反复针刺分离联合结膜下注射5-FU治疗青光眼术后滤过泡功能不良

目的:评估以反复针刺分离联合结膜下注射5-FU的方法处理青光眼术后功能不良滤过泡的效果。方法:回顾性分析2009-03/2013-02在我院以反复针刺分离联合结膜下注射5-FU的方法处理因青光眼术后滤过泡功能不良而眼压升高的连续病例34例34眼。分析治疗后眼压、滤过泡形态的变化及眼部并发症。结果:治疗后平均眼压从35.51mmHg降至14.43mmHg(P<0.05),成功率达91%。常见并发症包括角膜上皮损伤、结膜撕裂和脉络膜脱离等。结论:反复针刺分离联合结膜下注射5-FU的方法处理青光眼术后滤过泡功能不良安全有效。     

医院数据库数据安全维护的分析及策略

本文根据多年从事医院管理信息系统和网络系统建设及维护工作的经验,对医院数据库系统数据安全维护方面进行分析并提出相应的安全防范策略。     

微波消融与腹腔镜肝切除术治疗肝血管瘤的临床疗效比较

目的:比较微波消融与腹腔镜肝切除术治疗肝血管瘤的临床疗效。方法:回顾分析2009年1月至2012年12月收治的101例肝血管瘤患者的临床资料,根据病灶位置按治疗方式分为微波消融组(n=78,其中局部麻醉B超引导下穿刺定位微波消融术51例,全麻后腹腔镜直视下微波消融术27例)与腹腔镜组(n=23),对比两组患者术中、术后及随访情况。结果:微波消融组与腹腔镜组术中出血量平均(21.0±8.2)ml与(330.0±217.5)ml,手术时间平均(37.2±12.8)min与(182.6±90.2)min,两组差异有统计学意义(t=12.67、13.93,P<0.05);平均输血率分别为0(0/78)与13%(3/23),差异有统计学意义(χ2=10.485,P<0.05);术后第1天,AST、ALT平均(341.0±74.5)U/L、(284.0±85.3)U/L与(276.0±102.3)U/L、(219.0±75.8)U/L;术后12 h、24 h、48 h疼痛评分两组相比差异有统计学意义(P<0.05);住院总费用平均(2.9±0.6)万元与(2.2±0.5)万元,差异有统计学意义(P<0.05)。术后第3天AST、ALT恢复、术后住院时间及并发症发生率差异无统计学意义(P>0.05)。随访1~2年,瘤体血供完全消失率为83.3%(65/78),腹腔镜组均未见复发。结论:微波消融与腹腔镜肝切除术治疗肝血管瘤均是安全、有效及微创的治疗方法,应根据患者全身状况、肿瘤大小与位置等因素综合考虑,以选择合理的手术方式。     

Please quote: Tian Y, Liu GE, Zhao WJ, Peng YY, Song SM, Li L. Review of Chinese Journal of Traumatology in the year 2018. Chin J Traumatol. 2019;22(1):21–23. doi:10.1016/j.cjtee.2019.01.001

Li Y, Li PY, Sun SJ, et al. Chinese Trauma Surgeon Association for management guidelines of vacuum sealing drainage application in abdominal surgeries-Update and systematic review. Chin J Traumatol. 2019;22(1):1–11. doi:10.1016/j.cjtee.2018.10.005     

新疆维吾尔自治区维吾尔族和哈萨克族及汉族女性胆囊结石的流行病学调查

背景　新疆维吾尔自治区胆囊结石患病率较高,我国女性胆囊结石患病率高于男性,但目前缺乏关于新疆维吾尔自治区女性胆囊结石患病率的研究。目的　了解新疆维吾尔自治区维吾尔族、哈萨克族、汉族女性胆囊结石患病率及其影响因素,为其胆囊结石预防及治疗提供依据。方法　2011年6—9月采用典型抽样再多阶段分层随机抽样的方法选取新疆维吾尔自治区女性居民为调查对象,采用统一自制且翻译成维吾尔文的调查问卷对其进行基本情况调查,同时对调查对象行肝脏和胆囊腹部超声检查。比较不同民族以及各民族不同初潮年龄、月经不调、生育数量、分娩年龄女性胆囊结石患病率,并采用多因素Logistic回归分析女性胆囊结石患病率的影响因素。结果　共发放问卷3 508份,有效问卷3 175份,有效回收率为90.5%。3 175例女性胆囊结石患病率为16.9%（535/3 175）,其中维吾尔族、哈萨克族、汉族女性胆囊结石患病率分别为24.0%（222/924）、10.8%（94/873）、15.9%（219/1 378）。3个民族间胆囊结石患病率比较,差异有统计学意义（χ2=57.913,P<0.001）。多因素Logistic回归分析结果显示,初潮年龄〔OR=1.167,95%CI（1.007,1.353）〕、月经不调〔OR=6.486,95%CI（4.636,9.532）〕、生育数量〔OR=1.355,95%CI（1.237,1.483）〕是维吾尔族女性胆囊结石的影响因素（P<0.05）;初潮年龄〔OR=1.296,95%CI（1.007,1.668）〕、生育数量〔OR=1.240,95%CI（1.022,1.504）〕是哈萨克族女性胆囊结石的影响因素（P<0.05）;生育数量〔OR=1.341,95%CI（1.214,1.482）〕、分娩年龄〔OR=0.942,95%CI（0.892,0.996）〕是汉族女性胆囊结石的影响因素（P<0.05）。结论　新疆维吾尔自治区女性胆囊结石患病率较高,其中维吾尔族女性胆囊结石患病率与初潮年龄、月经不调、生育数量有关;哈萨克族女性胆囊结石患病率主要与初潮年龄、生育数量有关;汉族女性胆囊结石患病率主要与生育数量、分娩年龄有关。因此临床工作中应重点关注初潮年龄延迟,生育数量多,分娩年龄小的女性,尤其是胆囊结石患病率较高的维吾尔族人群。     

微创内镜保胆取息肉术与腹腔镜胆囊切除术治疗胆囊息肉的对比研究

目的：比较内镜微创保胆取息肉术与腹腔镜胆囊切除术治疗胆囊息肉的临床疗效。 方法：将2009年2月—2012年4月收治的196例符合条件的胆囊息肉患者,根据患者意愿分为内镜微创保胆取息肉术组（保胆组,103例）和腹腔镜胆囊切除术组（胆囊切除组,93例）,比较两组术中及术后的情况。 结果：两组在年龄、性别、合并症上差异均无统计学意义（均P>0.05）,具有可比性。保胆组 2例因术中取息肉后胆囊壁出血明显,改行胆囊切除术。与胆囊切除组比较,保胆组平均手术时间、术中出血量减少[（50.3±12.9）min vs.（61.2±16.7）min;（10.2±2.7）mL vs.（15.1±3.9）mL];术后疼痛、消化道不良反应发生率减少、首次排气时间缩短[16.83% vs. 32.26%;18.81% vs. 3.33%;（18.5±4.1）h vs.（26.2±5.3）h];远期并发症发生率减少（10.89% vs. 22.58%）（均P<0.05）。 结论：内镜微创保胆取息肉术较腹腔镜胆囊切除术痛苦轻、康复快、手术并发症少,对符合适应症的患者是一种安全、有效的术式。     

Effects of low‐frequency pulsed electromagnetic fields on plateau frostbite healing in rats

Plateau frostbite (PF) treatments have remained a clinical challenge because this condition injures tissues in deep layers and affected tissues exhibit unique pathological characteristics. For instance, low‐frequency pulsed electromagnetic field (PEMF) can affect tissue restoration and penetrate tissues. Therefore, the effect of PEMF on PF healing should be investigated. This study aimed to evaluate the effects of low‐frequency PEMF on PF healing systematically. Ninety‐six Sprague‐Dawley rats were randomly and equally divided into three groups: normal control, partial thickness plateau frostbite (PTPF), and PTPF with low‐frequency PEMF exposure (PTPF + PEMF). PTPF wounds were induced in the dorsum of the rats. The PTPF + PEMF group was exposed to low‐frequency PEMF daily. During PF healing, wound microcirculation in each group was monitored through contrast ultrasonography. Wound appearance, histological observation, and wound tensile strength were also evaluated. Results showed that the rate of the microcirculation restoration of the PTPF + PEMF group was nearly 25% faster than that of the PTPF group, and wound appearance suggested that the healing of the PTPF group was slower than that of the PTPF + PEMF group. Histological observation revealed that PEMF accelerated the growth of different deep tissues, as confirmed by tensile strength examination. Low‐frequency PEMF could penetrate PF tissues, promote their restoration, and provide a beneficial effect on PF healing. Therefore, this technique may be a potential alternative to treat PF.     

康柏西普联合不同手术方式对新生血管性青光眼疗效观察

目的：探讨玻璃体腔注射康柏西普后对新生血管性青光眼(NVG)患者房水中VEGF、IL-6、IL-8的影响,并观察其联合不同手术方式对NVG患者的疗效。

方法：选择2019-01/2020-02在中国人民解放军新疆军区总医院全军眼科中心就诊的NVG患者102例,均玻璃体腔注射康柏西普,3～5d后行手术治疗,按照随机数字抽签法分为小梁切除术组(50例50眼)及EX-PRESS引流器植入术组(52例52眼),运用酶联免疫吸附法分析房水中VEGF、IL-6、IL-8的变化情况,观察虹膜新生血管消退情况,比较两组手术疗效及术后眼压变化、视力改善情况及并发症发生情况。

结果：玻璃体腔注射康柏西普3～5d后房水中VEGF、IL-6、IL-8表达水平较术前降低(均P<0.05); 术后随访各时间点两组眼压水平均显著低于术前(均P<0.05),两组患者眼压在术后3、6、12mo组间比较有差异(均P<0.05); 术后6、12mo时EX-PRESS组视力优于小梁切除术组(P<0.05); 术后12mo,两组使用抗青光眼药物种类及数量无明显差异(均P>0.05); 随访12mo,EX-PRESS组患者手术成功率(86.5%)优于小梁切除术组(70.0%),且EX-PRESS组术后并发症发生率显著低于小梁切除术组(P<0.05)。

结论：玻璃体腔注射康柏西普后可以降低NVG患者房水中VEGF、IL-6、IL-8等因子表达,同时小梁切除术与EX-PRESS引流器植入术均可降低NVG患者眼压,但后者手术并发症较少、改善视力方面更有优势。     

双源CT三低扫描技术在低BMI患者冠状动脉成像中的应用

目的:探讨双源CT三低扫描技术在低(体质指数)BMI患者冠状动脉成像中的应用。方法:随机选择2018年5月-2019年5月在我院接受双源CT三低扫描患者冠状动脉成像低BMI患者60例,以随机数字表法分为a、b、c三组,每组20例,分别采用120、100、80kV管电压成像,对比三组的有效辐射剂量和图像质量评分。结果:三组患者图像的优良率分别为94.12%、93.41%、95.45%,三组冠状动脉图像质量无明显差异(P<0.05);三组有效辐射量随着管电压的降低而降低(P<0.05)。结论:双源CT三低扫描技术中采用合理的管电压对低BMI患者冠状动脉成像中不仅可以保证图像质量,还可以显著降低患者的辐射量。     

Lipid accumulation product as useful predictors of stroke: A correlation analysis between lipid accumulation index/cerebral vascular hemodynamics indexes and risk factors of stroke in 3264 people undergoing physical examination in Xinjiang

Objective:To investigate the relationship between lipid accumulation index and cerebral hemodynamic integral value in 3264 people undergoing physical examination, so as to analyze the correlation between different lipid accumulation product index (LAP) levels and stroke risk factors.Methods:This cross-sectional study was conducted from January to December 2019 on 3264 adults at the age of 19 to 85 living in Urumqi, Xinjiang. The stroke related risk factors were evaluated by the questionnaire survey. The enrolled subjects were divided into Q1 group (n = 817), Q2 group (n = 815), Q3 group (n = 816) and Q4 group (n = 816) according to the quartile site at a low-to-high-score manner.Results:The proportion of males was significantly higher than that of females in Q2, Q3, and Q4 groups. The proportion of middle-aged people and the elderly in Q2, Q3, and Q4 groups was significantly higher than that of youths (P < .05). The proportion of patients with history of hypertension, hyperlipidemia, physical inactivity, and smoking, and the levels of systolic blood pressure, diastolic blood pressure, fasting blood glucose, total cholesterol, high-density cholesterol, low-density cholesterol, triglyceride, body mass index, waist circumference increased with the increase of LAP level in different groups (P < .05). On both sides of the cerebral hemodynamic integral value (CVHI) index, Vmean, Vmax, Vmin showed a decreasing trend whereas peripheral resistance, pulse velocity, Zcv, dynamic resistance, critical pressure level, difference between diastolic and critical pressure showed an increase trend with the increase of LAP level. The normal rate of CVHI in 4 groups (>75 points) was 97.4%, 89.7%, 87.0, and 80.8%, respectively, showing a decreasing trend. Logistic regression results showed that the higher the LAP, the higher the abnormal risk of CVHI.Conclusion:There is a positive correlation between LAP and CVHI, the higher the LAP, the higher the risk of CVHI abnormality, which should be concerned seriously.