扎冲十三味丸联合温热蜡疗治疗脑梗死恢复期临床研究

目的:观察扎冲十三味丸联合温热蜡疗治疗脑梗死恢复期患者的临床疗效及对神经功能、活动能力的影响。方法:回顾性分析122例脑梗死恢复期患者的临床资料,根据资料中的治疗方法将患者分为对照组与治疗组各61例。对照组给予常规治疗,治疗组在对照组基础上运用扎冲十三味丸联合温热蜡疗治疗。比较2组治疗前后美国国立卫生研究院卒中量表(NIHSS)评分、日常生活能力评定量表(ADL)评分、Rivemead运动指数(RMI)评分、Berg平衡量表(BBS)评分、Fugl-Meyer上肢运动功能量表(S-FMMFA上肢)及Fugl-Meyer下肢运动功能量表(S-FMMFA下肢)评分变化,并比较2组临床疗效及不良反应发生情况。结果:治疗组总有效率95.08%,高于对照组83.61%(P<0.05)。与同组治疗前比较,治疗后2组NIHSS评分降低(P<0.05),ADL、RMI、BBS、S-FMMFA上肢、S-FMMFA下肢评分均升高(P<0.05);与对照组治疗后比较,治疗组治疗后NIHSS评分较低(P<0.05),ADL、RMI、BBS、S-FMMFA上肢、S-FMMFA下肢评分均较...     

数据驱动的三叉神经纤维束自动分割算法

目前三叉神经的纤维跟踪成像过程中普遍存在人工依赖性问题,主要包括人工绘制感兴趣区域(ROI)及手动筛选目标纤维束,导致结果的不确定性和数据误差。针对此类问题,提出一种数据驱动的三叉神经纤维自动分割算法。利用多组大脑样本的纤维数据,建立数据驱动的纤维聚类图谱,实现新样本纤维数据的自动分割,直接得到三叉神经纤维束。在实验中,选择25组青年健康人的数据作为样本数据。首先,利用FSL软件分割工具提取脑干作为ROI,进行确定性纤维跟踪。其次,通过对20组纤维数据进行多样本配准和谱聚类,创建数据驱动的纤维聚类图谱。根据三叉神经细小的特点,在建立纤维图谱过程中,通过对脑干纤维束进行二次分类来标注三叉神经纤维束。最后,选择5组青年健康人的新样本数据,将其脑干纤维数据应用纤维图谱自动分割得到三叉神经纤维束,并计算同一样本数据的自动分割结果与手动分割结果之间的加权Dice系数。结果显示,所提出的方法成功分割5组数据的三叉神经纤维束,而传统人工方法成功识别4组三叉神经纤维束,两者结果之间的加权Dice系数分别为0.865,0.939,0.824,0.942。该方法可以有效避免人为因素的影响,提高神经外科医生...     

Early-Stage Geopolymerization Process of Metakaolin-Based Geopolymer

The geopolymerization of aluminosilicate materials in alkaline environments is a complex physicochemical process that greatly influences the microstructure and engineering performances. This work aims to reveal the geopolymerization process of metakaolin-based geopolymer (MKG) in the first 5 d. Physicochemical characteristics of different evolution stages are disposed of in chronological order. The evolutions of electrical resistivity, dehydration process, volume deformation, and ionic concentration are comprehensively analyzed. Results show that chemical dissolution produces large dismantled fragments rather than small free monomers. The formation of a solid matrix follows the “spatial filling rule”, which means that gels grow by locking swelling fragments to form a framework, then densely filling residual space. Based on chemical models, early geopolymerization of MKG can be divided into six stages from the physicochemical perspective as dismantling, locking fixation, free filling, limited filling, second dissolution, and local mending. Those findings expand the understanding of the phase evolution of the early geopolymerization process; thus, the microstructure of MKG can be better manipulated, and its engineering performances can be improved.     

Individual treatment strategy for single urethrocutaneous fistula after hypospadias repair: a retrospective cohort study

BackgroundUrethrocutaneous fistula (UCF) remains the most common complication after hypospadias repair, and the recurrence rate of UCF is still high if the surgical techniques is not chosen properly, which called for better approaches to this problem. UCF presents different clinical characteristics due to their different locations and sizes, therefore we retrospectively analyzed the effects of different surgical techniques on single UCF after hypospadias repair in order to reduce the recurrence rates of UCF.MethodsA total of 602 patients diagnosed with UCF after hypospadias repair from January 2014 to December 2021 were enrolled. Baseline clinical characteristics such as age of patients, UCF location, size, surgical techniques were recorded. Patients were followed up in the outpatient clinic. The recurrence of UCF was defined as outcomes. Patients were divided according to the location of the UCF into a coronal UCF group and a non-coronal UCF group, which was then further classified according to the diameter of the UCF. The surgical technique and the recurrence rate of different types of UCF were analyzed and summarized.ResultsA total of 425 patients satisfied the inclusion criteria and 71 patients (16.7%) had recurrent UCF. Five surgical techniques were used to repair the UCF, namely tubularized incised plate (TIP) urethroplasty, Mathieu urethroplasty, double ligation, simple classical closure and trap-door procedure. The recurrence rate was 24.1%, 14.3%, 15.1%, 16.7%, and 22.2%, respectively. TIP or Mathieu urethroplasty is recommended for patients with coronal UCF with glans dehiscence or patients with coronal UCF diameter ≥4 mm without glans dehiscence. In patients with coronal UCF without glans dehiscence, double ligation is recommended for small UCF with diameter <2 mm, and simple classical closure is recommended for UCF with diameter 2–<4 mm. In patients with non-coronal UCF, double ligation is recommended for UCF with diameter <3 mm, and simple classical closure is recommended for UCF with diameter ≥3 mm.ConclusionsSingle UCF can be classified according to the location and size of the UCF. Different types of UCF should be treated with more appropriate individualized strategies, which can effectively reduce the recurrence rate of UCF.     

Outcomes of Eight‐Plate Epiphysiodesis for Residual Clubfoot Deformities

ObjectiveThe outcome of congenital clubfoot treatment is still challenging if the feet deformities are not completely corrected. Here we explore a minimal invasive procedure with an eight‐plate implant to correct the residual forefoot adduction deformity after treatment of neglected or relapsed clubfoot.MethodsWe retrospectively reviewed patients with residual forefoot adduction deformity after clubfoot treatment between January 2013 and June 2016. The patients underwent temporary epiphysiodesis of the lateral column of the mid‐foot, which in detail, an eight‐plate was placed on each side of the calcaneocuboid joint. The foot deformities were recorded according to the weight‐bearing radiographic measurements including talo‐first metatarsal angle, calcaneo‐fifth metatarsal angle and medial‐to‐lateral column length.ResultsA total of 13 patients (20 feet) with an average age of 7.8 years old were located with an average duration of 40.8 months follow‐up (range, 28 to 54 months). The average talo‐first metatarsal angle improved from 28.3° (range, 19° to 47°) preoperatively to 8.3° (range, 3° to 18°) and the calcaneo‐fifth metatarsal angle improved from 29.1° (range, 19° to 40°) preoperatively to 8.4° (range, 0° to 21°) at final follow‐up. The mean ratio of the medial‐to‐lateral column length improved from 1.14 ± 0.06 to 1.55 ± 0.09 with statistical significance (t = 3.566; P < 0.001).ConclusionsEight‐plate epiphysiodesis is an easy and effective method for the correction of residual forefoot adduction deformity after clubfoot treatment in growing children without the need of osteotomy.     

浅谈“七损八益”与三阴性乳腺癌雌激素受体、雄激素受体的表达

乳腺癌是我国女性发病率第一的恶性肿瘤[1],其中三阴性乳腺癌较其他类型乳腺癌相比,具有治疗棘手、预后更差的特点。"七损八益"是以阴阳损益之道来谈保身长全的理论思想。文章将结合"七损八益"的观点,从其损益转化的角度来讨论三阴性乳腺癌的治疗方法。其中以七损对应三阴性乳腺癌雌激素受体阴性,八益为应用雄激素受体治疗三阴性乳腺癌的手段。试以《内经》"七损八益"理论来探讨三阴性乳腺癌的关系,为研究治疗乳腺癌提供更多的思路。     

李曰庆教授辨证治疗前列腺疾病经验

李曰庆教授从医50余载,在中医外科和泌尿男科领域辛勤耕耘,勇于创新,取得了令人瞩目的成就,并在临床中应用中西医结合的治疗方法对泌尿男科等疾病进行治疗,经过多年临床积累了很多极具特色的用药经验。在慢性前列腺炎的诊疗上李曰庆教授强调辨证与辨病相结合,因证施治,综合治疗。在前列腺增生的治疗上,李教授提出从肾虚、血瘀、痰浊论治的辨证思路,采取温肾、活血及化痰的治疗方法。主要围绕李曰庆教授治疗前列腺疾病的理论及思路展开论述,旨在更好地指导临床。     

医院零星工程标准化、流程化管理模式的实践与应用

通过对标准化、流程化管理模式在医院零星工程中的应用,结合作者在管理中的实践经验,阐述该管理模式下的零星工程管理过程中的难点与建议.     

抗纤丸激活Nrf2信号通路抗小鼠慢性肝损伤的作用和机制研究

[目的]探讨抗纤丸对四氯化碳(CCL4)诱导的慢性肝损伤模型小鼠的保护作用及机制.[方法]BALB/c小鼠,分为正常组、模型组、甘草酸二铵组[60 mg/(kg·d)]、抗纤丸组[3 g/(kg·d)].腹腔注射CCL4橄榄油溶液建立慢性肝损伤小鼠模型,正常组腹腔注射等体积橄榄油.造模成功后,灌胃给药4周,检测血清丙氨...     

当代名老中医对紫癜性肾炎的认识举隅

紫癜性肾炎是以皮肤紫癜、便血、腹痛等为主要症状的肾脏损害疾病,病因迄今尚未完全阐明,多数人认为与某些细菌或病毒感染有关本文根据当代名老中医对本病的认识,做一个梳理比较,吴康衡教授提出了过敏性紫癜的病因以湿热毒为多,病位以脾胃为主,以脾胃湿热、络伤血溢、血溢瘀滞、气滞血瘀为主要病理环节的新见解他认为痛初多以风热内扰为先,治疗以疏风清热、散瘀止血为主．、孙郁芝教授主张重用活血化瘀、清热解毒药物的方法,李少川认为紫癜性肾炎病机是营血内耗,伤及肾阴,阴不足而阳不振,阳不振遂致肺、脾、肾气化功能失调j当代名老中医对本病痛机主要有脾胃湿热论、瘀血热毒论、肾阴虚损论等基本认识,在治疗方法上有疏风清热、散瘀止血,活血化瘀、清热解毒,滋阴固肾、调理脾胃的不同：