彩色多普勒超声诊断卵巢肿瘤蒂扭转的临床意义

目的：探讨彩色多普勒超声诊断卵巢肿瘤蒂扭转的临床意义。方法方便选取2012―2015年该院收治的58例疑似卵巢肿瘤蒂扭转患者作为观察目标，入选病例均应用彩色多普勒超声进行检查，并将检查结果同术后病理检查结果进行比较。结果58例患者中，术后病理证实卵巢肿瘤蒂扭转者51例，彩色多普勒超声共确诊49例，检查准确率为96.1%；囊壁增厚、腹腔或盆腔积液、可见混合型团块是卵巢肿瘤蒂扭转的主要彩超表现。结论卵巢肿瘤蒂扭转应用彩色多普勒超声诊断，可显著提高诊断准确率，具有积极的临床使用和推广价值。     

中西医结合治疗动眼神经麻痹疗效观察

目的了解中西医结合法治疗动眼神经麻痹的临床疗效。方法对我院2012-03—2014-03收治的动眼神经麻痹患者进行抽样,择取74例患者随机分成2组,对照组予以基础性西医疗法,实验组在对照组治疗基础上予以中医疗法(包括针刺及服用中药正容汤等),观察2组患者的临床治疗效果。结果实验组总有效率(94.60%)明显高于对照组(64.86%),差异具有统计学意义(P0.05)。结论中西医结合法治疗动眼神经麻痹临床疗效确切,安全系数高,值得临床大力推广使用。     

Gender,race and socioeconomic influence on diagnosis and treatment of thyroid disorders in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

Thyroid diseases are common, and use of levothyroxine is increasing worldwide. We investigated the influence of gender, race and socioeconomic status on the diagnosis and treatment of thyroid disorders using data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), a multicenter cohort study of civil servants (35-74 years of age) from six Brazilian cities. Diagnosis of thyroid dysfunction was by thyrotropin (TSH), and free thyroxine (FT4) if TSH was altered, and the use of specific medications. Multivariate logistic regression models were constructed using overt hyperthyroidism/hypothyroidism and levothyroxine use as dependent variables and sociodemographic characteristics as independent variables. The frequencies of overt hyper- and hypothyroidism were 0.7 and 7.4%, respectively. Using whites as the reference ethnicity, brown, and black race were protective for overt hypothyroidism (OR=0.76, 95%CI=0.64-0.89, and OR=0.53, 95%CI=0.43-0.67, respectively, and black race was associated with overt hyperthyroidism (OR=1.82, 95%CI=1.06-3.11). Frequency of hypothyroidism treatment was higher in women, browns, highly educated participants and those with high net family incomes. After multivariate adjustment, levothyroxine use was associated with female gender (OR=6.06, 95%CI=3.19-11.49) and high net family income (OR=3.23, 95%CI=1.02-10.23). Frequency of hyperthyroidism treatment was higher in older than in younger individuals. Sociodemographic factors strongly influenced the diagnosis and treatment of thyroid disorders, including the use of levothyroxine.     

A biological or a synthetic mesh in immediate breast reconstruction? A cohort-study of long-term Health related Quality of Life (HrQoL)

ObjectivesMeshes/matrices are commonly used in immediate breast reconstruction. There are few studies comparing biological and synthetic meshes and it is unknown what type of mesh gives the best long-term results. The aim of this study was to compare long-term health-related quality of life (HrQoL) and patient satisfaction in implant-based immediate breast reconstruction with a biological mesh (Surgisis®) with that of patients reconstructed with a synthetic mesh (TIGR ® Matrix Surgical Mesh).Material and methodsBoth cohorts were prospectively included and consecutively operated. Clinical data was collected. HrQoL was evaluated with EuroQoL-5 dimension – 3 levels questionnaire (EQ-5D-3L) and the Hospital Anxiety and Depression Scale (HADS) and the Breast-Q.Results and conclusionSeventy-one patients were operated on in the biological group and 49 in the synthetic group. The response rates were 75 and 84 per cent, respectively. Mean follow-up time was 74 months and 23 months, respectively. There were no statistical differences in satisfaction and quality of life between the two groups. Complications and radiation seem to lead to a lower satisfaction. Our findings could indicate that biological and synthetic meshes give an equal long-term result as regards patients’ perceived quality of life.     

基于复杂网络技术对电针治疗乳腺增生病处方分析

目的基于复杂网络技术分析电针治疗乳腺增生病的核心穴位及配伍穴相关性,并对电针波型进行探讨。方法检索中国期刊全文数据库(CNKI)、万方数据库、维普网数据库(VIP)中从1954年1月1日到2018年12月31日公开发表的电针治疗乳腺增生病的临床中文文献,利用Excel表格工具建立电针治疗乳腺增生病数据库,利用Matlab2014a软件进行节点中心性分析和聚类分析,利用Gephi0.9.1软件制作复杂网络示意图对分析结果进行描述和展示,利用Excel表格工具制作电针治疗乳腺增生病不同波形比例饼状图并分析其规律。结果选定43条电针处方:电针治疗乳腺增生病主穴核心度前三位依次为膻中穴、足三里、肩井穴;配伍穴位核心度前三位依次为太冲穴、太溪穴、脾俞穴;经络核心度前三位依次为足阳明胃经、任脉、足少阳胆经。配伍穴位相关性分析中,相关性频度前三位组合依次为太冲穴-太溪穴、太冲穴-肾俞穴、太冲穴-三阴交。电针波形中以连续波与疏密波常见,均具有较高的临床应用价值。结论电针治疗乳腺增生病处方以足阳明胃经为最多,其次为任脉;电针波型以连续波为主。