小针刀疗法配合四黄散外敷治疗胫骨结节骨软骨炎

[目的]观察小针刀疗法配合四黄散外敷治疗胫骨结节骨软骨炎的临床疗效。[方法]对92例胫骨结节骨软骨炎患者,随机分成两组,治疗组50例采用小针刀疗法配合四黄散外敷治疗;对照组42例单用四黄散外敷治疗。[结果]治疗组和对照组疗效和疗程比较,两组间有显著性差异(P0.05),治疗组明显优于对照组。[结论]小针刀疗法配合四黄散外敷治疗胫骨结节骨软骨炎,临床疗效确切,并可明显缩短疗程。     

封闭配合小针刀治疗胫骨结节骨软骨炎临床探讨

目的依据胫骨结节骨软骨炎发病机制，探讨手求胫骨结节骨软骨炎更为有效的治疗办法。方法通过对48例胫骨结节骨软骨炎患者应用封闭小针刀临床治疗观察。结果应用此方法治疗总有效率达到100％。结论认为此方法简单，操作方使，易于掌握，值得临床推行。     

安肾丸、清胃汤在治疗慢性牙周炎中的应用

目的探讨中药治疗慢性牙周炎的疗效。方法将70名慢性牙周炎患者分组治疗。试验组35名,用中药。对照组35名,按常规治疗。一月后观察疗效。结果试验组显效(82,86%),无效(17,14%),对照组显效(60%),无效(40%)。结论慢性牙周炎采用中药治疗可标本兼治。     

安肾丸、清胃汤在治疗慢性牙周炎中的应用

目的探讨中药治疗慢性牙周炎的疗效。方法将70名慢性牙周炎患者分组治疗。试验组35名,用中药。对照组35名,按常规治疗。一月后观察疗效。结果试验组显效(82,86%),无效(17,14%),对照组显效(60%),无效(40%)。结论慢性牙周炎采用中药治疗可标本兼治。     

欧柏宁凝胶剂治疗海军舰艇人员复发性阿弗他溃疡的短期疗效观察

目的观察欧柏宁凝胶剂治疗海军舰艇人员复发性阿弗他溃疡的疗效。方法经患者知情同意,将158例水面舰艇口腔溃疡患者分为试验组(80例)和对照组(78例)。每日复诊或回访评价疗效。对照组给予口腔溃疡散治疗,试验组给予欧柏宁凝胶剂治疗。结果试验组总有效78例,总有效率97.5%,其中显效71例(88.7%),有效7例(8.8%),无效2例(2.5%);对照组总有效70例,总有效率89.7%,其中显效65例(83.3%),有效5例(6.4%),无效8例(10.3%)。2组总有效率差异有统计学意义(χ2=4.008,P<0.05)。欧柏宁凝胶剂治疗复发性阿弗他溃疡的疗效优于口腔溃疡散的疗效。结论欧柏宁凝胶剂治疗口腔溃疡效果显著,值得在舰艇官兵中应用推广。     

中药外洗在痔疮术后康复中的应用

目的:探讨中药外洗应用于痔疮术后康复中的疗效。方法:将80例痔疮手术患者随机分为试验组和对照组。对照组仅给予一般传统治疗;试验组在专科护理的基础上加用中药外洗,治疗后比较两组临床疗效。结果:试验组显效:35例(87.5%),有效:4例(10.0%),无效:1例(2.5%),有效率为97.5%;对照组显效:15例(37.5%),有效:10例(25.0%),无效:15例(37.5%),有效率为62.5%。两组比较差异有统计学意义(P<0.05)。结论:痔疮术后配合中药外洗可以提高治疗效果。     

小骨窗开颅血肿清除术和大骨瓣开颅血肿清除术治疗高血压脑出血疗效观察

目的:观察并分析大骨瓣开颅血肿清除术和小骨窗开颅血肿清除术治疗高血压脑出血的疗效。方法:本文通过选取2014年2月到2015年2月于本院就诊的高血压脑出血患者共90例,依据入院顺序进行编号,将其分为对照组(采用大骨瓣开颅血肿清除术治疗患者)和观察组(采用小骨窗开颅血肿清除术治疗患者),比较两组临床疗效。结果:观察组显效88.9%(40/45)、有效11.1%(5/45)、无效0例;对照组显效51.1%(23/45)、有效4.0%(18/45)、无效9%(4/45);观察组总有效率100%显著高于对照组91.1%,差异有统计学意义(P0.05)。结论:在临床治疗过程中,比较两组的临床疗效,采用小骨窗开颅血肿清除术治疗高血压脑出血的疗效优于大骨瓣开颅血肿清除术的疗效,具有临床使用价值。     

高频超声诊断胫骨结节骨软骨炎的临床应用

目的探讨高频超声对胫骨结节骨软骨炎（Osgood-Schlatter disease，OSD）的诊断价值。方法选择OSD患者30例和正常对照组25例，观察2组胫骨结节上下骨骺、髌腱末端下止点及周围软组织的声像图特征，并与X线检查结果对比。结果OSD组髌腱体部和末端厚度均较对照组明显增厚、增宽，且不同病变程度OSD的髌腱体部与末端宽度及厚度、骨骺受损面积、碎骨前凸距离及滑膜囊积液程度也存在显著差异。结论高频超声技术可对胫骨结节骨软骨炎做出较准确的评价，可作为该病的首选检查方法。     

58例胫骨结节骨软骨炎临床误诊分析

目的:探讨分析胫骨结节骨软骨炎的X线表现。方法:对58例胫骨结节骨软骨炎患者资料进行回顾性分析,所有患者均采用X线检查,总结其X线特征。结果:58例患者的X线主要表现为:胫骨结节碎裂56例;胫骨结节密度增高突起48例;胫骨结节软组织肿胀影58例;髌韧带钙化3例。结论:胫骨结节骨软骨炎在临床较为少见,误诊率较高,需要医生引起高度重视。X线是辅助诊断此疾病的重要方法。     

温阳固表法治疗儿童反复呼吸道感染48例

目的:观察采用温阳固表法治疗儿童反复呼吸道感染的临床疗效。方法:68例患者随机分为治疗组48例、对照组20例,治疗组采用金屏汤治疗,对照组发作期给予西医对症处理,缓解期未经任何相关治疗,观察临床疗效。结果:治疗组痊愈11例(22.91%),显效20例(41.67%),有效12例(25.00%),无效5例(10.42%)。总有效率89.58%。对照组无痊愈病例,显效1例(5.00%),有效4例(20.00%),无效15例(75.00%),总有效率25.00%。治疗组临床疗效优于对照组(P<0.05)。结论:温阳固表法治疗儿童反复呼吸道感染疗效显著。     

Radial shock wave therapy in the treatment of chronic constriction injury model in rats: a preliminary study

Background Pain physicians pay close attention to neuropathic pain （NP）,since there is currently no ideal treatment.Radial shock wave therapy （RSWT） is a noninvasive treatment to chronic pain of soft tissue disorders.So far,there is no information on the use of RSWT for the treatment of NP.Therefore we observe the effects of RSWT on a NP model induced by chronic constriction injury （CCI） in rats.Methods Four different energy densities （1.0,1.5,2.0 and 2.5 bar） RSWT administered as a single session or repeated sessions in rats with NP induced by CCI of the sciatic nerve.The analgesic effect was assessed by measuring mechanical withdrawal threshold （MWT） and thermal withdrawal latency （TWL）.The safety was assessed through calculating sciatic functional index （SFI）.Results MWT and TWL increased after a single session of RSWT from day 1 to day 5 but retumed to baseline levels by day 10.Following repeated sessions of RSWT,both the MWT and TWL were significantly higher than NP group （P ＜ 0.01）for at least 4 weeks.In addition,no significant changes of SFI were observed in any groups after repeated sessions of RSWT and no increased pain or other side effects in any animals.Conclusions A single session of RSWT is rapidly effective in the treatment of CCI,but the efficacy maintained in a short period.However,repeated sessions of RSWT have prolonged efficacy.     

常见骨软骨缺血性坏死的X线诊断

目的探讨x线检查在骨软骨缺血性坏死诊断中的价值。方法对40例骨软骨缺血性坏死患者的常规放射资料进行回顾性分析。结果X线诊断股骨头骨骺缺血性坏死5例;胫骨结节骨软骨炎12例;耻骨联合骨软骨炎7例;剥脱性骨软骨炎6例;跖骨头缺血坏死7例;骨梗死3例。所有患者均有典型的x线表现。结论常规x线对骨软骨缺血坏死中晚期诊断有重要价值。     

心身放松疗法治疗广泛性焦虑症的疗效观察

目的观察心身放松疗法治疗广泛性焦虑症的临床疗效.方法将符合CCMD-3广泛性焦虑症诊断标准的45例门诊患者运用心身放松疗法治疗4周,用Zung氏焦虑自评量表(SAS)和汉密顿焦虑量表(HAMA)分别于治疗后第2周末、第4周末评定临床疗效.结果与治疗前比较,治疗后第2和第4周末SAS 、HAMA评分均显著性降低 (P＜0.01) ;临床痊愈率、显效率及总有效率分别为31.1%、68.9%及88.9%.结论心身放松疗法能有效治疗广泛性焦虑症.     

Avulsion fractures of tibial tuberosity in adolescents. Treatment with closed reduction and percutaneous screwing, using MRI to identify combined intraarticular lesions

Avulsion fracture of the tibial tuberosity is an uncommon lesion generally seen in adolescents. Intra-articular lesions combined with a tibial tuberosity fracture reported in the literature are; 3 patellar tendon ruptures, 2 anterior cruciate ligament tears, 2 medial collateral ligament tears, 2 medial meniscus tears, one arcuate ligament tear, and one lateral meniscus tear. In our study, both cases sustained an avulsion fracture of the tibial tuberosity. Preoperative MRI in one case revealed posterior cruciate ligament rupture. Under the image intensifier, we treated both patients by closed reduction and percutaneous screwing with 2 cancellous screws. Radiographic assessment showed complete healing of the avulsion fractures in both cases. Both of our patients gained previous levels of daily and sporting activity prior to the injury, and were completely asymptomatic. Our objective in reporting this case study is to point to the fact that there is no previous reporting of the avulsion fracture of the tibial tuberosity accompanied by posterior cruciate ligament rupture in the literature and to evaluate the findings of the minimal invasive treatment method we applied to both cases.     

度洛西汀治疗60例抑郁症伴发慢性疼痛的疗效观察

目的:探讨度洛西汀对抑郁症伴发慢性疼痛的疗效和不良反应。方法:用度洛西汀治疗60例伴发慢性疼痛的抑郁症患者,治疗8周后,采用汉米尔顿抑郁量表(HAMD)、汉米尔顿焦虑量表(HAMA)、医学结局研究用疼痛量表(MOSPM)和不良反应量表(TESS)评定疗效及不良反应。结果:治疗8周后,患者的抑郁、焦虑以及躯体疼痛症状均较治疗前明显减轻,抑郁症状的疗效为83%;疼痛症状的疗效为77%。治疗8周后HAMD、HAMA、MOSPM评分较疗前有显著性差异(P均<0.05),不良反应轻。结论:度洛西汀能明显改善抑郁患者的焦虑、抑郁、疼痛症状,不良反应轻、依从性好。     

动力髋内固定治疗股骨粗隆间骨折129例

目的探讨利用动力髋（DHS）治疗股骨粗隆间骨折的可行性和疗效。方法采用DHS内固定治疗股骨粗隆间骨折129例,其中男87例,女42例,平均61岁。按Evans分类：Ⅲ型51例,Ⅳ型55例,Ⅴ型23例。观察这种内固定方法的临床疗效。结果随访10～30个月,平均20个月。死亡1例,128例骨折愈合满意,恢复劳动能力或生活自理能力。结论 DHS内固定治疗股骨粗隆间骨折可达到固定牢靠、骨折愈合快、患者早期康复的目的,是治疗股骨粗隆间骨折的一种比较理想的手术方法。     

中度移位的肱骨大结节骨折手术与保守治疗的疗效对比

目的比较中度移位的肱骨大结节撕脱性骨折手术与保守治疗的临床效果。方法回顾性分析自2015年1月~2017年12月诊治的肱骨大结节骨折93例,采用非手术治疗48例(保守治疗组),采用切开复位内固定治疗45例(手术治疗组)。随访时采用Constant-Murley评分标准评价肩关节功能,X线评估骨折愈合及骨折块移位情况。结果末次随访时复查X线片,两组患者均达到临床骨折愈合标准。肩关节功能Constant-Murley评分,保守治疗组为(77.73±3.97)分,手术治疗组为(83.42±3.70)分,两组差异有统计学意义(P0.05)。结论手术干预与保守治疗在疼痛缓解、恢复日常生活功能方面均能取得良好的临床效果。但手术治疗可以提供更可靠的内固定,从而减少发生骨折块移位的风险,同时提供早期肩关节功能锻炼的机会,避免肩关节僵硬。     

关节镜下半腱肌腱单束重建前交叉韧带前内侧束损伤

目的观察关节镜下半腱肌腱单束重建前交叉韧带（ACL）前内侧束损伤的临床疗效。方法采用关节镜下半腱肌腱单束重建ACL前内侧束损伤患者18例,对比术前及术后末次随访时Lysholm、IKDC评分及KT-1000双侧膝关节胫骨结节前移差。结果 18例患者术后伸膝无受限,4周膝关节屈曲均达到110°,术后3个月膝关节屈曲120°-140°,平均124°。术后18例患者均获得随访,随访时间为6-18（12.5±5.3）个月;末次随访时患者IKDC、Lysholm评分均明显高于术前（P〈0.05）,屈膝30°位KT-1000双侧膝关节胫骨结节前移差明显小于术前（P〈0.05）。结论关节镜下自体半腱肌腱单束解剖重建ACL前内侧束损伤可以恢复膝关节的稳定性,临床疗效较好。     

Treatment of grade IIIB opens tibial fracture by ilizarov hybrid external fixator

Objective: We evaluated the results of patients who were treated with Ilizarov hybrid external fixator for type IIIB open tibial fractures. Materials and methods: 35 Gustilo grade IIIB tibial fractures of age between 18 to 42 years (22 male and 13 female) in which 12 distal fourth tibia (D/4) of C1.1 (6), C1.3 (6), 12 upper fourth Tibia (U/4) of A2 (8) and A3 (4) according to AO classification and 11 Tibial plateau fractures of Schatzker type VI (5) , V(5), IV(1) . All tibial plateau, proximal fourth fractures and lower fourth fractures of tibia and fibula (Reversed Hybrid), treated with Ilizarov hybrid fixator using two Ilizarov 5/8 rings and AO External fixator were followed up to 12-52 months. Results: D/4 fractures were united at 31.16678.3046 wks, U/4 at 24.005.2915 and Tibial plateau at 15.5454.160 weeks (p-0.00). ROM in tibial plateau type IV 130+/-00, type V 1248.94 , type VI 125+/-7.0711, D/4 of type C1.1 (50+/-0.00), type C1.3 (43 5.7755) whereas full ROM in U/4 fractures. Pin tract infection occurred in 21% of cases. Pain on walking in 20% of cases of type VI tibial plateau fractures and 80% of cases of type IV and V. Problem free in rest of parameter of function of VI and 100% problem in IV and V. Pain at rest observed in 20% of cases in type V. In 66.67% U/4 fractures had pain on walking but no other functions were compromised. In 33% D/4 fractures of C1.1 type had pain on walking only and had 1cm of shortening. Conclusion: On the basis of our experience, we suggest adopting this method for functional limb salvage after extensive complex high-energy injuries. This fixator is safe and versatile, effective in providing stability and allowing early rehabilitation, although the indications for its use are very relatively specific. Key words: Ilizarov hybrid external fixator, tibial plateau, upper fourth and distal fourth fractures, Clinical and Functional outcome.