成人脊髓纵裂畸形导致的脊髓拴系综合征的治疗

目的 总结成年脊髓纵裂畸形（SCM）导致的脊髓拴系综合征（TCS）的临床特点及手术治疗经验。方法 回顾性分析2007年9月至2019年3月手术治疗的21例成年SCM导致的TCS病人的临床资料。采用后路椎板切除、骨性或软骨性及纤维中隔分离切除、脊髓拴系松解、脊膜囊重建术。结果 21例中，男6例，女15例；年龄18~65岁，平均28.7岁；Ⅰ型7例， Ⅱ型14例。21例显微手术将中隔切除，脊髓拴系达Ⅰ级松解，无手术并发症。术后疼痛缓解或消失，双下肢无力及大小便功能障碍逐渐恢复。术后随访9个月至12年，平均5.8年；神经功能稳定及好转；随访期间未见拴系复发。结论 成人由SCM引发的TCS少见，以慢性腰腿痛为主要临床表现，手术在显微镜下行中隔分离切除、脊髓拴系松解及硬膜重建，疗效满意     

右单侧刺激电休克治疗研究进展

右单侧刺激电休克治疗是将电极放置于颞顶叶位置给予患者电刺激，是一种疗效显著、 不良反应较轻的电休克治疗模式，现就右单侧刺激电休克治疗的设置、作用机制、疗效、不良反应进行 综述。     

青年女性药物流产后风湿性舞蹈病1例报告

风湿性舞蹈病(Sydenham's chorea)又称小舞蹈病(chorea minor),是风湿热患者自身免疫介导的获得性神经精神障碍,是风湿热的主要神经系统表现[1]。A族乙型溶血性链球菌感染是主要诱因,此病在儿童多发,成年人少见[2],症状一般在6个月内缓解。本文报告1例育龄期女性药物流产术后发作风湿性舞蹈病,分析其发病的特殊性,并对诊疗方案进行讨论。     

肝转移的肾上腺皮质腺癌1例报道并文献复习

回顾性分析1例肝转移的肾上腺皮质腺癌(adrenocortical carcinoma,ACC)术前及术后的相关临床资料及相关文献。Weiss评分是ACC最常用的病理学诊断标准。本文1例患者术前增强CT考虑肝癌,术前肝穿刺活检示肝细胞肝癌。术后免疫组织化学结果示CD56和突触小泡蛋白(Syn)阳性,结果考虑ACC。术后行奥沙利铂/卡培他滨(oxaliplatin/capecitabine)化学治疗。随访至2019年2月14日,患者无不适,未见复发及转移。     

布地奈德联合沙丁胺醇吸入治疗喘息型慢性支气管炎急性发作疗效观察

目的分析布地奈德联合沙丁胺醇吸入治疗喘息型慢性支气管炎急性发作的效果。方法选取2017年4月至2018年4月我院收治的喘息型慢性支气管炎患者80例作为研究对象,将其分为观察组和对照组各40例,观察组应用布地奈德联合沙丁胺醇吸入治疗,对照组仅接受沙丁胺醇治疗,对比两组患者的治疗效果。结果观察组治疗有效率明显高于对照组,差异具有统计学意义(P0.05)。结论布地奈德联合沙丁胺醇吸入治疗喘息型慢性支气管炎急性发作能够比较好的改善患者临床症状,具有良好的疗效,临床应用价值较高,值得推广使用。     

Systematic Evaluation(Meta-analysis)of the Efficacy and Safety of Pudilan Xiaoyan Oral Liquid(蒲地蓝消炎口服液)in the Treatment of Suppurutive Tonsillitis in Children

To systematically evaluate the efficacy and safety of Pudilan Xiaoyan Oral in Liquid(蒲地蓝消炎口服液)in the treatment of suppurative tonsillitis in children.In WanFang,CNKI,VIP,CBM,PubMed,Embase and Corchrane and other databases,relevant literatures about Pudilan Xiaoyan Oral Liquid(蒲地蓝消炎口服液)in the treatment of pediatric suppurative tonsillitis were searched.The retrieval time was from the establishment of the database to April 2019.Relevant randomized controlled trials were extracted.The control group was treated with conventional antibiotics,and the observation group was treated with Pudilan Xiaoyan Oral Liquid(蒲地蓝消炎口服液)based on the control group.After they were summarized and analyzed,Cochrane Handbook 5.1 evaluation standard and RevMan 5.3 software were used to determine the quality of literature.A total of 172 literatures were retrieved and 23 randomized controlled trials were included.A total of 1188 children were in the experimental group while 1175 children were in the control group,involving 2363 children with suppurative tonsillitis.Meta-analysis showed that the total effective rate of Pudilan Xiaoyan Oral Liquid(蒲地蓝消炎口服液)combined with routine treatment was better than that of routine treatment(RR=0.88,95%CI(0.86,0.91),P<0.00001);Pudilan Xiaoyan Oral Liquid(蒲地蓝消炎口服液)combined with routine treatment in children was better than that of routine treatment alone in term of temperature recovery,sore throat time,the reduction of tonsil purulent secretion.There were few reports of adverse reactions and no serious adverse reactions.To sum up,Pudilan Xiaoyan Oral Liquid(蒲地蓝消炎口服液)combined with routine treatment can significantly improve the efficacy of children with suppurative tonsillitis,but due to the low quality of the included literature,it should be used cautiously.It is suggested that clinical randomized controlled trials should be designed with large sample size,multi-centers and conforming to international standards to improve the quality of evidence.     

新型冠状病毒肺炎合并Stevens-Johnson综合征样皮损一例

患者女，22岁，因间断发热、咳嗽伴呕吐13 d于2020年2月12日至华中科技大学同济医学院附属同济医院就诊。患者于2020年1月29日晨起出现发热，最高38.6 ℃，伴畏寒、嗜睡、咳嗽，1月31日出现呕吐、腹泻，自服复方金银花颗粒、解毒感冒颗粒、藿香正气丸、阿莫西林，症状无明显好转……