Thoracoscopy‐assisted mini‐open surgery for anterior column reconstruction in thoracic spinal tuberculosis

Objective: To evaluate the clinical effects of thoracoscopy‐assisted mini‐open surgery for anterior column reconstruction in thoracic spinal tuberculosis. Methods: Fifty‐eight patients, 35 men and 23 women, aged 39.2 (range, 19–60) years with thoracic spinal tuberculosis with an average kyphotic angle of 29.2° (range, 18°–42°) underwent thoracoscopy‐assisted mini‐open surgeries, including thorough debridement and anterior spinal reconstruction. According to the Frankel Grading system, preoperative neurological function was judged as Grade B in 3 cases, Grade C in 7, Grade D in 28, and Grade E in 20. All patients were followed up for an average of 4.6 years. Outcomes were evaluated retrospectively. Results: Surgery was accomplished successfully in all cases. The average operation time was 230 min (range, 180–320 min), the average intraoperative blood loss 570 ml (range, 350–1200 ml), and the mean drainage duration 3.6 days (3–5 days). Complications occurred in 19 patients (32.8%). Neurological improvement of one to three grades had occurred in 29 patients by final follow‐up. The average correction rate of the kyphotic angle was 36.4%, and no obvious correction loss was detected during follow‐up. No recurrent tuberculosis was found in the group. Conclusions: Thoracoscopy‐assisted mini‐open surgery provides a simple, safe, effective, and practical technology with minimal invasiveness for the treatment of thoracic spinal tuberculosis.     

PKRP、TUVP、SPP 3种前列腺切除术对阴茎勃起和射精功能的影响

目的 比较经尿道前列腺等离子双极电切术(PKRP)、经尿道前列腺汽化术(TUVP)和耻骨上前列腺切除术(SPP) 3种手术方式对BPH患者性功能的影响.方法 将符合此条件的121例前列腺切除患者进行随访,对手术前、后IPSS、性生活、勃起功能(IIEF-5)和射精情况(有无逆行射精、)予以评估.结果 (1)术后3个月3组IPSS评分均有显著下降;(2)3组术后的IIEF-5均有降低,其中SPP组有差异显著的统计学意义;(3) PKRP、TUVP、SPP 3组阴茎勃起功能障碍(ED)发生率分别为:8%、20%、30%:(4)TUVP组和SPP组术后逆行射精(RE)的发生率同术前比较有显著差异.结论 PKRP、TUVP、SPP术对患者性功能均有不同程度的影响,表现在阴茎勃起功能障碍 (ED) 和逆行射精 (RE),而PKRP对性功能的影响较轻.     

小切口经前路腹膜后人工髓核置换术治疗退行性腰椎间盘疾患

目的：评价应用小切口技术进行人工髓核假体置换治疗退行性腰椎间盘疾患的临床初步疗效。方法：2003年6月～2004年9月共施行人工髓核（PDN）置换术12例，男4例，女8例，平均年龄28．5岁。其中腰椎间盘突出症10例，椎间盘源性腰痛2例。包容型腰椎间盘突出症和椎间盘源性腰痛采用前路PDN置换，脱出游离型椎间盘突出症采用后路椎间盘摘除、前路PDN置换；术后评价内容包括临床和影像学结果。结果：平均前路切口长度4．2cm，前路平均手术时间80min，平均术中出血量110ml。PDN置入部位均为L4／5，共置入PR925型假体12枚。所有患者术后腰痛症状得到改善。术后平均随访6．5个月，影像学检查未见假体移位和脱出。结论：应用前路腹膜后小切口进行PDN置换在减少手术创伤的同时，可以有效防止髓核脱入椎管。近期效果肯定，但长期疗效有待进一步观察。     

Protective effects of leflunomide on renal lesions in a rat model if diabetic nephropathy

Diabetic nephropathy is one of the most common chronic complications of diabetes with poor efficacy of clinical treatment. This study investigated the protective effects of leflunomide, a new immunosuppressant, on tubulointerstitial lesions in a rat model of diabetic nephropathy. Diabetes was induced with streptozotocin (STZ, 50?mg/kg) by intraperitoneal injection in male Wistar rats. Two weeks after STZ injection, diabetic rats were treated daily for 8 weeks with low (5?mg/kg) and high dose (10?mg/kg) of leflunomide, and benazepril hydrochloride (4?mg/kg) as a positive control. In diabetic rats, the 24-h urine volume, urine protein and microalbumin, blood creatinine and urea nitrogen significantly increased, which were attenuated by leflunomide treatment in a dose-dependent manner (all p?相似文献   

Maximum principle for optimal control of anticipated forward–backward stochastic differential delayed systems with regime switching

This paper is concerned with a Pontryagin maximum principle for optimal control problem of stochastic system, which is described by an anticipated forward–backward stochastic differential delayed equation and modulated by a continuous‐time finite‐state Markov chain. We establish a necessary maximum principle and sufficient verification theorem for the optimal control by virtue of the duality method and convex analysis. To illustrate the theoretical results, we apply them to a recursive utility investment‐consumption problem, and the optimal consumption rate is derived explicitly. Copyright © 2015 John Wiley & Sons, Ltd.     

高强度聚焦超声系统治疗局限性前列腺癌（附26例报告）

目的探讨高强度聚焦超声系统(HIFU)治疗局限性前列腺癌的有效性及安全性。方法使用Sonablate-500聚焦超声系统对26例局限性前列腺癌患者进行治疗,观察术后3、6、12个月时的血清前列腺特异性抗原(PSA)、直肠指诊及经直肠B超情况。结果平均手术操作时间48min(28～86min),平均术后住院时间3.2d(2～9d)。治疗后3、6、12个月PSA与治疗前相比有显著降低(P<0.05),直肠指诊发现结节消失或减小的占73.3%(11/15),B超提示:低回声结节消失或缩小的占76.9%(20/26)。治疗后3、6、12个月各项检查结果经统计学检验无显著性差异。结论HIFU可以安全、有效杀死前列腺癌细胞,在治疗局限性前列腺癌方面具有美好的应用前景。     

腹腔镜前列腺癌根治术中保留神经血管束的疗效观察（附17例报告）

目的评价腹腔镜下前列腺癌根治术(LRP)中保留神经血管束(NVB)的临床意义。方法2005年8月—2008年3月,对17例局限性前列腺癌患者行LRP,术前临床分期T1b3例,T1c8例,T2b2例,T2c3例,T3a1例。术中采用保护尿道膜部括约肌和双侧前列腺旁神经血管束,重建膀胱颈部充分外翻后,间断、无张力行膀胱颈尿道吻合。结果17例手术均获成功,无一例中转开放。手术平均时间290min(190～370min),出血量平均360ml(200～640ml)。其中2例术中因处理阴茎背血管复合体(DVC)不当出现较大出血,分别为600ml和640ml,均未输血。术后随访6～37个月,全部患者排尿通畅,无肿瘤复发。14例术后6个月内恢复尿控能力,2例在术后9个月内恢复,1例术后12个月后尚存在轻度尿失禁。14例患者在术后12月内可以充分或部分勃起,3例不能勃起。结论LRP中保留双侧NVB,保护尿道膜部括约肌,能有效减少根治术后患者尿失禁及勃起障碍的发生。     

季节性指数平滑法在预测某院儿科门诊人次中的应用

目的应用季节性指数平滑法预测某院儿科门诊人次,为儿科合理调配医疗资源提供科学依据。方法基于2013年1月1日-2018年12月31日某院儿科门诊人次数据,使用SPSS22.0软件建立季节性指数平滑模型,采用2016年1月1日-2018年12月31日各季度儿科门诊人次数据进行验证,并对2019年1月1日-2020年12月31日儿科门诊人次进行预测。结果季节性指数平滑法的最优预测模型为Winters相加模型,该模型在Gamma(趋势)、Delta(季节)均有统计学意义,平稳的R^2分别为0.76,R^2值为0.79,标准化的BIC为20.69,模型残差为白噪声序列,平均相对误差为8.85%;2019年1月1日-2020年12月31日某院儿科门诊人次的预测仍呈现出持续上升的季节性和周期性趋势。结论季节性指数平滑法的Winters相加模型能够较好的拟合该院儿科门诊人次的实际值,可用于儿科门诊量及变化趋势的预测,值得推广应用。     

火针治疗结节性痒疹的临床研究进展

结节性痒疹属于结节性损害,四肢分布较多,尤以小腿伸侧分布较为常见,女性居多,为临床上较难治疗的慢性炎症性皮肤病之一。 结节性痒疹瘙痒无比且病程较长,又具有损容性,给病人的生活和身心都带来了巨大影响。如何较好治疗结节性痒疹,在医学界仍是一个较难解决的问题。近年来,随着医疗技术的不断研究和发展,火针疗法在治疗结节性痒疹中因其止痒迅速、简便价廉、疗效确切,在临床上大力推广,成为比较热门的治疗方法。文章通过近些年关于火针治疗结节性痒疹的文献查阅,介绍了结节性痒疹的发病机制及治疗方法,为临床医生对结节性痒疹的治疗提供多种治疗方法和思路,从而更好地将火针疗法推广到临床。