新一年 新思维 新药店

迎着大健康时代的召唤,我们共同走过了2013年,进入了令人期待又充满挑战的2014年。回首刚刚过去的一年,连锁药店真正走上了从消费者角度出发,贴心周到的为消费者服务的轨道。舒适的购物环境,丰富多彩的商品,贴心的促销方式,专业的用药指导,低廉的价格,使“小病到药店,大病到医院”开始深入人心。提供高品质的生活享受和全新的健康生活方式是人们在不觉中对身边药店的全新要求。     

股骨粗隆部骨折内固定失败的原因及其治疗措施

目的：研究和评估再次手术植骨内固定在股骨粗隆部骨折内固定失败病例中的应用疗效。方法对2007~2012年本院收治的21例共21部位股骨粗隆部骨折内固定失败病例采取再次切开复位植骨内固定术,并进行严密的临床随访。结果到访21例,其中20例达到骨愈合（95.2%）,其中15例骨折处没有疼痛,5例骨折处有轻微疼痛,所有患者均可下床活动。术后Harris评分平均89.2分。结论如果病例选择合适,操作恰当,采用再次手术植骨内固定在股骨粗隆部骨折内固定失败病例中,骨折愈合率高且髋关节功能恢复较好,是理想的选择之一。     

食管贲门癌术后膈疝的诊断及防治

我院自１９９０～１９９６年共施行食管贲门癌切除及食管胃吻合术１１２６例,发生经手术证实的膈疝６例,占０５３％,现将诊断及防治体会报告如下。１一般资料本组６例男４例,女２例。年龄３８～６６岁。食管癌５例,贲门癌１例。发现时间：术后２４ｈ～７ｄ３例,８...     

应用肺功能监测咳嗽变异性哮喘治疗疗效

目的：应用肺功能监测咳嗽变异性哮喘的疗效。方法：对42例咳嗽变异性哮喘病儿在发作期及缓解一年时进行常规肺功能及小气道功能检测。结果：发作期肺功能各项指标明显异常,尤其是50%及25%肺活量时最大呼气流速与身高比（V50/Ht,V25/Ht）异常率达92.9%,而缓解一年时肺功能各项指标有明显改善（P〈0.05,P〈0.01）,小气道功能基本正常率达73.81%。结论：咳嗽变异性哮喘经长期系统治疗后肺功能可改善,而肺功能监测可用于评价治疗疗效。     

抑癌基因RUNX3在鼻咽癌中的表达及其与分期的关系

目的 检测抑癌基因RUNX3在鼻咽癌中的表达状况及其与临床分期的关系.方法 采用免疫组织化学方法检测50例鼻咽癌和20例鼻咽黏膜慢性炎组织中RUNX3的表达状况,并分析与临床分期的关系.结果 RUNX3在鼻咽癌组织和黏膜慢性炎症组织中的阳性表达率分别为56%(28/50)、100%(20/20), 差异有统计学意义(P＜0.05);在鼻咽癌Ⅱ期、Ⅲ期、Ⅳa期、Ⅳb期病例的阳性表达率分别为69.2%(9/13)、64.7%(11/17)、50.0%(8/16)、0%(0/4),差异无统计学意义(P＞0.05),而Ⅱ和Ⅳb期比较差异有统计学意义(P＜0.05).结论 RUNX3基因在鼻咽癌中的表达明显下调,可能是个保护性因子;表达下调可能与临床分期有关.     

后路顶点经椎弓根截骨术治疗重度僵硬性脊柱侧后凸畸形

目的 评价后路顶点经椎弓根截骨术治疗重度僵硬性脊柱侧后凸畸形的安全性和早期临床治疗效果.方法 回顾性分析12例行后路顶点经椎弓根截骨术治疗重度僵硬性脊柱侧后凸畸形患者的术前、术后及随访时的X光像,对侧凸Cobb角、后凸Cobb角、躯干平衡等进行测量和分析.复习手术记录和病历,记录围手术期并发症.结果 本组患者12例,男4例,女8例,平均年龄20.1(9～57)岁,其中成人脊柱侧凸2例,先天性脊柱侧后凸畸形10例.平均随访9.2个月.融合固定节段平均12个节段.手术时间平均5.0 h,术中出血量平均1517 ml,回输自体血平均780 ml,异体输血平均1109 ml.手术前后主弯冠状面Cobb角分别为100.9°和48.8°,平均矫正率51.8%(P=0.000).节段性后凸Cobb角分别为81.7°和42.2°,平均矫正率为49.8%(P=0.000).随访时主弯冠状面Cobb角及节段性后凸Cobb角分别为50.7°和46.0°,矫形无明显丢失(P=0.763,P=0.698).手术前、后及随访时冠状面躯干平衡分别为16.3、14.7和12.0mm,随访时仅1例发生冠状面躯干失平衡(22 mm).2例患者出现一过性的下肢单侧肢体麻木、无力,获完全恢复.所有患者均无脊髓损伤.结论 后路顶点经椎弓根截骨术是矫正重度僵硬性脊柱侧后凸畸形的安全方法 ,早期结果 令人满意.     

Study on the Protective Effect of Shengmai San(生脉散) on the Myocardium in the Type 2 Diabetic Cardiomyopathy Model Rat

Objective:To study the effect of Shengmai San(生脉散Pulse-activating Powder) in protecting myocardium in the rat of the type 2 diabetic cardiomyopathy(DCM) model.Methods:The DCM rat model was established by combination of insulin resistance induced by a high-fat diet with intraperitoneal injection of high dose streptozotocin(50 mg/kg).And these rat models were randomly divided into three groups:a normal group(n=12,one of them died),a model group(n=15) and a Shengmai San group(treatment group,n=15).The damage of the myocardium was assessed by electrocardiogram at the twelfth week after modeling,and the blood glucose,cholesterol and triglyceride levels were determined;the content of the left cardiac ventricle myocardial collagen was quantified by Masson staining test;the level of myocardial cell apoptosis was detected with TUNEL apoptosis detection kit;the damage extent of the myocardial sub-cellular structures was observed by electron microscopy;the expression levels of cardiac TSP-1(Thrombospondin-1),TGF-β1(Transforming Growth Ffactor-β) and TRB-3(Tribbles homolog 3) proteins were detected by immunohistochemical method;the expression levels of cardiac TSP-1,A-TGF-β1 and L-TGF-β1 proteins were detected by Western blotting;and the expression levels of TSP-1 and TRB-3 mRNAs were detected by real-time quantitative PCR.Results:Compared with the control group,the blood glucose,cholesterol,triglycerides levels in both the model groups and the Shengmai San group were significantly decreased;the myocardial tissue was less damaged and the collagen content was reduced in the Shengmai San group;the myocardial sub-cellular structure was injured to a lesser extent;the expression levels of myocardial TSP-1,TGF-β1,TRB-3,and TSP-1,A-TGF-β1,L-TGF-β1 and chymase were decreased,and the expression levels of TSP-1 mRNA and TRB-3 mRNA were decreased in both the model groups and the Shengmai San group(the latter was better),.Conclusion:Shengmai San can inhibit myocardial fibrosis in the rat of diabetic cardiomyopathy,and significantly delay the formation of diabetic cardiomyopathy in hyperglycemia rats through multiple pathways.     

高血压丘脑出血破入脑室行脑室外引流术治疗体会

一、临床资料与方法 1.一般资料:我院2000年-2009年一共治疗60例高血压丘脑出血破入脑室的患者,其中男35例,女25例,入院查体昏迷8例,意识模糊10例,清醒42例.