In this series of 34 cases, 2 patients performed hepatic dect-jejunal anatomosis, 9 were PTCD external drainage, 8 were installation of internal drainage tubes through the PTCD, 9 were laparotories, 3 were cheemotherapeutic perfusison through artery and 3 were untreated. According to the follow-up results, the authors recommend that the internal drainage through PTCD is the better method to treat unresectable carcinoma of bile duct for proper patients.
Objective To evaluate the characteristics, classification, treatment methods, and cl inical outcomes of the spoke heel injuries in children. Methods From June 2001 to June 2008, 289 children with bicycle or motorcycle spoke heel injuries were treated, including 179 males and 110 females aged 2-12 years old (average 3.9 years old). There were 179 cases of skin contusion and laceration (type I), 83 cases of skin and soft tissue defect with Achilles tendon exposure (type II), and 27 cases of wide skin and soft tissue defect with the Achilles tendon defect and rupture (type III). The defect size of the skin or the soft tissues ranged from 3 cm × 2 cm to 11 cm × 7 cm in type II and type III injury. The time between injury and hospital admission was 1-53 days (average 14.5 days). Child patients with type I injury were managed with dressing or suturing after debridement. For the child patients with type II injury, the wound was repaired with the regional fascia flap in 53 cases, the reverse sural neurocutaneous vascular flap in 19 cases, the reverse saphenous neurocutaneous vascular flap in 9 cases, and the lateral supramalleolar flap in 2 cases. For the child patients with type III injury, 6 cases underwent primary repair of the Achilles tendon followed by the transposition of the reverse sural neurocutaneous vascular flap, 3 cases received primary repair of the wound with the reverse sural neurocutaneous vascular flap and secondary reconstruction of the Achilles tendon with the upturned fascia strip or the ipsilateral il iotibial tract transplant, and 18 cases underwent primary repair of the wound and the Achilles tendon with the sl iding bi-pedicled gastrocnemius musculocutaneous flap. The flap size ranged from 4 cm × 2 cm to 30 cm × 12 cm. All the donor sites were closed bypartial suture and spl it-thickness skins graft. The lower l imbs were immobil ized with plaster spl ints after operation. Results All the flaps survived except for 1 case of type II suffering from distal flap venous crisis 3 days after operation and 6 cases of type III suffering from distal flap necrosis 3-5 days after operation. All those flaps survived after symptomatic treatment. All the skin grafts at the donor site survived uneventfully. All the wounds healed by first intention. All child patients were followed up for 15-820 days (average 42 days). Child patients with type I and type II injury had a full recovery of ankle functions. While 25 cases of type III injury had ankle dorsal extension degree loss (10-30°) and unilateral plantar flexion strength decrease 3 months after operationwithout influence on walking, and 2 cases recovered well. Conclusion Spoke heel injury in children has special mec hanisms of injury, and the choice of proper treatment method should be based on the types of injury.
The Essential of ACC/AHA Guidelines for the Management of Patients with ST-Elevation Myocardial Infarction was introduced, including epidemology, initial management in the emergency department and hospital management.
Objective To establish the Chinese Evidence-Based Medicine/Cochrane Centre Database of Clinical Trials and Diagnostic Tests to provide reliable scientific data for clinical practice, teaching, research and systematic reviewers and submit the results of randomised controlled trials (RCTs) and controlled clinical trials (CCTs) to The Cochrane Collaboration. Methods Data were collected by handsearching and electronic searching based on the criterion of the Collaboration and clinical epidemiology. Results Up to December 2003, there were 16 652 RCTs /CCTs and 3 786 DT included in the database. A total of 4 966 RCTs and CCTs were submitted to the Collaboration. Nineteen specialized databases were set up. Conclusions The first phase of the Chinese Evidence-Based Medicine/Cochrane Centre Database of Clinical Trials and Diagnostic Tests has been completed. The database has provided advice for contributiors both at home and abroad.
摘要:目的: 总结2型糖尿病患者阴茎勃起功能障碍(ED)的相关危险因素及临床治疗评价。 方法 :分析收集两家医院120例住院及门诊2型糖尿病男性患者的性功能状况、年龄、糖尿病病程、血压、糖化血红蛋白、血脂、吸烟与否等指标,以及接受真空负压吸引联合万艾可治疗的79名患者追踪3个月的疗效评分。 结果 :男性2型糖尿患者中ED的患病率为658%,多因素回归分析显示患者年龄、糖尿病病程、糖化血红蛋白与ED的发生独立相关,而血压、血脂等因素〖WTBX〗P ＞005,无显著性差异。接受真空负压吸引联合万艾可治疗的79例ED患者其有效率达到759%。 结论 :男性2型糖尿病患者中ED是常见的合并症,患病率随年龄、糖尿病病程、糖化血红蛋白的增加而增加。真空负压吸引联合万艾可治疗糖尿病合并ED疗效可靠。Abstract: Objective: Make a conclusion on related ED risk factors and clinic therapy evaluation in 120 Type 2 male diabetic mellitus. Methods : Analyze and collect 120 cases in two hospitals regarding sexual function,age,diabetes course,blood pressure,HbA1c,bolldfat, smokingcondition,etc;follow up 79 cases for 3months and evaluate therapy as a result of vacuum subpressure absorption associated with viagra (sildenafil) therapy. Results : The ED rate in Type 2 male diabetic is 658%;the multifactorial regression analysis shows that occurrence of ED is respectively related with age,diabetes course,HbA1c;there isn’t obvious discrdpancy in blood pressure,blood fat,etc(P ＞005); the effective rate of vacuum subpressure absorption associated with Viagra (sildenafil) therapy in 79 cases is759%. Conclusion : It’s common complications to get ED among the Type 2 male Diabetics and the case rate goes up with the increase of age,diabetes course, HbA1c;it’s reliable to take therapy of vacuum subpressure absorption associated with Viagra.
ObjectiveTo summarize the current progress of clinical therapy for hemifacial microsomia (HFM). MethodsThe domestic and overseas articles concerning the treatment of HFM were reviewed and analyzed. ResultsThe unified therapeutic schedule of HFM has not yet been determined due to its variable clinical manifestation. Therapies mainly include: correction of bone deformity, which attain high effectiveness by adopting distraction osteogenesis or the improvement approach based on it; repair of the hypoplasia of facial soft tissue using graft of free tissue or autologous fat, augmentation of prosthesis materials. Autologous fat is becoming a hot research area and is widely used in recent years. For the aspect of treatment of microtia, different methods are adopted according to the severity of the malformation. ConclusionThe uniform clinical diagnosis and therapy of HFM are not determined for its complicated classification and unknown etiology. The research of etiology and tissue engineering may provide the therapy of HFM.