他克莫司联合308nm准分子激光治疗面部白癜风

目的探讨他克莫司联合308nm准分子激光在面部白癜风治疗中的应用效果。方法选取2017年2月-2019年2月医院84例面部白癜风患者为研究对象,根据入院单双号将受试者进行分组,其中对照组42例患者接受308nm准分子激光治疗,研究组42例患者在对照组的基础上联合他克莫司软膏治疗,比较两组患者治疗后1个月、3个月时的治疗总有效率以及治疗前后白斑面积与皮损区IL-17水平变化。结果研究组患者在治疗后1个月、3个月时的治疗总有效率均显著高于对照组(P<0.05),与治疗前相比,治疗后两组患者白斑面积及皮损区IL-17水平均显著减少,且研究组显著少于对照组(P<0.05)。结论他克莫司联合308nm准分子激光可有效缩小白斑面积,降低皮损区IL-17水平,疗效确切。     

周围性面神经麻痹的针刺时机探析

周围性面神经麻痹是临床常见的多发病,在治疗上多采用针刺治疗,而针刺的时机异同,会直接影响病患的恢复效果。现代医学研究普遍认为,急性期面瘫,面神经炎症,多发生水肿,不应尽快针刺治疗;而针灸临床多数报道表明,早期给予针刺,能有效提高临床有效率。因此,对于针刺时机则需进一步加强其标准化。本文则主要通过对近几年文献的检索,探索最佳针刺时机在面神经麻痹中的临床应用。     

运用彭静山教授“一点二穴三线四面取穴法”针刺治疗难治性面瘫

彭静山教授提出“一点二穴三线四面”八字取穴法。笔者运用此八字取穴法指导针灸临床取穴治疗难治性面瘫,临床效果显著。本文列举临床典型病例,详细阐述取穴和针刺治疗方法,并对治疗机理进行论述。对于难治性面瘫,单纯毫针针刺治疗效果有一定局限性,以“一点二穴三线四面”八字取穴法为基础,取穴点以透刺连接构成线、面,以芒针联合透刺法为主要治疗方法,可强化治疗效果、提高临床效应。     

针刺联合优质护理干预对周围性面神经麻痹急性期患者的影响

目的分析针刺联合优质护理干预对周围性面神经麻痹急性期患者的影响。方法以2016年1月—2019年2月60例周围性面神经麻痹急性期患者为研究对象,患者按照护理方法不同,将其分为对照组、观察组各30例患者,对照组进行神经内科的常规护理,观察组进行针刺联合优质护理干预,对2组患者临床疗效和护理满意度等进行观察。结果对照组总有效率为70%,观察组总有效率为96.6%(P<0.05)。对照组护理满意度为63.3%,观察组护理满意度为96.6%(P<0.05)。结论周围性面神经麻痹急性期患者临床治疗中,针刺联合优质护理干预的应用,可以提升患者临床疗效,降低患者住院时间,实现其护理满意度的提升。     

The validity of using profile predictions for class III patients planned for bimaxillary orthognathic surgery

This study assessed whether preoperative class III patients could recreate their facial difference based on a profile photograph. Twenty class III pre-surgery bimaxillary orthognathic patients used CASSOS (SoftEnable Technology Ltd.) to manipulate a distorted soft tissue image of them until they felt it resembled their current soft tissue profile. Patients were able to move their upper lip and lower chin backward and forwards, as well as the lower chin up and down. Differences in the mean absolute distance between the patient-perceived position of the upper lip (Labrale superious) and chin (Pogonion) and the actual position of their upper lip and chin were measured on two occasions. Intra-patient reproducibility was found to be excellent (ICC 0.93 to 0.98). All differences were statistically significantly greater than 3mm, and would be clinically significant. Patients were better at re-creating their AP chin position rather than their AP upper lip and vertical chin positions. Approximately half of patients undergoing surgical correction of their class III skeletal pattern were unable to correctly identify their pre-surgical facial profile. Given the lack of awareness of their profile, this questions the validity of using profile planning for informed consent.     

Minimally invasive temporalis tendon transposition and upper lid lipofilling for immediate and secondary facial reanimation in patients treated for malignant tumors of the parotid gland

Treatment for facial nerve-invading parotid malignancies usually results in complete facial palsy. The authors present a novel technique to treat facial palsy following radical parotid surgery and retrospectively evaluate results in terms of soft tissue symmetry at rest and during smiling and eyelid closure using the eFACE system.9 patients with facial palsy following parotid malignancies resection or undergoing parotidectomy with planned facial nerve resection for tumor invasion were treated with the association of mini-invasive temporalis flap rotation and upper lid lipofilling to restore symmetry of the middle facial third at rest and during smiling and eyelid closure. The technique was employed during the same surgical session as the tumor removal or for secondary facial reanimation.Systematic eFACE evaluation demonstrated significant improvement in static nasolabial fold depth orientation and oral commissure position, palpebral fissure narrowing during eye closure, and oral commissure movement and nasolabial fold depth and orientation with smile (p respectively .008, .011, 0.008, 0.035, 0.011, 0.008, and 0.011, Wilcoxon's test). Furthermore, all patients described subjective improvement of corneal discomfort.The presented technique appears promising in treating facial palsy in oncological patients, representing a potential alternative to other more complex reconstructive techniques.