苍耳虫喷雾剂治疗体表溃疡30例

我们自1995年2月～1997年11月应用苍耳虫喷雾剂治疗体表溃疡30例,并与维斯克治疗进行对比观察,取得了满意疗效,现总结如下。1　临床资料共60例患者,随机分成两组。治疗组30例中,男18例,女12例;年龄5～72岁;病程10年以上者2例,5～10年者5例,3～5年者8例,1～3年者7例,05～1年者5例,3个月～半年者3例;病因:外伤10例,感染9例,下肢静脉曲张5例,烧烫伤4例,糖尿病2例。对照组30例中,男17例,女13例;年龄6～75岁;病程10年以上者1例,5～10年者6例,3～5年者7例,1～3年者8例,05～1年者4例,3个月～半年者4例;病因:外伤11例,感染8例,下肢静脉曲张4例,烧烫…     

肾移植存活10年以上15例报告

目的探讨影响肾移植术后长期存活的相关因素。方法回顾性分析1985年至1994年异体肾移植存活10年以上者15例的临床资料。结果15例中存活18年1例,13年4例,12年7例,11年1例,10年2例。死亡原因:直肠癌1例,脑血管意外1例,肝功能衰竭1例。结论供肾质量,组织配型,免疫抑制剂的合理应用,术后并发症及患者的随访对移植肾的长期存活非常重要。     

点线面结合手法治疗膝关节骨性关节炎疗效观察

膝关节骨性关节炎是中老年常见的关节疾患。多呈缓慢进行性发展,女性多于男性,体胖多于体瘦者。临床上以膝关节疼痛反复发作、运动功能受限为主,甚至关节变形。笔者自2001年1月至今博采众长实施点线面结合特色手法治疗膝关节骨性关节炎150例,取得了较好疗效,现总结如下。1临床资料1.1一般资料本组150例,男66例,女84例;年龄40岁以下11例,40～50岁33例,51～60岁55例,61～70岁51例,最大年龄70岁,最小年龄39岁,平均年龄55岁;病史:1年以内24例,1年～2年33例,2年～3年42例,3年～5年23例,5年～10年15例,10年～20年8例,20年以上5例,病史最长25年,最…     

肾移植存活1O年以上15例报告

目的探讨影响肾移植术后长期存活的相关因素。方法回顾性分析1985年至1994年异体肾移植存活10年以上者15例的临床资料。结果15例中存活18年1例，13年4例，12年7例，11年1例，10年2例。死亡原因：直肠癌1例，脑血管意外1例，肝功能衰竭1例。结论供肾质量，组织配型，免疫抑制剂的合理应用，术后并发症及患者的随访对移植肾的长期存活非常重要。     

原发性胃淋巴瘤的诊断与治疗

目的 探讨原发性胃淋巴瘤的临床特点和治疗方法.方法 回顾性分析23例经病理证实为原发性胃淋巴瘤患者的临床资料.23例均行手术治疗,其中胃大部切除16例(D1 9例,D2 7例),全胃切除3例,姑息性切除术2例,剖腹探查术2例.术后21例患者接受辅助化疗.结果 本组总体5年生存率为80%.低度恶性14例,其巾病史5年以上有10例,生存期超过5年9例;高度恶性9例,病史5年以上有7例(失访2例),生存期超过5年2例.Ⅰ期13例,病史5年以上有10例,生存期超过5年9例;Ⅱ期7例,病史5年以上有5例(失访2例),生存期超过5年2例;Ⅲ～Ⅳ期3例,5年生存0例.根治性手术19例中病史5年以上有14例(失访1例),生存期超过5年12例;非根治性手术4例(失访2例),5年生存0例.低度恶性、早期并获得根治性切除的原发性胃淋巴瘤预后较好.结论 原发性胃淋巴瘤的术前诊断和分期主要依靠胃镜和CT检查.手术和术后辅助治疗是治疗早期原发性胃淋巴瘤的重要手段,非手术疗法是治疗晚期原发性胃淋巴瘤的主要方法.     

血封疗法临床应用体会

我院自１９８４年６月～１９９７年６月,运用血封疗法治疗慢性窦道８６７例,疗效显著。现将临床治疗情况汇报如下。１临床资料８６７例中男５８７例,女２８０例。窦道３个月～１年４５１例,１年～２年２８３例,２年以上１３３例,最长者２３年。有反复溃破病史者２８...     

骶尾部藏毛窦8例临床分析

2005年5月至2009年10月,我科收治骶尾部藏毛窦8例,取得满意效果,现报告如下。临床资料：本组男7例,女l例;年龄19～32岁,平均23．1岁;病程4个月至3年,〈1年1例,1～2年6例,〉2年1例。首诊7例,外院一次手术后复发l例。3例误诊为肛瘘,     

残胃吻合口癌九例临床分析

我院1986～1995年共收治胃癌342例．其中残胃吻合口癌9例．占2．63％，现报道如下。临床资料本组男6例．女3例．年龄45～68岁，50岁以上8例，平均年龄57．8岁。两次手术间隔时间11年2例，12年1例．13年2例．15年4例。首次术后病检为胃窦部溃疡5例，胃小弯侧溃疡2例．十二指肠球     

糖尿病性足病

现将我们 1990年至 1996年治疗并获得随访的 38例糖尿病性足病作一总结。1　临床资料1 1　一般资料　 38例中男 12例 ,女 2 6例 ;年龄 44～ 72岁。右侧 14例 ,左侧 17例 ,双侧同时发病者 7例。足部发病后经检查为糖尿病者 8例 ,糖尿病病史 5年以内 1例 ,5～ 10年 15例 ,10～ 15年 8例 ,15～ 2 0年 5例 ,2 0年以上 1例 ;随访 3个月～ 3年 ,平均 7个月零 6天。1 2　临床表现　足部病变出现前自感下肢发凉者 6例 ,静息痛 4例 ,活动后疼痛 6例。发病与外伤有关者 2 3例 ,其中轻微伤 15例。前足部足坏死 2 1例 ,感染 2 0例。同时伴高血压10例 ,眼…     

血栓闭塞性脉管炎和动脉硬化闭塞症的发病率研究

目的：研究我国血栓闭塞性脉管炎（TAO）和动脉硬化闭塞症（ASO）的发病率变化。方法：调查我国13家医院1983－1998年TAO10401例和ASO8843例。结果：第一组1983－1986年TAO2313例、ASO849例；1987－1990年TAO2869例、ASO1243例；1991－1994年TAO2271例，ASO1438例和1995－1998年TAO1653例，ASO1506例，第二组1991－1994年TAO605例，ASO593例；1995－1998年TAO418例，ASO1044例，结论：在我国，TAO发病率呈逐年明显下降，ASO呈明显增多的趋势。     

Hypotension, hypoxia, and head injury: frequency, duration, and consequences

BACKGROUND: Retrospective studies have suggested an association between systemic hypotension and hypoxia and worsened outcome from traumatic brain injury. Little is known, however, about the frequency and duration of these potentially preventable causes of secondary brain injury. HYPOTHESIS: Early episodes of hypoxia and hypotension occurring during initial resuscitation will have a significant impact on outcome following traumatic brain injury. DESIGN: Prospective cohort study. SETTING: Urban level I trauma center. PATIENTS: Patients with a traumatic brain injury who had a Glasgow Coma Score of 12 or less within the first 24 hours of admission to the hospital and computed tomographic scan results demonstrating intracranial pathologic features. Patients who died in the emergency department were excluded from the study. MAIN OUTCOME MEASURES: Automated blood pressure and pulse oximetry readings were collected prospectively from the time of arrival through initial resuscitation. The number and duration of hypotensive (systolic blood pressure, < or =90 mm Hg) and hypoxic (oxygen saturation, < or =92%) events were analyzed for their association with mortality and neurological outcome. RESULTS: One hundred seven patients met the enrollment criteria (median Glasgow Coma Score, 7). Overall mortality was 43%. Twenty-six patients (24%) had hypotension while in the emergency department, with an average of 1.5 episodes per patient (mean duration, 9.1 minutes). Of these 26 patients with hypotension, 17 (65%) died (P =.01). When the number of hypotensive episodes increased from 1 to 2 or more, the odds ratio for death increased from 2.1 to 8.1. Forty-one patients (38%) had hypoxia, with an average of 2.1 episodes per patient (mean duration, 8.7 minutes). Of these 41 patients with hypoxia, 18 (44%) died (P =.68). CONCLUSIONS: Hypotension, but not hypoxia, occurring in the initial phase of resuscitation is significantly (P =.009) associated with increased mortality following brain injury, even when episodes are relatively short. These prospective data reinforce the need for early continuous monitoring and improved treatment of hypotension in brain-injured patients.     

Data,information, knowledge,wisdom, and understanding

The digital age commenced in the mid-20th century and since we have seen approximately exponential growth in information. This period has also seen the rapid growth of computer technology that has facilitated, for instance, the derivation of whole genomes and automated drug discovery. Data, information, knowledge and wisdom lay the foundations for understanding how experience is formed from evidence and observations. When data are put into context, the resultant information can drive growth and further contribute to increased knowledge. Appreciating the source of data enables us to recognize and hopefully correct for inherent error and bias. Ultimately knowledge discovery can be automated to gain information from data and so on, enhancing our understanding of a given subject and expanding collective wisdom.     

Distribution, elimination, and action of d-tubocurarine in neonates, infants, children, and adults

The relation of plasma concentration of d-tubocurarine (dTc) to neuromuscular blockade, and the distribution and urinary excretion of dTc was determined in neonates (n = 4), infants (n = 6), children (n = 8), and adults (n = 8). The plasma concentration-time course curves to 24 hr are best described for all groups by three-compartment models. Both neonates and infants exhibit decreased plasma clearance (CLP), 1.1 +/- 0.08 and 1.0 +/- 0.06 ml X kg-1 X min-1, and in addition a prolonged t1/2 terminal phase, 311 +/- 44 and 306 +/- 35 (mean +/- SEM, min). The neonates' 24-hr urinary excretion, 27 +/- 2 (mean +/- SEM, % total dose) is significantly less than the adult value, 45 +/- 4% total dose. There was no significant difference seen in the log plasma concentration-evoked compound electromyogram (ECEMG) response between 20-80% paralysis for adults, children, infants, and five of the seven neonates studied. Two of the neonates had a significant shift of their log concentration-response curve to the right. There was also no significant difference between any of the groups in the time for 50% return of ECEMG stimulus height or the time required for recovery of the ECEMG from 25 to 75% of control value. for recovery of the ECEMG from 25 to 75% of control value.     

Laparotomy, laparoscopy, cancer, and beyond

The fate of laparoscopic methods for the treatment of cancer remains uncertain. Published middle-range oncologic results from nonrandomized studies demonstrate that laparoscopic methods are associated with an outcome comparable with results after open resection. The world awaits the 3- and 5-year oncologic results of the ongoing randomized and prospective trials. There is a possibility that laparoscopic methods may be associated with a survival benefit. Port tumors remain a concern. However, results at this writing suggest that these recurrences take place at a frequency similar to that of incisional recurrences following open cancer resection. Port tumors currently are viewed as local recurrences. Traumatization of the tumor at the time of resection is thought to be the most important surgery-related risk factor. The demonstration of a survival benefit in a randomized trial would likely have a tremendous impact on the surgical world. Avoidance of laparotomy-related immunosuppression and tumor stimulation, both of which have been well demonstrated in animal studies, theoretically, might account for differences in cancer outcome. The early postoperative period may be a critical time during which the fate of many cancer patients is determined. It is possible that this may be an ideal time frame for antitumor immunotherapy because the tumor burden is at its lowest, and because immunotherapy, unlike conventional chemotherapy, is unlikely to have a negative impact on wound and anastomotic healing. Perioperative nonspecific upregulation of immune function via pharmacologic means may improve long-term oncologic results. Similarly, preoperative tumor vaccines might provide patients with a specific means of combating any remaining tumor cells after curative resection. The results of several recently completed murine studies support both of these ideas. Finally, early postoperative administration of monoclonal antitumor antibodies might provide patients with specific means of combating any remaining tumor cells after curative resection. The introduction of advanced minimally invasive techniques nearly a decade ago has led to new methods of approaching malignant tumors that have the potential to have an impact on the oncologic outcome of cancer patients. This decade-long journey also has led to new insights regarding the impact of surgery on the patient. It also has alerted us concerning the importance of the immediate postoperative period in the patient's ongoing struggle against the tumor. These insights hopefully will lead to better surgical methods and new perioperative adjuvant therapies that will increase the rate of survival and reduce the recurrence rates for cancer patients.