壳聚糖化疗药物缓释药粒局部治疗骨巨细胞瘤的实验研究

目的 探讨骨巨细胞瘤化疗的可行性及确定生物可降解材料壳聚糖作为其治疗的药的载体的可能性。方法 体外培养骨巨细胞瘤标本,测定药物及壳聚糖的敏感性;将壳聚糖与化疗药制成缓释药粒,进行体外及体内释放试验。结果 骨巨细胞瘤对阿霉素（ＡＤＭ）、顺氨氯铂（ＣＤＤＰ）中度敏感。单纯壳聚糖对骨巨细胞瘤在体外无抑制作用。体外及体内试验第１ｄＡＤＭ释放量较大,其后在较低水平维持相对稳定的缓慢释放达８周以上。结论 骨巨     

计算机快速成型辅助个体化三踝骨折的手术治疗

Objective To compare the operation with computer-aided rapid prototyping technique and the conventional procedure for treatment of trimalleolar fractures.Methods Twenty-four patients with trimalleolar fracture who had been admitted to our hospital from March 2007 to March 2008 were divided into 2 even groups randomly.Group A underwent 3-dimensional reconstruction, computer simulation and rapid pro-totyping and demonstration of individual fracture model before operation.Group B received only conventional procedures.The therapeutic effects were evaluated by Cedell criteria and compared statistically between the 2 groups.Comparision between the 2 groups was made in the exposure time, reduction and fixation time curative effect.Results Fallow-up from 8 to 15 months revealed that the operation time for Group A (45.43 ± 9.38 minutes) was significantly shorter than for Group B (58.61 ± 12.32 minutes) (t = - 2.948, P < 0.05).The exposure time between the 2 groups had no statiscal difference (t = - 1.06, P =0.102).The excellent rate of curative effect in Group A was 83.3% and 66.7% in Group B.Conclusion Computer aided rapid prototyping can shorten the operation time and improve operational efficiency for trimalleolar fractures.     

计算机快速成型辅助个体化三踝骨折的手术治疗

Objective To compare the operation with computer-aided rapid prototyping technique and the conventional procedure for treatment of trimalleolar fractures.Methods Twenty-four patients with trimalleolar fracture who had been admitted to our hospital from March 2007 to March 2008 were divided into 2 even groups randomly.Group A underwent 3-dimensional reconstruction, computer simulation and rapid pro-totyping and demonstration of individual fracture model before operation.Group B received only conventional procedures.The therapeutic effects were evaluated by Cedell criteria and compared statistically between the 2 groups.Comparision between the 2 groups was made in the exposure time, reduction and fixation time curative effect.Results Fallow-up from 8 to 15 months revealed that the operation time for Group A (45.43 ± 9.38 minutes) was significantly shorter than for Group B (58.61 ± 12.32 minutes) (t = - 2.948, P < 0.05).The exposure time between the 2 groups had no statiscal difference (t = - 1.06, P =0.102).The excellent rate of curative effect in Group A was 83.3% and 66.7% in Group B.Conclusion Computer aided rapid prototyping can shorten the operation time and improve operational efficiency for trimalleolar fractures.     

胡珂教授运用《黄帝内经》理论辨治咳嗽的经验

《素问·咳论》是《黄帝内经》中论述咳嗽的专篇。其中"五藏六府皆令人咳,非独肺也"和"聚于胃,关于肺"作为著名的论点被历代所沿用,此突破了见咳治肺、从肺治咳的局限性,提示了咳嗽与其他脏腑的内在联系,更为后世医家治疗咳病开启了新思路。本文摘录胡珂主任医师在临床中运用小柴胡汤类和二陈汤加减治疗咳嗽的验案二则,旨在与同道共飨胡师灵活多变的临床辨证思维。     

特制人工肱骨头治疗肱骨上端骨肿瘤

目的：探讨特制人工肱骨头置换对破坏严重的肱骨上端骨肿瘤的治疗。方法：选取肱骨上端破坏严重的骨肿瘤病例。根据活检及ECT的结果确定肱骨的截除范围，良性肿瘤在肿瘤下2cm处截断肱骨，恶性肿瘤在肿瘤下5-7cm截断肱骨，按以上要求定制个体化的人工肱骨头，本组病例共12例，其中骨肉瘤5例，骨巨细胞瘤3例，软骨肉瘤2例，骨囊肿1例，骨母细胞瘤1例。均采用瘤段切除，特制人工肱骨头置换并辅以恶性肿瘤的术前及术后化疗。结果：术后随访1-3年，功能良好，优良率达83.3%。无1例术后感染及脱位。结论：对肱骨上端骨肿瘤，只要严格掌握适应证，采用特制的个体化的人工肱骨头进行置换及采用术前及术后辅助治疗，就能达到既切除肿瘤，又保留肢体和功能的良好手术效果。     

关节镜下双股半腱肌腱重建后十字韧带及相关问题的探讨

目的 观察关节镜下双股半腱肌腱转移重建后十字韧带(posterior cruciate ligament,PCL）的效果，分析其影响因素。方法 1998年6月～2002年6月共收治28例PCL损伤患者，男22例，女6例；年龄18～31岁，平均22.5岁。使用开口螺旋肌腱剥离器剥离半腱肌腱，保留肌腱远端附着点，在靠近肌腱肌腹交界处切断，对折成两股，关节镜下重建PCL，内口侧使用可吸收挤压螺钉固定。结果 术后平均随访33个月。后抽屉试验术前26例阳性，术后2例；Lachman试验术前均阳性，术后3例阳性，2例弱阳性；轴移试验术前12例阳性，术后均消失。随访评分采用IKDC评分方法：A级9例（32.1%)，B级16例（57.1%)，C级3例（10.8%)；Lysholm膝关节功能评分为92.7分。结论 关节镜下使用双股半腱肌腱转移重建PCL，通过两隧道转折处时，由于韧带两端无骨块，操作容易。可吸收挤压螺钉在隧道内口侧挤压固定，愈合后内口消失，避免隧道内口扩大导致韧带松弛、关节不稳。胫骨隧道外口原附着点附着牢固，股骨隧道外口固定坚强，重建韧带强度大。该手术还具有创伤小，能早期功能锻炼，并发症少等优点。     

灯盏细辛注射液治疗冠心病心绞痛的临床观察

目的 :观察灯盏细辛注射液治疗冠心病心绞痛的临床疗效与安全性。方法 :对 2 45例冠心病心绞痛患者 ,随机分为治疗组 160例 ,采用灯盏细辛注射液治疗 ;对照组 85例 ,采用复方丹参注射液治疗。结果 :治疗组、对照组治疗心绞痛的总有效率分别为 96 3 %、85 9% ,两组比较差异有显著性 (P <0 .0 5 ) ;两组心电图改善的总有效率分别为 79 4%、63 5 % ,两组比较差异有显著性 ( P <0 .0 5 ) ;两组在治疗前血液流变学无明显差异 ( P >0 .0 5 ) ,治疗组在治疗前后血液流变学有显著性差异 (P <0 .0 5 )。结论 :灯盏细辛注射液治疗冠心病心绞痛优于复方丹参注射液 ,且安全性好 ,副作用少。     

应用Steffee钢板治疗腰椎滑脱32例

应用Ｓｔｅｆｆｅｅ钢板治疗腰椎滑脱３２例盛选军，陈立龙，孙新，曾剑平，章莹，谢小定１９９０年以来应用Ｓｔｅｆｆｅｅ钢板复位固定治疗腰椎滑脱３２例，男１２例，女２０例；年龄２０～６２岁，平均４２岁。滑脱平面：Ｌ３～Ｌ４１例，Ｌ４～Ｌ５２例，Ｌ５～Ｓ１１...     

克氏针加冻干异体韧带内固定治疗肩锁关节完全性脱位13例

我院2001—2003年使用克氏针加冻干异体韧带内固定治疗肩锁关节完全性脱位13例，其效果满意，报告如下。     

几丁糖阿霉素缓释药粒治疗骨巨细胞瘤的临床初步观察

为了观察骨巨细胞瘤刮除术后局部应用几丁糖阿霉素缓释药粒的疗效及全身反应，对４例骨巨细胞瘤刮除术后残腔应用４倍于常规静脉阿霉素用量的几丁糖阿霉素缓释药粒，检测术后１，２及５天血浆中阿霉素含量，以及术后１周、１个月及６个月的肝肾功能。结果表明，术后１，２及５天血浆中阿霉素含量分别为（１４３．０５±２７．５５）ｎｇ／ｍｌ、（５２．１７±１１．２８）ｎｇ／ｍｌ及（４．２５±３．０７）ｎｇ／ｍｌ，术后１周、１个月及６个月的肝肾功能均正常。随访７个月～１９个月，无局部复发、全身反应及Ｘ线片复发表现。认为，几丁糖阿霉素缓释药粒用于骨巨细胞瘤刮除术后是安全、有效的。