胫骨中下1／3骨折延迟愈合或不愈合72例治疗体会

我科从2000年2月-2004年5月治疗胫骨中下1／3骨折延迟愈合或不愈合72例，取得了较好的治疗效果，现总结如下。     

小儿支原体肺炎的临床X线分析(附70例报告)

目的：通过70例经实验室证实的支原体肺炎的临床和X线回顾性分析，为临床提供X线诊断依据，材料和方法：收集我院近两年经冷凝集试验，式子支原体培养和／或PCR等方法确诊的70例临床，胸片资料进行分析。结果：学龄前儿童（6－14岁多见）45例，占64．2％，临床表现以干咳，发热为主要症状，胸部体征少或无；实验室检查血白细胞正常55例，占78．6％，胸部X线表现间质浸润型5例，占7．1％，小叶性肺泡渗出型21例，占30％，一个或几个肺叶，段实变型45例，占64．2％，病变分布上肺野15例，占21．4％，中肺野11例，占15．7％，下肺野49例，占70％，右侧38例，占54．3％，左侧35例，占50％，结论：支原体肺炎胸部X线征象以肺叶，肺段实变，密度较淡为特征性表现，结合发病年龄，症状及流行病学资料可为临床提供早期诊断依据。     

中国农村婚检忧思录

我国一位著名的社会学家日前撰文指出:在我国广大农村中,引起夫妻不和,导致分居、离婚的最根本原因已不再是一些日常琐事、邻里纠纷、婆媳不合等,更多的内在原因是夫妻在性生活上的隔阂和矛盾。而这些隔阂和矛盾大多是可以避免的,遗憾的是绝大多数夫妇在婚前自觉不自觉地跨越了“婚检”这一关而直接步入夫妻生     

血清急性时相蛋白在胃癌复发中的临床意义

目的　探讨血清急性时相蛋白在胃癌患者根治术后复发早期诊断中的价值。方法　检测1 2 0例胃癌患者 (胃癌根治 87例 ,胃癌姑息切除 33例。)手术前、后血清急性时相蛋白的水平并与健康对照组对照。对胃癌根治术的 87名患者 ,分别于术后 1 ,3 ,6 ,9,1 2个月检测血清急性时相蛋白水平 ,每 3个月随访 1次 ,观察其复发情况 ,至少随访 1 2个月或至死亡。结果　胃癌组血清C -反应蛋白(CRP)、α1 -抗胰蛋白酶 (α1 AT)和α -酸性糖蛋白 (α AG)水平显著高于健康对照组 (P <0 .0 1 ) ,铜蓝蛋白 (CER)、转铁蛋白 (TFR)和前白蛋白 (PAB)水平差异无显著性 (P >0 .0 5) ;胃癌根治组术后一定时期血清CRP ,α1 AT和α AG水平显著低于术前水平 ,其他指标无显著改变。根治组术后复发者血清CRP ,α1 AT和α AG水平手术前、后均显著高于未复发组 (P <0 .0 1 )。CRP ,α1 AT和α AG阳性组复发率 (60 % ,63 .3 % ,46 .1 5 % )显著高于阴性组 (1 4 .2 8% ,1 3 .1 6 % ,1 4 .85 % )。结论　检测急性时相蛋白有助于评估胃癌患者的预后 ,能为胃癌术后复发的早期诊断提供可靠的临床信息     

显微外科治疗脊髓栓系综合征一例

脊髓栓系综合征（ＴＣＳ）是由于各种先天和后天原因牵拉脊髓圆锥，使圆锥位置下降并产生一系列神经功能障碍和畸形的症候群。临床较少见，易误诊，我院于１９９６年１１月收治１例。患者女性，３４岁，因左侧臀区疼痛、间歇性跛行７年入院。２年前曾在外院ＣＴ检查诊为“...     

裂隙灯下针刺联合大剂量丝裂霉素C修复滤过泡

回顾性研究了Wills眼科医院1999年3月至2001年8月连续的滤过性手术失败患44例44眼，采用比以往报告的剂量大10倍的丝裂霉素C（MMC）和较大容积的麻醉剂在裂隙灯下进行滤过泡针刺修正术。方法：术前向患眼滴表面麻醉剂、5％聚维酮碘各1次。然后滴喹诺酮类抗生素4次，     

Effects of Hedan Tablet(荷丹片)on Lipid Profile,Proprotein Convertase Subtilisin/Kexin Type 9 and High-Density Lipoprotein Subfractions in Patients with Hyperlipidemia:A Primary Study

Objective: To investigate the effects of Hedan Tablet(荷丹片) on serum lipid profile, proprotein convertase subtilisin/kexin type 9(PSCK9) and high-density lipoprotein(HDL) subfractions in patients with hyperlipidemia. Methods: Thirty-seven patients with hyperlipidemia were randomized to treatment with Hedan Tablet 4.38 g/day as Hedan group(18 cases) or placebo(19 cases) as control group for 8 weeks. The lipid profile, PCSK9 and HDL subfractions were determined at day 0 and week 8 in both groups respectively. Results: Hedan treatment for 8 weeks mildly decreased serum low-density lipoprotein cholesterol(LDL-C) levels, while no changes were found in total cholesterol(TC), triglycerides(TG) and PCSK9 concentrations. Furthermore, Hedan treatment increased the concentration of large high-density lipoprotein cholesterol(HDL-C) and the percentage of large HDL subfraction, while decreased the concentration of small HDL-C and the percentage of small HDL subfraction without changing serum HDL-C levels in patients with hyperlipidemia. Conclusion: Hedan treatment of 4.38 g per day for 8 weeks could confer a favorable effects on serum LDL-C concentration as well as HDL subfractions.     

Short-andLong-Term Effects of Xuezhikang(血脂康),An Extract of Cholestin,on Serum Proprotein Convertase Subtilisin/Kexin Type 9 Levels

Objective:To investigate the short- and long-term effects of Xuezhikang(血脂康,XZK),an extract of Cholestin,on proprotein convertase subtilisin/kexin type 9(PCSK9) level.Methods:Thirty rats were randomly divided into three groups and were given saline,XZK 1,200 mg/kg or lovastatin 10 mg/kg respectively by daily gavage for 3 days(n=10 for each).Sixteen patients without previous iipid-lowering drug treatment for dyslipidemia received XZK 1,200 mg daily for 8 weeks.Fasting blood samples and liver tissue were collected at day 3 for rats,while the blood samples were obtained at baseline and week 8 from patients.The serum PCSK9 and lipid profile were measured.The expression of hepatic low density lipoprotein(LDL) receptor and sterol regulatory element binding protein 2(SREBP-2) were measured by real time-PCR.Results:PCSK9 levels in rats were significantly increased in the XZK and lovastatin groups(P=0.002,P=0.003 vs.control) at day 3,while no significant differences were found in the levels of lipid parameters.PCSK9 levels in patients increased by34%(P=0.006 vs.baseline) accompanied by total cholesterol and LDL-cholesterol decreased by 22%and 28%(P=0.001,P=0.002 vs.baseline).The hepatic mRNA levels of LDL-receptor and SREBP-2 were significantly increased in the XZK and lovastatin groups.Conclusion:XZK has significant impact on PCSK9 in a short- and long-term manner in both rats and humans.Moreover,the data indicated that as lovastatin,XZK increased PCSK9 levels through SREBP-2 pathway.     

单侧双通道内镜与经通道显微镜减压技术治疗腰椎管狭窄症疗效比较

目的 评价单侧双通道脊柱内镜技术和经通道显微镜双侧减压技术治疗腰椎管狭窄症的临床疗效.方法 回顾性分析65例单节段腰椎管狭窄症患者的资料.行单侧双通道脊柱内镜技术治疗的患者为34例,行经通道显微镜双侧减压技术治疗的患者为31例.比较两组患者手术时间、术后下地活动时间及住院天数.根据术前、术后1月、3月及末次随访时疼痛视觉模拟评分(visual analogue scale,VAS)、Oswestry功能障碍指数(oswestry disability index,ODI)及改良MacNab标准评价临床疗效.结果 所有患者均顺利完成手术且获得有效随访,随访时间6～12个月.两组患者术后1月、3月及末次随访时VAS、ODI评分随时间推移逐渐降低,且较术前均得到明显改善(P<0.05),但两组组间比较无明显差异(P>0.05).末次随访时根据改良MacNab标准,单侧双通道脊柱内镜技术组优良率94.1％,经通道显微镜双侧减压技术组优良率90.3％,两种术式临床疗效无明显差异.单侧双通道脊柱内镜技术组手术时间、术后下地活动时间及住院天数均小于经通道显微镜双侧减压技术组,差异有统计学意义(P<0.05).结论 单侧双通道脊柱内镜技术具有视野清晰、操作灵活、适应症广泛、学习曲线低等优点,用于治疗腰椎管狭窄症可取得良好临床效果.