Objective To explore whether there is enough clinical evidence to confirm that stereotactic aspiration does more good than harm in patients with cerebral hemorrhage. Method A systematic review of all relevant clinical studies on stereotactic aspiration in the treatment of cerebral hemorrhage. Results Eight randomized controlled trials (RCTs) including 757 patients and 17 nonrandomized controlled studies including 1 766 patients, as well as 20 uncontrolled studies including 1 244 patients were identified . All studies reported positive results regarding the effects. However, the quality of the included studies were generally poor. The main problem was that most trials reported them as a RCT, but no description of the method of randomization. Conclusions Stereotactic aspiration in the treatment of cerebral hemorrhage is promising based on present evidence. However, at present, we can not draw definite conclusion whether the treatment does more good than harm compared with noninvasive medical treatment because of the poor quality of included studies. Therefore, more high quality RCTs are required.
【摘要】 目的 探讨血管内治疗颅内动脉瘤围手术期并发症的原因及护理对策。 方法 对2007年3月-2011年1月收治的365例采用血管内治疗动脉瘤患者中22例围手术期出现并发症者的临床资料进行回顾性分析。 结果 22例患者围手术期出现并发症，占6%。动脉瘤破裂再出血6例，其中发生于术前2例，术中3例，术后1例；脑血管痉挛 10例；脑血管血栓形成 4例，穿刺部位血肿 2例。 结论 血管内治疗颅内动脉瘤围手术期，采取预见性护理措施预防及观察主要并发症的发生和正确处理并发症，可降低其病死率和致残程度。【Abstract】 Objective To study and discuss the reasons for and clinical nursing of perioperative complications for patients undergoing endovascular treatment for intracranial aneurysms. Methods Twenty-two of 365 aneurysm patients who had undergone endovascular treatment between March 2007 and January 2010 in our hospital had perioperative complications. We retrospectively analyzed their clinical data. Results Twenty-two patients had perioperative complications, accounting for about 6%. The aneurysm was ruptured in 6 cases, which occurred before surgery in 2 patients, during the surgery in 3, and after the surgery in 1. There were 10 cases of cerebrovascular spasm, 4 cases of cerebrovascular thrombosis, and 2 cases of puncture site hematoma. Conclusion During the perioperative period of endovascular treatment for intracranial aneurysms, prognostic prevention measures, observation of the occurrence of major complications and proper management of complications can effectively reduce mortality and the degree of disability.
Objective To introduce the cells and cell-transplantation methods for periodontal tissue engineering. Methods Recent l iterature about appl ication of cell-based therapy in periodontal tissue engineering was extensively reviewed, the cells and cell-transplantation methods were investigated. Results Mesenchymal stem cells were important cell resourcesfor periodontal tissue engineering, among which peridontal l igament stem cells were preferred. Bone marrow mesenchymal stem cells had several disadvantages in cl inical appl ication, and adipose-derived stem cells might be a promising alternative; different transplantation methods could all promote periodontal regeneration to some extent. Single-cell suspension injection could only promote a l ittle gingival regeneration, and tissue engineered scaffolds still needed some improvement to be used in periodontal regeneration, while cell sheet technique, with great cell loading abil ity and no need of scaffolds, could promote regeneration of cementum, periodontal l igament, and alveolar bone under different conditions. Conclusion Multipotent stem cells are fit to be used in periodontal tissue engineering; improvement of cell-transplantation methods will further promote periodontal regeneration.
【Abstract】 Objective To investigate the appl ication and significance of computer assisted orthopedicsurgery(CAOS) in orthopedic trauma surgery. Methods In orthopedic trauma surgery, the appl ication status of CAOS was?analysed and the related problems were summarized. Results At present, CAOS is seldom used to reduce fractures but frequently used to insert internal fixation devices and reconstruct the cruciate l igament in orthopedic trauma surgery. And the studies have shown its superiority. During CAOS appl ication, surgeons should pay attention to some problems such as the disadvantages, cl inical evaluation, the roles of the surgeons and correct micro-traumatic concept. Conclusion CAOS is very important and cannot be replaced in orthopedic trauma minimal invasion surgery and surgeons should pay attention to some important related problems to make it develop successfully in the study of CAOS.
OBJECTIVE: To review the methods of end-to-side anastomosis in repair of peripheral nerve injury and to analyze the difficulty faced. METHODS: By index of recent literature, the kind of experimental model, observation criteria and the clinical data were collected and analyzed. RESULTS: For different methods of end-to-side anastomosis in repair of peripheral nerve defect, the clinical outcomes were reported differently. The clinical application was fewer. There was lack of case summary and assessment criteria. CONCLUSION: The superiority of end-to-side anastomosis made it necessary to further study the mechanism and improvement of quality.
目的 评价国产吻合器和闭合器在食管癌消化道重建术中的应用价值。 方法 回顾性分析2005年3月-2008年4月期间收治的387例食管癌手术患者的临床资料，根据不同消化道重建方式分为手工吻合组（n=172）和器械吻合组（n=215），对两组患者吻合时间、术中出血量及术后并发症发生情况进行对比分析。 结果 全组无手术死亡。器械吻合组和手工吻合组术中出血量的差别无统计学意义（Pgt;0.05），但前者的吻合时间、住院时间均少于后者（Plt;0.05）。手工吻合组术后吻合口出血多于器械吻合组（5.2%比1.4%，Plt;0.05），发生吻合口漏亦多于器械吻合组（6.4%比2.8%，Plt;0.05）。随访1.5～2年，排除失访患者后，器械吻合组吻合口狭窄发生率低于手工吻合组（4.6%比10.3%，Plt;0.05）。 结论 国产吻合器与和缝合器用于食管癌的消化道重建安全有效，值得在基层医院推广应用。
目的 探讨急性扩容联合控制性降压在脊柱手术的应用。 方法 2007年7月-2009年1月，60例择期脊柱手术患者随机分成3组:A组：对照组；B组：急性扩容组；C组：急性扩容联合控制性降压组。A组输林格氏液15 mL/kg，诱导前30 min输入1/2，另1/2在2~3 h内输完。B组在A组基础上，诱导后30~45 min输入20 mL/kg 6%羟乙基淀粉。C组在B组基础上，持续泵注硝酸甘油0.5~10.0 μg/（kg•min）控制血压，同时增加输液量，增加有效循环血容量；止血后，缝合切口前，静脉注射速尿2~5 mg。 结果 A组平均血压无B、C组稳定，B、C组中心静脉压扩容后显著增加（Plt;0.05），红细胞压积显著降低（Plt;0.05）；C组出血量最少（Plt;0.05）。 结论 急性扩容联合控制性降压在脊柱手术中应用安全，可以大大减少出血量。
ObjectiveTo investigate the association between TNF-α gene -308G/A polymorphism and the risk of coronary atherosclerotic heart disease (CHD) in Chinese population.MethodsWe searched PubMed, Web of Science, CNKI, WanFang Data and VIP Databases from inception to February 2017, to collect case-control studies about the association between TNF-α gene -308G/A polymorphism and risk of CHD in Chinese population. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was performed by Stata 12.0 software.ResultsA total of 10 case-control studies were included. The results of meta-analysis showed a significant association between the TNF-α gene -308G/A polymorphism and CHD risk in Chinese population (A vs. G: OR=1.13, 95%CI 1.02 to 1.26, P=0.020; AA vs. GA/GG: OR=1.47, 95%CI 1.02 to 2.12, P=0.038; AA vs. GG: OR=1.50, 95%CI 1.04 to 2.16, P=0.029).ConclusionThe current evidence shows that the TNF-α gene -308G/A polymorphism may be associated with CHD risk in Chinese population and A allele may be a risk factor. Due to the limited quantity and quality of included studies, more high quality studies are needed to verify the above conclusion.
Objective To summarize the current status of pedicled flaps for defect repair and reconstruction after head and neck tumor resection, and to present its application prospects. Methods Related literature was reviewed, and the role evolution of pedicled flaps in the reconstruction of head and neck defects were discussed. The advance, anatomical basis, indications, advantages, disadvantages, and modification of several frequently used pedicled flaps were summarized. Results The evolution of pedicled flaps application showed a resurgence trend in recent years. Some new pedicled flaps, e.g., submental artery island flap, supraclavicular artery island flap, submandibular gland flap, and facial artery musculomucosal flap, can acquire equivalent or even superior outcome to free flaps in certain cases. Technological modification of some traditional pedicled flaps, e.g., nasolabial flap, pectoralis major myocutaneous flap, latissimus dorsi musculocutaneous flap, temporalis myofascial flap, and temporoparietal fascial flap, can further broaden their indications. These traditional flaps still occupy an irreplaceable role, especially in patients with poor condition and institution with immature microsurgical techniques. Conclusion The pedicled flaps still plays an important role in head and neck reconstruction after tumor resection. In certain cases, they demonstrate some advantages over free flaps, e.g., more convenient harvest, more rapid recovery, less expenditure, and better functional and aesthetic effect.
Objective To summarize the research progress in the diagnosis and treatment of pancreatic cystic neoplasms (PCNs). Method The guidelines and literatures related to the diagnosis and treatment of PCNs were collected and reviewed. Results At present, there was still no clear method to distinguish the types of PCNs and their benign and malignant, and there was still a dispute between domestic and foreign guidelines on the diagnosis and treatment of PCNs. Conclusion Clinical researchers still need to carry out more research, provide higher quality evidence, resolve the disputes existing in different guidelines, standardize the diagnosis and treatment process of PCNs, thus, PCNs can be identified early, diagnosed accurately and intervened in time.