六运会赛艇队损伤分析及推拿治疗评估

浙江赛艇队在六届全运会上共获得金牌3枚、银牌1枚,铜牌2枚,得63分的好成绩。本人作为随队保健医生,完整地记录了运动员损伤情况及推拿治疗资料。现综合分析如下: 一般资料:

心血管内科感染患者临床治疗观察

目的:分析心血管内科感染患者的临床治疗效果。方法:对我院接受临床治疗的114例心血管内科感染患者的临床治疗资料进行全面性分析回顾,总结患者的适应证状态。结果:心血管内科感染的发生率在6%左右,我院接受治疗的114例心血管内科感染患者的感染发生部位以下呼吸道感染为主,其余感染部位为上呼吸道感染、泌尿系统感染以及胃肠道感染等。结论:想要对心血管内科感染患者进行行之有效的治疗控制,就必须对每位患者具体的适应证状态进行准确把握,对于那些已经出现了感染的人员要及时进行用药指导以及重点监控保护工作。

心血管内科感染患者114例临床治疗分析

目的探讨如何有效提高心血管内科感染患者的临床治疗效果,以保证后期能够最大限度的为心血管内科感染患者提供治疗。方法对我院接受临床治疗的114例心血管内科感染患者的临床治疗资料进行全面性分析回顾,总结患者的适应证状态。结果心血管内科感染的发生率在6%左右,我院接受治疗的114例心血管内科感染患者的感染发生部位以下呼吸道感染为主,其余感染部位为上呼吸道感染、泌尿系统感染以及胃肠道感染等。结论想要对心血管内科感染患者进行行之有效的治疗控制,就必须对每位患者具体的适应证状态进行准确把握,对于那些已经出现了感染的人员要及时进行用药指导以及重点监控保护工作。

犬子宫蓄脓的诊断与治疗

犬子宫蓄脓症指犬子宫内膜异常增生和细菌感染,继发子宫体严重肿胀毛细血管通透性增强,产生大量炎性渗出液,导致子宫蓄脓。犬子宫蓄脓多发于发情后2-3个月的未经产犬或屡配不孕的中龄犬、高龄犬,个别的是因为剖腹产后感染所致,且以小型品种的老龄犬居多。该病的病因复杂,临床症状很多。可通过B型超声、X光片来诊断,一经确诊为子宫蓄脓症时,治疗一般以手术为主,摘除子宫、卵巢。

补中益气汤加减治疗亚临床甲状腺功能减退症临床观察

目的:观察补中益气汤加减治疗亚临床甲状腺功能减退症的效果。方法:100例随机分为观察组和对照组各50例,观察组用补中益气汤加减治疗,对照组用优甲乐治疗。结果:观察组TC-Ab、TPO-Ab、FT4、FT3、TSH、中医证候评分、6个月后维持亚临床甲状腺功能减退症、甲状腺功能恢复正常率均优于对照组(P<0.05)。结论:补中益气汤加减治疗亚临床甲状腺功能减退症效果较好。

贝朗Dialog+血液透析机的故障检修

德国贝朗血液透析机由德国贝朗集团生产,该机技术先进、质量可靠、操作方便、使用安全,数据显示为独特的彩色触摸屏控制、图式化显示,所有参数显示在一个屏幕上,信息量大[1-2]。采用QNX操作系统,能够将患者的治疗资料和机器内部设置参数、报警与消毒记录实时保存在硬盘中,医师能随时了解患者的情况,提高了机器的安全性和可维护性[3]。血液透析机可用于各种急、慢性肾衰竭患者的透析治疗[4]。血液透析机液路部件长期处于酸碱、

腰椎间盘术后椎间隙感染原因分析

腰椎间盘突出症手术摘除后继发椎间隙感染,临床上比较少见。为提高手术疗效,减少并发症,本文对我院自1981年1月至1990年12月间共手术治疗资料完整的腰椎间盘突出症378例。

CTL019可完全缓解复发性难治性急性淋巴母细胞白血病

诺华公司新嵌合式抗体受体CTL019的长期临床治疗资料显示,39名儿科复发性难治性急性淋巴母细胞白血病患者中有36名,即92%的患者病情获得完全缓解。急性淋巴母细胞白血病是儿童最常见恶性血液病,在15岁以下癌症患儿中达25%,成年人也可发生。患者骨髓中产生大量异常淋巴细胞,诊断后若不及时治疗,病情可迅速恶化,导致患者在数月内死亡。CTL019使用嵌合式抗体受体技术使患者的T细胞重新编程,以猎杀表达特异CD19蛋白的癌细胞。

近期绝经妇女采用激素替代疗法的决定因素

虽然激素替代疗法(HRT)对绝经后并发症的疗效不容置疑,但欧洲和美国仅少数妇女采用这种疗法。该研究调查了1986名年龄45岁～55岁的法国绝经妇女采用 HRT 疗法的情况,8.1%的妇女目前采用此疗法。采用此疗法的首要决定因素是出生地。出生于法国的妇女采用 HRT

视网膜母细胞瘤患者的视野研究

Objective: To describe the visual field defects in retinobl- astoma survivors and relate those defects to characteristics such as tumor siz e, tumor location, and treatment modality. Methods: Thirty-one patients treated for retinoblastoma were included in this study. Humphrey visual fields were det ermined in 33 eyes. Results: Twenty-seven patients (29 eyes, 68 tumors) had suf ficient diagnosis and treatment data available for further analysis. Twenty-six of the 27 patients had both absolute and relative visual field defects. Four ty pes of visual field defects were observed and correlated with location of the tu mor and therapy to the individual tumors: (1) no residual defect, (2) absolute s cotoma, (3) arcuate and sector scotoma, and (4) "pseudo"-visual field defects caused by relative enophthalmos resulting from radiation. Conclusions: Patients with retinoblastoma demonstrate a variety of long-term visual field defects af ter treatment for their intraocular disease. Characteristics that determine the size and type of defects are tumor size, tumor location, and treatment method.

成人红皮病:80例病例报道

Background: Erythroderma is a generalized erythema of the skin accompanied by a variable degree of scaling. However, most of the published series originate fr om Western countries. There is only one report from Africa, conducted in Dakar i n 1979. The aim of our study was to provide information about this condition in our country. Patients and methods: Our study was retrospective, dealing with 80 erythrodermic adults, examined between January 1981 and December 2000. Patient i nformation included clinical, laboratory, histopathologic and therapeutic data. We also noted patientsoutcomes within an average follow-up period of 30 month s. Thus,we calculated the mortality rate and estimated the probability of surviv al without relapses according to the Kaplan-Meier method. Results: The frequenc y of erythroderma in our dermatology department was 0.3%. The sex ratio (male/f emale) was 2.2. The average age of our patients was 53.78 ±18 years. Previous h istory of skin disease was found in 49/80 patients (61.2%) and 32 of them were suffering from psoriasis. Hyperthermia was significantly associated with drug re actions (P=0.013). Hypereosinophilia was not a specific finding. The mortality r ate was higher than that of an age-matched population. Conclusion: Adult erythr oderma is a rare condition. Its most common cause in our study was psoriasis. No cases of atopic dermatitis were found. Prognosis was adversely affected by the presence of erythroderma.

598例孕24～34周未足月胎膜早破患者临床表现和预后的前瞻性人群研究(DOMINOS队列研究)

Objective(s): Description of mothers “ characteristics, obstetricians” practices, and PPROM-linked mortality in all 81 maternity hospitals in the Rhone-Alpes Region, over a period of 2 years. Study design: Prospective cohort study of 598 women with PPROM between 24 and 34 weeks’gestation, leading to 680 births. At time of PPROM, collection of mothers’ socioeconomic characteristics, medical and obstetric histories and PPROM circumstances. Collection of perinatal management, neonates’ medical status and postnatal referral. Results: The birth rate after PPROM between 24 and 34 weeks’ gestation was 0.47% (95% CI: 0.42- 0.48). Sixty percent of PPROM occurred before 32 weeks’ gestation and 98% of births before 37 weeks. The incidence of previous PPROM was 14.3% . Antibiotics, corticosteroids, and tocolytics were given to 82, 78, and 52% of women, respectively. The rate of antibiotics and antenatal corticosteroids varied with gestational age (lower rates for antibiotics just after the limit of viability (23- 24 weeks) and after 32 weeks, higher rates of corticosteroids between 26 and 30 weeks). The PPROM- birth interval became shorter as gestation advanced. The incidence of C- section was 58.7% (n = 270), C- section before labour being the most frequent mode of delivery. Sixty-seven percent of neonates were born in Level- 3 hospitals. The overall neonatal mortality rate at 28 days decreased with gestational age at PPROM, and was 17.2% (16/93), 3% (6/200), and 0.41% (1/241) at 24- 27, 28- 31 and 32- 33 weeks of PPROM, respectively. Conclusion(s): After PPROM, antibiotics and antenatal corticosteroids were widely used in our cohort, and C- section rates were elevated. With that up-to-date management, the perinatal mortality rate was less than 3% following PPROM after 28 weeks’ gestation.

Prognositic factors and clinicopathologic characteristics of small gastrointestinal stromal tumor of the stomach:a retrospective analysis of 31 cases in one center

Objective： To analyze the clinicopathologic characteristics and prognostic factors of small gastrointestinal stromal tumor （GIST） of the stomach. Methods： A total of 31 small gastric GIST patients, including 10 males and 21 females, with a median age of 58 years （37- 81 years）, who underwent surgery at any time from 1999 to 2012 were included in this study. The clinical records of the patients were analyzed retrospectively. Results： Abdominal discomfort and pain （10 cases, 32.3%, respectively） were the two most common complaints among the patients. All patients received surgery, 11 received gastric wedge resection, 11 received subtotal gastrectom）5 5 received laparoscopic gastric wedge resection, and 4 received endoscopic submucosal dissection. No severe adverse complication was observed. A total of 29 patients （93.5%） were followed up. During the follow-up, 2 patients were found to exhibit tumor recurrence, and 1 patient had liver metastases. One patient died of tumor progressionwhile another died of another malignant tumor. Median progression free survival （PFS） time was 120.3 months, and median overall survival （OS） time was 130.4 months. Conclusion： Small gastric GIST has better prognosis. Surgery is the best choice for therapy. Micro-invasive procedures are safe and effective for elective patients. Tumor necrosis, tumor bleeding, and muscle invasion are potential prognostic factors of small gastric GIST.

Systematic review of Chinese herbal medicine for functional constipation

Constipation is a common gastrointestinal complaint in clinical practice, affecting an estimated 27% of the population. Many patients are disappointed by current conventional treatments and, therefore, seek help from complementary and alternative medicine （CAM）. Traditional Chinese medicine, is the most important part of CAM and has been practiced for treating diseases and promoting the health of humans for thousands of years, and has become a popular alternative choice. Although there are many Chinese herbal medicine （CHM interventions available, and some have been verified b＇ clinical trials, their efficacy and safety are still questioned by both patients and health care providers worldwide. The purposes of this review are, first, to appraise the qualities of individual study designs in the new Cochrane approach. Second, the benefits of individual CHM interventions or individual types of CHM intervention for the treatment of functional constipation are analyzed. Finally, valid and comprehensive conclusions are drawn, if applicable, in order to make clinical recommendations.

Surgical outcome of pancreatic cancer using radical antegrade modular pancreatosplenectomy procedure

AIM:To evaluate the surgical outcomes following radical antegrade modular pancreatosplenectomy (RAMPS) for pancreatic cancer. METHODS:Twenty-four patients underwent RAMPS with curative intent between January 2005 and June 2009 at the National Cancer Center, South Korea. Clinicopathologic data, including age, sex, operative findings, pathologic results, adjuvant therapy, postop-erative clinical course and follow-up data were retro-spectively collected and analyzed for this study. RESULTS:Twenty-one patients (87.5%) underwent distal pancreatectomy and 3 patients (12.5%) underwent total pancreatectomy using RAMPS. Nine patients (37.5%) underwent combined vessel resection, including 8 superior mesenteric-portal vein resections and 1 celiac axis resection. Two patients (8.3%) underwent combined resection of other organs, including the colon, stomach or duodenum. Negative tangential margins were achieved in 22 patients (91.7%). The mean tumor diameter for all patients was 4.09 ± 2.15 cm. The 2 patients with positive margins had a mean diameter of 7.25 cm. The mean number of retrieved lymph nodes was 20.92 ± 11.24 and the node positivity rate was 70.8%. The median survival of the 24 patients was 18.23 ± 6.02 mo. Patients with negative margins had a median survival of 21.80 ± 5.30 mo and those with positive margins had a median survival of 6.47 mo (P = 0.021). Nine patients (37.5%) had postoperative complications, but there were no postoperative mortalities. Pancreatic fistula occurred in 4 patients (16.7%):2 patients had a grade A fistula and 2 had a grade B fistula. On univariate analysis, histologic grade, positive tangential margin, pancreatic fistula and adjuvant therapy were significant prognostic factors for survival. CONCLUSION:RAMPS is a feasible procedure for achieving negative tangential margins in patients with carcinoma of the body and tail of the pancreas.

OBSERVATION ON THE THERAPEUTIC EFFECT OF BIRD-PECKING MOXIBUSTION OF SPECIFIC ACUPOINTS IN THE TREATMENT OF FUNCTIONAL DYSPEPSIA

Objective: To observe the therapeutic effect of moxibustion of some specific acupoints for treatment of functional dyspepsia (FD, qi-distension type). Methods:A total of 50 cases of FD patients were randomly divided into treatment group (n=26) and medication group (n=24). In treatment group, bird-pecking moxibustion was applied to Zhongwan (CV 12), Qihai (CV 6), Neiguan (PC 6) and Gongsun (SP 4) 5～6 times in every treatment till the local skin got flush. The treatment was given once daily, continuously for 10 days. In control group, the patients were ordered to take Motilium 10 mg/time, 3 times daily. Following 10 days’ treatment the therapeutic effect was assessed.Results:After treatment, of the 26 cases in treatment group, 11 (42.3%) were cured, 7 (26.92%) had remarkable improvement in their symptoms, 6 (23.07%) had improvement and 2 (7.69%) failed, with a total effective rate of 92.31%. Of the 24 cases in medication group, 9 (37.50%) were cured, 6 (25.00%) experienced remarkable improvement in their symptoms, 6 (25.00%) were improved and 3 (12.50%) failed, with a total effective rate of 87.50%. Comparison between two groups showed that the therapeutic effect of moxibustion was significantly superior to that of medication (P<0.05). In addition, the difference value of the therapeutic effect index (TEI) between post-and pre-treatment in treatment group was also significantly higher than that of medication group (P<0.05). Conclusion: Bird-pecking moxibustion of specific acupoints can effectively improve clinical symptoms of FD patients.

Alveolar Rhabdomyosarcoma of the Laryngohypopharynx： A Case Report

Introduction Rhabdomyosarcoma is one of the most commonly seen soft-tissue sarcomas in children and teenagers, approximately accounting for half of all soft-tissue sarcomas. The tumor is usually found in head and neck, four limbs and urogenital system. However, the tumor orig- inating from the laryngohypopharynx is rare. In 2008, a patient with alveolar rhabdomyosarcoma of the laryngohypopharynx was admitted to our hospital. Clinical information of the disease was reported as follows, and clinicopathologic features and current therapeutic principle were discussed and summarized in combination with the review of literature, to facilitate the diagnosis and treatment of the patients with rhabdomyosarcoma of the laryngohypopharynx in future.

Adjuvant radiotherapy for gallbladder cancer:A dosimetric comparison of conformal radiotherapy and intensity-modulated radiotherapy

AIM: To assess the efficacy and toxicity of conformal radiotherapy (CRT) and compare with intensity-modulated radiotherapy (IMRT) in the treatment of gallbladder cancer. METHODS: Between November 2003 and January 2010, 20 patients with gallbladder cancer were treated with CRT with or without chemotherapy after surgical resection. Preliminary survival data were collected and examined using both Kaplan-Meier and actuarial analysis. Demographic and treatment parameters were collected. All patients were planned to receive 46-56 Gy in 1.8 or 2.0 Gy per fraction. CRT planning was compared with IMRT. RESULTS: The most common reported acute toxicities requiring medication (Radiation Therapy Oncology Group, Radiation Therapy Oncology Group Grade 2) were nausea (10/20 patients) and diarrhea (3/20). There were no treatment-related deaths. Compared with CRT planning, IMRT significantly reduced the volume of right kidney receiving > 20 Gy and the volume of liver receiving > 30 Gy. IMRT has a negligible impact on the volume of left kidney receiving > 20 Gy. The 95% of prescribed dose for a planning tumor volume using either 3D CRT or IMRT planning were 84.0% ± 6.7%, 82.9% ± 6.1%, respectively (P > 0.05). CONCLUSION: IMRT achieves similar excellent target coverage as compared with CRT planning, while reducing the mean liver dose and volume above threshold dose. IMRT offers better sparing of the right kidney compared with CRT planning, with a significantly lower mean dose and volume above threshold dose.

Late course three-dimensional conformal radiotherapy for esophageal carcinoma

Objective： The aim of our study was to evaluate the clinical results and acute side effects of late course three-dimensional conformal radiotherapy （3DCRT） for esophageal carcinoma. Methods： From January 2004 to October 2006, 70 patients with esophageal carcinoma received late course 3DCRT. Their clinical data were analyzed retrospectively. The short-term clinical results, acute side effects, local control rates and survival rates were evaluated. Results： The complete response rate was 62.9%, partial response rate was 35.7%, and the overall response rate was 98.6%. The 1-, 2-and 3-year local control rates were 77.1%, 51.4% and 45.7%, respectively. The 1-, 2-and 3-year overall survival rates were 75.7%, 54.3% and 38.6%, respectively. The median survival time was 26 months. Conclusion： The technique of late course 3DCRT is an effective treatment for esophageal carcinoma and tend to improve the overall survival rate.

OBSERVATION ON THE EFFECT OF MOXIBUSTION ON HYPERBILIRUBINEMIA IN HEPATITIS B TYPE CIRRHOSIS PATIENTS

Objective: To study the effect of moxibustion on hyperbilirubinemia in hepatitis B cirrhosis patients. Methods: 56 cases of inpatients with hepatitis B cirrhosis were divided into treatment group (n=27) and control group (n=29) randomly. All the patients of these two groups were given with routine expectant treatment including administration of medicines (Bifendate, Eessentiale, Potenline, etc) for protecting liver functions, reducing the level of alanine aminotransferase (ALT), etc., and in the meantime, patients of the treatment group were also treated with moxibustion of Zusanli (足三里 ST 36), Taichong (太冲 LR 3) and Sanyinjiao (三阴交 SP 6), once daily, continuously for 4 weeks. Results: After 4 weeks of treatment, of the 27 and 29 cases of treatment and control group, 23 and 10 patients had improvement in clinical symptoms, 4 and 19 failed, with the total effective rates being 85.18% and 34.48% respectively. Serum total bilirubin (TBil) contents of treatment and control groups decreased significantly, and the level of TBil in the treatment group was significantly lower than that in the control group (P<0.01). Conclusion: Moxibustion is an effective remedy in relieving hyperbilirubinemia and improving clinical symptoms in the treatment of hepatitis B cirrhosis patients.