喜炎平注射液治疗急性上呼吸道感染126例

目的 探讨喜炎平注射液对急性上呼吸道感染的疗效。方法对126例初诊为急性上呼吸道感染的患者通过静滴喜炎平注射液及同时运用雾化吸入器加入喜炎平注射液，有咽痛、咳嗽、全身酸痛者加入中药水煎滤除液。结果总有效率93．7％，副作用不明显。结论喜炎平注射液治疗急性上呼吸道感染具有疗效好、疗程短、安全性高且毒副作用少的特点。     

Comparison of chemical compositions and osteoprotective effects of different sections of velvet antler

Ethnopharmacological relevance

Velvet antlers (VA) have been claimed for centuries to have numerous medical benefits including strengthen bones. To investigate and compare the anti-osteoporotic activities from different sections of VA.

Materials and methods

Fresh VA prepared from farmed sika deers (Cervus nippon) was divided into upper (VAU), middle (VAM), and basal (VAB) sections. The chemical constituents and anti-osteoporotic effect of different sections from VA were evaluated using ovariectomized rats.

Results

Levels of water-soluble extracts, diluted alcoholic extract, amino acids, testosterone, insulin-like growth factor (IGF)-1and testosterone plus estradiol significantly differed among the different sections. Levels of these constituents were significantly higher in the upper section than in the basal section. Moreover, levels of testosterone and IGF-1 of the VAM were also significantly higher than those of the VAB. Calcium level increased downward from the tip with statistical significance. The strength of vertebrae increased in all VA-treated groups compared to the control, but only treatment with VAU and VAM increased the strength of the femur and the microarchitecure of the trabecular bone. Alkaline phosphatase levels of VAU- and VAM-treated groups significantly decreased, but osteocalcin did not significantly change. Moreover, VAU and VAM dose-dependently increased proliferation and mineralization of MC3T3-E1 cells.

Conclusion

Our study provides strong evidence for the regional differences in the effectiveness of velvet antler in treating osteoporosis. However, further studies are needed to elucidate the bioactive chemical constituents associated with the anti-osteoporotic effects of velvet antler.     

腔内钬激光碎石术治疗输尿管上段结石的体会(附121例报告)

目的探讨腔内钬激光碎石术治疗上段输尿管结石的技巧与方法。方法回顾性分析121例应用硬性输尿管肾镜和钬激光碎石术治疗上段输尿管结石患者资料。结果单次碎石成功率为95%(115/121)。术后随访2周~6个月,除6例失败者外,结石排净率98%(113/115),I VU示肾盂积水由术前(3.5±0.8)cm降至(1.5±0.4)cm(P<0.01),无输尿管狭窄发生。结论腔内钬激光碎石术治疗上段输尿管结石,尤其是结石直径>1cm同时合并输尿管息肉及狭窄者有明显优势,熟练掌握输尿管镜的技巧和方法是保证手术成功的重要因素之一。     

内镜下联合应用凝血酶和去甲肾上腺素治疗急性上消化道出血

目的:探讨有效、简便的上消化道出血的治疗方法.方法:通过内镜对36例上消化道出血的患者进行内镜下使用凝血酶和去甲肾上腺素联合止血.结果:36例确诊为上消化道出血的患者采用内镜喷洒凝血酶和肾上腺素后,有效止血34例,有效率94%.2例经过内镜治疗后无效,其中1例在内镜治疗时无效,1例在止血后24h后再次出血.结论:内镜下联合应用凝血酶和去甲肾上腺素是治疗上消化道出血的有效方法.     

婴幼儿急性上呼吸道梗阻临床诊断分析

目的快速准确确定上呼吸道梗阻平面，采取有效及时的救治，提高治愈率，降低新生儿死亡率。方法详细询问病史，简单易行有效的气道检查，配合纤维喉镜及影像检查。结果经过临床分析均能快速查明阻塞部位、性质、程度。结论通过阻塞部位的定位分析，为有效救治赢得了宝贵的时间，治疗方案的选择提供了重要的参考价值。     

Voice recognition products-an occupational risk for users with ULDs?

BACKGROUND: Voice recognition systems (VRS) allow speech to be converted both directly into text-which appears on the screen of a computer-and to direct equipment to perform specific functions. Suggested applications are many and varied, including increasing efficiency in the reporting of radiographs, allowing directed surgery and enabling individuals with upper limb disorders (ULDs) who cannot use other input devices, such as keyboards and mice, to carry out word processing and other activities. Aim This paper describes four cases of vocal dysfunction related to the use of such software, which have been identified from the database of the Voice and Speech Laboratory of the Massachusetts Eye and Ear infirmary (MEEI). METHOD: The database was searched using key words 'voice recognition' and four cases were identified from a total of 4800. RESULTS: In all cases, the VRS was supplied to assist individuals with ULDs who could not use conventional input devices. Case reports illustrate time of onset and symptoms experienced. CONCLUSION: The cases illustrate the need for risk assessment and consideration of the ergonomic aspects of voice use prior to such adaptations being used, particularly in those who already experience work-related ULDs.     

Initial satisfying experience of total retroperitoneal laparoscopic radical nephroureterectomy: a retrospective comparative research

BackgroundRadical nephroureterectomy (RNU) is the principal method for treatment of high-risk upper urinary tract urothelial carcinoma (UTUC). The transperitoneal approach is associated with poor disease progression, but the distal ureter-bladder cuff (DUBC) resection through retroperitoneal laparoscopic approach is difficult. This study proposed a modulated RNU technique, namely, total retroperitoneal laparoscopic radical nephroureterectomy (tRLRNU), with its advantages of DUBC resection and requiring fewer trocars etc. The efficiency, safety, and short-term impacts were retrospectively compared with total transperitoneal laparoscopic radical nephroureterectomy (tTLRNU).MethodsTotal of 12 patients who received tRLRNU and 28 patients who received tTLRNU were enrolled. The choice of surgical approach was random and their data were retrospectively analyzed. During tRLRNU, the laparoscope was versed towards the caudal direction and a retroperitoneal laparoscopic ureterectomy was performed. The bladder cuff was entirely transected and the bladder incision was sutured. The tRLRNU cases were compared with the tTLRNU cases in terms of general clinical data, pathologic parameters, peri-operative parameters, adjuvant therapy, and short-term outcomes. The independent samples t-tests, chi-square tests, and Fischer exact tests were used to analyze the differences.ResultsThere were no significant differences in the basic patient characteristics between the 2 groups. The data were comparable. There were significantly fewer trocars utilized in tRLRNU group compared to tTLRNU group (P=0.0008). tRLRNU group experienced less blood loss (98.33±61.32 versus 170.71±121.32 mL; P=0.017), smaller drainage volume (182.08±163.60 versus 1,924.82±3,370.02 mL; P=0.011), and shorter extubation time (5.67±1.07 versus 8.57±6.96 days; P=0.040) compared to tRLRNU group. There were no statistically differences in the other peri-operative parameters, including whole operation time, transfusion, visceral and vascular injuries, open conversion, post-operative bleeding, recovery time of intestinal function, and discharge time. The patient outcomes in tTLRNU group at 6 months were significantly worse than that of tRLRNU group by comparing progression-free survival, progression survival and mortality (P=0.039).ConclusionsThe tRLRNU was potentially safer, minimally invasive, and more effective compared to the tTLRNU. Due to the small sample size, short follow-up time and no randomization of the study, future comparative studies are warranted to further analyze long-term outcomes of tRLRNU.     

非静脉曲张上消化道出血379例病因分析及内镜诊疗体会

目的对379例非静脉曲张上消化道出血的病因进行分析,探讨不同原因的内镜治疗方法。方法回顾性分析我院1996-2005年379例非静脉曲张良性上消化道出血内镜诊断和治疗。结果消化性溃疡出血是非静脉曲张良性上消化道出血的主要病因,其次为急性胃黏膜病变。胃黏膜下血管病变、食管病变及上消化道癌也是引起该类出血的原因之一。早期内镜检查提高出血责任病灶检出的阳性率,绝大多数良性上消化道小量渗血均可以通过内镜下局部注射及局部电凝法止血,确认为小动脉或小静脉出血时,止血是主要的治疗方法。结论(1)非静脉曲张上消化道出血仍以消化性溃疡为首,急性胃黏膜病变次之,胃黏膜下血管病变、上消化道癌、食管病变的上消化出血均可表现为大量呕血。(2)无内镜诊疗禁忌症者,应及时内镜探查以明确出血原因,确定引起出血的责任病灶;(3)对于不同情况的上消化道出血应区别对待,使用不同的内镜止血方法,才能达到满意的治疗效果。(4)内镜止血后复发出血选择性内镜复查效果好。     

Vascular air embolism during percutaneous nephrolithotomy without pneumopyelogram: a case report of successful rescue

Vascular air embolism (VAE) is a rare complication of percutaneous nephrolithotomy. Paradoxical air embolization resulting from VAE may be more likely to occur in patients with an atrial-septal defect, such as patent foramen ovale. Here, the case of a female patient with VAE that occurred during percutaneous nephrolithotomy is presented. Although the patient was diagnosed with patent foramen ovale, she recovered well without any severe paradoxical air embolization symptoms. To our knowledge, this is the first report of VAE with paradoxical air embolization that occurred in a patient with patent foramen ovale during percutaneous nephrolithotomy that was conducted without pneumopyelography.     

A case report on a child with fracture and dislocation of the upper cervical spine accompanied by spinal cord injury

Rationale:This study describes an 8-year-old boy with a C2 fracture and dislocation with a left C2–C3 articular process interlocking and spinal cord injury who underwent open reduction and internal fixation using the posterior cervical approach and achieved satisfactory results.Patient concerns:An 8-year-old boy underwent an emergency transfer from a previous hospital after a car accident.Diagnoses:Axial fracture and dislocation with spinal cord injury (American Spinal Injury Association grade C), traumatic shock, brain contusion, intracranial hemorrhage, mandibular fracture, pulmonary contusion and hemorrhage, left vertebral artery stenosis, and multiple fractures throughout the body. Radiological examination revealed a fracture of the lower edge of the C2 vertebral body, fourth-degree anterior spondylolisthesis of the C2 vertebral body, interlocking of the left C2–C3 articular processes, widening of the C2–C3 vertebral space, and occlusion of the V1 and 2 segments of the left vertebral artery.Interventions:The boy was immediately intubated and transferred to the pediatric intensive care unit for rescue treatment. However, the reduction was unsuccessful with 2 weeks of cranial traction. Thus, an open reduction was performed under general anesthesia. One month after the surgery, the boy was discharged from the hospital on foot after rehabilitation treatment.Outcomes:The boy was discharged from the hospital 1 month after surgery. At the 8-month follow-up, a radiological examination showed that the corrected C2 vertebral body fracture and dislocation were satisfactorily reduced, and the spinal cord was adequately decompressed. The internal fixation position was also good, and the spinal sequence had recovered well. In summary, except for the muscle strength of the right upper limb, which was slightly worse, the other clinical symptoms were significantly improved.Lessons:In treating cervical fracture and dislocation with unilateral facet lock, the posterior open reduction of pedicle screw and lateral mass screw internal fixation achieved satisfactory results. Consequently, treating complex cervical spine injuries in children requires an accurate diagnosis and careful treatment strategy.