壮医针挑并艾灸治疗糖尿病周围神经病变临床观察

目的：观察壮医针挑并艾灸对糖尿病周围神经病变200例的疗效。方法：取龙路、火路网络在体表的反应穴或皮下反应点，每次选2～3个穴位，持针尖快速刺入皮肤0．1～0．2cm，绞断表皮少许纤维，尽量不出血，每3天1次，配合艾灸，10次为1疗程。结果：显效102例，有效78例，无效20例。总有效率为90％。结论：壮医针挑并艾灸治疗糖尿病周围神经病变疗效仍显著。     

核桃仁泥外敷治疗肌肉注射后皮下硬结的疗效观察

采用核桃仁泥外敷治疗１３８例（实验组）肌肉注射后皮下硬结，并与４０例（对照组）采用新鲜土豆片外敷硬结法比较。结果表明：实验组患者治疗１５天后Ⅰ度和Ⅱ度硬结治愈率分别为８１．１３％和４２．２５％，总有效率达９２．０３％，明显优于对照组（Ｐ＜０．００１）。     

The “Biplanar” forehead lift

A new technique of forehead rhytidectomy is presented that combines the best features of the coronal incision with those of the anterior hairline incision. The plane of dissection is formed by an anterior subcutaneous plane dissecting a lateral subgaleal plane. This approach is particularly valuable in patients with high foreheads, severe static wrinkling, and asymmetrical eyebrows.Presented in part at the Annual Meeting of the American Society of Aesthetic Plastic Surgeons, Boston, MA, 1984     

止血带致皮下出血并休克的不良反应1例报告

患者,男,64岁,以“左手掌皮下条索状硬结10年,加重伴小指屈曲畸形1年”于2005年12月6日入院。查:左手掌第五掌指关节处皮肤皱褶,皮下一纵行挛缩带如弓弦样感,使第五掌指关节呈屈曲90°位畸形,严重影响功能和外观。诊断为左手掌腱膜挛缩症。无高血压、冠心病及糖尿病史,心电图正常,肝肾功能、血常规和血凝化验均在正常范围,于12月8日在臂丛麻醉下行掌腱膜松解切除植皮手术。常规应用电子气囊止血带,压力40kPa,定时60min,手术切开皮肤后即发现止血带失用,出血明显,约在止血带使用6min时,患者述疲乏不适,继而突然出现心率减慢(48次/min),血压下降(60/48mmHg)。麻醉师考虑与使用     

Altered chromatin landscape in circulating T follicular helper and regulatory cells following grass pollen subcutaneous and sublingual immunotherapy

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Visceral fat is associated with high-grade complications in patients undergoing minimally invasive partial nephrectomy for small renal masses

Introduction:Minimally invasive partial nephrectomy is standard of care treatment for small renal masses.Objective:We evaluated the relationship between subcutaneous and visceral obesity with high-grade postoperative 30-day complications in patients undergoing minimally invasive partial nephrectomy.Methods:We retrospectively identified 98 patients at our institution from 2014 to 2017 who underwent laparoscopic or robotic-assisted partial nephrectomy due to suspected renal cell carcinoma. Patients were stratified based on presence or absence of high-grade (Clavien ≥ IIIa) 30-day postoperative complications. Means were compared with the independent t test and proportions with chi-square analysis. Multivariate logistic regression was performed to determine independent predictors of high-grade 30-day complications.Results:Mean nephrometry score was 6.7 with 21 (21.4%) patients having hilar tumors. Mean estimation of blood loss was 207 mL, mean operating time was 223 min, and mean warm ischemia time was 23 min. The majority of patients had clear renal cell carcinoma (n = 83, 84.7%) and pT1a disease (n = 76, 77.6%) with negative margins (n = 89, 90.8%) on pathology. There were 5 (5.1%) patients who experienced a high-grade postoperative 30-day complication. Mean visceral fat index was an independent predictor of high-grade 30-day complications (odds ratio: 1.02; 95% confidence interval: 1.002–1.03; p = 0.027).Conclusions:Visceral obesity should be considered as a prognostic indicator of outcomes in patients undergoing surgical treatment for a small renal mass.