针灸联合药物外敷对上热下寒型痤疮患者临床症状及生活质量影响

目的:探讨采用针灸联合药物外敷方案对改善上热下寒型痤疮患者症状,提高其生活质量的作用。方法:选择本院2018年1月~2018年10月收治上热下寒型痤疮患者计110例,随机分为采用自制中药面膜外敷对照组(n=55)与联合针灸方案治疗的实验组(n=55),对比治疗效果。结果:实验组治疗总有效率高于对照组,P<0.05;治疗后体质积分低于对照组,P<0.05;皮损积分低于对照组,P<0.05;DLQI评分低于对照组,P<0.05;复发率低于对照组,P<0.05。结论:对上热下寒型痤疮患者采用针灸联合中药外敷方案治疗疗效理想,可改善体质,减轻皮损,可降低复发率,有利于提高患者的生活质量。     

混合痔微创手术应用套扎器与传统外剥内扎术临床对比分析

目的:探讨混合痔微创手术应用套扎器与传统外剥内扎术临床对比分析。方法:选取2017年3月~2019年3月本院接诊的混合痔行微创手术患者,随机抽取230例,按随机数字表法将其分成观察组115例,对照组115例,观察组患者使用套扎器进行治疗,对照组采用传统外剥内扎术进行治疗。结果:经过治疗后,观察组患者身体恢复快,总有效率达到95%,明显高于对照组,差异有统计学意义(P<0.05)。结论:在混合痔微创手术中,应用套扎器治疗具有较高的研究价值。     

平乐郭氏正骨联合小夹板外固定对老年桡骨远端骨折患者掌倾角及腕关节功能的影响

目的：探讨平乐郭氏正骨联合小夹板外固定对老年桡骨远端骨折（DRF）患者掌倾角及腕关节功能的影响。方法：回顾性分析2019年3月—2022年4月本院收治的103例老年DRF患者的临床资料,根据复位手法的不同分成常规复位组（n=51,常规手法复位）、中医复位组（n=52,平乐郭氏正骨手法复位）,两组复位后均予以小夹板外固定。比较两组腕关节尺偏角、掌倾角、腕关节主动活动度（AROM）及腕关节功能恢复效果。结果：两组腕关节尺偏角、掌倾角均随治疗时间增加而减小（P <0.05）,尺偏角的组间与时点无交互作用（P>0.05）,掌倾角的组间与时点存在交互作用（P <0.05）,其中中医复位组治疗后即刻、6周及12周的尺偏角、掌倾角均明显大于常规复位组（P <0.05）;治疗后12周,两组患侧腕关节背伸、掌屈、旋后时的AROM均大于治疗前,且中医复位组均明显大于常规复位组（P <0.05）;中医复位组腕关节功能恢复优良率为96.15%,明显高于常规复位组的82.35%,差异有统计学意义（P <0.05）。结论：对老年DRF患者实施平乐郭氏正骨联合小夹板外固定治疗,可...     

Proton Beam Therapy – the Challenges of Delivering High-quality Evidence of Clinical Benefit

The use of proton beam therapy (PBT) offers the opportunity to improve greater conformality of radiotherapy treatment delivery in some patients. However, it is associated with a high capital cost and the need to build new dedicated facilities. We discuss how the global radiotherapy community can respond to the challenge of producing high-quality evidence of clinical benefit from PBT in adult patients. In the UK, the National Cancer Research Institute-funded Clinical and Radiotherapy Translational group has established the PBT Clinical Trial Strategy Group. An eight-point framework is described that can assist the development and delivery of high-quality clinical trials.     

Skin CanceR Brachytherapy vs External beam radiation therapy (SCRiBE) meta-analysis

Background and purpose

To compare cosmesis and local recurrence (LR) of definitive external beam radiation therapy (EBRT) vs brachytherapy (BT) for indolent basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) of the skin.

External beam radiation therapy combined with airway stenting leads to better survival in patients with malignant airway obstruction

Background and objective

Malignant airway obstruction (MAO), a common complication of patients with advanced lung cancer, causes debilitating dyspnoea and poor quality of life. Two common interventions used in the treatment of MAO include bronchoscopy with airway stenting and external beam radiotherapy (EBRT). Data are limited regarding their clinical effectiveness and overall effect on survival.

Methods

A retrospective chart review of patients treated with airway stenting and/or EBRT at the Johns Hopkins Hospital for MAO between July 2010 and January 2017 was reviewed. Demographics, performance status, cancer histology, therapeutic intervention and date of death were recorded. Survival was calculated using cox regression analysis.

Results

Of the 606 patients who were treated for MAO, 237 were identified as having MAO and included in the study. Sixty‐eight patients underwent rigid bronchoscopy and stenting, 102 EBRT and 67 a combined approach. Patients who underwent stenting hand an increased hazard ratio (HR) of death in comparison to those who received combination therapy (HR: 2.12, 95% CI: 1.02, 4.39), while there was a trend towards significance in the EBRT alone group in comparison to the combination therapy group (HR: 1.62, 95% CI: 0.93, 2.83).

Conclusion

In this retrospective analysis, combination therapy with stenting and EBRT led to better survival in comparison to stenting or EBRT alone. Prospective cohort trials are needed to confirm these results.

     

赵绍琴教授辨治外感咳嗽经验

外感咳嗽是临床常见病 ,但若辨治不得法 ,往往使病情迁延或变生它症 ,因此虽是小病也应当重视。赵绍琴教授认为 :外感咳嗽的辨治 ,应脉舌色症合参 ,病虽不重 ,调治也应综合考虑 ,其论治颇具特色。本文从“重声痰之辨 ,以明六淫所因 ;舌脉并重 ,以辨病机兼夹 ;立法处方 ,注重因势利导 ;饮食起居 ,也当慎重”等几方面对先生的辨治经验进行了介绍。     

家兔副神经外支及其分支的起始核

实验用真成年家兔15只。(1)HRP注入副神经外文,标记细胞出现在注射侧延髓锥体交叉下端和脊髓C_(1-5)节段,88.9%标记细胞分布在C_(1-4)。标记细胞成群或散在地分布在延髓锥体交叉下端中央管的前外、颈髓前角和中间带的各亚核。标记细胞的最大径在30.9-123.5μm之间,41μm以上的占88.8%。在注射侧的C_1、2、3、脊神经节、迷走神经下节和交感神经颈上节观察到标记细胞。(2)HRP注入斜方肌神经,标记细胞分布在同侧脊髓C_(1-8)节段,标记细胞分布在前角的大多数亚核。(3)在胸锁乳突肌神经近侧断端涂HRP结晶,标记细胞出现在同侧延髓锥体交叉下端和脊髓C_(1-3)节段,标记细胞分布在前角的多数亚核。斜方肌神经和胸锁乳突肌神经起始核在脊髓的位置有较多的重叠。     

慢性进行性眼外肌瘫痪和Kearns-Sayre综合征的线粒体DNA突变分析

目的 探讨慢性进行性眼外肌瘫痪(chronic progressive external ophthalmoplegia，CPEO)和Kearns-Sayre综合征(Kearns—Sayre syndrome，KSS)的线粒体DINA(mitochondrial DNA，mtDNA)突变特点。方法 用Southern印迹方法检测7例CPEO和4例KSS患者的肌肉组织mtDNA，并进一步用聚合酶链反应产物直接测序来明确缺失的具体范围；用聚合酶链反应-限制性内切酶分析法检测有无mtDNA A3243G点突变。结果 发现5例患者(2例CPEO和3例KSS)存在mtDNA的大片段缺失；1例KSS患者存在A3243G点突变。5例大片段缺失的大小及缺失范围各不相同，从3．0～8．0kb不等，缺失型mtDNA占总mtDNA的比例为37．6％～87．0％。聚合酶链反应产物测序表明这5例缺失类型均未见文献报道。结论 与CPEO和KSS患者相关的最常见的mtDNA突变为大片段缺失，A3243G点突变也可在少数患者中检测到。     

Right-sided microtia and conductive hearing loss with variable expressivity in three generations

Familial cases of microtia and meatal atresia are rare, and both dominant and recessive inheritance have been suggested. We here report a family with right-sided external ear malformations and conductive hearing loss in a grandfather, his daughter and granddaughter. The grandfather and the granddaughter both had microtia and meatal atresia, whereas the daughter had a normal outer ear except for a narrow meatus and auricular appendages. The pedigree suggests autosomal dominant inheritance with variable expressivity.