经皮穿刺髓核成形术治疗腰椎间盘突出症初步临床报道

目的　寻求一种简单、安全、有效、微创的椎间盘突出症治疗方法。方法　对 1 6例腰椎间盘突出症采用经皮穿刺髓核成形术 (Nucleoplasty)治疗 ,并对其疗效进行观察分析。 结果　全部患者经二周至一个月短期随访 ,症状均有不同程度改善 ,疗效优良率为 93 8% ,有效率为 1 0 0 %。未发现明显并发症。结论　髓核成形术是一种先进、安全、有效的椎间盘突出微创手术 ,具有操作简单、安全、微创、疗效佳、恢复快、无需住院等优点。     

Critical size defect in the canine mandible.

OBJECTIVE: The purpose of this study was to determine the minimum size defect in a canine mandible that would not spontaneously heal during the dog's natural life (the critical size defect). STUDY DESIGN: Sixteen adult female mongrel dogs underwent continuity resection on both sides of the mandible to create bilateral defects. In 8 dogs, mandibular defects ranging from 5 to 20 mm were created with periosteal resection. In the other 8 dogs, mandibular defects ranging from 30 to 60 mm were created preserving the periosteum. The dogs were then killed at 6 months and the defects examined using radiographs and histologic analysis. RESULTS: When the periosteum was removed, mandibular defects greater than 15 mm failed to heal across the entire defect. However, when the periosteum was preserved, mandibular defects needed to be greater than 50 mm in order to fail to heal. CONCLUSION: The critical size defect in a canine mandible model is 15 mm when the periosteum is removed and 50 mm when the periosteum is preserved.     

乳腺良恶性病变的磁共振T2*W首过灌注成像与血管生成相关性研究

Objective： To study the diagnostic value of T2^＊-weighted first-pass perfusion imaging in breast tumors. Methods： We analyzed the magnetic resonance imaging （MRI） information along with the pathological and immunohistochemistry results. Magnetic resonance imaging was performed in 28 patients with breast tumor. The time to signal intensity curves were generated according to the T2^＊-weighted first-pass perfusion imaging. The curve＇s maximal signal intensity drop rate and maximal signal intensity decrease time were analyzed and compared with the pathological diagnoses after surgery. Results： Malignant breast lesions showed higher maximal signal intensity drop rate （44.69% ± 17.07 vs. 17.22% ±7.49, P 〈 0.001） than benign lesions, but there was no significant difference of maximal signal decrease time between those two lesions （23.94 s ± 4.92 vs. 20.02 s ± 6.83, P 〉 0.05）. Conclusion： The T2^＊-weighted first-pass perfusion imaging has enough sensitivity and specificity in breast tumor diagnosis.     

Studies on Toxicity of Nitroquine-Dapsone Compound and Therapeutic Effects of Folic or Folinic Acid on Toxicated Animals

The toxic effects of nitroquine-dapsone compound(NQD)in mice and dogs were studied.The therapeutic index of NQDin mice is 1911,the greatest among the 6 antimalarials tested.Thetoxic effects of NQD(50 mg/kg/day for 3 days per os)and nitro-quine in dogs were manifested by injuries on the adrenal cortexand intestinal epithelium.When folic acid(4 mg/kg/day for 4 days)or calcium leucovorinum(0.3 mg/kg/day for 4 days)were usedconcomitantly with NQD,the death rate and the incidence of dia-rrhea in the toxicated dogs were greatly reduced,the injury on theintestinal epithelium was much milder,and the goblet cells weremuch more numerous than those without treatment.The results suggestthat folic acid and calcium leucovorinum can protect the undifferen-tiated cells in the intestinal crypts from being injured by NQD.     

超声电丛刺治疗后急性脑梗死患者神经功能缺损及实验室相关指标的变化

目的:观察超声电丛刺头穴丛刺法治疗急性脑梗死的效果,以及治疗前后体感诱发电位指标及血液生化指标变化。方法:①选择2003-01/2005-06在沈阳脑科医院神经内科住院的急性脑梗死患者261例,男160例,女101例。均为首次患病,且对治疗方案知情同意。将上述患者随机分为2组:丛刺治疗组131例,对照组130例。②丛刺治疗组:采用超声电丛刺治疗仪于头部电丛刺顶区(运动区),以100～200Hz疏密波电针通过6～8h,1次/d,1个疗程30次。对照组:均予以常规脑血管病药物同等治疗。丛刺治疗组和对照组均干预30d。两组疗效判定标准:治疗后神经功能缺损评分减少91%～100%为基本恢复,减少46%～90%为显著进步,减少18%～45%为进步。③采用酶联免疫法测定血浆α-颗粒膜蛋白水平;应用放射免疫法测定血浆血栓素A2水平;采用酶联免疫吸附法双抗体夹心法测定血浆D-二聚体水平;采用免疫透射比浊方法测定脂蛋白(a)水平。应用神经电生理检测仪检测体感诱发电位。④计数和计量资料差异比较采用χ2检验和t检验。结果:急性脑梗死患者261例均进入结果分析。①丛刺治疗组131例中:基本恢复31例,显著进步80例,进步15例,总有效率为96%(126/131);对照组130例:基本恢复14例,显著进步68例,进步12例,总有效率为72%(96/130);丛刺治疗组总有效率明显高于对照组(P<0.01)。②丛刺治疗组治疗后血浆α-颗粒膜蛋白、血栓素A2、D-二聚体和脂蛋白(a)含量较治疗前明显降低(P<0.01)。③丛刺治疗组治疗后体感诱发电位的波潜伏期与传导时间较治疗前明显缩短(P<0.01)。结论:超声电丛刺治疗急性脑梗死效果显著,可显著改善急性脑梗死患者体感诱发电位指标及血液生化指标。     

危重患者经外周静脉置入中心静脉导管的临床研究——前瞻性随机对照研究

目的 比较经外周静脉置入中心静脉导管(peripherally inserted central catheter,PICC)与经锁骨下静脉中心静脉置管在危重患者中的临床应用.方法 通过前瞻性随机对照研究方法,将80例ICU危重患者分为PICC组(40例)和锁骨下静脉组(40例),观察两组穿刺成功率、穿刺时间、穿刺不良反应发生率等.结果 PICC组较锁骨下静脉组一次穿刺成功率高(92.5%vs 75.0%,χ2=4.501,P=0.034),穿刺时间短[(15.7±5.3)min vs(23.9±6.3)min,t=-6.263,P=0.000],总不良反应发生率低(10.0%vs 27.5%,χ2=4.021,P=0.045).结论 PICC穿刺简便易行,危险性小,在危重患者中PICC置管优于锁骨下静脉置管.     

Performance and comparison of the Cockcroft-Gault and simplified Modification of Diet in Renal Disease formulae in estimating glomerular filtration rate in a Chinese Type 2 diabetic population.

AIMS: Our aim was to assess performances of the Cockcroft-Gault and simplified Modification of Diet in Renal Disease (MDRD) formulae in estimating glomerular filtration rate (GFR) in Chinese diabetic populations and their association with vascular risks. METHODS: A total of 1009 patients with Type 2 diabetes were categorized into low estimated GFR groups (GFR < 60 ml/min/1.73 m(2)) and control groups by the two equations. The performances of these formulae were assessed at different stages of kidney function. Carotid artery intima-media thickness (IMT) and the prevalence of diabetic retinopathy or albuminuria were compared among the groups. The ability of these formulae to identify established vascular risk markers using sensitivity, specificity, positive and negative predictive values were also compared. RESULTS: The prevalence of low estimated GFR was 32.7% with the Cockcroft-Gault formula and 5.2% with the MDRD formula, respectively. In low estimated GFR subjects by the MDRD formula, IMT was significantly thicker than those by the Cockcroft-Gault formula (1.2 mm vs. 1.0 mm; P < 0.05), with a higher prevalence of albuminuria (78.4 vs. 52.8%, P < 0.05) and diabetic retinopathy (46.5 vs. 30.5%; P < 0.05). The Cockcroft-Gault formula gave a specificity of 71.7% and a sensitivity of 37.0%, and the MDRD formula gave a specificity of 96.6% and a sensitivity of 7.9% in estimating low GFR relevant for established vascular risks. CONCLUSIONS: These formulae performed differently in Chinese diabetic populations. The simplified MDRD formula is minimally superior to the Cockcroft-Gault formula for its high specificity and positive predictive values in estimating low GFR relevant for vascular risks.     

从六经辨治腰椎间盘突出症

腰椎间盘突出症是临床常见病、多发病。随着现代影像诊断技术的发展,该病的诊断越来越明确,治疗方法多有牵引、针灸、理疗、穴注等,具体到针灸治疗本病症,则多从足太阳、足少阳、足少阴论治,笔者从六经辨治本症,取得较好疗效,现分经论述如下。1太阳证(1)表现:恶寒,全身酸胀不适;或恶风汗出,腰背有僵硬感;或腰臀部及下肢后外侧牵强不适;更甚者脊柱和腰部像折断一样疼痛,下肢不能运动自如。查舌淡、苔薄白或薄黄,脉浮紧或浮缓或弦。(2)处方:合谷、列缺、外关、后溪、风门、膀胱俞、委中、昆仑、京骨、大钟、金门等。以泻法为主。(3)方义:太阳…     

自拟带状疱疹方治疗带状疱疹26例

带状疱疹由于其灼痛钻心、皮肤红斑、群集小疱,在中医文献中列入“丹门”;又因其好发于胸肋、腰部,故又名“缠腰火丹”.其病因病机多为毒邪、肝火、湿热、气血瘀阻.毒火留于血分发为红斑;湿热困于肝脾遂起水疱;气血阻于经络则见疼痛,临床上多以清泻肝火、渗利湿热、活血止痛为治.笔者使用自拟带状疱疹方治疗26例带状疱疹,经临床观察,疗效满意,现介绍如下.