医疗损害纠纷处理机制存在问题及解决措施

目的分析云南省医疗损害纠纷处理机制存在的问题，提出解决方略。方法对云南省2001～2007年的医疗损害纠纷情况进行分析，剖析现有处理机制存在的问题以及由此带来的社会问题。结果提出处理医疗损害纠纷的解决方案。结论医疗损害纠纷是社会问题，应当从社会管理的高度建立医疗损害处理机制。     

结肠损伤的一期手术治疗（附30例临床分析）

目的 探讨结肠损伤的术式。方法 30例结肠损伤均行一期手术，其中缝合修补25例，结肠切除5例。结果 术后并发肠瘘1例，切口感染3例，并发症发生率13．3％。经抗炎、引流、支持等治疗均痊愈。结论 只要严格掌握适应症，结肠损伤一期手术治疗是一种可行的手术方法。     

阴茎折断9例报告

目的 提高阴茎折断的诊治水平。方法 报告阴茎折断9例,并结合文献对其发病机理、病理、诊断和治疗进行讨论。结果 9例均采用纵形小切口行阴茎血肿清除加白膜修补术。随访8例,失访1例,随访时间3～96个月,1例阴茎勃起时轻度弯曲,但不影响性交,7例阴茎无弯曲、硬结,性功能正常。结论 阴茎折断手术疗效满意,应尽早手术治疗。纵形小切口手术简单,创伤小,适于临床应用。     

Edaravone effects on the expression levels of collagen type i and iv after spinal cord injury in rats北大核心

BACKGROUND: Edaravone, an effective free radical scavenger, has been reported to significantly improve the rehabilitation of limb locomotion after spinal cord injury (SCI), but the underlying mechanism remains unclear. OBJECTIVE: To explore the mechanism underlying edaravone promoting the recovery of limb locomotion in rats with SCI by observing the Basso, Beattie, Bresnahan scores and expression levels of collagen type I and IV. METHODS: Thirty-six rats were randomly allocated into three groups (n=12 per group): sham group (laminectomy plus intraperitoneal injection of normal saline), model group (SCI model by NYU impactor plus intraperitoneal injection of normal saline), and edaravone group (SCI model by NYU impactor plus intraperitoneal injection of edaravone). All rats were given the administration at the 1st day post-SCI for consecutive 7 days. The Basso, Beattie, Bresnahan scores were tested at 1, 3, 5 and 7 days post treatment. On day 7, all rats were sacrificed to remove the spinal cord, and the morphology of neurons in the spinal cord were observed by Nissl staining; the expression levels of collagen type I and IV were detected by immunohistochemistry and western blot assays. RESULTS AND CONCLUSION: Compared with the model group, the Basso, Beattie, Bresnahan scores in the edaravone group were significantly increased at day 5 post treatment (P < 0.05). Nissl staining showed a clear boundary between grey matter and white matter, and a large nucleolus in the neurocytoplasm in the sham group; there was a complete structure of neurons, slight cellular swelling and small hematoma area in the edaravone group; many and large cavitations and swollen nucleus were found in the neurons, even without nucleolus. Immunohistochemistry and western blot assay results showed that the expression levels of collagen type I and IV in the edaravone group were significantly higher than those in the model group (P < 0.05). These results indicate that edaravone can promote the recovery of limb locomotion of rats with SCI, probably via up-regulating the expression levels of collagen type I and IV. © 2018, Journal of Clinical Rehabilitative Tissue Engineering Research. All rights reserved.     

Abordaje y manejo de las lesiones retroperitoneales traumáticas

Traumatic retroperitoneal injuries constitute a challenge for trauma surgeons. They usually occur in the context of a trauma patient with multiple associated injuries, in whom invasive procedures have an important role in the diagnosis of these injuries. The retroperitoneum is the anatomical region with the highest mortality rates, therefore early diagnosis and treatment of these lesions acquire special relevance. The aim of this study is to present current published scientific evidence regarding incidence, mechanism of injury, diagnostic methods and treatment through a review of the international literature from the last 70 years. In conclusion, this systematic review showed an increasing trend towards non-surgical management of retroperitoneal injuries.     

延红胶囊治疗跌打损伤的药效学实验研究

目的:观察延红胶囊治疗大鼠跌打损伤的疗效。方法:击打致大鼠局部血瘀实验观察病理组织学变化;检测血瘀大鼠血流变学指标;二甲苯致小鼠耳肿胀实验观察耳肿胀率变化;醋酸所致小鼠扭体实验观察对扭体次数的影响。结果:延红胶囊能改善击打致大鼠局部血瘀的体表淤血和水肿症状(P<0.05);能恢复大鼠肌纤维损伤,减少间质水肿;能显著降低血瘀模型大鼠的高、中、低切变率全血黏度、血浆黏度(P<0.05),对血流变学指标有显著的改善作用;能降低二甲苯致小鼠的耳肿胀率(P<0.05);能减少醋酸致小鼠的扭体次数(P<0.05)。结论:延红胶囊具有一定的行气活血散瘀、抗炎、止痛作用。     

软组织内热治疗针体外温度变化的特点分析

目的研究软组织内热治疗针在体外的温度分布特点,为进一步研究其在体内温度分布打下基础。方法使用数字测温仪测量软组织内热治疗针在设定42％、50％、60％、80％下加热5min、10min、15min、20min时从针尖至针体末端每隔2cm处的温度。结果内热针针身温度分布分3段：针尖温度中等,距针尖2—6cm段温度较高,距针尖10cm到针体末端段温度较低。针尖到针身8cm段温度差别较小,与设定加热温度接近。针尖温度比设定加热温度低1-2℃。针身温度随加热时间的变化波动不明显。结论软组织内热治疗针在体外加热过程中,针身温度容易控制,稳定性好,针尖温度与设定温度接近。     

脑外伤后综合征患者生活质量及相关心理因素分析

目的探讨脑外伤后综合征患者的生活质量和相关心理因素。方法对2008年12月-2009年10月我院门诊32例脑外伤后综合征患者进行健康状况问卷（SF-36）、抑郁自评量表（SDS）、焦虑自评量表（SAS）调查。结果PCS组各维度的分值明显低于对照组（P〈0.05）,PCS组的焦虑、抑郁评分明显高于对照组（P〈0.05）,除躯体疼痛、精力维度外,余各维度分值与SDS评分负相关,各维度中只有生理机能和一般健康状况两项和SAS评分负相关（P〈0.05）。结论脑外伤后综合征患者生活质量低于一般水平,抑郁、焦虑评分越高,生活质量越低。     

Diagnosis of blunt traumatic aortic injury 2007: still a nemesis

In recent years, the use of multidetector computed tomography (MDCT) for the diagnosis of acute thoracic injury in blunt trauma has expanded. MDCT has shown high accuracy for the diagnosis or exclusion of injury to the aorta and its primary branches, decreasing the need for thoracic angiography and allowing earlier treatment of this often rapidly fatal lesion. With increasing use of MDCT, more subtle injuries and variants of vascular anatomy are being recognized that create pitfalls in the diagnosis. Of perhaps more concern is the recognition that aortic injury can occur with little or no associated mediastinal hematoma, the principle chest radiographic finding indicating a need for further imaging. The importance of recognizing unusual sites of aortic injury, congenital variants of mediastinal anatomy, the precise extent of injury, and the anatomic pathology present as key factors in deciding among treatment options is emphasized.     

Impingement syndromes of the ankle

Ankle impingement syndromes are categorised according to their anatomical site around the tibiotalar joint. Anterolateral, anterior and posterior ankle impingement has been extensively described in the orthopaedic and radiology literature with more recent studies describing posteromedial and anteromedial impingement. This article aims to demonstrate the potential spectrum of imaging findings for each ankle impingement syndrome as well as the relative contributions of ultrasound and MR imaging for diagnosis and image-guided treatment.