目的：觀察卡介菌多糖核酸聯合潤燥止癢膠囊治療慢性蕁麻疹的療效。方法： 將2008年4月~2009年4月門診就診的86例慢性蕁麻疹患者隨機分成兩組，治療組44例采用卡介菌多糖核酸2 mL肌注，隔日1次，18次為1療程；同時予口服潤燥止癢膠囊4粒，3次/d，連續治療36天；對照組42例單獨口服潤燥止癢膠囊，方法療程同治療組。結果： 治療組有效率為90.91%,對照組為7143%。兩組比較差異有顯著性（Plt;005）。結論： 卡介菌多糖核酸聯合潤燥止癢膠囊治療慢性蕁麻疹療效確切。
為預防應激性潰瘍和消化道出血, 質子泵抑制劑( PPI) 、組胺H2 受體拮抗劑( H2 RA) 以及硫糖鋁在ICU中的應用非常普遍。既往的研究認為以PPI 或H2RA 為代表的抑酸劑( ASD) 可致胃液pH 值增高, 為細菌在胃腔內定植創造了條件, 并進而增加醫院獲得性肺炎( HAP) , 尤其是呼吸機相關性肺炎( VAP) 發生的風險。我們通過文獻復習發現,ASD 與VAP 的關聯性迄今仍無明確的證據, 已有的臨床研究結論互為矛盾; 另一方面, 既往研究多集中于硫糖鋁與H2RA 的比較, 有關PPI 和H2RA 導致VAP 的風險比較研究仍然缺乏, PPI 是否比H2 RA 更易發生VAP 也缺乏研究可資證明。為此我們將有關內容綜述如下, 以供同道參考。
Objective To investigate the clinical applicationand curative effect of isoionic microtrauma arthroscope on treatment of knee arthropathy. Methods From May 2003 to November 2004, 52 cases of knee joint injury were cured by using isoionic microtrauma arthroscope, including 30 cases ofknee osteoarthritis, 10 cases of meniscus injury, 5 cases of kneecap dislocation, 5 cases of laxity of anterior cruciate ligation and 2 cases of rheumatoid arthritis. In accordance with Lysholm criterion for knee joint function, the scores were 35.5±4.9 before operation. Results All of these patients were followed up for 2-17 months. The scores of knee joint function was 86.4±5.3 after operation, and there was significant difference (Plt;0.001). Conclusion Isoionic microtrauma arthroscope is characterized by low-temperature hemoagglutination, crimpling,boiling, cutting and hemostasia, which makes kneejoint arthroscope operation easier-to-do, miner histological scathe and lighter side effect; so it is favourable for functional recovery and its curative effect is satisfactory.
Objective To evaluate clinical outcomes, patient satisfaction, and maintenance after treatment from mandibular implant-supported overdentures with different attachment types. Methods We searched six electronic databases: the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 4, 2005), Current Controlled Trials, MEDLINE (1966 to Sept. 2005), EMBASE (1984 to Sept. 2005), and Chinese biomedical database disk (1978 to Sept. 2005). Eleven Chinese professional journals in oral health were also handsearched from their first published issues. Three authors screened and selected the studies, appraised their methodological quality and extracted data from the studies. The results were presented narratively by meta-analysis. Results After strict screening, 12 trials involving 282 patients were included. Two of the trials were included in a meta-analysis with 27 patients in bar-clip group, 29 patients in ball-spring group, and the other trials were described thoroughly. The findings seemed to indicate that the bar-clip group had the highest retention but more oral mucosa complications, while the ball-spring group had good retention and less oral mucosa complications but needed more aftercare treatments, and the magnetic group had less retention but better peri-implant outcomes. Conclusions There is inadequate evidence to prove which is the best choice for mandibular implant-supported overdentures among bar-clip, ball-spring and magnetic attachments. More controlled clinical trials are required to guide clinicians on the choice of the type of attachment in mandibular implant-supported overdenture.
Objective To investigate the relationship between velopharyngeal functions and factors such as age at operation , cleft type, performing procedure.Methods FFT technique and velopharyngeal X-ray examination were used to evaluate the velopharyngeal functions of 82 patients. The relatively important factors affecting velopharyngeal functions were searched out through regression analyse and pearson correlation. Results A significant positive correlation was confirmed between AAO(age at operation) and A1/A2(velopharyngeal incompetence), Plt;0.001. AAO also showed linear regression with A1/A2. Model was significant, Plt;0.001. Quotation: A1/A2(velopharyngeal incompetence)=0.005 852×AAO+0.961. Conclusion AAOwas an important affecting factor on velopharyngeal functions. The earlier the cleft is repaired, the more normal velopharyngeal functions will be obtained.
【摘要】 目的 觀察腹腔鏡手術聯合孕三烯酮治療子宮內膜異位癥合并不孕的療效及不同評分系統對妊娠結局的預測價值。 方法 回顧性分析2004年1月-2006年12月收治的97例子宮內膜異位癥合并不孕患者的臨床病理資料，統計其術后妊娠率及活產率。 結果 術后1年內與1~2年的妊娠率與活產率比較，差異均無統計學意義（Pgt;0.05）。根據美國生育協會1985年修訂的子宮內膜異位癥分期標準（r-AFS）進行分期，各期患者術后妊娠率差異無統計學意義（Pgt;0.05）；但隨著分期升高，活產率逐漸下降（Plt;0.05）。子宮內膜異位癥生育指數（EFI）評分越高，其妊娠率和活產率也越高（Plt;0.05）。 結論 子宮內膜異位癥患者腹腔鏡手術后聯用孕三烯酮可能會提高遠期妊娠率。r-AFS分期對妊娠結局的預測有一定局限性，而EFI具有較好的預測性。【Abstract】 Objective To evaluate the therapeutic effectiveness of laparoscopic surgery combined with gestrinone treatment in the infertile women with endometriosis (EM), and the value of different score systems to predict gestational outcome. Methods We retrospectively analyzed the clinical data of 97 infertile women with EM who were treated in our hospital from January 2004 to December 2006, and collected their pregnancy rate (PR) and live birth rate (LBR) after operation. Results There was no significant difference of PR and LBR within the 1st year and between the 1st and the 2nd year (Pgt;0.05). There was no significant difference of PR among women of various stages of EM based on the 1985 edition of risk stratification for patients with EM put forward by American Fertility Society (r-AFS) (Pgt;0.05), but the LBR decreased with the raising of the stages (Plt;0.05). The endometriosis fertility index (EFI) was positively correlated with PR and LBR (Plt;0.05). Conclusion Laparoscopic surgery combined with gestrinone may increase the long-term pregnancy rate of women with EM. R-AFS classification is limited in predicting the gestational outcome of women with EM, while EFI achieves a better result.
Objective To explore a new method of treating early avascular necrosis of femoral head (AVNFH). Methods Sixty-nine New Zealand adult rabbitswith a mean weight of 2.8 kg after AVNFH presenting were randomly divided into three groups. In group A, deproteinized bone(DPB) combined with the recombinant plasmid pcDNA3.1/vascular endothelial growth factor 165(VEGF165) was implanted in the drilled channel of the necrotic femoral head. In group B, only DPB was implanted. In group C, channel was drilled without DPB or plasmid implanted. Femoral head specimens were obtained 3 days, 1, 2, 4, 8 and 16 weeks after operation. The expression of VEGF165 was examined by RT-PCR, Western blot and immunohistochemical techniques. X-ray testedbone formation generally. Angiogenesis and repair of the femoral head were observed by histological and histomorphometric analysis. Results In group A, the expressions of VEGF165 mRNA and protein were detected 3 days postoperatively, reached apex 1 week and lasted more than 3 weeks after implantation. The ratios of IOD of collagen type Ⅰ were 0.29±0.11, 0.55±0.13 and 0.67±0.10 IOD/μm2 respectively at 2, 4 and 8 weeks postoperatively and the ratios of IOD of new capillary vessels were 0.33±0.10and 0.57±0.16 IOD/μm2 respectively at 2, 4 weeks postoperatively in group A, showing statistically significant difference (Plt;0.01) when compared with groups B and D. X-ray test indicated much bone callus formed early. Conclusion Transfection of the VEGF165 gene can enhance local angiogenesis at early stage andDPBVEGF165 compound can improve bone formation. Deproteinized bone combined with VEGF165 gene provides a potential method for therapy of osteonecrosis.
Objective To understand status of technical realization, present development, faced problems, and application prospects of reduced-port laparoscopic surgery for rectal cancer, and to analyze safety and feasibility so as to provide theoretical and practical basis for clinical application and promotion. Method By searching the databases such as Medline, Embase, and Wanfang, etc., the relevant literatures about reduced-port laparoscopic surgery for rectal cancer were collected and reviewed. Results At present, the most common reduced-port laparoscopic surgery was the 1-port laparoscopic surgery, 2-port laparoscopic surgery, and 3-port laparoscopic surgery. The 1-port laparoscopic surgery had the effects of minimal invasiveness and cosmesis, but it was difficult to perform. The 2-port laparoscopic surgery for rectal cancer preserved as far as possible the effect of minimal invasiveness, the difficulty of procedure was reduced greatly, which was easy to be learnt and promoted. The experience of the 3-port laparoscopic surgery for rectal cancer contributed to the technical development of the 1-port laparoscopic surgery, with no need for the assisted incision for intraoperative specimen. The reduced-port laparoscopic surgery for rectal cancer was technically feasible and safe, which possessed the equal or better short-term outcomes as compared with the conventional 5-port laparoscopic or open surgery beside the radical resection for rectal cancer. However, the stringent technique for the laparoscopic surgery was necessary and it needed to overcome the learning curve. Conclusions Reduced-port laparoscopic surgery has some obvious advantages in minimal invasiveness, cosmesis, and enhanced recovery. More large-sample, multi-center, randomized controlled trials are eager to further confirm safety, effectiveness, and feasibility of reduced-port laparoscopic surgery for rectal cancer.
The freeze-drying is a technology that preserves biological samples in a dry state, which is beneficial for storage, transportation, and cost saving. In this study, the bovine pericardium was treated with a freeze-drying protectant composed of polyethylene glycol (PEG) and trehalose (Tre), and then freeze-dried. The results demonstrated that the mechanical properties of the pericardium treated with PEG + 10% w/v Tre were superior to those of the pericardium fixed with glutaraldehyde (GA). The wet state water content of the rehydrated pericardium, determined using the Karl Fischer method, was (74.81 ± 1.44)%, which was comparable to that of the GA-fixed pericardium. The dry state water content was significantly reduced to (8.64 ± 1.52)%, indicating effective dehydration during the freeze-drying process. Differential scanning calorimetry (DSC) testing revealed that the thermal shrinkage temperature of the pericardium was (84.96 ± 0.49) ℃, higher than that of the GA-fixed pericardium (83.14 ± 0.11) ℃, indicating greater thermal stability. Fourier transform infrared spectroscopy (FTIR) results showed no damage to the protein structure during freeze-drying. Hematoxylin and eosin (HE) staining demonstrated that the freeze-drying process reduced pore formation, prevented ice crystal growth, and resulted in a tighter arrangement of tissue fibers. The frozen-dried bovine pericardium was subjected to tests for cell viability and hemolysis rate. The results revealed a cell proliferation rate of (77.87 ± 0.49)%, corresponding to a toxicity grade of 1. Additionally, the hemolysis rate was (0.17 ± 0.02)%, which is below the standard of 5%. These findings indicated that the frozen-dried bovine pericardium exhibited satisfactory performance in terms of cytotoxicity and hemolysis, thus meeting the relevant standards. In summary, the performance of the bovine pericardium treated with PEG + 10% w/v Tre and subjected to freeze-drying could meet the required standards.
Objective To investigate the effectiveness of meniscal allograft in treatment of discoid meniscus tear. Methods Between May 2005 and September 2009, 7 cases of discoid meniscus tear were treated with meniscal allograft. There were 2 males and 5 females with an average age of 22.6 years (range, 18-33 years). The locations were the left knee in 5cases and the right knee in 2 cases. The causes were sport trauma in 4 cases, impact injury in 2 cases, and no apparent reason in 1 case. Of them, 7 cases had joint tenderness gap, 2 cases had positive results in floating patella test, 7 cases had positive results in McMurray test, and 6 cases had positive results in squatting test. The range of knee motion was 0-60°. The disease duration ranged from 3 months to 17 years (median, 26 months). Results The number of the pins was 9-13 (mean, 11). The operative time ranged from 1.5 to 2.7 hours (mean, 1.7 hours). The postoperative fever time ranged from 31 to 57 hours (mean, 46.4 hours). Incisions healed by first intention in 6 cases; infection occurred in 1 case after operation and was cured after 18 days of local irrigation with antibiotic sal ine. Seven patients were followed up 21.6 months on average (range, 12-53 months). The range of knee motion was 0-125°. All patients had the negative results of floating patella test, McMurray test, and squatting test. MRI showed that there was a good heal ing between the transplanted meniscus and the surrounding synovium. The Japanese Orthopaedic Association (JOA) score was 80.71 ± 4.82 at 6 months after operation, showing significant difference (t=10.11, P=0.00) when compared with the score (41.71 ± 8.07) before operation. Conclusion Meniscal allograft in treatment of discoid meniscus tear is a rel iable and effective method, which can ease knee pain.