现有预防非妊娠期妇女膀胱炎复发的临床证据如下:①连续预防性使用抗生素:一系列随机对照试验研究表明,连续预防性使用抗生素(甲氧苄氨嘧啶、复方磺胺甲噁唑、呋喃妥英、头孢克洛或一种喹啉)6～12个月可以减少复发性膀胱炎的发生率,但各种不同用药方案间未发现感染率有差异.一个比较持续性每日使用抗生素与性交后使用抗生素的随机对照试验表明,1年后尿培养阳性率差异无统计学意义.②性交后预防性使用抗生素(复方磺胺甲噁唑、呋喃妥英或一种喹啉):4个随机对照试验研究表明,性交后2 h内使用复方磺胺甲噁唑、呋喃妥英或喹啉较安慰剂能显著降低膀胱炎发生率.一个关于性交后预防性使用抗生素和每日连续使用抗生素的随机对照试验发现,1年后二者的膀胱炎发生率的差异无统计学意义.③一次性使用复方磺胺甲噁唑:一个小样本随机对照试验发现,连续每日预防性使用复方磺胺甲噁唑与在膀胱炎症状出现后一次性使用复方磺胺甲噁唑相比,前者能显著降低膀胱炎发生率.但由于证据太有限,不能得出肯定结论.④酸果蔓汁(cranberry juice)和酸果蔓制品:一个系统评价发现,酸果蔓汁及其制品能预防复发性膀胱炎的证据不足.⑤用马尿酸乌洛托品预防:缺乏研究马尿酸乌洛托品的可靠的随机对照试验.
目的：探讨在CT引导下经小关节内侧缘穿刺，应用造影剂观察药物分布，准确行靶位注射胶原酶［1］治疗术后复发的腰椎间盘突出症的疗效。方法:10例经临床确诊为腰椎间盘突出症术后复发的患者,在CT引导下经小关节内侧缘入路将穿刺针直接刺入突出物内,注射欧乃派0.5 ml，观察药物分布情况后，注入胶原酶600 u。临床观察患者术后6～12个月的治疗效果，用改良的Macnab方法评价疗效。结果:10例患者穿刺针均顺利准确刺入突出物，造影剂均匀分布在突出物及盘内。治疗优、良率为100%，无严重并发症。结论: CT引导下穿刺造影，观察造影剂的扩散后，再行靶位注射胶原酶对于术后复发的腰椎间盘突出症，可以进一步提高治疗效果，减少并发症的发生。
Ｎｉｎｅｔｙ ｃａｓｅｓ ｏｆ ｓｕｒｇｉｃａｌｌｙ ｔｒｅａｔｅｄ ｒｅｃｕｒｒｅｎｔ ｈｅｐａｔｏｃｅｌｌｕｌａｒ ｃａｒｃｉｎｏｍａ ｉｓ ｒｅｐｏｒｔｅｄ ｗｉｔｈ ａｎａｌｙｓｉｓ ｏｆ ｔｈｅ ｍａｃｈａｎｉｓｍ ｏｆ ｒｅｃｕｒｒｅｎｃｅ ａｎｄ ｆａｃｔｏｒｓ ａｆｆｅｃｔｉｎｇ ｔｕｍｏｒ ｒｅｃｕｒｒｅｎｃｅ． Ｅａｒｌｙ ｄｅｔｅｃｔｉｏｎ ｏｆ ｒｅｃｕｒｒｅｎｃｅ ｄｅｐｅｎｄｓ ｏｆ ＡＦＰ ｍｅａｓｕｒｅｍｅｎｔｓ ａｎｄ ｕｌｔｒａｓｏｎｏｇｒａｐｈｙ ｆｏｌｌｏｗｕｐ ｍｏｎｉｔｏｒｉｎｇ ａｆｔｅｒ ｒｅｓｅｃｔｉｏｎ． Ｈｅｐａｔｉｃ ｒｅｓｅｃｔｉｏｎ ｉｓ ｔｈｅ ｆｉｒｓｔ ｃｈｏｉｃｅ ｏｆ ｔｒｅａｔｍｅｎｔ ｗｈｅｎｅｖｅｒ ｉｔ ｉｓ ｆｅａｓｉｂｌｅ． Ｉｎｔｒａｔｕｍｏｒ ｅｔｈａｎｏｌ ｉｎｊｅｃｔｉｏｎ ａｎｄ ｔｒａｎｓｃａｔｈｅｔｅｒ ａｒｔｅｒｉａｌ ｃｈｅｍｏｅｍｂｏｌｉｚａｔｉｏｎ ｄｕｒｉｎｇ ｏｐｅｒａｔｉｏｎ ｈａｓ ｂｅｅｎ ｂｅｎｅｆｉｃｉａｌ ｉｎ ｓｏｍｅ ｐａｔｉｅｎｔｓ ｗｉｔｈ ｕｎｒｅｓｅｃｔａｂｌｅ ｒｅｃｕｒｒｅｎｔ ｈｅｐａｔｏｃｅｌｌｕｌａｒ ｃａｒｃｉｎｏｍａ． Ｔｈｅｓｅ ｒｅｓｕｌｔｓ ｓｕｇｇｅｓｔ ｔｈａｔ ｒｅｏｐｅｒａｔｉｏｎ ｆｏｒ ｒｅｃｕｒｒｅｎｔ ｈｅｐａｔｏｃｅｌｌｕｌａｒ ｃａｒｃｉｎｏｍａ ｍａｙ ｂｅ ａｎ ａｐｐｒｏａｃｈ ｔｏ ｉｍｐｒｏｖｅ ｔｈｅ ｌｏｎｇｔｅｒｍ ｓｕｒｖｉｖａｌ ａｆｔｅｒ ｈｅｐａｔｉｃ ｒｅｓｅｃｔｉｏｎ．
【Abstract】 Objective To explore the effect of recurrent anterior shoulder dislocation on the secondary intra-articular injuries through analyzing the correlation between the number of dislocation, disease duration, and the secondary intra-articular injuries. Methods The clinical data were analyzed retrospectively from 59 patients with recurrent anterior shoulder dislocation who underwent arthroscopic Bankart reconstruction using suture anchor between January 2005 and June 2009. There were 48 males and 11 females, and the average age was 27.6 years (range, 15-42 years). The causes of first dislocation included contact sports (21 cases), non-contact sports (13 cases), daily activities (11 cases), and trauma (14 cases). The average number of preoperative dislocations was 10.6 times (range, 3-32 times). The time between first dislocation and surgery was 11 months to 12 years (median, 5.9 years). The results of apprehension test and relocation test were positive in all patients. The University of California Los Angeles (UCLA) score was 22.3 ± 2.4, and Constant-Murley score was 73.1 ± 5.8 preoperatively. According to the arthroscopic findings, the effect of recurrent anterior shoulder dislocation on the secondary intra-articular injuries was analyzed. Results All incisions healed by first intention, and no early complication occurred. All 59 patients were followed up 37.3 months on average (range, 16-58 months). At last follow-up, UCLA score was 34.6 ± 1.7 and Constant-Murley score was 86.7 ± 6.1, showing significant differences when compared with preoperative scores (P lt; 0.05). The number of preoperative dislocations was positively correlated with the severity of secondary articular cartilage injury (rs=0.345, P=0.007) and the severity of Hill-Sachs injury (rs=0.708, P=0.000). The time between first dislocation and surgery had a positive correlation with the severity of secondary articular cartilage injury (rs=0.498, P=0.000), but it had no correlation with the severity of Hill-Sachs injury (rs=0.021, P=0.874). Conclusion For patients with recurrent anterior shoulder dislocation, early Bankart reconstruction is benefit to functional recovery of shoulder and can avoid or delay the occurrence or development of secondary intra-articular injuries.