股骨颈骨折几种闭合复位方法的评价(译文)

在股骨颈移位骨折的治疗中,试用了7种不同的闭合复位方法。其中Whitman's法在骨折床台上进行,正常肢体外展,患肢由屈曲牵引至完全伸直位后,维持牵引并外展到与对侧肢体相称位,单髋人字石膏外固定(1914年)。 Leadbetter's法也在骨折床台上进行。将患肢髋部屈曲90°,沿大腿轴线行手法牵引。同时股骨干稍内收,患肢缓慢行环形活动至外展、内旋位,患肢向下降至骨折床台面时,行跟掌试验以验证是否完全复位(1933年)。 Bozan's法利用骨折床台使双下肢维持在伸直位,大绷带放置在患肢髂嵴部位,小绷带放置在患肢腹股沟皱襞最高点处实施牵引。然后整个患肢极度内旋,在维持侧方牵引的同时,患肢外展并轻度过牵(1934年)。     

自杀基因联合中医药疗法治疗肿瘤的设想

自杀基因疗法是一种具有良好应用前景的肿瘤治疗新措施。但如何有效提高疗效是目前仍须解决的关键性问题。由于免疫机制在自杀基因疗法旁杀伤效应中的重要作用，激活荷瘤机体的免疫功能，改善自杀基因抗肿瘤作用的炎症免疫微环境，是提高肿瘤自杀基因疗法疗效的主要策略。中医中药在调节机体免疫状态方面具有肯定的作用，与其他方法比较具有明显优势。因而，将自杀基因疗法与中医中药联合应用，有可能起到提高肿瘤自杀基因疗法疗效，防止肿瘤复发的作用。提出了自杀基因联合中医药疗法治疗肿瘤的新设想，为肿瘤基因治疗提供了一种新的思路和模式。     

穴位敷贴对哮喘豚鼠引喘潜伏期及肺组织病理变化的影响

【目的】从微观病理探讨穴位敷贴治疗哮喘的机制。【方法】采用随机对照的研究方案 ,以自制敷贴方敷贴实验性哮喘模型颈背“穴位”。敷贴方由麻黄、细辛、甘遂、延胡、附片、防风、五味子、白芥子组成。【结果】从第 6天开始 ,贴药组点头呼吸的潜伏时间明显延长 ,与哮喘组比较差异有显著性 (P <0 .0 5) ;从第 9天始穴位敷贴组豚鼠发生点头呼吸的频度明显减少 ,与哮喘组比较差异有显著性 (P <0 .0 1) ;且贴药组有降低豚鼠炎性渗出及嗜酸性粒细胞数的作用 (与哮喘组比均P <0 .0 5)。【结论】提示穴位敷贴治疗哮喘可能是通过延长哮喘发作的潜伏期 ,减小哮喘发作的频度 ,减少肺组织水肿、渗出 ,降低嗜酸性粒细胞的肺系局部浸润而实现的。     

HNE1细胞株光动力学治疗前后形态学的动态变化

目的 探讨体外光动力学治疗（ＰＤＴ）引起鼻咽癌（ＮＰＣ）细胞死亡的作用机制。方法对鼻咽癌细胞株ＨＮＥ１体外光动力学治疗前后形态学变化进行动态观察。结果 对照组ＨＮＥ１细胞培养３ｈ,６ｈ,１２ｈ,２４ｈ和４８ｈ后细胞形态与正常培养组ＨＮＥ１细包开始变形皱缩,细胞界限模糊,细胞透光度和立体感较差,治疗２４～４８ｈ后细胞发生凋亡。结论 体外光动力学治疗对ＨＮＥ１具有明显的杀伤效应并ＨＮＥ１细胞凋亡。ＰＤ     

穴位注射加贴敷治疗乳腺增生的临床研究

97例患者随机分为穴位注射组 (31例 )、穴位贴敷组 (35例 )、穴位注射加贴敷组 (31例 )进行临床观察。结果穴位注射组与穴位贴敷组疗效相似 (P>0 .0 5 ) ,而穴位注射加贴敷组疗效明显优于单纯穴位注射组及穴位贴敷组 (P<0 .0 5 )。由此说明 ,穴位注射加贴敷这一综合疗法治疗乳腺增生病具有效佳、副作用小、取穴少、疗程短等优点。此外还证实这一疗法对卵巢激素有一定的影响。     

木村病临床分析

木村病(Kimura's disease,KD)又称嗜伊红增多性淋巴肉芽肿,是一种罕见的慢性进行性免疫炎性疾病,近年来我科共收治3例,现报告如下.     

中医整体排毒疗法对终末期肾功能衰竭的治疗作用

[目的]观察张琪“保元降浊八法”等中医整体排毒疗法对终末期肾功能衰竭(简称肾衰)的治疗作用及对其预后影响。[方法]对肾小球滤过率小于10 mL/min、未进行维持性透析的终末期肾衰患者32例采用中医整体排毒疗法,包括口服中药汤剂、口服中药制剂、中药结肠透析以及对症处理和必要时给予临时透析治疗。观察患者存活情况、中医征候和证型变化情况,检测患者的血生化等指标,并对其中尚存活者与已死亡病例进行对比分析。[结果]终末期肾衰患者未能进行透析等替代治疗者,中医证侯属本虚标实、寒热错杂,病变过程中其证候不断发生改变。经中医整体排毒疗法治疗后,患者3个月存活率为90.6％,半年存活率81.3％,1年存活率71.9％。将其中尚存活病例(存活组)和已病死病例(死亡组)比较,两组年龄、病程、血清肌酐、尿素氮、血红蛋白均无显著性差异(P>0.05),但存活组尿量多于死亡组(P<0.01),血清白蛋白也较高(P<0.05)。[结论]中医整体排毒疗法对于因经济等原因不能接受维持性透析的终末期肾衰患者仍有改善临床症状,稳定血肌酐、尿素氮、血红蛋白、血清白蛋白等作用,是维持终末期患者继续生存的有效疗法;终末期患者的尿量、血清白蛋白水平与能否长期存活有一定的关系。如能有意识地改善这类患者的尿量和营养状况,对延长他们     

Review: Bioresorbable polymeric stents: current status and future promise

Metal stents and, more recently, polymer-coated metal stents are used to stabilize dissections, eliminate vessel recoil, and guide remodeling after balloon angioplasty and other treatments for arterial disease. Bioresorbable polymeric stents are being developed to improve the biocompatibility and the drug reservoir capacity of metal stents, and to offer a transient alternative to the permanent metallic stent implant. Following a brief review of metal stent technology, the emerging class of expandable, bioresorbable polymeric stents is described, with emphasis on developments in the authors' laboratory.     

A Review of Laser Technology and Light-Tissue Interactions as a Background to Therapeutic Applications of Low Intensity Lasers and Other Light Sources

Abstract

This paper reviews aspects of laser physics, radiometry and photochemistry relevant to the use of low intensity light therapy delivered by lasers or conventional lamps. Current theories regarding the biophysical mechanisms of low intensity laser therapy are reviewed. Characteristics of laser radiation such as monochromaticity, coherence, collimation, speckle, beam profile, penetration depth and temporal modulation of irradiation, and the relevance of these factors to photon propagation are explained. Physical principles that describe light–tissue interactions are presented. The importance of irradiance and radiant exposure is discussed and methods of quantifying these values are shown. Clinical implications are briefly discussed.     

Ethics knowledge in physical therapy: a narrative review of the literature since 2000

Abstract

Objective: The purpose of this narrative review is to assess current physical therapy ethics knowledge by synthesizing literature published since 2000.

Method: This review builds on an earlier analysis.6 A rigorous search of major databases (including Medline, CINAHL, and PubMed) was conducted using specific keywords and explicit inclusion and exclusion criteria. The final review included 27 peer-reviewed articles and three editorials/lectures.

Results: Four themes of papers were identified that focused on (1) development of physical therapy ethics knowledge, (2) ethical issues related to conducting research, (3) how ethical issues are identified and managed and how ethical practice is taught, and (4) development of theoretical ethical decision-making models.

Discussion: The literature reflects a steady growth in interest in physical therapy ethics. Some 'gaps' in knowledge have been addressed but others have not, such as the impact of the institutional environment and cultural dimensions of practice on ethical reasoning. Research studies, using mostly qualitative approaches, identify similar issues but a synthesis of the findings is made difficult by lack of consistency in purpose and study design. While inclusion of ethics content in physical therapy curricula is recommended, little is known about how this is currently being achieved. Ethical theories are poorly integrated into the discussion of ethics in practice.

Conclusion: This review reveals the continuing need to ensure the development of physical therapy ethical knowledge by consistently incorporating both ethical theories and practice knowledge in education curricula and establishing a rigorous research agenda that accurately reflects the unique and multidimensional nature of clinical practice.