超声乳化吸除及人工晶状体植入术治疗小瞳孔白内障的临床探讨

目的:探讨小瞳孔时的白内障超声乳化术的手术技巧和临床效果。方法:对23例(27眼)散瞳后小瞳孔的白内障患者采用钝性分离及非切开的牵拉法扩大瞳孔,进行原位超声乳化并人工晶状体囊袋内植入术。结果:术后随访6～12mo,所有病例术后视力较术前有不同程度的提高,术后视力0.1～0.2者5眼,0.3～0.5者14眼;0.8以上者8眼。结论:采用钝性分离及非切开的牵拉扩大瞳孔法,原位超声乳化可使小瞳孔的白内障恢复良好的视力和生理性圆瞳孔或近圆瞳孔,手术并发症少。     

羊膜加巩膜前部覆盖防治羟基磷灰石义眼座眶内植入暴露的临床分析

目的:探讨羊膜加前部巩膜覆盖对防治羟基磷灰石(HA)义眼座植入暴露的临床效果。方法:采用羊膜联合自体或异体巩膜为加固物对13例(13眼)行Ⅰ、Ⅱ期HA义眼座植入,随访12～20mo。结果:13例均获得了较好的疗效,未见其他并发症。结论:在行HA义眼座植入时采用羊膜联合前部自体或异体巩膜覆盖加固有利于结膜创口的愈合,预防创口裂开,减少义眼座暴露。     

儿童散光度散光轴向的分析

目的:探讨3～10岁儿童散光度散光轴向分布情况。方法:10g/L阿托品常规散瞳验光检查2299眼。结果:3～10岁儿童散光度分布在0.25～2.00D,合例散光占96.35%,反例散光占0.52%,斜轴散光占3.13%。结论:3～10岁儿童散光以合例散光为主,斜轴散光次之,极少部分为反例散光。     

Current role of local ablative treatments for hepatocellular carcinoma.

Due to modern diagnostic imaging and the sensitive alpha-fetoprotein test, small hepatocellular carcinoma can now be detected at an early stage. Studies have shown that surgical resection of the tumors is a valuable treatment. Local treatment under ultrasound guidance was initially considered as an alternative when patients' liver reserves were not good enough for surgical resection; however, this technique has been improved and the results indicate that its survival rate can compete with that of surgical resection. In follow-up studies of patients with small hepatocellular carcinoma, a 5-year survival of 60% has been achieved after percutaneous ethanol injection therapy. Percutaneous microwave coagulation therapy and percutaneous radiofrequency ablation therapy have been shown to have some advantages over percutaneous ethanol injection therapy, although the follow-up durations of these studies were not long enough. Percutaneous ethanol injection therapy, percutaneous microwave coagulation therapy and percutaneous radiofrequency ablation therapy have become the 3 most widely used techniques for the treatment of hepatocellular carcinomas that are less than 5 cm in diameter and have a tumor number less than 3. In general, a tumor size of 3 to 5 cm is a good candidate for radiofrequency ablation and a tumor size of 2 to 3 cm is suitable for radiofrequency ablation or microwave coagulation. If the tumor size is around 2 cm or less, microwave coagulation or ethanol injection is often chosen due to the relatively low cost and similar efficacy. Ethanol injection also has the advantage of needing only a fine needle for injection. Informed selection of the appropriate technique, or combining a technique with transcatheter hepatic arterial embolization according to the tumor size and number, might provide the most effective treatment and achieve better results for hepatocellular carcinoma, even if the liver reserve is not good. However, large-scale, randomized, controlled trials are required before a definitive conclusion can be reached.     

Psychometric evaluation of the Taiwan version of the Disability of the Arm, Shoulder, and Hand (DASH) questionnaire.

BACKGROUND AND PURPOSE: To adapt the Taiwan version of the Disability of the Arm, Shoulder, and Hand (DASH) questionnaire and evaluate its psychometric properties. METHODS: The DASH questionnaire was adapted through the process of translation, back-translation, and expert review. Eighty two subjects with upper extremity disorders were recruited in a medical center and 46 of these patients could be followed up to assess retest reliability in less than 10 days. Cronbach alpha and intraclass correlation coefficient were used to evaluate the internal consistency and test-retest reliability. Principal axis factor analysis was performed to assess the factor-construct validity, while concurrent validity was tested with the Medical Outcomes Study Short Form-36 (SF-36) Taiwan version questionnaire. RESULTS: The internal consistency of the Taiwan version of the DASH questionnaire was high (Cronbach alpha = 0.96) and the test-retest reliability was satisfactory (intraclass correlation coefficient = 0.9). Principal axis factor analysis confirmed the 1-factor model. The Pearson correlation coefficients of the DASH questionnaire to the SF-36 showed a correlation with physical component summary scores rather than mental component summary scores. Bodily pain, physical function and role-physical scores among the SF-36 subscales were most significantly correlated with DASH disability/symptom scores. CONCLUSION: The Taiwan version of the DASH questionnaire is a valid and reliable measure of health status for patients with upper-extremity disorders.     

Percutaneous microwave coagulation therapy under ultrasound guidance for small hepatocellular carcinoma.

BACKGROUND AND PURPOSE: Percutaneous microwave coagulation therapy (PMCT) can effectively treat hepatocellular carcinomas (HCCs) smaller than 2 cm. However, for tumors 2 to 3 cm in size, combination of transarterial chemoembolization (TACE) or multiple insertions of electrodes may be more effective. This study investigated the treatment efficacy of PMCT for tumors 2 to 3 cm in size. METHODS: Nineteen HCCs smaller than 3 cm in diameter (< 2 cm in 11, and 2-3 cm in 8) in 18 patients (including 14 previously treated patients) were treated by PMCT under ultrasound guidance. One or 2 PMCT electrodes were consecutively inserted either into the left and right portion, or into the distal and proximal portion of the tumor, according to the size, shape, and margin of tumors and puncture direction. Liver function tests and contrast-enhanced computed tomography were used to examine preoperative status and response to PMCT. RESULTS: After an average of 1.6 emissions of PMCT, 18 tumors (95%) were completely ablated. The only case of treatment failure was due to a tumor location which made the approach of the electrode difficult. Bacteremia developed after the procedure in 1 patient (5%) and local inflammatory reaction of the puncture wound in another (5%). During follow-up ranging from 5 to 19 months, no recurrence was noted at the site of the original tumors. Tumor recurrence was detected at another site 2-9 months after PMCT in 9 of the 14 previously treated patients. CONCLUSION: PMCT can effectively and safely treat HCCs smaller than 3 cm in size without combination of TACE or multiple insertions of electrodes.     

COX-2、Survivin蛋白在卵巢上皮性癌中的表达及与临床病理因素的关系

目的探讨卵巢上皮性癌组织中环氧合酶2（COX-2）与Survivin的表达以及与临床病理因素的关系。方法采用免疫组化Elivision染色法检测COX-2、Survivin蛋白在60例卵巢上皮性癌组织、20例正常卵巢、20例良性卵巢上皮性肿瘤及20例交界性卵巢上皮性肿瘤中的表达。结果COX-2、Survivin蛋白在正常卵巢、良性卵巢上皮性肿瘤、交界性卵巢上皮性肿瘤组织及卵巢上皮性癌组织中的表达差异有高度显著性（P〈O．05）。COX-2表达与卵巢上皮性癌患者盆腹腔淋巴结有无转移呈显著相关性（P〈O．05）。Survivin基因表达与卵巢上皮性癌的病理类型有相关性（P〈O．05）、Survivin基因表达与淋巴结转移有显著相关性（P〈O．05）。结论COX-2、Survivin蛋白在卵巢上皮性癌中高表达，并在卵巢上皮性癌的发生、发展中起着重要作用，说明卵巢上皮性癌的发生非单一基因作用，而是多基因协同作用。     

企业工人保健意识、技能及保健用品配备现状调查

目的为了解企业工人自我保健的态度、知识、技能与保健用品配备的现状,为探索企业开展健康教育与健康促进提供参考依据。方法在大连造船重工集团和大连船用柴油机厂,采取分层抽样的方法对328人,由经过统一培训的调查员进行问卷方法进行调查。结果被调查的328人中,认为疾病可以预防的有315人,占96.0%;认为家庭应该配备保健用品的有275人,占83.8%;认为学习和掌握保健知识与方法对健康有好处的有319人,占97.3%;最关心的问题是身心是否健康的有294人,占89.6%。结论对企业工人广泛开展健康教育,特别是进行有针对性的保健技能的培训,对于促进自我保健水平的提高具有积极的意义。     

原发性肝癌的诊治进展

原发性肝癌(以下简称肝癌)是我国最常见的恶性肿瘤之一,自20世纪90年代以来,肝癌的年病死率已上升为城市和农村恶性肿瘤病死率的第二位和第一位。目前,外科治疗为主的综合治疗已经成为肝癌治疗的主流。随着认识的不断深入,一些新观念也相继进入临床。一、诊断在临床上,肝癌的诊断包括定性诊断和定位诊断两个方面。目前以高危人群为主要诊断对象的肝癌临床诊断体系已经较为完善,如果遵循甲胎蛋白(AFP)/AFP异质体+乙型肝炎病毒(HBV)免疫标志物+B超→CT或/和MRI(必要时行肝动脉造影)的诊断步骤,实验室检查与影像学检查相结合,可使绝大多…     

上田法和电脑中频协同治疗脑性瘫痪

目的探讨上田法和电脑中频协同治疗小儿脑性瘫痪(脑瘫)的疗效。方法观察和评定上田法和电脑中频协同治疗小儿脑瘫60例的疗效;收集和评定此前本科单用上田法治疗小儿脑瘫56例的疗效,比较两者连续治疗4个疗程(120 d)后疗效。结果上田法和电脑中频联用总有效率96.7%,单用上田法总有效率82.1%,两者比较有显著性差异(P<0.05)。结论上田法和电脑中频协同治疗小儿脑瘫有显著疗效。