基于“双壁理论”探讨ARCOⅡ期股骨头坏死的保髋治疗策略

保髋治疗对于青壮年股骨头坏死(osteonecrosis of the femoral head,ONFH)患者至关重要,尤其是国际骨微循环研究学会(Association Research Circulation Osseous,ARCO)Ⅱ期,被认为是进行保髋治疗的黄金时期。如何选择合适的保髋治疗方式并提高疗效,是临床亟待解决的问题。“双壁理论”根据股骨头的坏死范围是否累及前侧壁和外侧壁将ONFH分为3种类型,即双壁完好型、单壁受累型、双壁受累型,不同分型的治疗方法也不同。本文概述了“双壁理论”,并基于该理论探讨了ARCOⅡ期ONFH的保髋治疗策略。

基于中日友好医院分型ARCOⅡ期股骨头坏死的自然塌陷病程

背景:股骨头坏死是骨科难治性疾病之一,不同分期、分型下的股骨头坏死自然塌陷病程影响着该病的进展及预后。目的:探究不同中日友好医院(China-Japan Friendship Hospital,CJFH)分型下国际骨循环研究协会(Association Research Circulation Osseous,ARCO)Ⅱ期股骨头坏死未塌陷患者5年内自然塌陷病程,并分析不同CJFH分型的股骨头塌陷率及塌陷风险。方法:回顾性选取2016年10月至2017年10月在西安交通大学附属红会医院门诊确诊为ARCOⅡ期股骨头坏死未塌陷的患者为研究对象,根据是否塌陷将患髋分为塌陷组(n=82)和未塌陷组(n=70),统计不同CJFH分型的股骨头塌陷风险以及5年内塌陷时间、塌陷数量和塌陷率,并绘制不同CJFH分型股骨头的Kaplan-Meier生存曲线图。结果与结论:①共纳入患者97例,152髋,随访期间有82髋塌陷,总塌陷率为53.9%,其中M型、C型、L1型、L2型和L3型塌陷率分别为0.0%,36.7%,51.4%,72.2%和77.8%,各组间比较差异有显著性意义(P<0.05);②在塌陷风险方面,L1型塌陷风险为C型的1.704倍(P>0.05),而L2型、L3型塌陷风险分别为C型的3.866倍、6.423倍(P<0.05);③在Kaplan-Meier生存曲线方面,ARCOⅡ期患者股骨头中位生存时间为3年,95%置信区间为2.885-3.471年,第1,3,5年股骨头生存率分别为65.1%(99/152),50.7%(77/152),46.1%(70/152);④结果表明,不同CJFH分型影响着ARCOⅡ期股骨头坏死患者的塌陷率,其中L3型患者塌陷率最高,L2型和L1型患者次之,C型患者塌陷率较低,M型患者无塌陷,这表明股骨头外侧柱的保留对股骨头坏死自然塌陷病程有重要意义。

股骨头坏死ARCO 3A期平片分期准确性及误分期原因分析

目的评估X线平片对股骨头坏死ARCO3A期分期的准确性,并分析其误分期的原因。方法回顾性分析2017年1月至2023年7月同期行髋关节正、蛙式位X线及CT检查,且髋关节CT分期为ARCO3A期的158例股骨头坏死患者,其中14例为双侧ARCO3A期,共计172例ARCO3A期股骨头坏死,F/M=67/91,平均年龄43.7±11.8岁。观察髋关节X线正、蛙式位图像进行ARCO分期并统计结果。结果髋关节X线分期为ARCO 3A期139例,误分期为ARCO 2期33例,准确率为80.8%;对照同期髋关节CT图像,X线误分期病例中未发现软骨下骨折6例(18.2%)、未发现坏死区骨折4例(12.1%)、未发现股骨头局限塌陷23例(69.7%)。结论X线对股骨头坏死ARCO 3A期分期的准确性高,但仍存在误分期的状况。在临床工作中,正位结合蛙式位,仔细观察关节面局部轻微不光整及软骨下、坏死区骨折等征象有助于提高X线平片对股骨头坏死ARCO3A期分期的准确性。

金匮肾气丸辅治Ⅱ-Ⅲ期糖尿病肾病疗效观察

目的:观察金匮肾气丸辅治Ⅱ-Ⅲ期糖尿病肾病的临床疗效。方法:74例按照随机数字表法分为对照组与研究组各37例,两组均用达格列净和贝那普利治疗,研究组加用金匮肾气丸。结果:研究组总有效率与估算肾小球滤过率(eGFR)水平高于对照组(P<0.05),中医证候积分、血肌酐(SCR)、血尿素氮(BUN)、24h尿总量蛋白(TUP)和尿微量白蛋白/尿肌酐(UMA/UCR)以及空腹血糖(FBG)水平均低于对照组(P<0.05)。结论:金匮肾气丸辅治Ⅱ-Ⅲ期糖尿病肾病可提高疗效。

Effect of Tongluo Shenggu Prescription on ARCO Stage Ⅱ non-traumatic femoral head necrosis: A prospective study

Objective:To observe the clinical results and therapeutic characteristics of Tongluo Shenggu Decoction in the treatment of ARCOⅡnon-traumatic femoral head necrosis.Methods:120 patients with ARCOⅡnon-traumatic femoral head necrosis from January 2016 to January 2017 were studied by prospective matched and controlled design.60 cases in the treatment group were treated with Tongluo Shenggu Formula.The control group(60 cases)received high energy extracorporeal shock wave therapy.The imaging stability rate,Harris score and SF-36 score were used as clinical efficacy indicators,followed up for 24 months,and the follow-up results were statistically analyzed.Results:Among the 120 patients,5 fell off and the rest were followed up.The imaging stability rate is heavy.The imaging stability rate of the patients in the treatment group is 78.95%,while that in the control group is 72.41%.The two groups have the same stability rate(P>0.05).In Harris score,the Harris score of the patients in the treatment group was 92.678.45 points,significantly higher than that of the control group(80.3924.65 points),the difference was statistically significant(p<0.05),and the pain degree,joint function and joint deformity score of the treatment group were better than those of the control group(p<0.05).In the SF-36 score,the scores of physiological function,physiological function,physical pain,overall health,social function and emotional function in the treatment group were significantly higher than those in the control group,the difference was statistically significant(p<0.05).the incidence of adverse events in the treatment period of the two groups was lower and the patients could relieve themselves in the later stage.Conclusion:Tongluo Shenggu prescription has definite curative effect in treating ARCOⅡnon-traumatic femoral head necrosis,especially in improving hip joint function,relieving hip joint pain and improving quality of life.To observe the clinical results and therapeutic characteristics of Tongluo Shenggu Decoction in the treatment of ARCOⅡnon-traumatic femoral head necrosis.Methods:120 patients with ARCOⅡnon-traumatic femoral head necrosis from January 2016 to January 2017 were studied by prospective matched and controlled design.60 cases in the treatment group were treated with Tongluo Shenggu Formula.The control group(60 cases)received high energy extracorporeal shock wave therapy.The imaging stability rate,Harris score and SF-36 score were used as clinical efficacy indicators,followed up for 24 months,and the follow-up results were statistically analyzed.Results:Among the 120 patients,5 fell off and the rest were followed up.The imaging stability rate is heavy.The imaging stability rate of the patients in the treatment group is 78.95%,while that in the control group is 72.41%.The two groups have the same stability rate(P>0.05).In Harris score,the Harris score of the patients in the treatment group was 92.678.45 points,significantly higher than that of the control group(80.3924.65 points),the difference was statistically significant(p<0.05),and the pain degree,joint function and joint deformity score of the treatment group were better than those of the control group(p<0.05).In the SF-36 score,the scores of physiological function,physiological function,physical pain,overall health,social function and emotional function in the treatment group were significantly higher than those in the control group,the difference was statistically significant(p<0.05).the incidence of adverse events in the treatment period of the two groups was lower and the patients could relieve themselves in the later stage.Conclusion:Tongluo Shenggu prescription has definite curative effect in treating ARCOⅡnon-traumatic femoral head necrosis,especially in improving hip joint function,relieving hip joint pain and improving quality of life.

产妇泌乳Ⅱ期启动延迟发生率及影响因素分析

目的分析住院期间产妇泌乳Ⅱ期启动延迟的发生率和影响因素,指导母乳科学喂养。方法采用便利抽样法选取医院产科2023年4月至7月收治的分娩产妇121例,按是否发生泌乳Ⅱ期启动延迟分为延迟组(41例)和非延迟组(80例)。收集产妇一般人口学特征,分析疾病史、生育史、母乳喂养教育等因素对产妇泌乳Ⅱ期启动延迟发生的影响。结果产妇泌乳Ⅱ期启动延迟发生率为33.88%。多因素Logistic回归分析结果显示,年龄不低于35岁[OR=3.576,95%CI(1.081,11.833),P=0.037],产次为初产[OR=4.082,95%CI(1.282,12.997),P=0.017],分娩方式为剖宫产[OR=4.648,95%CI(1.347,16.041),P=0.015],妊娠期糖尿病[OR=10.893,95%CI(2.612,45.432),P=0.001],母乳喂养指导[OR=5.399,95%CI(1.458,19.988),P=0.012],母婴30 min内未早期接触[OR=4.200,95%CI(1.316,13.404),P=0.015],新生儿24 h内有效吮吸次数不超过8次[OR=3.845,95%CI(1.141,12.954),P=0.030]均为发生泌乳Ⅱ期启动延迟的影响因素。结论该院产妇泌乳Ⅱ期启动延迟发生率较高,年龄≥35岁、初产、剖宫产、妊娠期糖尿病、未接受母乳喂养指导、母婴30 min内未早期接触、新生儿24 h内有效吮吸次数≤8次均为发生泌乳Ⅱ期启动延迟的危险因素。

股骨头坏死ARCO 2期CT征象对新发骨质吸收区预测价值分析

目的 分析股骨头坏死ARCO 2期CT征象对新发骨质吸收区的预测价值。方法 回顾性分析2011年至2017年进行髋关节CT检查国际骨微循环研究协会(Association Research Circulation Osseous,ARCO)2期的股骨头坏死94例患者(F/M=24/70,中位年龄41.0(33.3-54.0)岁)。评估初次CT检查的征象,包括骨质坏死的位置、ARCO分期范围、密度和增生反应区的形态。根据随访3年有无骨质吸收区将病例分为新发骨质吸收组和无骨质吸收组。对比两组CT征象的差异,并分析单一和CT征象组合对新发骨质吸收区的预测价值。结果 骨质坏死位于中外侧柱或内中外侧柱、坏死范围大于30%及增生反应区呈横行在新发骨质吸收组显著多于无骨质吸收组。CT征象组合2(骨质坏死位置、坏死范围及增生反应区呈横行形态)对新发骨质吸收区的预测价值最大,曲线下面积(Area Under Curve,AUC)为0.79,敏感性和特异性分别为89.13%和62.50%,阈值>1。结论 如果骨质坏死区位于中外侧柱或内中外侧柱,坏死范围大于30%,且增生反应区呈横行,则易发生骨质吸收区,应密切随访。

ARCO 2/3期股骨头坏死骨质吸收区MR影像评估

目的分析MR对ARCO2/3期股骨头坏死骨质吸收区的检出率及骨质吸收区MR特征,并探讨骨质吸收区不同MR信号可能的病理基础。方法回顾性分析2015年1月至2022年10月就诊于骨科并行MR检查的312例ARCO 2/3期股骨头坏死病例,最终纳入41例,男/女=29/12,其中5例为双侧股骨头坏死,共46例股骨头坏死。根据骨质吸收区T2WI信号特点将病例分为两组,组1-T2WIⅠ型信号(等、稍高信号),组2-T2WIⅡ型信号(高信号)。评估并比较两组间骨质吸收区及相关CT/MR征象。结果MR检出骨质吸收区的敏感性为70.6%,特异性为100%。组2骨质吸收区的数量、ADC值、骨髓水肿分级以及骨质吸收区是否与软骨下骨折相连的几率大于组1,组2骨质吸收区的密度低于组1。结论MR检出骨质吸收区有良好的敏感性和极高的特异性。骨质吸收区T2WIⅠ型信号可能混淆于骨髓水肿中,应仔细甄别;骨质吸收区T2WIⅡ型信号更常伴软骨下骨折和大范围骨髓水肿,可能提示破坏性修复,应密切随访、及时干预。

通络生骨方治疗ARCOⅡ期非创伤性股骨头坏死的前瞻性临床研究

目的:观察通络生骨方治疗ARCOⅡ期非创伤性股骨头坏死的临床结果及疗效特点。方法:采用前瞻性配对、对照设计方法,对2016年1月~2017年1月的120例ARCOⅡ期非创伤性股骨头坏死的患者进行研究。其中治疗组60例,行通络生骨方治疗;对照组60例,行高能体外冲击波治疗。以影像学稳定率、Harris评分、SF-36评分作为临床疗效指标,随访24个月,统计并分析随访结果。结果:120例患者随访中脱落5例,其余患者均获得随访。两组影像学稳定率比较,差异无统计学意义(P>0.05);治疗组Harris评分明显高于对照组,差异有统计学意义(P<0.05),且治疗组在Harris评分中的疼痛程度、关节功能、关节畸形分值方面优于对照组(P<0.05);SF-36评分中,治疗组生理功能、生理职能、躯体疼痛、总体健康、社会功能、情感职能分值均明显高于对照组,差异具有统计学意义(P<0.05),两组在治疗期间不良事件发生率较低且后期均能自行缓解。结论:通络生骨方在治疗ARCOⅡ期非创伤性股骨头坏死方面疗效肯定,尤其在改善髋关节功能、缓解髋关节疼痛以及提高生活质量方面更为明显。

Prognostic and predictive significance of MSI in stages Ⅱ/Ⅲ colon cancer

In colon cancer,classic disease staging remains the key prognosis and treatment determinant.Although adjuvant chemotherapy has an established role in stageⅢcolon cancer patients,in stageⅡit is still a subject of controversy due to its restriction to a small subgroup of patients with high-risk histopathologic features.Patients with stageⅡtumors form a highly heterogeneous group,with five-year relative overall survival rates ranging from 87.5%(ⅡA)to 58.4%(ⅡC).Identifying those for whom adjuvant chemotherapy would be appropriate and necessary has been challenging,and prognostic markers which could serve in the selection of patients more likely to recur or benefit from adjuvant chemotherapy are eagerly needed.The stronger candidate in this category seems to be microsatellite instability(MSI).The recently reported European Society for Medical Oncology guidelines suggest that MSI should be evaluated in stageⅡcolorectal cancer patients in order to contribute in treatment decisionmaking regarding chemotherapy administration.Thehypothetical predictive role of MSI regarding its response to 5-fluorouracil-based adjuvant chemotherapy has proven a much more difficult issue to address.Almost every possible relation between MSI and chemotherapy outcome has been described in the adjuvant colon cancer setting in the international literature,and the matter is far from being settled.In this current report we critically evaluate the prognostic and predictive impact of MSI status in patients with stageⅡand stageⅢcolon cancer patients.

Impact of lymphatic and/or blood vessel invasion in stage Ⅱ gastric cancer

AIM： To determine the prognostic value of lymphatic and/or blood vessel invasion （LBVI） in patients with stage 11 gastric cancer. METHODS： From January 2001 to December 2006, 487 patients with histologically confirmed primary gas- tric adenocarcinoma were diagnosed with stage 11 gas- tric cancer according to the new 7th edition American Joint Committee on Cancer stage classification at the Department of Gastric Cancer and Soft Tissue Surgery, Fudan University Shanghai Cancer Center. All patients underwent curative gastrectomy with standard lymph node （LN） dissection. Fifty-one patients who died in the postoperative period, due to various complications or other conditions, were excluded. Clinicopathologicalfindings and clinical outcomes were analyzed. Patients were subdivided into four groups according to the status of LBVI and LN metastases. These four patient groups were characterized with regard to age, sex, tumor site, pT category, tumor grading and surgical procedure （subtotal resection vs total resection）, and compared for 5-year overall survival by univariate and multivariate analysis. RESULTS： The study was composed of 320 men and 116 women aged 58.9 ± 11.5 years （range： 23-88 years）. The 5-year overall survival rates were 50.7% and the median survival time was 62 too. Stage Ⅱ a cancer was observed in 334 patients, including 268 T3N0, 63 T2N1, and three TIN2, and stage Ⅱb was observed in 102 patients, including 49 patients T3N1, 51 T2N2, one TIN3, and one T4aN0. The incidence of LBVI was 28.0% in stage II gastric cancer with 19.0% （51/269） and 42.5% （71/167） in LN-negative and LN- positive patients, respectively. In 218 patients （50.0%）, there was neither a histopathologically detectable LBVI nor LN metastases （LBVI-/LN-, group I）; in 51 patients （11.7%）, LBVI with no evidence of LN me- tastases was detected （LBVILN-, group 11）. In 167 patients （38.3%）, LN metastases were found. Among those patients, LBVI was not determined in 96 patients （22.0%） （LBVI-γLN, group Ⅲ）, and was determined in 71 patients （16.3%） （LBVI＋LN＋, group Ⅳ）. Correla- tion analysis showed that N category and the number of positive LNs were significantly associated with the presence of LBVI （P 〈 0.001）. The overall 5-year sur- vival was significantly longer in LN-negative patients compared with LN-positive patients （56.1% vs 42.3%, P = 0.015）. There was a significant difference in the overall 5-year survival between LBVI-positive and LBVI- negative tumors （39.6% vs 54.8%, P = 0.006）. Overall 5-year survival rates in each group were 58.8% （ Ⅰ）, 45.8% （Ⅱ）, 45.7% （Ⅲ） and 36.9% （Ⅳ）, and there was a significant difference in overall survival between the four groups （P=-0.009）. Multivariate analysis in stage 11 gastric cancer patients revealed that LBVI in- dependently affected patient prognosis in LN-negativepatients （P = 0.018） but not in LN-positive patients （P = 0.508）. CONCLUSION： In LN-negative stage 11 gastric cancer patients, LBVI is an additional independent prognostic markeF, and may provide useful information to identify patients with poorer prognosis.

Prognostic values of chromosome 18q microsatellite alterations in stage Ⅱ colonic carcinoma

AIM: To investigate the prognostic value of chromosome 18q microsatellite alterations (MA) in stage Ⅱ colon cancer. METHODS: One hundred and six patients with sporadic stage Ⅱ colon cancer were enrolled in this study. DNA was extracted from formalin-fixed, paraffin-embedded tumor and adjacent normal mucosal tissue samples. MA, including loss of heterozygosity (LOH) and microsatellite instability (MSI), was analyzed by polymerase chain reaction, polyacrylamide gel-electrophoresis and DNA sequencing at 5 microsatellite loci on chromosome 18q (D18S474, D18S55, D18S58, D18S61 and D18S64).RESULTS: Among the 102 patients eligible for MA information, the overall frequencies of LOH, high and low frequency MSI/microsatellite stable were 49.0%, 17.6% and 82.4%, respectively. The high frequency of 18q-LOH was signif icantly associated with the poor 5-year overall survival (OS) (P=0.008) and disease free survival (P=0.006). High levels of MSI were significantly associated with a longer 5-year OS (P=0.045) while the higher frequency of 18q-LOH at the loci of D18S474 and D18S61 was significantly associated with a poorer 5-year OS (P=0.010 and 0.005, respectively). But multivariate analysis showed that only the frequency of 18q-LOH was significantly associated with the prognosis of the disease. CONCLUSION: High frequency of 18q-LOH is an independent prognostic factor indicating poor prognosis of the patients with stage Ⅱ colon cancer.

Different strategies of treatment for uterine cervical carcinoma stage ⅠB2-ⅡB

Uterine cervical cancer is the second most common gynecological malignancy. It is estimated that over 35% of tumors are diagnosed at locally advanced disease, stage ⅠB2-ⅡB with an estimated 5-year overall survival of 60%. During the last decades, the initial treatment for these women has been debated and largely varies through different countries. Thus, radical concurrent chemoradiation is the standard of care in United Sated and Canada, and neoadjuvant chemotherapy followed by radical surgery is the first line of treatment in some institutions of Europe, Asia and Latin America. Until today, there is no evidence of which strategy is better over the other. This article describe the evidence as well as the advantages and disadvantages of the main strategies of treatment for women affected by uterine cervical cancer stage ⅠB2-ⅡB.

Macroscopic appearance of TypeⅣand giant Type Ⅲ is a high risk for a poor prognosis in pathological stage Ⅱ/Ⅲ advanced gastric cancer with postoperative adjuvant chemotherapy

AIM To evaluate whether a high risk macroscopic appearance(Type Ⅳ and giant Type Ⅲ) is associated with a dismal prognosis after curative surgery, because its prognostic relevance remains elusive in pathological stage Ⅱ/Ⅲ(p Stage Ⅱ/Ⅲ) gastric cancer.METHODS One hundred and seventy-two advanced gastric cancer(defined as pT2 or beyond) patients with p Stage Ⅱ/Ⅲ who underwent curative surgery plus adjuvant S1 chemotherapy were evaluated, and the prognostic relevance of a high-risk macroscopic appearance was examined. RESULTS Advanced gastric cancers with a high-risk macroscopic appearance were retrospectively identified by preoperative recorded images. A high-risk macroscopic appearance showed a significantly worse relapse free survival(RFS)(35.7%) and overall survival(OS)(34%) than an average risk appearance(P = 0.0003 and P < 0.0001, respectively). A high-risk macroscopic appearance was significantly associated with the 13^(th) Japanese Gastric Cancer Association(JGCA) pT(P = 0.01), but not with the 13^(th) JGCA pN. On univariate analysis for RFS and OS, prognostic factors included 13^(th) JGCA p Stage(P < 0.0001)and other clinicopathological factors including macroscopic appearance. A multivariate Cox proportional hazards model for univariate prognostic factors identified highrisk macroscopic appearance(P = 0.036, HR = 2.29 for RFS and P = 0.021, HR = 2.74 for OS) as an independent prognostic indicator. CONCLUSION A high-risk macroscopic appearance was associated with a poor prognosis, and it could be a prognostic factor independent of 13^(th) JGCA stage in p Stage Ⅱ/Ⅲ advanced gastric cancer.

Successful Treatment of Postpeak Stage Patients with ClassⅡ Division 1 Malocclusion Using Non-extraction and Multiloop Edgewise Archwire Therapy: A Report on 16 Cases

Aim To determine cephalometrically the mechanism of the treatment effects of non-extraction and multiloop edgewise archwire （MEAW） technique on postpeak Class Ⅱ Division 1 patients. Methodology In this retrospective study, 16 postpeak Class Ⅱ Division 1 patients successfully corrected using a non-extraction and MEAW technique were cephalometrically evaluated and compared with 16 matched control subjects treated using an extraction technique. Using CorelDRAW software, standardized digital cephalograms preand post-active treatments were traced and a reference grid was set up. The superimpositions were based on the cranial base, the mandibular and the maxilla regions,and skeletal and dental changes were measured. Changes following treatment were evaluated using the paired-sample t-test. Student＇s t-test for unpaired samples was used to assess the differences in changes between the MEAW and the extraction control groups. Results The correction of the molar relationships comprised 54% skeletal change （mainly the advancement of the mandible） and 46% dental change. Correction of the anterior teeth relationships comprised 30% skeletal change and 70% dental change. Conclusion The MEAW technique can produce the desired vertical and sagittal movement of the tooth segment and then effectively stimulate mandibular advancement by utilizing the residual growth potential of the condyle.

Pattern of Refractive Correction and Timing of Stage Ⅱ IOL Implantation after Congenital Cataract Extraction

Congenital cataract occurs during infancy when the axial length and corneal and visual function are in the sensitive stages of rapid development..Inappropriate surgical intervention not only fails to restore visual function,.but also causes irreversible serious influences upon eyeball development in children diagnosed with congenital cataract. At present, the uncertainty of selection of intraocular lens(IOL) degrees during the eyeball development period is averted by using a main treatment of congenital cataract that includes two-stage surgery:.stage I cataract extraction and stage II IOL implantation. However, the accurate selection of a refractive correction method and the timing of IOL implantation during stage II surgery for aphakic eyes remains controversial following stage I cataract extraction..This review retrospectively summarizes the current progress and existing problems indicated by related recent studies focusing on refractive correction pattern and IOL implantation timing.

富血小板血浆联合髓芯减压植骨术治疗ARCOⅡ期非创伤性股骨头坏死的效果分析

目的:研用富血小板血浆联合髓芯减压植骨术治疗国际骨微循环研究协会(ARCO)Ⅱ期非创伤性股骨头坏死的效果。方法:本研究选择100例2018年7月至2020年7月期间广水市第一人民医院收治的ARCOⅡ期非创伤性股骨头坏死患者作为研究对象。样本选择完毕后,按照随机数表法将其分为对照组和观察组,每组各有患者50例。用富血小板血浆联合髓芯减压植骨术对观察组患者进行治疗,对照组患者单纯接受髓芯减压植骨术。比较两组患者治疗后的Harris髋关节功能评分(Harris评分)、视觉模拟评分法(VAS)评分及股骨头的存活率。结果:术后,观察组患者Harris评分中的疼痛评分、功能评分、畸形评分、活动范围评分均高于对照组患者,差异有统计学意义(P<0.05)。术后3个月、6个月及12个月,观察组患者的VAS评分均低于对照组患者,差异有统计学意义(P<0.05)。术后对两组患者进行随访(随访至今)得知,观察组患者股骨头的存活率为96.00%,对照组患者股骨头的存活率为84.00%,二者相比差异有统计学意义(P<0.05)。结论:用富血小板血浆联合髓芯减压植骨术治疗ARCOⅡ期非创伤性股骨头坏死的效果显著,能减轻患者术后的疼痛感,改善其髋关节的功能,提高其股骨头的存活率。

Construction of TGP StageⅡWorks

In the construction of Three Gorges Project, the total amount of concrete is about 28 Mm\+3 , and the total amount of metal works and reinforcement is approximately 0.72 Mt . The TGP is constructed in 3 stages . The preparation period together with the first stage is 5 years , the second stage and third stage are both 6 years .In the second stage construction of 6 years (1998～2003) , there are 18.46 Mm\+3 of concrete to be placed and 0.192 Mt of metal works and embedded parts for mechanical and electric equipment to be installed . In 1999, a world record of annual concrete placement of 4.585 Mm\+3 was set . In 2000, it is planned to place 5.4 Mm\+3 of concrete and to install 38 000 t of metal works . Construction equipments and layout of construction site , concrete production and its temperature control, metal works, mechanical and electric equipments in the second stage construction are presented.

The path toward prognostication and prediction in stage Ⅱ colon cancer

Currently,there are several newer biomarkers that may be clinically useful in colon cancer. This paper focuses on a few of these biomarkers,namely microsatellite instability,loss of heterozygosity at chromosome 18q(LOH18q) and multi-gene assays,and discusses the clinical evidence behind their predictive or prognostic abilities. The results show that although there have been several newer prognostic factors identified,such as LOH18 q and multi-gene assays,none of these factors can predict benefit from treatment. Therefore,ongoing prospective clinical trials are still needed to further assess the role and optimal use of these tests.

八段锦对冠心病PCI术后Ⅱ期心脏康复负性情绪及生活质量的影响

目的探讨八段锦对冠心病经皮冠状动脉介入治疗(PCI)术后Ⅱ期心脏康复患者负性情绪及生活质量的影响。方法将冠心病PCI术后Ⅱ期心脏康复患者80例随机分为对照组及治疗组,对照组采用常规治疗,治疗组在对照组的基础上增加八段锦康复锻炼。8周后,进行NT-proBNP、LVEF、6MWT检测及SDS、SAS、SF-36评分,观察不良事件发生情况。结果治疗后治疗组NT-proBNP较本组治疗前明显降低(P<0.05),LVEF、6MWT较对照组明显升高(P<0.05),SDS评分、SAS评分较对照组降低更明显,SF-36评分较对照组升高更明显(P<0.05);2组不良事件发生率无统计学差异(P>0.05)。结论八段锦健身功法能有效增强心脏功能,增加运动耐量,缓解PCI术后的焦虑、抑郁等不良心理状态,提高生活质量,促进全面恢复。