探讨介入治疗软组织血管畸形的临床疗效及安全性

探讨介入治疗软组织血管畸形的临床疗效及安全性。方法搜集1998年1月至2008年12月经介入治疗各种血管畸形31例,男19例,女12例,年龄12—51岁,发生于四肢的血管畸形最为常见,其他部位的有躯干、生殖器官等。治疗方法为在DSA引导下：①经皮穿刺血管畸形注射硬化剂治疗;②经导管供血动脉对血管畸形进行栓塞治疗。结果所有病例的畸形血管团得到全部或大部分闭塞、血管畸形局部肿胀减轻、溃破出血停止、软组织肿块变硬变小及固定;所有病例术中术后均无严重并发症发生。结论介入治疗软组织血管畸形是一种有效的、创伤小的治疗方法,在目前情况下应作为首选的治疗方法。     

低频超声治疗下腰部软组织损伤性疼痛的临床报告

目的观察低频低强度超声对软组织损伤性疼痛的治疗作用。方法115例下腰部软组织损伤性疼痛，分为试验组63例，为超声加电脑中频治疗；对照组52例，为电脑中频与超声空白治疗（不开机，余同试验组）。超声频率22kHz，强度1W／cm^2，使用移动法，1次／日，每次10min。电脑中频：耐受量，每次20min，1次／日。VAS（visual analogue scale）疼痛视觉模拟评分及疗效判定：治疗前、治疗7次后VAS值进行自身比较，VAS下降〉80％为显效，VAS下降20％～80％为有效，VAS下降〈20％为无效，VAS增加为恶化。X^2检验用于组间比较。结果试验组总有效率84．1％，对照组总有效率61．5％。两组比较，P〈0．01（X^2=7．05），差异非常显著。治疗中与治疗后无不良反应发生。结论22kHz、1W／cm^2低频超声治疗增加了临床镇痛效果，具有临床应用价值。     

Peptide vaccination therapy for bone and soft tissue sarcoma

Bone and soft tissue sarcomas are relatively difficult to treat or cure. Despite a multidisciplinary approach involving surgery, chemotherapy, and radiotherapy, metastatic or relapsed diseases are difficult to cure. Therefore, novel therapeutic options need to be explored. We investigated the use of peptide vaccination therapy for synovial sarcoma and osteosarcoma. The present trial for synovial sarcoma showed the safety, immunogenic properties, and partial clinical efficacy of peptides. However, the power of the vaccine, at least in the present trial, is not strong enough to suppress tumor growth in the presence of gross residual tumors. Therefore, the use of the vaccination therapy as an adjuvant to chemotherapy for the treatment of refractory tumors may be a promising tool.     

针刺运动疗法治疗软组织损伤的应用与效应

目的:探讨针刺运动疗法的理论来源及其在运动系统软组织损伤治疗干预中的应用效果。方法:探讨针刺运动疗法的理论来源、干预方法及临床应用的效果,并与传统针灸疗法相对比。结果:针刺运动疗法来源于人体阴阳整体平衡原理,可以提高针灸疗法对运动系统软组织损伤的干预效果,减轻患部肿痛,改善患者的运动功能,缩短疗程。结论:针刺运动疗法的诞生改变了传统针刺疗法单一、绝对静止体位的治疗状态,为运动系统软组织损伤的临床干预提供了一种新的疗法。同时丰富了针灸的治疗手段。     

针刺运动疗法治疗软组织损伤的应用与效应

目的：探讨针刺运动疗法的理论来源及其在运动系统软组织损伤治疗干预中的应用效果。方法：探讨针刺运动疗法的理论来源、干预方法及临床应用的效果，并与传统针灸疗法相对比。结果：针刺运动疗法来源于人体阴阳整体平衡原理，可以提高针灸疗法对运动系统软组织损伤的干预效果，减轻患部肿痛，改善患者的运动功能，缩短疗程。结论：针刺运动疗法的诞生改变了传统针刺疗法单一、绝对静止体位的治疗状态，为运动系统软组织损伤的临床干预提供了一种新的疗法。同时丰富了针灸的治疗手段。     

Differential diagnosis between benign and malignant soft tissue tumors utilizing ultrasound parameters

Purpose

Preoperative discrimination between benign and malignant soft tissue tumors is critical for the prevention of excess application of magnetic resonance imaging and biopsy as well as unplanned resection. Although ultrasound, including power Doppler imaging, is an easy, noninvasive, and cost-effective modality for screening soft tissue tumors, few studies have investigated reliable discrimination between benign and malignant soft tissue tumors.

Methods

To establish a modality for discrimination between benign and malignant soft tissue tumors using ultrasound, we extracted the significant risk factors for malignancy based on ultrasound information from 40 malignant and 56 benign pathologically diagnosed soft tissue tumors and established a scoring system based on these risk factors.

Results

The maximum size, tumor margin, and vascularity evaluated using ultrasound were extracted as significant risk factors. Using the odds ratio from a multivariate regression model, a scoring system was established. Receiver operating characteristic analyses revealed a high area under the curve value (0.85), confirming the accuracy of the scoring system.

Conclusion

Ultrasound is a useful modality for establishing the differential diagnosis between benign and malignant soft tissue tumors.

     

Efficacy of manual therapy.

The use of manual therapy to treat somatic pain syndromes and associated disabilities is widespread. Yet, the efficacy of manual therapy has not been previously established because equivocal findings in the literature prevent definitive conclusions. The purposes of this article are (1) to establish objective criteria for judging the validity of manual therapy research, (2) to identify and discuss the results of those trials that were determined to be valid demonstrations of treatment efficacy or valid demonstrations of nonuseful therapy, and (3) to determine whether patients who benefit from manual therapy have common characteristics. The abstracts or full reports of 146 titles with appropriate key words were reviewed. Of these, 105 studies were not primary studies of manual therapy and were thus eliminated from review. In the 41 remaining studies, 18 did not utilize statistical comparisons or report blinded assessment of outcome measures. Nine controlled studies yielded negative results, but the statistical power or minimum sample size required to detect potential differences between manual therapy and control groups was not described. The 14 studies that met the efficacy criteria were categorized by the following factors: (1) the anatomical region of intervention, (2) pragmatic versus explanatory goals, and (3) primary intervention (manipulation, mobilization, combination). There was a paucity of valid explanatory research in all areas and a particular absence of controlled trials involving manual therapy applied to the peripheral joints. Manual therapy for low back pain, however, was studied extensively. The analysis of valid trials provided clear evidence that manual therapy, particularly manipulation, can be an effective modality when used to treat patients who have low back pain. A preliminary "profile" of the patient with low back pain who would likely benefit from manual therapy included acute symptom onset with less than a 1-month duration of symptoms, central or paravertebral pain distribution, no previous exposure to spinal manipulation, and no pending litigation or workers' compensation. Suggestions for future manual therapy research are discussed.     

Specific soft tissue mobilization in the management of soft tissue dysfunction

SUMMARY. Following injury, the ability of soft tissue to tolerate the demands of functional loading decreases. A major part of the management of soft tissue dysfunction lies in promoting soft tissue adaptation to restore the tissue's ability to cope with functional loading. Specific soft tissue mobilization (SSTM) uses specific, graded and progressive application of force by the use of physiological, accessory or combined techniques either to promote collagen synthesis, orientation and bonding in the early stages of the healing process, or to promote changes in the viscoelastic response of the tissue in the later stages of healing. SSTM should be applied in combination with rehabilitation regimes to restore the kinetic control of the tissue. The principles of SSTM are reviewed with regard to the general principles of treating soft tissue dysfunction and areas identified for further research into this field. Copyright 1998 Harcourt Publishers Ltd.     

皮下埋线治疗慢性软组织损伤53例

MATERIALSANDMETHODSMaterialsAcceptioncriteria:thecriteriaswerecoincidentwithtraditionalmedicinediagnosisandeffectcriteriaestablishedbynationaltradi-tionalmedicineadministrationbureau.106casesofchronicsofttis-sueinjurypatientswereselectedinourresearchandrandomlydi-videdintosubcutaneousline-embeddingtherapygroupandacupunctureandventousetherapygroupwith53caseseach.Therewere25malesand28femalesinsubcutaneousline-embeddingtherapygroupwithmeanage49.5(22-76)years,course0.04-20(average4.1)years,…     

Ceftriaxone therapy of bone and soft tissue infections in hospital and outpatient settings

Ceftriaxone, a broad-spectrum cephalosporin with a markedly extended half-life, was administered to 100 patients with 56 bone and 44 soft tissue infections. Sixty-eight received 1 g twice daily, and 32 received 2 g once daily intravenously. Overall, 91% had a satisfactory clinical response, with similar efficacies in both treatment regimens. In six patients, failure to achieve a cure correlated well with the development of resistance to ceftriaxone during therapy in Enterobacter and Pseudomonas species (two cases) and with superinfection with Bacteroides fragilis (four cases). In 41 patients, intravenous drug therapy was continued after discharge from the hospital. In this group, 1,093 patient-days of hospitalization were saved, amounting to $150,020 in cost savings. The prolonged half-life facilitated the administration of ceftriaxone in this setting.     

针刺结合运动疗法治疗急性软组织损伤后疼痛的疗效观察

目的观察针刺结合运动疗法治疗急性软组织损伤后疼痛的临床疗效。方法20例运动员,发生急性闭合性软组织损伤56例次,包括肌肉损伤46例次,韧带和其他损伤10例次。采用针刺阿是穴、针刺对侧郄穴并主动活动、弹力绷带固定及适当休息的方法。治疗前和治疗一两次后观察疼痛数字等级评分(NRS)。结果治疗前NRS为7.696±1.536,治疗后NRS为2.304±1.572,治疗后NRS(P<0.001)显著下降。结论采用针刺结合运动疗法,可改善急性软组织损伤后的疼痛。     

动态干扰电抽吸法治疗腰部软组织损伤

目的　观察动态干扰电抽吸法对腰部软组织损伤的治疗效果。方法　 1 73例腰部软组织损伤患者被随机分成三组 ,分别采用动态干扰电抽吸法 (治疗组 )、静态干扰电流 (对照组 )、感应电点送 (对照组 )进行治疗。结果　治疗组痊愈显效率 77.97%。两对照组痊愈显效率分别为 50 %和 4 9.4 4%。治疗组疗效明显优于对照组。 ( χ2 =2 2 .0 9% ,P值 <0 .0 1 )结论　动态干扰电抽吸法对腰部软组织损伤具有较好疗效     

超声引导下介入治疗在军事训练软组织损伤中的应用研究

目的评价超声在诊断军事训练软组织损伤、超声引导下介入治疗及术后监测随访中的应用价值。 方法选取2015年6月至2018年6月于空军军医大学第一附属医院检查的军事训练伤官兵患者198例,所有患者均对损伤部位进行超声检查,结合患者病情及意愿,选择保守治疗或行超声引导下介入治疗,所有患者均于治疗后1～3个月进行随访,依据超声检查结果及临床症状改善情况分为治愈、好转和无明显变化。总有效率=治愈率+好转率。比较2种治疗方法的疗效,分析军事训练伤超声表现及随访结果。 结果198例确诊为军事训练伤软组织损伤的患者中,131例接受超声引导下介入治疗,67例采取保守治疗。131例接受超声引导下介入治疗的患者中治愈99例,好转30例,无明显变化2例,总有效率为98.5%;67例接受保守治疗的患者中治愈26例,好转24例,无明显变化17例,总有效率为74.6%,2者总有效率比较差异有统计学意义（χ²=29.05,P<0.05）。在治疗有效的各种类型软组织损伤患者中,超声随访均表现为厚度、回声、血流等较治疗前情况好转或恢复正常。 结论高频超声能够准确诊断军事训练软组织损伤,精准定位实时引导微创治疗,并可动态监测康复情况,值得临床推广应用。     

Detection of soft tissue foreign bodies in the presence of soft tissue gas.

OBJECTIVE: To determine the effect of soft tissue gas on the accuracy of foreign body detection by realtime sonography. METHODS: This was a prospective randomized study using glass, metal, and bone inserted into turkey breasts to simulate human soft tissue foreign bodies. Air was subsequently injected around a random selection of the foreign bodies to simulate soft tissue gas that can accompany a blast or high-force injury. Using a linear transducer, physicians credentialed in the use of sonography were each asked to scan the breasts, identify the location of any foreign body, and describe whether the object located was bone, metal, or glass. They were also asked to describe the characteristics of the foreign body, including surface echogenicity, visibility, and artifacts, if any. RESULTS: The sensitivity for localization of each foreign body by each sonographer was 100% (48 of 48) and was unaffected by the presence of soft tissue gas. The accuracy of classifying the foreign body was poor except with bone. Glass and metal were often confused with each other. With the addition of soft tissue gas over the foreign bodies, the sensitivity of classifying the foreign body was decreased further from a combined 58% to 28%. The presence of soft tissue gas decreased the amount of reflection of the foreign body and obscured the subtle differences in the brightness of each foreign body, leading to a decrease in the accuracy of identification but not localization of the foreign body. CONCLUSIONS: In an experimental model, soft tissue gas does not affect the localization of soft tissue foreign bodies. However, correct identification of the type of foreign body is limited by soft tissue gas because of loss of the typical sonographic characteristics.     

Management of soft tissue sarcoma

Sarcomas are rare and unusual neoplasms that can be found in any tissue and can have life-threatening outcomes. Caring for these patients can be a great challenge and requires a multidisciplinary team.