距骨颈骨折的手术治疗

目的探讨距骨颈骨折的手术治疗及并发症防治。方法回顾2000年至2004年手术治疗的距骨颈骨折12例,总结其手术入路、内固定方法及术后处理。结果所有患者均在术后12~14d伤口拆线出院,无伤口感染、不愈合或皮肤坏死发生。12例患者中有10例获得随访,随访7个月至5年,平均3年4个月。按Hawkins标准优2例、良7例、中1例,创伤性骨关节炎4例,距骨无菌性坏死2例。结论对于复位不理想的距骨颈骨折应积极行切开复位内固定,强调骨折的解剖复位,避免术后过早负重,降低术后并发症的发生几率。     

The Effect of Severe Shot Peening on Fatigue Life of Laser Powder Bed Fusion Manufactured 316L Stainless Steel

Severe shot peening (SSP) was used on additive manufactured 316L by laser powder bed fusion. The effect of the post processing on the surface features of the material was analyzed through residual stress measurements, tensile testing, hardness-depth profiles, and fatigue testing by flexural bending. The results showed that SSP can be utilized to form residual stresses up to −400 MPa 200 μm below the surface. At the same time, a clear improvement on the surface hardness was achieved from 275 HV to near 650 HV. These together resulted in a clear improvement on material strength which was recorded at 10% improvement in ultimate tensile strength. Most significantly, the fatigue limit of the material was tripled from 200 MPa to over 600 MPa and the overall fatigue strength raised similarly from a low to high cycle regime.     

普通钢板内固定治疗胫骨骨折并发症原因分析

目的分析普通钢板内固定治疗胫骨骨折术后骨不连的发生原因与治疗对策。方法自1998年7月～2005年12月共收治胫骨骨折患者182例。全部采用普通钢板内固定治疗。术后平均随访14个月（12～18个月）。结果182例中有175例达到临床愈合标准,并已拆除钢板,未发生骨髓炎、再骨折等并发症。经X线片检查,骨折均为骨性愈合,骨折临床愈合时间12～16周,平均14周。7例未达到临床愈合标准,发生率为3．85％。患者同时合并有腓骨骨折,主要并发症为术后骨不连。结论普通钢板内固定目前仍是基层医院治疗胫骨骨折的有效方法,只要严格掌握适应症,熟练掌握操作规程,可以减少并发症,提高疗效。     

GC法测定小儿氨酚烷胺颗粒中盐酸金刚烷胺

目的建立GC法测定小儿氨酚烷胺颗粒中盐酸金刚烷胺。方法采用HP-5毛细管柱（30 m×0.32 mm×0.25μm）,FID检测器;气化室温度为220℃,检测室温度为300℃。采用程序升温,初始温度为70℃,以10℃/min升至140℃。载气：氮气,流速为4 mL/min;进样量为1μL;分流比：1∶50。采用内标法定量。结果盐酸金刚烷胺在0.1~0.7 mg/mL线性关系良好（r=0.999 6）。平均回收率为99.27%,RSD值为0.66%（n=9）。结论本法简便、准确、重复性好,可用于小儿氨酚烷胺颗粒中盐酸金刚烷胺的测定。     

中药内服结合外敷治疗脾虚血瘀型肝癌腹水疗效观察

目的观察中药内服结合外敷治疗原发性肝癌腹水的临床疗效。方法将60例脾虚血瘀型原发性肝癌腹水患者随机分为治疗组和对照组,各30例。对照组口服安体舒通,治疗组采用健脾活血利水内服方及逐水药外敷,疗程均为15天。观察两组腹水、生活质量、中医症状改善情况。结果治疗组腹水的改善优于对照组(P<0.05);治疗后治疗组Karnofsky评分较治疗前提高(P<0.05),对照组降低(P<0.05);两组治疗前后差值比较有统计学意义(P<0.05);治疗后治疗组患者腹胀、腹痛等症状明显改善(P<0.05),且较对照组改善显著(P<0.05)。结论中药内服结合外敷治疗原发性肝癌腹水疗效显著,并可改善临床症状,提高患者生活质量。     

田菁以磷增氮的研究

对环境施磷增加田菁[Sesbania cannabina(Retz.)pers.]结瘤固氮的作用是有限度的,受环境供磷水平的制约。 在广州石牌地区花岗岩发育赤红壤中,田菁以磷增氮的土壤有效磷临界水平(ppm P)为25.6(0.1 N HCL法)。 在无氮培养液中,秋植和春植田菁以磷增氮的供磷临界水平(毫摩尔P)分别为0.78和0.48,植株体内含磷量的临界水平(P％)分别为0.213和0.157。该临界供磷水平与含磷量有受季节性影响的倾向。介质的高磷水平还会引起田菁固氮量的下降。 在低磷的介质中,增磷对田菁根瘤的形成,发育和固氮酶活性有明显的促进作用。在磷供应达到一定水平后,继续增磷的促进作用不显著。未发现高磷供应对田菁的根瘤数有不良影响,但对其根瘤干重、特别是固氮酶活性有抑制作用。     

《黄庭经》存思炼养术与中医藏象学说的关系探讨

对晋代道教上清派经典《黄庭经》存思炼养之法进行探讨,论述其存思五脏之神炼养术中藏象学说的内涵,并认为《黄庭经》"肾间命门说"是明代温补学派命门学说的理论源头之一,是命门学说发展过程中的重要环节。藉以指出《黄庭经》对中医藏象学说发展的贡献。     

舒适护理在心血管内科护理工作中的应用研究

目的探讨舒适护理在心血管内科护理工作中的应用效果。方法选取本院2011年4月～2012年5月收治的心血管内科患者327例,随机分为两组,163例患者采用常规护理为对照组,164例患者采用舒适护理为观察组,比较两组患者的住院时间与患者满意度。结果观察组住院时间为（14.1±2.9）d,明显小于对照组[（17.4±3.8）d],观察组患者满意度（93.3%）明显高于对照组（81.0%）,差异均有统计学意义（P〈0.05）。结论在心血管内科护理工作中,舒适护理具有重要的临床价值,可以帮助患者改善情绪,缩短患者的住院治疗时间,提升患者满意度,值得临床推广使用。     

改良外剥内扎术结合中药治疗混合痔250例

目的观察改良外剥内扎手术结合中药治疗混合痔的临床疗效。方法对250例混合痔患者采用改良外剥内扎手术治疗,外痔少量或部分切除,尽量多剥离,针对有病灶的内痔黏膜予以结扎;术后予太宁栓和消炎痛栓肛塞,痔疾宁溶液熏洗和坐浴,以红油膏、白玉膏、生肌散等中药外敷换药。结果治愈215例,好转35例,无效0例,总有效率为100%。结论本方法操作简单,患者痛苦小,手术后遗症少,值得推广。     

Vertical split fracture of the vertebral body following oblique lumbar interbody fusion: A case report

Rationale:Oblique lumbar interbody fusion (OLIF) is an effective and safe surgical technique widely used for treating spondylolisthesis; however, its use is controversial because of several associated complications, including endplate injury. We report a rare vertebral body fracture following OLIF in a patient with poor bone quality.Patient concerns:A 72-year-old male patient visited our clinic for 2 years with lower back pain, leg radiating pain, and intermittent neurogenic claudication.Diagnoses:Lumbar magnetic resonance imaging revealed L4-5 stenosis.Intervention:We performed OLIF with percutaneous pedicle screw fixation and L4 subtotal decompressive laminectomy. We resected the anterior longitudinal ligament partially for anterior column release and inserted a huge cage to maximize segmental lordosis. No complications during and after the operation were observed. Further, the radiating pain and back pain improved, and the patient was discharged. Two weeks after the operation, the patient visited the outpatient department complaining of sudden recurred pain, which occurred while going to the bathroom. Radiography and computed tomography revealed a split fracture of the L5 body and an anterior cage displacement. In revision of OLIF, we removed the dislocated cage and filled the bone cement between the anterior longitudinal ligament and empty disc space. Further, we performed posterior lumbar interbody fusion L4-5, and the screw was extended to S1.Outcomes:After the second surgery, back pain and radiating pain in the left leg improved, and he was discharged without complications.Lesson:In this case, owing to insufficient intervertebral space during L4-5 OLIF, a huge cage was used to achieve sufficient segmental lordosis after anterior column release, but a vertebral body coronal fracture occurred. In patients with poor bone quality and less flexibility, a huge cage and over-distraction could cause a vertebral fracture; hence, selecting an appropriate cage or considering a posterior approach is recommended.