ARRIF-Ⅲ型的研制、生物力学测试及临床初步应用

目的　研制一种新型腰椎滑脱复位内固定器 ,在此内固定器固定后 ,能方便地平行置入两枚BAK ;同时测试RF Ⅱ型及ARRIF Ⅲ型的生物力学特点。方法　使用对照法 ,10具健康成年人腰2 ～骶2 椎体标本 ,制成腰椎滑脱模型 ,用生物力学测试机测试RF Ⅱ型及ARRIF Ⅲ型固定后的脊柱标本复合物的应力遮挡及应力 应变。结果　 30 0 0N轴向载荷下及 2 0Nm前屈与侧弯力矩下RF Ⅱ型和ARRIF Ⅲ型的应力遮挡及应力 应变均有显著差异 ,但其绝对值较小。ARRIF Ⅲ型的临床初步应用取得了满意的效果。结论　两种内固定器的固定效果均较好 ,但RF Ⅱ型在固定后的即刻 ,有较显著的微动 ;ARRIF Ⅲ型在复位固定后可较方便地同时置入两枚BAK。ARRIF Ⅲ型可用于Ⅰ°～Ⅲ°的椎体滑脱症的复位与固定     

关节镜技术的历史与新进展

现代的关节镜从膀胱镜演变而来，创伤小，适用广泛。近年膝关节镜技术在半月板病变处理上有逆行全切法等新方法，交叉韧带重建、软骨移植成为研究热点；关节镜技术除应用于肩关节及其它小间隙关节，还开展治疗弹响髓等关节外应用；个性化康复锻炼提高了手术疗效。     

冠心病患者体外反搏后心功能改变

应用体外反搏治疗33例冠心病患者,治疗前后进行心功能检查比较,结果是肺水指数下降4.19％(P<0.05),心室射血时间增加7.74％(P<0.05),射血流速指数增加5.39％(P>0.05),系统血管阻抗降低16.97％(P<0.001),心排量增加10％(P<0.01),心搏量增加13.32％(P<0.01),心率减慢6.66％(P<0.05),心搏指数增加13.23％(P<0.05),心脏指数增加10.63％(P<0.01),说明心功能检查有较好改善。     

Termination Of Sustained Tachycardia By External Noninvasive Pacing

Invasive cardiac pacing has proved useful in the induction and termination of reentrant sustained tachycardias. In one of our two cases, programmed ventricular extra-stimulation was used to induce sustained ventricular tachycardia from the endocardial surface of the right ventricle. Induced ventricular tachycardia was terminated by burst ventricular pacing with an external cardiac pacemaker. In our second patient, external pacing was effective at inducing and terminating sustained supraventricular tachycardia. These patients illustrate that the principles of terminating sustained reentrant tachycardia with invasive pacing may also apply to noninvasive external pacing. The usefulness of this approach in treating reentrant tachycardias needs further evaluation.     

Study on Tongkuaixiao Babu plaster in treating cancer pain

Objective: To explore the efficacy of Tongkuaixiao Babu plaster (TKXBBP) in treating cancer pain.Methods: In the clinical observation, sixty-five patients with moderate or severe cancer pain were randomly divided into two groups: 32 in the treated group (TKXBBP group) and 33 in the control group (Bucinnazine group). The therapeutic effects in relieving pain, improving quality of life (QOL), and the rate of satisfaction the patients felt of the two groups were compared respectively. Results: TKXBBP was effective in treating cancer pain. There wasn’t any statistically significant difference in total effective rate (P>0.05), but the statistical difference was significant in obvious remission rate (P<0.05) between the treated and control group, and the effect on serious pain shown in the treated group was better than that of the control group (P<0. 05). The difference in the initiation time of relieving cancer pain was insignificant (P>0.05), while in the remission period, the treated group showed its treatment was obviously superior to that of the control group (P<0.05). TKXBBP showed better effect in the improvement of QOL (P<0.05) and satisfaction rate, with significant difference between the treated and the control groups (P<0.01).Conclusion: TKXBBPs effect in treating cancer pain was obvious, its application was safe and convenient. It was shown that the external treatment with this kind of Chinese medicine had great advantage in treating cancer pain.     

胫腓骨下段开放性粉碎骨折的治疗(附20例临床报告)

目的探讨胫腓骨下段开放性粉碎骨折的综合治疗。方法20例胫腓骨下段开放性粉碎骨折采用半环槽式外固定器固定、皮瓣转移、腓骨内移、骨折端加压并同期行上干骺端骨延长等综合治疗方法。结果伤口均一期愈合，所有皮瓣均成活，骨折临床愈合平均时间19周，7例因严重骨缺损经骨折端加压并同期行上干骺端骨延长后肢体均恢复正常长度。无1例针眼感染和血管、神经损伤。临床优良率为90％(18／20)。结论a)半环槽外固定器能克服胫腓骨下段开放性粉碎骨折的治疗困难，具有立体均衡固定。刚性可调，避免肢体受压。便于再次创面处理以及同期行骨折端加压和肢体延长等优点。b)半环槽式外固定器结合皮瓣转移、腓骨内移以及骨折端加压并同期行上干骺端骨延长等综合治疗方法是胫腓骨下段开放性粉碎骨折可选择的较好治疗措施之一。     

一次手术治愈外直肌全麻痹

过去，为了保证前段的血液供应，外直肌全麻痹的手术治疗要分２～３次完成，考虑到全麻痹的外直肌已无功能，我们提出在这种条件下可以不动含睫状前动脉的外直肌，只退后内直肌和将上，下直肌的外侧１／２移到外直肌的附着处，如此安排，可以一次手术完成治疗，这样可以缩短治疗时间，减少病人的痛苦和负担，我们治疗了７例８眼，结果比较满意。     

Cervifix颈椎后路杆固定系统垂直水平悬吊改良单开门椎管成形术

目的:评价Cervifix固定垂直水平悬吊改良单开门椎管成形术的疗效。方法:35例颈椎病患者,男23例,女12例;年龄47~68岁,平均56·4岁;34例为脊髓型颈椎病,1例为颈椎术后翻修;椎管矢状径4·6~9·3mm;椎管矢状面狭窄率达39%~84%,平均49·3%;减压节段C3-C59例,C3-C620例,C4-C76例。常规行后正中入路单开门椎管成形术,在所减压的节段侧块上Cervifix固定,采用Roy-Camille置入侧块螺钉。先用磨钻在所减压节段的棘突根部开预穿孔,开门后穿粗丝线于Cervifix的纵连杆拉紧并打结,行水平方向固定。垂直方向在开门侧的椎板上打预穿孔,用“斜拉桥”原理悬吊于临近未减压的棘突上加固。使椎板保持在开门状态。术后颈围领保护3个月。结果:35例平均随访15个月(7~18个月)。术前JOA评分平均8·0分,术后平均15·7分。术后3个月复查CT及X线片未见螺钉松动和再关门现象。仅有3例诉颈部有僵硬感,局部无疼痛。肌电图及体感诱发电位、感觉运动传导速度基本接近正常。6个月后僵硬感基本消失。结论:Cervifix固定垂直水平悬吊改良单开门椎管成形术操作简单、安全,维持开门效果好。术后患者颈部症状恢复快、效果满意,是治疗多节段颈椎病及颈椎管狭窄症的一种有效可行的方法。     

健脾疏肝利水法为主内外合治恶性腹腔积液

观察健脾疏肝利水为主的中医药内服外敷治疗恶性腹腔积液的疗效。设治疗组 3 8例采用内服中药加中药外敷腹部 ,配服西药利尿剂。对照组 2 7例 ,常规服西药利尿剂及对症治疗 ,疗程均为 1个月。结果 :治疗组有效率为65 7% ,对照组有效率为 48 1% (P <0 0 5 )。生存期 6个月以上、1年以上者 :治疗组分别为 12例、4例 ,对照组为 5例、0例。提示以中医药内外合治为主对恶性腹腔积液疗效明显高于单纯用西药利尿剂