目的 观察体外冲击波治疗髌腱末端病的效果。 方法 2006年1月－2010年12月67例髌腱末端病患者全部采用非手术治疗，其中38例采用体外冲击波治疗，11例采用手法按摩疗法，5例采用体外擦药酒、药膏，4例注射醋酸泼尼松龙加普鲁卡因，9例采用针灸疗法。观察体外冲击波治疗与其他非手术疗法之间的效果有无差异。 结果 经相同疗程治疗后，采用体外冲击波治疗者显效25例，有效10例，效果不明显3例；采用其他非手术疗法者显效9例，有效12例，效果不明显8例；两组治疗结果差异有统计学意义（Z=?2.966，P=0.003）。 结论 应用体外冲击波治疗髌腱末端病方法简便，操作安全，疗效显著，较其他非手术治疗方法有明显的优势。但对运动员患者应用此方法时，应与训练安排紧密结合起来，才能收到最大的效果。Objective To explore the therapeutic effect of extracorporeal shock wave therapy (ESWT) on patellar tendinopathy (PT). Methods A total of 67 cases who were diagnosed with PT between January 2006 and December 2010 were selected. All of the patients were treated with conservative treatment, including ESWT in 38, massage therapy in 11, ointment in 5, injection with prednisolon acetate and procaine in 4, and acupuncture in 9. The therapeutic effects of ESWT and other treatment were observed and compared. Results After the same treatment duration, the therapeutic effect was excellent in 65.79%, good in 26.32%, and fair in 7.89%, respectively in patients who had undergone ESWT; while the result was excellent in 31.03%, good in 41.38%, and fair in 27.59% , respectively in the patients who had received the other conservative treatments. The difference was significant (Z=?2.966, P=0.003). Conclusions ESWT is easy, safe, and effective for PT. It has more distinct advantages than other conservative treatments. However, it’s better to combine the treatment with training plans when the patients are athletes.
The etiology and pathogenesis of age-related macular degeneration (AMD) are unclear and difficult fot treatment. Some genetic research evidences in recent years have shown that the relationship between lipid metabolism-related gene polymorphism and AMD is statistically significant; it has also been found that blood lipid levels are related to AMD, and lipid-lowering drugs may have the effect of delaying the development of AMD in clinically. Abnormal lipid metabolism may play an important role in the occurrence and development of AMD. Clarifying the role of lipid metabolism in the occurrence and development of diseases will help reveal the pathogenesis of diseases and promote early diagnosis, monitoring and prevention of diseases, and provide an entry point for treatment.
Age-related macular degeneration (AMD) is a multifactorial disease affected by environmental factors and genetic variation, which is a major cause of irreversible vision loss in the elderly. miRNA is a kind of endogenous non-coding RNA, which plays an important role in the pathogenesis of AMD, such as oxidative stress, pathological neovascularization and inflammation, by inhibiting or silencing the expression of transcription genes. miRNA has unique advantages in terms of ease synthesis, targeting and additive effect, a large number of experiments have proved the therapeutic potential of miRNA in AMD, which is expected to become a new method for the treatment of AMD in the future. Since the pathogenesis of AMD has not been fully elucidated, it is still necessary to continue to study the pathogenesis of AMD, the biological effects and mechanisms of various miRNA in the occurrence and development of AMD, and observe its therapeutic effects in AMD, so as to provide more effective options for the precise prevention and treatment of AMD.
With the development of rehabilitation medicine being promoted as a national strategy, the rehabilitation medicine has developed rapidly in China, and the number of rehabilitation medicine departments in tertiary general hospitals has increased greatly. However, the discipline development faces some problems, such as unreasonable physical condition setting, nonstandard clinical path of rehabilitation technology, inaccurate discipline positioning, loopholes in safety management, inadequate rehabilitation quality control, and imperfect talent construction system. This paper attempts to discuss the strategic thinking of the development of rehabilitation medicine from six dimensions: foundation, technology, system, safety, quality control, and talents, so as to provide a reference for discipline builders.
Objective To summarize the research progress of acute kidney injury after liver transplantation. Method The literatures on acute kidney injury after liver transplantation was collected and reviewed. Results Acute kidney injury after liver transplantation was associated with multiple risk factors. Early prevention and treatment of risk factors in perioperative period was the main measure to reduce acute kidney injury after liver transplantation. Early postoperative diagnosis and timely intervention could reduce the incidence of chronic kidney disease and improve the long-term prognosis of liver transplantation recipients. Conclusion Acute kidney injury is a common complication after liver transplantation which affects prognosis and long-term survival of patients.
ObjectiveTo explore the relationship between myocardial viability in patients with coronary artery disease who underwent elective coronary artery bypass grafting (CABG) and early application of intra-aortic balloon pump (IABP) after coronary revascularization, and to provide relevant clinical reference for the pre-implantation of 16G single-lumen catheter in the femoral artery of high-risk patients to facilitate the addition of IABP after operation.MethodsThis retrospective study included 521 patients (414 males and 107 females, aged 62.50±8.82 years) who underwent positron emission tomography (PET)-computed tomography (CT) perfusion-metabolism imaging prior to CABG surgery in our institution from December 2015 to August 2020. The myocardial viability information and left ventricular functional parameters were measured, including the proportion of non-viable myocardium (perfusion-metabolic imaging match), hibernating myocardium (perfusion-metabolic imaging mismatch) and dysfunctional myocardium (non-viable+viable myocardium), left ventricular ejection fraction, left ventricular end-diastolic volume and left ventricular end-systolic volume (LVESV). The patients were divided into an IABP group and a non-IABP group according to whether they received IABP treatment after revascularization. The clinical data were reviewed and compared to explore significant impact factors between the two groups. And the multivariate logistic regression analysis was performed to investigate the correlation between preoperative myocardial viability and early use of IABP after CABG.ResultsIn multivariate logistic regression analysis, the amount of non-viable, dysfunctional myocardium and LVESV value were identified as the independent predictors for the probability of IABP use in the initial postoperative period. Receiver operating characteristic analysis showed that 9.5% non-viable myocardium, 19.5% dysfunctional myocardium, and LVESV of 114.5 mL were the optimal cutoff for predicting early IABP implantation during CABG.ConclusionThe myocardial survival status displayed by preoperative PET-CT myocardial perfusion-metabolism imaging can predict the possibility of applying IABP in CABG perioperative period. In addition to routine pre-anesthesia assessment, anesthesiologists can conduct risk stratification assessment for patients with CABG according to the results of preoperative myocardial viability imaging, which is of great significance to ensure the perioperative safety of high-risk patients with CABG.
Objective To explore application of preoperative examination in the colorectal cancer patients. Methods The preoperative examination data of patients diagnosed definitely as colorectal cancer at West China Hospital of Sichuan University from November 2006 to June 2007 was retrospectively study, and the application situation and relationship among all preoperative examination in the colorectal cancer patients were analyzed. Results According to the inclusion criteria, 438 colorectal cancer patients were included which involved 260 males and 178 females. Preoperative examinations included two to sixteen items, with an average of 10.61 items. According to correlation analysis, positive correlation existed among lung function and blood type ( r =0.161, P =0.001), tumor marker ( r =0.118, P =0.014), chest X-ray ( r =0.113, P =0.018), routine electrocardiogram ( r =0.198, P =0.000) , while lung function and immune and stress reaction exhibit a negative correlation ( r =-0.106, P = 0.027) with preoperative examinations. At the same time, immune and stress reaction had positive correlation to CT examinations of abdomen ( r =0.151, P =0.001) as well as endorectal ultrasound ( r =0.330, P =0.000). Using univariate analysis, the influence of tumor location ( P =0.012) and operative method ( P =0.004) on the number of examination items was significant. Conclusion Preoperative examination of colorectal tumor surgery mainly includes routine examination, neoplasm-related examination and important organs function detection. And three levels of preoperative menu can be set up in early stage. Establishment of normalization preoperative combined examination may be helpful to consummate preoperative evaluation and improve medical quality.