简介：

简介：客观：为了分析损伤的数据，有在欺骗的地震的胸的损害的病人为更好在主要地震理解胸的损害的类型和后果承认了到医药科学(弦音器)的德黑兰大学的医院。方法：登记6的AfterBam地震。5在Richter上可伸缩，526个损伤病人进入弦音器的医院。在之中“他们，53个病人支撑了胸的损害。结果：这个组由21females(39.6%)和32男性(60.4%)组成。十五个病人(28.3%)孤立胸损害。Ribfracture(36.4%)是在我们的病人的最普通的损害，haemo/pneumothorax(25.5%)列在后面。表面的损害是最普通的伴随损害。有胸损害的多重损伤的病人与孤立的胸损害(P=0.003)有更高的损害严厉分数(ISS)对病人。结论：胸墙损害和haemo/气胸在地震的幸存牺牲品包括损害的一个可观的数字。因而，这些病人的多数能与观察或试管thoracostomy被对待。我们应该训练并且装备健康工人和救援队的成员在这块地里对待并且设法这些病人。

简介：

简介：AbstractPurpose:Some surgeons believe that chest computed tomography (CT) scan should be used more prudently in management of blunt chest trauma patients. This study aimed to evaluate the clinical predictors of abnormal chest CT scan findings in trauma patients.Methods:This cross-sectional study was conducted on blunt chest trauma patients aged ≥18 years who were referred to the emergency departments of two educational hospitals and underwent chest CT scan. These patients were enrolled in the study using a non-probability sampling method. The exclusion criteria included: class III or IV hemodynamic shock, need for immediate surgical or neurosurgical interventions, penetrating trauma, lack of required information, and pregnancy. Demographic factors, accident details, trauma mechanism, vital signs, and level of consciousness in predicting abnormal chest CT scan findings were evaluated. Analysis was performed using IBM SPSS statistics 21.Results:A total of 977 patients (male 51.5%, female 48.5%) with the mean age of (41.71 ± 14.24) years, range 18-88 years were studied; 34.2% of them with high energy trauma mechanism. With 334 (34.2%) patients had abnormal findings on chest X-ray (CXR) and 332 (34.0%) cases had an abnormal findings on chest CT scan (agreement rate was 99.4%). There was a significant correlation between male gender (p < 0.0001), GCS<15 (p < 0.0001), high energy trauma mechanism (p < 0.0001), unstable hemodynamics (p < 0.01), and clinical signs and symptoms (p < 0.0001) with chest CT findings. Chest wall deformity (odds = 8; p < 0.0001), generalized tenderness (odds = 6.6, p < 0.0001), and decreased cardiac sound (odds = 3.8, p < 0.0001) were the important and independent clinical predictors of abnormal chest CT scan findings.Conclusion:Based on the findings, chest wall deformity, generalized tenderness, decreased cardiac sound, distracting pain, chest wall tenderness, high energy trauma mechanism, male gender, respiratory rate > 20 breathes/min, decreased pulmonary sound, and chest wall crepitation were independent clinical predictors of abnormal chest CT scan findings following blunt trauma.

简介：目的：观察推拿手法治疗颈源性头痛的临床疗效。方法：54例患者随机分为推拿组和药物组，推拿组27例，接受中医推拿治疗，药物组27例，口服布洛芬治疗。比较治疗前2星期和治疗后2星期病患的头痛程度（VAS）、头痛发作频率和颈椎功能障碍（NDI）的改善。结果：治疗前推拿组和药物组的VAS，发作频率和NDI评分差异无统计学意义；治疗后两组VAS，发作频率，NDI均有下降，推拿组与药组比较差异有统计学意义（P〈0．01）。结论：推拿治疗颈源性头痛疗效优于常规剂量布洛芬。

简介：关键词针灸治疗-头疼-症候群区别处理-医药记录鍏抽敭璇？?堝埡鐤楁硶-澶寸棝-杈ㄨ瘉璁烘不-鐥呮CLC数字R246.1作者：黄蔷(1979鈥?，女性，居民，药的主人

简介：Angioneuroticheadacheisaparoxysmalviolentdistendingheadacheduetodisturbanceofvasculardiastolicandsystolicfunctions.Itbelongstothecategoryof'headache'intraditionalChinesemedicine(TCM)andoftenresultsfromstagnationoftheliver-qianddeficiencyofthe

简介：AbstractSurgical stabilization of the flail chest is challenging and has no established guidelines. Chest wall integrity and stability are the main factors that ensure the protection of intrathoracic organs and an adequate respiratory function. Here, we report a novel chest wall reconstruction technique in a 45-year-old man with a traumatic left flail chest and open pneumothorax diagnosed both clinically and radiographically. Rib approximation and chest wall reconstruction was done using intercostal figure-of-eight suture and polypropylene mesh with vascularized musculofascial flap. The patient improved gradually and was discharged after three weeks of total hospital stay. He returned to regular working after a month with no evidence of respiratory distress or paradoxical chest movement. Follow-up visit at one year revealed no lung hernia or paradoxical chest movement. This is a novel, feasible and cost-effective modification of chest wall reconstruction that can be adopted for thoracic wall repair in case of open flail chest, which needs emergency surgical interventions even in resource constraint settings.

简介：

简介：Background:Becausethecauseandetiologyofchronicheadacheisnotyetfullyexplained,thetreatmentofthissymptomisnotsimple.Thisstudycomparestheeffectsofaromaacupunctureandnormalacupunctureappliedonchronicheadachepatients,inordertoestablishaprimarydataforfurtherstudiesofnewtreatmentsanddevelopmentsofnewpracticalacupuncture.Methods:38clinicalexperimentparticipantsweregatheredandthroughaquestionnairepatientswhoexperiencedheadacheformorethan4hoursadayandmorethan15dayspermonthwerequalifiedaschronicheadachepatients.Thequalifiedpatientswereclassifiedintotwogroups,aromaacupuncturegroup(AromaATgroup,n=23)andnormalacupuncturegroup(ATgroup,n=15).

简介：无

简介：为回顾1949-2004年针灸治疗血管性头痛的状况，以推动针灸临床的发展，根据《中国现代针灸信息数据库》数据，计量分析针灸治疗血管性头痛的临床文献。从1956年起针灸治疗血管性头痛的文献报道逐年增加，呈平稳增长趋势，临床治疗以针刺为主，临床选穴以邻近取穴与辨证取穴相结合。

简介：ＣＲｅｓｅａｒｃｈＩｎｓｔｉｔｕｔｅｏｆＳｕｒｇｅｒｙ，ＤａｐｉｎｇＨｏｓｐｉｔａｌ，ＴｈｉｒｄＭｉｌｉｔａｒｙＭｅｄｉｃａｌＵｎｉｖｅｒｓｉｔｙ，Ｃｈｏｎｇｑｉｎｇ４０００４２，Ｃｈｉｎａ（ＬｉｕＢＳ，ＷａｎｇＺＧ，ＷｅｎｇＧＷ，ＹａｎｇＺＨ，Ｌ...

简介：关键词针灸药联合了-头疼-医药记录鍏抽敭璇吗？?堣嵂缁撳悎-澶寸棝-鐥呮CLC数字R246.1作者：孙继山(1936鈥?，男、主要医生

简介：In40casesofheadachetreatedbyhydroacupunctureplusTuina,incomparisonwith35casestreatedwithmedicationsplusTuina,theresultsshowedthatthetherapeuticeffectwasbetterinthetreatmentgroupthaninthecontrolgroup.

简介：

简介：摘要The present global pandemic of COVID-19 has brought the whole world to a standstill, causing morbidity, death, and changes in personal roles. The more common causes of morbidity and death in these patients include pneumonia and respiratory failure, which cause the patients to require artificial ventilation and other techniques that can improve respiratory function. One of these techniques is chest physiotherapy, and this has been shown to improve gas exchange, reverse pathological progression, and reduce or avoid the need for artificial ventilation when it is provided very early in other respiratory conditions. For patients with COVID-19, there is limited evidence on its effect, especially in the acute stage and in patients on ventilators. In contrast, in patients after discharge, chest physiotherapy in the form of respiratory muscle training, cough exercise, diaphragmatic training, stretching exercise, and home exercise have resulted in improved FEV1 (L), FVC (L), FEV1/FVC%, diffusing lung capacity for carbon monoxide (DLCO%), endurance, and quality of life, and a reduction in anxiety and depression symptoms. However, there are still controversies on whether chest physiotherapy can disperse aerosols and accelerate the rate of spread of the infection, especially since COVID-19 is highly contagious. While some authors believe it is possible, others believe the aerosol generated by chest physiotherapy is not within respirable range. Therefore, measures such as the use of surgical masks, tele-rehabilitation, and self-management tools can be used to limit cross-infection.

简介：AbstractCurrently, the diagnosis of tuberculosis (TB) is mainly based on the comprehensive consideration of the patient's symptoms and signs, laboratory examinations and chest radiography (CXR). CXR plays a pivotal role to support the early diagnosis of TB, especially when used for TB screening and differential diagnosis. However, high cost of CXR hardware and shortage of certified radiologists poses a major challenge for CXR application in TB screening in resource limited settings. The latest development of artificial intelligence (AI) combined with the accumulation of a large number of medical images provides new opportunities for the establishment of computer-aided detection (CAD) systems in the medical applications, especially in the era of deep learning (DL) technology. Several CAD solutions are now commercially available and there is growing evidence demonstrate their value in imaging diagnosis. Recently, WHO published a rapid communication which stated that CAD may be used as an alternative to human reader interpretation of plain digital CXRs for screening and triage of TB.

简介：AbstractBackground:No convincing modalities have been shown to completely prevent postdural puncture headache (PDPH) after accidental dural puncture (ADP) during obstetric epidural procedures. We aimed to evaluate the role of epidural administration of hydroxyethyl starch (HES) in preventing PDPH following ADP, regarding the prophylactic efficacy and side effects.Methods:Between January 2019 and February 2021, patients with a recognized ADP during epidural procedures for labor or cesarean delivery were retrospectively reviewed to evaluate the prophylactic strategies for the development of PDPH at a single tertiary hospital. The development of PDPH, severity and duration of headache, adverse events associated with prophylactic strategies, and hospital length of stay postpartum were reported.Results:A total of 105 patients experiencing ADP received a re-sited epidural catheter. For PDPH prophylaxis, 46 patients solely received epidural analgesia, 25 patients were administered epidural HES on epidural analgesia, and 34 patients received two doses of epidural HES on and after epidural analgesia, respectively. A significant difference was observed in the incidence of PDPH across the groups (epidural analgesia alone, 31 [67.4%]; HES-Epidural analgesia, ten [40.0%]; HES-Epidural analgesia-HES, five [14.7%]; P <0.001). No neurologic deficits, including paresthesias and motor deficits related to prophylactic strategies, were reported from at least 2 months to up to more than 2 years after delivery. An overall backache rate related to HES administration was 10%. The multivariable regression analysis revealed that the HES-Epidural analgesia-HES strategy was significantly associated with reduced risk of PDPH following ADP (OR = 0.030, 95% confidence interval: 0.006-0.143; P < 0.001).Conclusions:The incorporated prophylactic strategy was associated with a great decrease in the risk of PDPH following obstetric ADP. This strategy consisted of re-siting an epidural catheter with continuous epidural analgesia and two doses of epidural HES, respectively, on and after epidural analgesia. The efficacy and safety profiles of this strategy have to be investigated further.

简介：AbstractPurpose:Blunt thoracic injuries are common among elderly patients and may be a common cause of morbidity and death from blunt trauma injuries. We aimed to examine the impact of chest CT on the diagnosis and change of management plan in elderly patients with stable blunt chest trauma. We hypothesized that chest CT may play an important role in providing optimal management to this subgroup of trauma patients.Methods:A retrospective analysis was performed on all the admitted adult blunt trauma patients between January 2014 and December 2018. Stable blunt chest trauma patients with abbreviated injury severity (AIS) < 3 for extra-thoracic injuries confirmed with chest X-ray (CXR) and chest CT on admission or during hospitalization were included in the study. The AIS is an international scale for grading the severity of anatomic injury following blunt trauma. Primary outcome variables were occult injuries, change in management, need for surgical procedures, missed injuries, readmission rate, intensive care unit (ICU) and length of hospital stay.Results:There are 473 patients with blunt chest trauma included in the study. The study patients were divided into two groups according to the age range: group 1: 289 patients were included and aged 18-64 years; group 2: 184 patients were included and aged 65-99 years . Elderly patients in group 2 more often required ICU admission (11.4% vs. 5.2%), had a longer length of ICU stay (days) (median 11 vs. 6, p = 0.01), and the length of hospital stay (days) (median 14 vs. 6, p = 0.04). Injuries identified on chest CT has led to a change of management in 4.4% of young patients in group 1 and in 10.9% of elderly patients in group 2 with initially normal CXR. Chest CT resulted in a change of management in 12.8% of young patients in group 1 and in 25.7% of elderly patients in group 2 with initially abnormal CXR.Conclusion:Chest CT led to a change of management in a substantial proportion of elderly patients. Therefore, we recommend chest CT as a first-line imaging modality in patients aged over 65 years with isolated blunt chest trauma.