Schistosomal myelitis: findings at MR imaging

Schistosomal spinal cord involvement is a rare complication of infection by Schistosoma mansoni. This work reports the MR imaging findings in a patient with schistosomal myelitis involving the lower spinal cord and conus medullaris. MR imaging showed a focal mass with a slightly nodular surface and which had peripheral enhancement after contrast administration. The MR appearance of this complication of schistosomal infection is important to recognize so that early medical therapy can be started in an attempt to maximize neurologic recovery.     

甲磺酸去铁胺抑制精索静脉曲张睾丸支持细胞模型铁死亡的研究

目的:探究甲磺酸去铁胺对精索静脉曲张睾丸支持细胞氧化应激模型的保护作用。方法:细胞实验选择小鼠睾丸支持细胞TM-4,设置对照组(A组)、甲磺酸去铁胺+对照组(B组)、氯化钴组(C组)、甲磺酸去铁胺+氯化钴组(D组)。C组和D组加入400 μmol/L氯化钴,随后培养细胞24 h构建精索静脉曲张氧化应激模型。B组和D组加...     

Endoscopic variceal ligation is superior to combined ligation and sclerotherapy for esophageal varices: A multicenter prospective randomized trial

Patients who have bled from varices remain at risk for rebleeding. There is interest in methods that would enable rapid eradication of varices. The present trial was designed to study whether combining ligation with sclerotherapy will allow quicker eradication of varices than either modality alone. Patients with bleeding esophageal varices were randomized into ligation or combination therapy groups. Patients in the ligation group were treated with endoscopic rubber band ligation alone. In combination group patients, each variceal column was ligated distally and 1 mL of ethanolamine was injected proximal to each ligated site. Subsequent treatment sessions were at 7- to 14-day intervals until varices were eradicated. The clinical and endoscopic characteristics of 25 patients in the ligation group were similar to those of 22 patients in the combination group. Follow-up was up to 30 months. Active bleeding was controlled in 100% of patients in the ligation group and 75% of those in combination group (P = NS). It took 3.3 +/- .4 (range, 1-7) sessions to eradicate varices with ligation and 4.1 +/- .6 (1-7) with combination therapy (P = NS). Survival (four deaths in ligation group, 8 in combination group), rebleeding rate (25% vs. 36%), and varix recurrence (16% vs. 23%) also were similar. There were more complications with combination therapy, including deep ulcers (65% vs. 20%; P < .05); dysphagia (30% vs. 0%; P < .05), with three strictures requiring dilation; and pain (30% vs. 10%; P = NS). Our results show that sclerotherapy combined with ligation offers no benefit over ligation alone. The higher complication rate with combination therapy does not warrant this approach.(Hepatology 1997 Jan;25(1):71-4)     

麦邦数据远程传输型血糖仪临床测量准确性的评价研究

目的 评价麦邦数据远程传输型血糖仪监测院外糖尿病患者血糖水平的准确性,为麦邦数据远程传输型血糖仪的临床使用提供数据参考。方法 应用等效性临床试验研究设计,按照纳入排除标准选取广州市天河区已诊断为糖尿病的患者,共计210例,采用麦邦数据远程传输型血糖仪和我院内分泌科所使用的美国雅培辅理善越佳型血糖仪,分别测量受试者指端血的血糖浓度,并与静脉血生化血糖值进行比较,分别计算两种血糖仪的测量结果与生化仪血糖值的相关系数和测量偏倚。上述的血糖检测控制在20 min内全部完成。结果 两种便携式血糖仪与全自动生化仪所测结果的相关系数分别为r=0.98、0.97,相关性均较好,且呈线性相关;两种血糖仪与生化仪测量值差值95%的置信区间均在标准等效区间（-0.83,0.83）mmol/L内,均满足临床等效性要求;麦邦数据远程传输型血糖仪95.28%的数据在临床可接受范围内,高于国家标准的要求,而雅培辅理善越佳型血糖仪低于此标准;各组检测结果之间差异虽无统计学意义（P＞0.05）,但两种血糖仪检测的结果均高于生化仪检测的结果。结论 通过等效性分析,麦邦数据远程传输型血糖仪可以用于临床血糖监测及个人血糖检测,但不能取代实验室血糖检测结果作为临床诊断标准;麦邦数据远程传输型血糖仪的数据传输功能,方便医生根据患者情况适时调整血糖控制方案,降低并发症的发生。     

远程自助监控和危急预警系统对老年慢性病的应用价值

随着社会老龄化和慢性疾病的发展,远程自助监控和危急预警逐渐成为一种新的医疗模式。远程自助监控系统可用于健康监测、疾病诊断、咨询、教育、老年慢性病管理、长期护理以及转诊和连续医疗,尤其可用于慢性心力衰竭和慢性糖尿病的治疗。危急预警可有效救治患者突发急性病,满足老年人护理需求并解决医疗资源配置不合理的问题。本文综述了远程自助监控和危急预警系统对老年人慢性病的应用价值。     

Effect of Gua Sha therapy on patients with diabetic peripheral neuropathy: A randomized controlled trial

ObjectiveTo examine the effect of Gua Sha therapy in the treatment of diabetic peripheral neuropathy (DNP).DesignAn open-label randomized controlled study was conducted with usual care as the control (60 subjects in Gua Sha group and 59 subjects in usual care group). Outcome measures included Toronto Clinical Scoring System (TCSS), Vibration Perception Threshold (VPT), Ankle Brachial Index (ABI), and fasting plasma glucose (FPG). There were 12 consecutive sessions of Gua Sha, one session per week.ResultsAfter the first cycle of Gua Sha intervention, only performance of sensory function measured by the VPT, and peripheral artery disease symptoms by the ABI were statistically significant differences between the two groups (both P values < 0.01), and the total TCSS score and the FPG level were no group differences (P = 0.14, and 0.25, respectively). At the eight-week and 12-week post intervention assessment, Gua Sha therapy significantly reduced severity of neuropathy symptoms, improved performance of sensory function, reduced peripheral artery disease, and better controlled plasma glucose by comparing with the control group (all P values < 0.01). The changes of mean scores of TCSS, VPT, ABI and the plasma glucose levels in the Gua Sha group showed a significant change from baseline to week 12, indicating that Gua Sha therapy induced progressive improvement in the management of DPN symptoms, sensory function, peripheral artery disease and glucose levels. No serious adverse events were reported in either arm. Gua Sha therapy in this study was effective, safe and well tolerated by patients.ConclusionGua Sha therapy appears to be effective at reducing the severity of DPN in a clinically relevant dimension, and at improving other health outcomes in patients with DPN. While this study found that Gua Sha therapy is a promising treatment in reducing the symptoms of patients with DPN, further, larger sample studies are required to confirm the effects of Gua Sha therapy in patients with DPN.     

改良Kocher-Langenbeck入路治疗髋臼后壁骨折临床观察

目的旨在探讨改良Kocher-Langenbeck入路对于髋臼后壁骨折的治疗效果。方法回顾性分析2006年7月至2009年2月通过改良入路治疗的12例髋臼后壁骨折患者,依据Matta制定的标准,术后3个月的X线片上对骨折的残余移位进行测量以评估骨折复位情况,以及Merled＇Aubigne及Postel评分系统对随访时的临床效果进行评估,并注意观察并发症的情况。结果随访2~5年,平均为3.1年,依据Matta制定的X线分级标准,优良11例（91.7%）,可1例（8.3%）。根据Merled＇Aubigne及Postel评分系统对临床效果进行评估,优（18分）9例（75%）,良（15~17分）2例（16.7%）,可（12~14分）1例（8.3%）。患者均无术后神经功能损害,1例术前有神经功能损害的患者在术后得以改善。所有患者均未出现深部感染,内固定物松动,复发性脱位,肺栓塞以及固定手术翻修等情况,也无股骨头缺血性坏死患者。结论该入路对单纯、移位性、非粉碎性髋臼后壁骨折,手术时间较短,可防止股骨头血供的进一步损害和骨化性肌炎的发生,不失为较好的一种手术入路选择。     

新型人工髓核置换对邻近上节段三维运动与椎间盘内压影响的实验研究

目的评价果胶/聚乙烯醇复合水凝胶人工髓核植入对腰椎稳定性的影响;并通过与腰椎前路融合比较,探讨其对邻近节段运动范围和椎间盘内压的影响。方法采用6具新鲜人体腰椎标本(L3～L5)在机器人脊柱测试机上进行生物力学测试。观察正常椎间盘、CoPP人工髓核置换和腰椎前路cage植入3种状态下L4/5和L3/4的运动范围以及L3/4椎间盘内压的变化情况。结果在L4/5手术节段,CoPP组与完整椎间盘组的角位移除左侧屈运动方向差异有显著性外(P<0.05),其他方向两者之间差异均无显著性(P>0.05)。而cage组与完整椎间盘组或CoPP组之间,在所有的运动方向均有显著性差异(P<0.05)。而在相邻上节段L3/4,CoPP组与完整椎间盘组的运动范围除左侧屈运动方向差异有显著性外(P<0.05),其他方向两者之间差异均无显著性(P>0.05)。而cage组与完整椎间盘组或CoPP组之间,在所有的运动方向,L3/4运动范围的差异均有显著性(P<0.05)。CoPP组与完整椎间盘组的椎间盘内压在所有的运动方向两者之间的差异无显著性(P>0.05),而cage组与完整椎间盘组或CoPP组的椎间盘内压在前屈后伸及左右侧屈运动方向两者之间差异有显著性(P<0.05),而在轴向旋转方向,两者之间差异无显著性(P>0.05)。结论 CoPP人工髓核植入能保留手术节段的运动功能,稳定脊柱;相对腰椎融合手术,CoPP对相邻节段运动范围和椎间盘内压无明显影响,从而可降低或避免相邻节段退变的发生率。     

初发和复发翼状胬肉成纤维细胞分泌基质金属蛋白酶的比较及汉防己甲素对其的影响

目的检测培养的初、复发翼状胬肉成纤维细胞分泌基质金属蛋白酶(matrix metalloproteinases,MMPs)的情况,并作为观察指标了解汉防己甲素(tetrandrine,Tet)对其的抑制作用。方法相同的条件下培养初、复发翼状胬肉与正常球结膜成纤维细胞,酶联免疫吸附试验检测培养的细胞上清液中MMP-1、MMP-3、MMP-9的含量,同时应用10-5mol·L-1Tet作用于培养的初、复发翼状胬肉成纤维细胞,48h后分析培养液中上述MMPs含量的变化。结果培养的初、复发翼状胬肉成纤维细胞上清中MMP-1含量均较正常球结膜高(均为P<0.05),加入10-5mol·L-1Tet后均明显下降(均为P<0.05),但初发翼状胬肉上清中MMP-1含量仍高于正常球结膜(P<0.05),而复发翼状胬肉上清中MMP-1含量与正常球结膜相比差异无统计学意义(P>0.05);初发翼状胬肉上清中MMP-1含量明显高于复发翼状胬肉,加入Tet后仍较复发翼状胬肉高(均为P<0.05)。培养的初发翼状胬肉成纤维细胞上清中MMP-3含量较正常球结膜高(P<0.05),加入10-5mol·L-1Tet后明显下降(P<0.05),但仍高于正常球结膜(P<0.05);复发翼状胬肉上清中MMP-3含量低于正常球结膜(P<0.05)。培养的初、复发翼状胬肉和正常球结膜成纤维细胞上清中均未检测到MMP-9。结论初、复发翼状胬肉成纤维细胞MMP-1、MMP-3的分泌有明显的差异,Tet对初、复发翼状胬肉成纤维细胞MMP-1及初发翼状胬肉MMP-3的分泌有明显的抑制作用。