广州地区双侧股骨近端双能X射线吸收法测量骨密度1055名的临床价值

目的:观察双侧股骨近端相应部位骨矿密度的差异性,探讨双能X射线吸收法测量双侧股骨近端的诊断价值。方法:选择2001-11/2005-12在暨南大学附属第一医院进行骨密度测量的广州地区受试者1055例(女性组789例、男性组266例)。①所有受试者进行了双侧股骨近端(股骨颈、股骨转子区、股骨颈上部和整体髋关节)双能X射线吸收法骨密度测量,比较双侧股骨近端骨密度。②从受试者中筛选出绝经后妇女500例,按照世界卫生组织1994年制定的方案,依据双侧股骨近端各测量部位的最低T值进行诊断,比较双侧股骨近端骨密度测量结果在诊断水平上可造成的差异。③从受试者中随机选取30例(男8例,女22例,年龄21～72岁,平均42.1岁)同时进行了两次骨密度测量,计算各测量部位的精密度和最小显著变化值。结果:①女性组和男性组双侧股骨近端各测量部位骨密度值呈高度正相关(r=0.88～0.97,P<0.001)。男性组各部位骨密度值双侧差异均不显著;女性组中整体髋关节的骨密度值存在较小的但有统计学意义的差异(骨密度差值=0.030g/cm2,t=2.387,P=0.017),右侧高于左侧。②在500例绝经后妇女中,左右侧股骨近端结果一致者83.2%(416/500),84例(16.8%)双侧测量结果可产生不一致的诊断。经精密度校正后7.0%(35/500)双侧测量结果可产生不一致的诊断。③股骨近端不同部位的单侧测量精密度在0.7%～2.2%,而相应部位的双侧测量精密度在0.6%～1.2%。双侧测量精密度比单侧测量提高20%～45%。结论:①广州地区女性股骨近端的骨密度值存在较小的但有统计学意义的差异。②双侧测量精密度比单侧测量提高,有助于监测骨矿物质密度变化。③有部分的个体双侧测量会改变单侧测量的诊断结果,单侧测量存在有漏诊的可能性。     

《解剖学杂志》投稿须知

一男性尸体,约55岁,身高170.0cm,身体消瘦。笔者在解剖其腹腔时发现,腹腔内大部分器官形态位置正常,而乙状结肠位置异常,其上方降结肠位置基本正常,长度21.0cm,至左侧髂嵴最高点上缘高度续以乙状结肠起始,继而此乙状结肠随其系膜自降结肠最下端开始斜行转向右侧越过脊柱至右髂窝,全长19.5cm,其下端上方紧邻盲肠和阑尾,继而向下越过骨盆上口移行为直肠(图1)。     

不同年龄段下肢深静脉血栓形成危险因素分析

目的探讨下肢深静脉血栓形成（DVT）的发病危险因素。方法 204例下肢深静脉血栓形成的住院患者按年龄分为A组（〈45岁）和B组（≥45岁）,比较两组危险因素的临床资料并进行分析。结果手术（非骨科手术）因素A组明显高于B组,有统计学意义（P〈0.05）;高血压、创伤及骨折、恶性肿瘤、心脏病、糖尿病等因素B组明显高于A组（P〈0.05）;而长期卧床、下肢静脉曲张史、吸烟、饮酒两组无明显差异（P〉0.05）。结论下肢深静脉血栓形成随着年龄增长其危险因素逐渐增多,中老年患者大多存在2个以上危险因素。     

中药治疗帕金森病研究思路探讨

帕金森病目前是神经内科的难题,属于专项中的神经退行性疾病,严重危害了人民群众的健康,至今仍无有效的治疗方法.因西医西药治疗方法的副作用和手术创伤较大,开发有效治疗帕金森病的中药具有很大价值.     

经颈静脉置管联合足背静脉溶栓治疗混合型下肢深静脉血栓形成

目的探讨经颈静脉置管联合足背静脉溶栓治疗混合型下肢深静脉血栓形成的临床疗效。方法回顾性分析78例混合型下肢深静脉血栓形成患者临床资料。放置下腔静脉滤器后,经颈静脉置管溶栓治疗,同时予以经患侧足背静脉溶栓治疗。观察术后患者的临床症状和体征变化,行彩超评价静脉通畅程度,患者出院后经门诊随访其近期疗效。结果78例患者成功经右颈内静脉置管以及经患侧足背静脉溶栓。48例患者放置下腔静脉滤器,滤器放置成功率100%。术后患者的临床症状均明显缓解,彩超示下肢深静脉血流通畅。患者出院后随访1年,随访结果提示近期疗效满意。结论采用经颈静脉置管联合足背静脉溶栓治疗混合型下肢深静脉血栓形成可以取得较好的临床疗效。     

Evidence-based practice method of integrative Chinese and Western medicine based on literature retrieval through PICO question and complementary and alternative medicine topics

An evidence-based practice method according to literature retrieval through PICO （Patients,Intervention,Comparison,Outcome） questions and complementary and alternative medicine （CAM） topics,which can obtain helpful evidence for guiding clinical practice,was introduced with a practical example in this paper.The knowledge of diseases and Western medicine treatment can be acquired by literature retrieval through PICO question,while searching by CAM topics may provide evidence for Chinese medicine （CM）.Thus the author held that literature retrieval through both PICO question and CAM topics was an ideal evidencebased practice method for integrative Chinese and Western medicine （ICWM）.However,since the standard in CM evidence hierarchy is still under study,the value of the CAM thematic retrieval method remains very limited.In the future,studies on the definition and hierarchy of CM evidences and the herb-drug interaction between Western and Chinese medicine during a combination therapy should be strengthened to improve the status of ICWM evidence-based practice.     

Herb-drug interaction: An emerging issue of integrative medicine

With the increasing enhancement of people＇s awareness of self-care,the voice for humans to return to nature is growing louder and louder.Drugs with natural plants as raw materials are increasingly favored by people all over the world for their unique advantages in preventing and curing diseases, rehabilitation and health care,especially in Europe,     

Therapeutic evaluation on complex interventions of integrative medicine and the potential role of data mining

It is a common view that the integration of Chinese medicine （CM） and modern Western medicine is an efficient way to facilitate the development of CM. Integrative medicine is a kind of complex interventions. Scientific therapeutic evaluation plays a crucial role in making integrative medicine universally acknowledged. However, the modern method of clinical study, which is based on the concept of evidence-based medicine, mostly focuses on the population characteristics and single interventional factor. As a result, it is difficult for this method to totally adapt to the clinical features of CM and integrative medicine as complex interventions. One possible way to solve this issue is to improve and integrate with the existing method and to utilize the evaluation model on complex interventions from abroad. As an interdisciplinary technique, data mining involves database technology, artificial intelligence, machine learning, statistics, neural network and some other latest technologies, and has been widely used in the field of CM. Therefore, the application of data mining in the therapeutic evaluation of integrative medicine has broad prospects.     

Primary tracheobronchial amyloidosis in China: Analysis of 64 cases and a review of literature

Primary tracheobronchial amyloidosis (TBA) is a rare pulmonary disease.A systematic review was performed on 64 cases of primary TBA in China and progress in the diagnosis and treatment of this disease is discussed.The Chinese biological and medical databases from 1970 to 2010 were searched and 75 cases of complete clinical and pathological data were identified.The clinical characteristics of the disease were summarized and longitudinal comparisons were made of diagnostic and treatment methods over time.The results showed that the morbidity associated with primary TBA has increased over recent years.The clinical manifestations were non-specific.Progressive dyspnea, cough and sputum were the most common symptoms.The percentage of patients undergoing computed tomography (CT) scan has increased over the years.The bronchoscopy and transbrochial lung biopsy (TBLB) were usually sufficient to establish the diagnosis.Treatment was reported for a total of 44 cases.Bronchoscopic Nd:YAG laser irradiation, argon plasma coagulation (APC) and drugs administration such as steroids and colchicines were reported to be effective in some patients.It is concluded that the demographic characteristics and clinical manifestations of primary TBA patients in China are largely consistent with findings reported in other countries.Dramatically more cases were reported in recent years, mainly due to the extensive application of bronchoscopy since 1990s.Chest CT scan provides important clues for the diagnosis of the disease.The definite diagnosis was confirmed by bronchoscopic findings and Congo red staining of biopsy specimen.Bronchoscopic Nd:YAG laser irradiation, argon plasma coagulation (APC) and drugs administration, such as steroids and colchicines were reported to be effective in some patients.