Postmenopausal osteoporosis is a type of osteoporosis with high bone transformation rate, caused by a decrease of estrogen in the body, which is a systemic bone disease characterized by decreased bone mass and increased risk of fracture. In recent years, as a kind of non-pharmacologic treatment of osteoporosis, defined by whole-body vibration less than 1 g (g = 9.81 m/s2), low magnitude whole-body vibration is widely concerned, mainly because of its small side effects, simple operation and relative safety. Studies have shown that low magnitude whole-body vibration can improve bone strength, bone volume and bone density. But a lot of research found that, the therapeutic effects of low magnitude whole-body vibration are different depending on ages and hormone levels of subjects for animal models or human patients. There has been no definite vibration therapy can be applied to each subject so far. Studies of whole-body and cellular level suggest that low magnitude whole-body vibration stimulation is likely to be associated with changes of hormone levels and directed differentiation of stem cells. Based on the analysis of related literature in recent years, this paper made a review from vibration parameters, vibration effects and the mechanisms, to provide scientific basis and clinical guidance for the treatment of postmenopausal osteoporosis with low magnitude whole-body vibration.
ObjectiveTo evaluate clinical value of colon leakage score (CLS), a preoperative predictive scoring system, for risk of anastomotic leakage after left-sided colorectal cancer surgery. MethodsThe clinical data of 310 patients who underwent left-sided colorectal cancer surgery from January 2010 to December 2014 were studied retrospectively. Risk factors for postoperative anastomotic leakage were analyzed by univariate analysis. The sensitivity and specificity of CLS system were determined by receiver operating characteristic (ROC) curve analysis. Resultsa total of 14 patients were diagnosed as anastomotic leakage. The point of CLS for the patients with anastomotic leakage was significantly higher than that for the patients without anastomotic leakage (14.21±5.76 versus 4.43±3.36, t=9.474, P=0.000). The results of ROC curve analysis showed that the sensitivity and specificity of the CLS system were 92.9% and 88.6%, respectively. The area under the curve was 0.957 (95% CI 0.924-0.991). The best cut off value of CLS was 10 (The Youden index was 0.867). The results of univariate analysis showed that the age, preoperative hemoglobin level, status of intestinal obstruction, and blood loss were associated with postoperative anastomotic leakage (P<0.05). ConclusionThe preoperative predictive score system CLS could accurately predict occurrence of anastomotic leakage. While large, multicenter prospective randomized controlled trial is still needed to further confirm it.
目的 探討十二指腸良性腫瘤的手術治療方式及術后早期營養管理的效果。方法 回顧性分析2009年1月至2011年12月期間我科收治的15例十二指腸良性腫瘤患者的臨床資料，根據腫瘤的生長部位及腫瘤大小實施不同的手術方式，術后早期給予腸內營養治療及消化液回輸，觀察術后患者并發癥發生率及術后2個月內的返院情況。結果 15例患者中2例患者腫瘤位于十二指腸乳頭下、直徑2.5cm和2.0cm，2例位于降部與水平部交界處、直徑2.3cm和2.5cm，1例位于十二指腸升部、直徑3.5cm，該5例患者行十二指腸節段切除并空腸吻合術。4例患者腫瘤位于十二指腸乳頭、直徑1.0～2.0cm，3例位于乳頭上緣、直徑1.5～1.8cm，2例位于球部與降部交界處、直徑2.0cm和1.8cm，1例位于十二指腸乳頭下、直徑1.2cm，該10例患者均行腫瘤局部切除術（位于乳頭部的腫瘤同時行乳頭成形術）。圍手術期無死亡病例。1例（1/15）發生胃排空障礙，經禁食、減壓及營養支持治愈出院。術后住院時間為7～10d，平均8d。術后2個月患者均接受隨訪，恢復良好，無返院患者。結論 手術切除是十二指腸良性腫瘤的首選治療手段，手術方式取決于腫瘤的生長部位和大小，術后早期營養管理安全、有效。
目的 總結膽管結核的臨床特點，以提高膽管結核的認識和診斷水平。方法 分析1例膽管結核患者的臨床資料、診斷過程并復習文獻。結果 根據患者病程中有盜汗、胸片中有陳舊性結核、術前結核感染T細胞斑點試驗（T-SPOT. TB）（＋＋＋）等信息，結合術中快速病理，明確診斷為膽管結核，行膽腸吻合術后，抗結核治療6個月后患者痊愈。結論 膽管結核是一種罕見疾病，對于年輕患者患有占位性病變導致梗阻性黃疸、影像學中腫瘤特征不典型、患者來自結核高發區、有陳舊性結核病史、病程中有低熱盜汗等任一癥狀者，應該注意結核的鑒別診斷，首選T-SPOT. TB檢測或內鏡引導下穿刺活檢，術中冰凍活檢是避免膽管結核患者過度醫療的最后一道防線。
Objective To compare diagnosis values of computed tomography (CT) and magnetic resonance imaging (MRI) in preoperative staging of rectal carcinoma. Methods The imaging data of 81 patients with rectal carcinoma from January 2013 to January 2017 in the Hefei Second People’s Hospital were retrospectively analyzed. Based on the postoperative pathological results, the diagnostic accordance rates of CT and MRI on the T staging and N staging were calculated. Results The sensitivities of the CT and MRI on the preoperative T staging of rectal carcinoma were 69.1% (56/81) and 82.5% (52/63), the difference was not statistically significant (χ2=3.396, P=0.065), the Kappa values was 0.521 and 0.371, respectively, the MRI on the T staging was in a good agreement with the pathological diagnosis. The sensitivitie of the T1-2, T3, and T4 stagings with CT was 70.0%, 66.7%, and 72.0%, respectively, with MRI was 83.3%, 83.3%, and 81.0%, respectively, which had no significant difference respectively between the CT and the MRI. The areas under the receiver operating characteristic curve of the T1-2, T3, and T4 stagings with the CT and MRI were 0.809, 0.689, 0.798 and 0.897, 0.826, 0.869, respectively. The sensitivities of the CT and MRI on the preoperative N staging of rectal carcinoma were 59.3% (48/81) and 65.1% (41/63), the difference was not statistically significant (χ2=0.509, P=0.476), the Kappa values were 0.371 and 0.463, respectively. The sensitivities of the N0, N1, N2 stagings with CT were 64.7%, 45.5%, 64.0%, with MRI were 70.3%, 63.2%, 72.5%, which had no significant difference respectively between the CT and the MRI. Conclusions Results of in this study show that MRI is superior to CT for judgment of tumor infiltration. Neither CT nor MRI is able to provide satisfactory assessment of lymph node metastasis.
【摘要】目的探討乳腺癌根治術式改良的方法及其在減少術后早期并發癥中的意義。方法398例乳腺癌患者，行乳腺癌根治術22例，Patey氏手術83例，Anchincloss手術247例，改良Anchincloss手術46例。比較不同術式術后早期并發癥發生情況。結果乳腺癌根治術術后的早期并發癥發生率明顯高于其它術式（Plt;0.01）； Patey氏手術與Anchincloss手術相比，皮下積液、皮瓣壞死的發生率差異無顯著性意義（Pgt;0.05），但患側上肢水腫的發生率前者高于后者（Plt;0.01）； 改良Anchincloss手術的并發癥發生率明顯低于前3種術式（Plt;0.01），且其手術時間比其它術式平均縮短20 min。結論改良Anchincloss手術能明顯減少術后早期并發癥發生率并縮短手術時間。
【摘要】 目的 探討難治性癲癇不同類型手術的預后與病程長短有無相關關系。 方法 回顧性分析2005年1月-2009年12月在四川大學華西醫院神經外科進行難治性癲癇手術的143例患者，根據Engel分級對預后進行評估，分別分析各類型手術不同病程時間之間的預后差異以及相關關系。 結果 不同病程組顳葉手術和顳葉合并顳葉外手術的預后差異無統計學意義（Pgt;0.05），兩者之間無相關關系；顳葉外手術的預后在不同病程組間差異有統計學意義（Plt;0.05），兩者之間呈負相關。 結論 顳葉外癲癇手術的預后與病程存在相關關系；病程越短，預后越好。【Abstract】 Objective To discuss the relationship between prognosis of different intractable epilepsy surgeries and the disease course. Methods A total of 143 patients who had undergone surgeries for intractable epilepsy in the Neurosurgery Department of West China Hospital of Sichuan University from 2005 to 2009 were enrolled, and the prognosis with different disease course were assessed based on the Engel classification. Results Between different disease duration groups, the difference between the prognosis of the temporal surgery and the surgery of temporal lobe combined with other lobes was not statistically significant (Pgt;0.05), which indicated no relationship between the disease course and the prognosis. However, the difference between the prognosis of the surgeries outside the temporal lobe was statistically significant (Plt;0.05), which showed that patients with a longer disease course had a worse prognosis. Conclusion The prognosis of the epilepsy surgery outside the temporal lobe is correlated with the disease course. The shorter course has a better prognosis after surgery.