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Therapeutic Effect of Canalith Repositioning Procedures with or without Anti-vertigo Drugs on Benign Paroxysmal Positional Vertigo

目的　比较单纯手法复位和手法复位合并口服抗眩晕药治疗良性阵发性位置性眩晕（BPPV）的短期和长期疗效。 方法　将2004年1月－2011年6月期间收治的236例BPPV患者随机分为两组，对照组112例采用单纯手法复位，观察组124例在手法复位基础上配合口服抗眩晕药治疗，两组均于1周和3个月后复查，并随访观察1年，且比较其疗效。 结果　观察随访1年后，对照组总治愈率92.86% (104/112），观察组治愈率为93.54%（116/124），两者比较差异无统计学意义。 结论　单纯手法复位和手法复位合并口服抗眩晕药治疗BPPV其疗效相当，但可作为BPPV患者的首选治疗方法。Objective　To evaluate the short-term and long-term effect of canalith repositioning procedures with or without anti-vertigo drugs on benign paroxysmal positional vertigo (BPPV). Methods　A total of 236 cases of BPPV that were treated with particle repositioning maneuver with medicine treatment from January 2004 to June 2011. The patients were divided into control group (112 patients, underwent canalith repositioning procedures) and observation group (124 patients, underwent canalith repositioning procedures with medication of anti-vertigo drugs). The two groups were reappraised after one week and three months respectively, and the follow-up duration was one year. Results　The success rate was 92.86% (104/112) in the control group and 93.55%(116/124) in the observation group one year after the treatment. The difference between the two groups was not significant. Conclusion　The effect of canalith repositioning procedures with or without anti-vertigo drugs on BPPV does not differ much from each other.

Evidence-Based Research on Hospital Report System in Canada and the Enlightenment to China

Objective　To summarize and analyze the experience of Canadian hospital report, including report contents, indicators system and result application, so as to provide basis for improving Chinese hospital information report and enhancing healthcare regulation. Methods　Official networks and databases in Canada were searched, and relative policies, documents, research reports and information reports were included. Results　Canadian Hospital Report Project carried out by Canadian Institute for Health Information was effective for gathering and comparing hospitals’ information, and regulating healthcare service. Ontario Hospital Report Project, as a local policy based on national hospital report project, was a good example of local government to improve healthcare service regulation. Conclusion　Canadian Hospital Report and Ontario Hospital Report enlighten us that, carrying out the comparison of hospitals in the same type, ensuring the comparability of data, setting comprehensive and scientific report contents and indicators, and emphasizing the self-evaluation function and self-improvement function of the hospital performance evaluation.

胃癌中p16基因研究概况

Pulmonary Embolism with Normal D-dimer Level: Nine Cases Report

【Abstract】 Objective To improve the knowledge of pulmonary embolism with normal D-dimer levels. Methods Nine consecutive patients of established pulmonary embolism with a normal D-dimer concentration admitted from January 2004 to December 2009 were analyzed retrospectively. Results Pulmonary embolism was confirmed in the 9 patients with a normal D-dimer concentration. Pulmonary embolismwas confirmed in only one patientwith an unlikely probability of pulmonary embolism. Wells score was 3 and the localization of the emboli was segmental emboli. In other 8 patients with a likely clinical probability of pulmonary embolism, the complaints of those patients existed between 1 hour and 2 months.Wells score was between 4. 5 and 7. 5, with a median of 6. 0. D-dimer concentration was between 0. 1 and 0. 5 mg/L, with a median of 0. 3 mg/L. The localization of the emboli was sub-segmental emboli in 3 cases,segmental emboli in 4 cases, and central emboli in 2 cases. Conclusions Our findings indicate that it is essential to examine the patient and assess the clinical probability at the first, then the D-dimer concentration should be taken into account. In patients with a likely clinical probability, a normal D-dimer test result can not exclude pulmonary embolism, and additional imaging testing is necessary.

批量烧伤患者的急救护理

目的　探讨批量重度烧伤患者急救护理方法。 方法　于2012年7月11日一次性收治严重大面积烧伤患者13例。其中特重大烧伤伴中、重度呼吸道损伤者8例。入院时立即启动应急预案，组织医护人员合理分工、配合，抢救有序，立即建立静脉通道，气管切开，呼吸机辅助呼吸，创面清创处理，加强疼痛、心理护理，积极做好分流工作。 结果　13例中除1例因烧伤后因多脏器功能衰竭死亡，其余12例均平稳渡过休克期，在短期内治愈出院，生活能自理，随访满意。 结论　健全的抢救预案、第一时间建立指挥领导小组、抢救时人力合理安排、急救药品及物品准备充足、丰富的临床经验、较强的综合应变能力，抢救人员配合默契，护理中严密全程监测病情、对重点伤员重点实施心理护理，可提高烧伤患者的抢救成功率，减少并发症发生。

Evaluation of Encircling Constriction of Superficial Femoral Vein in Treatment of Primary Deep Venous Insufficiency

目的　评价股浅静脉瓣膜环形缩窄术治疗原发性下肢深静脉瓣膜功能不全(primary deep venous insufficiency,PDVI)的疗效和应用价值。方法　2002年4月至2006年4月期间经顺行性静脉造影加Valsalva试验证实为PDVI者119例(158条),其中2002年4月至2004年1月收治者仅行大隐静脉高位结扎剥脱+交通支结扎术(前期治疗组),2004年2月至2006年4月收治者在前期治疗方法的基础上加行股浅静脉瓣膜环形缩窄术(后期治疗组),以CEAP(clinical,etiologic,anatomic,and pathophysiologic)临床分级与临床记分评价2组的疗效。结果　2组患者术后临床分级及临床记分均明显下降(前期治疗组由5.9±3.6降至2.1±1.3,P＜0.01; 后期治疗组由6.4±3.5降至1.7±1.8,P＜0.01),且后期治疗组较前期治疗组下降程度更大(P＜0.01)。结论　股浅静脉瓣膜环形缩窄术有助于PDVI患者临床症状缓解,因此术前明确诊断为PDVI的患者,应行股浅静脉瓣膜环形缩窄手术。

原位皮片回植法加皮片戳孔对减少腋臭并发症的观察

目的　用原位皮片回植法加皮片戳孔法，对微创腋臭根治术并发症的观察。 方法　对2008年2月－2010年2月、2010年3月－2012年2月的178例住院患者，分别进行原位皮片回植法、原位皮片回植法加皮片戳孔加3L敷贴加压包扎治疗腋臭。 结果　前期组采用原位皮片回植法治疗腋臭住院患者共82例，发生并发症23例，发生率为28.05%；后期组采用原位皮片回植法加皮片戳孔治疗腋臭住院患者共96例，发生并发症8例，发生率为8.33%。并发症发生率后期组低于前期组，差异有统计学意义（P＜0.01）。 结论　采用原位皮片回植法加皮片戳孔治疗腋臭，患者发生并发症的几率较少，简单易行，值得推广。

人工真皮与自体皮复合移植修复头部皮肤癌术后颅骨外露

目的　探索以人工真皮加自体皮复合移植修复头皮皮肤癌切除术后大面积颅骨外露的手术治疗方式。 方法　2011年8月－2013年1月6例头皮皮肤癌术后颅骨外露患者，一期以Mohs外科术式切除肿瘤组织，切除后外露颅骨组织颅骨电钻间隔0.5～1.0 cm钻孔，行人工真皮移植，3～4周后在新鲜肉芽组织上行二期自体皮移植术覆盖创面。 结果　6例皮肤癌术后颅骨外露患者创面修复，皮片成活好，外观好，耐磨性好，不影响术后放射治疗，术后无复发。 结论　人工真皮加自体皮复合移植修复头皮皮肤癌切除术后大面积颅骨外露的方法具有风险较低、技术要求低、术后效果好的优点，是基层医院修复大面皮肤软组织缺损的较好选择。

Study on the Relationship Between STHZMDR1 Gene Expression in Liver Cell and Cholesterol Calculus in Gallbladder

【Abstract】Objective To explore the relationship between the expression of MDR1 gene in liver cell and the formation of cholesterol calculus in gallbladder.Methods The mRNA expression level of MDR1 gene in liver cell of the cholesterol calculus group and the normal control group were measured through reverse transcriptionpolymerase chain reaction (RT-PCR)， and microglobulin β2 was used as internal contrast.Results The MDR1 mRNA expression level of the cholesterol calculus group was lower than that of the normal control group(1.30±0.19 vs 2.25±0.28, P＜0.01). Conclusion The formation of cholesterol calculus in gallbladder is related to the reducd expression level of MDR1 gene in liver cell.

Clinical Significance of Serum TGF-β1 and IL-23 in The Diagnosis of Gastric Cancer

ObjectiveTo study the serum transforming growth factorβ1 (TGF-β1) and interleukin-23 (IL-23) expression in the patients with chronic gastric ulcer or gastric cancer, and to investigate the clinical value of TGF-β1 and IL-23 on the prevention and treatment of gastric cancer. MethodsThe serum levels of TGF-β1 and IL-23 in cancer group (83 cases), gastric ulcer group (184 cases), and control group (58 cases) were detected by using ELISA assay method. The difference of serum TGF-β1 and IL-23 levels in patients with gastric cancer with different pathological parameters were compared. ResultsThe serum levels of TGF-β1〔(15.96±3.92) ng/mL〕and IL-23〔(645.25±234.18) ng/mL〕in gastric cancer group were higher than those of the gastric ulcer group〔(10.10±3.58) ng/mL, (496.10±108.32) ng/mL〕and normal control group〔(9.87±2.86) ng/mL, (372.75±89.27) ng/mL〕, the difference were statistically significant (P < 0.05). The levels of serum TGF-β1 in gastric cancer patients of stageⅠ-Ⅱ, ⅢandⅣwere successively increased, and the differences were statistically significant (P < 0.05). The levels of serum TGF-β1 in poorly differentiated gastric cancer or with lymph node metastasis patients were higher than those in high-middle differentiation or without lymph node metastasis patients, the difference were statistically significant (P < 0.05). There were no significant difference in the levels of serum TGF-β1 between different tumor diameter and different location (P > 0.05). The level of serum IL-23 in patients with stageⅠ-Ⅱwas higher than that in stageⅢandⅣ, the difference was statistically significant (P < 0.05). Ther were no significant difference in serum IL-23 levels between the different degree of differentiation, lymph node metastasis or not, different tumor diameter and different location of the tumor (P > 0.05). ConclusionTGF-β1 and IL-23 have important reference value in judging the stage and malignancy degree of gastric cancer.