P)组 ,每组 15例。I组 :氟芬合剂 (芬太尼 2 μg/kg) ;M组 :静脉泵注咪唑安定 1.5～ 2 .0 μg/kg·min ;P组 :静脉泵注异丙酚 2 5～ 75 μg/kg·min。每组患儿术中镇静评分在 2～ 4分。 结果　I组镇静效果比M组和P组差 (P <0 .0 5 ) ,呼吸抑制和术后躁动发生率较高。清醒时间I组比M组和P组延长 ,M组比P组延长 (P <0 .0 5 )。结论　持续静脉泵注异丙酚或咪唑安定是小儿骶管麻醉术中较为理想的镇静方法。     

一种稳定的急性胰腺炎胰腺外多器官损伤大鼠模型

目的研究一种病理进程平稳的急性胰腺炎胰腺外多器官损伤动物模型.方法应用小剂量中等浓度胆盐、胰管内低压注射的方法,动态观察实验大鼠胰腺、肺、肝脏及肾脏的功能和病理改变.结果这种新的急性坏死性胰腺炎大鼠模型具有胰腺外持续、稳定的肝、肾损伤.结论这种急性坏死性胰腺炎大鼠模型适合于多器官功能损伤的病理机制及治疗学研究.     

Alpha-smooth muscle actin in pathological human disc nucleus pulposus cells in vivo and in vitro

That a contractile actin isoform has been found in cells of other cartilage tissues in healing and disease states prompted this investigation of the presence of alpha-smooth muscle actin (alpha-SMA) in pathological human intervertebral disc tissue. The presence of this isoform has been reported in human intervertebral disc specimens obtained at autopsy from subjects for whom there were no reported symptoms. An objective of this study was to evaluate the cell density and percentage of alpha-SMA-containing cells in pathological nucleus pulposus tissue obtained from lumbar disc surgery from 17 patients. Additionally, explants of nucleus pulposus material were cultured to determine how alpha-SMA expression changed with time in vitro. Seventy-six 5-mm diameter explants (approximately 2 mm thick) pooled from six lumbar surgeries were cultured for 1, 2, 4, or 6 weeks. Microtomed sections of paraffin-embedded specimens were stained with hematoxylin and eosin or a monoclonal antibody to alpha-SMA. Histologically, cells were categorized as to alpha-SMA phenotype (positive or negative), and the areal cell density was determined. The evaluation of the cultured nucleus pulposus explants also included documentation of the percentage of cells that were round or elongated and the percentage of the cells that were part of a group (group: >/= 2 cells). Every nucleus pulposus section exhibited the presence of alpha-SMA-containing cells, which accounted for approximately 24 percent of the cells in vivo. In vivo, the cell density was significantly higher in older individuals (p = 0.02). The average time for cell outgrowth from the explants was 8.6 days. Approximately 10-15 percent of the cells in the explants stained positive for alpha-SMA. The time in culture had no significant effect on any of the outcome measures except the percentage of alpha-SMA-containing cells that were round (p = 0.008), with values decreasing through 4 weeks and then slightly rising at 6 weeks. The role of alpha-SMA in intervertebral disc pathology warrants further investigation.     

精索扭转误诊24例分析

目的：分析精索扭转误诊的原因及教训，提高临床医生对该病的认识水平与警惕性，以减少误诊的发生。方法：对24例外院误诊的精索扭转病例进行回顾性分析。结果：24例患者均经手术证实为精索扭转，因未能及时诊断，延误时机而切除缺血坏死的睾丸。结论：彩色多普勒血流动态显像应作为诊断该疾病的常规与首选检查方法，对精索扭转一旦确诊或疑有精索扭转的患者应及早行紧急复位，以期挽救睾丸。同时行睾丸固定术也十分必要，对于确诊毫无保留价值的睾丸需行切除。     

医疗设备投资决策的敏感性分析研究

不恰当的医疗设备投资对医院及患者的利益均会造成损失，因此，在投资决策前进行严谨科学地可行性评估十分必要。通过对净现值的敏感性分析，医院的决策者可以了解各种不确定因素对投资方案经济效果的影响程度，以及投资方案对外部条件变化的承受能力，从而掌握风险条件下正确的决策原则和决策方法。     

膝关节镜手术并发症临床分析

1997年1月～2005年12月，我院对324例膝关节疾病患者行关节镜手术治疗，其中23例出现各种并发症。笔者总结分析其产生原因并提出防治措施。     

散发型Creutzfeldt-Jakob病的MRI表现

目的探讨散发型Creutzfeldt-Jakob病（sCJD）的MR特点。方法回顾性分析3例临床诊断为sCJD的患者资料，MR采用SE T1 WI、快速自旋回波（FSE）T2 WI、扩散加权成像（DWI）扫描，观察其MR表现特征。结果3例SE TI WI和FSE T2 WI序列对基底节区和皮质的病变显示不佳，DWI则可清晰地显示病变，额、顶、枕叶皮质最常受累，表现为高信号，病变可对称，也可不对称，皮层下区脑白质信号未见异常。双侧尾状核、丘脑也可受累，DWI上呈高信号。晚期脑实质广泛萎缩，以皮质为著。结论sCJD采用DWI序列结合其特征性的临床表现可作出较为准确的诊断。     

中切口切开法重睑成形术

目的介绍一种简便有效,恢复快的中切口重睑成形术.详细阐述该方法的手术要点,重睑成形术所遵循的原则等.方法术前灵活定位,局部麻醉下做长15 mm的小切口,去除切口内部分眼轮匝肌及睑板前脂肪,将上睑皮肤与睑板固定.结果采用中切口切开法重睑成形术180例,效果满意.结论中切口重睑成形术创伤小,恢复快,是一种简便有效的方法.术中应严格遵循无创操作,宁窄勿宽,对过度依赖额肌的患者,手术前后进行睁眼训练.     

改良Maquet三联手术治疗复发性髌骨脱位12例初步报告

[目的]探讨膝关节镜下髌骨支持带调整和胫骨结节内移抬高(改良Maquet术)三联手术治疗复发性脱位的疗效。[方法]对2004年以来12例复发性髌骨脱位行膝关节镜探查外侧支持带松解,内侧支持带紧缩,胫骨结节内移抬高三联手术。术后随访平均16.5个月(10~25个月)。[结果]Q角术前(20.8±4.5)°,术后(10.2±2.1)°(P<0.01),Lysholm膝关节评分(Lysholm knee score scale,LKSS)术前(51.8±7.3)分,术后(93.4±3.4)分(P<0.01),髌股关节关系改善,无脱位发生。[结论]本手术方法具有创伤小,并发症少,功能恢复好,疗效确切的优点。