99Tc-MDP治疗强直性脊柱炎的疗效观察

目的观察^99Tc-亚甲基二膦酸盐(MDP)注射液治疗强直性脊柱炎的疗效。方法对83例强直性脊柱炎患者静脉滴注^99Tc—MDP，观察治疗前后临床和实验室指标及副作用。结果^99Tc—MDP治疗强直性脊柱炎的总有效率为89％，在减轻临床症状，尤其是改善晨僵和关节活动度方面疗效明显，且无明显副作用。结论用^99Tc—MDP，治疗强直性脊柱炎疗效显著，使用安全。     

全髋关节置换术治疗强直性脊柱炎14例效果观察

目的探讨全髋关节置换术治疗强直性脊柱炎的临床疗效。方法回顾性分析解放军第十八医院收治的14例强直性脊柱炎患者的临床资料,并分析采用全髋关节置换术后的治疗疗效。结果术后,患者后髋关节活动度有明显改善,Harris评分增加,VAS评分降低。结论全髋关节置换术治疗强直性脊柱炎,可改善关节功能,缓解疼痛,疗效肯定。     

全髋关节置换术治疗强直性脊柱炎髋关节强直效果探究

目的 探究全髋关节置换术治疗强直性脊柱炎髋关节强直的临床效果.方法 选取收治的25例强直性脊柱炎髋关节强直患者作为观察对象,进行常规的全髋关节置换术治疗以及术后康复锻炼,通过患者治疗前后Harris评分与髋关节总活动度的数据对比,判断其临床疗效.结果 治疗前患者Harris评分为(31.2±8.6)分,髋关节总活动度(64.2±12.9)度,治疗后患者Harris评分为(73.5±5.6)分,髋关节总活动度(152.6±15.1)度,两组数据对比均有显著差异(P＜0.05),有统计学意义.结论 全髋关节接置换术能有效治疗强直性脊柱炎髋关节强直病症,缓解病人痛苦,疗效快且副作用小,值得在临床实践中广泛推广使用.     

强直性脊柱炎中西医结合治疗前后影像学对比

目的 :探讨强直性脊柱炎 (AS)中西医结合治疗前后影像学表现与临床疗效的关系。方法 :32例患者经临床和影像学明确诊断 ,采用中西医结合方法治疗 ,中医益气补肾 ,活血通络 ,口服强直性脊柱丸 ,中药薰腰、针灸、推拿。西医口服消炎痛 ,理疗。治疗前后均摄X线平片及CT片对比观察。结果 :临床疗效显著好转 19例(5 9 4 % ) ,好转 11例 (34 4 % ) ,无效 2例 (6 2 % ) ,总有效率为 93 8%。影像表现 :全部病例均侵犯双侧骶髂关节 ,共 6 4个关节 ,显著好转 11例 (34 4 % ) ,好转 6例 (18 7% ) ,无变化 12例 (37 5 % ) ,进展 3例 (9 4 % ) ,有效率为5 3 1%。结论 :中西医结合治疗AS疗效好 ,早发现、早治疗可痊愈 ;影像学监测临床疗效经济、可靠。     

黄芪联合柳氮磺吡啶治疗强直性脊柱炎疗效的初步观察

目的观察黄芪注射液联合柳氮磺吡啶对强直性脊柱炎急性活动期的临床疗效。方法将我院门诊及住院的36例强直性脊柱炎患者随机分为两组,治疗组19例,予黄芪注射液联合柳氮磺吡啶治疗,对照组17例,予柳氮磺吡啶治疗,疗程6周,并于第3、6周对两组病例进行疗效评价并对比。结果(1)第3周治疗组疗效各指标较治疗前明显改善(P<0.05),对照组改善不明显(P>0.05),两组比较差异有统计学意义(P<0.05);(2)第6周两组疗效各指标较治疗前明显改善(P<0.05),两组比较差异无统计学意义(P>0.05);(3)治疗全程治疗组未见相关不良反应。结论黄芪注射液联合柳氮磺吡啶对强直性脊柱炎急性活动期症状的控制有帮助,但其长期疗效有待进一步观察。     

CT引导下骶髂关节注药治疗强直性脊柱炎

目的:探讨CT引导下骶髂关节腔内注药治疗强直性脊柱炎骶髂关节痛疗效。材料和方法:对16例强直性脊柱炎患者行CT引导下双侧骶髂关节腔内注入曲安奈德(1ml) 甲氨蝶呤(5mg) 1%利多卡因(3ml),随访2~10个月,观察患者临床症状的变化情况。结果:16例均成功完成CT引导下的双侧骶髂关节腔内注药的治疗。其中,14例有效,2例无效。结论:CT引导下骶髂关节腔内注药治疗强直性脊柱炎骶髂关节痛的近期疗效好,远期疗效有待观察。     

强直性脊柱炎髋关节强直的中期全髋关节置换术

目的探讨强直性脊柱炎髋关节强直的外科治疗。方法回顾性研究2001年5月—2007年5月24例40髋强直性脊柱炎髋关节强直行关节置换情况,观察术后髋关节功能及并发症。结果随访24～60个月,所有患者髋关节疼痛得到了不同程度的缓解,术后Harris评分提高到60～92分,平均82分。术后6个月所有患者血沉均在30 mm/h以下。结论强直性脊柱炎髋关节强直中期关节置换可改善功能、提高患者生活质量。     

单纯后方入路治疗合并强直性脊柱炎颈椎骨折

目的 总结采取单纯后方入路治疗合并强直性脊柱炎下颈椎骨折的特点及治疗效果.方法 分析2003年6月-2008年6月住院治疗的合并强直性脊柱炎颈椎骨折患者26例,分析受伤机制、损伤严蕈程度、救治过程、手术记录、术后随访记录和康复过程,评价术后神经功能恢复程度及骨折愈合情况.结果 有6例患者采取单纯后方人路手术治疗,脊髓损伤按美国脊髓损伤学会(ASIA)分级:A级2例,B级1例,C级2例,D级1例.所有患者均采取后路复位侧块固定融合手术,2例A级患者分别于术后2,3个月因呼吸功能衰竭死亡.其余4例随访37个月(12～54个月),骨折均愈合,愈合时间平均3.8个月(3～5个月),神经功能显著改善.1例患者因发生硬脊膜外血肿症状加重至B级,术后达到D级,C级及D级患者均恢复到损伤前水平,2例A级损伤患者发生低钠血症.本组患者均未发生内固定相关并发症.结论 合并强直性脊柱炎颈椎骨折在骨折端无骨缺损时,复位后对位对线良好者可通过单纯后方入路完成固定融合手术,并可实现骨折稳定愈合.     

英夫利昔单抗治疗强直性脊柱炎（附80例报告）

目的：探讨英夫利昔单抗治疗治疗强直性脊柱炎临床效果。方法：80例强直性脊柱炎,英夫利昔单抗首次5mg/kg,静脉输注浓度,首次给药后的第2周和第6周及以后每隔6周各给予相同的剂量治疗。结果：80例患者中临床治愈20例,显效22例,有效28例,无效10例,总有效率87.5%（70/80）;2例出现输液反应,对症治疗后缓解。结论：本组结果显示英夫利昔单抗治疗强直性脊柱炎患者有效率高;显不良反应少,安全性较高。     

全脊柱加骶髂关节SPARCC评分对益赛普治疗强直性脊柱炎疗效的评估与预测价值

目的:探究全脊柱加骶髂关节SPARCC评分在评估及预测肿瘤坏死因子抑制剂(益赛普)治疗强直性脊柱炎疗效中的应用价值。方法:选取54名活动期的强直性脊柱炎患者并予以益赛普治疗,于治疗的基线期(治疗前)和12周进行临床评估及MRI检查。使用SPARCC评分系统,对患者治疗前后脊柱及骶髂骨的骨髓水肿进行评分,同时对比临床疗效评估进行研究。结果:治疗后强直性脊柱炎患者骨髓水肿的改善与疾病活动度指标ASDAS、BASDAI、CRP、ESR的改善具有相关性(P <0.05),且Kappa检验显示使用SPARCC评分评估益赛普治疗的无效、显效与临床疗效评价指标ASAS40具有一致性(Kappa值=0.514,P <0.001)。Logistic回归分析及ROC曲线显示全脊柱加骶髂关节的SPARCC评分(OR=1.086,P=0.045;AUC=0.811,P=0.005)是益赛普疗效的预测因素。结论:全脊柱加骶髂关节的SPARCC评分可以用于评估及预测益赛普对强直性脊柱炎的疗效。     

Optimization of the system of medical service of students of Cadet Schools of the Ministry of Defense of the Russian Federation

One of the factors of the successful military career guidance Cadet schools students is preserving and promoting their health. Medical support of children and adolescents aged 10-17 years should include the full range of medical and preventive measures defined for this group. The state of providing outpatient care for pupils at the Cadet School in St. Petersburg was studied. These results show that full medical care in accordance with the standards can be based only on children's health clinics. It is important that the organization of medical support pupils cadet schools should be cooperate with civilian health care.     

带状疱疹83例误诊原因分析

带状疱疹是由水痘—带状疱疾病毒引起的皮肤科常见疾病。其主要的病理损害,一是受累神经的严重炎症性浸润,继而导致受侵犯神经节内神经细胞变性、坏死;二是皮肤的水泡。迅速抑制神经节和相应的感觉神经纤维的充血、水肿和坏死,防止粘连形成,达到迅速镇痛、改善皮损,缩短病程及防止后遗症的发生是治疗的关键。因而,尽早明确诊断,     

Estimation of accumulated dose of radiation by method of ESR-spectrometry of dental enamel of mammals

ESR-spectrometry was used to investigate radiation-induced paramagnetic centers in enamel of mammals: carnivores (polar bear and fox), ungulates (reindeer, European bison, moose), and man. Values at half the microwave power saturation of the radiation signal, P_1/2, evaluated at room temperature, was found to range from 16 to 26 mW for animals and man. A new approach to discrimination of the radiation induced signal from the total ESR spectrum of reindeer enamel is proposed. ‘Dose-response’ dependencies of enamel of different species mammals were measured within the dose range from 0.48 up to 10.08 Gy. Estimations of ‘radiosensitivity’ enamel of carnivores and ungulates showed good agreement with radiosensitivity enamel of man by ESR method.     

Analysis of the results of the international comparison of activity measurements of a solution of Fe

The results of an international comparison of activity measurements of a solution of ⁵⁵Fe organized by the BIPM in 2005 are reported and analysed. This exercise, which follows the procedures of the CIPM mutual recognition arrangement to update older comparisons, is a renewal of the comparison organized by the BIPM that took place in 1978. A EUROMET comparison was organized in 1996 specifically to compare activity measurements of a ⁵⁵Fe solution by means of liquid-scintillation techniques. Results of these three comparisons are presented and discussed in this paper.

The radionuclide solution was provided by the NPL, which also distributed the samples to the participants. The activity of the ampoules was measured by 16 laboratories using 12 methods producing 25 results. Some general considerations on uncertainty assessments pertaining to the different techniques used are drawn. The outcome of four different estimators is compared from which the presence of at least one outlier can be confirmed. Further measurements should be made to try to reduce the discrepancy between the results. To date the outcome of the present comparison does not show an improvement to that of the 1996 comparison.     

Evaluation of the results of various technics of non-surgical therapy of varicocele

A new method of non-surgical treatment of varicocele syndrome is described: it consists in sclerotherapy of spermatic vein by trans-femoral percutaneous catheterization with balloon-catheters. In 8 cases venous thrombosis has been induced by direct electric clotting. The techniques and a 6 months follow-up are discussed. It is pointed out that this procedure should be considered as the method of choice for tubular lesions and sub-fertility prophylaxis in young people and in childhood.     

延迟性脾破裂误漏诊原因分析

目的探讨延迟性脾破裂误漏诊原因和预防措施.方法回顾性分析总结12例延迟性脾破裂中的诊断和误漏诊的经验与教训.结果本组延迟性脾破裂的误漏诊5例(41.66%).对多发伤与脾破裂并存可能认识不足,外伤史轻微或伤员隐瞒外伤史,缺乏腹痛-缓解-突然再腹痛的典型病史,缺乏“对冲性脾破裂”力学分析和整体化诊断思路等为其误漏诊的主要原因.结论详细的外伤史和全面系统检查,重视腹以外多发伤掩盖腹内脏器伤及延迟性脾破裂可能.确立外伤-腹内脏器伤-脾破裂整体化诊断思路.不间断地辅以B超检查脾形态学变化和腹内有无积液,腹腔穿刺确定有无血腹、X线胸腹部检查观察左侧胸肋角和膈肌运动情况、必要时CT检查以尽早发现脾包膜下血肿,降低延迟性脾破裂误漏诊率.