新肩三针穴位注射为主治疗肩手综合征的临床研究

目的评价新肩三针穴位注射治疗脑卒中后肩手综合征的临床疗效。方法采用随机对照的方法,将72例符合纳入标准的患者分为治疗组(针刺 新肩三针穴位注射)和对照组(单纯用针刺)。用脑卒中临床神经功能缺损程度评分量表,肩关节疾患治疗成绩判定标准和手掌手指功能评价进行临床疗效评定。结果治疗组疗效明显优于对照组,差异有统计学意义(P<0.05)。结论新肩三针穴位注射是治疗脑卒中后肩手综合征的有效治疗方法。     

不同频率电刺激对神经痛的干预作用

神经痛是由周围神经病变引起并放射至该神经支配范围内的疼痛，其临床症状重，持续时间长，治疗困难。本文总结近年来应用疏波、密波与疏密波电针和经皮电刺激于神经痛治疗的临床研究，结合相关实验对电针频率与补泻的关系研究，探索针灸治疗神经痛的可能应用前景。     

A prospective analysis of 1400 pulmonary artery catheterizations in patients undergoing cardiac surgery

During 1983 and 1984, 1305 patients underwent 1,400 pulmonary artery (PA) catheterizations. Successful placement was achieved in 1397 (99.6%) of 1,403 attempts. The catheters were inserted via the right internal jugular vein on 1364 occasions. The median duration of monitoring was 28 h with a range from 3 to 220 h. Central venous puncture complications included carotid artery puncture in 67 instances (4.8%) and pneumothorax in one patient. Insertion of the catheters was associated with supraventricular arrhythmias on 11 occasions, ventricular arrhythmias on 930 (66.4%), right bundle branch block on two and a total heart block on one occasion. Eighteen (2.3%) of the 794 cultured catheter tips were positive. An in situ time of more than 72 h was associated with a significantly higher percentage (7.2%) of positive tip cultures compared with an in situ time of less than 72 h (P less than 0.01). Repeated PA catheterization was not associated with significantly more complications than the initial catheterization. The results show that monitoring with a PA catheter in cardiac surgical patients is associated with a low incidence of morbidity.     

喉罩全麻在颈动脉狭窄造影及介入治疗术中的应用

目的：观察喉罩全麻下行颈动脉狭窄的造影诊断及介入治疗术的临床效果。方法：择期DSA下颈动脉狭窄患者23例，年龄42-78岁，无明显肺部疾患及喉罩禁忌症患者，异丙酚（Pmpofol）泵入静脉全麻下插入喉罩完成手术，观察其不同时段的BP（MAP）、SpO2、HR、ECG（ST-Ⅱ）。结果：各时段的BP（MAP）、Sp02、HR、ECG（ST-Ⅱ）比较无显著性差异。结论：喉罩全麻在行颈动脉狭窄的造影诊断及介入治疗术的临床效果是肯定的。喉罩全麻颈动脉狭窄造影介入治疗     

Spigelian hernias: a prospective analysis of baseline parameters and surgical outcome of 34 consecutive patients

Most of the papers published on spigelian hernia are either case reports or small retrospective series. In this prospective multicenter study, we aimed to outline the specific features of spigelian hernias and patients’ characteristics more clearly. Surgeons enrolled patients to be entered into the database as they diagnosed and treated the hernias at will. The baseline and surgical outcome parameters were noted in each patient. A painful mass was the main presenting complaint in half of 34 patients. Accurate preoperative diagnosis was possible in 31 patients. Open intraperitoneal mesh repair was the preferred technique. The mean hospital stay and time until return to normal daily activities were 4.1 and 15.6 days. Although a rare condition, diagnosis of a spigelian hernia is not difficult once remembered. Its surgical repair seems to cause few complications and is very well tolerated by the patient.     

吸入麻醉药作用机制的5埃理论

在过去的20多年中，对吸入麻醉药作用机制的合理解释大量增多，同时也提出了更多目前还不能回答的问题。Eger等提出了吸入麻醉药产生对伤害性刺激无体动反应的作用靶位可能是两个相距5埃的位点的假设，简称5埃理论。现就相关问题作一综述。     

硬膜外穿刺针外套管在腹腔镜小儿斜疝高位结扎术中的应用

目的探讨硬膜外穿刺针外套管在腹腔镜小儿斜疝疝囊高位结扎中的应用价值。方法2003年4月-2006年5月,我院对230例小儿斜疝手术应用硬膜外穿刺针外套管代替雪橇钩针实施腹腔镜疝内环口荷包高位结扎术。结果230例手术均获得成功,手术时间：单侧161例8-10 min,嵌顿疝39例15-20 min,双侧30例16-20 min;术后未见有阴囊水肿及睾血疼痛及缺血坏死。术后随访2-6个月111例,6-12个月52例,12-24个月37例,24-36个月30例,无复发。结论硬膜外刺针外套管可替代小儿疝囊结扎专用的雪橇钩针,简便,经济,适合在所有基层医院推广。     

瑞芬太尼对老年患者麻醉诱导时血流动力学的影响

［摘要］目的观察瑞芬太尼全麻诱导对老年患者血流动力学的影响。方法60例ASAⅠ～Ⅱ级老年患者随机分成3组，F组、R1组和R2组，每组20例。F组静脉诱导用药：咪达唑仑0.05 mg·kg-1，芬太尼3 μg·kg-1，丙泊酚1 mg·kg-1，待入睡后注入维库溴铵0.1 mg·kg-1气管插管；R1组用瑞芬太尼1 μg·kg-1代替芬太尼；R2组用瑞芬太尼1.5 μg·kg-1代替芬太尼。观察诱导时血压、心率的变化，同时记录使用阿托品和麻黄碱情况。结果R2组最低血压（MAP1 ）、最高血压（MAP2）明显低于其他两组(P＜0.05＝； R2组 最低心率（HR1）、最高心率（HR2）明显低于F组(P＜0.05＝。结论瑞芬太尼可以用于老年患者的全麻诱导，但在诱导时要密切注意血流动力学变化。     

针刺推拿中药综合治疗颈性眩晕疗效观察

目的观察针刺推拿中药综合治疗颈性眩晕的疗效。方法设综合组80例、电针组42例、推拿组68例和中药组36例,进行疗效比较分析。结果综合组有效率为93.8%,电针组有效率为73.8%,推拿组有效率为86.8%,中药组有效率为69.4%,综合组有效率与其他几组比较差异均有统计学意义（P〈0.05）。结论采用电针、推拿、中药相结合的综合疗法治疗颈性眩晕集诸单一疗法之精华,避免单一疗法的局限性,可提高有效率。     

不同针刺深度对前列腺增生症大鼠重量指数的影响及形态学观察

目的与方法 采用深刺和浅刺对丙酸睾酮所致前列增生症（BPH）大鼠模型进行干预，研究其作用殊同。结果 针刺组前列腺，膀胱指数明显小于模型组；形态学观察，针刺组较模型组增生明显减轻，腺上皮呈单层柱状，腺体数目明显减少，间质充血，钙化明显减轻，结缔组织无增生，腺腔内分泌物减少。深刺组好于浅刺组。结论 深刺对实验性BPH大鼠的干预作用好于浅刺方法。