肌电生物反馈两种治疗方法的对照研究

本文对松弛性肌电生物反馈疗法的两种治疗方法,单纯性语言训练(SVT)与播放录音带的音乐和语言训练(MVT)进行对照,SVT组总有效率、显效率均较MVT组高(88.35％>79.31％;44.83％>13.97％);SVT组所需好转、显效疗次(5.84<7.16;7.42<10.92)皆较MVT组少,获效快。生物反馈治疗或经MVT治疗效不佳者宜采用STV,或两者相结合的方法。对文化水平和暗示性较高,意念丰富,自我控制和调整能力较强或行巩固,强化治疗者可采用MVT。

高压氧治疗手术植皮后修复33例报告

我院自1988年12月以来,采用高压氧治疗皮肤移植33例,疗效显著,并随机抽取常规治疗组30例,作为对照组进行对比观察,报告如下。1 临床资料 本组患者男28例,女5例,年龄13～60岁。患者多为创伤、烫伤后修复,需借助于手术植皮才能使创面修复。植皮后做高压氧时间最早为手术后第1天,最长20天,最少6次,最多做20次,总结如下。

尖锐湿疣治疗与复发的防治

尖锐湿疣(以下简称尖疣)是由某些类型的人类乳头瘤病毒引起的生殖器周围皮肤的增生性疾病。我们采用刮除加化学药物点涂法治疗59例尖疣的实践中,注意到疣体的再发与血液污染的关系,提出防治的问题。现总结如下: 1 临床资料 1.1 一般资料:59例尖疣中,男性23例,女性36例;年龄17～42岁,病期1～10个月;男性尖疣多见于包皮内板、冠状沟处,女性多见阴道口、会阴部等处。疣体数目少至几粒,多至几十粒。

多种物理因子治疗颈椎病268例疗效观察

颈椎病是颈椎间盘非特异性病变引起的头、颈、四肢、上胸背及内脏症侯群的统称,在中老年患者中极为常见,多数患者需要物理治疗。为进一步比较各种物理因子治疗的效果,我们用颈椎间歇牵引分别配合直流电、电脑中频、超短波及TDP治疗颈椎病患者268例。兹将治疗观察结果报告如下:

Furazolidone,amoxicillin,bismuth and rabeprazole quadruple rescue therapy for the eradication of Helicobacter pylori

AIM： To compare the efficacy and side effect profiles of three furazolidone and amoxicillin-based quadruple rescue therapies for the eradication of Helicobacter pylori （H pylonS. METHODS： Patients who failed in the Hpylori eradication therapy for at least one course were randomly allocated into three groups. Group A received rebaprazole 10 mg＋ amoxicillin 1 g ＋ furazolidone 100 mg, and bismuth subcitrate 220 mg, twice daily for 1 wk; group B received the same regimen of group A but for 2 wk; and group C received the same regimen of group B, but furazolidone was replaced by furazolidone 100 mg three times daily. To record the side effect profiles at the end of the treatment, Hpylori eradication was assessed with 13C-urea breath test 4 wk after therapy. RESULTS： Sixty patients were enrolled including 28 males, and 20 patients in each group. The average age of the patients was 49.2 years, ranging from 18 to 84 years. H pylori eradication rates with per-protocol analysis were 82%, 89% and 90% in the three groups, respectively. Side effects were found in 11 patients, including mild dizziness, nausea, diarrhea and increased bowel movement. None of the 11 patients needed treatment for their side effects. CONCLUSION： One- or two-week furazolidone and amoxicillin-based quadruple rescue therapy with a low dose furazolidone （100 mg bid） for the eradication of Hpylori is effective. Extending the antibiotic course to 14 d could improve the eradication rates.

Traditional Chinese surgical treatment for anal fistulae with secondary tracks and abscess

AIM:To evaluate the efficacy and safety of traditional Chinese surgical treatment for anal fistulae with secondary tracks and abscess.METHODS:Sixty patients with intersphincteric or transsphincteric anal fistulas with secondary tracks and abscess were randomly divided into study group [suture dragging combined with pad compression(SDPC)] and control group [fistulotomy(FSLT)].In the SDPC group,the internal opening was excised and incisions at external openings were made for drainage.Silk sutures were put through every two incisions and knotted in loose state.The suture dragging process started from the first day after surgery and the pad compression process started when all sutures were removed as wound tissue became fresh and without discharge.In the FSLT group,the internal opening and all tracts were laid open and cleaned by normal saline postoperatively till all wounds healed.The time of healing,postoperative pain score(visual analogue scale),recurrence rate,patient satisfaction,incontinence evaluation and anorectal manometry before and after the treatment were examined.RESULTS:There were no significant differences between the two groups regarding age,gender and fistulae type.The time of healing was significantly shorter(24.33 d in SDPC vs 31.57 d in FSLT,P < 0.01) and the patient satisfaction score at 1 mo postoperative followup was significantly higher in the SDPC group(4.07 in SDPC vs 3.37 in FSLT,P < 0.05).The mean maximal postoperative pain scores were 5.83 ± 2.5 in SDPC vs 6.37 ± 2.33 in FSLT and the recurrence rates were 3.33 in SDPC vs 0 in FSLT.None of the patients in the two groups experienced liquid and solid fecal incontinence and lifestyle alteration postoperatively.The Wexner score after treatment of intersphincter fistulae were 0.17 ± 0.41 in SDPC vs 0.40 ± 0.89 in FSLT and transsphincter fistulae were 0.13 ± 0.45 in SDPC vs 0.56 ± 1.35 in FSLT.The maximal squeeze pressure and resting pressure declined after treatment in both groups.The maximal anal squeeze pressures after treatment were reduced(23.17 ± 3.73 Kpa in SDPC vs 22.74 ± 4.47 Kpa in FSLT) and so did the resting pressures(12.36 ± 2.15 Kpa in SDPC vs 11.71 ± 1.87 Kpa in FSLT),but there were neither significant differences between the two groups and nor significant differences before or after treatment.CONCLUSION:Traditional Chinese surgical treatment SDPC for anal fistulae with secondary tracks and abscess is safe,effective and less invasive.

Use of new once-daily 5-aminosalicylic acid preparations in the treatment of ulcerative colitis:Is there anything new under the sun?

5-aminosalicylate(5-ASA)agents remain the mainstay treatment in ulcerative colitis(UC).A number of oral 5-ASA agents are commercially available,including azobond pro-drugs,as well as delayed-and controlledrelease forms of mesalazine.However,poor adherence due to frequent daily dosing and a large number of tablets has been shown to be an important barrier to successful management of patients with UC.Recently, new,once-daily formulations of mesalazine,including the unique multi-matrix delivery system and mesalazine granules,were proven to be efficacious in inducing and maintaining remission in mild-to-moderate UC,with a good safety profile comparable to that of other oral mesalazine formulations.In addition,they offer the advantage of a low pill burden and might contribute to increased long-term compliance and treatment success in clinical practice.This editorial summarizes the available literature on the short-and medium-term efficacy and safety of the new once-daily mesalazine formulations.

Decision-Making in a Governmental Healthcare Organization by Analytic Hierarchy Process

This paper contains research on strategic decision-making in a local government. In a profit-oriented organization, the option that maximizes profits tends involve reaching an agreement between stakeholders. However, there is tendency for stakeholders to differ in their beliefs as to what is desirable particularly in a non-profit organization. In a local government, it is especially difficult for the interests of a stakeholder group to be completely in agreement. This research considers the use of the analytical hierarchy process （Saaty, 1971） as a solution for one of the difficulties of decision-making in a local government. This research is a case study to explore the strategy of a local Japanese healthcare management organization. The conclusion was drawn to decide which strategic option should be taken by using the analytical hierarchy process. Also, it was found what to work on a countermeasure that prevents the negative effects that are generated by selecting the strategic option.

ANALYSIS OF 312 CASES OF REPEAT CORONARY ARTERY BYPASS GRAFTING

Objective To evaluate repeat coronary artery bypass grafting (CABG) in 312 patients. Methods The data of 312 patients (average age 65±9 years) who had CABG operation in Hartford hospital were collected and analyzed. The mean duration follow up after the first CABG was 11.8±4.5 years. A total of 1069 bypass grafts were performed. Among them, 386 were arterial grafts such as internal mammary artery, radial artery and gastroepiploic artery; 682 were venous grafts and 1 Gore-Tex graft. Results The operative mortality was 4.5%. Fifteen patients ( 4.8%) had peri-operative myocardial infarction and 46 patients (15%) had low cardiac output syndrome. Intra-aortic balloon pump (IABP) was used in 131 patients before, during and after operation. One hundred and nineteen patients weaned off IABP and recovered. Conclusion Although the difficulties and risk factors were increased, the results of redo CABG were still good.

椅旁CAD/CAM数字化修复

数字化技术具有精准、高效的特点。自计算机辅助设计和计算机辅助制作(CAD/CAM)技术引入到口腔修复领域以来,已经有30多年的历史,期间技术不断地完善和进步,临床应用也越来越广泛,并且获得了很好的临床效果。同时,椅旁CAD/CAM技术使临床医生可以一次独立完成修复体的设计和制作,在单疗次内为患者提供美观精确的修复体,大大节省了就诊时间和医疗资源。

《邪恶的人》就此“复活”

整个匹兹堡都在为之颤抖……众所周知的银幕上的两个最耀眼的明星在5个月的时间里使人心满意足、神魂颠倒,她们是莎伦·斯通和伊莎贝尔·阿佳妮,两个漂亮的脸蛋专门惩罚那些最不为天使所动的人,《邪恶的人》是一部没有公开的重拍片,谁知道原片导演克卢佐对此会有何感想…… 《邪恶的人》1955年1月首次在银幕是放映。亨利·乔治·克卢佐让他的妻子薇拉扮演克里斯蒂娜。

Efficacy observation on acupuncture-moxibustion at Ciliao(BL 32) for primary dysmenorrhea due to cold-dampness

Objective： To observe the clinical efficacy of acupuncture plus moxibustion at Ciliao （BL 32） for primary dysmenorrhea （PD） due to cold-dampness. Methods： A total of 58 cases with PD due to cold-dampness were randomly allocated into an observation group （n=29） and a control group （n=29）. Patients in the observation group were treated with acupuncture and suspended moxibustion at Ciliao （BL 32）, whereas patients in the control group were treated with routine acupuncture alone. After three courses of treatment, the clinical efficacy was evaluated and compared between the two groups. Results： After treatment, the symptom scores were significantly reduced in both groups （P〈0.05）, but there were no significant between-group differences in clinical efficacy and symptom scores （P〉0.05）. Conclusion： With fewer points and less pain, acupuncture-moxibustion at Ciliao （BL 32） can obtain similar effect as routine acupuncture therapy for PD due to cold-dampness.

Surgical outcomes of subtotal colectomy with antiperistaltic caecorectal anastomosis vs total colectomy with ileorectal anastomosis for intractable slow-transit constipation

Background:Few studies have compared the surgical outcomes of different surgical procedures currently used to treat refractory colonic slow-transit constipation(STC),despite the increase in the number of cases.This study aimed to analyse the long-termsurgical outcomes of subtotal colectomy with antiperistaltic caecorectal anastomosis(SC-ACRA)vs total colectomy with ileorectal anastomosis(TC-IRA)for severe STC.Methods:Between January 2005 and January 2015,we retrospectively collected clinical data of 55 patients who underwent TC-IRA(n=35)or SC-ACRA(n=20)for severe STC at our institution.The post-operative functional outcomes between the two groups were compared.Results:There were no significant differences in age(P=0.655),sex(P=0.234),period of constipation(P=0.105)and defecation frequency(P=0.698)between the TC-IRA and SC-ACRA groups.During a median follow-up period of 72 months(range,12–120 months),there were no significant differences between the TC-IRA and SC-ACRA groups regarding the median number of bowel movements per day[3(1/6–7)vs 3(1/6–5),P=0.578],Cleveland Clinic Florida Constipation Score[2(0–20)vs 2(0–19),P=0.454],Cleveland Clinic Incontinence Score[0(0–5)vs 0(0–2),P=0.333]and Gastrointestinal Quality of Life Index[122(81–132)vs 120(80–132),P=0.661].Moreover,there was no significant difference in the incidence of postoperative complications between the two groups(37.1%vs 25.0%,P=0.285).Conclusions:Our findings indicate that both TC-IRA and SC-ACRA are effective treatments for severe STC,with similar long-termoutcomes.

Study on timing and dosage of acupuncture in stroke treatment

Objective： To summarize the timing-efficacy relationship and the dosage–efficacy relationship of acupuncture in stroke treatment. Method： Literature research was conducted for quantitative clinical studies of acupuncture in stroke treatment, with the entry point on the timing factor and dosage factor. A hierarchical analysis was performed on observing the time–efficacy relationship and the dosage–efficacy relationship before, during and after acupuncture. Results： Though the retrieved studies differ especially in such timing factors as needle retaining time, acupuncture interval and course, they share an agreement in the acupuncture intervention time point, acupuncture timing, specificity of acupoints and acupuncture manipulation. Conclusion： The optimal stimulation is the core of the research on the timing-efficacy relationship and the dosage–efficacy relationship of acupuncture and also the key to the clinical efficacy.

Component analysis of Chinese medicine and advances in fuming-washing therapy for knee osteoarthritis via unsupervised data mining methods

OBJECTIVE: To analyze the component law of Chinese medicines in fuming-washing therapy for knee osteoarthritis(KOA), and develop new fuming-washing prescriptions for KOA through unsupervised data mining methods.METHODS: Chinese medicine recipes for fuming-washing therapy for KOA were collected and recorded in a database. The correlation coefficient among herbs, core combinations of herbs, andnew prescriptions were analyzed using modified mutual information, complex system entropy cluster, and unsupervised hierarchical clustering, respectively.RESULTS: Based on analysis of 345 Chinese medicine recipes for fuming-washing therapy, 68 herbs occurred frequently, 33 herb pairs occurred frequently, and 12 core combinations were found.Five new fuming-washing recipes for KOA were developed.CONCLUSION: Chinese medicines for fuming-washing therapy of KOA mainly consist of wind-dampness-dispelling and cold-dispersing herbs, blood-activating and stasis-resolving herbs,and wind-dampness-dispelling and heat-clearing herbs. The treatment of fuming-washing therapy for KOA also includes dispelling wind-dampness and dispersing cold, activating blood and resolving stasis, and dispelling wind-dampness and clearing heat. Zhenzhutougucao(Herba Speranskiae Tuberculatae), Honghua(Flos Carthami), Niuxi(Radix Achyranthis Bidentatae), Shenjincao(Herba Lycopodii Japonici), Weilingxian(Radix et Rhizoma Clematidis Chinensis), Chuanwu(Radix Aconiti), Haitongpi(Cortex Erythrinae Variegatae), Ruxiang(Olibanum),Danggui(Radix Angelicae Sinensis), Caowu(Radix Aconiti Kusnezoffii), Moyao(Myrrha), and Aiye(Folium Artemisiae Argyi) are the main herbs used in the fuming-washing treatment for KOA.

Long-term follow-up of haploidentical transplantation in relapsed/refractory severe aplastic anemia:a multicenter prospective study

In recent decades,haploidentical stem cell transplantation(haplo-SCT)to treat severe aplastic anemia(SAA)has achieved remarkable progress.However,long-term results are still lacking.We conducted a multicenter prospective study involving SAA patients who underwent haplo-SCT as salvage therapy.Long-term outcomes were assessed,mainly focusing on survival and quality of life(QoL).Longitudinal QoL was prospectively evaluated during pretransplantation and at 3 and 5 years posttransplantation using the SF-36 scale in adults and the PedsQL 4.0 scale in children.A total of 287 SAA patients were enrolled,and the median follow-up was 4.56 years(range,3.01–9.05 years)among surviving patients.During the long-term follow-up,268 of 275 evaluable patients(97.5%)obtained sustained full donor chimerism,and 93.4%had complete hematopoietic recovery.The estimated overall survival and failure-free survival for the whole cohort at 9 years were 85.4%±2.1%and 84.0%±2.2%,respectively.Age(≥18 years)and a poorer performance status(ECOG>1)were identified as risk factors for survival outcomes.For Qo L recovery after haplo-SCT,we found that QoL progressively improved from pretransplantation to the 3-year and 5-year time points with statistical significance.The occurrence of chronic graft versus host disease was a risk factor predicting poorer QoL scores in both the child and adult cohorts.At the last followup,74.0%of children and 72.9%of adults returned to normal school or work.These inspiring long-term outcomes suggest that salvage transplantation with haploidentical donors can be routine practice for SAA patients without human leukocyte antigen(HLA)-matched donors.

Management and outcomes of patients with Crohn’s disease with first vs multiple surgeries:results from the PRACTICROHN study

Background:Surgery in Crohn’s disease(CD)may be associated with poor prognosis and clinical and surgical recurrence.The aim of this study was to describe and compare the post-operative management and outcomes of patients with CD who underwent first vs recurrent surgeries.Methods:Observational study that included adult CD patients from 26 Spanish hospitals who underwent ileocolonic resection with ileocolonic anastomosis between January 2007 and December 2010.Data were retrospectively collected from the medical records.Results:Data from 314 patients were analysed,of whom 262(83%)underwent first surgery and 52(17%)referred to previous CD surgeries.Baseline characteristics were similar between the two groups except for a higher rate of stricturing behavior at diagnosis among re-operated patients(P=0.03).After surgery,a higher proportion of re-operated patients received prophylactic treatment with immunomodulators compared with patients with first surgery(P=0.04).In re-operated patients,time to clinical recurrence was not associated with the fact of receiving or not prophylaxis,whereas,in patients with first surgery,recurrence-free survival was greater when prophylaxis was received(P=0.03).Conclusions:After surgery,a higher proportion of patients with previous surgeries received prophylactic treatment with immunomodulators compared with patients with first surgery.Although prophylactic treatment was beneficial for preventing clinical recurrence in patients operated on for the first time,it did not significantly reduce the risk of further recurrence in patients with previous surgeries.This suggests that effective prophylactic therapies are still needed in this subset of patients.