【摘要】 目的 观察运用涎腺镜对慢性下颌下腺炎诊断和治疗的临床效果。 方法 应用涎腺镜观察32例慢性下颌下腺炎患者导管,根据不同病因给予相应治疗。分别于手术前当天,手术后2、7 d,4周,6、12个月观察治疗效果。 结果 32例慢性下颌下腺炎患者中,28例存在导管结石。手术后2 d大部分患者胀痛症状明显缓解,之后1个月内呈逐渐缓慢缓解趋势,手术后6~12个月胀痛感略有回升表现。结论 运用涎腺镜治疗慢性下颌下腺炎是微创、有效的。【Abstract】 Objective To observe the clinical effect of chronic inflammation of submandibular gland treated by sialoendoscopy. Methods The conduit of 32 patients with chronic inflammtion of submandibular gland under sialoendoscopy, and to observe the curative effect after two, seven days, four weeks, six and 12 months. Results Of the all of 32 patients, 28 had stones in duck. Two days after surgery, the most patients has bursting pain palliation, and then relieved gradually; from six to 12 months after surgery, bursting pain rebounded slightly. Conclusions Use of sialoendoscopy on chronic inflammtion of submandibular gland is minimally invasive and effective treatment.
ObjectiveTo evaluate long-term radiographic and clinical effectiveness of total cervical disc replacement (TDR) with Prodisc-C prosthesis at a minimum of 10 years follow-up.MethodsThe clinical data of 118 patients with cervical disc degeneration disease (CDDD) treated with TDR by using Prodisc-C prosthesis between December 2005 and April 2008 were retrospectively analyzed. There were 66 males and 52 females, with the age of 25-62 years (mean, 46.8 years). There were 38 cases of cervical spondylotic radiculopathy, 28 cases of cervical spondylotic myelopathy, and 52 cases of mixed cervical spondylotic myelopathy. The operative segments were C3-7, including 90 cases of single segment, 20 cases of continuous double segments, and 8 cases of continuous three segments. A total of 154 Prodisc-C prostheses were used during the operation. The clinical effectiveness was evaluated by pain visual analogue scale (VAS) score, neck disability index (NDI), Japanese Orthopaedic Association (JOA) score, and Odom grade before and after operation. Imaging evaluation indicators included range of motion (ROM), sagittal lordosis angle, intervertebral disc height (IDH), and prosthesis displacement, subsidence, loosening, locking, and heterotopic ossification (HO), adjacent segment degeneration (ASD), and other complications. Patients were grouped according to whether HO or ASD occurred or not, the ROM of surgical segment was compared.ResultsAll patients were followed up 121-150 months (mean, 135.8 months). No revision operation was performed during the follow-up period. The VAS, NDI, JOA scores and Odom grades were significantly improved at 1 week after operation and last follow-up when compared with preoperative ones (P<0.05); VAS and NDI scores were further improved at last follow-up than those at 1 week after operation (P<0.05); there was no significant difference in JOA scores and improvement rates between at 1 week after operation and at last follow-up (P>0.05). The ROM of the whole cervical spine and the operative segment decreased at 1 week and 10 years after operation when compared with preoperative ones (P<0.05), but there was no significant difference in the other time points (P>0.05); there was no significant difference in the ROM between the upper adjacent segment (UAS) and the lower adjacent segment (LAS) at each time point after operation (P>0.05). There was no significant difference in sagittal lordosis angle of cervical spine before and after operation (P>0.05); the sagittal lordosis angle of operative segment increased significantly at 1 week, 6 months, 1 year, and 2 years after operation (P<0.05). The IDH of operative segment was significantly improved at each time point after operation (P<0.05), but there was no significant difference in IDH between UAS and LAS at each time point after operation (P>0.05). No prosthesis displacement, subsidence, or loosening occurred at each time point after operation. There was no significant difference of the prosthetic displacement and subsidence distance between all time points after 6 months after operation (P>0.05). At last follow-up, the incidence of prosthetic locking/fusion was 10.4%, showing no significant difference when compared with 6 months (1.9%) (P<0.05). The incidence of upper ASD and lower ASD was 1.3% and 2.6% respectively at 1 week after operation. The incidence of upper ASD and lower ASD increased gradually with time prolonging, and there were significant differences between different time points (P<0.05). The ROM of operative segment in ASD group was lower than that in non-ASD group at each time point after operation, but there was no significant difference (P>0.05). HO appeared in 58.4% of the segments at 6 months after operation, and the incidence of HO increased significantly with time, which was significantly different from that at 6 months after operation (P<0.05). The ROM of operative segments in HO group was significantly lower than that in non-HO group at 6 months, 2 years, 5 years, and 10 years after operation (P<0.05).ConclusionTDR has little effect on adjacent segments, although there are some imaging complications, it has no significant effect on the improvement of overall clinical effectiveness. Prodisc-C prosthesis can provide long-term, safe, and definite clinical effectiveness in the treatment of CDDD.
Objective To observe the influence of the indomethacin on the proliferative and invasive activity of OCM-1 human choroidal melanoma cells. Methods OCM-1 cells were cultured with different concentrations of indomethacin (25, 50, 100, 200, 400 mu;mol/L ), and their proliferation were assessed by methyl thiazolyl tetrazolium（MTT）, invasive behaviors were examined by cell invasion assays, expression of survivin and VEGF were evaluated by reverse transcriptase polymerase chain reaction（RT-PCR）, immunofluorescence staining, ELISA and western blot analysis. Result All concentrations of indomethacin in this study can inhibit the proliferation and invasion of OCM-1 cells in a time and dosage-dependant manner（MTT/24 h：F=19.642，P＜0.01；MTT/48 h：F=136.597，P＜0.01；MTT/72 h：F=582.543，P＜0.01；invasion assays：F=54.225，P＜0.01）. Immunofluorescence staining indicated that survivin and VEGF mainly expressed in the cytoplasm of OCM-1 cells. Survivin mRNA in OCM-1 cells was inhibited by 100, 200, 400 mu;mol/L indomethacin（F=16.679，P＜0.01）. The concentrations of survivin were (787.3plusmn;47.37), (257.0plusmn;26.21), (123.3plusmn;8.02) pg/ml in control group and 100, 400 mu;mol/L indomethacin groups, respectively. Survivin expression was also significantly down-regulated in indomethacin-treated cells by Western blot analysis.Indomethacin had no effects on VEGF expression in OCM-1 cells.Conclusions Indomethacin can inhibit proliferation and invasion of OCM-1 cells in vitro,down-regulated expression of survivin may be the mechanism.
Objective To observe the expression of vascular endothelial growth factor A (VEGFA) and its receptors sFlt-1, kinase insert domain receptor (KDR) in lightinjured human retinal pigment epithelial (RPE) cells. Methods Cultured human RPE cells (8th - 12th generations) were divided into normal control group and light damage group. The cells of two groups were exposed to the 18 W cold white light (2200±300) Lux for 12 hours to induce light damage responses, but the cells of normal control group were packed by tinfoil with doubledeck high pressure disinfection. The VEGF-A, sFlt-1 and KDR mRNA and protein expressions were detected by reverse transcriptionpolymerase chain reaction (RT-PCR) and Western blot at 0, 6, 12, 24 hours after light damage. Results The VEGF-A mRNA and protein expressions in light damage group were significantly increased at 6 hours, and reached its peak at 12 hours after light damage which obviously higher than that in normal group (t=2.74, 2.93; P＜0.05), and then went down gradually. The sFlt-1 mRNA and protein expressions in light damage group reached its peak at 12 hours after light damage which obviously higher than that in normal group (t=4.32, P＜0.01), but obviously lower than that in normal group at 24 hours after light damage (t=2.41, P＜0.05). The KDR mRNA and protein expressions in light damage group were obviously higher than that in normal group at 24 hours after light damage （t=2.89, P＜0.05）,but there was no changes at 6, 12 hours after light damage (t=1.84, P＞0.05). Conclusions At 6, 12 hours after light damage, the expressions of VEGF-A and sFlt-1 increases significantly and KDR expression is stable in lightinjured RPE cells. At 24 hours after light damage, the expression of VEGF-A and sFlt-1 decreases, but KDR expression increases in light-injured RPE cells.
Objective To explore the effects of drugs on functions of mitochondria in retinal nerve cells, and to lay a foundation of the investigation of drug protection for retinal nerve cells. Methods Cultivation of the retinal nerve cells of 8 eyes of neonatal calves was performed. The changes of fluorescent density of the mitochondria of cultured cells labeled by dye rhodamine 123 (Rh123) before and after the activation of the medicines, including ferulic acid (FA), arginine, glycine,taurine, vitamine E and brain derived neurotrophic factor( BDNF) respectively, were detected by laser-scanning confocal microscopy. Results FA with the concentration of 500 μg/ml led the diphasic variation of the fluorescent intensity of mitochondria. After scanning for 60.772 seconds when treated with FA firstly, the fluorescent intensity decreased rapidly (from 45.425±4.153 to 22.135±5.293); while after 112.774 seconds when treated secondly, the in tensity increased obviously (from 19.655±4.383 to 28.247±4.764), and after 168.773 seconds when treated thirdly the intensity still increased. After scanning for 56.457 seconds when treated with vitamin E (12.5 mg/ml), the fluorescent in tensity increased obviously (from 88.255±5.039 to 111.273±4.529), which suggested that vitamin E with the concentration of 12.5 mg/ml strengthen the fluorescent intensity. After scanning for 58.147 and 134.148 seconds when treated with BDNF(50 ng/ml) respectively, the fluorescent intensity increased obviously (from 69.115±5.038 to 77.225±5.131) which suggested that BDNF with the concent ration of 50 ng/ml led the increase of the fluorescent intensity. Glycine (2.5 mg/ml) and arginine(30 mg/ml) didn’t affect the fluorescent intensity of mitochondria, and taurine (6.25 mg/ml) caused the appreciable decrease of the fluorescent intensity . Conclusion FA, BDNF and vitamin E may promote the metabolism of retinal nerve cells via the path of mitochondria, while amino acids may adjust the activation of retinal nerve cells through other ways. (Chin J Ocul Fundus Dis，2004，20：229-232)
Objective To summarize the recent development on chondroprotective effect of alendronate (ALN) on articular cartilage in osteoarthritis (OA). Methods The related literature was reviewed and the main achievements in vitro/vivo studies in the fields were summarized. Results ALN can improve the metabolic microenvironment of the articular cartilage in OA, inhibit subchondral bone remodeling, so it has potential protective effect on articular cartilage. Conclusion ALN is expected to become a disease-modifying OA drug in future, but OA treatment still lack a uniform basic and clinical evaluation criteria, so it has guiding significance in development and application of ALN to develope a uniform standard and obtain the clinical data.
Objective To investigate the effects of gamma;-interferon (IFN-gamma; on the expression of costimulatory molecules B7-1 (CD80) and B7-2 (CD86) and Fas/FasL in human retina. Methods Nine human eyes were obtained from the eye-bank of Zhongshan Ophthalmic Center. Six eyes were used for making retinal wholemounts, and 12 retinal wholemounts from each eye were put into the 24-hole culture board which had 2ml DMEM/F12 culture medium in each hole. The wholemounts were divided into 3 groups whose concentration of IFN-gamma; was 0, 200, and 1000 U/ml respectively. After cultured in 37℃ culture box (95%O 2，5%CO 2) for 24 hours, the expressions of B7-1 (CD80), B7-2 (CD86), and Fas/FasL on these retinal wholemounts were detected by immunohistochemical method. The retinal wholemounts from 3 healthy people were detected by immunohistochemical method as the control. Results Expression of FasL but not B7-1, B7-2 or Fas was found in the control group, while the expression of B7-1, B7-2 and Fas and increased expression of FasL were found after cultured with IFN-gamma;. Conclusion IFN-gamma; may be involved in the occurrence of ocular immune response and induction of apoptosis via the stimulation of expression of costimulatory molecules and Fas/FasL, which plays an important role in the activation of T lymphocytes. (Chin J Ocul Fundus Dis, 2006, 22: 117-119)
ObjectiveTo evaluate the short-term effectiveness of Hyprocure subtalar stabilization for adolescent flexible flatfoot. MethodsBetween December 2013 and September 2015, 14 cases (26 feet) of adolescent flexible flatfoot were treated with Hyprocure subtalar stabilization. There were 10 males (18 feet) and 4 females (8 feet) with the average age of 14.5 years (range, 12-18 years). There were 12 cases (24 feet) of congenital flatfoot and 2 cases (2 feet) of flatfoot caused by neurological diseases. The preoperative pain visual analogue scale (VAS) was 4.2±0.4; the American Orthopaedic Foot and Ankle Society (AOFAS) ankle and foot function score was 72.2±12.3. Simple Hyprocure subtalar stabilization was used in 8 feet, and a combination of minimally invasive percutaneous Achilles tendon lengthening or gastrocnemius lysis, preposing of posterior tibial tendon and spring ligament tightening surgery, or open dorsal medial cuneiform osteotomy and bone graft in 18 feet. The VAS score and AOFAS ankle and foot function score were used to evaluate the effectiveness. The talus-the first metatarsal angle (T1MT), the talus-the second metatarsal angle (T2MT), and talonavicular coverage angle (TCA) were measured on the anteroposterior X-ray film; the Meary's angle, calcaneal inclination angle (CI), and the talar declination (TD) were measured on the lateral X-ray film. ResultsAll incisions healed well. Two cases (2 feet) had tarsal sinus pain, which was cured after symptomatic treatment. All patients were followed up 5-24 months (mean, 14.5 months). Pain was obviously relieved. At last follow-up, VAS score was significantly decreased to 1.4±0.3 (t=27.676, P=0.000). AOFAS ankle and foot function score was significantly increased to 94.5±10.8 (t=7.765, P=0.000). The postoperative X-ray film showed that medial arch was elevated after the Hyprocure subtalar stabilization was placed in tarsal sinus. At last follow-up, the T1MT, T2MT, TCA, Meary's angle, and TD were significantly improved when compared with preoperative ones (P < 0.05); CI has no significant improvement (t=0.109, P=0.598). ConclusionHyprocure subtalar stabilization is simple, effective for adolescent flexible flatfoot, the short-term effectiveness is good. But the indications should be strictly controlled, treatment should be individualized, corresponding auxiliary soft tissue and bone surgery is needed. The long-term effectiveness needs further follow-up.
摘要:目的: 探讨临床护理安全规范化管理的有效方法和效果。 方法 :成立病房护理安全管理小组;完善护理安全管理制度,培养质量管理意识;改善重点环节工作流程,强化质量监控;构建护理安全文化氛围。 结果 : 患者满意度明显提高,用药错误、管道脱落、压疮、投诉等发生率明显降低(〖WTBX〗P lt;0005)。 结论 : 规范化的护理安全管理提高了护理质量,保障了患者的安全,有效降低了护理风险的发生。Abstract: Objective: To discuss a effective way and effect of standardardized management of clinical nursing safety.Methods :Setted up nursing safety management team; Improved the nursing safety management system and trained awareness of quality management; Improved workflow of key links,and strengthened the quality control; Built a nursing safety culture. Results : Patients satisfaction improved obviously, and the medication errors、 pipe off、pressure sores、the incidence of complaints such as decreased obviously(P lt;0005).Conclusion : Standardized management of nursing safety improved the nursing quality, protected patients safety, and effectively reduced the risk of the occurrence of nursing.
ObjectiveTo explore the application effect of preoperative health education in patients with glaucoma. MethodsA total of 120 patients with glaucoma who underwent the surgery from February 2013 to December 2014 were randomly divided into control group and observation group, with 60 cases in each. The routine health education was performed on the patients in the control group while the personalized health education (on the basis of adopting the knowledge of the self-designed questionnaire) on the ones in the observation group. The results of Self-rating Anxiety Scale (SAS), Self-rating Depressive Scale (SDS), extent of disease knowledge, and nursing satisfaction were observed. ResultsAfter health education, the scores of SAS and SDS was 29.9±7.6 and 32.0±7.8, respectively in the observation group, which were significantly lower than those in the control group (34.9±7.9 and 35.9±8.3, P<0.05). Awareness of related knowledge and nursing satisfaction were 53 patients (88.3%) and 57 patients (95.0%) in observation group and 49 patients (81.7%) and 53 patients (88.3%) in the control group, (P>0.05). ConclusionPreoperative health education can improve the patients psychology and may reduce the occurrence of complications.