两种方法整复合并Hill-Sacks损伤的难复性肩关节喙突下脱位

目的：评价对抗牵引法整复合并Hill-Sacks损伤的难复性肩关节喙突下脱位的临床疗效。方法：回顾性分析2013年12月至2020年6月收治的56例合并Hill-Sacks损伤的难复性肩关节前脱位患者,脱位类型均为喙突下脱位。在肩关节腔注射麻醉下分别采用对抗牵引法（试验组）和传统Hippocrates法（对照组）进行复位,各28例。其中试验组男11例,女17例;年龄（61.95±19.32）岁;左侧9例,右侧19例。对照组男12例,女16例;年龄（63.13±12.75）岁;左侧11例,右侧17例。治疗前后分别对两组疗效进行评价,包括复位成功率、复位时长、复位成功距离受伤时间、并发症和功能恢复情况（肩关节Constant评分）。结果：试验组和对照组复位成功率分别为92.86%（26/28）和67.86%（19/28）,差异有统计学意义（P<0.05）;单纯复位时长分别为（4.25±2.13） min和（6.31±1.69） min,差异有统计学意义（P<0.05）;复位成功距离受伤时间分别为（9.16±0.94） h和（8.94±1.31） h,差异无统计学意义（P>0.05）。试验组无血管神经损伤和骨折等并发症发生,对照组2例腋神经损伤,1例肱骨头骨折。试验组和对照组肩关节Constant评分分别为（92.34±5.62）分和（90.91±4.73）分,差异无统计学意义（P>0.05）。结论：采用肩关节腔注射麻醉下对抗牵引法整复合并Hill-Sacks损伤的难复性肩关节喙突下脱位的成功率高,并发症相对较少。     

'I will not cut . . . ': the oath that defined urology

OBJECTIVE

To explore different interpretations of the clause embedded in the Hippocratic Oath, prohibiting surgery for stones, and its relevance for urology.

METHODS

Various translations of the Oath, from the original Greek edition to historical revisions, were reviewed.

RESULTS

Controversy surrounds different translations and interpretations of the Oath about the practice of lithotomy among ancient healers. The reasons Hippocratic physicians were prohibited from performing lithotomy are several, but the consensus is that untrained physicians pledged not to undertake such a complicated procedure, but to refer their patients to other healers who specialized in that practice.

CONCLUSION

The Hippocratic Oath actually defined, identified and legitimized urology as the first medical speciality.     

Varicose veins: Hippocrates to Jerry Moore

Seven volumes from the Cowlishaw Collection were selected for review. The authors highlight the evolution of treatment of venous diseases from the ancient Greek times to the modern day through the writings of Hippocrates, Ambroise Pare, Richard Wiseman and other famous physicians of the past. An important Australian contribution by Jerry Moore is described in detail. Jerry Moore introduced 'high ligation' of the great saphenous vein late in the nineteenth century by modifying Trendelenburg's original procedure. The operation withstood the test of time and it is performed today according to his recommendations.     

环境与疾病理论奠基人——希波克拉底

希波克拉底(Hippocrates, 460-370 BC), 古希腊名医, 西方医学奠基人。他是人类医学历史长河中的“里程碑式人物”, 被认为是历史上第一位流行病学家。他创造了“四体液学说”医学理论, 使人类医学摆脱神学, 迈入自然医学模式; 他辛勤笔耕on Airs, Waters, and Places著作, 奠定了两千多年的流行病学思想基础; 他以高尚的医德为人称道, 其《希波克拉底誓言》传颂至今; 他与门徒集成大作《希波克拉底文集》, 传育了一代代医者。故, 希波克拉底被尊称为“医学之父”。     

试论孙思邈和希波克拉底医德理念与现代医学生医德教育

医学是一门生命科学。医生职业素质和道德水平的高低,直接关系着患者的生命与健康,医学院校的学生应当从理论和实践的结合上理解医学道德的重要性。古今中外,有许多著名的医家,以他们高尚的医德、精湛的医术而流芳百世。在医德方面影响力最大的,当首推中国的孙思邈和希腊的希波克拉底。孙思邈的医德论述,为后世医家所推崇。希波克拉底是西方医学科学之父,其誓言已经成为西方众多医学院校的毕业典礼上的宣誓词。两者的医德观,分别代表了中西方医德的理念,其共同的医德理念认为,品行兼优是作为一名合格医生的准则,对病人必须一视同仁。这些医德理念对于我们今天的医学生培养仍然具有指导意义。在医学教育中,应当通过多种形式将医德教育融人到医学生学习的各个环节。     

Ecballium Elaterium for Gastrointestinal Cancer

Dear EditorI read with great interest the article by Jafargholizadeh et al., (2016) for the possible cytotoxic effects of Ecballium elaterium (L.) A. Richard fruit on gastric cancer cells due to its cucurbitacins. Although this toxicherb has been known since antiquity and was mentioned by ancient writers (as Hippocrates, Theophrastus Pliny,Dioscorides, Avicenna and others), Hippocrates was the first who suggested the administration of Ecballiumelaterium for the management of gastrointestinal cancer. Particularly, in the Book of Εpidemics II, Hippocratesof Kos (c. 460 - c. 370 BC) wrote the following: “Ἀπό γαστρός ταραχῆς ἤ ἀπό βηχός καρκίνου γινομένου, τόστόμα πικραίνεται∙ διδόναι δέ πίνειν ἐλατήριον δίς ἤ τρίς, ἤν μή ψιλός ᾖ” (If you develop cancer after a digestivedisorder or a cough, your mouth becomes bitter. The patient is given elaterium two or three times, unless thepatient is thin) (6,22). The administration of elaterium in this text was probably related to its laxative properties. Itis worth mentioning that the name Ecballium elaterium originates from the Greek words “ἐκβάλλω” (ekvállo)which means discharge and “ἐλατήριον” (elatírion) which means spring, because of a specific characteristic of theseeds of the plant, which are ejected like springs, even by the lightest touch of the surface of the fruit, when it is ripe.     

An octopus in the nostrils

Nasal polyposis is a recurring research topic, as it affects 2 to 4% of the population. The aim of this historical note is to delve back into the original texts written by Hippocrates and discuss their relevance to the term “polyp”, meaning “many feet”, like an octopus.     

希波克拉底对肿瘤的认识

希波克拉底继承了古埃及医学的认识,再结合自己的临床观察和医疗实践,对肿瘤的相关内容进行了探索。希波克拉底将肿瘤单独列为一类疾病进行研究,并认识到肿瘤富含血管、浸润性生长的特点;他从“四体液”学说探讨了肿瘤的发病原因;他虽然没有提出有效的治疗肿瘤的方法,但其所提倡的根据个体差别选择治疗方案,对无法治愈者采取姑息治疗的思想,符合当前肿瘤综合治疗的原则;他重视对肿瘤患者病情的把握和预测,并主张及时通知家属;他提出的相关伦理学思想至今仍在沿用。