动力髋螺钉加拉力螺钉治疗股骨粗隆间骨折

股骨粗隆间骨折临床上十分常见,动力髋螺钉（DHS）内固定是常用的治疗方法,2001年8月～2007年2月采用DHS加拉力螺钉治疗股骨粗隆间骨折21例,取得满意疗效,报道如下。     

锁骨钩钢板治疗锁骨远端骨折和肩锁关节脱位

目的观察锁骨钩钢板治疗Neer Ⅱ型锁骨远端骨折和TossyⅢ型肩锁关节脱位的疗效。方法对NeerⅡ型锁骨远端骨折11例、TossyⅢ型肩锁关节脱位26例采取锁骨钩钢板固定,术中注重对锁骨和肩锁关节的复位固定并修复喙锁韧带。结果37例患者经过7～13个月,平均9个月的随访,均获得良好的复位和固定,无感染、断钉、血管、神经损伤等并发症。参照付幕勇等疗效评定标准,优：27例,良：10例。结论锁骨钩钢板是治疗NeerⅡ型锁骨远端骨折和TossyⅢ型肩锁关节脱位的理想方法。早期取出内固定有利于功能的恢复。     

钢针经皮撬拨复位治疗跟骨关节内骨折

跟骨骨折为临床常见损伤,约占全身骨折的2％,其中60％～75％的跟骨骨折累及距下关节面,对于跟骨关节内骨折治疗方法较多,效果各异,但总体疗效并不满意。我们自2000年3月-2005年8月。采用钢针经皮穿针撬拨复位治疗跟骨关节内骨折42例（44足）,经术后随访,疗效满意。现总结报告如下。     

武汉医学会陈孝平院士健康科普工作室首届健康科普大赛优秀作品揭晓

4月7日,武汉医学会陈孝平院士健康科普工作室首届健康科普大赛颁奖典礼在科普中国等20个平台"云"上同步直播。     

血浆同型半胱氨酸水平与维持性血液透析患者认知功能障碍的相关性及干预性治疗的临床研究

目的 探讨血浆同型半胱氨酸(Hcy)水平与维持性血液透析(MHD)患者认知功能障碍的相关性及干预性治疗方案。方法 选择2019年1月至2022年1月该院收治的186例MHD患者为观察组,根据患者血浆Hcy水平分为高Hcy组(血浆Hcy水平≥15μmol/L)和正常Hcy组(血浆Hcy水平<15μmol/L);另选取同期年龄和性别相匹配的120例健康体检者为健康对照组。统计各组基线资料,采用蒙特利尔认知评估量表(MoCA)评估各组认知功能,并分析血浆Hcy水平与MoCA评分的相关性。同时根据高Hcy组治疗方案的不同进一步分为A组(维生素B₆ 60 mg/d+维生素B₁₂ 0.5 mg/d)和B组(叶酸5 mg/d+维生素B₆ 60 mg/d+维生素B₁₂ 0.5 mg/d),统计两组基线资料并比较治疗前后血浆Hcy水平及MoCA评分。结果 高Hcy组、正常Hcy组、健康对照组年龄、性别比例、体质量指数、吸烟史比例、白细胞计数、空腹血糖、血脂等基线资料比较,差异均无统计学意义(P>0.05)...     

火针疗法联合熊珍软膏治疗老年性皮肤瘙痒症疗效观察

目的 探究火针疗法联合熊珍软膏治疗老年性皮肤瘙痒症的效果.方法 以2020年1—12月于成都中医药大学附属医院治疗的156例老年性皮肤瘙痒症患者为研究对象,将患者随机分为2组.对照组78例予以常规西药治疗,研究组78例在对照组治疗基础上予以火针疗法联合熊珍软膏治疗.观察2组患者治疗3周后疗效,比较治疗前、治疗3周后中医...     

幽门螺杆菌感染及同型半胱氨酸与急性缺血性卒中短期结局的相关性研究

目的 研究幽门螺杆菌（helicobacter pylori,Hp）感染及同型半胱氨酸（homocysteine,Hcy）与急性缺血 性卒中（acute ischemic stroke,AIS）短期结局的相关性。 方法 采用前瞻性队列研究的方法,纳入唐山工人医院2014年1-12月的120例首发AIS患者。入院后 测定Hp-IgG阳性率、Hcy水平,进行美国国立卫生研究院卒中量表（National Institutes of Health Stroke Scale,NIHSS）评分,收集其他可能影响短期结局的相关因素（包括一般临床资料及生化指标）。对患 者进行短期结局（发病2个月）改良Rankin量表（modified Rankin Scale,mRS）评分。 结果 ①短期结局不良组的Hp感染率及Hcy水平显著高于结局良好组,比较差异具有显著性（P ＜0.05）。②以AIS短期结局为应变量,单因素Logistic回归分析发现,年龄、性别、基线NIHSS评分、Hp感 染及Hcy水平与AIS患者短期结局相关。③以AIS短期结局为应变量,单因素分析中P＜0.05的因素为自变 量,进行多因素Logistic回归分析,结果显示年龄[比值比（odds ratio,OR）=1.021,P =0.017]、基线NIHSS 评分（OR =2.318,P＜0.001）、Hp感染（OR =1.038,P =0.008）、Hcy（OR =1.029,P＜0.001）与AI S患者短 期结局不良相关。 结论 Hp感染、高Hcy血症是AIS患者短期结局不良的危险因素。     

微创经皮与传统开放椎弓根螺钉置入固定胸腰椎骨折的文献荟萃

BACKGROUND: Open reduction pedicle screw fixation for thoracolumbar fracture could obtain satisfactory effects, and has been extensively used. However, it has potential risk during and after repair. Minimally invasive percutaneous pedicle screw technique minimizes the trauma and complications of soft tissue. It remains poorly understood which is better minimally invasive percutaneous or conventional open pedicle screw fixation for the repair of thoracolumbar fracture. OBJECTIVE: To perform quality evaluation and meta-analysis on curative effect and postoperative complications of minimally invasive percutaneous and conventional open pedicle screw fixation in the treatment of thoracolumbar fractures. METHODS: A detailed search of several electronic databases, including Cochrane Library, PubMed, WanFang, CNKI, VIP and CBM, was undertaken. Simultaneously, Chinese Journal of Orthopaedics, Chinese Journal of Orthopaedic Trauma, and Chinese Journal of Trauma were checked by hand to identify controlled trials regarding minimally invasive percutaneous and conventional open pedicle screw fixation in the treatment of thoracolumbar fractures published from inception to 2015, and the references of the included studies were checked. According to inclusion and exclusion criteria, references were screened, data were extracted and quality was evaluated by four investigators independently. Meta-analysis was conducted using RevMan 5.2 software. The quality of references of the included controlled trials was assessed with CONSORT statement and some surgery clinical evaluation indexes. RESULTS AND CONCLUSION: We included 28 studies, including 25 randomized controlled trials/quasi-randomized controlled trials and 3 retrospective comparative studies, with 1 285 patients. Meta-analysis results demonstrated that compared with the conventional open pedicle screw, minimally invasive percutaneous pedicle screw fixation could significantly reduce operation time, blood loss, hospital stays, postoperative complication rate and height loss (P < 0.05). No significant difference in postoperative pain grade was detected between them (P > 0.05). These results indicate that minimally invasive percutaneous pedicle screw fixation for thoracolumbar fracture was safe and reliable, had small trauma, less blood loss, rapid recovery, short hospital stay, and less postoperative complications. Nevertheless, methods and results of most studies are not detailed enough. We suggested reporting randomized controlled trials according to related standards in order to improve the report quality and authenticity of randomized controlled trials.       

幽门螺杆菌感染及血清同型半胱氨酸对老年脑梗死的影响

目的 研究幽门螺杆菌感染以及血清同型半胱氨酸对老年脑梗死患者发病的影响,探讨老年脑梗死的危险因素以及治疗方法.方法 选取＞60岁46例的脑梗死患者作为梗死组,选取的＞60岁46例无脑梗死患者为对照组,对两组进行对比,用ELUSA和酶标法检测幽门螺杆菌抗体以及血清中同型半胱氨酸的浓度.结果 患者的幽门螺杆菌感染的阳性率:对照组感染24例,感染率52.2％,梗死组感染37例,感染率80.4％,结果表明梗死组患者幽门螺杆菌感染的发生率明显高于对照组;梗死组患者血清中Hp-IgG浓度和同型半胱氨酸浓度明显高于对照组,差异有统计学意义(P＜0.05).结论 幽门螺杆菌感染和高同型半胱氨酸症是老年脑梗死发病的危险因素,临床脑梗死患者应注意对幽门螺杆菌感染以及高血清同型半胱氨酸症的治疗.     

家族性高胆固醇血症性黄瘤病LDL-R基因的突变

目的　研究3个家族性高胆固醇血症黄瘤病家系低密度脂蛋白受体基因突变方式，初步探讨基因型与临床表型的关系。方法　对3例先证者及25个家系成员进行血脂测定、临床检查后，采用聚合酶链反应-变性高效液相色谱，结合扩增产物直接序列分析检测低密度脂蛋白受体基因，结果与GenBank比对，分析突变的病理意义。结果　3例先证者出生时即有黄瘤，之后多处出现黄瘤，并有角膜环，可确诊为家族性高胆固醇血症黄瘤病。先证者1低密度脂蛋白受体基因发现D601N错义突变；先证者2多次出现早发冠心病症状，低密度脂蛋白受体基因发现C122Y错义突变。先证者3低密度脂蛋白受体基因未发现突变位点。28例家系成员共确诊4例杂合子患者。结论　低密度脂蛋白受体基因两个外显子的突变可能是导致家族性高胆固醇血症黄瘤病的原因。