Anterior urethral valves without diverticulae: A report of two cases and a review of the literature

Two unusual cases of anterior urethral valves (AUV) without diverticulae are presented. The first case is a male child born with prenatal diagnosis of bilateral hydronephrosis. On cystoscopy, iris‐like diaphragm valves were encountered about 3 mm distal to the skeletal sphincter. In the second case, an 18‐month‐old male child was investigated for recurrent febrile urinary tract infections and obstructed urinary symptoms. Cystoscopy confirmed the presence of slit‐like valves 5 mm distal to the skeletal sphincter. Fulguration of the AUVs was performed in both cases. It may be worthwhile to review all cases of anterior urethral obstruction collectively and re‐categorize them appropriately to include the unusual AUVs without diverticulum in that classification.     

痔瘘洗必灵袋泡剂治疗血栓外痔30例

目的:观察痔瘘洗必灵袋泡剂熏洗坐浴治疗血栓外痔的临床疗效。方法:将58例血栓外痔患者随机分为治疗组30例和对照组28例,治疗组给予痔瘘洗必灵袋泡剂熏洗坐浴治疗,对照组给予1:5 000高锰酸钾熏洗坐浴治疗。结果:治疗后,治疗组疼痛评分优于对照组,差异均有统计学意义(P0.05);治疗组有效率96.7%,对照组有效率78.6%,治疗组明显优于对照组(P0.05)。结论:痔瘘洗必灵袋泡剂熏洗坐浴治疗血栓外痔有明显疗效。     

中医药治疗糖尿病周围神经病变

糖尿病周围神经病变(diabetic peripheral neuropathy,DPN)是糖尿病(diabetic mellitus,DM)累及周围神经系统的疾病,是糖尿病患者临床上最为常见的三大慢性并发症之一。现代医学对于DPN的病因及发病机制尚未完全阐明,目前认为主要是与血管神经障碍、代谢障碍和血液成分改变等因素相关,其病理改变主要是周围神经的节段性脱髓鞘和轴突变性或两者兼有。至此,长久以来西医除控制血糖和对症治疗外,尚无切实有效的治疗药物。近年来的研究结果及临床经验表明,中医药治疗DPN疗效确切,具有多靶点、多层面、多途径等优势。     

中药垫外敷治疗乳腺增生63例

目的:观察中药垫外敷治疗乳腺增生的疗效。方法:将63例乳腺增生患者随机分为对照组30例和治疗组33例,对照组采用逍遥丸口服治疗,治疗组采用中药垫外敷治疗。结果:治疗组超声声像疗效、症状疗效均优于对照组(P0.05)。结论:中药垫外敷治疗乳腺增生疗效显著。     

从“道法自然”探眩晕临床证治

中医对眩晕病证的认识,从病因病机、辨证论治到处方用药,无不彰显着“道法自然”“取象比类”思维的妙处.“象”思维是中国古人认知世界的主要思维方式,是一种对客体形态的再认识与内在实质的理解相统一的认识活动.中医运用“取象比类”方法来阐释阴阳、五行、藏象等中医经典理论,更用之来指导临床.“培土生金”“增水行舟”“提壶揭盖”“釜底抽薪”等治法,皆体现了道法自然的思想.眩晕的病位在脑窍,病变脏腑主要在肝、脾、肾,尤与肝关系最为密切.其治疗应祛避外风,镇熄肝风,清疏上窍,培土养正.     

中医药综合疗法治疗糖尿病足59例临床研究

目的:探讨中药内服和外治相结合的综合疗法治疗糖尿病足的临床疗效及作用机制。方法:将118例患者随机按数字法分为对照组57例和治疗组59例。对照组采用西医常规疗法,治疗组在西医常规治疗的基础上加用中药内服,中药熏洗、湿敷方等综合措施。两组疗程均为8周。进行治疗前后创面面积、创面深度、肉芽组织形态、脓液情况、创周红肿、疼痛、温度评分;检测治疗前后患肢腓总神经和腓肠神经的运动神经传导速度(MNCV)和感觉神经传导速度(SNCV);检测治疗前后纤维蛋白原(FIB),糖化血红蛋白(Hb A1c),一氧化氮(NO),内皮素(ET),血管内皮生长因子(VEGF)水平;计算创面闭合指数。结果:两组临床疗效经Ridit分析,治疗组优于对照组(P0.05);治疗后治疗组创面面积、创面深度、肉芽组织形态、脓液情况、创周红肿评分均低于对照组;治疗后治疗组腓总神经和腓肠神经的MNCV和SNCV的速度均快于对照组(P0.01);治疗后8周治疗组创面愈合率和创面闭合指数均高于对照组(P0.05);治疗后治疗组FIB,Hb A1c,ET水平均低于对照组(P0.01),治疗组NO和VEGF水平均高于对照组(P0.01)。结论:在西医常规治疗的基础上,中药内服和局部给药相结合的疗法促进了创面的愈合,促进了神经的传导速度,提高了临床疗效,其作用机制可能与降低FIB,Hb A1c,调节NO/ET,升高VEGF水平有关。     

综合康复疗法对糖尿病足的临床疗效观察

目的观察综合康复疗法对糖尿病足的临床疗效。方法将98例糖尿病足患者分为常规治疗组50例，只给予内科常规治疗；综合康复组48例，在内科常规治疗基础上加用综合康复疗法。结果治疗1个月后，下肢动脉血管多普勒检测显示，综合康复组糖尿病足0级患者的血流参数改善更明显（P〈0．05）；治疗2个月后，综合康复组患者疗效明显优于常规治疗组（P〈0．01）。结论综合康复疗法治疗糖尿病足疗效明显，有利于糖尿病足尽早康复。     

骨折外固定加创面冲洗疗法的临床应用及护理

1992年12月至1995年6月，对38例四肢开放骨折并感染的患应用外固定架的同时行创面冲洗疗法，取得满意效果。总结治疗方法与护理体会如下：观察肢体局部变化及外固定架位置是否合适、及时调整外固定架，并准确使用有效抗生素冲洗液。对骨折并骨髓炎患行密闭式冲洗疗法，注意冲洗速度，拔管时间和拔管顺序。此方法手术创面小，便于早期活动，促进骨折愈合，避免关节僵直，大大缩短了住院时间。     

Moving from institutional dependence to entrepreneurialism. Creating and funding a collaborative research and practice development position

Aims of the paper. The paper describes the creation of, the rationale behind and the external funding of a collaborative research‐clinical practice development position. The paper also demonstrates the benefits of nursing's collaboration with external funding bodies and the value of moving from our traditional position of assuming that ‘the hospital’ will always provide. Background. There is a constant refrain that nursing must become more ‘research‐based’ and develop an active research culture. In harsh financial times however, funding for research development is scarce. Nurses can respond to this by bemoaning the lack of money or by taking an entrepreneurial approach, creating innovative project proposals that develop new partnerships and attract external funding. Discussion. Institutional support for clinical research is often more verbal than financial as most health care systems are experiencing extreme financial stringencies. Nurses need to reconsider the notion that every initiative must automatically be funded by the institution. In this paper we show how in a busy major hospital, clinicians and researchers collaborated to create and fund the kind of innovative research and practice development position that may be impossible to fund through existing budgets. Conclusion. With creativity and determination, nurses can challenge the orthodoxy that they are solely dependent on institutional funding. If there is a clear project vision, a convincing rationale, a strongly argued ‘business case’ and a passionate and persistent team, then innovative new projects and positions can be realized. Relevance to clinical practice. Developing clinical focused, practice based research is now a worldwide policy and practice imperative for nurses. Unfortunately, current levels of institutional funding are unlikely to support research promotion positions and initiatives. This paper outlines an approach to securing funding for research initiatives that can create exciting new positions and develop productive partnerships between researchers, clinicians and external agencies.     

驻黎维和中国二级医院第七批51例眼外伤l临床分析

目的分析联合国驻黎巴嫩临时维和部队（UNIFIL）中国二级医院眼科眼外伤的致伤原因、特点,以预防和减少眼外伤的发生。方法对UNIFIL中国二级医院眼科第七批医疗队2011年3月1日～10月20日任务期内眼科门诊及住院眼外伤患者病例进行回顾性分析。结果 51例（55眼）眼外伤中,男46例,女5例;年龄9～48岁,平均30.15岁;右眼25例,左眼22例,双眼4例;维和军人34例,当地及国际雇员16例,当地学生1例;国籍：黎巴嫩16例,西班牙9例,法国6例,尼泊尔4例,中国3例,坦桑尼亚3例,韩国3例,马来西亚2例,葡萄牙2例,意大利1例,德国1例,印度1例;受伤至就诊时间：24 h以内30例,1～7 d 17例,7 d以上4例;受伤分类：眼球钝挫伤占45.09%,其他各类眼外伤（如电光性眼炎、角膜结膜异物、角结膜烫伤化学烧伤、角膜擦伤等）占54.91%;受伤原因：工作中受伤30例,运动中受伤7例,拳击伤6例（均为外国军人）,各种意外伤7例。在二级医院接受治疗48例（门诊43例,住院治疗5例）,1例角膜白斑未治,送三级医院遣返回国手术治疗2例。结论眼外伤是维和人员常见的眼病,应加以重视并积极预防,一旦发生,及时到专科诊治,减少并发症的发生。