网孔状硅胶引流管与丝裂霉素C在鼻内镜额窦手术中的应用

Objective To investigate effect about application of mesh silica-drainage tube and mitomycin C (MMC) synchronization in endoscopic sinus surgery. Methods We selected 65 patients (116 sides)who have been operated on under nasal endoscopy in this study,included chronic frontal sinusitis,frontal mucocele,osteoma and inverted papilloma. 35 patients (64 sides) of the total was performed to apply mesh silica-drainage tube and MMC synchronization in endoscopic sinus surgery, which as MMC group;the other 30 patients (52 sides) who were not apply it as a control. What's more, all patients were followed 2 ～ 3 years after operation, and the postoperative efficacy and the incidence of complication in the two groups were compared. Results The total effective rate in MMC group(97.4%) was higher.than that of the control group(72.9%) (P<0.01). In MMC group, nasal adhesion after endoscopic sinus surgery was 1 case, and the incidence of complication was 1.6% ;but in control group, nasal adhesion was 7 cases,the ostium of frontal sinus atresia 1 case, the nasofrontal duct stenosis 2 cases, recurrence of the polyps or tumors 2 cases, so the incidence of complication was 23.1% The incidence of complication rate in MMC group was lower than that of the control group (P<0.01)Conclusion To apply mesh silica-drainage tube and mitomycin C synchronization in endoscopic sinus surgery can improve clinical effects of operation method, and postoperative complications are obviously decreased. So this method is convenient, safe and effective.     

网孔状硅胶引流管与丝裂霉素C在鼻内镜额窦手术中的应用

Objective To investigate effect about application of mesh silica-drainage tube and mitomycin C (MMC) synchronization in endoscopic sinus surgery. Methods We selected 65 patients (116 sides)who have been operated on under nasal endoscopy in this study,included chronic frontal sinusitis,frontal mucocele,osteoma and inverted papilloma. 35 patients (64 sides) of the total was performed to apply mesh silica-drainage tube and MMC synchronization in endoscopic sinus surgery, which as MMC group;the other 30 patients (52 sides) who were not apply it as a control. What's more, all patients were followed 2 ～ 3 years after operation, and the postoperative efficacy and the incidence of complication in the two groups were compared. Results The total effective rate in MMC group(97.4%) was higher.than that of the control group(72.9%) (P<0.01). In MMC group, nasal adhesion after endoscopic sinus surgery was 1 case, and the incidence of complication was 1.6% ;but in control group, nasal adhesion was 7 cases,the ostium of frontal sinus atresia 1 case, the nasofrontal duct stenosis 2 cases, recurrence of the polyps or tumors 2 cases, so the incidence of complication was 23.1% The incidence of complication rate in MMC group was lower than that of the control group (P<0.01)Conclusion To apply mesh silica-drainage tube and mitomycin C synchronization in endoscopic sinus surgery can improve clinical effects of operation method, and postoperative complications are obviously decreased. So this method is convenient, safe and effective.     

泪小管显微吻合术的疗效观察及预后影响因素分析

Objective To evaluate lacrimal duct anastomosis microscopic observation and prognostic factors. Methods Retrograde lacrimal sac incision into 68 cases of anastomosis and direct anastomosis of 60cases of intubation. Clinical observation of two methods to observe the prognostic factors. Results Retrograde Anastomosis lacrimal sac incision total effective rate 86. 76% and direct anastomosis intubation total efficiency 91.66%; two methods the total effective rate P ＞ 0.05, no significant difference. Conclusion Microsurgical anastomosis of lacrimal canal lacrimal duct in traumatic fracture with a clear surgical field level. Operating fine,accurate, and minimal tissue damage in the process of looking for nasal surgery ends is critical, applications can use a variety of methods, to achieve the maximum recovery for wounds and reduce the failure rate of surgery, for patient rehabilitation.     

The acute adhesive small-bowel obstruction timing of surgical intervention、 indications and prognosis

Objective To investigate the acute adhesive small-bowel obstruction timing of surgical intervention、indications and prognosis. Methods A retrospective analysis of 48 cases of acute adhesive smallbowel obstruction of the clinical data, surgical timing and indications, which were treated from January 2000 to July 2009.Results 41 patients cured,5 cases improved, two deaths from septic shock, postoperative pulmonary infection in 10 cases,8 cases of wound infection, intra-abdominal residual abscess in 5 cases, short bowel syndrome in 3 cases,2 cases of renal insufficiency, which were cured through combined treatment. Conclusion Acute adhesive intestinal obstruction in a conservative course of treatment should be to discover clues of early intestinal strangulation, decisive decision to surgical treatment, timing of surgery are advised to be early, not late.Being loose instead of strict in surgical indications is the important measures to improve the clinical cure rate and reduce complications and mortality.     

Effect of health education in treatment of cervical spondylopathy by blocking of nerve ganglion

Background:The clinical symptoms of disorders of temporomandibular joint,clicking of joint and dyscinesia of mandibular,which treatment ways are virious and its curative effect is different.Objective:To explore the effect of the ulotrasonic wave treatment of 116 patients with disorders of temporomandibular joint.Unit:Affiliated Second Hospital of Qiqihaer Medical College.Subject:116 patients with temporomandibular joint,47 males and 69 females,aged 14-70 years old,average 36 years old.Disease history recorded from 2 days to several months.Pathosenic parts:18 cases were bilateral,42 cases were dextral and 56 cases were left.Pathogenic factors included mental,traumatic and others factors.clinical stages:75 cases in dysfunction period of masseter (65 per cent),36 cases in disturbance period of structure of joint (31 per cent) and 5 cases in period of organic changes.Intervention:With CSL-I type ultrasonic wave treatment machine produced by Shanghai,frequency 800 kHz,diameter 3.5cm,we used the method of contact and movement,which adopted liquid paraffin as coupled agent.We told patients open mouth slightly and placed sound-head on the part of temporomandibular joint,0.75-1.0W/cm,once 10 minutes,once each day and 10 days as a treatment course.We can observe the effect after two courses of treatment,meantime adopt comprehensive treatment like rehabilitative therapy to eliminate causes of diseases.Main result measurements index:recovery:joint pain disappears,extent of opening mouth normal,snap disappears and figure of opening mouth abnormity disappears;improved:joint pain obviously alleviates,extent of opening mouth obviously improves and snap and figure of opening mouth alleviate;ineffective:no changes before and after treatment.Results:75 cases disorders of masseter function,75 cured (58 in one treatment course,17 in two treatment course),recovery rate 100 per cent;36 cases of disorders of joint structure,28 cured (18 in one treatment course,10 in two treatment course),recovery rate 77.78 per cent.8 cases improved (two treatment courses),total effective rater 100 per cent;5 cases of organic changes,4 cases improved (two treatment courses),1 case ineffective,total effective rate 80 per cent.Conclusion:The treatment of ultra wave of temporomandibular joint can alleviate pain and improve blood circulation,ralax contracted muscle,and improve injury recovery.     

Significance of 125I radioactive seed implantation on growth differentiation factor and programmed death receptor-1 during treatment of oral cancer

BACKGROUND Oral cancer(OC)is the most common malignant tumor in the oral cavity,and is mainly seen in middle-aged and elderly men.At present,OC is mainly treated clinically by surgery or combined with radiotherapy and chemotherapy;but recently,more and more studies have shown that the stress trauma caused by surgery and the side effects of radiotherapy and chemotherapy seriously affect the prognosis of patients.AIM To determine the significance of 125I radioactive seed implantation on growth differentiation factor 11(GDF11)and programmed death receptor-1(PD-1)during treatment of OC.METHODS A total of 184 OC patients admitted to The Second Affiliated Hospital of Jiamusi University from May 2015 to May 2017 were selected as the research subjects for prospective analysis.Of these patients,89 who received 125I radioactive seed implantation therapy were regarded as the research group(RG)and 95 patients who received surgical treatment were regarded as the control group(CG).The clinical efficacy,incidence of adverse reactions and changes in GDF11 and PD-1 before treatment(T0),2 wk after treatment(T1),4 wk after treatment(T2)and 6 wk after treatment(T3)were compared between the two groups.RESULTS The efficacy and recurrence rate in the RG were better than those in the CG(P<0.05),while the incidence of adverse reactions and survival rate were not different.There was no difference in GDF11 and PD-1 between the two groups at T0 and T1,but these factors were lower in the RG than in the CG at T2 and T3(P<0.05).Using receiver operating characteristic(ROC)curve analysis,GDF11 and PD-1 had good predictive value for efficacy and recurrence(P<0.001).CONCLUSION 125I radioactive seed implantation has clinical efficacy and can reduce the recurrence rate in patients with OC.This therapy has marked potential in clinical application.The detection of GDF11 and PD-1 in patients during treatment showed good predictive value for treatment efficacy and recurrence in OC patients,and may be potential targets for future OC treatment.     

依达拉奉对急性大面积脑梗死患者高敏C反应蛋白影响的临床研究

Objective To explore the effects of edaravone on high sensitivity C-reaction protein (hsCRP) in patients with acute massive cerebral infarction. Methods 86 cases with acute massive cerebral infarction were selected from December 2006 to December 2008. all the cases were divided into two groups, control group and cure group. routine treatment was used to the control group, on the basis of control group'therapy,edaravone was given to cure group. the level of hsCRP was detected before and after treatment, and the results of cure was compared. Results ①the total effective rate in two groups existed statistical difference (P<0.05);② the level of hsCRP in two groups before treatment and in the 7th and the 14th of treatment existed statistical difference(P<0.01), the level of hsCRP in the 7th and the 14th of treatment in cure group existed statistical difference(P<0.05). Conclusion Edaravone can decrease the level of hsCRP in patients with massive cerebral infarction, and has significant clinical efficacy,which should be the reference for the doctors.     

Surgical method choice and coincidence rate of pathological diagnoses in transduodenal ampullectomy: A retrospective case series study and review of the literature

BACKGROUND Transduodenal ampullectomy(TDA) is not in wide clinical use due to its low radical effect and a high recurrence rate of tumors. However,TDA is still an effective treatment method; it has great clinical value in cases of duodenal benign tumors,precancerous lesions,and benign and malignant borderline tumors,and can avoid the risks associated with pancreaticoduodenectomy with larger resection range and greater thoroughness than endoscopic papillectomy.AIM To investigate the surgical method choice and the coincidence rate of pathological diagnoses in TDA for ampullary neoplasms.METHODS Ten patients with ampullary neoplasms underwent TDA based on the fact that their endoscopic biopsy results suggested benign lesions,and the endoscopic ultrasound(EUS)-assessed tumors were resectable. All cases underwent duodenal ampullary lesion endoscopic biopsy,intraoperative frozen-section pathological examination,and postoperative pathological examination.RESULTSThis study included seven patients with benign tumors and three with malignant tumors(1 pTis,2 pT1),according to the postoperative pathology results. The coincidence rate of the postoperative pathology results with the intraoperative frozen-section biopsy results was 100%(10/10),and the coincidence rate with the endoscopic biopsy results was 70%(7/10) based on pathological characteristics.The endoscopic biopsy false-negative rate was 30%(3/10). All patients were followed for 6 to 70 mo without tumor recurrence or metastasis.CONCLUSION The coincidence rate of postoperative pathology results,intraoperative frozensection pathology results,and endoscopic biopsy results is the restraining factor of TDA clinical application. Endoscopic biopsy results and EUS have importance relevance to surgical planning. Intraoperative frozen-section pathology results have a significant influence on the choice of surgical procedure.     

依达拉奉对急性大面积脑梗死患者高敏C反应蛋白影响的临床研究

Objective To explore the effects of edaravone on high sensitivity C-reaction protein (hsCRP) in patients with acute massive cerebral infarction. Methods 86 cases with acute massive cerebral infarction were selected from December 2006 to December 2008. all the cases were divided into two groups, control group and cure group. routine treatment was used to the control group, on the basis of control group'therapy,edaravone was given to cure group. the level of hsCRP was detected before and after treatment, and the results of cure was compared. Results ①the total effective rate in two groups existed statistical difference (P<0.05);② the level of hsCRP in two groups before treatment and in the 7th and the 14th of treatment existed statistical difference(P<0.01), the level of hsCRP in the 7th and the 14th of treatment in cure group existed statistical difference(P<0.05). Conclusion Edaravone can decrease the level of hsCRP in patients with massive cerebral infarction, and has significant clinical efficacy,which should be the reference for the doctors.     

Hepatoid adenocarcinoma of the stomach: Thirteen case reports and review of literature

BACKGROUND The aim of the present study was to examine the clinical characteristics of hepatoid adenocarcinoma of the stomach (HAS) and its diagnosis,treatment,and prognosis.CASE SUMMARY A retrospective analysis of 13 HAS cases was performed.The mean age of the 13patients was 66.08 years,and 10 of the 13 patients were male.Prior to treatment,the alpha-fetoprotein levels in the serum were elevated in 7 patients,the tumour was located in the distal or gastric body in 11 patients,and the gastroscopy pathological results showed that 3 patients had poorly differentiated tumours and that 8 patients had moderately/poorly differentiated tumours.Abdominal CT scans showed local stomach wall thickening,and enlarged lymph nodes were visible around the stomach in 8 patients.Of the 13 patients,11 underwent radical surgery.The clinical pathological staging was as follows:Stage Ⅱ in 2 cases;stage Ⅲ in 8 cases;and stage Ⅳ in 1 case.A total of 3 patients were lost to follow-up.Otherwise,as of the last follow-up,3 patients had survived for 56 mo,and the other 7 patients failed to achieve long-term survival (survival period of 1-56 mo).CONCLUSION HAS is a special type of gastric cancer,and the prognosis of HAS has improved compared with past prognoses.Measurement of alpha-fetoprotein,early diagnosis,active surgical treatment,and application of new diagnostic and treatment techniques are conducive to improving the prognosis of HAS.     

韶关市农村留守儿童孤独感状况调查

目的了解广东省韶关市农村地区留守儿童孤独感现状及其影响因素。方法对韶关市某地区两所农村小学3～6年级学生中的489名留守儿童采用儿童孤独量表和自编调查表进行问卷调查。结果17．6％留守儿童存在孤独感,不同性别孤独感发生率无差异性,不同年龄及不同年级间孤独感发生率差异均有极显著性（P〈0.01）;随年级增加,孤独感发生率呈下降趋势（X^2趋势=5．970,P〈0.05）。留守儿童孤独感与健康状况、学习成绩、学习困难程度、父母教育方式、父母间关系和老师教育方式等因素显著相关（P〈0.01～0．05）。结论农村地区留守儿童中存在一定程度的孤独感问题,老师和家长应以正确的态度和方法对待留守儿童,以减少其孤独感的发生。     

产科新生儿不同部位经皮测黄报警预值的可靠性观察

目的对比观察产科新生儿不同部位经皮胆红素（TCB）报警预值的可靠性。方法132例产科新生儿采取随机数字分组法分为正常产组和剖宫产组各66例,新生儿均于产后第4天同一时间点应用KJ8000经皮测黄仪分别测量额、胸、腹、额胸、额胸腹TCB值,TCB〉12．9mg／dl者,取得亲属同意抽取静脉血检测血清胆红素（SB）,对比分析不同部位TCB及其与sB值的差异。结果两组分别有17例或21例达到TCB报警预值。两组TCB或sB相同方法及相同部位比较,差异无统计学意义（P〉0．05）;两组TCB不同部位对比,额部值最低、胸部值最高,且与其他部位同组对比差异均有统计学意义（P〈0．01）;两组sB值对比差异无统计学意义（t=1．53,P〉0．05）,与不同部位TCB对比均以胸部数值差异无统计学意义（P〉0．05）,而与其他部位TCB两组差异均有统计学意义（P〈0．01）。结论正常产与剖宫产新生儿术后sB对比差异无意义;TCB动态监测以胸部结果更接近SB。     

Determination of loss of quality of life

Physiatrists are a valuable resource in legal settings, where assessment of functional capacity to perform work and of future medical needs must be determined. Physiatrists help determine what future medical care is needed to restore and maintain an individual at the maximum level of life function. This article focuses on the use of a quality of life (QOL) rehabilitation model, rather than a medical model, for enhancing functional performance, modifying environments, and facilitating patient coping. We discuss use of the QOL model to describe and influence a patient's physical, psychological, cognitive, vocational/economic, and social/leisure domains.     

血液透析患者家庭护理提供者的生活质量调查

目的:了解江汉油田血液透析(血液透析)患者家庭护理提供者(护理者)的生活质量。方法:对60例血液透析患者的家庭护理提供者进行一般情况和生活质量综合评定问卷(QOLI-74)调查,并进行相关性和多因素回归分析。结果:家庭护理提供者各维度的主观生活满意度与其客观指标相关,但也与其需求、年龄、文化程度、与患者的关系有关。结论:客观状态是影响主观生活满意度的重要因素,同时应考虑护理者的需求、年龄、文化程度、与患者的关系对护理者主观生活满意度的影响。     

星状神经节阻滞治疗失眠疗效观察

失眠症又称不寐，指入睡困难，或维持睡眠障碍（易醒、早醒和再入睡困难）导致睡眠时间减少或睡眠质量下降，不能满足身体生理需要，明显影响日间社会功能和生活质量。现将星状神经节阻滞治疗失眠疗效观察总结如下。