右冠状动脉介入治疗的临床疗效及安全性观察

目的　观察右冠状动脉 (冠脉 )介入治疗 (PCI)的临床疗效及安全性。方法　回顾性分析 1995— 2 0 0 2年间进行的 188例 2 0 2处右冠脉靶血管介入治疗的特点。结果　 188例右冠脉病变共 2 0 2处右冠脉靶血管 ,靶血管介入成功率为 91 1%,其中 15 0例植入支架 174枚 ;PCI失败 18例 ,均发生在右冠脉近中段 ;室颤 2例 ,PCI后无复流现象 6例 ,早期急性冠脉闭塞 1例 ,冠脉破裂 3例 ,死亡 3例。随访 1～ 96月 ,绝大多数临床症状改善。结论　右冠脉病变的PCI是一项成功率高、并发症少、近远期临床疗效俱佳的治疗手段。     

腹腔镜监视下Ⅰ期经肛门巨结肠根治术10例报告

1998年,Torre首先提出治疗先天性巨结肠采用一期经肛门拖出术（transanal endorectal pull-through or transanal surgvry,TAS）。手术经肛门施行．不需开腹或应用腹腔镜技术游离肠管。该术式具有简便、合并症少、费用低、创伤小等优点。在国内尤其是经济欠发达或没有腹腔镜技术的地区得到迅速开展,然而该术式视野仅限于肛门区．术中腹腔内情况难以发现。如结肠系膜出血、结肠扭转、拖下吻合的结肠张力过大、腹腔内脏器（大网膜、小肠、卵巢）嵌入肌鞘内等。基于此我们采用微型腹腔镜监视下完成该手术。取得良好的效果．现报告如下。     

Does Waldenstrom’s macroglobulinemia also cause bone destruction? A rare case report

Waldenstrom’s macroglobulinemia (WM) is a rare type of malignant B-cell lymphoma. The main feature of WM is elevated serum monoclonal immunoglobulin M, similar to multiple myeloma (MM). Unlike in MM, the rarity of destructive bone lesions in WM has been repeatedly emphasized. We report a unique case of WM with a vertebral compression fracture as the first symptom. This case highlights that the presence or absence of bone destruction may not clearly distinguish between WM and MM. The possibility of WM should be considered in patients with vertebral fracture and destruction as the first presentation. Performing vertebral bone marrow aspiration biopsy during percutaneous vertebroplasty is a convenient and effective method to assist in the diagnosis of WM.     

Highlight from recent cancer literature

正Two cellular lineages are identified to initiate prostate cancer Identifying the cells of origin for prostate cancer is a key step to improve disease prevention and therapeutics. However, the identity of these cells has been long debated and remains inadequately defined because of a lack of proper animal models. Now, recent findings by Xin and colleagues provide new insight on the origins of prostate cancer. Their report, published in Cancer Cell, shows that prostate cancer can initiate from     

Rational fluid management in today's ICU practice

Intravenous fluid therapy has evolved significantly over time. From the initial report of the first intravenous administration of sodium-chloride-based solution to the development of goal-directed fluid therapy using novel dynamic indices, efforts have focused on improving patient outcomes. The goal of this review is to provide a brief overview of current concepts for intravenous fluid administration in the ICU. Results of recently published clinical trials suggesting harmful effects of starch-based solutions on critically ill patients are discussed. Concepts for goal-directed fluid therapy and new modalities for the assessment of fluid status as well as for the prediction of responsiveness to different interventions will continue to emerge. Advances in technology will have to be critically evaluated for their ability to improve outcomes in different clinical scenarios.     

我国特色数据库建设研究现状

通过对1996-2009年我国特色数据库研究的调查统计分析,总结和评价了近年我国特色数据库领域的研究重点和研究方向,对特色数据库研究的未来趋势进行了预测。     

高度近视合并青光眼患者视神经纤维层厚度的变化

目的:通过光学相干断层成像(OCT)检测高度近视合并青光眼患者视神经纤维层厚度的变化规律。方法:选取2017-01/12于我院进行治疗的高度近视合并青光眼患者80例160眼作为观察组,并选择同期于我院进行体检的健康志愿者60例120眼作为对照组。采用OCT分析所有受检者视神经纤维层厚度。结果:与对照组受检者相比,观察组患者鼻侧、颞上、鼻下、鼻上、颞下及全周平均视神经纤维层厚度均降低,而颞侧视神经纤维层厚度升高(P<0.05),且观察组中屈光度-10.00^-11.00D的患者鼻侧、颞上、鼻下、鼻上、颞下及全周平均视神经纤维层厚度均显著高于屈光度≥-12.00D的患者(P<0.05)。Spearman相关分析结果显示,观察组患者屈光度的绝对值与鼻侧、颞上、鼻下、颞下及全周平均厚度视神经纤维层厚度呈负相关,与颞侧视神经纤维层厚度呈正相关。结论:高度近视合并青光眼患者除颞侧外各象限视神经纤维层变薄。     

Triquetral fracture with associated pisiform subluxation

We herein present a case of right triquetral fracture with associated pisiform and flexor carpi ulnaris subluxation in a 29-year-old man. Initial radiography showed a right triquetral fracture. Computed tomography and magnetic resonance imaging demonstrated a triquetral fracture with a subluxated pisiform. Open reduction and lag screw fixation of the right triquetrum was performed, with good subsequent recovery of function. Although triquetral fracture with subluxation of the pisotriquetral joint is uncommon, attending clinicians should bear in mind the possibility of such an injury when managing traumatic ulnar-sided wrist pain.     

元认知能力与护生实习前焦虑程度的相关研究

目的 调查了解实习前护生的元认知能力和焦虑程度,并对其进行相关性研究.方法 对414名实习前护生,采用《大学生元认知能力量表》和《状态-特质焦虑量表》进行问卷调查,并将资料进行统计分析.结果 在焦虑程度上,本科护生与专科护生差异有统计学意义(P<0.05);元认知能力与焦虑程度呈负相关.结论 元认知能力是影响实习前护生焦虑程度的因素,提高元认知能力对减少焦虑有积极意义.