中国康复医学杂志2005年第20卷文题索引

A癌症心理治疗对癌症化疗患者焦虑及胃肠反应影响的临床研究.娄书花,郝玉风,马冬萍.604.早期Hodgkin淋巴瘤患者完全缓解后生存质量的调查及分析.王轶楠,周文华.621.心理行为干预对癌症患者化疗呕吐反应的影响.李运智,李世雪,宋杰,等.852.容易漏诊的颈椎肿瘤病例回顾性分析.杨卫新,何怀,昝云强.526.空间诱变肿瘤细胞和生物工程细胞的染色体实验观察.靳耀英,向青,徐波,等.820.BBell麻痹电针配合运动疗法治疗Bell麻痹的疗效观察.马红鹤,李锦瑞,李禹燕,等.701.Bell麻痹治疗效果的影响因素分析.郑光新,赵晓鸥,崔晓倩,等.830.扳机点胸锁乳突肌…     

看病时常用的英文

1.He feels headache,nausea and vomiting.2.He is under the weather.3.He began to feel unusually tired.4.He feels light-headed.5.She has been shut-in for afew days.6.Her headis pounding.7.His symptoms include loss of appetite,weight loss,excessivefatigue,fever and chills.8.He feels exhausted or fatigued most of the ti me.9.He has beenlackingin energy for some ti me.10.He feels drowsy,dizzy and nauseated.11.He feels as though everything around hi mis spinning.12.He has noticed some loss of hea…     

业务测验(127)答案与题解

答　　案1.A.D.E　　　　　　2.C.D.E　　　　　　　3.A.B.D.E4.C.D.E5.B.D.E6.A.C.D7.A.C.D8.B.C.E9.C.D.E10.A.D.E11.A.D.E12.A.C.D13.C.D.E14.B.C.D.E15.C.D.E16.C.D.E17.A.B.D18.A.B.C.D19.C.D.E20.A.C.D21.B.C.D22.B.C.D23.A.C.D.E24.A.C.D.E25.B.C.E题　　解1.额叶释放征包括:1正常人即存在牵张反射的强化,例如眼轮匝肌反射(叩击眉间时发生)。正常人只在开始叩击的几次发生瞬目反射,以后不明显。当有锥体系、锥体外系损害或脑弥散性病变时,该反射变得快而明显,且随每次叩击重复出现;2婴儿期存在的反…     

基层医务人员多选题试题选登(十七) 中医内科多选题试题

[A型题】(试题1~46) 1.感冒四时皆有,主要是感受()邪所致: A.风 B.寒 C.暑 D。湿 E.热 2.除哪项外,都是感冒的临床特征:() A.恶寒发热 B.弃塞流涕 C.头身疼痛 D.苦薄脉浮 E.咳嗽痰多 3.哪一项不是区别凤寒感冒与风热感冒的依据全() A.恶寒与发热的多少 B.明喉疼痛与不彩 C.口渴与不码 D.舌苔薄白与薄黄 E.头痛身痛与否 4.感冒的基本病理是:() A.肺卫失调 B.肺气失宣 C.肺气失降 D.邪阻经络 E.以上都不是 5.病感冒恶寒发热,身痛无汗,鼻流清涕,咽痛口渴,心烦,舌首薄黄,脉俘数,证属:() A.风寒证 B.风热证 C.挟暑证 D.挟燥证 E.表寒…     

生理学试题答案

!口.刁....卜︺‘.....,..11.... 一、.非皿 1.(寸),2.(x),3.(x),4.(x),5.(x),6.(x),7.(x),8.(犷),9.(寸)10.(寸),11.(x),12.(x),13.(甲),1 4.(了),15.(x).16.(x),17.(x),18.(了),19.(了),20.(了). 二、选择皿 1.(〕.2.B,3.B,4.B,5.B,吧.C,7 .B,8.A,9.B,10.C,11.B,12.A,13.B,14.B,15.C .16-人.17.B,18.A,19.A,20.B 三、城充. 1.血红蛋白运输氧和二氧化碳。 2.①趁血鱼厦娜验鱼里丝主②趣业鱿丛上⑧纤维蛋白形成 3在丝遮这玉里多 4.窦房结,加快 5.①肺通气,②肺换气,③气体在血渔生运输,④组织换气 6.①肾小球滤过,②肾小管和集合管…     

本期“继教园地”思考题

选择题:1.根据研究者是否对观察对象主动地施加干预,医学研究可分为实验性研究与()性研究两大类A.对照B.随机C.双盲D.观察E.以上都不对2.“均衡”的原则,主要针对()性研究而言A.实验B.随机C.观察D.对照E.以上都不对3.严格地说,()的实验性研究,是康复医学疗效评价的“金标准”A.随机化分组B.对照C.随机D.分组E.双盲4.公式Sx珋=S樤n中,n越大,标准误Sx珋越()A.小B.大C.大小不定D.不变E.以上都不对5.单因素k水平设计,不言而喻就是指实验中仅涉及一个具有k水平的实验因素,k=2时,如果具体问题和实验条件允许,常采取以下配对形式之一()A.…     

抗肿瘤血管生成在淋巴瘤治疗领域的研究进展

Wang ES,Temya-Feldslein J,Wu Y,et al.Targeting autocrine and paracrine VEGF receptor pathways inhibits human lymphoma xenografts in vivo.Blood,2004,104:2893-2902.

Elezkurtaj S,Kopitz C,Baker AH,et al.Adenovirus-mediated overexpression of tissue inhibitor of metallopmteinases-1 in the liver:efficient protection against T-cell lymphoma and colon carcinoma metastasis.J Gene Med,2004,6:1228-1237.

Kruger A,Arit MJ,Gerg M,et al.Antimetastalic activity of a novel mechanism-based gelatinase inhibitor.Cancer Res,2005,65:3523-3526.

O'Reilly MS,Boehm T,Shing Y,et al.Endostatin:an endogenous inhibitor of angiogenesis and tumor growth.Cell,1997,88:277-285.

Abdollahi A,Hahnfehh P,Macrcker C,et al.Endostatin's antiangiogenic signaling network.Mol Cell,2004,13:649-663.

Carmeliet P.Angiogenesis in life,disease and medicine.Nature,2005,438:932-936.

Ribatti D.Judah Folkman,a pioneer in the study of angiogenesis.Angiogenesis,2008,11:3-10.

Li ww,Hutnik M,Gehr G.Anfiangiogenesis in haematological malignancies.Br J Haematol,2008,143:622-631.

Wolpin BM,Mayer RJ.Systemic treatment of coloreetal cancer.Gastroenterology,2008,134:1296-1310.

Dong X,Han ZC.Yang R,et al.Angiogenesis and antiangiogenic therapy in hematologic malignancies.Crit Rev Oncol Hematol,2007.62:105-118.

Giatromanolaki A,Koukourakis MI,Pezzella F,et al.Pbosphorylated VEGFR2/KDR receptors are widely expressed in B-cell nonHodgkin's lymphomas and correlate with hypoxia inducible factor activation.Hematol Oncol,2008,26:219-224.

Folkman J.Antiangiogenesis in cancer therapy-endostatin and its mechanisms of action.Exp Cell Res,2006,312:594-607.

Bertolini F,Fusetti L,Mancuso P,et al.Endostatin,an antiangiogenie drug,induces tumor stabilization after chemotherapy or anti-CD20 therapy in a NOD/SCID mouse model of human highgrade non-Hodgkin lymphoma.Blood,2000,96:282-287.

Ling Y,Yang Y,Lu N,et al.Endostar,a novel recombinant human endostatin.exerts antiangiogenic effect via blocking VEGF-induced tyrosine phosphorylation of KDR/Flk-1 of endothelial cells.Biochem Biophys Res Commun,2007,361:79-84.

王金万,孙燕,刘永煜,等.重组人血管内皮抑索联合NP方案治疗晚期NSCLC随机、双盲、对照、多中心Ⅲ期临床研究.中国肺癌杂志,2005,8:283-290.

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4.5~5.5岁聋儿与正常儿童语音清晰度的比较

目的研究同年龄段聋儿与正常儿童的语音发音特征及差异。方法选用《聋儿听力语言康复评估题库》,采用三级人员评估方法,分别对4.5～5.5岁的听障组(20例聋儿)和健听组(20名正常儿童)进行声母和韵母清晰度测试。结果与结论声母清晰度测试显示,聋儿发音清晰度最高的声母为/b.m.d.l.j/,其次为/h.f.r.p.t.n.g.x/,最后为/zh.z.k.c.sh.q.s.ch/;正常儿童发音清晰度最高的声母为/b.p.f.g.m.d.h/,其次为/k.j.x.t.r.l/,最后为/q.zh.ch.sh.n.z.s.c/。韵母清晰度测试显示,两组发音清晰度最高的韵母为单韵母,其次为复韵母,最后为鼻韵母,听障组儿童的三类韵母平均清晰度均明显小于健听组儿童(P<0.01)。     

急救护理学相关词汇

1.prehospital emergency medical care院外急救2.intensive care unit,ICU加强医疗病房3.heart rate,HR心率4.arterial blood pressure,Bp动脉压5.central venous pressure,CVP中心静脉压监测6.cardiac output,CO心排血量7.electrocardiogram,ECG心电图8.cardiac arrest心搏骤停9.sudden death猝死10.cardio-pul monary resuscitation,CPR心肺复苏术11.cardio-pul monary-cerebral resuscitation,CPCR心肺脑复苏12.shock休克13.trauma创伤14.prehospital index,PHI院前指数15.trauma score,TS创伤记分16.multiple organ dysfunc…     

《中国临床康复》杂志2006年1月1-4期稿件基本数据分析

国际编委GERMANY Prof.Werner Hacke,M.D.,Ph.D.,M.A.,Department of Neurology,University of Heidelberg Medical School;JAPAN Prof.Kazuo Higa.M.D.,Ph.D.,Department of Anesthesiology,Fukuoka University School of Medicine;JAPAN Prof.Takenori Yamaguchi,M.D.,Ph.D.,National Cardiovascular Center of Japan;NETHERLANDS Prof.J.van Gijn,M.D.,Ph.D.,Department of Neurology,Utrecht University Medical Center;SINGAPORE Prof.Tat-Leang Lee,MBBS.,MMED.,Department of Anesthesia,…     

MRI在脊柱压缩骨折病因鉴别诊断中的作用

目的：探讨MRI在脊柱压缩骨折病因鉴别诊断中的作用。方法：回顾性分析114例经临床病理证实的脊柱压缩骨折,分别观察分析椎体、椎间盘、附件等的病理性形态及MRI信号改变,结果：脊柱转移瘤35例,仅2．7％残余正常骨髓信号,压缩椎体后部膨大,74．2％椎弓根受累,51％伴椎旁软组织肿块,42％伴椎管内硬膜外软组织肿块。脊柱结核20例。90％椎体相邻面破坏,椎间盘均破坏,85％向后成角,仅2例附件破坏,90％椎旁脓肿。骨质疏松25例,100％骨折椎体可见残余正常骨髓信号。外伤骨折34例,64％维间盘破裂,55％伴骨碎片,结论：脊柱转移瘤、脊柱结核、脊柱骨质疏松及脊柱外伤引起的脊柱压缩骨折均有各自的MRI特征性表现,MRI是鉴别脊柱压缩骨折病因有效的影像学手段。     

骨密度测量与胸腰椎压缩骨折植入物治疗方式的选择

背景：经皮椎体后凸成形治疗中聚甲基丙烯酸甲酯附着在骨折断端,尽管起到了即刻固定骨折的作用,但也妨碍了纤维组织再生及新骨的形成,从长远角度来说是不利于非骨质疏松骨折愈合.目的：分析骨密度测定对中老年胸腰椎压缩骨折手术方式及植入物选择的指导意义.方法：选择单节段胸腰椎压缩骨折患者,根据腰椎L2～4骨密度值测定结果分为骨质疏松组和非骨质疏松组.骨质疏松组行球囊扩张椎体后凸成形治疗,非骨质疏松组行椎弓根钉置入复位内固定治疗.结果与结论：骨质疏松组3例术中发生骨水泥椎旁渗漏,非骨质疏松组1例患者出现伤口感染.治疗后随访20～28个月,骨质疏松组2例发生邻近椎体骨折,非骨质疏松组内固定物取出后未出现椎体高度丢失、局部后凸角度增大等情况.骨质疏松组手术时间、出血量及术后3 d 目测类比疼痛评分低于非骨质疏松组（P 〈 0.05）;两组椎体高度和局部后凸角较治疗前恢复显著（P 〈 0.05）,非骨质疏松组较骨质疏松组更明显（P 〈 0.05）.表明经皮椎体后凸成形及椎弓根螺钉置入复位内固定均是中老年胸腰椎椎体压缩骨折的理想治疗方法,应根据患者骨质疏松程度采取针对性的治疗方法和植入物,疗效会更加显著.     

Kyphoplasty for Vertebral Augmentation in the Elderly With Osteoporotic Vertebral Compression Fractures: Scenarios and Review of Recent Studies

Background

Vertebral compression fractures caused by osteoporosis are among the most common fractures in the elderly. The treatment focuses on pain control, maintenance of independence, and management of the osteoporosis. Elderly patients often encounter adverse effects to pain medications, do not tolerate bed rest, and are not ideal candidates for invasive spinal reconstructive surgery. Percutaneous vertebral augmentation (vertebroplasty or kyphoplasty) has become popular as a less-invasive alternative. However, studies have questioned the effectiveness of these procedures.

Methods

The authors conducted a MEDLINE search using relevant search terms including osteoporosis, osteoporotic vertebral compression fracture, elderly, kyphoplasty and vertebroplasty.

Case summary/Results

Two elderly patients presented with a fracture of their third and first lumbar vertebral body, respectively. One patient progressed well with conservative treatment, whereas the other patient was hospitalized secondary to pain after conservative measures failed to offer improvement. The hospitalized patient subsequently opted for a kyphoplasty and was able to resume his normal daily activities after the procedure.

Conclusions

Selecting patients on an individual case-by-case basis can optimize the effectiveness and outcomes of a vertebral augmentation. This process includes the documentation of an osteoporotic vertebral compression fracture with the aide of imaging studies, including the acuity of the fracture as well as the correlation with the physical examination findings. Patients who are functional and improving under a conservative regimen are not candidates for kyphoplasty. However, if the conservative management is not successful after 4 to 6 weeks and the patient is at risk to become bedridden, an augmentation should be considered. A kyphoplasty procedure may be preferred over vertebroplasty, given the lower risk profile and better outcomes regarding spinal alignment.     

老年非外伤性脊柱压缩骨折的MRI分析

目的探讨MRI对老年非外伤性脊柱压缩骨折的病因诊断。方法回顾分析65例经临床病理证实的老年脊柱压缩骨折，分别观察分析椎体、椎间盘及附件的MRI形态、信号改变。结果脊柱转移瘤36例，仅2．8％残余正常骨髓信号，骨折椎体后部或前后部均膨大，75％椎弓根受累。脊柱骨质疏松29例，100％骨折椎体内残余正常骨髓信号，椎体前后缘平直或稍内凹。结论脊柱转移瘤、骨质疏松引起的脊柱压缩骨折各有其特征性的MRI表现，MRI是诊断老年非外伤脊柱压缩骨折病因有效的影像学方法。     

Management of Osteoporosis and Spinal Fractures: Contemporary Guidelines and Evolving Paradigms

Physicians involved in treating spine fractures secondary to osteopenia and osteoporosis should know the pathogenesis and current guidelines on managing the underlying diminished bone mineral density, as worldwide fracture prevention campaigns are trailing behind in meeting their goals. This is a narrative review exploring the various imaging and laboratory tests used to diagnose osteoporotic fractures and a comprehensive compilation of contemporary medical and surgical management. We have incorporated salient recommendations from the Endocrine Society, the American Association of Clinical Endocrinology (AACE), and the American Society for Bone and Mineral Research (ASBMR). The use of modern scoring systems such as Fracture Risk Assessment Tool (FRAX®) for evaluating fracture risk in osteoporosis with a 10-year probability of hip fracture and major fractures in the spine, forearm, hip, or shoulder is highlighted. This osteoporosis risk assessment tool can be easily incorporated into the preoperative bone health optimization strategies, especially before elective spine surgery in osteoporotic patients. The role of primary surgical intervention for vertebral compression fracture and secondary fracture prevention with pharmacological therapy is described, with randomized clinical trial-based wisdom on its timing and dosage, drug holiday, adverse effects, and relevant evidence-based literature. We also aim to present an evidence-based clinical management algorithm for treating osteoporotic vertebral body compression fractures, tumor-induced osteoporosis, or hardware stabilization in elderly trauma patients in the setting of their impaired bone health. The recent guidelines and recommendations on surgical intervention by various medical societies are covered, along with outcome studies that reveal the efficacy of cement augmentation of vertebral compression fractures via vertebroplasty and balloon kyphoplasty versus conservative medical management in the elderly population.     

Effect of osteoporosis on internal fixation after spinal osteotomy: A finite element analysis

Background: Severe kyphotic deformity can affect the quality of life of the elderly and is commonly treated by an osteotomy. Considering that the elderly often suffer from osteoporosis, the safety and efficacy of internal fixation are particularly important. The aim of this study was to analyse the effect of osteoporosis on internal fixation after spinal osteotomy.Methods: One patient with a thoracolumbar kyphotic deformity who underwent spinal osteotomy was included. The CT images of the entire spine were used to construct a finite element model of the spine internal fixation after osteotomy. Material parameters were assigned to osteoporosis and normal bone groups, and the loads were used to simulate different working conditions, including axial compression, flexion, extension and lateral bending.Findings: Compared with normal bone mass, the pressure on osteotomized vertebrae was reduced by 8.32%, 1.92%, 36.79% and 79.80% in mild osteoporosis model during axial compression, flexion, extension and lateral bending, respectively. The pressure on screws and rods was increased in an osteoporosis model under axial compression. During flexion and lateral bending, the pressure on screws was increased but was decreased on rods. The opposite result was found during extension. With the degree of osteoporosis increases, the change of stress is more obvious.Interpretation: Under different bone mass conditions, the distribution patterns of stress in vertebrae, screws and rods were relatively similar. Collectively, the stress levels of vertebral bone were decreased and the stress levels of the screw/rod system were increased in an osteoporosis model compared to a normal bone model. Hence, osteoporosis may increase the risk of fracture and internal fixation failure.     

椎体成形术治疗骨质疏松性椎体压缩性骨折

[目的]探讨经皮椎体成形术（PVP）治疗骨质疏松性椎体压缩性骨折的近期临床效果.[方法]自2007年3月至2009年4月应用PVP治疗骨质疏松所致椎体压缩性骨折36例,共45个椎体,术前术后应用国际通用疼痛目测分级评分法（VAS）评价其疼痛程度.[结果]36例患者45个手术穿刺部位均成功,术后疼痛全部得到缓解,无一例发生严重并发症.[结论]PVP治疗骨质疏松性椎体压缩性骨折创伤小,能有效缓解疼痛,维持椎体的稳定性.     

胸腰椎骨折后路椎管减压AF内固定

目的:研究AF椎弓根螺钉固定的临床治疗方法和治疗效果。方法:对41例胸腰椎骨折行内固定,有椎体或椎板骨折导致椎管狭窄和脊髓压迫,应进行椎管减压,并常规行小关节及横突间植骨。术后常规引流48 h,植骨者术后卧床4周,佩带支具1年。结果:41例中随访36例,随访时间3~36月,平均17.5月。根据手术前后影像学评价(椎体高度的恢复,椎管侵占率,脊核后凸cobbs'角)和神经功能评价(Francel分级),优良率80.5%,其中2例分别于手术后7个月和9个月出现固定系统的松动,经取出固定系统、卧床佩带支具后病情稳定,骨折愈合。结论:AF椎弓根螺钉固定牢固可靠,能达到精确复位固定及椎管有效减压,疗效确切。     

Percutaneous vertebroplasty: an update.

Percutaneous vertebroplasty is an imaging-guided interventional technique in which surgical polymethylmethacrylate is injected via a large bore needle into a painful compressed vertebral body. This technique is safe and effective, and provides increased strength and pain relief in vertebrae weakened by bone diseases. Among the current indications for vertebroplasty are intractable nonradicular pain caused by compression fractures due to osteoporosis, myeloma, metastasis, and aggressive vertebral hemangioma. Contraindications include bleeding disorder, unstable fracture, and lack of definable vertebral collapse. The preprocedural evaluation, technique, complications, and expected results of performing this procedure are also reviewed.     

经皮穿刺椎体成形术治疗老年性骨质疏松性椎体压缩骨折的临床应用

目的探讨经皮穿刺椎体成形术治疗老年性骨质疏松性椎体压缩骨折的临床疗效。方法 2006年1月2009年1月收治患者147例（214个椎体）脊柱骨折者,男56例,女91例;年龄61～80岁,平均69岁。脊柱骨折部位为T8～L3,其中胸椎98个,腰椎116个。采用C形X线机透视引导下于俯卧位或侧卧位进行经皮穿刺椎体成形术,注射聚甲基丙烯酸甲酯（PMMA,骨水泥）。测量并计算术前和术后椎体前/后缘高度比值,疗效评价按WHO标准。结果 118例获随访,随访时间3～7个月,平均4个月。147例214个椎体均手术成功,骨水泥注射量1.0～8.0mL/椎体。术后2～4h疼痛开始缓解,无显著危害性并发症发生,术前和术后椎体前/后缘高度比值无显著性差异,118例随访3～7个月疗效评价按WHO标准完全缓解加部分缓解率为100%。结论经皮穿刺椎体成形术是一种治疗老年性骨质疏松性椎体压缩骨折的微创手术,能够有效缓解骨质疏松性椎体骨折引起的疼痛,维持椎体稳定性,恢复椎体的高度,是一种简单、安全、有效的方法 。