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51.
Levente Gáspár Zoltán Jónás László Kiss György Vereb Zoltán Csernátony 《European journal of orthopaedic surgery & traumatology : orthopedie traumatologie》2009,19(6):403-407
Background Coccygodynia can cause severe pain and disability in patients. There are contradictions in the literature regarding the final
results of coccygectomy for coccygodynia. We evaluated the long-term effects of coccygectomy on the intensity, characteristics,
and manifestation of pain caused by coccygodynia to determine the adequacy of operation among treatment modalities.
Materials and methods Thirty-four patients with coccygodynia were treated by coccygectomy. In 22 cases, trauma, and in one case childbirth was the
cause. 11 cases were regarded as idiopathic. The intensity, characteristics of pain, and the most painful activities were
evaluated at an average of 7.6 (3–18) years of follow-up time.
Results Before the operation, all 34 patients had pain while sitting, moreover, 26 of them had pain during standing, walking, at night
or a combination of these. 21 patients had intolerable or very intensive, mainly acute, sharp or burning pain. 11 patients
had dyschesia, 2 had dysuria and 6 had dyspareunia. At follow-up, 7 patients were completely free of pain, 15 others had moderate,
11 medium, and only one patient had severe, but none had intolerable pain. Only seven patients had acute, sharp or burning
pain postoperatively. The decrease of average pain score from 8.0 to 3.2 was significant (P < 10−12). The number of the patients with dyschesia and dyspareunia decreased from 11 to 7 and from 6 to 3, respectively. Two patients
had dysuria, but their complaints did not change after the operation. One of the two patients who needed reoperation had an
excellent final result, while the other remained unchanged. 12 and 16 patients (together 82%) regarded the final result of
the operation excellent and good, respectively. The condition of five others did not change, while one became worse. The patients
with younger age, smaller body mass index, and less co-morbidities had better final result. There were no serious complications.
Conclusion Coccygectomy for coccygodynia is a safe method to decrease the intensity of pain and other complaints of the patients. The
operation can be the choice of treatment if conservative measures fail. 相似文献
52.
目的评价早期胃癌不同扩大手术的实际意义,以选择合理的胃切除和淋巴结清除范围。方法以临床病理资料完整、施行规范D2及扩大手术的217例早期胃癌患者为研究对象。分析施行不同扩大手术的原因、淋巴结清除的必要性及第Ⅱ站淋巴结转移与临床病理因素的相关性。结果胃上部癌行全胃切除术6例,No.5、6淋巴结均未见转移;联合脾、脾动脉切除2例,No.10、11p、11d淋巴结均未见转移;胃下部癌联合横结肠系膜切除3例,No.15淋巴结未见转移。以上病例术中多数误认为进展期胃癌而扩大了胃切除或淋巴结清除范围,手术时间长,术中失血较多。胃下部癌清除的第Ⅱ站淋巴结中No.11p、12a、14v均未见转移;黏膜下癌(sm癌)中,No.7、8a淋巴结转移率明显高于黏膜内癌(m癌)(P〈0.05);淋巴管癌栓阳性者No.7淋巴结转移较阴性者明显增多(P〈0.001),No.1、13淋巴结转移仅出现在淋巴结转移高危病例(sm、癌灶大于3.0cm、凹陷型,淋巴管癌栓阳性)。结论早期胃癌不需施行淋巴结扩大清除术和联合脏器切除。早期胃上部癌不需施行全胃切除术。早期胃下部癌中No.11p、12a、14v淋巴结不需清除.但对胃下部癌淋巴结转移高危病例,应行标准D2淋巴结清除术。 相似文献
53.
Evaluation of students undertaking fieldwork education placements is a critical process in the health professions. As training programs and practice evolve, systems for assessing students need to be reviewed and updated constantly. In 1995, staff of the occupational therapy training program at the University of Queensland, Australia decided to develop a new tool for assessing student fieldwork performance. Using an action research methodology, a team developed the Student Placement Evaluation Form, a flexible and comprehensive criterion-referenced evaluation tool. The present paper examines action research as an appropriate methodology for considering real-life organisational problems in a systematic and participatory manner. The action research cycles undertaken, including preliminary information gathering, tool development, trial stages and current use of the tool, are detailed in the report. Current and future development of the tool is also described. 相似文献
54.
55.
市售三厂家18种复方氨基酸注射液的质量评价 总被引:3,自引:0,他引:3
目的对市售3厂家(A、B和E)共9批18种复方氨基酸注射液进行质量比较。方法参考国内外同类产品质量标准,从澄明度、透光率、性状、pH值、不溶性微粒、抗氧剂量、细菌内毒素和含量等方面进行比较。结果外观均为无色澄明液体,430nm波长处透光率均大于99%,pH在5.42~6.61间;A、B、E3厂不溶性微粒≥10、≥25μm的粒子数分别为1.41、0.32,0.83、0.21和1.55、0.56个/ml;抗氧剂的量分别为<33、近330和>500mg/L;细菌内毒素检查与含量测定符合中国药典及国家标准要求。结论不同厂家的产品质量确实存在一定的差异。 相似文献
56.
Vandana Jain Supriya Dabir Debraj Shome Tina Dadu Sundaram Natarajan 《Survey of ophthalmology》2009,54(2):286
We report the case of a 25-year-old male patient who presented with complaints of redness, photophobia, and decreased vision in the right eye of a week's duration. Slit-lamp biomicroscopic examination revealed a cream-colored, irregular elevated inferior iris mass, extending on to the anterior lens surface. Differential diagnoses of a fungal granuloma, a medulloepithelioma, and an amelanotic melanoma were considered. An excisional biopsy of the mass was performed through a superior clear corneal incision. Polymerase chain reaction analysis of the aqueous humor showed a positive pan fungal genome. Histopathology of the biopsied mass showed a giant cell granuloma with surrounding numerous branching, septate hyphae. Culture growth revealed Aspergillus fumigatus We report this case because of the rarity of Aspergillus iris granuloma as a primary presentation of endogenous Aspergillosis and review the relevant literature. Absence of a significant systemic history compounded the diagnostic dilemma in our patient. Definitive differentiation of this rare entity from a foreign body, amelanotic melanoma, and other inflammatory conditions such as sarcoidosis and tuberculosis, may be possible only on microbiological and histo-pathological evaluation. 相似文献
57.
58.
目的 了解目前国内中药治疗绝经后骨质疏松症的临床治疗研究的现状。方法 对检索到的50篇有关中药治疗绝经后骨质疏松症的临床研究论文,按照牛津循证医学中心证据水平标准和临床试验的没计原则,从诊断标准、纳入和排除标准、组间基线可比性、随机、对照、双盲、统计学方法、疗效判断、疗程及药物的不良反应、随访等多个方面进行分析评价。结果 50篇相关文献中,按照牛津循证医学中心证据水平标准评价,推荐级别为B级的占44.0%,C级的占56.0%;证据水平为2b级的占40.0%,3b级的占4.0%,4级的占56.0%;随机对照试验文献占44.0%;临床对照试验文献占4.0%;采用随机双盲者占9.1%,随机单盲者占18.2%,说明组间基线可比的占31.8%,有诊断标准的占90.9%,有纳入和排除标准的占86.4%,说明统计方法的占52.4%,有客观疗效评价指标的占90.9%,说明药物不良反应的占9.1%。结论 有关中医药治疗绝经后骨质疏松症的临床研究论文日益增多,但随机对照试验比例偏低,研究设计及论文撰写水平有待进一步提高。 相似文献
59.
学生课堂教学质量评价问题浅析 总被引:1,自引:0,他引:1
综合分析河南中医学院近三年以来学生课堂教学质量评价反馈的信息,认为引发课堂教学评价偏差的人为因素有评价者的能力水平、责任心、情感倾向。其对策为:改变教师的被动地位,进一步修订评价体系,加强对组织评价者的培训,强化临床课的教学,进一步提高学生的认识,跟踪调查课堂教学质量评价。 相似文献
60.
重视药物利用评价研究,开展药物利用评价活动 总被引:1,自引:1,他引:0
药物利用评价是当前医院合理用药的深入发展的重要体现,也是临床药学的重要工作之一。本文论述了药物利用评价的目的、意义、方法和进展,以及药物利用评价在医院药房中的应用,以期引起有关人员的重视。 相似文献