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.
目的 总结胆管结核的临床特点，以提高胆管结核的认识和诊断水平。方法 分析1例胆管结核患者的临床资料、诊断过程并复习文献。结果 根据患者病程中有盗汗、胸片中有陈旧性结核、术前结核感染T细胞斑点试验（T-SPOT. TB）（＋＋＋）等信息，结合术中快速病理，明确诊断为胆管结核，行胆肠吻合术后，抗结核治疗6个月后患者痊愈。结论 胆管结核是一种罕见疾病，对于年轻患者患有占位性病变导致梗阻性黄疸、影像学中肿瘤特征不典型、患者来自结核高发区、有陈旧性结核病史、病程中有低热盗汗等任一症状者，应该注意结核的鉴别诊断，首选T-SPOT. TB检测或内镜引导下穿刺活检，术中冰冻活检是避免胆管结核患者过度医疗的最后一道防线。
目的 探讨十二指肠良性肿瘤的手术治疗方式及术后早期营养管理的效果。方法 回顾性分析2009年1月至2011年12月期间我科收治的15例十二指肠良性肿瘤患者的临床资料，根据肿瘤的生长部位及肿瘤大小实施不同的手术方式，术后早期给予肠内营养治疗及消化液回输，观察术后患者并发症发生率及术后2个月内的返院情况。结果 15例患者中2例患者肿瘤位于十二指肠乳头下、直径2.5cm和2.0cm，2例位于降部与水平部交界处、直径2.3cm和2.5cm，1例位于十二指肠升部、直径3.5cm，该5例患者行十二指肠节段切除并空肠吻合术。4例患者肿瘤位于十二指肠乳头、直径1.0～2.0cm，3例位于乳头上缘、直径1.5～1.8cm，2例位于球部与降部交界处、直径2.0cm和1.8cm，1例位于十二指肠乳头下、直径1.2cm，该10例患者均行肿瘤局部切除术（位于乳头部的肿瘤同时行乳头成形术）。围手术期无死亡病例。1例（1/15）发生胃排空障碍，经禁食、减压及营养支持治愈出院。术后住院时间为7～10d，平均8d。术后2个月患者均接受随访，恢复良好，无返院患者。结论 手术切除是十二指肠良性肿瘤的首选治疗手段，手术方式取决于肿瘤的生长部位和大小，术后早期营养管理安全、有效。
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.
【摘要】 目的 探讨难治性癫痫不同类型手术的预后与病程长短有无相关关系。 方法 回顾性分析2005年1月-2009年12月在四川大学华西医院神经外科进行难治性癫痫手术的143例患者，根据Engel分级对预后进行评估，分别分析各类型手术不同病程时间之间的预后差异以及相关关系。 结果 不同病程组颞叶手术和颞叶合并颞叶外手术的预后差异无统计学意义（Pgt;0.05），两者之间无相关关系；颞叶外手术的预后在不同病程组间差异有统计学意义（Plt;0.05），两者之间呈负相关。 结论 颞叶外癫痫手术的预后与病程存在相关关系；病程越短，预后越好。【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.
【摘要】目的探讨乳腺癌根治术式改良的方法及其在减少术后早期并发症中的意义。方法398例乳腺癌患者，行乳腺癌根治术22例，Patey氏手术83例，Anchincloss手术247例，改良Anchincloss手术46例。比较不同术式术后早期并发症发生情况。结果乳腺癌根治术术后的早期并发症发生率明显高于其它术式（Plt;0.01）； Patey氏手术与Anchincloss手术相比，皮下积液、皮瓣坏死的发生率差异无显著性意义（Pgt;0.05），但患侧上肢水肿的发生率前者高于后者（Plt;0.01）； 改良Anchincloss手术的并发症发生率明显低于前3种术式（Plt;0.01），且其手术时间比其它术式平均缩短20 min。结论改良Anchincloss手术能明显减少术后早期并发症发生率并缩短手术时间。
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.