关节镜辅助下多轴锁定钢板内固定治疗胫骨平台骨折

目的观察关节镜辅助下多轴锁定钢板(LCP)内固定治疗胫骨平台骨折的临床疗效。方法胫骨平台骨折24例均采用关节镜辅助下手术,对于SchatzkerⅠ～Ⅳ型骨折使用单侧多轴LCP固定,Ⅴ、Ⅵ型骨折采用双切口、双侧固定。结果 22例获得随访6～36个月,平均22个月。膝关节功能参照Rasmussen评分标准:优14例,良5例,可2例,差1例。结论关节镜辅助下多轴LCP内固定治疗胫骨平台骨折具有创伤小、骨折愈合快、关节功能恢复好、并发症少的优点。     

191例鼻咽癌颈部半束与全束照射的结果分析

目的 探讨与全束照射比较,半束照射技术能否提高鼻咽癌患者的区域淋巴结控制率和减少放射性后组脑神经损伤(RILCN)发生率.方法 191例以连续接受根治性放疗的鼻咽癌患者为研究对象,常规分割照射,采用同期非随机对照研究的方法,将患者分为半束照射组(80例)和全束照射组(111例);以Kaplan-Meier法计算生存率、Log-rank检验进行差异检验、Cox比例风险模型和Logistic回归模型进行多因素分析.结果 全组5年总生存率为67.3%,半束组与全束组5年总生存率分别为62.3%和67.4%,差别无统计学意义(X2=0.244,P=0.621);性别和临床分期为预后因素.5年区域淋巴结控制率分别为80.6%和83.1%,差别无统计学意义(X2=1.425,P=0.237);N分期为其预后因素.半束照射组和全束照射组的RILCN发生率分别为8.8%(7/80)和9.0%(10/111),两组间差别无统计学意义(X2=0.004,P=0.951).结论 与全束照射相比,半束照射技术未能提高鼻咽癌患者的区域淋巴结控制率和减少放射性后组脑神经损伤发生率.     

越补越虚 当心血瘀

刘先生年轻时体质就弱,针灸、推拿、火罐、刮痧、热敷等都用过.心脑脾肾都补了个遍,不仅没有效果.身体反而越来越虚。近几年身体更不如前.干瘦.头晕.眼睛像蒙了层纱.脾气很大.动不动就发火。感冒月月光顾.有了风声雨声最     

撮谷道养生法干预孕期痔病的应用性研究

目的:为观察在治未病理论指导下,采用撮谷道养生法预防孕妇痔病发生的疗效.方法:将270例孕14 ～ 36周社区女性随机等分为干预组、对照组,干预组采用常规干预加撮谷道养生法,对照组采用常规干预.结果:270例中完成试验246例,剔除24例(8％).痔病发生率干预组26例(20.8％),对照组46例(38.0％),两组比...     

不同呼气末正压对ARDS犬肺复张后氧输送的影响

Objective To explore the effect of different positive end expiratory pressures (PEEP) on oxygen delivery (DO2) after recruitment maneuvers (RM) in dogs with acute respiratory distress syndrome (ARDS). Method After ARDS models established in 15 dogs by oleic acid, static P-V (pressure-volume) curves were determined by low flow technique. Lower inflection point (LIP) was set by two-way linear regression methods. RM was operated with the pressure control method. ARDS dog models were randomly divided into three groups, namely PEEP 8 cmH2O group (group A), 12 cmH2O group (group B) and 16cmH2O group (group C) after RM (equivalent to pressure at4 cmH2O under LIP, 4 cmH2O near LIP, and 4 cmH2O above LIP, respectively). Hemodynamics and arterial blood gas analysis were monitored before RM, 0, 5, 10 and 15 min after RM. The recruited volume was measured by P-V curve method 15 min after RM and respiratory mechanics was also observed at the same time. Then DO2 was calculated. The quantitative variables were summarized as the mean and SD. The t-test was used to compare continuous variables between the two independent samples. One-way analysis of variance was used to compare variables among three groups. The level of significance was set at P＜0.05 for all the tests. Results In group A, the levels of PaO2 were significantly reduced 5 min, 10 min and 15 min after RM[(257 ± 23 )mmHg, (253±21)mmHg, and (255±19)mmHg] compared with PaO2 at 0 min [(322 ± 20) mmHg] (P＜0.05).But in group B and group C, the levels of PaO2 5 min, 10 min and 15 min after RM were not lower than level of PaO2 at 0 min after RM (P＞0.05 ). The levels of PaO2 in groups B and C were higher than that in group A at the same time (P＜0.05). The recruited volume distinctly increased with PEEP levels escalated [(50±12 ) mL, (124 ±15) mL, and ( 157 ±10)mL](P＜0.05). However, the increment in the recruited volume from PEEP 8 cmH2O to 12 cmH2O was dramatically greater than that from PEEP 12 cmH2O to 16 cmH2O.There was no significant difference in static compliance between group A and B [(14.3 ± 2.2) mL/cmH2O vs. (17.2±1.4)mL/cmH2O] (P ＞ 0.05 ). But compared with groups A and B, the static compliance in the group C significantly reduced(10.5 ± 0.9) mL/cmH2O ( P ＜ 0.05 ). The ratios of DO2 after RM to DO2 before RM were different at different levels of PEEP. The levels of DO2 after RM[( 1.15 ± 0. 11 ),( 1. 14 ± 0.12), ( 1.14 ± 0. 12) and ( 1.16 ± 0.11 )] increased more greatly than that before RM ( 1.00 ±0.09) in the group B (P ＜ 0.05 ). It did not occurred in the groups A and C. Conclusions The PEEP 12 cmH2O set at near the LIP after RM could be the optimal PEEP. Not only can it improve DO2 and the static compliance, but also maintain oxygenation and the recruited volume after RM.     

闭合复位经皮克氏针固定治疗儿童肱骨髁上骨折

目的总结闭合复位经皮克氏针固定治疗儿童肱骨髁上骨折的疗效。方法18例儿童肱骨髁上骨折,均属GartlandⅢ型,均行闭合复位经皮克氏针固定。结果平均随访6(3~12)个月,所有骨折术后平均8.8(6~12)周愈合。参照F lynn临床功能评定标准:优13例,良2例,一般3例,优良率为83.3%。结论闭合复位经皮克氏针固定治疗儿童肱骨髁上骨折,是一种安全、简便、损伤小、固定可靠、有效的方法。     

中医按摩保健操预防社区孕妇痔病疗效观察

目的：为观察在治未病理论指导下采用中医按摩保健操,预防孕妇痔病的临床疗效。方法：将90例孕14-36周社区女性随机等分为干预组、对照组,干预组采用常规干预加肛门保健操。对照组采用常规干预。结果：90例中完成84例,干预组中4例剔除,对照组2例脱落。痔病发生率干预组8例（19．5％）,对照组13例（30．2％）,两组比较有统计学意义（P〈0．01）。痔病发生频率干预组（0．40）低于对照组（0．43）。未发现不良事件及不良反应。结论：在治未病理论指导下,采用中医按摩保健操,是预防孕妇痔病的一种安全、简易、有效的方法。     

胸腔镜下双侧交感神经链T3加旁路神经切断术治疗原发性手汗症

原发性手汗症在亚洲人群中的发病率高于1%[1].在胸腔镜下行交感神经链切断术(ETS)是其有效的治疗方法.自2007年9月至2009年6月,我院收治152例原发性手汗症患者,在胸腔镜下行双侧交感神经链T3+旁路神经切断术,现总结其治疗经验.     

某市高校教师亚健康现状及影响因素调查

目的了解高校教师亚健康的发生情况及其影响因素,为促进高校教师的健康提供科学依据。方法对3所大学1 158名教师的健康状况进行问卷调查。结果某市高校教师亚健康检出率为54.5%,亚健康的主要表现为记忆力下降、入睡困难、疲倦等症状。工作压力大、家庭琐事繁多、同事之间竞争激烈、教学任务繁重、经济压力大以及睡眠时间少是亚健康发生的主要原因。结论某市高校教师的健康状况不容乐观。