晚期肺癌患者化疗相关性味觉改变与生活质量及应对方式的相关性

目的 了解肺癌患者化疗相关性味觉改变的发生现状,并分析其与生活质量、应对方式的相关性,为制订针对性的措施减轻患者味觉改变提供参考.方法 对144例晚期肺癌化疗患者采用中文版化疗相关性味觉改变量表、癌症患者生命质量量表和医学应对方式量表进行问卷调查.结果 晚期肺癌化疗患者味觉改变发生率为54.9％;患者化疗相关性味觉改变总分为7.60±2.57,化疗相关性味觉改变与生活质量量表功能维度、总体健康状况呈显著负相关,与部分症状维度呈正相关(P＜0.05,P＜0.01);医学应对方式量表中面对维度与整体味觉改变总分呈负相关,屈服维度与不适症状和味觉异常维度呈正相关(P＜0.05,P＜0.01).结论 晚期肺癌化疗患者味觉改变发生率较高,处于中重度水平,对患者生活质量造成一定程度影响;患者采取积极应对方式有助于减轻味觉改变.     

How to select the lowest instrumented vertebra in Lenke type 5 adolescent idiopathic scoliosis patients?

BACKGROUND CONTEXTThe lowest instrumented vertebra (LIV) determination in Lenke type 5 Adolescent Idiopathic Scoliosis (AIS) requires a thorough understanding and prediction of the correction force on the LIV from coronal, sagittal, and axial plane. Although many LIV selection criteria have been reported, none of them comprehensively evaluated the multidimensional characteristics of the LIV till now.PURPOSETo develop and evaluate our LIV selection criteria in Lenke type 5 AIS patients using pedicle screw system via posterior approach.STUDY DESIGNA retrospective study.PATIENT SAMPLEAll consecutive patients with Lenke 5 curves who were treated with one-stage selective lumbar fusion using complete pedicle screw system in our center from January 2006 to December 2017, with minimum 2-year follow-up.OUTCOME MEASURESAge, gender and Risser grade, fused levels, operating time, intraoperative blood loss, complications, and Scoliosis Research Society (SRS)-22 questionnaires outcome were recorded. Coronal, sagittal, and axial parameters were measured from plain radiographs.METHODSA total of 138 consecutive patients with Lenke 5 curves treated with selective lumbar fusion were retrospectively analyzed, with minimum 2-year follow-up. Our LIV selection criteria include: (1) the most cephalad vertebrae touched by central sacrum vertical line (CSVL); (2) Nash-Moe rotation being equal or less than grade I on the standing AP radiograph; (3) CSVL cross between the two pedicles of LIV on concave bending film; (4) not at the apex of kyphosis. Radiographic data, operative data, perioperative complications and SRS-22 outcomes were collected and analyzed.RESULTSThe mean follow-up period was 50.9±24.7 months. The thoracolumbar/lumbar curve was corrected from 46.9°±8.9° before surgery to 5.5°±2.6° at the final follow-up. The C7-CSVL was 19.7±6.2 mm before surgery and 5.2±3.4 mm at the final follow-up. The LIV translation was corrected from 22.3 ±5.4 mm before surgery to 4.8 ± 2.6 mm at the final follow-up, with the correction rate of 78.4%. The LIV tilt was corrected from 21.6 ± 4.4° before surgery to 2.6 ± 2.3° at the final follow up, with the correction rate of 87.9%. Our LIV saved 0.3 level than SRS-last barely touching vertebra, 0.6 level than SRS-last substantially touching vertebra, 0.9 level than neutral vertebra, and 1.4 level than stable vertebra.CONCLUSIONThe present study indicates using our LIV criteria, our study achieved the correction rate of thoracolumbar/lumbar curve as 88.9%, with the rate of adding on or coronal imbalance as 8.7% (12/138). The criteria may provide important guidance for preoperative decision-making in Lenke 5 AIS patients, and more multicenter prospective studies with larger samples are needed to further validate the findings of this study.     

新生儿缺氧缺血性脑病CT诊断对评估疗效的影响

目的：分析新生儿缺氧缺血性脑病（ＨＩＥ）治疗前后ＣＴ分度的变化,探讨ＨＩＥＣＴ诊断在评估疗效中的作用和影响。方法：选取１９９２－１９９９年在我院住院的ＨＩＥ患４００例,按不同的年龄段分组,所有病例均在发病时和治疗后分别行薄层ＣＴ扫描,对ＨＩＥ进行ＣＴ诊断分度,分析其统计数据。结果：不同程度、不同年龄组的ＨＩＥ患儿治疗后加重或减轻的比例也明显不同,结论：新生儿缺氧缺血性脑病按不同的年龄段分组,及其ＣＴ诊断严格分度,是对准确判断ＨＩＥ疗效的有力补充。     

西沙必利治疗糖尿病性胃轻瘫35例疗效评价

目的 :探讨全胃肠道促动力药物西沙必利对糖尿病性胃轻瘫 (DGP)的治疗作用。方法 :采用胃电图(EGG)体表描记法 ,分别描记DGP患者治疗前后及对照组EGG的数值 ,间接判断DGP患者治疗前后胃排空功能变化。结果 :治疗前DGP与对照组胃体、胃窦部的平均振幅 (AP)、峰值频率 (FP)均存在显著性差异 (P <0 .0 5或P <0 .0 1)。治疗后 2组比较 ,除胃窦AP外 ,胃体AP、FP及胃窦FP均无显著性差异 (P >0 .0 5 ) ,胃轻瘫患者的临床症状也得到显著改善。结论 :西沙必利是治疗DGP的有效药物。     

Graves 与ABO血型的关联分析

目的：探讨Graves病(GD)与ABO血型的相关性。方法：采用玻片凝集法鉴定我院汉族GD患者215例ABO血型分布并进行疾病与血型的关联分析。结果：GD患者血型分布特征为O＞B＞A＞AB。发病相对危险率(RR),O型RR＞2,其他血型均RR＜1;A/O、B/O、AB/O均RR＜1(P＜0.01～0.0001)。结论：GD的发生可能与ABO血型有关。     

Twenty one cases of vertebral-artery-type cervical spondylosis treated with acupuncture and moxibustion.

The vertebral-artery-type cervical spondylosis iscommonly encountered in the middle aged and oldpeople.The author has treated 21 cases of vertebral-artery-type cervical spondylosis by acupuncture andmoxibustion,with the other 19 cases treated only byacupuncture as the controls.The results are reportedas follows.Clinical Data     

p27~(KIP1)在骨巨细胞瘤中表达的意义

目的 :研究骨巨细胞瘤中 p2 7KIP1 的表达 ,探讨其与骨巨细胞瘤发生病理分级与预后的关系。方法 :应用免疫组化 S- P法检测 40例骨巨细胞瘤石蜡标本中 p2 7KIP1的表达。结果 :p2 7KIP1的表达与骨巨细胞瘤的病理分级呈明显相关。 p2 7KIP1在 40例骨巨细胞瘤中总表达阳性率为 45 .0 % (18/40 ) ,其中 、 级为 5 7.1% (16 /2 8) , 级为16 .7% (2 /12 ) ,组间差异显著。结论 :p2 7KIP1蛋白在 级骨巨细胞瘤表达阳性率较 、 级明显减低 ,对骨巨细胞瘤的诊断和分级有意义 ,可作为诊断、分级和预后判定的指标之一。