基于倾向性评分的中医复杂干预临床疗效评价

临床研究的成功与否,与是否有效控制偏倚有关。在非随机化的观察性研究中,倾向性评分能减少对比组间的差异,缩小偏倚。与试验设计阶段进行配比控制偏倚相比,倾向性分析法不受试验设计(随机对照试验设计)方法的限制,无须在试验设计阶段进行随机,其结果更接近真实世界的实际干预效果而非临床试验的效果。因此,倾向性分析应用于中医个性化治疗的复杂干预疗效评价是适合的,具有重要的研究前景和使用价值。     

针药结合治疗脑卒中后肢体疼痛疗效观察

目的观察针刺结合益气活血补肾方对脑卒中后肢体疼痛的疗效。方法将60例脑卒中后肢体疼痛患者随机分为治疗组(n=30)与对照组(n=30),治疗组在康复训练基础上予以针刺结合益气活血补肾方治疗,对照组予以康复训练。治疗4周后观察疼痛视觉模拟评分(VAS)、肢体疼痛缓解时间等情况。结果两组治疗后疼痛视觉模拟评分均较治疗前降低,差异有统计学意义(P<0.01),且治疗组低于对照组,差异有统计学意义(P<0.01)。治疗组疼痛缓解时间较对照组短,差异有统计学意义(P<0.05)。结论针刺结合益气活血补肾方对脑卒中后肢体疼痛疗效较好。     

Study of persistence and loss of patch test reactions to dichromate and cobalt *

Allergic contact dermatitis has been suggested as a possible cause of vulval vestibulitis, a condition of unknown aetiology characterized by burning, stinging and dyspareunia, with symptoms localised to the vestibule. To examine this relationship, 30 women with vulval vestibulitis were patch tested using a standard series of contact allergens and a special series relevant lo perianal and vulval disorders. Other potential allergens identified by the patients as causing aggravation were also included. There were 5 positive reactions, 4 to nickel and 1 to fragrance mix, though none of these reactions were considered relevant. Our results suggest that allergic contact dermatitis is unlikely to be a primary factor in the development or persistence of vulval vestibulitis. Patch testing patients with vulval vestibulitis cannot routinely be recommended.     

糖胃康治疗糖尿病性胃轻瘫的临床研究

目的探讨糖胃康对糖尿病性胃轻瘫（diabetic gastroparesis,DGP）的临床疗效及作用机理。方法选择90例糖尿病性胃轻瘫患者随机分组,其中30例予降糖治疗与糖胃康治疗（治疗组）,30例予降糖治疗与吗丁啉治疗（对照组）,30例予降糖治疗（空白对照组）,观察各组临床疗效、胃动素（MOT）及胃排空率等变化。结果糖胃康可以明显改善DGP患者的临床症状,增加胃排空率,改善胃肠蠕动功能,明显缩短胃排空时间,有利于血糖（餐后2h血糖及果糖胺）的控制;治疗组治愈率63．33％（19例）,与对照组（26．67％,8例）及空白组（10．00％,3例）比较,差异有显著性（P〈0．01）;总有效率93．33％,与对照组（63．33％）及空白组（33．33％）比较,差异有显著性（P〈0．01）;治疗组疗效优于其他两组。结论糖胃康对DGP具有良好的治疗效果。 医疗法     

46,XY性发育异常35例病因及临床分析

目的分析35例儿童46,XY性发育异常(disorders of sex development,DSD)的病因、临床特征,以期对临床工作有所帮助。方法回顾分析35例46,XY DSD患儿的临床资料,总结其临床特点及其它辅助检查,部分患儿行相关基因突变检测。结果 35例患儿中,社会性别男性25例,女性10例。其中3例完全性雄激素不敏感综合征(complete androgen insensitivity syndrome,CAIS)、3例卵睾型DSD、8例5α-还原酶缺乏、2例Kallmann综合征、2例46,XY单纯性腺发育不全、余17例患儿诊断为小阴茎及隐睾10例、尿道下裂7例。8例患儿存在SRD5A2突变,存在AR和FGFR1突变者各1例。结论 46,XY性发育异常的病因复杂,及早诊断和治疗对患儿的身心健康至关重要,基因检测可帮助明确病因。     

新型人工半骨盆的研制与临床应用的初步报告

目的：研制新一代的人工半骨盆并临床应用。方法：应用计算机三维重建、个体化设计及数控制造技术研制新一代的人工半骨盆,应用椎弓根螺钉固定假体,将新型人工半骨盆置换入人体。结果：临床应用1例髂骨软骨肉瘤术后复发患者,手术顺利,随访3个月,患者恢复良好,X线检查未见异常。患侧髋关节活动及下肢感觉、运动等正常,可持拐下地。结论：计算机三维重建、个体化设计及制造技术研制人工半骨盆,增加了假体固定后的可靠性和稳定性,有较好临床应用前景。人工半骨盆的外形和功能“仿生”及生物力学上的稳定性,仍是人工半骨盆研究的重点。     

临床营养专科护士培训实践与成效

目的 探讨临床营养专科护士培训实践方法,为国内临床营养专科护士的培养提供参考.方法 基于临床营养专科护士核心能力构建培训体系,对115名学员采用理论授课(4周)与临床实践(8周)相结合方式分阶段进行培训.结果 学员总成绩(90.69±2.28)分;学员对培训的总体满意度为98.26％.结论 临床营养专科护士培训可提高专科护士营养相关知识和技能,促进专科护士持续成长.     

Clinical features, radiological imaging, and treatment strategies of nonmetallic intraorbital foreign bodies: a retrospective analysis

AIM: To provide comprehensive data on nonmetallic intraorbital foreign bodies (IOFBs) by summarizing and analyzing material types, clinical manifestations, imaging features, and treatment strategies.METHODS: Totally 28 nonmetallic IOFB cases treated at Shengjing Hospital of China Medical University from 2012 to 2020 were retrospectively reviewed. The types of foreign bodies, clinical features, imaging manifestations, and treatment outcomes were analyzed.RESULTS: Among all cases, 67.8% (19/28) of the foreign bodies were organic. The top three entrances were the upper eyelid skin (7/28), lower fornix conjunctiva (6/28), and lower eyelid skin (4/28). In most cases (11/28, 39.3%), foreign bodies remained in the medial orbits. The major clinical manifestations included eyelid redness and swelling (20/28, 71.4%), conjunctival congestion and edema (17/28, 60.7%), and ophthalmoptosis (15/28, 53.6%). Infection was the main complication, which occurred in 57.1% (16/28) of all cases. Computerized tomography (CT) values differed for different foreign bodies and varied in the different periods after injury. The plant- and grease-derived foreign bodies and the surrounding pus cysts showed different signals on magnetic resonance imaging (MRI). The prognosis varied with different foreign body types, surgery timing, and intraoperative management.CONCLUSION: The majority of nonmetallic IOFBs are organic and often remain in the superior, medial, and inferior areas of the orbit. Clinical manifestations vary owing to their different textures. CT and MRI facilitate the identification of foreign body materials. Plant-derived foreign bodies should be completely removed, and surgical treatment is a complicated process.     

综合心理干预治疗糜烂型扁平苔藓的临床研究

目的:观察心理干预治疗口腔扁平苔藓(OLP)的临床疗效。方法:选择糜烂型OLP患者72例,随机分为对照组和干预组各36例,对照组给予单纯曲安奈德注射液、利多卡因局部封闭治疗,干预组在此基础上给予心理干预。结果:干预组病例糜烂面积控制和临床症状缓解的总有效率明显高于对照组(P<0.05),且1年后复查,干预组复发率明显低于对照组(P<0.05)。结论:心理干预治疗能有效改善糜烂型OLP不良状况,增强药效,从而缩短治疗时间,有效控制远期的复发,对OLP的最终治疗效果有促进作用。