高度近视白内障超声乳化术69例临床分析

目的　通过对高度近视白内障超声乳化摘除及人工晶体植入术的临床总结 ,分析高度近视白内障超声乳化术后视力的影响因素。方法　对 6 9例 (93眼 )眼轴 >2 6mm的高度近视并发白内障患者施行角膜内隧道切口超声乳化摘除及人工晶体植入术。结果　术后 1个月裸眼视力≥ 0 4者 5 5只眼 (5 9 14 % ) ,矫正视力≥ 0 4者 6 7只眼 (72 0 4 % )。结论　高度近视并发白内障行超声乳化摘除及人工晶体植入 ,能够有效提高患者视力 ,手术安全 ,疗效可靠     

超声弹性成像与BI-RADS-US诊断不同类型乳腺肿物的应用价值

目的 探讨超声弹性成像(UE)与BI-RADS-US分类在乳腺肿块诊断中的应用价值.方法 选取2014年7月至2016年7月在海口市中医院就诊的乳腺肿块患者89例,共计134个病灶,均进行二维超声及弹性成像检查,分别行BI-RADS-US分类、UE评分及面积比诊断.结果 89例134个乳腺肿块中,良性41例62个肿块,恶性48例72个肿块;BI-RADS-US分级诊断恶性乳腺肿块的灵敏度为84.72%,特异度为74.19%,准确性为79.85%;UE评分诊断恶性乳腺肿块的灵敏度为86.11%,特异度为87.10%,准确性为86.57%;恶性病灶面积比值为(1.68±0.54),明显高于良性病灶(P<0.05),UE面积比值ROC曲线下面积为0.832(P<0.05),面积比值1.30为最佳诊断界点.灵敏度为81.94%,特异度为70.97%,准确性为76.87%.结论 BI-RADS-US、UE评分及面积比值诊断乳腺肿块良恶性有较好的应用价值,在临床实践中可作为重要的参考指标.     

Comparison between Glidescope,Airtraq and Macintosh laryngoscopy for emergency endotracheal intubation in intensive care unit: Randomized controlled trial

Background

Emergency endotracheal intubation in intensive care is a major challenge that can be associated with life-threatening complications. The aim of this study was to evaluate the success of the first attempt of endotracheal intubation and incidence of complications using Macintosh laryngoscopy, Airtraq or Glidescope during emergency intubation in intensive care.

Virtual Reality for Upper Limb Rehabilitation in Subacute and Chronic Stroke: A Randomized Controlled Trial

Objective

To evaluate the effectiveness of reinforced feedback in virtual environment (RFVE) treatment combined with conventional rehabilitation (CR) in comparison with CR alone, and to study whether changes are related to stroke etiology (ie, ischemic, hemorrhagic).

Agreement of Musculoskeletal Ultrasound and Clinical Assessment of Shoulder Impairment in Manual Wheelchair Users With Various Duration of Spinal Cord Injury

Objectives

To determine (1) agreement of musculoskeletal ultrasound (MSK-US) findings of shoulder pathology and related shoulder special test results in individuals with varied durations of manual wheelchair (MWC) use after spinal cord injury (SCI); and (2) whether shoulder musculoskeletal impairments, per MSK-US and clinical examination, differed in individuals with SCI and varying durations of MWC use.

A clinical assessment of the Glidescope videolaryngoscope in nasotracheal intubation with general anesthesia

STUDY OBJECTIVES: To evaluate the efficacy and safety of the Glidescope videolaryngoscope as a device to aid nasotracheal intubation, and to determine whether the GSVL provides a better laryngeal view in patients with difficult laryngoscopy compared with the Macintosh laryngoscope. DESIGN: Prospective, clinical study. SETTING: Two university hospitals. PATIENTS: 156 healthy adult ASA physical status I and II undergoing elective plastic and intraoral surgery with general anesthesia. INTERVENTIONS: After anesthesia induction with intravenous injection of fentanyl 2 microg/kg, propofol 2 mg/kg, and vecuronium 0.1 mg/kg, nasotracheal intubation was performed using GSVL. MEASUREMENTS: Preoperative airway measurements were taken to predict potential difficult airways. During nasotracheal intubation using GSVL, laryngeal views, times required for full visualization of glottis and successful intubation, difficulty encountered and auxiliary maneuvers adopted, and upper airway trauma were recorded. The laryngeal views obtained by GSVL and by Macintosh laryngoscope were compared. MAIN RESULTS: The laryngeal views obtained by GSVL in all patients were Cormack and Lehane (C&L) grades I and II, and the success rate of intubation using GSVL at one attempt was 98.1%. The times required for visualization of the glottis and successful intubation were 40.2 +/- 11.5 s and 52.7 +/- 12.3 seconds, respectively. Patients with C&L grade II needed more auxiliary maneuvers to achieve successful intubation than did those with C&L grade I (P < 0.001). In 36 patients with potential difficult airways, the frequency of difficult laryngoscopy (C&L grades III and IV) with the Macintosh laryngoscope (58.3%) was significantly higher than with the GSVL (0%, P < 0.05). The frequency of minor upper airway trauma was 4.5%. CONCLUSIONS: The GSVL is an effective device for nasotracheal intubation and may be incorporated easily into routine clinical practice. Compared with the Macintosh laryngoscope, the GSVL can provide an improved laryngeal view in the patient with difficult airway.     

董氏苏脾饮结合针刺四缝穴治疗小儿疳证(疳气型)67例

以董氏苏脾饮消补兼施结合针刺四缝穴治疗小儿疳证(疳气型)67例,观察治疗前后饮食情况、体格发育及其他伴随症状的变化,平均疗程4．48周。结果：治愈19例,好转44例,未愈4例,总有效率为94．1％。     

Crush syndrome in a Cornish tin miner

A miner buried by a fall of rock in a Cornish tin mine developed a severe crush syndrome. He survived after early amputation of a crushed leg, peritoneal haemodialysis and other treatment.