雾化吸入灭活草分枝杆菌治疗中度支气管哮喘的临床研究

Objective To introduce inhaled inactivated-mycobacterium phlei on prevention and treatment of moderate bronchial asthma to observe the clinical effect. Method This study was a prospective and controlled study. The patients diagnosed with asthma in our out-patient from March 2009 to December 2010 were collected, who met the following conditions were included in the study: age≥ 14 years; met the criteria of moderate chronic persistent bronchial asthma in Global Initiative for Asthma (GINA) in 2008; suspended receiving systemic corticosteroids, Montelukast, ketotifen and other anti-inflammatory and anti-allergic drugs in one month; no significant respiratory tract infections; and other serious illnesses or abnormalities known.A total of 100 patients with asthma were selected, including 37 males and 63 females, age (32.11 ± 12.95 )years. The patients were randomly(random number) divided into two groups: A group(treatment group; 16males and 34 females, age 33.56 ± 14.23 years) and B group (control group; 21 males and 29 females,age 30.66 ± 11.50 years); 50 in each group. No significant difference was noted between the two groups on age and gender composition. The patients in A group were treated with inhaled inactivated-mycobacterium phlei F. U. 36 Injection 1.72 μg/mL × 2 that adding 3 mL normal saline, once a day for 5 days. The patients in B group were treated with salmeterol xinafoate and fluticasone propionate powder for inhalation (50/100 μg), twice daily for sustainable use. The patients in the two groups were observed for one month. During this course, the patients in the two groups could inhale the salbutamol sulphate aerosol as need to relieve symptoms. And the number of using was recorded. Pulmonary function test and asthma provocative test were carried out on the Day O, 6 and 31. ACT scores were measured before and after the treatment. Results On Day 6 and 31 after treatment, the negative conversion rates of asthma provocative test of the patients in A group were 82% and 78% respectively, B group were 84% and 90% respectively. Provocative test of the patients in the two groups were negative conversion significantly before and after treatment. There was no significant difference between the two groups by chi-square test (P ＞ 0. 05 ). Completely random designed data was analyzed by analysis of variance. The analysis showed that the accumulated doses of methacholine of the patients in the two group increased significantly ( P ＜ 0. 05 ), but no difference between the two groups.There was a improvement trend on forced expiratory volume in one second( FEV1 )of the patients in A group after treatment, but no difference. FEV1 of the patients in B group increased significantly higher ( P ＜0.05), which was significantly higher than A group on the 31th day (P ＜0. 05); Peak expiratory flow (PEF) of the patients in the two group increased significantly on Day 6 and 31 after treatment (P ＜0.05 ).On Day 31, B group was significantly higher than A group ( P ＜ 0. 05 ); Scores of asthma control test (ACT)of the patients in the two group were significantly increased, and the number of using of salbutamol sulfate aerosol was significantly reduced (P ＜0.01 ). B group was obvious than group A (P ＜0.05 ). During treatment, there were only two adverse reaction cases of transient low fever; most obvious was on the third day.Conclusions Inhaled inactivated-mycobacterium phlei would inhibit the airway hyperresponsiveness of the patients with moderate bronchial asthma in short time, improve the symptoms, reduce the acute exacerbation, and reduce the use of rescue medication, which has the roles of prevention and treatment of moderate asthma in a certain period of time.     

Phwarmaclogiic therapy in management of cancer—related pain

Background:According to small scale of investigation,world health organization(WHO)infers thwat moderate and serious pain is observed in about 1/3 of patients receiving active anti-cancer therapy and 60% in late stage.Cancer-related pain is a threat to patients‘ living quality and confidence,so rehabilition becomes an important part in treatment of cancer.Objective:To observe effect of pharmaologic therapy in management of cancer-related pain.Unit:Affiliated First Hospital of Dalizn Medical University.Subjects:230 cases of cancer diagnosed by pathological and physiochemical examination and complicated with cancer-reated pain were investigated,including 138 males,92 females aged 8-90(mean:67) years old.Somatic pain,81 cases,visceral pain,133 cases,neural pain,16 cases.All cases were the first time to receive ladders pharmacological therapy.NRS method was adopted and degrees of pain were expressed by nubbers(0-10) with 0 expressing painless,10 expressing sever pain.Grading of pain:0:no pain;1-3:minor pain;4-6:moderate(sleep was affected);7-10;severe pain(unable to sleep).Intervention:Different ladders of therapy were taken according to different pain graded.First ladder:suitable to minor and part of moderate grade of pain,non-opium drugs,Fenbid was used.Second ladder:suitable to moderate pain and minor opium was adopted codein/Ap-237.In treatment courses,if pain didn‘t alleviated completely,dosage was added or ladder was in creased.Third ladder:suitable to severe pain or cases not effective by second ladder ,,major opium was used,morphine or fentanyl, dosage of former,60-300mg/d,dosage of later,2.5-5.0mg/72h,dosage was modified according to 30%-50% of former dosage,until obvious effect was achieved.Strict drug-taking time was obeyed.When using fentanyl,if effect wasn‘t satisfying at 2th,3th day,morphine was supplied,dosage of fentanyl was modified by 24h total amount of morphine.Administration way:oral,anal were first choices and muscle injection of morphine was used when ecessary.Result:Alleviatin condition:Minor:before therapy,40 cases,after therapy,2 cases,alleviation rate.95.0%;Moderate before therapy,92 cases ,after therapy,26 cases,alleviation rate,71.7;Severe:before therapy,98 cases,after therapy,19 cases,alleviation rate,80.6% Conclusion:Ladders pharmacologic therapy was and effective method in treatment of cancer-related pain.     

Effect evaluation of artemisia desertorum spreng on ability of daily life after extraction of impacted tooth

AIM：To investigate the effect of locally used Shahaosan on preventing the complication of extraction of impacted tooth.METHODS:274 cases patients with extraction of impacted teeth were randomly devided into 3 groups named A,B and C.Shahaosan and Yunnan white drug were grocessed into drug A and B by department of pharmacy with the same color,shape and quality which are blind to doctors and patients.When the impacted teeth were extracted,administed group A (92 cases) with drug A,group b(86 cases) with drug B and group c(96 cases) was a blank control.After the operation,incidence and severe intensity of dry socket in each group were observed and evaluated by scores.RESULTS:The incidence of dry socket in group a,B and C were 0.09%(1/92),2.32%(2/86),8.33%(8/96).There was no significant difference between group A and B,group b and C,while a significant difference showed between group A and C.The PoSSe score in group A,B and C was 19.36,27.80 and 22.83 respectively.Afer the experiment the department of pharmacy informed that drug A is Shahaosan and drug b is Yunnan white drug.CONCLUSTON:Compiments of dry socket induced by extracting of lower jaw impacted teeth can be prevented by locally administered with Shahaosan,but no significant effect of alleviating the symptom of dental extraction.     

Effect of Durogesic in the treatment of cancer pain

Objective To evaluate the effectiveness of transdermal fentanyl (Durogesic)in the treatment of cancer pain.Methods 30 cases of patients with moderate to servere cancer pain were treated using Durogesic,and 30 patients were treated using sustained-release hydrochloride morphine tablets as control group.Durogesic began from the dosage of 25μg/h to individual doses,and hydrochloride morphine began from 30 mg to individual doses.The duration of treating time was 3 weeks,Results The response rate of pain relief was 80.0% in Durogesic group and 83.3% in hydrochloride morphine group,respectively;Quality of life scores were(27.27±3.53)before treatment and (32.67±2.88)after treatment(P<0.05)in Durogesic group;The main side effect were dizziness,nausea and somnolence.Conclusion Durogesic is effective in the treatment of cancer pain,it can improve the quality of life scores and the side effect is mild to tolerate.     

Postpartum pubic symphysis diastasis-conservative and surgical treatment methods,incidence of complications: Two case reports and a review of the literature

BACKGROUND Widening of the pubic joint of more than 10 mm is diagnostic and defined as pubic symphysis diastasis and is considered a complication of vaginal childbirth or pregnancy.As it is a rare pathology(ranging from 1 in 300 to 1 in 30000 pregnancies),no gold standard treatment has been defined.CASE SUMMARY This study examines two cases,a 27-year-old woman(gravida 1,para 1)and a 32-year-old woman(gravida 2,para 2),who presented to the clinic after uneventful vaginal deliveries.A normal pregnancy with no complications was observed in both patients.Severe pain in the pubic region occurred after labour and was accompanied by complicated locomotion.Pubic symphysis diastasis was confirmed radiologically and bed rest with lateral decubitus positioning was recommended.Oral non-steroidal antiinflammatory drugs were administered to relieve pain exacerbations.The symptoms decreased after treatment.Posttreatment magnetic resonance imaging(MRI)in the first case showed a reduction in symphyseal separation with no signs of osteitis.Three years later the symptoms recurred;MRI examination showed no further symphyseal widening or signs of osteitis.A relapse of symphyseal separation was diagnosed and conservative treatment was re-administered resulting in successful recovery.In the second case,pain recurred when the patient conceived for the second time.This time no benefit following conservative treatment was observed.Persistent pain and complicated locomotion led to scoliotic deformation of the lumbar part of the spine and leg length discrepancy,thus surgical treatment was chosen and internal pubic synthesis was performed.CONCLUSION Overall,surgical treatment resulting from insufficient conservative treatment showed a high risk of postoperative complications following the treatment of postpartum pubic symphysis diastasis.     

Efficacy of different doses of sugammadex after continuous infusion of rocuronium

AIM: To evaluate the effects of two different doses of sugammadex after maintenance anesthesia with sevofluorane and remifentanil and deep rocuroniuminduced neuromuscular blockade(NMB).METHODS: Patients between 20 and 65 years of age, with American Society of Anesthesiologists physical status classification Ⅰ-Ⅱ, undergoing gynecological surgery were included in a prospective, comparative and randomized study. NMB was induced with an injection of 0.6 mg/kg of rocuronium followed by continuous infusion of 0.3-0.6 mg/kg per hour to maintain a deep block. Anesthesia was maintained with sevofluorane and remifentanil. Finally, when surgery was finished, a bolus of 2 mg/kg(group A) or 4 mg/kg(group B) of sugammadex was applied when the NMB first response in the train-of-four was reached. The primary clinical endpoint was time to recovery to a train-of-four ratio of 0.9. Other variables recorded were the time until recovery of train-of-four ratio of 0.7, 0.8, hemodynamic variables(arterial blood pressure and heart rate at baseline, starting sugammadex, and minutes 2, 5 and 10) and adverse events were presented after one hour in the post-anesthesia care unit.RESULTS: Thirty-two patients were included in the study: 16 patients in group A and 16 patients in group B. Only 14 patients each group were recorded because arterial pressure values were lost in two patients from each group in minute 10. The two groups were comparable. Median recovery time from starting of sugammadex administration to a train-of-four ratio of 0.9 in group A and B was 129 and 110 s, respectively.The estimated difference in recovery time between groups was 24 s(95%CI: 0 to 45 s, Hodges-Lehmann estimator), entirely within the predefined equivalence interval. Times to recovery to train-of-four ratios of 0.8(group A: 101 s; group B: 82.5 s) and 0.7(group A: 90 s; group B: 65 s) from start of sugammadex administration were not equivalent between groups. There was not a significant variation in the arterial pressure and heart rate values between the two groups and none of the patients showed any clinical evidence of residual or recurrent NMB. CONCLUSION: A dose of 2 mg/kg of sugammadex after continuous rocuronium infusion is enough to reverse the NMB when first response in the Train-OfFour is reached.     

Therapeutic effect of hyperbaric oxygen on 32 cases of magraine

Background:Clinical manifestation of magraine is periodical onset of fluctuating headache caused by dysfunction of nerve-vessel,which mechanism is still unclear.Objective: To evaluate therapeutic effect of hyperbaric oxygen on magraine.Unit:Central Hospital of Jinzhou City.Subjects: According to diagnosis standards formulated by 1998 International Headache association,64 cases magraine in neural department of central hospital of Jinzhou city were randomly divided into 2 groups.Treatment group:12 males,20 females,aged 18-50 (mean:34)years old with disease course 4 months to 20 years (mean:4.5 years).Control group:13 males,19 females,aged 16-48(mean:33)years old with disease course 3 months to 18 years(mean:5 years).There was no obvious difference at sex,age,conditon between 2 groups.Intervention:Control group:Buflomedil was used,0.1g,once a day,venous injection and 14 days as a therapeutic course.Control group:On base of drug therapy,hyperbaric oxygen chamber therapy was adopted,raising pressure for 30-35min,stabilized pressure for 40 min,reducing pressure for 20 min,therapy pressure 0.2 MPa,once a day,10 days as a therapeutic course.Main prognosis index:Control:no relapse of headache when treating;Marked:Headache alleviated,continuing time shortened obviously,onset times reduced over 60%;Effective:Headache alleveated and continuing time shortened,onset times reduced over 50%;Ineffective:above standards couldn‘t be achieved.Result: Comparison of therapeutic effects between two groups see table 1.Conclusion: Both combination of hyperbaric oxygen with drug and simple drug therapy could reduce onset frequency of magraine,but combination therapy was more effective,and could shorten effect-producing time.     

改进三测单在创伤病房疼痛记录中的临床应用研究

Objective To investigate the effect of improved three-item nursing recording sheet on simplifying nursing record and pain management in trauma ward. Methods The patients involved two wards in our department were divided into control group and study group. Control group was adopted conventional nursing recording sheet to record pain information with words. In study group, the improved three - item nursing recording sheet added pain scoring column was used to record pain information through the curve form. The effect, satisfaction of pain control and nursing record costing time were compared between two groups. Results Satisfaction of patients in study group was better than control group ( P＜0.05 ) ; The effect of pain control in study group wassignificantly better than control group (P＜0.001 ) ; The time of nurse recording was reduced one-third. Conclusions The improved recording sheet can make doctors and nurses visually, dynamically know pain intensity and trends, make patients receive timely and effective treatment, promote patient satisfaction with pain control, save recording time. This method is suitable for the surgical department.     

改进三测单在创伤病房疼痛记录中的临床应用研究

Objective To investigate the effect of improved three-item nursing recording sheet on simplifying nursing record and pain management in trauma ward. Methods The patients involved two wards in our department were divided into control group and study group. Control group was adopted conventional nursing recording sheet to record pain information with words. In study group, the improved three - item nursing recording sheet added pain scoring column was used to record pain information through the curve form. The effect, satisfaction of pain control and nursing record costing time were compared between two groups. Results Satisfaction of patients in study group was better than control group ( P＜0.05 ) ; The effect of pain control in study group wassignificantly better than control group (P＜0.001 ) ; The time of nurse recording was reduced one-third. Conclusions The improved recording sheet can make doctors and nurses visually, dynamically know pain intensity and trends, make patients receive timely and effective treatment, promote patient satisfaction with pain control, save recording time. This method is suitable for the surgical department.     

Efficacy of 1.2L polyethylene glycol plus ascorbic acid for bowel preparations

BACKGROUND A low-volume polyethylene glycol(PEG) solution that combines ascorbic acid with PEG-based electrolyte solution(PEG-ASC) is gaining mainstream acceptance for bowel preparation due to reduced volume and improved taste.Although several reports showed that bowel preparation with PEG-ASC volume lower than 2.0 L with laxative agents could be an alternative to traditional preparation regimen, the cleansing protocols have not been fully investigated.AIM To evaluate the cleansing efficacy of 1.2 L PEG-ASC solution comparing with 2.0 L PEG electrolyte(PEG-ELS) for bowel preparations.METHODS A randomized, single-blinded, open-label, single-center, non-inferiority study was conducted. In total, 312 Japanese adult patients(aged > 18 years) who underwent colonoscopy were enrolled. Patients were randomly allocated to bowel lavage with either 1.2 L of PEG-ASC solution with at least 0.6 L of an additional clear fluid(1.2 L PEG-ASC group) or 2.0 L of PEG-ELS(PEG-ELS group). Then, 48 mg of sennoside was administered at bedtime on the day before colonoscopy, and the designated drug solution was administered at the hospital on the day of colonoscopy. Bowel cleansing was evaluated using the Boston Bowel Preparation Scale(BBPS). The volume of fluid intake and required time for bowel preparation were evaluated. Furthermore, compliance, patient tolerance,and overall acceptability were evaluated using a patient questionnaire, which was assessed using a visual analog scale.RESULTS In total, 291 patients(1.2 L PEG-ASC group, 148; PEG-ELS group, 143) completed the study. There was no significant difference in successful cleansing, defined as a BBPS score ≥ 2 in each segment, between the two groups(1.2 L PEG-ASC group, 91.9%; PEG-ELS group, 90.2%; 95%CI:-0.03-0.09). The required time for bowel preparation was significantly shorter(164.95 min ± 68.95 min vs 202.16 min± 68.69 min, P < 0.001) and the total fluid intake volume was significantly lower(2.23 L ± 0.55 L vs 2.47 L ± 0.56 L, P < 0.001) in the 1.2 L PEG-ASC group than in the PEG-ELS group. Palatability, acceptability of the volume of solution, and overall acceptability evaluated using a patient questionnaire, which was assessed by the visual analog scale, were significantly better in the 1.2 L PEG-ASC group than in the PEG-ELS group(7.70 cm ± 2.57 cm vs 5.80 cm ± 3.24 cm, P < 0.001). No severe adverse event was observed in each group.CONCLUSION The 1.2 L PEG-ASC solution was non-inferior to the 2.0 L PEG-ELS solution in terms of cleansing efficacy and had better acceptability among Japanese patients.     

霉菌性脊柱炎1例报告

1 Clinical data A man aged 40 years old was admitted to our hospital for 10 days due to aggravation of satiety of upper abdomen as well as vomiting, nausea. Satiety developed without apparent predisposing cause 2 months ago and aggravated after meals. Nausea and vomiting occurred 10 days ago,2 to 3 times a day. After a period of time, dry vomiting became predominated accompanied by occasional dull pain of upper abdomen.     

小儿麻醉临床分析研究

Objective To investigate the ketamine and propofol anesthesia for pediatric clinical effect.Methods From january 2009 to February 2010 in our hospital 80 cases surgery children were randomly divided into two groups of 37 cases of ketamine anesthesia using ketamine alone, 43 cases combined with propofol ketamine anesthesia to observe the postoperative incidence of adverse reactions, and postoperative recovery time,for statistical analysis. Results The preoperative and postoperative changes in HR and RR were better than the ketamine group, the difference was statistically significant, P＜ 0. 05; 9.3% adverse reaction rate in combined group was 24. 3% lower than the ketamine group,There were significant differences between groups, P ＜0. 05;recovery time in children of combimed group were less than ketamine group, the difference was also statistically significant, P＜ 0.05. Conclusion Ketamine and propofol anesthesia for children is better than a single ketamine anesthesia, should be widely applied.     

Treatment of of rheumatic disease by Chinese druge fumigation and steaming

AIM:To observe therapeutic effect of fumigation and steaming with Chinese drugs in the rheumatic diseases.METHODS:Drugs removing rheumatic disease,warming channels and dispersing cold,activating blood circulation were used for fumigation and steaming treatment in 84 cases with rheumatic diseases,once a day,20min each time,10times as a treatment course.Among them,4 cases received treatment for 2 and 3 course of treatment respectively.RESULTS:18 cases were corrected completely,64 were improved,2 showed no improvement,and total effective rate was 98%CONCLUSION:Through hot and therapeutic effect of drugs,lesions can be managed directly in fumigation and steaming trestment.     

Efficacy of fascia iliaca compartment nerve block as part of multimodal analgesia after surgery for femoral bone fracture

BACKGROUND: Fascia iliaca compartment nerve block(FICNB) has been an established technique for postoperative analgesia after surgery for femoral bone fracture. FICNB is technically easy, effective for postoperative pain control after operation for femoral bone fracture and decreases the complications induced by systemic analgesic drugs. The severity of postoperative pain is affected by genetics, cultural and social factors across the world. In this study we assessed the efficacy of fascia iliaca compartment nerve block when it is used as part of multimodal analgesia after surgery for femoral bone fracture.METHODS: An institution-based case control study was conducted from September, 2013 to May, 2014. All patients who had been operated on under spinal anesthesia for femoral bone fracture were included. The patients divided into a FICNB group(n=20) and a control group(n=20). The FICNB group was given 30 mL of 0.25% bupivacaine at the end of the operation. Postoperative pain was assessed within the f irst 24 hours, i.e. at 15 minutes, 2 hours, 6 hours, 12 hours and 24 hours using 100 mm visual analogue scale(VAS), total analgesic consumption, and the time for the f irst analgesic request.RESULTS: VAS pain scores were reduced within the f irst 24 hours after operation in the FICNB group compared wtih the control group. VAS scores at 2 hours were taken as median values(IQR) 0.00(0.00) vs.18.00(30.00), P=0.001; at 6 hours 0.00(0.00) vs. 34.00(20.75), P=0.000; at 24 hours 12.50(10.00) vs. 31.50(20.75), P=0.004; and at 12 hours(17.80±12.45) vs.(29.95±12.40), P=0.004, respectively. The total analgesic consumption of diclofenac at 12 and 24 hours was reduced in the FICNB group, and the time for the fi rst analgesic request was signifi cantly prolonged(417.50 vs. 139.25 minutes, P=0.000).CONCLUSIONS: A single injection for FICNB could lead to postoperative pain relief, reduction of total analgesic consumption and prolonged time for the fi rst analgesic request in the FICNB group after surgery for femoral bone fracture. We recommend FICNB for analgesia after surgery for femoral bone fracture and for patients with femoral bone fracture at the emergency department.     

Crizotinib-induced acute fatal liver failure in an Asian ALK-positive lung adenocarcinoma patient with liver metastasis: A case report

BACKGROUND Crizotinib-induce hepatotoxicity is rare and non-specific, and severe hepatotoxicity can develop into fatal liver failure. Herein, we report a case of fatal crizotinib-induced liver failure in a 37-year-old Asian patient.CASE SUMMARY The patient complained of dyspnea and upper abdominal pain for a week in August 2017. He was diagnosed with anaplastic lymphoma kinase-rearranged lung adenocarcinoma combined with multiple distant metastases. Crizotinib was initiated as a first-line treatment at a dosage of 250 mg twice daily. No adverse effects were seen until day 46. On day 55, he was admitted to the hospital with elevated liver enzymes aspartate aminotransferase(AST)(402 IU/L), alanine aminotransferase(ALT)(215 IU/L) and total bilirubin(145 μmol/L) and was diagnosed with crizotinib-induced fulminant liver failure. Despite crizotinib discontinuation and intensive supportive therapy, the level of AST(1075 IU/L),ALT(240 IU/L) and total bilirubin(233 μmol/L) continued to rapidly increase,and he died on day 60.CONCLUSION Physicians should be aware of the potential fatal adverse effects of crizotinib.     

Function exercises after artificial total hip replacement

Background:The effects that total hip replacement(THR)can alleviate pain,reconstruct function of hip joint and improve patients‘ daily living ability have been proved,success has a direct relationship with postoperative function exercises.Objective:To observe effects of postopervative function exercises after artificial total hip replacement.Unit:Second People‘s Hospital of Binzhou City.Subjects:17 cases of TRs were investigated including 11 males and 6 females,aged 62-81(mean:68.9) years old.Intervention:Postoperative function exerciese consisted of three stages:First stage:one week after operation was passive function exercises stage.(1)When patients came to consciousness,static isometric contraction of quadriceps muscle of thigh was taken;Supine position,tip of foot directed upward to contract muscle of thigh for 9 seconds and relaxed for 1 seconds which was a movement,3 times per day and 2-30 movements every time.2) Flexing and extending of ankle joint:Flexing and extending for 10 seconds at maximal degree as a movement,3 times every day and 20-30 movements every time.(3) ISometric contraction of gluteal muscles:supine position,both legs were extened and both arms laid at body sides natural,gluteal muscles were contracted for 9 seconds and relaxed for 1 which was a movement,3 time per day,20-30 movements every time.(4)Depp breathing:patients breathed at maximal limit and exhaled,3-4 times every day and 10 minutes every time.(5Function exercises with CPM exercise apparatus of lower limbs.Second stage:2 weeks after operation was active function exercise stage.In this stage,active function exercises were taken besides contents of first stage.(1Flexing of knee and hip joints:Supine position,abduction of affected limbs at 15&;#176;-30&;#176;heel of affeected limb was moved slowly towards buttock with knee flexing.This exercise began with 0&;#176;-30&;#176;and increased 5&;#176; every day with maximal limit under 90&;#176;。（2) Muscle exercises of upper limbs,3 times per day and 10 min per time.(3)Upward move ment at supine position:Exercises of upper limbs,head,neck and chest were taken.Head,neck,chest were elevated 10&;#176;-30&;#176;with help of ring chest-developer,2 times per day and 10 minutes per time.(4)Elevation of affected at sitting psoition;affected limbs hug down,upper part of body was braced with both hands backwards slightly to contract muscles of thigh,affected limbs were elevated to heel,but under bed horizontal line,3 times per day and 10 minutes per time.Third stage:Instruction of right getting up and loading.Patients were encoraged to move with crutch at 7th day,loaded successively with crutch from 2th week and crutches were removed from 12th week.In this stage,exercises began from sitting up and when active flexing and extending of hip joint,atients were in structed to take abducor,extorsion,adductor,intorsion until squatting,3-4 times per day and 10 minutes per time.Result:Modified hip joint function evaluation standards were adopted consisted of pain scores,living ability scores,movement scores,moving distance scores and function of hip joint was divided into:excellent:10 score,good:≥80 scores,fair:≥60 scores,trace:≥40 scores,poor:,40 scores.After 12-24months of follow-up survey,excellent,15 cases ,good,1 case,trace,1 case and no complications were found.Conclusiong:Postoperative function exercises after THR could promote functional recovery of hip joint and prevent complications.     

不同光疗方式对G6PD缺乏致新生儿高胆红素血症的疗效观察

Objective To observe the curative effect of different mode of phototherapy in treating hy-perbilirubinemia of newborn caused by G6PD deficiency. Methods 102 cases suffering from hyperbilirubinemia of newborn caused by G6PD deficiency were divided into group intermittence phototherapy and group continue phototherapy randomly and got curative effect observation. 48 cases in group intermittence phototherapy got 6 hours phototherapy per time and 2 times per day separated by 6 hours. 54 cases in group continue phototherapy got 24 hours continue phototherapy. Determination of microamount bilirubin was taken until the numerus was un-der 205.6 μmoL/L. As a result, the one day drop-out value of bilirubin and the days for it to decrease under 205.6 μmol/L in two groups had no remarkable difference. That means intermittence phototherapy can take the place of continue phototherapy.     

Effect comparison between sacral blocking and massage combined with traction on protrusion of lumbar intervertebral disc

Background:Epidural injection is an important method in treatment of protrusion of lumbar intervertebral disc.Especially in the recent decade sacral injection is adopted more and more often.Objective:To compare the clinical effects of sacral blocking and massage combined with traction.Unit:Yinhe Hospital of Beijing.Subjects:290 outpatients with grade Ⅱ of ASAI were selected from May,1994 to July,2000.Patients were randomly divided into observation group(n=145)and control group(n=145).Sacral blocking was adopted in observation group and 80 males and 65 females aged 20-78(mean:46.4)years old were included with disease course 3 days to 30 years.Massage combined with treaction was adopted in control group and 74 males and 71 females aged 22-74(mean:44.9)years oled were inmcluded with disease course 2 days to 10 years.Interention:Sacral blocking:Operation was according to sacral blocking and druge(dexamethasone injection,2 mg;0.75% bupivavaine hydrochloride,5 ml;saline,50ml) were injected slowly after success of puncture.Patient rested for 0.5h after injection and left treatment room if no adverse effects occurred.Massage combined with traction:Massage was adopted after traction to every patients.(1)Massage:Patient was seated at square stool and lower limbs separated naturally with same width of shoulders.Doctors sit behind patient.First,thubs of both hands were pressed on projecting part near spinous process(pressing points were selected according to different projecting part).Flexing and extending forward and backward were taken at the same time and extent was ddecided addording to patients‘ maximal endurable degree,5-10 timmes.Upper part of body was turned 45 degrees to left and right.Massage was still taken to affected part,3-t times.(2)Traction:Pelvis was extracted with general physical therapy and massage table.Supine position,chest and treaction bandage were fixed,tractiron wheel was turned slowly until patient felt comfortable with maximal endurance as limit(traction force,20-40kg),After extracting for 5 minutes,massagee switch was turned on to take rolling massage to bck and both lower libmbs.Traction force was increased every5 minutes and limit was still according to patient‘s maximal endurance,30 minutes for every time,once a day and ten times as a therapeutic course.Cohclusion:Effect of sacral blocking on protrusion of lumbar intervertebral disc was positive and fewer therapeutic time were needed.Massage combined with traction was also effective,safe and no adverse effects wer observed,but more therapeutic times were neeeded and inconveinient.     

伽玛刀治疗原发性三叉神经痛疗效观察

Objective To evaluate the therapeutic efficacy of gamma knife in treatment of primary trigeminal neuralgia Methods Retrospectively analysis of 120 cases with primary trigeminal neuralgia treated by gamma knife in our department From Jan. 2003 to Mar. 2008 were performed. All cases were treated with the 4 mm collimator and targeted at the proximal nerve at the root entry zone located by MRI. The target dose varied from 80 -90 Gy. Results After a follow-up of 20. 0 ±4. 5 months, complete relief of pain occurred in 69 patients (57. 5%), 50% -90% relief in 34 (28. 3%), relief less than 50% in 12(10.0%) but no relief in 5(4.2 %).The efficient rate was 95. 8% . The common complications include numbness, absence of corneal reflex. 83 patients (69. 2%) experienced temporal facial numbness and 14 patients (11. 7%) reported continuous numbness after treatment of the gamma knife. Conclusions Gamma knife radiosurgery is a minimally invasive technique for the treatment of primary trigeminal neuralgia with few complications.     

The comparison of effects of rapid opiate detoxification with ketamine complex and with tramadol and naltrexone under general anesthesia with propofol

Objective To release the heroin addicts‘ sufferings,we made rapid opiate detoxification by injecting naloxine under the general anesthesia.Method 160 volunteers were divided at randon into two groups:Group A were performed under the combined anesthesia with propofol,midazolam and kelamine.Group B were performed under the combined anesthesia with propofol with midazolam and tramadol.The vital signs were recorded and the withdrawal syndrome of the volunteers were assessed during the whole process.Result All of the withdrawal symptoms scores 24 hours after ROD in group B were lower than its pre-treatment;The symptoms of the thirs,tsleeping disturbance,nausea and vomiting,skeletal muscular pains and anorexia scores in group A were also lower than its pre-treatment;and no too much differeence belween group A and group B.But tearing,anxiety and diarrhea scores in group A were almost the same as the pre-treatment and higher than group B.Both groups received of the naloxone treatment smoothly,and remained in the hospital for about 3 days.Conclusion The effect of rapid opiate detoxification of naltrexone with the ketamine or tramadol under anesthesia is obvious.The tramadol is better than others.