Efficacy and safety of Xinglouchengqi decoction for acute ischemic stroke with constipation: study protocol for a randomized controlled trial

Objective

To investigate the efficacy and safety of Xinglouchengqi (XLCQ) decoction in treatment of acute ischemic stroke with constipation.

重症急性胰腺炎的治疗探讨

目的：探讨重症急性胰腺炎（SAP）的治疗方法。方法：回顾性总结1995－2000年重症急性胰腺炎83例的治疗资料。结果：其中保守治疗37例，手术治疗46例，治愈69例，死亡14例，总病死率为16．9％，重症I组级52例，死亡4例；重症Ⅱ级31例，死亡10例，重症I级，Ⅱ级患者病死率分别为7．7％，32．3％，二组间差异有显著性意义（P＜0．05），结论：SAP病死率与胰腺炎的严重性有显著相关性，应根据病情而选择治疗方案，手术时机是重要影响因素，围手术期处理相当重要。     

肝炎病毒感染与肝门部胆管癌发病关系的探讨

目的　探讨乙型肝炎 (乙肝 )和丙型肝炎 (丙肝 )病毒感染在肝门部胆管癌发病中的作用。　方法　采用免疫组织化学方法对 6 8例石蜡包埋肝门部胆管癌患者手术标本中乙肝病毒X蛋白和丙肝病毒C蛋白水平进行检测 ,并结合临床资料进行分析。　结果　 6 8例肝门部胆管癌中乙肝病毒X蛋白阳性率为 8 8% (6 / 6 8) ,丙肝病毒C蛋白阳性率为 35 3% (2 4 / 6 8) ,两者均阳性 1例(1 5 % ) ;乙肝、丙肝病毒感染的肝门部胆管癌在分化程度 (χ2 =8 7,P <0 0 1)、浸润程度 (χ2 =6 7 8,P<0 0 1)、淋巴结转移 (χ2 =4 3,P <0 0 5 )、根治程度 (χ2 =5 1,P <0 0 5 )与非病毒感染的肝门部胆管癌比较差异有显著意义。　结论　乙肝病毒X蛋白、丙肝病毒C蛋白可能在乙肝、丙肝病毒感染肝门部胆管癌的发病原因中起重要作用。乙肝、丙肝病毒感染的肝门部胆管癌恶性程度高 ,可能预后较差     

微创经皮肾取石术联合B超定位及监测治疗上尿路结石的体会

目的探讨微创经皮肾取石术联合B超定位及监测治疗上尿路结石临床疗效。方法将118例单侧上尿路结石患者分为两组,微创经皮肾取石术联合B超治疗上尿路结石62例为实验组,以微创经皮肾术取石56例患者为对照组。结果实验组的一期结石清除率显著高于对照组(P0.05),平均手术时间、平均术中出血量、平均取石次数、住院时间、平均住院费用等显著少于或短于对照组(P均0.05)。两组患者均无严重并发症。结论微创经皮肾取石术联合B超治疗上尿路结石具有定位准确、创伤小、安全有效、结石取尽率高等优点,能有效治疗上尿路结石。     

Schroeder-Essed术治疗先天性单纯阴茎弯曲

目的 探讨Schroeder-Essed术治疗单纯性阴茎下屈畸形的疗效.方法 回顾分析1999年1月至2009年7月收治的尿道开口正常的阴茎下屈畸形患者21例,年龄3～42岁,平均13.3岁,下弯平均约15°～90°,平均45°,侧弯1例约40°.均采用Schroeder-Essed术辅以阴茎皮肤脱套的手术方法,必要时结合尿道游离以及尿道成形术治疗.结果 手术后阴茎弯曲完全纠正20例,Ⅰ型3例矫正阴茎弯曲后利用阴茎背侧包皮行Duckett尿道成形术.Ⅱ型和Ⅲ型共17例、Ⅳ型1例经Schroeder-Essed术辅以阴茎皮肤完全脱套术弯曲得到完全矫正.术后近期并发症主要为疼痛、尿道不适;远期并发症为尿瘘1例,局部皮肤感染1例,残留下弯1例(约15°)但不影响正常性生活.随访6～25个月,疗效满意.2例成年患者性生活正常.结论 Schroeder-Essed术结合阴茎皮肤脱套技术能矫正大多数单纯阴茎弯曲畸形,简便易行、并发症少,是治疗轻中度单纯阴茎下屈畸形的良好方法.     

Is carotid artery disease responsible for perioperative strokes after coronary artery bypass surgery?

The coronary and extracranial carotid vascular beds are often simultaneously affected by significant atherosclerotic disease, and stroke is one of the potential major complications of coronary artery surgery. As a result, there is no shortage of reports in the vascular surgery literature describing simultaneous coronary and carotid artery revascularizations. Generally, these reports have found this combination of operations safe, but have stopped short of proving that it is necessary. Intuitively, simultaneous carotid endarterectomy and coronary artery bypass surgery could be justified if most perioperative strokes were the result of a significant carotid stenosis, either directly or indirectly. At first glance this appears to be a fairly straightforward issue; however, much of the evidence on both sides of the argument is circumstantial. One significant problem in analyzing outcome by choice of treatment in patients presenting with both coronary and carotid disease is the multiple potential causes of stroke in coronary bypass patients, which include hemorrhage and atheroemboli from aortic atheromas during clamping. But this controversial subject is now open to discussion, and our debaters have been given the challenge to clarify the evidence to justify their claims.     

Abnormal neural activity in children with attention deficit hyperactivity disorder: a resting-state functional magnetic resonance imaging study

In this study, a newly reported regional homogeneity approach was used to analyze blood oxygen level-dependent functional magnetic resonance imaging data on resting state in boys with attention deficit hyperactivity disorder. Boys with attention deficit hyperactivity disorder showed decreased regional homogeneity in the frontal-striatal-cerebellar circuits, but increased regional homogeneity mainly in the occipital cortex. Our findings are consistent with the hypothesis of abnormal frontal-striatal-cerebellar circuits in attention deficit hyperactivity disorder. The regional homogeneity approach may be a potentially useful method in exploring the pathophysiology of attention deficit hyperactivity disorder.     

骨质疏松性椎体压缩骨折经皮穿刺球囊扩张后凸成形术后再骨折的相关因素研究

目的探讨骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fracture,OVCF)行经皮穿刺球囊扩张后凸成形术(percutaneous kyphoplasty,PKP)后出现椎体再骨折的相关因素。方法回顾性研究2002年12月-2008年5月行PKP治疗的84例胸腰椎OVCF患者临床资料。其中男11例,女73例;年龄55～90岁,平均70.1岁。术后84例均获随访,随访时间24～96个月,平均38个月。其中12例于术后3～52个月出现邻近和/或间隔椎体压缩性骨折;余72例均随访24个月以上,未出现再骨折。比较再骨折组和未发生再骨折(对照组)患者的临床资料,分析导致再骨折的相关因素。结果两组患者在性别、年龄、术中穿刺方式(单、双侧穿刺)、骨折节段数目(≤3个及>3个椎体)、单椎体骨水泥注入量、术后椎体高度压缩率、术后椎体后凸角以及术前骨密度方面比较,差异均无统计学意义(P>0.05);在骨水泥向椎间盘泄露方面比较,再骨折组显著高于对照组,差异有统计学意义(χ2=5.294,P=0.032)。结论骨水泥向椎间盘泄露是PKP术后出现其他椎体再骨折的相关因素。     

肿瘤型假体无菌性松动翻修术后疗效观察

目的探讨采用普通长柄假体或同种异体骨假体复合物(allograft-prosthesis composite,APC)翻修治疗肿瘤型假体无菌性松动的疗效。方法 2002年1月-2008年6月,收治14例肿瘤型假体无菌性松动患者。男8例,女6例;年龄21～70岁,平均43.9岁。肿瘤部位:股骨远端8例,股骨近端2例,胫骨近端4例。假体置换术后6～31年出现患肢疼痛,负重和行走时加重;6例出现患肢短缩畸形。术前参照美国骨与软组织肿瘤协会(MSTS)功能评分系统行关节功能评分为(16.36±1.50)分。X线片检查见假体明显松动和下沉。出现症状至入院时间为3～9年,平均4.5年。7例骨量严重丢失(骨皮质厚度减少>50%)、假体下沉>2 cm、假体穿破骨皮质或即将穿破骨皮质者采用APC翻修;7例骨量丢失不严重(骨皮质厚度减少<50%)者,采用订制普通长柄假体翻修。结果患者切口均Ⅰ期愈合;2例出现腓总神经一过性麻木,对症治疗后3个月内恢复。患者术后均获随访,随访时间2年2个月～7年,平均3.6年。翻修术后患者术前疼痛症状均缓解,关节功能改善。术后12个月MSTS功能评分为(23.43±2.56)分,与术前比较差异有统计学意义(t=8.910,P=0.024)。X线片检查示,术后12个月2例采用普通长柄假体翻修患者出现骨水泥周围无症状透亮线,无假体松动和周围感染等并发症;其余患者未见明显异常。结论肿瘤型假体无菌性松动后再次行翻修重建肢体功能可行,根据患者骨量丢失情况选择APC或普通长柄假体翻修,可获较好疗效。