后颅窝扩大成形术治疗Arnold-Chiari畸形合并脊髓空洞症的临床研究

目的研究Arnold—Chiari畸形合并脊髓空洞症显微外科手术中后颅窝底及寰椎后弓切除对脑组织和寰枕部稳定性的影响及钛网后颅窝扩大成形术对保持后颅窝结构、功能稳定的临床应用。方法对12例Arnold—Chiari畸形钛网后颅窝及寰椎后弓扩大成形患者与156例未成型患者的术后临床症状、枕颈部的稳定性及生活质量进行对照。结果12例扩大成型患者术后临床症状不明显,生活质量高;而未成型者多有头痛、头晕、枕颈交界部不适等症状以及惧怕枕颈部遭受外力的恐惧心理。结论钛网后颅窝及环椎后弓扩大成形术可相对维持后颅窝的生理结构,减少患者的临床症状,提高生活质量。     

枸椽酸氢钾钠治疗输尿管小结石的临床研究

目的:探讨枸椽酸氢钾钠治疗输尿管小结石的临床价值.方法:将63例伴肾绞痛的输尿管小结石(＜0.6 cm)患者分为用药组31例和对照组32例,均采用解痉、输液、利尿治疗,用药组加口服枸椽酸氢钾钠颗粒,并记录排石情况,排出结石的大小.结果:在观察期内用药组28例排出结石,有效率90.3%,对照组22例排出结石,有效率68.8%,两者存在统计学差异(P＜0.05),排出结石的时间用药组(3.3±2.1)d,对照组(4.1±2.3)d,存在统计学差异(P＜0.05),排出结石大小比B超测得均小,用药组有统计学差异(P＜0.05),对照组无统计学意义(P＞0.05),用药组未出现药物不良反应.结论:枸椽酸氢钾钠能有效缩小输尿管结石,加快结石的排出,是内科保守治疗输尿管小结石安全有效的辅助治疗药物.     

艾儒棣教授运用桃红四物汤治疗皮肤病的经验

吾师艾儒棣教授为全国著名中医外科专家，从医40余年，学验颇丰。临床常用桃红四物汤（桃仁10g，红花10g，当归10g，川芎10g，生地黄30g，赤芍20g）加味治疗多种中医外科疾病，每多得心应手，疗效满意，今录其5例介绍如下。     

高效液相色谱法测定香薷药材中香芹酚和百里香酚的含量

目的 :建立香薷药材中香芹酚和百里香酚的含量测定方法。方法 :用高效液相色谱法 ,95 %乙醇超声提取 ,色谱柱InertsilODS-3,流动相甲醇 水 冰醋酸 (60∶40∶2 ) ,检测波长 274nm。结果 :香芹酚在 023～215μg (r=0.9999) ,百里香酚在 039～236μg (r =0.9999)有良好的线性关系 ;平均回收率分别为香芹酚 99.9% (RSD 1.4 % ) ,百里香酚 98.6 % (RSD 1.3% ) ,重复性的RSD分别为香芹酚 1.1% ,百里香酚 1.6 %。结论 :该方法可靠、便捷 ,可以作为控制香薷药材质量的方法。     

新疆芍药化学成分的研究

目的 :研究新疆芍药的化学成分。方法 :用柱色谱分离 ,利用化合物的理化性质及波谱方法鉴定。结果 :分离并鉴定了芍药苷 (paeoniflorinⅠ )、白芍苷 (albiflorinⅡ )、芍药新苷 (lactiflorinⅢ )、胡萝卜苷 (daucosterolⅣ )和蔗糖 (sucroseⅤ )等 5个成分。结论 :这些化合物均为首次从该植物中分离得到。另芍药新苷化学结构曾 2次被修正 ,本研究分析后确认了其中的 1个结论。     

脂蛋白(a)检测在脑梗死患者中的应用

目的 :探讨脂蛋白 (a) [Lp(a) ]在脑梗死患者中的应用价值。方法 :检测 68例脑梗死患者急性期和恢复期中血清Lp(a)、甘油三酯 (TG)、总胆固醇 (TC)、高密度脂蛋白胆固醇 (HDL)、低密度脂蛋白胆固醇 (LDL)、载脂蛋白A1(ApoA1)、载脂蛋白B(ApoB)等水平的变化 ,并选 71例健康人作为对照组 ;同时比较脑梗死患者急性期与恢复期血脂的变化。结果 :脑梗死组的Lp(a)、TC、LDL、ApoB明显高于对照组 ,具有显著性差异 (P <0 0 1) ;ApoA1明显低于对照组 ,具有显著性差异 (P <0 0 1)。脑梗死患者急性期LDL水平比恢复期明显降低 ,具有显著性差异 (P <0 0 1) ,其他指标无显著性差异 (P >0 0 5 )。Lp(a)与其他 6项指标之间均无相关性。结论 :Lp(a)在脑梗死患者发病急性期与稳定期中是一个独立的危险因素 ,可作为反映脑梗死患者脂类代谢异常的重要指标 ,对判断脑梗死的预后可能具有重要意义     

万古霉素治疗下呼吸道耐甲氧西林葡萄球菌感染的疗效观察

目的观察万古霉素(方刻林)治疗呼吸重症监护室(RICU)下呼吸道耐甲氧西林葡萄球菌(MRS)感染的临床疗效及安全性. 方法将2001年10月～2003年5月间我院RICU的MRS感染患者随机分为两组,在常规治疗的基础上,治疗组18例,采用方刻林0.5g,静脉滴注,3次/d;对照组17例,给予万古霉素0.5g,静脉滴注,3次/d,两组疗程为7～14 d. 结果方刻林组治愈率为61.1%,有效率为94.4%,细菌清除率为77.8%;万古霉素组治愈率为64.7%,有效率为94.1%,细菌清除率为82.4%,两组比较差异无显著性. 结论方刻林与万古霉素的临床疗效差异无显著性,方刻林治疗下呼吸道MRS感染疗效确切,使用安全.     

胸痛发作小于3h的急性主动脉综合征与非ST段抬高型心肌梗死的差异化风险评估

目的 研究在胸痛发作小于3h的情况下,急性主动脉综合征(AAS)及非ST段抬高型心肌梗死(NSTEMI)的差异化风险评估.方法 回顾性分析AAS患者69例,NSTEMI患者136例,对两组数据进行统计学分析,比较组间差异.利用单因素及多因素Logistic回归分析评估AAS及NSTEMI的差异化风险因素.比较各差异化风...     

Simplified Chinese Version of the Spinal Instability Neoplastic Score in Evaluating Patients with Metastatic Spinal Tumor: A Cross‐Cultural Adaptation and Validation

ObjectiveTo translate the original English version of the Spinal Instability Neoplastic Score (SINS) into simplified Chinese, adapt it cross‐culturally, validate its psychometric properties in measuring spinal instability in patients with metastatic spinal tumors in the Chinese mainland, examine the reliability and validity to demonstrate its accuracy and applicability in clinical practice.MethodsPatients diagnosed with metastatic spinal disease between January 2016 and January 2020 were recruited. The number of participants was advised to be at least 50 for appropriate analysis of reliability, construct validity, as well as ceiling or floor effects, and recruitment of 100 patients was advised for internal consistency analysis. The study was conducted in two phases: first, the SINS was translated into simplified Chinese; second, the factor structure, internal consistency, test–retest reliability, validity, and floor and ceiling effects of the SC‐SINS were assessed. The internationally recognized cross‐cultural adaptation guidelines were followed. Internal consistency was evaluated with Cronbach''s alpha. Test–retest reliability was examined among the patients with a 4‐week interval. The validity of the Chinese version of SINS (SC‐SINS) was assessed by examining its relationship with Kostuik classification. Principal component analysis was conducted to confirm the factor structure of each subscale.ResultsA total of 160 participants (88 males and 72 females) were enrolled. No major difficulties occurred in the forward and backward translations of SINS. The internal consistency of SC‐SINS was excellent (Cronbach''s α =0.857, ranging from 0.68 to 0.85). Test–retest reliability was also excellent with a value of 0.89, ranging from 0.86 to 0.95. Validity analyses indicated that the SC‐SINS was positively and significantly correlated with Kostuik classification. The correlation between “Posterolateral Involvement of Spinal Elements” and “1‐2 Partial Damage” was the highest with a correlation value of 0.792. The correlation between “Pain” and “1–2 Partial Damage” was the lowest with a value of 0.341. All items showed principal component coefficients greater than 0.4. The values of Factor 1 ranged from 0.523 to 0.681; Factor 2 ranged from 0.591 to 0.731; Factor 3 ranged from 0.613 to 0.754; Factor 4 ranged from 0.461 to 0.711; Factor 5 ranged from 0.513 to 0.701; and Factor 6 ranged from 0.501 to 0.668. In addition, neither floor nor ceiling effects were seen in the SC‐SINS.ConclusionThe SC‐SINS demonstrated high internal consistency and test–retest reliability, which has been proven valid and reliable to measure spinal stability in patients from the Chinese mainland with metastatic spinal tumor.     

微创截骨手法整复术治疗拇外翻

目的:探讨微创截骨手法整复术治疗拇外翻的临床疗效.方法:自2018年1月至2019年5月采用微创截骨手法整复术治疗拇外翻患者31例(42足),其中男3例,女28例;年龄18～76(50.1±4.9)岁.观察并比较手术前后拇外翻角(hallux valgus angle,HVA),第1,2跖骨间角(inter metat...