依沙吖啶宫腔注入法治疗胎盘植入的临床观察

目的 观察用依沙吖啶（利凡诺）宫腔注入法治疗胎盘植入的效果.方法 将我院1999年1月至2005年1月不需手术可以保守治疗的胎盘植入40例,随机分为两组,研究组采用依沙吖啶宫腔注入法治疗,对照组采用氨甲蝶呤静脉滴注治疗,观察其疗效及不良反应.结果 人绒毛膜促性腺激素β亚单位（βhCG）下降时间及胎盘排出时间两组差异无统计学意义（P＞0.05）.出现黏膜炎症的患者研究组0例,对照组7例,差异有统计学意义（P＜0.05）;白细胞下降低于正常的患者,研究组1例,对照组8例,差异有统计学意义（P＜0.05）.结论 依沙吖啶宫腔注入法治疗胎盘植入简单方便,安全有效,不良反应少,值得推广.     

Behavioral problems and related factors in children of different aged patients with schizophrenia——A cross-sectional study

BACKGROUND: With the age growing, changes of behavioral problems in children whose parents had schizophrenia, differences of related factors and ways for particular intervention should be further studied. OBJECTIVE: To survey the behavioral problems in children of different aged patients with chizophrenia and investigate the correlation between behavioral problems and related factors in different aged groups. DESIGN: Cross-sectional study. SETTING: Shandong Mental Health Center. PARTICIPANTS: A total of 364 patients with schizophrenia were selected from eleven psychiatric hospitals from June 1999 to June 2000. There were 179 males and 185 females, and their ages ranged from 28 to 45 years. All patients met modified diagnostic criteria of schizophrenia (the second edition), China Classification of Mental Diseases and Diagnostic Criteria. Meanwhile, children of the 364 patients were grouped based on their ages, including 6–11 years old group [n =217; 114 males and 103 females; mean age of (9±2) years] and 12–16 years old group [n =147; 99 males and 48 females; mean age of (14±1) years]. The Chinese norms of Achenbach's Child Behavior Check List were regarded as the normal control group. METHODS: Children who received self-made mental health related factors inventory and Achenbach's Child Behavior Check List were involved in this study. All children and their parents provided the confirmed consent. Achenbach's Child Behavior Check List was used for parents to mainly evaluate children, and the results manifested various behavioral problems based on different sexes and different ages. Self-made mental health related factors inventory contained questionnaires for parents and children, respectively. In this study, home situation of parents as well as personality characteristics and educational styles of children were mainly evaluated. MAIN OUTCOME MEASURES: ① Scores of Achenbach's Child Behavior Check List in different aged children; ② Scores of self-made mental health related factors inventory based on different home situations and educational styles. RESULTS: Children of 364 patients were involved in the final analysis. ① There were no significant differences in total score of Achenbach's Child Behavior Check List and sex in the two groups (P > 0.05). There were significant differences in schizoid, body recount, aggression, depression, hyperactivity, violating discipline, compulsion and total abnormal rate of boys between the 6–11 years old group and the normal control group (P < 0.05–0.01). In addition, there were also significant differences in poor communication, depression, hyperactivity, violating discipline, compulsion and total abnormal rate of girls between the 6–11 years old group and the normal control group (P < 0.05–0.01). ② As compared with normal control group, scores of home environment in the two aged groups demonstrated that educational level was low; interpersonal relationship was poor; relation to children was not closed; relationship between husband and wife was not harmonious; positive rate of family history was high; economic status was poor; family atmosphere was poor. Therefore, there was significant difference (P < 0.01). Educational level in parental generation and single parent family in the 6–11 years old group were higher than that in the 12–16 years old group, with significant difference (P < 0.05). As compared with the normal control group, results of education demonstrated that children in the two aged groups had poor communication with other children; they had poor behaviors in schools; most of them were boarded and had poor relationship with their parents; teaching styles for children were different. CONCLUSION: All children of different aged patients with schizophrenia had poor home environment and education; and they were often affected by other factors. Behavioral problems were changed with the age growing; in addition, these changes were related to home environment, education and society. Therefore, comprehensive intervention may be an ideal method.     

118例小切口膝关节粘连松解术后的康复训练

股骨干、股骨髁部骨折患者因外伤、固定、手术等因素可致膝关节周围组织粘连而造成膝关节伸屈功能障碍,影响工作和生活。2000年1月-2005年12月,我们采用小切口松解术,配合术后综合康复训练治疗118例膝关节粘连,取得满意效果,现报告如下。1临床资料本组118例,男96例,女22例;年龄     

DR与CT对急性膝关节损伤的诊断价值对比研究

目的对比研究数字化X线摄影(DR)与CT对急性膝关节损伤的诊断价值。方法回顾分析我院2017年3月至2019年1月收治的100例急性膝关节损伤患者的临床资料,将CT检查及DR检查所得的图像进行对比分析,比较两种检查对不同损伤类型的检出率及诊断骨折塌陷和劈裂距离的准确性。结果CT检查检出患者的骨折损伤类型共94例,检出率为94.00%(94/100);DR检查检出患者的骨折损伤类型共61例,检出率为61.00%(61/100)。CT检查的检出率显著高于DR检查(P<0.05);DR检查在诊断骨折塌陷和劈裂距离测量的准确性显著低于CT检查(P<0.05)。结论DR和CT检查均可有效地显示膝关节损伤的影像学特点,但CT检查鉴别诊断膝关节损伤的能力优于DR检查,临床应用价值更高。     

果胶酶联合小苏打治疗胃石症40例临床观察

目的观察果胶酶联合小苏打治疗胃石症的疗效。方法将2008年1月—2013年6月经胃镜确诊的胃石症患者80例,随机分为对照组（只口服小苏打）和观察组（口服果胶酶联合小苏打）,对2组治愈时间、治愈率进行比较。结果观察组的治愈时间、治愈率明显优于对照组（P〈0.05﹚。结论果胶酶联合小苏打治疗胃石症疗效显著,值得推广。     

髓内钉与锁定钢板治疗肱骨近端骨折临床疗效的Meta 分析

目的:系统评价髓内钉与锁定钢板治疗肱骨近端骨折的临床疗效。方法:使用计算机检索Pubmed,Embase,Cochrane Library,万方,知网,VIP 数据库,检索从建库到2019 年12 月的所有关于髓内钉与锁定钢板治疗肱骨近端骨折的随机对照试验。由2 名评价者对独立纳入的文献进行数据提取后,用RevMan5.3 软件进行Meta 分析。结果:按照规定的文献检索方式,最终纳入7 篇RCT 研究,研究中共纳入患者412 例,分析结果显示:在手术时间、术中出血量、骨折愈合时间方面髓内钉组优于锁定钢板组,两者之间差异具有统计学意义;在术后6 个月Constant-Murley 评分方面,两者之间差异无统计学意义。结论:治疗肱骨近端骨折髓内钉与锁定钢板均可取得良好疗效,但在减少手术时间、术中出血量以及缩短骨折愈合时间方面髓内钉更具优势,但仍需高质量的临床研究进一步验证。     

不同抗栓治疗模式对房颤患者体内血小板活化的影响

目的观察不同抗栓方式对非瓣膜性心房颤动（NVAF）患者血浆溶血磷脂酸（LPA）含量变化的影响，为临床进行抗栓治疗提供依据。方法235例未接受抗栓治疗的NVAF患者，随机分为阿司匹林／双嘧达莫治疗组（A组）、阿司匹林／固定剂量华法林治疗组（B组）及适宜剂量华法林治疗组（C组）。测定治疗前、治疗后2周和6周血浆LPA含量，分析各年龄亚组的变化并进行疗效比较。结果B组在2周和6周后血浆LPA含量的降低幅度均显著大于其他两组：A组中〈60岁年龄亚组血浆LPA在2周和6周后均较治疗前显著降低，其他曲个年龄亚组治疗前后无显著变化；B组的〈60岁和60～75岁年龄亚组的血浆LPA含量在2周和6周后均较治疗前显著降低，〉75岁年龄组在治疗前后则无显著变化；C组符年龄亚组的山浆LPA含量在2周和6周后均较治疗前显著降低。结论不同抗栓治疗方式对不同年龄段NVAF患者体内血小板活化有不同影响。小于60岁者可给予阿司匹林联合双嘧达莫治疗，60～75岁的患者可给予阿司匹林联合固定剂量华法林治疗，大于75岁的患者推荐应用适宜剂量的华法林（INR1．5～2．1）治疗。     

会阴手术盛器及托盘的制作和应用

会阴部手术由于手术部位和手术方式的特殊性，会给手术者的操作带来一定的不便。为更好地配合手术，使手术者得心应手，我们特制了一个会阴手术盛器及托盘，在临床上应用方便，效果满意。现介绍如下。     

以胸痛为主诉的胃穿透性溃疡并腹腔脓肿1例报道

病例患者，男，39岁，因“左胸痛伴消瘦1月”于2007年10月31日人院。患者左胸疼痛部位不固定，游走性，呈针刺或撕裂样痛，发作不规律，与进食、活动等无关，每次发作持续0．5-1h，能自行缓解。无发热、咳嗽、气短、心悸、胸闷，无恶心、呕吐、反酸、腹痛等，曾多处就诊，行心电图、胸片等检查无异常。疑诊“肋间神经痛”，先后予以非甾体抗炎药和尼美舒利分散片等治疗无效，1月内消瘦明显，体重下降5kg。既往体健。     

肝脏功能和生化指标对心力衰竭程度及预后的预测价值

心力衰竭是一个重大的公共健康问题,可导致患者反复住院、生活质量受损和预期寿命缩短。心力衰竭患者,尤其是急性失代偿期心力衰竭患者心排血量降低、中心静脉压升高和心脏指数降低,这些血流动力学异常引起的灌注不足可导致肝细胞缺血、缺氧和坏死,引起肝脏功能和生化指标异常。肝功能检测异常见于约76%的心力衰竭患者,最近的研究发现肝脏的某些生化指标和肝功能指标异常可预测心力衰竭患者再入院、住院期间死亡和需要肝移植的风险,且与疾病的严重程度和预后相关。对心力衰竭的诊断和治疗也有一定的指导价值。