Ankle Fractures: Supination-Eversion Fractures Stage II Primary and Late Results of Operative and Non-Operative Treatment

Sixty-nine patients with stage II supination-eversion fractures of the ankle, 34 treated by operation and 35 treated conservatively, were seen at follow-up after 3–10 years. There was no statistically significant difference between the results of the two methods. However, larger series and perhaps a longer observation time are probably needed to decide whether the displacement of the lateral malleolus as a result of non-operative treatment affords the same possibility of unhindered ankle function as union of the lateral malleolus in the anatomical position obtained by operation.     

Effect of an impaired oral stage on swallowing in patients with Parkinson's disease

We investigated the swallowing function in patients with Parkinson's disease (PD) using deteriorated tongue control because patients with PD frequently exhibit an impaired oral stage of swallowing and the tongue movement affects oral and pharyngeal stage. In total, 201 patients with PD (106 men, 95 women; mean age 70·6 ± 8·0 years; median Hoehn‐Yahr Stage III) were studied. The patients swallowed 10 mL of liquid barium under videofluorography, and their oral transit time (OTT) was measured. Based on 20 healthy controls (mean age 70·3 ± 7·8 years) with an OTT + 2 standard deviation (0·89 + 2 × 0·46) of 1·81 s, the patients with PD were divided into 167 patients with an OTT < 1·81 s and 34 patients with an OTT ≥ 1·81 s. Swallowing function was compared between the groups and assessed using logistic regression analysis. The following factors were significantly associated with oral stage impairment in both groups: tongue‐to‐palate contact, tongue root‐to‐posterior pharyngeal wall contact, premature spillage into the pharynx, aspiration and onset of swallowing reflex. Logistic regression analysis showed that tongue root‐to‐posterior pharyngeal wall contact, onset of swallowing reflex and aspiration were independent factors. PD patients with prolonged OTT displayed poor lingual control and decreased range of motion of the tongue due to bradykinesia and rigidity. Such problems in the oral stage affected the subsequent pharyngeal stage of swallowing with aspiration. Lingual movement in the oral stage thus appears to play an important role in the sequential movement of swallowing in PD.     

早期乳腺癌保乳手术临床疗效观察

目的探讨早期乳腺癌保乳手术的临床疗效、美容效果和不良反应的发生情况。方法回顾性分析阜阳市人民医院自2009年5月至2011年5月,确诊为早期乳腺癌患者57例的临床资料,其中保乳手术组(27例)采用保乳手术,改良手术组(30例)采用改良根治术。全部患者均给予患侧全腋窝淋巴结清扫术。结果在近期手术并发症、无病生存分析中,两组比较差异无统计学意义(P>0.05)。但保乳手术组美容效果评价优的患者(22/27,81.5%)显著优于改良手术组,且评价手术近期疗效,两组比较差异有统计学意义(P<0.05)。结论保乳手术组的近期不良反应、无病生存时间与改良手术组相似,但美容评价显著优于改良手术组。     

中医药不同时机介入治疗脑梗死急性期

目的探讨中医药对脑梗死急性期患者不同时机介入治疗的疗效。方法在脑梗死急性期患者常规治疗的基础上,采用中医药介入疗法,时间点选择在治疗的第1、3、5、7天,利用美国国立卫生研究院卒中量表及日常生活活动量表(Brathel指数)等方法分析其临床疗效。结果Ⅲ组(第3天)介入中医药治疗总有效率为95.0%,优于其他各组。结论第3天介入中医药治疗效果最为明显,是相对平衡的介入时间点。     

癌症晚期患者丧亲者哀伤反应的质性研究

目的研究癌症晚期患者丧亲者的哀伤反应。方法 2014年6-8月,采用目的性抽样法选取在深圳市人民医院宁养院的15例晚期癌症患者的亲属为研究对象,对其进行深度访谈,采用Colaizzi的7步分析法进行分析、整理并提炼主题。结果癌症晚期患者丧亲个体的哀伤反应主要表现在身体、心理、社会和灵性方面。结论癌症晚期患者丧亲者经历艰难的心理历程,丧子、丧偶和丧亲的哀伤反应存在差异,护理人员应了解丧亲者的需求,帮助丧亲者建立积极的应对方式。