椎体成形术与椎体后凸成形术治疗骨质疏松性椎体压缩骨折术后伤椎再塌陷的对比研究

目的观察椎体成形术（percutaneous vertebroplasty,PVP）和椎体后凸成形术（percutaneous kyphoplasty,PKP）治疗骨质疏松性椎体压缩骨折（osteoporosis vertebral compression fracture,OVCF）术后发生伤椎再塌陷情况的差异。方法回顾性分析2007年1月~2012年1月本院采用此2种术式治疗,并获完整随访的OVCF患者资料581例。依据术式分组并测量术前、术后3 d内及末次随访的伤椎高度,对比伤椎再塌陷发生率及再塌陷所造成的矫正高度丢失比的组间差异,并结合既往研究及影像观察分析差异原因。结果术后伤椎再塌陷发生率PVP组为2.94%,PKP组为16.19%;再塌陷所造成矫正高度丢失比PKP组为〉PVP组。结论 PVP、PKP治疗OVCF,术后伤椎再塌陷风险不同,PKP较PVP更严重,此现象需引起重视,值得进一步研究。

Intra-set correlation analysis of medical records of thyroid cancer treated by traditional Chinese medicine Master ZHOU Zhongying

Objective Based on intra-set correlation analysis, this paper deconstructs the clinical medical records of traditional Chinese medicine(TCM) Master ZHOU Zhongying in treating thyroid cancer, and analyzes the experience in “mechanism-syndrome-medicine-prescription” for thyroid cancer.Methods Through Medcase data processing platform, based on Frequent Pattern(FP)-Growth enhanced correlation analysis algorithm, the medical records of Professor ZHOU Zhongying for the treatment of thyroid cancer from June 1, 2001 to February 28, 2015 were analyzed within the set.Results This study involved 43 medical records, 43 patients, and 167 visits. After processing intra-set correlations, 28 groups of highly correlated symptoms, 21 groups of highly correlated tongue images, 10 groups of highly correlated pulse conditions, 28 groups of highly correlated pathogenesis, 34 groups of highly correlated herbs, and 26 groups of highly correlated western medicine diagnosis were selected. Professor ZHOU Zhongying treats thyroid cancer according to syndrome differentiation. Symptoms with more association rules included neck swelling, neck pain, cough, and dry mouth;tongue images with more association rules included dark purple tongue, dark red tongue, and fissured tongue;pulse conditions with more association rules were wiry pulse, thready pulse, small pulse, and slippery pulse;the pathogenesis with more association rules was phlegm and blood stasis, damp-heat accumulation,and impairment of both Qi and Yin;herbs with more association rules were Chaihu(Bupleuri Radix), Zeqi(Sun Euphoribiae Herb), and Tiandong(Asparagi Radix);western medicine diagnosis with more association rules included thyroid cancer, insomnia, and chronic gastritis.Conclusion Thyroid cancer mostly presents as deficiency in origin and excess in manifestations. The basic pathogenesis is phlegm and blood stasis, damp-heat accumulation, and impairment of both Qi and Yin, which are closely related to liver, kidney, and spleen. Professor ZHOU Zhongying adopts both attack and supplement approaches as the general treatment principle, with a strong emphasis on regulating Qi and relieving depression, eliminating phlegm and resolving stagnation, eliminating dampness and turbidity, clearing fire and destroying poison, moistening dryness and softening hard mass, invigorating Qi and nourishing Yin, and paying attention to nourishing liver and kidney, invigorating spleen and stomach,while protecting the heart and lungs.

Re-analysis on Heidan Disease (Black Jaundice) in Synopsis of Golden Chamber (Jin Gui Yao Lue)

Heidan disease(black jaundice)is a kind of jaundice,which is caused by lingering and chronic jaundice,often with blood stasis and damp-heat,etc.The clinical symptoms of Heidan disease(black jaundice)are similar to those of cirrhosis caused by multiple chronic liver diseases in Western medicine.Heidan disease(black jaundice)generally belongs to yin jaundice type,and the pathogenesis is mostly related to blood stasis and dampness stagnation,often with damp-heat residue.According to Zhongjing Zhang,the prescription Xiaoshi Fanshi powder for the treatment of Heidan disease(black jaundice)is based on the understanding that the nature of Heidan disease(black jaundice)is inseparable from the two key pathological factors of dampness and blood stasis.The treatment of jaundice should be based on removing blood stasis and dampness,supplemented by soothing the liver and promoting the transportation function of spleen,removing blood stasis and harmonizing the collaterals,and promoting diuresis and reducing jaundice.In the treatment of jaundice,removing blood stasis and purging turbidity should be stressed,and powerful tonification should be used with caution.Since blood stasis and turbidity are always intermingling and often complicated with damp heat,the method of warm drying should be used with caution.For promoting blood circulation,removing blood stasis,and dredging the liver-biliarycollaterals,drasticmedicine shouldbeused withcaution.