简介：AbstractBackground:Meniere’s disease (MD) is an idiopathic disorder of the inner ear, which manifests as cochleo-vestibular dysfunction. Hearing loss will progress to a profound levelin a subset of patients with MD, and vestibular interventions can independently cause loss of hearing. The aim of this study was to systematically review the published literature describing the safety and efficacy of CI in patients with MD.Materials and methods:A systematic literature review was conducted in accordance PRISMA guidelines to identify articles that assessed at least one functional outcome in patients with MD who underwent CI. Demographic information, disease history, MD symptoms, outcomes measures, and complications related to CI were extracted from included studies.Results:In total, 17 studies were included, and 182 patients with MD underwent CI. The weighted-mean age was 61.9 years (range 27-85). Study objective and methodology varied, and there was significant heterogeneity in CI outcome measures reported. In total, 179 (98.3%) of 182 patients reported objective improvements in at least one hearing metric after CI. A total of 69 patients (37.9%) reported vertigo or severe dizziness prior to CI, compared to 22 patients (15.4%) postoperatively. Two studies reported significant reductions in postoperative Tinnitus Handicap Inventory score (THI). Quality of life assessments varied between studies. Complications rates were low with only nine patients (4.9%) reporting a serious CI-related complication.Conclusions:This systematic review evaluated 17 studies describing the safety and efficacy of CI in patients with MD and encountered many challenges due to small sample sizes, and heterogeneity in study design and outcomes measured. Despite these limitations, this study of 182 patients is to the best of our knowledge the largest systematic review evaluating the safety and efficacy of CI in MD. The results of this study support the need for a standardized approach to evaluating outcomes of CI in patients with MD in future studies.

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简介：AIM:Toinvestigatethelifetimeriskofdevelopmentofesophagealadenocarcinomaand/orhigh-gradedysplasiainpatientsdiagnosedwithBarrett’sesophagus.METHODS:DatawereextractedfromtheUnitedKingdomNationalBarrett’sOesophagusRegistryondateofdiagnosis,patientageandgenderof7877patientsfromwhohadbeenregisteredfrom35UnitedKingdomcenters.LifeexpectancywasevaluatedfromUnitedKingdomNationalStatisticsdatabasedupongenderandageatyearatdiagnosis.Thesedatawerethenusedwithpublishedestimatesofannualadenocarcinomaandhigh-gradedysplasiaincidencesfrommetaanalysesandlargepopulation-basedstudiestoestimateoveralllifetimeriskofdevelopmentofthesestudyendpoints.RESULTS:ThemeanageatdiagnosisofBarrett’sesophaguswas61.6yearsinmalesand67.3yearsinfemales.Themeanlifeexpectancyatdiagnosiswas23.1yearsinmales,20.7yearsinfemalesand22.2yearsoverall.Usingdatafrompublishedmeta-analyses,thelifetimeriskofdevelopmentofadenocarcinomawasbetween1in8and1in14andthelifetimeriskofhigh-gradedysplasiaoradenocarcinomawas1in5to1in6.Usingdatafrom3largerecentpopulation-basedcohortstudiesthelifetimeriskofadenocarcinomawasbetween1in10and1in37andofthecombinedendpointofhigh-gradedysplasiaandadenocarcinomawasbetween1in8and1in20.AgeatBarrett’sesophagusdiagnosisisreducingandlifeexpectancyisincreasing,whichwillpartiallycounter-balancelowerannualcancerincidence.CONCLUSION:Thereisasignificantlifetimeriskofdevelopmentofhigh-gradedysplasiaandadenocarcinomainBarrett’sesophagus.

简介：韩碧英教授是在针灸部门ofGuang的一位主要医生汉语的中国学院的一所人医院医学科学。她从事临床的实践将近40年了并且积累了丰富的临床的经验，特别在临床的症候群区别。我是幸运的跟随教授汉在周末练习针灸并且向他学习。我现在为参考与证明的格介绍她的学术想法和临床的经验。

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简介：【摘要】回顾性分析 5例 Madelung’s病病人资料，探讨此病病因、临床表现及治疗方法。该病病因尚不清，常见于中年男性，肿块主要对称分布于头颈部及上躯干部，呈典型“牛颈”或“驼峰”样外观。手术切除为主要治疗方法。该病恶变率低、预后良好。

简介：AbstractObjective:To review indications and techniques for the endoscopic endonasal approach to the craniovertebral junction (CVJ), analyze postoperative outcomes, and discuss important technical considerations.Methods:A retrospective analysis was performed on all patients undergoing endonasal endoscopic approaches to the CVJ from May 2007 to June 2017. Demographic information, presenting symptoms, imaging results, treatment course, postoperative functional status, and follow-up were recorded.Results:There was a total of 30 patients in this series, with a mean follow-up of 11.7 months. The average age was 33.6 years (range, 5-75 years), with 18 females and 12 males. The majority of patients (n = 22, 73.3%) had Chiari malformation type 1 with basilar invagination and symptomatic cervicomedullary compression as the indication for surgery. Intraoperative cerebrospinal fluid leak (CSF) was noted in 3 cases of odontoid resection and a single case of skull base resection. There were no postoperative CSF leaks. Overall, 81% of patients resumed regular diet by post-operative day 2 (range, 0-8 days). Severe postoperative dysphagia occurred in two cases with one requiring gastrostomy tube placement and another utilizing total parenteral nutrition for support prior to eventual gastrostomy. On average, patients were extubated by postoperative day 0.93 (range 0-3 days), with 85% extubated by postoperative day 1. A tracheotomy was required in one patient.Conclusion:The endonasal endoscopic approach is a valuable technique for access to the CVJ with minimal disruption of respiratory and alimentary function.

简介：Theapplicationofhumanhomografthasbeenpopularincardiovascularsurgeryandshownperfecteffects.Butthedifficultytogetgraftgreatlylimiteditsclinicalap-plication.Thethawedhomograftcannotbeusedinsomecasessinceitisnotclearwhetheritcanbere-cryopreservedwithoutdamage.Weconductedthepresentstudytoknowthechangesinviabilityofthehomograftafterrefreezinginsixhumanpul-

简介：目的探讨小儿Amyand’s疝（Amyand’shernia，AH）的临床特点及治疗方法，提高诊治水平。方法回顾性分析2004年1月至2010年12月作者收治的18例AH患儿的临床资料。结果18例患儿中，男性17例，女性1例，中位年龄1．2岁（23d至5岁3个月）。临床特点：腹股沟区肿块18例，呕吐11例，发热10例；9例白细胞增高；5例腹部X线检查显示肠梗阻；3例彩超可见阑尾“双边”影，2例见条索状低回声。治疗方法：10例因合并阑尾炎，行疝囊高位结扎术时一并切除阑尾；8例仅行疝囊高位结扎术。18例均痊愈出院。术后病理检查提示单纯性阑尾炎5例，化脓性阑尾炎3例，坏疽性阑尾炎2例。结论小儿AH临床少见，I型AH处理上跟一般嵌顿疝相同，将阑尾直接还纳入腹腔；Ⅱ、Ⅲ型AH则需行阑尾切除。根据术中情况正确处理不同类型的AH，一般均可取得较好的疗效。

简介：ThisarticlereviewstheeffectivenessofintratympaniccorticosteroidsforvertigocontrolinM_eni_ere'sdiseaseat2-yearsfollow-upaccordingtotheguidelinesexpressedbytheAmericanAcademyofOtolaryngology-Head&NeckSurgery.DespitetheincreaseduseofintratympaniccorticosteroidsforvertigocontrolinM_eni_ere'sdiseasethereisdebateastotheireffectiveness,particularlycomparedtogentamicin.Evenso,afterjustasinglecourseofinjections,corticosteroidscanreliablyprovidecompletevertigocontrol(ClassA)at2-yearsinabout50%ofcasesasindicatedinarecentdouble-blindrandomizedcontrolledclinicaltrial(Pateletal.,2016).Buttheeffectivenessofintratympaniccorticosteroidstrulyincreaseswhentreatmentisprovided'as-needed',wherebycompletevertigocontrolisestablishedinupto91%ofcases.Onthebasisofavailableliterature,thereisgoodevidencetorecommendtheuseofintratympanicsteroidtreatmentforvertigocontrolinM_eni_ere'sdisease,butpatientsmustbemonitoredfornon-response.Therationalefortreatingpatientsas-neededandthepossiblereasonsforcorticosteroidnonresponsearediscussed.

简介：KONGRao-qi,male.bornin1944.Wasajuniorconsultantdoctor,astandingmemberandthedcputysecretary-generalofZhejiangProvincialAcupuncturcAssociation.thedirectorofZhejiangscalp-acupointcommittee,tichasbccnengagedinacupuncturepracticeformorethan30years.Withgreatattainmentsinthescalpacupuncture.Heishighlyskilledattheacupuncturetreatmentofapoplecticsequelae,

简介：<正>八十年代的人中虽然不少已经有了固定的收入,但总觉得钱不够用:要去关心最新的mp4,想换700万像素的拍照手机,还要听周杰伦的演唱会……"80s"理不理财?如何理财?

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简介：现将心电图运动试验非——段参数简介如下,供参考。1、Q—Tc:运动后Q—Tc<运动前Q—Tc为阴性,≥运动前Q—Tc为阳性。2、△R<0为阴性,≥0为阳性。△R为V5R波运动后与运动前平均振幅之差,单位为mm。3、△RST<0为阴性,≥0为阳性。

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简介：Objective:Toobservetheclinicalefficacyofacupuncture-moxibustionintreatingAlzheimer’sdisease(AD).Methods:Forty-eighteligibleADpatientswereenrolledtoreceiveacupunctureplusherb-partitionedmoxibustion.Mini-mentalstateexamination(MMSE)wasadoptedforevaluationbeforeandafterintervention,andthetherapeuticefficacywasobserved.Results:Afterintervention,theMMSEscorechangedsignificantly(P<0.01),andthetotaleffectiveratewas83.3%.Conclusion:Acupuncture-moxibustioncansignificantlyimprovethecognitivefunctionofADpatients,beneficialtothegeneralpromotionofthequalityoflife.

简介：AbstractPeyronie’s disease (PD) is a benign, progressive fibrotic disorder characterized by scar or plaques within the tunica albuginea (TA) of the penis. This study provides new insights into the pathogenesis of PD based on data from different studies regarding the roles of cytokines, cell signaling pathways, biochemical mechanisms, genetic factors responsible for fibrogenesis. A growing body of literature has shown that PD is a chronically impaired, localized, wound healing process within the TA and the Smith space. It is caused by the influence of different pathological stimuli, most often the effects of mechanical stress during sexual intercourse in genetically sensitive individuals with unusual anatomical TA features, imbalanced matrix metalloproteinase/tissue inhibitor of metalloproteinase (MMP/TIMP), and suppressed antioxidant systems during chronic inflammation. Other intracellular signal cascades are activated during fibrosis along with low expression levels of their negative regulators and transforming growth factor-β1 signaling. The development of multikinase agents with minimal side effects that can block several signal cell pathways would significantly improve fibrosis in PD tissues by acting on common downstream mediators.