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21.
外科手术,特别是出血量较大的急诊手术、术中出血较多的心内直视手术、以及颅脑外科手术等用血量大,一直是医疗中棘手的问题,而随着人们对输血所带来并发症的重视,以及近年来血源不足及合理输血、血液保护等,使得自体输血成为主流。本文就自体输血在临床应用,特别是大出血性手术中的应用价值作一综述。 相似文献
22.
OBJECTIVE: To study the effect of high-frequency (100 Hz) repetitive conditioning electrical stimulation (CES, 10 min) on human somatosensory evoked potentials (SEPs) to evaluate if short-term cortical plasticity could be induced. METHODS: Painful electrical stimulations were applied to thumb (D1) and little finger (D5) fingertips, respectively. The 124-channel EEG was recorded from 10 healthy male volunteers. Peak stages around 34, 45, 212, 331 ms were analyzed with focal maximum amplitude (FA) and area magnitude (AM) of scalp field potential, topography, and equivalent current dipole source localisation, comparing before and after two-level CES (high- vs. low-level) applied to the He-Gu acupoint. RESULTS: After a high-level CES, the positive FA and AM of the current efflux showed a significant increase at the early phase 34 ms, and significantly decreased at 45 ms in D1 SEPs. The negative FA and AM of the current influx were significantly increased at late phase 350 ms of the D5 SEPs. Only 36 ms, the z-axis position of dipole was significantly changed from (x: -15.9 mm, y: 29.6 mm, z: 43.9 mm) to (x: -12.9 mm, y: 29.4mm, z: 51.5mm) for the D5 SEPs. CONCLUSIONS: The high-level CES significantly attenuated the subsequent cortical activation (45 ms peak for D1 stimulation). Both low- and high-level CES significantly enhanced the late activities (226, 350 ms) in D5 stimulation. This may be explained by pain sensation change at the level of subcortical cingulate cortex induced by the site-dependent post-effect of CES. SIGNIFICANCE: This study showed cortical plasticity induced by conditioning somatosensory stimulation. 相似文献
23.
Emir Q. Haxhija Prof. Dr. Johannes M. Mayr Wolfgang Grechenig Michael E. Höllwarth 《Operative Orthopadie und Traumatologie》2006,18(2):120-134
OBJECTIVE: Surgical reduction and retention of apophyseal avulsion injuries at the medial epicondyle to prevent joint instability, lasting malalignment, or pseudarthrosis. INDICATIONS: Absolute: intraarticular apophyseal dislocation of the medial epicondyle, complete lesion of the ulnar nerve. Relative: dislocation of the apophysis (> 4 mm) in children > 5 years of age; the need for intervention increases in children as the degree of dislocation, age, and athletic activity increase. CONTRAINDICATIONS: Dislocation of the medial epicondyle (< or = 4 mm) in children < 5 years of age, provided the fragment location is not intraarticular. SURGICAL TECHNIQUE: Open reduction of the apophysis through a medial approach. Identification of the ulnar nerve. In young children or with small fragments fixation with Kirschner wire. Screw fixation in older children or for larger fragments. POSTOPERATIVE MANAGEMENT: Long upper-arm plaster cast until wound healing is achieved. Subsequently, upper-arm plaster cast for 3 weeks. Removal of Kirschner wires after 4-6 weeks, screw removal after 8-12 weeks. Physiotherapy only if marked reduction of elbow mobility is found 6 weeks after cast removal. RESULTS: From January 1, 1994 to December 31, 2003, 25 children with an average age of 12 years suffering from medial epicondylar avulsion fractures were operated on using open reduction and Kirschner wire fixation. An average of 3 years after the injury 14 of these children underwent follow-up examination using a procedure that took subjective, clinical and radiologic parameters into account. Two children showed a slight reduction in overall strength of the injured extremity when compared with the contralateral extremity. One child had a flexion deficit of 10 degrees, all other children showed movement limitations of < or = 5 degrees compared to the contralateral extremity. In all the cases available to follow-up, there was a slight increase in valgus alignment of the elbow joint compared with the uninjured side (3 degrees on average). All fractures consolidated within 6 weeks. 相似文献
24.
经皮激光椎间盘减压术治疗椎间盘源性腰痛 总被引:1,自引:0,他引:1
目的探讨经皮激光椎间盘减压术(percutaneous laser disc decompression,PLDD)治疗椎间盘源性腰痛的疗效。方法2002年6月~2004年12月我院对36例椎间盘源性腰痛,采用英国DIOMED公司半导体激光仪,激光功率15W,每个激光脉冲持续1s,间隔1s,照射能量800~1200J。VAS评分评价治疗效果。结果手术时间15~60min,平均30min。32例出现“疼痛复制效应”。36例随访6~36个月,平均11个月,32例有效(术后VAS评分改善≥3分18例,≥分14例),4例无效,有效率88.9%(32/36)。结论PLDD治疗椎间盘源性腰痛安全、有效、微创。 相似文献
25.
Vincent Chung Liang Liu Zhaoxiang Bian Zhongzhen Zhao Wai Leuk Fong Wan Fung Kum Jing Gao Min Li 《Movement disorders》2006,21(10):1709-1715
The objective of this study is to assess the efficacy and safety of herbal medicines (HMs), as a monotherapy or adjunct therapy, compared to placebo or conventional approaches in the treatment of idiopathic Parkinson's disease (PD). We conducted a systematic review of randomized controlled trials from both conventional and alternative medicine sources. Outcome measures were overall improvement, quality of life, reduction of levodopa dose, and adverse events. Nine studies were included, each testing a different HM. Six of the trials had limited internal validity due to major flaws in design, including the lack of proper randomization; insufficient blinding; unclear inclusive criteria in terms of diagnostic criteria, baseline staging, and duration of disease; lack of proper sample size calculation; and insufficient data analysis. Imbalances in gender and ethnicity among the patients in the included trials were observed. No major adverse events emerged, and no specific pattern was detected from the trials describing such data. In addition to major methodological defects, heterogeneity in (1) HM tested, (2) control treatment, and (3) outcome measure hindered in-depth data analysis and synthesis. Current evidence is insufficient to evaluate the efficacy and safety of various HMs. Further studies with improved trial design and reporting, with assessment on cost-effectiveness, quality of life, and qualitative data are warranted. 相似文献
26.
李联崑 《中国实用妇科与产科杂志》2006,22(8):582-583
放射治疗在杀死肿瘤细胞的同时,对肿瘤周围器官的细胞和组织也有杀伤作用,从而引起近期放疗反应和远期并发症。 相似文献
27.
慢性萎缩性胃炎是以胃黏膜上皮和腺体萎缩、黏膜变薄为特征的慢性疾病。属中医胃脘痛、胃痞等范畴。其病因病机较为复杂,多与饮食不调、情志不畅有关,尤其是饮酒、过食刺激之品,致使脾胃受损,阳气郁遏不振,纳运失司,化源不足,气血阴液亏乏;或中焦运化无力,湿邪滞塞,郁而化热;或 相似文献
28.
PURPOSE: The aim of this study was to determine the reproducibility of measurements made using the Sonogage Corneo-Gage Plus 2 (Cleveland, Ohio) ultrasound pachymeter of total corneal and corneal epithelial thickness in 5 different regions of the cornea. METHODS: Twenty-seven subjects at the New England College of Optometry (NECO) and 20 subjects at the Southern College of Optometry (SCO) were enrolled in this study. Measurements were taken of the central cornea as well as the nasal and temporal regions of the midperipheral and peripheral regions of the right cornea of each subject. Identical measurements were again taken in these subjects 1 week later at approximately the same time of day. Within-subject variations were then assessed using paired t tests. RESULTS: The only significant measurement differences that were found between visits were for full corneal thickness at both the nasal and temporal midperipheral locations. The mean differences for these locations were 13.5 microm and 13.7 microm, respectively. CONCLUSIONS: Epithelial corneal thickness and central and peripheral total corneal thickness measurements using the Corneo-Gage Plus 2 pachymeter were reproducible; however, midperipheral total corneal thickness measurements showed poor reproducibility. 相似文献
29.
30.
表皮生长因子对牛眼小梁细胞c—fos基因表达的诱导 总被引:4,自引:0,他引:4
目的研究表皮生长因子(epidermalgrowthfactor,EGF)对小梁细胞的作用。方法应用分子杂交技术研究EGF对体外培养的牛眼小梁细胞c-fos基因表达的诱导和3H胸腺核苷酸(3H-thymidineincorparation,3H-TdR)掺入法观察细胞DNA的合成。结果小梁细胞的3H-TdR掺入率随着EGF浓度不同而变化,浓度为20~150ng/ml时,细胞掺入率随浓度增加升高(P<0.01)。与对照组相比,EGF刺激停止生长的小梁细胞0.5小时后,c-fos基因开始表达,1小时后达高峰,至2小时后消失。不同浓度EGF刺激小梁细胞1小时后,c-fos基因表达呈浓度依赖性。结论实验结果表明EGF刺激小梁细胞增殖或进入生长状态,可能与c-fos基因产物的信号传递作用有关。 相似文献