提高股骨干骨折合并同侧股骨颈骨折早期诊断率的前瞻性研究

Objective To evaluate a serf-designed diagnostic protoeol which can early detect a femoral neck fracture for patients with a femoral shaft fracture. Methods From September 2005 to June 2007, a self-developed protocol was used to detect an ipsilateral femoral neck fracture for all the patients with femoral shaft fracture who had sought treatment in our department. This protocol consisted of anteroposterior plain radiography of internal rotator, intraoperative fluoroscopy of the hip, a fine (2 mm) cut computed to-mographic scan through the femoral neck, postoperative anteroposterior and lateral plain radiography of the hip in the operating room prior to awakening the patient, at the time of follow-up anteroposterior and lateral plain radiography of the hip in the presence of hip pain. The diagnostic effects of the protocol were compared with those of conventional diagnosis used for all the patients with femoral shaft fracture who had sought treatment in our department from September 2003 to August 2005. A chi-square analysis comparing the protocol group (September 2005 to June 2007) and the non-protocol group (September 2003 to August 2005) was used to assess the early and delayed diagnosis rates for an associated ipsilateral femoral neck fracture. Results The earlydiagnosis rate of an associated femoral neck fracture by the protocol was 93.8%, markedly higher than that by conventional method (46.2%), with statistically significant difference (χ2 = 4.069, P =0.044). Conclu-sion In presence of a femoral shaft fracture. this protocol consisting of plain radiography of intemal rotator, intraoperative fluoroscopy of the hip, fine cut computed tomographic scan of the femoral neck, postoperative plain radiography of the hip, and follow-up plain radiography of the hip in the presence of hip pain, may sig-nificantly improve the diagnostic rate of an associated femoral neck fracture.     

漯河市消灭丝虫病调查研究

漯河市丝虫病防治工作于1984年经省考核验收已达到部颁基本消灭丝虫病标准，于2002年8～10月开展了消灭丝虫病达标监测工作，全市3个县监测覆盖率占流行乡镇的36．33％，流行区人口监测率3．57％，未发现微丝蚴阳性者。3个县各解剖淡色库蚊3000只以上，未发现人体幼丝虫阳性蚊。证实我市近30年的防治措施是有效的，已达到部颁消灭丝虫病标准。     

对影响医患关系的医学人文素质内涵的探讨

就人文素质的基本理论,与其它学科的相互关系,及人文素质的社会性是其根本特点做以说明,同时强调人文素质对医学人文素质的重要理解是关爱生命,并指出医患关系影响下的人文素质和医护救助三大基本原则,以及人文素质影响下的健康新概念,为人类的自身生存。用人文素质的态度要求医务人员关注,研究疾病的发展,形成,提高医护人员的人文素质的主要内容等做了探讨。     

临床常见食物嵌塞疗效观察与分析

食物嵌塞是临床常见症状之一,因其影响咀嚼,常常给患者带来很大的烦恼。长期食物嵌塞,除导致局部炎症外,还可引起牙周组织萎缩、邻面龋、同侧咀嚼功能减退等严重后果。但多数食物嵌塞通过我们的正确治疗,是可以避免和纠正的。本文对77例常见的食物嵌塞形式进行了分析治疗,现总结如下:     

红医精神融入公管专业学生“医学人际沟通” 教学的实践研究

红医精神在人民卫生事业发展时期,为医学人才培养提供了重要精神引领。以岗位胜任力为导向的教学改革,要求在培养医学公共事业管理专业学生掌握扎实的医学专业技能同时还应具有塑造优良组织形象、提升医学人际沟通和管理公关危机等医务公共关系能力。在传承红色基因、创新医学教育的指导下,让“政治坚定”引领的“为人民健康服务”成为学习动力;“技术优良”追求的“精益求精的品质”成为学习目标;“无私奉献、救死扶伤”体现的“尊重患者、共同参与、公共责任”成为工作准则。结合空军军医大学红医特色文化,采用案例重现式教学,探索出“理论 体验 实践 反思”的教学实践道路。     

书写表达在肿瘤患者中运用的研究进展

正书写表达是一种通过书写披露和表达与个人重要经历有关的感受和想法来促进身心健康的心理干预方法~([1])。随着生物-心理-社会医学模式的建立和发展,对疾病存在重要影响的社会及心理因素在临床治疗过程中越来越受到关注。调查~([2-3])显示,有40%~50%的成人肿瘤患者表现有明显的心理痛苦,对治疗的依从性、医护工作的满意度以及生活质量均有很大影响。好的心理状态不仅可以激发机体     

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.       

Sema4D对RSV所致哮喘大鼠Th1/Th2的免疫调节及咳喘宁口服液的干预作用

目的:探讨脑信号蛋白4D(semaphorin 4D,Sema4D)对呼吸道合胞病毒(respiratory syncytial virus,RSV)所致哮喘大鼠Th1/Th2的免疫调控及咳喘宁的干预作用。方法:60只SPF级Wistar大鼠随机分为10组,即正常组,模型组,Sema4D组,Sema4D抗体组,咳喘宁低、中、高剂量组,以及Sema4D+咳喘宁低、中、高剂量组。除正常组外,其余各组采用RSV合并卵清蛋白(ovalbumin,OVA)诱导大鼠哮喘模型。HE染色观察肺组织病理变化;ELISA法检测支气管肺泡灌洗液(bronchoalveolar lavage fluid,BALF)中炎症因子白细胞介素4(interleukin-4,IL-4)、IL-6、IL-8、肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)和干扰素γ(interferon-γ,IFN-γ)的含量。结果:HE染色结果显示,模型组、Sema4D组及Sema4D+咳喘宁低剂量组大鼠肺组织均有明显的炎症细胞浸润和炎性损伤,而Sema4D抗体组,咳喘宁低、中、高剂量组,以及Sema4D+...     

Marfan综合征基因定位与基因诊断

Ｍａｒｆａｎ综合征是一种常染色体显性遗传的结缔组织疾病。本文阐述了用连锁分析方法对Ｍａｒｆａｎ综合征进行基因定位，并阐明了微纤维元基因与Ｍａｒｆａｎ综合征的关系，同时对Ｍａｒｆａｎ综合征的基因诊断作了一定的探讨。