简介：Theinductionofinfertilityinmalesofseveralspeciesthroughepididymalinterferenceismoredifficulttoachievebyreductionoftheamountsofepididymalsecretions(ega-glucosidase,L-camifine)orimmunologicalinterferencewithsecretedproteins(egD/E,P34H,P26h)thanbydirectactionsofdrugsonspermfunction(eginhibitionofglyceraldehyde3-phosphatedehydrogenasebychloro-compounds).Thelatterapproachholdspromiseformankindashumanspelmaresusceptibletoglycolyticinhibition.Futurecontraceptivedevelopmentsmayarisefromproductionoftargetedinhibitors,researchonthedisplacementofspermproteinsintheepididymisandinterferencewithspermplasmamembraneionchannels.(As/anJAndrof1999Jun;1:29-36)

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简介：AbstractTonsillectomy is a very common procedure in children, often performed on an outpatient basis. Severe postoperative pain is common, and can be prolonged. Despite a large number of available analgesic medications, often employed in combination, achieving adequate pain control remains a persistent challenge. Research suggests a tendency among caregivers to undertreat pain, and a need for detailed care instructions and education to ensure adequate pain management. Furthermore, ongoing questions regarding the safety and efficacy of the most commonly used medications have led to wide variance in practice patterns and continuous reassessment through research that yields sometimes conflicting results. This review summarizes the current state of the literature and presents a management approach which attempts to maximize pain control while minimizing potential harm with combinations of medications and modification based on patient-specific factors.

简介：Objective:Toreporttheexperienceinthediagnosisandtreatmentofpost-traumaticpseudoaneurysmsandarteriovenousfistulas.Methods:Aseriesof30patients(11womenand19men)withposttraumaticpseudoaneurysmswerereviewedretrospectively.Amongthem7patients(5womenand2men)wereassociatedwitharteriovenousfistula.Results:Thecausesincludedsharppenetrationtrauma(18cases),blunttrauma(6cases)andiatrogenicarterialinjury(6cases).Themainclinicalmanifestationsconsistedoflocalpulsatilemass(26cases),vascularbruits(19cases),thrill(13cases),ischemiaofdistallimb(9cases),neuropathy(5cases)andpseudoaneurysmrupture(2cases).Allpatientsunderwentsurgery.Theoperationsincluded:ligationofthevessels(12cases),surgicalresectionandprimarysuturerepainofthevasculardefectoranastomosis(11cases),vascularreconstructionwithautogenoussaphenousvein(3cases)andsyntheticvasculargraft(4cases).Conclusions:Becauseoftheimminentclinicalcourse,earlyoperationisusuallyindicated.Theoperativetreatmentiseffectiveandsafeformostofthepatientswithpost-traumaticpseudoaneurysmsandarteriovenousfistulas.

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简介：目的：观察头针、体针结合治疗中风后共济失调的临床疗效。方法：选择符合诊断标准的中风后共济失调患者124例，采用头针、体针结合治疗，观察治疗前后脑血管血液流速变化及总体治疗效果。结果：根据Berg平衡量表评定结果，总有效率93．5％。治疗前后日常生活活动能力（ActivitiesofDailyLiving，ADL）指数比较，总有效率91．1％。治疗前后椎基底动脉血液流速比较差异具有统计学意义（P〈0．05）。结论：针刺治疗中风共济失调疗效明显。

简介：目的：研究以黄芪注射液穴位注射配合艾灸疗法对化疗后白细胞减少症患者白细胞数量及细胞免疫的影响。方法：将恶性肿瘤化疗后白细胞减少症患者86例，随机分为黄芪注射液穴位注射配合艾条温和灸治疗组（治疗组）、西药口服组（对照组），分别进行对照治疗，以治疗前后临床症状、外周血白细胞数量、T淋巴细胞亚群CD3^＋、CD4^＋、CD8^＋含量的变化为指标进行实验观察。结果：黄芪注射液穴位注射配合艾条温和灸较升白药口服有明显提高外周血白细胞数的作用；前者能提高肿瘤患者外周血T细胞亚群CD3^＋、CD4^＋含量、使CD4^＋／CD8^＋比值升高，两组比较有显著性差异（P〈0．01）；并且能明显改善全身虚损症状。结论：黄芪注射液穴位注射配合艾条温和灸能有效升高白细胞，改善恶性肿瘤患者的全身症状。

简介：客观：调查创伤的有三个尖头的不足的外科的治疗的最佳的时间和过程。方法：从1984年5月到2004年9月，八个病人为创伤的有三个尖头的阀门不足经历了操作。所有病人，男性，从7～67年变老[中部：38年，意味着：（38。5±18。1)年]。在损伤和操作之间的间隔从1个月到20年[中部：19个月，意味着：(52.5±80.3)月)]。Inseven病人，有三个尖头的不足被归因在三个病人包括车辆事故弄钝胸损伤，另外的病人是一处stab创伤。诊断是证实的byechocardiography。在病人的外科手术前的心脏的功能作为纽约HeartAssociation(NYHA)班Ⅱ-Ⅳ被分类。在手术期间，有三个尖头的阀门的前面的传单完全或部分在所有病人由于索的破裂被乱摆。氏族的传单的索的破裂在一个病人被发现。前面的传单在二个病人被穿孔。Septalleaflet被缩回并且支持者到在二个病人的室的中隔。阀门修理为所有病人被打算。最后，阀门修理在3个病人成功地被执行，有三个尖头的代替在5个病人被执行。结果：没有早或迟了的死亡发生了。与follow-upthrough为7-129月的临床的表明和回响心动描记法[中部：39个月，平均数:(53.4±42.8)月]，所有病人作为NYHA班Ⅰ被分类，没有任何changes.Conclusions：创伤的有三个尖头的不足的令人满意的治疗能被外科的治疗获得。更早的外科可以增加有三个尖头的阀门修理的可行性并且阻止恰好室的功能的恶化。

简介：目的：观察电针对中风后抑郁患者抑郁情绪及神经功能缺损程度的影响。方法：选择经临床、CT或MRHY-实的中风患者90例，按随机数字表分为3组，每组30例。三组患者均给予中风常规治疗，电针组加用电针，西药组加用氟西汀，对照组加用安慰剂，连续60d。结果：与对照组比较，电针组、西药组患者的汉密尔顿抑郁量表（HamiltonDepressionRatingScale，HAMD）和改良爱丁堡－斯堪的纳维亚评分（ModifiedEdinburgh—ScandinaviaStrokeScale，MESSS）下降，Barthel指数评分上升（P〈0．05）；电针组、西药组总体疗效无显著差异，电针组、西药组总体疗效优于对照组。结论：电针能改善抑郁表现，促进神经功能康复。

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简介：Cochlearimplantationisauniquemethodtore-constructauditionforpatientswithseveretoprofoundhearingloss.Withincreasingclinicalapplicationofthistechnique,itsrehabilitativeeffectsinpatientshasbecomeanimportanttopicofhearingandspeechrehabilitationresearch.Thisarticleisanoverviewofhearingandspeechrehabilitativetraining,rehabilitativeefficacyevaluationandfactorsaffectingrehabilitationefficacyfollowingcochlearimplantation.

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简介：AbstractThrombotic microangiopathy (TMA) is characterized by systemic microvascular thrombosis, target organ injury, anemia and thrombocytopenia. Thrombotic thrombocytopenic purpura, atypical hemolytic uremic syndrome and Shiga toxin E-coli-related hemolytic uremic syndrome are the three common forms of TMAs. Traditionally, TMA is encountered during pregnancy/postpartum period, malignant hypertension, systemic infections, malignancies, autoimmune disorders, etc. Recently, the patients presenting with trauma have been reported to suffer from TMA. TMA carries a high morbidity and mortality, and demands a prompt recognition and early intervention to limit the target organ injury. Because trauma surgeons are the first line of defense for patients presenting with trauma, the prompt recognition of TMA for these experts is critically important. Early treatment of post-traumatic TMA can help improve the patient outcomes, if the diagnosis is made early. The treatment of TMA is also different from acute blood loss anemia namely in that plasmapheresis is recommended rather than platelet transfusion. This article familiarizes trauma surgeons with TMA encountered in the context of trauma. Besides, it provides a simplified approach to establishing the diagnosis of TMA. Because trauma patients can require multiple transfusions, the development of disseminated intravascular coagulation must be considered. Therefore, the article also provides different features of disseminated intravascular coagulation and TMA. Finally, the article suggests practical points that can be readily applied to the management of these patients.

简介：目的将与traumatic以后癫痫观察在病人的生活的质量并且讨论影响因素。我们用生活Scale-31(QOL-31)的质量作为控制与traumatic以后癫痫和100个健康的人估计了105个病人，并且在消沉上进行了回顾的分析的方法，自我等级压抑规模(SDS)和自我等级焦虑规模(SAS)，焦虑，损伤的地点，抓住的控制，EEG和治疗学的依从。有癫痫获得了的traumatic以后的结果病人很在QOL-31上比控制组降低(P<0.01)，但是比SDS和SAS上的控制组高(P<0.01)。多重回归分析显示生活的质量上的主要影响因素是焦虑，治疗学的依从，消沉，损伤的癫痫的抓住和地点的差的控制。在有posttraumatic癫痫的病人的生活的质量显著地衰退了的结论。医生们应该与癫痫注意病人的心理、心理的问题，例如消沉和焦虑，提高治疗学的依从并且控制癫痫的抓住，它是改进预后的关键。

简介：AbstractPost-traumatic osteomyelitis (PTO) is a worldwide problem in the field of orthopaedic trauma. So far, there is no ideal treatment or consensus-based gold standard for its management. This paper reviews the representative literature focusing on PTO, mainly from the following four aspects: (1) the pathophysiological mechanism of PTO and the interaction mechanism between bacteria and the body, including fracture stress, different components of internal fixation devices, immune response, occurrence and development mechanisms of inflammation in PTO, as well as the occurrence and development mechanisms of PTO in skeletal system; (2) clinical classification, mainly the etiological classification, histological classification, anatomical classification and the newly proposed new classifications (a brief analysis of their scope and limitations); (3) imaging diagnosis, including non-invasive examination and invasive examination (this paper discusses their advantages and disadvantages respectively, and briefly compares the sensitivity and effectiveness of the current examinations); and (4) strategies, including antibiotic administration, surgical choices and other treatment programs. Based on the above-mentioned four aspects, we try to put forward some noteworthy sections, in order to make the existing opinions more specific.

简介：Thisreviewaimsatevaluatingtheexistingevidenceregardingpostreperfusionsyndrome,providingadescriptionofthepathophysiologicmechanismsinvolvedandpossiblemanagementandpreventivestrategies.APubMedsearchwasconductedusingtheMeSHdatabase,＂Reperfusion＂AND＂livertransplantation＂werethecombinedMeSHheadings;EMBASEandtheCochranelibrarywerealsosearchedusingthesameterms.52relevantstudiesandoneongoingtrialwerefound.Theconceptofpostreperfusionsyndromehasevolvedthroughyearstoamultisystemicdisorder.Theimplicationsofthemainorgan,recipientandprocedurerelatedfactorsinthegenesisofthiscomplexsyndromearediscussedinthetextasthenovelpharmacologicandtechnicalapproachestoreduceitsincidence.Howevertheavailableevidenceaboutriskfactors,physiopathologyandpreventivemeasuresisstillconfusing,thepresenceoftwomaindefinitionsandthenumerosityofpossibleconfoundingfactorsgreatlycomplicatestheinterpretationofthestudies.

简介：在对待击以后的便秘加专利汉语药观察针灸的临床的功效。

简介：取病变相应节段的华佗夹脊穴为主穴，配以阿是穴，主穴采用平补平泻手法，配穴于皮损周围沿皮平刺，采用泻法。然后选择疼痛较明显的部位，用三棱针快速刺入，立即出针，并在周围连续刺3．5次，用闪火法在被刺部位施以火罐，治疗56例中老年带状疱疹后遗神经痛患者，结果痊愈36例，显效17例，无效3例，总有效率94．6％。

简介：目的：观察电针不同穴位对脑梗死偏瘫患者脑电的近期影响。方法：将脑梗死患者按2：1比例随机分为电针神经干组和常规电针组，分别予以针刺神经干及针刺常规穴位治疗，每目治疗1次，治疗14次后进行疗效评定。结果：电针神经干组较常规电针纽疗效好，近期脑电差异具有统计学意义（P〈0．05）。结论：电针神经干可明显改善偏瘫肢体的神经功能缺损及脑功能状况，疗效优于常规电针组。

简介：目的：照观察针药结合与单纯西药治疗中风后抑郁症（PSD）的疗效及不良反应。方法：采用开放性对照研究方法，将93例抑郁症患者随机分为三组，针药组30例、百忧解A组30例、百忧解B组33例。针药组口服百忧解20mg／d并加以针刺，百忧解A组口服百忧解20mg／d，百忧解B组口服百忧解20～40mg／d；三组治疗时间均为42d，以汉密尔顿抑郁量表（HAMD）及副反应观察量表（TESS）分别观察三组的疗效及不良反应。结果：针药组有效率为86．7％，百忧解A组为63．3％，百忧解B组为87．9％，针药组疗效优于百忧解A组，与百忧解B组疗效差异无统计学意义（P〉0．05），但药物不良反应发生率百忧解B组高于针药组。结论：药并用是脑卒中后抑郁症的一种疗效确切且副反应少的治疗方法。