200例青春期启动提前女童中医证候的临床调查

目的分析青春期启动提前女童的中医辨证分型特点。方法采集2008年3月—2011年3月在复旦大学附属儿科医院中医科就诊的青春期启动提前女童患儿200例的中医证候,进行统计分析,总结患儿的中医辨证分型特点。结果 200例患儿主证诊断为阴虚火旺证的比例最高(174例,占87.0%),其次是肝郁化火证(25例,占12.5%)及湿热内蕴证(1例,占0.5%);3种证型诊断的平均秩次由高到低依次为阴虚火旺证(462.87)、肝郁化火证(287.22)、湿热内蕴证(146.91);149(74.5%)例患儿同时具有阴虚火旺证和肝郁化火证的诊断,阴虚火旺证为主合并肝郁化火证最多见(88例占44.0%),肝郁化火证为主合并阴虚火旺证次之(46例占23.0%)。结论阴虚火旺证和肝郁火旺证型是性早熟和青春期发育提前女童主要的中医辨证分型,二者同时存在的合并证型在临床辨证用药中不容忽视。     

老年骨折手术耐力探讨

为了减轻老年人骨折引起的疼俪，预防并发症，降低病死率，恢复肢体功能，对老年人骨折采取手术治疗是重要的手段，但老年患者能否安全渡过因手术期，现结合我院1984－19964收治老年骨折54例经验进行探讨一临床资料1．一般资料：男37例，女门例年龄ho－69岁32例，70－79岁门例，80－84岁5例，平均712岁。2骨折类型：股骨转子间骨折8例，股骨颈骨折25例，股骨干骨折2例，骸骨骨折3例，胜骨平台骨折2例，胜味骨骨折4例，肢骨干骨折4例，前臂骨折6例，3．并存病：本组54例中，有并存病37例，占总数的68．5Q，其中有2种或2种以上并存病27例占总…     

加压滑动鹅头钉治疗股骨粗隆下骨折

本院从１９９６年至１９９９年，用Richard钉治疗股骨粗隆下骨折１２例，收到了良好的效果。报告如下。临床资料１．一般资料：本组１２例，均为男性；年龄３０～５６岁，平均４１．２岁。车祸伤６例，跌倒２例，高处坠落伤４例。２．手术方法：采用连续硬膜外麻醉；平卧手术台，患臀抬高１５°；切口股骨上段外侧纵形切口；在粗隆下２．０cm处，打入３枚不同方向带刻度导针，钻入股骨头；摄片后，留１枚导针，去除其余２枚；导针指引下，用铰刀扩孔后，拧入加压螺钉；骨折处复位，套入钢板，与股骨干固定，小转子骨折相应固定。术后常规使…     

带锁髓内钉与外固定支架治疗胫骨骨折的疗效比较

带锁髓内钉治疗胫骨骨折虽然在技术和操作方面要求高,但具有手术切口小、组织损伤轻、弹性固定、术后可早期活动及并发症少等优点,故应用越来越普遍.我院2000年4月至2003年4月应用带锁骨髓内钉治疗胫骨骨折38例,并与同期采用外固定支架治疗的34例作了比较,现报道如下.     

利胆护肝合剂治疗婴儿肝炎综合征的临床与实验研究

应用利胆护肝合剂治疗婴儿肝炎综合征２９例，结果显示其退黄、改善肝功能效果与中药汤剂对照组相似；动物实验结果显示：该药对血清总胆红素、谷丙转氨酶、血清甘胆酸改善治疗组明显较对照组快；总胆管插管胆汁流量较对照组明显增多，＾９０Ｔｃ－ＥＩＤＡ肝胆显像示肝摄取功能明显好转，肝肠通过时间明显缩短。     

单纯碎裂电位指导心房颤动消融的初步临床观察

Objective To evaluate the feasibility of mdiofrequency catheter ablation of atrial fibrilla-tion (AF) guided by complex fractionated atrial electrograms (CFAEs). Methods Twenty-two patients with drug refractory and symptomatic AF(16 paroxysmal, 6 persisten) were enrolled. Using Carto, the left atrial or biatrial replica was created during spontaneous or induced AF, and areas associated with CFAEs were identi-fied. Radiofrequency ablation at the site with CFAEs was performed and the end points were to eliminate CFAEs or convert to sinus rhythm. Results Thirteen patients(59%)were converted to sinus rhythm, (7 cases conver-ted directly to sinus rhythm, and 6 via the intermediate atrial tachycardia(AT) or atrial flutter (AFL). The re-maining nine patients required cardioversion with D. C. shock or drug. Repeat ablation was performed in 6 pa-tients (5 AT/AFL, 1 paroxysmal AF). During(10.9 ±4.8) months follow-up, 16 patients (73%) were free of arrhythmia and symptoms. CFAEs were most commonly found along the left interatrial septum, pulmonary veins, left atrial roof. CFAEs ablation prolonged AFCL[(157 ± 18) ms vs (211 ± 32) ms, P < 0.05]. Only one patient had pericardial tamponade that required pericardiocentesis. Conclusion Radiofrequeney catheter abla-tion of atrial fibrillation (AF) guided by CFAEs is safe and effective.     

时毓民教授治疗儿童性早熟经验浅谈

性早熟是小儿时期一种常见的内分泌疾病,时毓民教授应用滋肾阴,泻肝肾火,化痰散结等方法治疗小儿性早熟取得了良好的临床疗效。故根据时毓民教授治疗性早熟的辨证及用药特点,总结其临证经验,浅析其遣方用药规律,从而指导临床。     

甲硝唑的不良反应分析及合理使用

对近15年来医学文献中所报道的甲硝唑不良反应进行总结分析.结果甲硝唑常见的不良反应有消化系统不良反应、神经系统不良反应、过敏反应、泌尿系统不良反应等.     

单纯碎裂电位指导心房颤动消融的初步临床观察

Objective To evaluate the feasibility of mdiofrequency catheter ablation of atrial fibrilla-tion (AF) guided by complex fractionated atrial electrograms (CFAEs). Methods Twenty-two patients with drug refractory and symptomatic AF(16 paroxysmal, 6 persisten) were enrolled. Using Carto, the left atrial or biatrial replica was created during spontaneous or induced AF, and areas associated with CFAEs were identi-fied. Radiofrequency ablation at the site with CFAEs was performed and the end points were to eliminate CFAEs or convert to sinus rhythm. Results Thirteen patients(59%)were converted to sinus rhythm, (7 cases conver-ted directly to sinus rhythm, and 6 via the intermediate atrial tachycardia(AT) or atrial flutter (AFL). The re-maining nine patients required cardioversion with D. C. shock or drug. Repeat ablation was performed in 6 pa-tients (5 AT/AFL, 1 paroxysmal AF). During(10.9 ±4.8) months follow-up, 16 patients (73%) were free of arrhythmia and symptoms. CFAEs were most commonly found along the left interatrial septum, pulmonary veins, left atrial roof. CFAEs ablation prolonged AFCL[(157 ± 18) ms vs (211 ± 32) ms, P < 0.05]. Only one patient had pericardial tamponade that required pericardiocentesis. Conclusion Radiofrequeney catheter abla-tion of atrial fibrillation (AF) guided by CFAEs is safe and effective.