慢性心功能不全药物治疗的研究进展

目的：论述慢性心功能不全（CHF）药物治疗的国内外研究进展。方法：复习近年来国内外有关CHF药物治疗的试验，并结合临床经验进行归纳与分析。结果：对心衰发生与发展机制的认识经历了心-肾机制、心脏-周围循环机制及神经-体液机制3个阶段。CHF的药物治疗主要有血管紧张素转换酶抑制剂（ACEl）、β-受体阻滞剂、利尿剂、洋地黄制剂及非洋地黄类正性肌力药、血管紧张素受体拮抗剂（ARB）和醛固酮拮抗剂。结论：CHF的药物治疗近年来已取得显著进步，降低了CHF患者的病死率和住院率。     

慢性心功能不全药物治疗的研究进展

目的论述慢性心功能不全(CHF)药物治疗的国内外研究进展.方法复习近年来国内外有关CHF药物治疗的试验,并结合临床经验进行归纳与分析.结果对心衰发生与发展机制的认识经历了心-肾机制、心脏-周围循环机制及神经-体液机制3个阶段.CHF的药物治疗主要有血管紧张素转换酶抑制剂(ACEl)、β-受体阻滞剂、利尿剂、洋地黄制剂及非洋地黄类正性肌力药、血管紧张素受体拮抗剂(ARB)和醛固酮拮抗剂.结论CHF的药物治疗近年来已取得显著进步,降低了CHF患者的病死率和住院率.     

牙体牙髓科常见医患纠纷分析

目的 分析牙体牙髓科常见医患纠纷投诉的类型和原因,探讨预防对策.方法 近3年纠纷投诉患者72例,对纠纷投诉的类型和产生的原因进行总结分析.结果 类型中服务质量、服务态度、费用、其他所占百分比分别约为50%、30%、16%、6%;产生原因为医德医风、服务艺术、操作规范、其他和非医生源性所占百分比分别约为20%、18%、23%、10%和29%.结论 牙体牙髓科的纠纷投诉大多数与医生处理上的欠缺有关,是可以避免的.     

传统治疗方面的研究在重要医学杂志中所占比例很小

2008年至2009年，6种重要医学杂志发表了328项评价药物治疗的研究，其中只有不到三分之一（104／328）的研究是比较两种治疗方法，或帮助医生和患者决定采用何种治疗方案、用药剂量、如何避免不良反应和治疗期限方面的研究。研究者查阅了这6种杂志，定量评价了生物医学研究的盲点——对比两种现有治疗的有效性，为治疗选择提供依据。     

腹壁硬纤维瘤的治疗

探讨自体阔筋膜移植或结合腹直肌前鞘翻转成形加自体阔筋膜移植，在修复硬纤维瘤切除后腹壁大缺损的作用。方法；在大腿外侧面作平行的二个皮肤纵形切口，皮下潜行分离后用切割器切除阔筋膜，并进行０．５厘米重叠的褥式缝合修补缺损。     

Villous adenomas and carcinoma of the duodenum in Gardner's syndrome

Patients with Gardner's syndrome are increasingly found to have polyps on routine upper gastrointestinal endoscopy, and their risk of developing periampullary carcinoma is between 3-12%. We report a 45 year old man with Gardner's syndrome who presented with periampullary carcinoma 5 years after colectomy. Review of the literature amassed another 21 cases of periampullary carcinoma in patients with Gardner's syndrome.     

初发精神疾病到精神科就诊途径分析

目的 探讨精神疾病患者的就诊途径,使精神疾病患乾能得到早期而正确的治疗。方法 采用自制《精神疾病就诊途径调查表》对４００例精神疾病患者的就诊途径及影响因素进行调查。结果 首诊于非精神科中西医４６．００％,首选搞迷信活动３８．７５％,首诊于精神科１４．００％,首选其他方式治疗１．２５％。大部分器质性精神障碍、神经症、抑郁症首诊于非精神科中西医,小部分精神分裂症首诊于精神科,大部分癔症首选搞迷信活动。首诊于精神科已婚者多,３个月内就诊于精神科以癔症、躁狂症、抑郁症为多,农村患者搞迷信活动多,就诊的决定者是家属。结论 精神疾病患乾有较严重的诊途径偏差,精神专科就诊率低。     

Extra-abdominal desmoid tumour of the leg

Extra-abdominal desmoid tumour is a rare tumour and only a few cases occurring in the limbs have been reported. A 35-year-old woman presented with gradually increasing swelling in the upper leg. She had a mild, dull, aching pain in the tumour. Wide local excision was done and the tumour was found mainly in the subcutaneous tissue, which histopathologically proved to be an extra-abdominal desmoid tumour. This case had an abnormal radiological appearance of peripheral calcification of tumour and saucer-shaped lesion in the underlying tibial cortex. The patient had no recurrence at two years follow-up.     

Mesenteric cystic teratoma in children

Mesenteric teratoma is an extremely rare tumor, arising, akin all other teratomas, from totipotent primordial cells and displays a mixture of tissues of tridermal or bidermal origin. Two cases of mature mesenteric teratoma in a 5-month-old girl and a 4-month-old boy, the youngest reported in the literature, excluding a case recently diagnosed prenatally, are described. Diagnostic tools, differential diagnosis and management are also discussed.     

骨韧带样纤维瘤的临床影像观察

目的:探讨骨韧带样纤维瘤的临床及影像学表现。方法:分析5例经手术及病理证实的骨韧带样纤维瘤患者的CT、MRI表现。结果:5例患者,3例呈膨胀性改变,2例呈溶骨性改变伴软组织肿块形成,病变区信号不均匀,增强呈环形强化。结论:骨韧带样瘤是一种罕见骨肿瘤,在CT、MRI没有特征性表现,诊断须密切结合临床表现及病理改变,注意与其它骨肿瘤进行鉴别。     

腹壁韧带样纤维瘤临床特点和治疗(附33例病例报告)

目的 探讨腹壁韧带样纤维瘤的临床特点和治疗.方法 回顾分析该院外科1998～2008年收治的33例腹壁韧带样纤维瘤患者的临床资料.结果 33例腹壁韧带样纤维瘤患者行广泛切除术26例和根治切除术7例,术后合并放射治疗10例,全组病例复发率21.2%(7/33).结论 腹壁韧带样纤维瘤复发率高,侵袭性生长,治疗应按低度恶性软组织肿瘤处理.治疗首选外科手术,放疗、化疗和内分泌治疗可能对肿瘤有效.     

对照研究软通道微创与内科保守治疗高血压脑出血

目的:评价软通道微创治疗高血压脑内血肿疗效.方法:高血压脑出血患者62例分为治疗组33例和对照组29例.对照组患者使用神经内科常规治疗,治疗组患者在采用内科常规治疗的基础上使用软通道微创早期引流.2组在人院时和入院后7d行(格拉斯哥昏迷量表,Glasgow coma scale,GCS)评分,入院时和入院后14d及30d行(斯勘的纳维亚卒中量表,Scandinavianstroke scale,SSS)评分.结果:治疗组手术后SSS评分14d(t=5.79,P<0.01)及30d(t=6.84,P<0.01),治疗组明显优于对照组.结论:通过对照研究发现,软通道微创治疗能够明确改善高血压脑内血肿患者的症状.     

Mesenteric panniculitis of the colon

Mesenteric panniculitis is a recently described, non-specific inflammatory disorder of the intestinal mesentery. The majority of cases reported concern the mesentery of the small intestine. We report a case of mesenteric panniculitis of the colon in a patient with Crohn’s disease and review 22 reported cases of mesenteric panniculitis of the colon. The clinical presentation of patients with colonic mesenteric panniculitis was variable, although different from that of small intestinal mesenteric panniculitis. The condition has been reported in all except two cases, and was aided by ultrasonography and computerised tomography. Mesenteric panniculitis of the colon would appear to carry a poorer prognosis than small intestinal mesenteric panniculitis as it presents at a more advanced stage and because of the dangers inherent in colonic obstruction secondary to the panniculitis. We recommend that surgical intervention should be restricted to biopsy to confirm diagnosis, and resection of obstructing mass lesions.