极间距离L身高H之比的研究

本文发现，Ｌ／Ｈ的值有两种、一种是胸前极间距离Ｌ１与身高Ｈ之比，另一种是胸背极间距离平均值Ｌ与Ｈ之比。国人目前关于Ｌ／Ｈ的报导，与Ｓｒａｍｅｋ的０．１６８不同，其原因是测量极间距离的方法不同产生的，并不是中国人与外国人的体型差别引起的，在心搏出量的非线性公式中，用０．１６８Ｈ代替Ｌ更为合理。     

健康青年人双足间的距离对静态站立平衡功能的影响

目的 探讨健康青年人静态站立时双足间的距离对平衡功能的影响,为平衡功能训练提供理论基础。 方法 选取健康青年受试者30例,其中男7例,女23例,分别在睁眼和闭眼两种方式下,采用平衡评估训练仪评估双足并拢站立、双足分开（50cm）站立和双足最适距离站立3种模式下的静态平衡功能,即压力中心（COP）的相关参数,包括前后摆动幅度标准差、左右摆动幅度标准差、前后平均运动速度、左右平均运动速度、运动椭圆面积、运动长度共6个量化指标,并进行数据分析。 结果 双足最适距离站立时,双侧足跟间平均距离为（18.63±3.67）cm,双侧足尖间平均距离为（29.60±4.93）cm。在睁眼和闭眼状态下,双足并拢站立时的前后摆动幅度标准差、左右摆动幅度标准差、前后平均运动速度、左右平均运动速度、运动椭圆面积和运动长度与双足分开（50cm）站立和最适距离站立时比较,差异均有统计学意义（P<0.05）;睁眼和闭眼状态下,双足最适距离站立时的左右摆动幅度标准差、左右平均运动速度、运动椭圆面积、运动长度与双足分开（50cm）站立时比较,差异均有统计学意义（P<0.05）。 结论 健康青年人在静态站立时,双下肢间有最适距离,在这种距离下,站立静态平衡功能最佳。     

成年人身高与去脂组织重的关系

目的研究成年人去脂组织重(fat-free mass,FFM)与身高之间的关系,并建立预测FFM的简单方程.方法对955名健康成年人进行人体测量和生物电阻抗测量,按BMI分为肥胖组和非肥胖组,按年龄分别45岁以下组和45岁以上组,分析FFM与年龄和肥胖的关系.根据FFM是身高的异速生长指数的模型关系,进行非线性回归,建立指数曲线回归方程.结果18～45岁健康成年人的身高为(1.65±0.07)m,体质量为(62.03±10.69)kg,体脂质量(11.28±6.75)kg,体脂含量(17.91±8.67)%,去脂组织含量(82.02±8.87)%,BMI(22.85±2.99)kg/m2,而46～74岁健康成年人的相应指标为(1.62±0.08)m,体质量为(66.08±10.21)kg,体脂质量(14.56±6.44)kg,体脂含量(22.09±9.23)%,去脂组织含量(77.58±10.07)%,BMI(25.19±2.95)kg/m2,差异有显著性意义(P＜0.05);18～45岁与46～74岁的健康人的FFM分别为(50.93±10.23),(51.53±10.07)kg,差异无显著性意义(P＞0.05);健康成年人的FFM并不随年龄增加;非肥胖组与肥胖组的FFM也是相对不变的.预测男性FFM的适宜方程为FFM(kg)=24.98×身高1.68,预测女性FFM的适宜方程为FFM(kg)=22.84×身高1.42.结论以身高为变量能估计出正常成年人FFM的近似值.     

PICC最佳置入长度与身高相关性研究

目的探讨PICC导管最佳置人长度和身高的关系以及尖端位置情况,为临床PICC专科护士提供科学的理论依据。方法将234例患者按照身高分为两组：A组113例,身高155～170cm;B组121例,身高171～180cm。置管到达测量长度后,胸部X线片定位。比较两组PICC导管尖端置于最适位置的成功率、导管异位情况。结果两组导管尖端置入最佳位置比较,差异无显著意义（P〉0．05）。B组导管尖端走行异常高于A组,A组低位异常高于B组,差异均有显著意义（P〈0．05）。右臂导管尖端走形异常的发生率（7．87％）高于左臂（4．67％）,差异有显著意义（P〈0．05）。两组组内左、右臂导管尖端异常的比较差异无显著意义（P〉0．05）,B组左、右臂导管尖端走行异常高于A组,P〈0．05,差异有显著意义。结论PICC置管患者的导管最佳置人长度和身高有关。身高越低,越容易发生低位;身高越高,走行异常的发生率越高,且右臂尖端走行异常的发生率高于左臂。     

经皮椎间孔镜技术治疗极外侧型腰椎间盘突出症观察

目的观察经皮椎间孔镜技术治疗极外侧型腰椎间盘突出症的临床疗效。方法选取2013年9月～2015年2月我院收治的26例极外侧型腰椎间盘突出症患者,均予以经皮椎间孔镜手术治疗。术后随访2年以上,对手术前后腰、腿痛VAS评分进行比较,并于术后2年进行疗效评定。结果 26例患者均顺利完成手术,无一例发生术中神经根或硬膜损伤等并发症。手术时间63～102(平均73.6)min;住院时间4～7(平均5.1d)。术后即时和不同随访时间,腰、腿痛的VAS评分均较术前显著下降(P<0.05)。术后随访2年时,采用改良MacNab疗效评价,中26例、优16例、良7例、可1例、差2例,总优良率为88.5%。结论极外侧型腰椎间盘突出症行经皮椎间孔镜技术治疗,可取得良好的近期疗效。     

经皮椎间孔镜治疗极外侧型腰椎间盘突出症的效果

目的 观察经皮椎间孔镜治疗极外侧型腰椎间盘突出症(FLLDH)的效果。方法 选取2019年4月至2021年4月南石医院收治的FLLDH患者100例为研究对象,按随机数字表法分为对照组和研究组,每组50例。对照组予以传统开放性手术,研究组予以经皮椎间孔镜手术,对比两组临床疗效、手术临床指标(手术时间、术中出血量、卧床时间)、视觉模拟评分法(VAS)及腰椎功能(Lehmann)评分。结果 研究组治疗总有效率[98.00%(48/50)]较对照组[84.00%(42/50)]高(P<0.05)。研究组手术时间、卧床时间均较对照组短,术中出血量较对照组少(P<0.05)。两组术后24 h VAS评分和术后3个月Lehmann评分较术前改善(P<0.05),术后24 h研究组VAS评分较对照组低(P<0.05),研究组Lehmann评分与对照组比较,差异未见统计学意义(P>0.05)。结论 经皮椎间孔镜治疗FLLDH患者可以提高临床疗效,减少术中出血量,缩短手术时间、卧床时间,缓解患者疼痛情况,改善患者腰椎功能。     

椎间孔镜技术治疗极外侧型腰椎间盘突出症的近期疗效观察

目的探讨椎间孔镜技术治疗极外侧型腰椎间盘突出症的近期疗效。方法回顾性分析该院2011年7月-2013年3月23例极外侧型腰椎间盘突出症患者,均采用椎间孔镜技术治疗;年龄34~54岁,平均42.1岁;采用腰腿痛视觉模拟评分(VAS)测评入院时和椎间孔镜术后(术后即刻、术后1周、1个月、3个月及末次随访),末次随访采用改良Mac Nab标准评定临床疗效。结果 23例患者手术后随访9~18个月,平均12.6个月。所有患者腰痛、腿痛的VAS评分由术前的(6.87±1.38)和(8.58±1.42)分下降到术后末次随访时的(2.45±0.52)和(1.55±0.45)分,术后随访与术前比较差异均有显著性(P0.01)。末次随访采用改良Macnab疗效评定标准评估,术后优良率均为91.3%,1例患者于术后出现腰背部疼痛,于卧床休息服用非甾体消炎药3 d后症状消失。结论椎间孔镜技术治疗极外侧型腰椎间盘突出症近期疗效明显。     

极外侧入路椎间融合术在腰椎退行性疾病中的应用效果

目的分析极外侧入路椎间融合术在腰椎退行性疾病中的应用效果。方法选择本院收治的50例腰椎退行性疾病患者,全部患者选择极外侧入路椎间融合术治疗,观察分析治疗效果。结果全部患者顺利完成手术,平均术中出血量为(145. 5±4. 7) m L,平均手术时间为(56. 3±2. 2) min,平均住院时间为(7. 2±1. 5) d。术后4例患者出现屈髋乏力,2个月后症状彻底恢复。6例患者术后出现大腿前方感觉麻木感,6～8周后症状消失或者缓解。本研究患者无腹腔脏器和大血管损伤、脑脊液漏、椎间隙定位错误、麻痹性肠梗阻、生殖股神经永久性损伤等并发症。全部患者接受为期24个月的随访,结果发现末次随访时,患者的腰痛视觉模拟(VAS)评分、下肢痛VAS评分均显著低于术前(P 0. 05),日本骨科协会腰椎(JOA)评分显著高于术前(P 0. 05)。结论选择极外侧入路椎间融合术治疗腰椎退行性疾病患者能取得比较理想的效果,并发症少,椎间融合率高。     

卧床危重患者身高测量尺的设计与应用

临床危重及卧床患者,由于病情原因无法站立测量身高。由于身高测量不及时。数据绘制不准确,导致不能及时为临床提供诊疗数据。鉴此,笔者设计一种身高测量尺,应用于卧床及危重患者的身高测量。既提供了准确的身高数据,又保证了危重及卧床患者的安全。介绍如下。     

维生素D营养状况与儿童身高发育的相关性分析

目的探讨维生素D营养状况与儿童身高发育的相关性。方法回顾性分析2018年6月～2019年6月某地区的学龄前儿童300例临床资料,根据儿童年龄的不同将其分为婴儿组(1个月～1岁)100例、幼儿组(1～3岁)100例、学龄期组(3～14岁)100例。均测量其身高,并进行维生素D检测,比较三组当前状态下维生素D营养状况与儿童身高发育的相关性。结果婴儿组维生素D缺乏率以及相对缺乏率均低于幼儿组、学龄前组,且幼儿组低于学龄前组,婴儿组维生素D正常率均高于幼儿组、学龄前组,且幼儿组高于学龄前组,差异有统计学意义(P<0.05);经Pearson分析,三组儿童维生素D营养状况与身高水平之间均呈正相关(P<0.05)。结论儿童均存在一定的维生素D缺乏情况,且学龄期儿童的维生素D相较于幼儿以及婴儿而言,更为明显。维生素D营养状况与儿童身高发育之间存在正相关的关系,要采取有效措施进行相应的补充。     

A Randomized Controlled Clinical Study to Quantify the Effect of Small Changes in the Design of Pacing Electrodes on Threshold Voltages

A double-blind randomized study of three pacing leads, identical in all ways except for the surface of their electrodes, is presented. The leads were implanted in 30 patients. Ten patients (Group A) received a standard Laserdish lead (dish electrode with laser pores), 10 patients (Group B) received a platinum-iridium coated modified Laserdish electrode, and 10 patients (Group C) received a platinum-iridium coated dish electrode identical to that in Group B except for the absence of laser pores. All leads were implanted by the same operator via the subclavian vein and all patients received an Optima MPT pulse generator. Direct measurement at implantation of pacing threshold and endocardial electrograms showed no significant difference between the three groups (mean ± standard deviation voltage thresholds 0.30 ± 0.06 V at 0.5 ms and 0.21 ± 0.05 V at 1.0-ms pulse durations, R wave amplitude 7.6 ± 3.2 mV). Significant differences (P = 0.001) were found in threshold impedances at implant (Group A 940 Ω, Group B 782 Ω, Group C 673 Ω). Ten further measurements of voltage threshold were made over the next 2 years. Overall, at a pulse duration of 1.0 ms, a significantly reduced (P < 0.025) threshold voltage was found for both the electrode with pores and platinum-iridium coating compared with pores alone (20%), and with pores and platinum-iridium coating compared with the coating alone (18%). There was no significant difference between using platinum-iridium alone or pores alone. We have shown that a controlled randomized study, using electrodes that are identical except for the characteristics being assessed, can enable effects of small differences in electrode design to be quantified.     

急性心肌梗死与巨细胞病毒感染相关性分析

目的探讨急性心肌梗死发病与人巨细胞病毒感染的关系。方法应用间接酶联免疫吸附试验检测急性心肌梗死患者血清中巨细胞病毒特异性IgM,IgA抗体。结果急性心肌梗死患者血清IgM,IgA搞体分别为69·2%和28·8%,明显高出对照组人群,两组间比较差异非常显著。结论急性心肌梗死发病与巨细胞病毒感染有关。     

A Preliminary Study to Examine the Effects of Aerobic and Therapeutic (Nonaerobic) Exercise on Cardiorespiratory Fitness and Coronary Risk Reduction in Stroke Survivors

Rimmer JH, Rauworth AE, Wang EC, Nicola TL, Hill B. A preliminary study to examine the effects of aerobic and therapeutic (nonaerobic) exercise on cardiorespiratory fitness and coronary risk reduction in stroke survivors.

Objectives

To compare the effects of 3 different exercise training regimens on cardiorespiratory fitness and coronary risk factor reduction in subjects with unilateral stroke.

Design

A cluster assignment by residential location repeated-measures design.

Setting

University-based medical center.

Participants

Fifty-five subjects with unilateral ischemic stroke were assigned to the following groups: intensity (n=18), duration (n=19), and therapeutic exercise (n=18).

Intervention

A 14-week intervention with subjects randomized to 1 of 3 interventions: (1) moderate intensity, shorter duration (MISD) exercise (gradually increasing exercise intensity while keeping exercise duration constant at 30 min), (2) low-intensity, longer duration (LILD) exercise (gradually increasing duration to 60 min while keeping exercise intensity constant), or (3) conventional therapeutic exercise (TE) consisting mainly of strength, balance, and range of motion activities. All groups exercised 3 days per week.

Main Outcome Measures

Peak oxygen consumption (Vo₂peak), submaximal oxygen consumption (V?o₂), lipid panel, and resting blood pressure.

Results

The MISD group attained more favorable effects on systolic (P<.04) and diastolic blood pressure (P<.002) and total cholesterol (TC) (P<.036) compared with LILD and TE groups. Both MISD (P<.029) and LILD (P<.045) showed significant reductions in triglycerides compared with TE (P<.029). There was no significant change in Vo₂peak and submaximal V?o₂ in any of the groups.

Conclusions

Overall, both MISD and LILD conditions achieved greater clinical and significant gains in coronary risk reduction compared with TE.     

潮气量对极低出生体重儿高频震荡通气时p(CO2)的影响及最佳设置分析

目的观察极低出生体重儿高频震荡通气(high-frequency oscillation ventilation, HFOV)时血p(CO₂)的变化,探讨潮气量对血p(CO₂)的影响及最佳潮气量值。方法接受HFOV治疗的极低出生体重儿80例,记录通气过程中各项参数,包括呼吸频率、呼吸幅度、平均气道压、吸入氧浓度、潮气量、每分通气量、p(CO₂)、二氧化碳扩散系数(carbon dioxide diffusion coefficient, DCO₂),共监测毛细血管血气数据812个,其中p(CO₂)≥55 mm Hg的血气数据439个为观察组,p(CO₂)<55 mm Hg的血气数据373个为对照组,比较2组呼吸参数;采用多因素logistic回归分析极低出生体重儿p(CO₂)升高的影响因素;绘制ROC曲线,评估潮气量及其他通气参数对极低出生体重儿p(CO₂)升高的预测效能。结果观察组吸入氧浓度(0.49±0.13)高于对照组(0.32±0.14)(P<0.05),潮气量[(1.62±0.37)mL/kg]、每分通气量[(0.61±0.29)mL/kg]及DCO₂[(32.49±14.92)mL²/s]均低于对照组[(2.18±0.52)mL/kg、(0.92±0.23)mL/kg、(68.47±31.44)mL²/s](P<0.05);潮气量(OR=0.028,95%CI:0.006~0.132,P<0.001)、每分通气量(OR=0.003,95%CI:<0.001~0.028,P<0.001)、DCO₂(OR=0.936,95%CI:0.910~0.963,P<0.001)是极低出生体重儿p(CO₂)升高的影响因素;潮气量、每分通气量、DCO₂的最佳截断值分别为1.81 mL/kg、0.62 mL/kg、38.84 mL²/s时,预测极低出生体重儿p(CO₂)升高的AUC分别为0.833(95%CI:0.766~0.887,P<0.001)、0.596(95%CI:0.516~0.673,P<0.001)、0.830(95%CI:0.762~0.885,P<0.001),灵敏度分别为81.25%、93.75%、72.50%,特异度分别为75.00%、31.25%、93.75%,潮气量及DCO₂预测极低出生体重儿p(CO₂)升高的AUC明显高于每分通气量(P<0.05)。结论潮气量对使用HFOV呼吸支持的极低出生体重儿p(CO₂)有明显影响,保持潮气量不低于1.81 mL/kg对控制p(CO₂)水平有较好指导价值。     

Bio-oss/富血小板纤维蛋白复合物修复牙槽骨缺损区后牙移动的效果及可行性

目的探讨Bio-oss/富血小板纤维蛋白(PRF)复合物修复牙槽骨缺损区后牙移动的效果和可行性。方法前瞻性将2016年1月至2018年6月收治的牙槽骨缺损区行正畸矫治的患者38例(65颗牙)采用随机数字表法分为对照组(19例34颗牙)和观察组(19例31颗牙),对照组于牙槽骨缺损区植入Bio-Oss骨粉,观察组于牙槽骨缺损区植入PRF/Bio-Oss复合物。记录两组正畸治疗前创面愈合情况;根据锥形束CT(CBCT)计算正畸牙齿术前-术后6个月、术前-术后12个月(正畸治疗6个月)平均垂直骨吸收量、骨密度值;术后6个月、12个月计算正畸牙齿各部位唇侧骨厚度及月平均移动距离。结果观察组创面愈合时间短于对照组,2周创面愈合率大于对照组(P <0. 05);观察组术前-术后6个月、术前-术后12个月垂直骨吸收量低于对照组,骨密度平均值高于对照组(P <0. 05);观察组术后12个月正畸牙齿颈部、中间、根尖的唇侧骨低于对照组(P <0. 05);观察组术后12个月正畸牙齿月平均移动距离小于对照组(P <0. 05)。结论 PRF/Bio-Oss复合物修复牙槽骨缺损区可减少缺损区骨吸收量,提高骨密度值,进一步减小术后正畸牙齿移动距离。     

Ultrasonographic evaluation of cervical lymph node metastases in esophageal cancer with special reference to the relationship between the short to long axis ratio (S/L) and the cancer content

Cervical lymph node metastasis was evaluated sonographically in 58 esophageal cancer patients. The short to long axis ratio (S/L) is a useful way to detect lymph node metastasis as opposed to the long axis alone. In other words, the lymph node exceeding 10 mm in long axis and with S/L over 0.5 showed a much higher incidence of metastasis than S/L under 0.5 in the analysis of the 126 detected lymph nodes. The cancer content was calculated with a microcomputer in each of the total 77 metastatic lymph nodes by enlarging the microscopic specimen 8 or 16 times using a magnifying apparatus. The average cancer content in the metastatic lymph nodes with S/L under 0.5 and over 0.5 was 26.0% and 59.1%, respectively, revealing a statistically significant difference (p less than 0.01). Thus, cancer proliferation in the metastatic lymph nodes of esophageal cancer is closely related to the increase in S/L.     

聚左旋乳酸可吸收微型接骨板的体内降解特性

背景:国外聚左旋乳酸微型接骨板和螺钉的价格昂贵,限制了其存国内的广泛应用.目的:观察国产聚左旋乳酸微型接骨板在家犬体内的力学衰减过程及其降解特性.设计、时间及地点:随机对照动物体内实验,于2005-0112006-12在吉林人学第一医院整形外科实验室完成.材料:聚左旋乳酸接骨板和螺钉由中国科学院长春应用化学研究所研制,初始分子质量约7.5×104,杨氏模量3.3～3.6GPa,强度48-55 MPa.方法:在12只成年杂种犬下颌骨建立双侧骨折模型,采用聚左旋乳酸接骨板螺钉固定系统行骨折内固定.然后按取材时闻随机分为术后1,3,6,12个月4个时间点,每个时间点3只.主要观察指标:观察各时间点接骨板大体降解情况,测试接骨板三点弯曲强度,检测接骨板黏均分子质量并计算其降解率.结果:12只犬均进入结果分析.降解过程中接骨板最人抗弯强度随时间的延长呈逐步下降的趋势,术后6个月,衰减率已达到初始强度的82.31%.各个时间点间均存在显著差异(P<0.05).随着降解时间的逐渐延长,接骨扳黏均分子质量呈现下降趋势.至术后12个月,分子质量降解率已达91.80%,各时间点间均存在显著差异(P<0.05).将接骨板最大抗弯强度衰减率与接骨板黏均分子质量降解率间进行双变量相关性分析,显示两者呈正相关性(r=0.876,P<0.05).结论:随时间的变化聚左旋乳酸微型接骨板逐渐降解,其力学强度逐渐减弱,分子质量逐渐降低,其降解过程与下颌骨骨折的愈合过程基小相符合.     

滋阴活血润肠法对烫伤大鼠肠黏膜屏障的影响

目的:了解和揭示滋阴活血润肠法对SD大鼠烫伤后1周内血浆肿瘤坏死因子、内毒素、肠组织细胞凋亡的影响,探讨本法对肠黏膜屏障保护作用的机制,以期为临床探寻更有效的肠黏膜保护药物。方法:将SD大鼠70只随机分成三组,第一组为滋阴活血润肠中药治疗组(便可通组)30只,第二组为对照组(单纯烫伤组)30只,制备成烫伤模型,分别予以便可通、生理盐水灌胃;第三组为正常组10只。均检测血浆肿瘤坏死因子、内毒素的含量,观察大鼠肠组织细胞凋亡的变化。结果:滋阴活血润肠法可明显抑制烫伤模型大鼠内毒素易位,减少肿瘤坏死因子的产生,抑制肠组织细胞凋亡。结论:中医滋阴活血润肠法有较理想的肠道屏障保护作用,是预防和治疗肠道屏障功能障碍引发的多器官、多系统功能衰竭的重要方法之一。     

The proportion of prostate-specific antigen (PSA) complexed to alpha(1)-antichymotrypsin improves the discrimination between prostate cancer and benign prostatic hyperplasia in men with a total PSA of 10 to 30 microg/L

BACKGROUND: The aim of this study was to assess the diagnostic accuracy of the proportion of prostate-specific antigen (PSA) complexed to alpha(1)-antichymotrypsin (PSA-alpha(1)ACT:PSA ratio) in the differential diagnosis of prostate cancer (CaP) and benign prostatic hyperplasia (BPH) in men with total PSA of 10-30 microg/L. METHODS: We used our immunoassays (ELISAs) for total PSA and PSA-alpha(1)ACT complex to study 146 men. In 123, total PSA was between 10 and 20 microg/L; 66 of these had CaP and 57 BPH. In 23 men, total PSA was between 20 and 30 microg/L; 14 of these had CaP and 9 BPH. We calculated the area under the ROC curves (AUC) for total PSA, PSA-alpha(1)ACT complex, and PSA-alpha(1)ACT:PSA ratio, and determined the cutoff points that gave sensitivities approaching 100%. RESULTS: In the total PSA range between 10 and 20 microg/L, the AUC was significantly higher for the PSA-alpha(1)ACT:PSA ratio (0.850) than for total PSA (0.507) and PSA-alpha(1)ACT complex (0.710; P <0.0001). A cutoff ratio of 0.62 would have permitted diagnosis of all 66 patients with CaP (100% sensitivity) and avoided 19% of unnecessary biopsies (11 of 57 patients). In the total PSA range between 20 and 30 microg/L, the AUC for the PSA-alpha(1)ACT:PSA ratio (0.980; 95% confidence interval, 0.82-0.99) was greater than the AUC for total PSA (0.750; 95% confidence interval, 0.51-0.89; P = 0.042). In this range, a cutoff point of 0.64 would have permitted the correct diagnosis of all 14 patients with CaP and 6 of the 9 with BPH. CONCLUSIONS: The diagnostic accuracy of the PSA-alpha(1)ACT:PSA ratio persists at high total PSA concentrations, increasing the specificity of total PSA. Prospective studies with large numbers of patients are needed to assess whether the ratio of PSA-alpha(1)ACT to total PSA is a useful tool to avoid unnecessary prostatic biopsy in patients with a total PSA >10 microg/L.