三黄散外敷治疗合并上消化道出血的急性痛风性关节炎28例临床观察

目的:观察三黄散外敷治疗合并上消化道出血的急性痛风性关节炎的临床疗效。方法:将56例合并上消化道出血的急性痛风性关节炎患者按照随机数字表法分为治疗组和对照组,每组28例。对照组给予氟比洛芬凝胶贴膏贴敷治疗,治疗组予三黄散外敷治疗。2组均以1周为1个疗程。观察2组临床疗效,以及治疗前后关节疼痛数字评分法(NRS)评分、C反应蛋白和患者对疗效的整体评价。结果:治疗组有效25例,无效3例,总有效率为89.29%;对照组有效21例,无效7例,总有效率为75.00%。2组比较,差异有统计学意义(P < 0.05)。治疗后,2组关节疼痛NRS评分和C反应蛋白较治疗前均有改善(P < 0.05),且治疗组优于对照组(P < 0.05)。结论:中药三黄散外敷治疗急性痛风性关节炎安全有效。     

清热通痹膏辅助治疗痛风性关节炎的疗效观察

目的探讨清热通痹膏外敷辅助治疗急性痛风性关节炎的疗效.方法将104例急性痛风性关节炎患者随机分为观察组和治疗组各52例,两组均采用扶他林口服治疗.观察组加用清热通痹膏局部外敷.结果两组治疗总有效率比较,差异有显著性意义(P＜0.05).结论清热通痹膏外敷辅助治疗急性痛风性关节炎肿痛疗效显著.     

双柏膏外敷辅助治疗急性痛风性关节炎的疗效观察

目的探讨双柏膏外敷辅助治疗急性痛风性关节炎的疗效.方法将72例急性痛风性关节炎患者随机分为观察组和对照组各36例,两组均采用等剂量的秋水仙碱及非甾体抗炎药治疗.观察组在此基础上同时局部外敷双柏膏.结果两组治疗总有效率比较,差异无显著性意义(P>0.05);观察组关节止痛时间为(4.1±1.2) h,住院时间为(5.2±1.1) d,对照组分别为(8.4±2.3) d、(9.4±2.0) d,两组对应项比较,差异有显著性意义(均P<0.05).结论双柏膏外敷辅助治疗急性痛风性关节炎疗效显著,可明显缩短病程,能更快地减轻患者痛苦.     

清热通络方外敷联合常规疗法治疗急性痛风性关节炎30例临床观察

目的:观察清热通络方外敷联合常规疗法治疗急性痛风性关节炎关节肿痛的临床疗效.方法:将64例急性痛风性关节炎患者随机分为治疗组和对照组,每组32例.对照组采用活血化瘀药静脉滴注,碳酸氢钠片、塞来昔布胶囊、醋酸泼尼松片口服治疗,治疗组在对照组基础上加用清热通络方外敷治疗.2组均以7 d为1个疗程.观察2组临床疗效,以及治疗...     

清热通痹膏辅助治疗痛风性关节炎的疗效观察

目的 探讨清热通痹膏外敷辅助治疗急性痛风性关节炎的疗效。方法 将104例急性痛风性关节炎患者随机分为观察组和治疗组各52例，两组均采用扶他林口服治疗。观察组加用清热通痹膏局部外敷。结果 两组治疗总有效率比较．差异有显著性意义（P〈0、05）。结论 清热通痹膏外敷辅助治疗急性痛风性关节炎肿痛疗效显著。     

栀黄止痛散外敷联合依托考昔治疗痛风性关节炎急性期30例临床观察

目的:观察栀黄止痛散外敷联合依托考昔治疗痛风性关节炎急性期的临床疗效。方法:将60例痛风性关节炎急性期患者随机分为治疗组和对照组,每组30例。对照组口服依托考昔治疗,治疗组在对照组治疗基础上给予院内制剂栀黄止痛散外敷。2组均以2周为1个疗程。观察2组患者临床疗效,以及治疗前后疼痛视觉模拟评分法(VAS)评分、血尿酸(BUA)、红细胞沉降率(ESR)、C-反应蛋白(CRP)。结果:治疗组治愈21例,好转7例,无效2例,总有效率为93.33%;对照组治愈17例,好转4例,无效9例,总有效率为70.00%。2组比较,差异有统计学意义(P<0.05)。治疗后,2组VAS评分、BUA、ESR、CRP较治疗前均有下降(P<0.05),且治疗组优于对照组(P<0.05)。结论:栀黄止痛散外敷联合依托考昔对于控制痛风性关节炎急性期具有良好的疗效。     

金生膏外敷治疗急性痛风性关节炎的护理

目的:总结金生膏外敷治疗急性痛风性关节炎的效果及体会。方法:对30例患者在常规西医治疗的同时外敷金生膏并进行相应的中西医结合护理。结果:观察组总有效率为93.3%,对照组总有效率为66.7%,两组比较差异有统计学意义(P<0.01)。结论:金生膏外敷治疗急性痛风性关节炎效果好。     

塞来昔布联合二黄膏外敷治疗瘀热阻滞型急性痛风性关节炎65例临床观察

目的:观察塞来昔布联合二黄膏外敷治疗瘀热阻滞型急性痛风性关节炎的临床疗效.方法:将140例急性痛风性关节炎患者按照随机数字表法分为治疗组和对照组,每组70例.在基础治疗的同时,对照组予塞来昔布胶囊每次200 mg,每日2次,口服;治疗组予塞来昔布胶囊每日200 mg,每日1次,口服,同时加用二黄膏局部外敷疼痛部位.2组...     

热痹方外敷治疗急性痛风性关节炎的临床观察

目的:观察热痹方外敷联合塞来昔布治疗急性痛风性关节炎的临床疗效及安全性。方法:采用简单随机化对照的临床试验设计,将80例急性痛风性关节炎患者分为治疗组和对照组,每组40例。对照组口服塞来昔布,每次200 mg,每日2次;治疗组在对照组治疗基础上予以自拟热痹方患处外敷,每日1次。2组均治疗5 d。观察2组临床疗效,治疗前和治疗后第3,5天VAS评分,以及治疗前后红细胞沉降率(ESR)、C-反应蛋白(CRP),并观察不良反应。结果:治疗组显效24例,有效13例,无效3例,总有效率为92.50%;对照组显效12例,有效23例,无效5例,总有效率为87.50%。2组间比较,差异无统计学意义(P>0.05);但治疗组的显效例数明显高于对照组。治疗后第3天,2组VAS评分均有改善(P<0.01或P<0.05),且治疗组较对照组改善明显(P<0.05)。治疗后第5天,2组VAS评分均继续改善(P<0.05),2组间比较,治疗组虽较对照组数值偏低,但差异无统计学意义(P>0.05)。治疗后,2组ESR、CRP较治疗前均降低(P<0.05);2组间比较,治疗组数值虽较对照组偏低,但差异无统计学意义(P>0.05)。2组治疗前后血常规、肝肾功能比较,差异均无统计学意义(P>0.05)。结论:热痹方外敷联合塞来昔布治疗急性痛风性关节炎起效快、疗效显著,无不良反应,值得临床推广。     

扶他林缓释片合加味四妙散内服治疗98例急性痛风性关节炎的疗效观察

目的探讨中西医结合治疗急性痛风性关节炎的临床疗效。方法98例符合急性痛风性关节炎的患者随机分为两组，治疗组以扶他林缓释片合加味四妙散内服，疗程一周，并与单纯用扶他林缓释片口服的对照组比较。结果治疗后中西药组患者的症状体征积分与单纯西药组之间的差异有统计学意义（P〈0．01或P〈0．05），两组在临床治愈率方面的差异有统计学意义（P〈0．05）；两组患者治疗前后症状和体征积分及实验室指标的变化，与治疗前比较有统计学意义（P〈0．01）。结论扶他林缓释片合加味四妙散内服治疗急性痛风性关节炎有较好的作用，疗效优于单纯扶他林缓释片治疗。     

胸腰椎骨折椎弓根内固定断裂与植骨融合方式的相关性分析

[目的]探讨胸腰椎骨折椎弓根螺钉内固定系统内固定术后,椎弓根螺钉断裂与植骨融合方式之间的关系,以探讨胸腰椎骨折植骨融合的最佳方式。[方法]回顾性研究1995年5月~2005年12月本院脊柱外科收治的胸腰椎骨折病人197例,其中A组单纯内固定(不植骨)患者14例,B组“H”形椎板植骨21例,C组横突间植骨67例,D组椎间、椎内联合横突间植骨95例。[结果]术后随访6~32个月,内固定断裂12例,其中A组4例,B组3例,C组5例,D组0例,4组中D组内固定断裂率显著低于其他3组(P<0.05)。[结论]椎间、椎体内联合横突间植骨重建脊柱三柱的稳定性,符合人体生物力学原理,能有效降低内固定断裂的发生。     

On the measurement of the functional properties of the CFTR

A number of methods are currently employed to assess the functional properties of CFTR channels and their response to pharmacological potentiators, correction of the defective CFTR trafficking, and vectorial introduction of new proteins. Here we review the most common methods used to assess CFTR channel function. The suitability of each technique to various experimental conditions is discussed.     

Preservation of the pylorus and resection of the head of the pancreas

The historical evolution of the pylorus-preservation resection of the head of the pancreas is traced from the first resections early in this century to relative standardization of the operation, to a lowering of the operative mortality, and to an interest in improving nutritional status after resection. There are many theoretical advantages for the function of the upper gastrointestinal tract after pylorus and gastric preservation, such as maintenance of gastric capacitance and equilibration of osmotic pressure in gastric digestants, foodstuff digestion and absorption, and bowel motility. After the pylorus-preserving resection, gastric emptying is normal, pyloric function to prevent duodenal reflux is often normal, and gastric acids and serum levels of duodenal hormones are at normal levels, whereas after standard pancreatoduodenectomy, all of these are often abnormal. No prospective blinded studies have been published comparing nutritional values after the two operative procedures, but evidence is presented of a satisfactory result with regard to gastric capacitance, body weight gain, and lack of postgastrectomy symptoms. An undoubted advantage of the pylorus-preserving feature is a simplification of the operation. These gains are achieved without increase in operative mortality, without increase in the incidence of jejunal ulcer, and without theoretical or actual decrease in value of the procedure as a cancer operation, except in patients with duodenal carcinoma proximal to the ampulla of Vater.     

下颌全牙弓后移量及最后界的测量

目的：研究下颌牙弓的有效后移量及找寻下颌牙弓移动的后界。方法：选取涉及拔除下颌第三磨牙或下颌第三磨牙缺失的病例18例（男6例,女12例）。采用种植支抗牵引下牙弓向远中,治疗完成时所有病例均明确到达下颌牙弓后界,即下颌第二磨牙远中到达下颌升支前缘软组织交界处。应用治疗前后的曲断片测量下颌第二磨牙远中到升支前缘的距离。结果：下颌第二磨牙后移量为（3.49±1.21）mm;治疗后磨牙后间隙的长度为（4.43±0.97）mm。结论：下颌牙弓可确定性地实现整体后移;最大后移量由磨牙后间隙的长度决定;其最后界止于下颌第二磨牙远中与下颌升支前缘软组织交界处。     

The Measurement of the Inclination Angle of the Hamate and Analysis of the Inclination Angle for the Rotation Deformity of the Little Finger in the Fixation of the Carpometacarpal Joint

ObjectiveComplex base fractures of the fifth metacarpal bone and dislocation of the fifth carpometacarpal joint are more prone to internal rotation deformity of the little finger sequence after fixation with a transarticular plate. In the past, we have neglected that there is actually a certain angle of external rotation in the hamate surface of transarticular fixation. This study measured the inclination angle of the hamate surface relative to the fifth metacarpal surface for clinical reference.MethodsIn a prospective single‐center study, we investigated the tilt angle of 60 normal hamates. The study included thin‐layer computed tomography (CT) data from 60 patients from the orthopaedic clinic and inpatient unit from January 2017 to March 2020, including 34 men and 26 women who were 15~59 years old, average 35 years old. The CT data of 60 cases in Dicom format of the hand was input into Mimics and 3‐Matics software for three‐dimensional (3D) reconstruction and measuring the angle α between hamate surface and the fifth metacarpal surface. According to the possible placement of the transarticular plate on the fifth metacarpal surface, we measured the angle β between the hamate surface 1 and the fifth metacarpal surface and the angle γ between the hamate surface 2 and the fifth metacarpal surface.ResultsThe average angle between the hamate surface and the fifth metacarpal surface was 11.66°. The hamate surfaces 1 and 2 have an external rotation angle of 7.30° and 7.51° on average with respect to the fifth metacarpal surface, respectively. There is no statistically significant difference in the angles between the two groups (P > 0.05).ConclusionsThe horizontal angle of the dorsal side of the hamate is different from the back of the fifth metacarpal surface, and the hamate has a certain external rotation angle with respect to the fifth metacarpal surface. No matter how the transarticular plate is placed, the plate always has a certain external rotation angle relative to the fifth metacarpal surface. When the fixation is across the fifth carpometacarpal joint, if the plate does not twist and shape, it will inevitably cause internal rotation of the fifth metacarpal, resulting in internal rotation deformity of the little finger sequence.     

静脉输注甘露醇开放血脑屏障对抗生素透过血脑屏障的影响

目的　通过快速静脉输注甘露醇可逆性开放血脑屏障 (BBB) ,探知此方法能否增加抗生素透过BBB的量 ,在何时达到最高峰 ,其通透量增加后临床上有无不良反应。方法　采用自身配伍设计 ,共 6个样本组。对照组仅使用抗生素 ;其余 5组分别在使用甘露醇前 60、3 0min ,同时使用甘露醇后 3 0、60min使用抗生素 ,各组皆取使用抗生素后 1h的脑脊液测其抗生素浓度。抗生素选用头孢三嗪。结果　测量值经过q检验 ,经 2 0 %甘露醇处理前后的CSF中的头孢三嗪浓度差异有非常显著性。全组患者经临床观察未出现神经系统的不良反应。结论　经静脉快速输注2 0 %甘露醇后可以使透过BBB的水溶性抗生素的量增加 ,两者使用的顺序是在抗生素使用 3 0min内即给予甘露醇快速滴注。该方法不会增加低神经毒性抗生素在中枢神经系统的不良反应。     

Preservation of the pylorus in resection of the head of the pancreas

Whipple's pancreatoduodenectomy was the standard operation for diseases of the head of the pancreas for more than 40 years, but the results were vitiated in part by poor gastrointestinal function and malnutrition. Reintroduced in 1978, pylorus-preserving proximal pancreatoduodenectomy (PPPP) has had an increasing impact on pancreatic surgery as its benefits have been recognized: improved nutritional status, decreased incidence of postgastrectomy syndromes, and a technically easier operation. Postoperative mortality rates and 5-year survival rates are comparable with those of the classic Whipple procedure. PPPP is indicated for most patients with chronic pancreatitis of the pancreatic head. It is also appropriate for patients with periampullary cancer and for those with pancreatic cancer arising from the lower part of ‘the head and the uncinate process. More than 650 patients have now undergone PPPP: 31% for chronic pancreatitis and 66% for periampullary and pancreatic cancers. We assess the indications for PPPP, outline the operation, and review the results.