艾灸督脉对肾精亏虚型卒中后轻度认知障碍患者认知功能和中医症状的临床疗效研究

背景 卒中后轻度认知障碍（PSMCI）是卒中后患者常见并发症,影响患者全面康复的同时也给其家庭带来了经济和精神方面的压力。 目的 观察艾灸督脉对肾精亏虚型PSMCI患者认知功能及中医症状的临床疗效。 方法 选取2020年7月至2021年7月河南中医药大学第一附属医院康复中心收治的符合纳入标准的PSMCI患者60例为研究对象,采用随机数字表法将其分为艾灸组和对照组,每组30例。对照组患者给予常规基础治疗及常规认知功能康复训练,艾灸组患者在对照组基础上进行艾灸督脉治疗,1次/d,5次/周,持续4周。比较治疗前后两组患者简易智能精神状态量表（MMSE）、蒙特利尔认知评估量表（MoCA）、血管性痴呆中医辨证量表（SDSVD）中肾精亏虚型和脑卒中专用生活质量量表（SS-QOL）评分,并评定两组治疗的临床疗效和安全性。 结果 艾灸组患者治疗前后MMSE、MoCA、SDSVD、SS-QOL评分差值大于对照组（P<0.05）。艾灸组患者治疗后临床疗效优于对照组（P<0.05）。两组患者治疗安全性比较,差异无统计学意义（P>0.05）。 结论 艾灸督脉可以改善PSMCI患者的认知功能和中医症状,临床疗效佳,且安全性较好。     

连续5年辽宁地区肾综合征出血热流行病学及临床回顾性分析

目的 总结分析近5年辽宁地区肾综合征出血热(HFRS)患者的流行病学及临床特点,为下一步防治提供依据.方法 选取2009年1月-2013年12月中国医科大学附属盛京医院感染科收治的276例HFRS患者的流行病学及临床资料进行回顾性分析,同时复习相关文献进展.结果 收治的HFRS患者发病以秋冬季最高,占38.76％,夏季偏少仅占13.04％,其余时间则呈散发,平均发病年龄(44.01±13.71)岁,男性占76.81％,临床分型中型最多为54.71％,重型、危重型分别占30.79％和9.05％,部分患者存在多脏器损伤及继发感染、心律失常、呼吸衰竭、神经系统受累等并发症.死亡8例占2.89％,死亡原因分别为消化道大出血2例,顽固性休克1例,心脏骤停1例,肺水肿1例,呼吸衰竭3例.结论 辽宁地区秋冬季为HFRS发病高峰,而非以往双峰型,青壮年为主要发病人群,临床分型中型最多,但重型、危重型比例仍高,且临床表现复杂多样,个体化、预见性治疗是改善重症患者临床转归的关键.     

后路全椎体切除技术在外伤后严重陈旧性胸腰段后凸畸形矫正中的应用

Background Post-traumatic kyphosis is a common potential complication of spinal trauma and correct management of this problem is becoming ever more impcrtant.Although posterior vertebra column resection has been increasingly adopted to correct severe spinal deformity,no series of reports were found on severe post-traumatic kyphosis in the thoracolumbar region.Therefore,the present cohort retrospective study is presented to evaluate the clinical and radiographic results of posterior vertebra column resection with instrument fusion performed in patients with severe post-traumatic kyphosis.Methods From May 2004 to May 2006,53 patients（38 male,1 5 female）at an average age of 37.6 years（range,24 to 66 years）,were surgically treated for symptomatic post-traumatic thoracolumbar kyphosis with a posterior wedge closing osteotomy at our hospital.Among them,5 consecutive adult patients with severe post-traumatic kyphosis were included in this study.Operation time, blood lOSS and complications were noted in each case.Radiographic documentation was made on the basis of standing anterior-posterior（AP）and lateral views and three dimensional reconstruction images of computed tomography （CT） scans were used to further identify the apex region of a sharp angular deformity.Sagittal correction was assessed in terms of effective regional deformity（ERD）for the injury Ievel.Assessment of radiological fusion at follow-up was based on the presence of trabecular bone bridging at the osteotomy site according to Brantigan.Preoperative and postoperative clinical assessments were performed by using Oswestw disability index（ODI）, back pain was rated in all patients by the visual analog scale （VAS） preoperatively,postoperatively and at the latest follow-up.Results The mean operating time was 265 minutes（220-408 minutes）,with an average blood loss of 1 362 ml （870-2570 m1）.Each patient finished at least two years of follow-up.The average ERD significantly decreased from 69°（58°-86°）,preoperatively to 4°（1°-8°） after surgery （P=0.01 7）;with a mean correction of 65°.ERD averaged 1 0.4°（7°-1 7°）at the latest follow-up with a mean loss of 6.4°.VAS and ODI scores improved from preoperative 7.4（6.0-9.0） and 55.2（48.0-60.0） to 2.3（1.0-4.0） and 1 2.2（7.0-18.0）at the latest follow-up.Full bone fusion was achieved in all patients.Complications occurred in two patients：one had a transient weakness of the Ieft side lower extremity and the symptom improved spontaneously without further treatment within one month;the other patient suffered a deep wound infection three weeks after the operation,and recovered well by additional debridement,continuous perfusion and drainage.Conclusions Posterior vertebra column resection can satisfactorily correct severe post-traumatic kyphosis in thoracolumbar region.Nevertheless,this challenging procedure should be performed by experienced spinal surgeon to minimize complications.     

急性肾绞痛药物治疗体会

近年来 ,我院选择解痉、止痛、利尿等药物联合应用治疗急性肾绞痛 92例 ,起到良好效果 ,现报告如下。1 资料与方法本组 92例均为输尿管结石所致的急性肾绞痛 ,男 6 7例 ,女 2 5例 ,年龄 1 8～5 8岁 ,平均 34 .5岁 ,发病至就诊时间0 .5～1 2小时。初次发病 70例 ,反复发病 2 2例。临床表现　患者常以一侧腹部突发性剧烈绞痛为特点 ,阵发性地加重 ,其中剧烈运动后发作 36例 ,夜间睡眠中翻身后发作 30例 ,排尿时发作 1 1例 ,原因不明突发 1 5例 ,其中向下腹、会阴及大腿内侧放射痛 5 1例 ,伴有排尿困难 2 0例 ,肉眼血尿 1 5例 ,所有病例均有镜…     

河南地区Brugada综合征患者 DSG2、TTN及 GATA4基因的变异分析

目的:探讨河南地区Brugada综合征与DSG2、TTN及GATA4基因变异的相关性。方法:选取100例患者作为研究对象,100名健康体检者作为对照组。检查两组的心电图、超声心动图,留取外周血样,对DSG2、TTN及GATA4基因进行测序,并将结果与标准序列进行对比。结果:研究组心电图检查均发现存在室性心律失常;超声心...     

节日串串记

早上，就在丈夫匆匆忙忙赶着去上班时，正在削苹果的妻子笑吟吟地提醒道：“亲爱的，今天是个特别的日子，我敢打赌你早就忘得一干二净了。”     

眼眶骨折MEDPOR填充术的护理

眼眶爆裂性骨折伴眶内容嵌顿,必须通过手术达到消除眼球内陷及复视。做好手术前、后的护理是手术成功的关键:术前加强心理护理,协助医生做好术前检查及准备;术后加强病情观察,指导患者眼球运动的训练方法,消除复视尤为重要。