基于文献挖掘技术的海洋中药药对“石决明-牡蛎”应用规律及作用机制

目的：对石决明-牡蛎的临床应用热点、发展趋势、配伍特点、应用规律及组方作用机制进行分析,为该药对临床用药及深入研究提供参考。方法：基于中国知网等多种现代文献数据库,检索含有石决明-牡蛎药对临床应用热点及现代临床处方,对药对临床应用热点及发展趋势利用Citespace进行可视化分析,对处方的药物组成、功效主治、药物剂量等进行统计,运用SPSS Modeler 18.0等多种统计软件对石决明-牡蛎药对主治病症及配伍用药规律进行分析。结果：可视化分析中共纳入90篇文献,该领域近几年发文逐渐下降,其中临床应用热点关键词为高血压、络虚生风、失眠等。临床处方共检索到80首,涉及121味中药,配伍用药频次分析表明应用频率前10位的药物分别是钩藤、天麻、龙骨、牛膝、白芍、菊花、黄芩、栀子、甘草、首乌藤。关联规则分析表明核心配伍主要有“钩藤-牛膝”“龙骨-地龙-川芎”等,并结合因子可靠性分析,得到的新药物组合为“天麻-首乌藤-杜仲-桑寄生-益母草”“牛膝-钩藤”“黄芩-甘草-珍珠-夏枯草”“龙骨-地龙-僵蚕”“菊花-川芎”“茯苓-石菖蒲”“白芍-栀子-茯神”。石决明-牡蛎药对配伍主要用于治疗肝阳上亢型的...     

Pneumatization of the inferior turbinate

Pneumatization of the inferior turbinate is an extremely rare intranasal anatomical variation. Only a few cases have been reported yet. In this paper we present two cases, one unilateral and one bilateral case with pneumatization of the inferior turbinate.     

桂枝加龙骨牡蛎汤加减联合弱激光血管外照射治疗室性早搏66例

目的:观察桂枝加龙骨牡蛎汤加减治疗室性早搏的临床疗效。方法:选择室性早搏(气血两虚型)患者132例,随机平行分为对照组与治疗组各66例,对照组予酒石酸美托洛尔片治疗,治疗组在对照组治疗的基础上予桂枝加龙骨牡蛎汤加减联合弱激光血管外照射治疗,观察两组患者治疗前后的中医证候积分、24小时总心搏数和早搏总次数、焦虑自评量表(self-rating anxiety scale,SAS)评分及抑郁自评量表(self-rating depression scale,SDS)评分、血液流变学指标等,比较两组患者临床疗效。结果:对照组有效率为72.72%,治疗组有效率为89.40%,两组有效率比较,差异有统计学意义(P<0.05)。两组患者治疗后,中医证候积分、24小时总心搏数和早搏总次数均较治疗前明显减少,差异有统计学意义(P<0.05);组间比较,差异有统计学意义(P<0.05)。两组患者治疗后,血流动力学指标中全血比黏度高切、全血比黏度低切、血浆比黏度、血小板聚焦率、纤维蛋白原、红细胞沉降率均较治疗前降低,差异有统计学意义(P<0.05);组间比较,差异有统计学意义(P<0.05)。两组患者治疗后,SAS评分和SDS评分均较治疗前明显降低,差异有统计学意义(P<0.05);组间比较,差异有统计学意义(P<0.05)。两组患者在治疗期间均未出现明显药物不良反应及并发症。结论:桂枝加龙骨牡蛎汤加减联合弱激光治疗气血两虚型室性早搏,可有效改善临床症状,减少早搏次数,改善血流动力学指标,缓解患者焦虑及抑郁情绪,且无明显不良反应。     

Effects of turbinoplasty versus outfracture and bipolar cautery on the compensatory inferior turbinate hypertrophy in septoplasty patients

IntroductionThe most common cause of septoplasty failure is inferior turbinate hypertrophy that is not treated properly. Several techniques have been described to date: total or partial turbinectomy, submucosal resection (surgical or with a microdebrider), with turbinate outfracture being some of those.ObjectiveIn this study, we compared the pre- and postoperative lower turbinate volumes using computed tomography in patients who had undergone septoplasty and compensatory lower turbinate turbinoplasty with those treated with outfracture and bipolar cauterization.MethodsThis retrospective study enrolled 66 patients (37 men, 29 women) who were admitted to our otorhinolaryngology clinic between 2010 and 2017 because of nasal obstruction and who were operated on for nasal septum deviation. The patients who underwent turbinoplasty due to compensatory lower turbinate hypertrophy were the turbinoplasty group; Outfracture and bipolar cauterization were separated as the out fracture group. Compensatory lower turbinate volumes of all patients participating in the study (mean age 34.0 ± 12.4 years, range 17–61 years) were assessed by preoperative and postoperative 2 month coronal and axial plane paranasal computed tomography.ResultsThe transverse and longitudinal dimensions of the postoperative turbinoplasty group were significantly lower than those of the out-fracture group (p = 0.004). In both groups the lower turbinate volumes were significantly decreased (p = 0.002, p < 0.001 in order). The postoperative volume of the turbinate on the deviated side of the patients was significantly increased: tubinoplasty group (p = 0.033).ConclusionBoth turbinoplasty and outfracture are effective volume-reduction techniques. However, the turbinoplasty method results in more reduction of the lower turbinate volume than outfracture and bipolar cauterization.     

Assessing the efficacy of a modified crushing technique for the management of concha bullosa: a cone beam computer tomography study

IntroductionAlthough many surgical techniques exist to manage obstructive concha bullosa, there continues to be a drive to find the least invasive technique with the fewest complications and best results.ObjectivesThe purpose of this study is to describe and assess the short- and long-term efficacy of a modified crushing technique for concha bullosa management.MethodsPatients who met inclusion criteria underwent a detailed nasal examination and cone beam computed tomography imaging prior to and after septoplasty with crushing surgery for obstructive concha bullosa. Patients were divided into short- and long-term groups based on their followup period such that the short-term group had a mean followup of 15.14 months (range 6–22 months) and the long-term group had a mean followup of 56.66 (range 29–80) months.ResultsTwenty-four cases of obstructive concha bullosa were included in this study with 13 short-term and 11 long-term follow-ups. All patients showed a significantly decreased postoperative CB size (p < 0.001). There was no correlation between age and postoperative CB change in area (p = 0.39) and no significant difference in the amount of postoperative CB area reduction between the short-term and long-term groups (p = 0.35). No patients experienced bleeding, synechia, conchal destruction, or olfactory dysfunction on followup evaluations.ConclusionsOur modified crushing technique is a simple, effective, and lasting treatment option for concha bullosa. From our experience, there have been no complications and no instances of concha bullosa reformation during the follow-up period.     

Reconstruction of the inner site of the auricle with two local skin flaps

The external auditory canal and the auricular concha were reconstructed with two local skin flaps after resection of a primary adenoid cystic carcinoma of the external auditory canal. The upper part of the inner site of the auricle was covered with a superiorly-based posterior skin flap and the lower part of it with an inferiorly-based anterior one. Both were cutaneous flaps with a random pattern of blood supply. At the same time the surgical field after the flaps had been raised made additional excision easy, including partial mastoidectomy and parotidectomy. After 10 years of the operation auricular disfigurements and recurrence of the tumour are not observed.     

耳后“旋转门”岛状皮瓣在Ⅰ期修复耳甲缺损中的应用

目的 探讨耳后“旋转门”岛状皮瓣Ⅰ期修复耳甲内皮肤组织缺损的方法及疗效.方法 利用耳后“旋转门”中央蒂岛状皮瓣Ⅰ期修复耳甲内组织缺损,最小面积为1.0 cm×1.3 cm,最大面积为2.7cm×3.0 cm.结果 15例术后岛状皮瓣均存活良好,经6个月至5年随访,耳廓外形均较满意.结论 耳后“旋转门”岛状皮瓣血供可靠,形态、色泽、质地与周围正常组织一致,供瓣区隐蔽,是修复耳甲软组织缺损修复的最佳术式之一.     

大块耳轮缺损Ⅰ期修复方法的改进

目的介绍大块耳轮缺损Ⅰ期修复技术。方法应用陈氏对外伤性耳廓部分缺损修复术式，并改进设计以耳廓缺损前缘为蒂的耳后乳突区皮瓣，携带耳甲后软骨块，或以缺损缘一端为蒂，切取一条正常软骨宽０．３～０．４ｃｍ，固定支撑，皮瓣包卷覆盖塑形。供区两个Ｖ－Ｙ滑行推进皮瓣或断层皮片移植修复。结果完成手术１１例，均获成功，耳廓总体不减小，形态恢复较满意。结论此方法为修复大块耳廓缺损提供了简便、安全可靠的一种新方法。