脂肪栓塞综合征早期诊断与治疗(附10例临床报告)

目的　总结脂肪栓塞综合征 (FES)早期诊断及治疗经验。方法　根据 1 0例 FES患者早期体征、临床表现及实验室检查改变 ,进行有效的治疗 ,并对结果进行评价。结果　 1 0例 FES均痊愈。结论　早期识别 FES是治疗的关键 ,对于 FES,防重于治     

多发伤合并脂肪栓塞综合征的临床特点和诊治分析

目的分析多发伤患者脂肪栓塞综合征(FES)的临床特点,总结其诊治经验。方法收集2007年1月～2012年6月我科收治多发伤5 074例患者临床资料,有25例在创伤后继发FES。结合本组患者临床资料,分析其发病特点、诊断和治疗方法。结果 25例均为多发伤,损伤严重程度(ISS)≥16,FES发生率0.49%,脂肪栓塞症状伤后平均43.68h。所有患者给与积极有效的治疗措施,其中治愈12例,明显好转后转当地医院治疗7例,植物状态1例,放弃治疗1例,死亡4例,死亡率为16%。结论在多发伤中,FES发生率低但死亡率高,关键是对FES的早期诊断和及时处理创伤后长骨骨折。选择积极有效的综合治疗,改善创伤后FES患者的预后。     

股骨干骨折并发脂肪栓塞综合征的诊断与治疗

目的 探讨股骨干骨折后脂肪栓塞综合征（FES）的诊断与治疗方法。方法 1989－1998年收治的股骨干骨折病人212例，对并发FES的8例病人的临床表现、治疗方法与结果进行描述。结果 184例单股骨折病人发生FES4例，28例双股骨骨折病人发生FES4例，发生率分别为2．2％和16．7％，P＜0．05。结论 FES更好发于双股骨骨折病人；骨折的早期开放复位固定可降低FES的发生率，而骨折髓内针固定有增加FES发生的危险；呼吸支持和循环维持是治疗FES的关键，早期大剂量激素应用有肯定的治疗效果。     

腹部闭合性损伤的早期救治(附87例分析)

目的：提高腹部闭合性损伤的救治水平，方法：回顾分析87例腹部闭合性脏器损伤患者的早期救治。结果：全组治愈81例。并发症9例，肺部感染3例，急性呼吸窘迫综合征1例，多器官功能衰竭1例，肾功能不全1例，切口感染1例，骨折畸形愈合1例，脾窝积液1例，死亡6例，结论：在对腹部闭合性损伤患者施行早期救治时，及早进行诊断性腹穿及B超检查，尽快明确诊断，积极正确地抗休克治疗，早期剖腹探查是提高腹部闭合性损伤病人救治成功率的关键。     

高压氧治疗高海拔地区糖尿病足的临床观察

目的:探讨高压氧治疗高海拔地区糖尿病足的治疗作用.方法:将36例确诊为糖尿病足的患者随机分为对照组进行常规治疗,治疗组在对照组的基础上行高压氧治疗,依据Wenger疗效标准进行效果评价.结果:治疗组疗效明显优于对照组(P＜0.001),治愈时间明显缩短.结论:高压氧可以有效改善糖尿病足的血液循环,促进糖尿病足早期康复,...     

大型高低压氧舱在高原临床应用初探

本文首次报告了我院(驻地海拔3658米)近两年来使用高压氧在西藏高原治疗582例各类患者的结果。其总有效率为99.14％。特别是高压氧疗法对急慢性高原病的疗效令人欣慰。315例急性高原病的治愈率达100％,其中的高原昏迷和高原肺水肿患者全部迅速治愈,慢性高原病的有效率也达100％。作者认为:高压氧疗法是救治急慢性高原病的一种理想方法,高压氧疗法在高原医学中的应用具有广阔前景。     

大型高低压氧舱在高原临床应用初探

本文首次报告了我院 (驻地海拔3658米) 近两年来使用高压氧在西藏高原治疗582例各类患者的结果。其总有效率为99.14％。特别是高压氧疗法对急慢性高原病的疗放令人满意:315例急性高原病的治愈率达100％,其中的高原昏迷们高原肺水肿患者全部迅速治愈,慢性高原病的有效率也达100％。作者认为:高压氧疗法是救治急慢性高原病的一种理想疗法,在高原医学中应用具有广阔前景。     

高压氧治疗超早期脑梗死的疗效及对神经元特异性烯醇化酶和内皮素的影响

目的研究高压氧治疗对超早期脑梗死患者的疗效及对神经元特异性烯醇化酶（NSE）、血浆内皮素（ET）的影响。方法超早期脑梗死患者分为高压氧治疗组35例和对照组33例。两组基础药物治疗相同，高压氧（HBO）治疗组采用GY-3．2型高压氧舱0．2MPa压力治疗，比较两组治疗前后NSE、血浆ET水平和神经功能缺损评分的变化。结果治疗30d后，HBO组和对照组总有效率分别为88．6％和63．6％，NSE、ET、神经功能缺损评分HBO组均优于对照组，差异有统计学意义（P〈0．05）。结论高压氧治疗能降低超早期脑梗死患者NSE和血浆ET水平。高压氧治疗通过增加供氧、调节超早期脑梗死患者的血管舒缩功能、减轻脑水肿来保护神经细胞，改善患者的神经功能。     

闽北地区烧伤救治网络运行效果分析

目的针对闽北地区烧伤救治的现状,为提高闽北地区烧伤救治水平,提高烧伤的治愈率,降低死亡率、致残率,建立了烧伤救治网络,并对该网络运行效果进行评价。方法28例烧伤面积80%以上或Ⅲ度烧伤50%以上的病人以是否经救治网络救治,分成治疗组(15例)和对照组(13例),前者经烧伤救治网络进行规范的早期急救和转送的患者,后者为经非烧伤救治网络内医疗机构救治,或未经任何医疗机构救治直接转送的患者。对两组死亡率、全身感染发生率以及治愈时间等进行比较分析。结果治疗组死亡率、并发症发生率低于对照组,治愈时间较对照组短。结论通过建立烧伤救治网络,使患者能得到及时、正确的专业救治,减少了休克和其他烧伤并发症的发生,降低了死亡率和致残率。     

妊娠晚期急性一氧化碳中毒高压氧救治1例

高压氧已被认为是治疗一氧化碳（CO）中毒的首选方法，但妊娠期CO中毒的高压氧治疗一直存在争议。2008年3月我科成功救治1例妊娠晚期急性CO中毒患者。现报告如下：     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.