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find Author "吴峰" 4 results
  • 三例漂浮前臂损伤的诊治

    目的 总结3 例漂浮前臂损伤的诊治体会。 方法 2008 年4 月- 2010 年9 月收治3 例漂浮前臂损伤男性患者,均为高处坠落致伤后3 h ~ 1 d 入院。均为闭合骨折。入院后对月骨周围性脱位、肘关节后脱位手法复位,腕关节功能位石膏外固定,肘关节深屈肘石膏托外固定。待肿胀消退后,对腕舟骨行骨折复位内固定。1 例合并同侧桡骨远端骨折,行骨折复位内固定术并腕关节支架外固定于中立位,其余2 例行术后石膏托固定腕关节于中立位。术后第2 天行手指主动屈伸功能锻炼,拆除固定后行肘、腕关节功能锻炼。 结果 3 例患者术后切口均Ⅰ期愈合。术后1 例随访2 个月后失访,骨折未愈合。其余2 例分别随访29 个月及17 个月,骨折均愈合。采用Inglis 等改良的美国特种外科医院(HSS)肘关节评分标准评定肘关节功能为95 分及97 分,Sarmiento 等的腕关节功能评分系统评定腕关节功能为3.5 分及4.5 分。 结论 漂浮前臂损伤是前臂双极关节的严重骨折- 脱位,通过仔细查体和影像学资料分析,及时行关节及骨折复位、固定治疗,预后较好。

    Release date:2016-08-31 05:42 Export PDF Favorites Scan
  • 用累积和分析方法研究经口腔前庭入路腔镜甲状腺手术的学习曲线

    目的探讨经口腔前庭入路腔镜甲状腺手术的学习曲线,为学习该术式的医生提供参考。方法回顾性分析76例经口腔前庭入路腔镜甲状腺手术患者的临床资料,患者来源于2020年9月1日至2021年8月31日期间河南中医药大学第一附属医院普外科一病区,由有开放手术经验的同一主刀医师最初完成。采用累积和(cumulative sum,CUSUM)分析方法绘制学习曲线,研究具有开放手术经验的主刀医师从初步学习阶段过渡到熟练掌握阶段需要的最少学习病例数,比较不同学习曲线阶段患者的手术时间、术中出血量、术后引流量、术后住院时间、淋巴结清扫数目及术后并发症发生率指标。结果本研究中76例患者的中位手术时间为127.00 min。采用CUSUM分析方法绘制学习曲线,最佳拟合方程为CUSUMn=–0.394 4 n2+24.348 n+243.02(P<0.05,拟合系数=0.831)。CUSUM学习曲线在手术病例数第24例时达峰值,以此为界将学习曲线划分为学习提高期(n=24)和熟练掌握期(n=52)2个阶段,2个阶段患者的基线资料如年龄、性别、手术部位、肿瘤性质及肿瘤直径方面比较差异均无统计学意义(P>0.05),具有可比性。学习提高期的手术时间[中位数(上、下四分位数)]长于熟练掌握期 [163.50(136.25,194.50)min比120.00(110.00,135.00),Z=–5.144,P<0.001],且学习提高期术后并发症发生率高于熟练掌握期(50.0%比14.5%,χ2=6.474,P=0.011),2个阶段的术中出血量、术后引流量、术后住院时间及淋巴结清扫数目比较差异无统计学意义(P>0.05)。结论从本研究的结果提示,对于有腔镜经验的甲状腺专科医师,经口腔前庭入路腔镜甲状腺手术有明显的学习曲线,在完成24例手术后可认为从初步学习阶段过渡到熟练掌握阶段。

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  • Research status and prospect of mandibular sensory dysfunction after transoral endoscopic thyroidectomy vestibular approach

    ObjectiveTo summarize the research status of mandibular sensory dysfunction after transoral endoscopic thyroidectomy vestibular approach (TOETVA), and explore its potential treatment methods and existing problems, and provide ideas and methods for future clinical treatments or research. MethodThe domestic and foreign literatures about peripheral nerve injury and its treatment after TOETVA were searched and reviewed. ResultsMental nerve injury was considered to be the main cause of mandibular sensory dysfunction after TOETVA. Due to the lack of unified definitions and assessment standards, the true incidence remained unclear. In order to reduce the risk of mental nerve injury, methods such as exposing the mental nerve and combining vestibular approaches during surgery had certain advantages. In terms of treatment, several methods promoting nerve repair were noteworthy, including B vitamins, nerve growth factors, physical therapy and so on. In addition, some auxiliary treatments of Traditional Chinese Medicine also showed effectiveness in promoting nerve regeneration. ConclusionsIt is essential to avoid damage to the mental nerve and mandibular tissues during surgery. For patients with significant complaints postoperatively, active treatment should be pursued. Establishing objective and quantifiable standards for evaluating mandibular sensory dysfunction and seeking effective clinical plans through a multidisciplinary approach may be the direction for future research.

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  • In vitro anti-tumor effect and mechanism of clove extracts against radioresistant esophagus cancer cell

    ObjectiveTo explore the in vitro anti-tumor effect of clove extracts (CEs) on radioresistant esophageal cancer cell KYSER and its mechanism.MethodsEthanol extracts of clove bud were prepared. Gas chromatography was used to identify the main active components of CEs. In vitro cell culture method was used to observe the effect of CEs at different concentrations on KYSER cell growth. Methyl thiazolyl tetrazolium (MTT) method was used to detect the effect of different concentration CEs on KYSER’s survival and its’ manner. Transmission electron microscope (TEM) was used to observe the changes of KYSER’s organelle microstructure after CEs treated. Transwell chamber method was used to detect the impact of CEs on KYSER’s migration ability. The apoptosis rate and cell cycle distribution of KYSER treated by CEs were quantitatively determined by flow cytometry. Clone formation experiment was used to detect the clone formation ability of KYSER treaded by CEs.ResultsThe main components of CEs were eugenol, eugenol hydrocarbon, and eugenol acetate. In vitro cell culture showed that 0.4% CEs could inhibit KYSER growth. MTT assay showed that the concentration of CEs≥0.5% could inhibit the survival of KYSER in a dose-dependent manner. TEM assay showed that after treated by 0.5% CEs, KYSER’s microvilli became shorter and wider, ribosomes in the cytoplasm decreased, mitochondria atrophied, and a large number of autophagosomes were formed. Transwell migration assay showed that relative migration rates of KYSER after treated by 0.5% CEs and 0.6% CEs were (65±4)% and (41±3)%, respectively. Compared with the control group, the differences were statistically significant (P<0.001). Flow cytometry showed that the apoptosis rates of the control group, the 0.5% CEs treated group, and the 0.6% CEs treated group were (5.63±0.50)%, (11.77±0.42)%, and (19.44±0.19)%, respectively, and the differences between the control group and the two CEs treated groups were statistically significant (P<0.001). Flow cytometry showed that the G1 phase ratios of cells in the control group, the 0.5% CEs treatment group, and the 0.6% CEs treatment group were (61.99±1.20)%, (75.38±1.50)%, and (78.81±1.00)%, respectively, and the differences between the control group and the two CEs treated groups were statistically significant (P<0.001). The clonal formation experiment showed that after 24 h of CEs treatment, the clonal formation rates of the control group, the 0.5% CEs treatment group, and the 0.6% CEs treatment group were (80.5±1.0)%, (18.1±0.8)%, and (5.0±0.5)%, respectively, and the differences between the control group and the two CEs treated groups were statistically significant (P<0.001).ConclusionCEs can exert anti-tumor effect on radioresistant esophageal cancer cells by inducing autophagy and apoptosis, promoting cell cycle arrest, inhibiting cell energy metabolism, and inhibiting migration.

    Release date:2021-02-08 08:00 Export PDF Favorites Scan
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