目的评估活血通络法治疗静息性股骨头坏死患者的临床疗效和影像学表现。方法 2005年6月至2013年1月,回顾55例59髋静息性股骨头坏死患者采用活血通络中药干预前后的临床和影像资料,男39例、女16例,平均年龄(36.4±10.1)岁,平均随访(4...目的评估活血通络法治疗静息性股骨头坏死患者的临床疗效和影像学表现。方法 2005年6月至2013年1月,回顾55例59髋静息性股骨头坏死患者采用活血通络中药干预前后的临床和影像资料,男39例、女16例,平均年龄(36.4±10.1)岁,平均随访(4.38±2.38)年。病因为激素性、酒精性、特发性的患者分别为28例(28髋)、10例(10髋)、17例(21髋);ARCOⅠ、Ⅱ期分别为10髋、49髋。采用Harris量表评估髋关节功能,SF-36量表评估生活质量,临床与影像学进展分别采用有或无疼痛、有或无塌陷进展进行评估,并与文献报道的静息髋自然转归对比,评价中医药防治股骨头坏死的效果。结果本组股骨头坏死患者均随访2年以上,2-5年40例,>5、≤10年13例,>10年2例。治疗前后患者的Harris评分无统计学差异(89.7±10.5 vs 96.4±12.0)。SF-36健康量表评分中精神健康状况(P=0.004)及活力(P=0.000)、角色限制(P=0.001)、心理健康(P=0.003)的评分在治疗后均有上升,具有统计学差异。ARCOⅠ、Ⅱ期分别有2髋(20.0%)、3髋(6.1%)出现疼痛;分别有4髋(40.0%)、9髋(18.4%)出现塌陷。与文献报道的静息髋自然转归对比,临床和影像学进展率明显降低。结论活血通络法中药干预静息性股骨头坏死效果明显,降低了临床和影像学进展率,提示股骨头坏死早期诊断、早期治疗的重要性。展开更多
目的探索痹祺胶囊治疗膝骨关节炎(KOA)的临床疗效及其对KOA影像学的影响。方法采取随机对照临床试验,试验对象为100例就诊于广东省中医院风湿科门诊就诊的KOA患者。随机分为治疗组(痹祺胶囊治疗)50例和对照组(骨化三醇胶囊+碳酸钙D3片治...目的探索痹祺胶囊治疗膝骨关节炎(KOA)的临床疗效及其对KOA影像学的影响。方法采取随机对照临床试验,试验对象为100例就诊于广东省中医院风湿科门诊就诊的KOA患者。随机分为治疗组(痹祺胶囊治疗)50例和对照组(骨化三醇胶囊+碳酸钙D3片治疗)50例。观察治疗前后两组的骨关节炎指数(The Western Ontario and McMaster Universities Osteoarthritis,WOMAC评分)、疼痛的视觉模拟(VAS)评分以及磁共振膝关节评分(MRI osteoarthritis knee Score,MOAKS评分)的变化,以及血常规、肝肾功能、心电图等安全性指标及不良事件。结果共纳入患者100例,脱落16例,纳入分析84例。治疗组在治疗24周后WOMAC评分以及24周与0周WOMAC评分差值与对照组比较差异显著(P<0.05),痹祺胶囊对WOMAC评分的改善优于对照组。两组治疗24周后MOAKS评分差异无统计学意义(P>0.05)。亚组分析结果提示,对于未使用非甾体消炎药(NSAIDs)的患者,在治疗24周后,治疗组MOAKS评分与对照组比较,差异显著(P<0.05),在未使用NSAIDs药物的患者中,痹祺胶囊对MOAKS评分的改善优于对照组。治疗组共有2例,对照组有1例发生不良反应,两组之间不良反应发生率差异无统计学意义(P>0.05)。结论痹祺胶囊可以更好地改善KOA患者的关节僵硬和功能状态,可以更好地改善未合并服用止痛药患者膝关节影像学。展开更多
Objective To investigate the clinical features and management of bronchogenic cyst in the adults. Methods We retrospectively reviewed 50 patients admitted to our hospital with histopathologically proved bronchogenic c...Objective To investigate the clinical features and management of bronchogenic cyst in the adults. Methods We retrospectively reviewed 50 patients admitted to our hospital with histopathologically proved bronchogenic cyst from January 1983 to December 2007. Of all the patients, 28 were male and 22 were female, with an average age of 36.9 (range, 18 to 64) years. The symptoms, location of the cysts, imaging evaluation, surgical treatment manner, and outcome of these patients were analyzed. Results Symptoms were present in 33 of the 50 patients, and cough was the most common symptom. Thirteen patients presented with complications: hemoptysis, infected cyst, dysphagia, paralysis, and hoarseness. The locations of the cysts included the mediastinum (28 cases), pulmonary parenchyma (12 cases), hilar area (3 cases), visceral pleura (1 case), and some rare locations including the intestinal mesentery (1 case), retroperitoneum (1 case), adrenal gland (1 case), neck (2 cases), and dura matter of the cervical verte-brae (1 case). Chest X-ray was performed in 36 patients and computed tomography (CT) was performed in 41 patients. The bronchogenic cyst in CT was characterized as a round, well circumscribed, unilocular mass, with density ranging from that of water to high density (0-50 Hu). As for treatment, complete resection of the bronchogenic cyst was performed in 47 (94%) patients, subtotal resection was performed in 3 (6%) patients. Open surgery was performed in 45 (90%) patients, and thoracoscopy (video-assisted thoracic surgery) was performed in 5 (10%) paitients. Of the 12 patients with intrapulmonary cyst, 11 patients underwent lobectomy and 1 patient underwent wedge resection. Postoperative sequelae occurred in 2 patients, 1 with persistent air leakage and 1 with hoarseness. All patients were proved with bronchogenic cyst pathologically. The average follow-up period was 6.5 years (range, 4 months to 10 years), and no late sequelae or recurrence of the cyst occurred. Conclusions The clinical and imaging presentations o展开更多
Objective. To investigate whether laparoscopy can be considered as adequate and reliable as standard laparotomy in predicting optimal cytoreduction (RT ≤ .1 cm) in patients with advanced ovarian cancer. Methods. From...Objective. To investigate whether laparoscopy can be considered as adequate and reliable as standard laparotomy in predicting optimal cytoreduction (RT ≤ .1 cm) in patients with advanced ovarian cancer. Methods. From March to November 2003, 95 patients with suspected advanced ovarian or peritoneal cancer have been evaluated. Thirty- one cases were excluded due to an anesthesiological class of risk ASA III- IV (51.6% ) and for the presence of a large size mass reaching the xiphoid (48.4% ). Sixty- four patients completed the study. All patients were submitted to preoperative clinico- radiological evaluation and then to both laparoscopy and standard longitudinal laparotomy, sequentially. Some specific preoperatively defined parameters were analyzed during each procedure in order to obtain the most accurate evaluation on the possibility to get an optimal cytoreduction. Results. The overall accuracy rate of laparoscopy in assessing optimal cytoreduction was 90% .The negative predictive value (NPV) of the clinical- radio- logic evaluation corresponded to 73% , whereas in no case was the judgment of unresectable disease obtained by laparoscopy changed by the laparotomic approach (NPV 100% ). On the contrary, an optimal debulking was achievable in 34 of 39 cases (87% ) selected as completely resectable by explorative laparoscopy. Conclusions. Laparoscopy can be considered super imposable to standard longitudinal laparotomy in identifying not optimally resectable advanced ovarian cancer patients.展开更多
文摘目的评估活血通络法治疗静息性股骨头坏死患者的临床疗效和影像学表现。方法 2005年6月至2013年1月,回顾55例59髋静息性股骨头坏死患者采用活血通络中药干预前后的临床和影像资料,男39例、女16例,平均年龄(36.4±10.1)岁,平均随访(4.38±2.38)年。病因为激素性、酒精性、特发性的患者分别为28例(28髋)、10例(10髋)、17例(21髋);ARCOⅠ、Ⅱ期分别为10髋、49髋。采用Harris量表评估髋关节功能,SF-36量表评估生活质量,临床与影像学进展分别采用有或无疼痛、有或无塌陷进展进行评估,并与文献报道的静息髋自然转归对比,评价中医药防治股骨头坏死的效果。结果本组股骨头坏死患者均随访2年以上,2-5年40例,>5、≤10年13例,>10年2例。治疗前后患者的Harris评分无统计学差异(89.7±10.5 vs 96.4±12.0)。SF-36健康量表评分中精神健康状况(P=0.004)及活力(P=0.000)、角色限制(P=0.001)、心理健康(P=0.003)的评分在治疗后均有上升,具有统计学差异。ARCOⅠ、Ⅱ期分别有2髋(20.0%)、3髋(6.1%)出现疼痛;分别有4髋(40.0%)、9髋(18.4%)出现塌陷。与文献报道的静息髋自然转归对比,临床和影像学进展率明显降低。结论活血通络法中药干预静息性股骨头坏死效果明显,降低了临床和影像学进展率,提示股骨头坏死早期诊断、早期治疗的重要性。
文摘目的探索痹祺胶囊治疗膝骨关节炎(KOA)的临床疗效及其对KOA影像学的影响。方法采取随机对照临床试验,试验对象为100例就诊于广东省中医院风湿科门诊就诊的KOA患者。随机分为治疗组(痹祺胶囊治疗)50例和对照组(骨化三醇胶囊+碳酸钙D3片治疗)50例。观察治疗前后两组的骨关节炎指数(The Western Ontario and McMaster Universities Osteoarthritis,WOMAC评分)、疼痛的视觉模拟(VAS)评分以及磁共振膝关节评分(MRI osteoarthritis knee Score,MOAKS评分)的变化,以及血常规、肝肾功能、心电图等安全性指标及不良事件。结果共纳入患者100例,脱落16例,纳入分析84例。治疗组在治疗24周后WOMAC评分以及24周与0周WOMAC评分差值与对照组比较差异显著(P<0.05),痹祺胶囊对WOMAC评分的改善优于对照组。两组治疗24周后MOAKS评分差异无统计学意义(P>0.05)。亚组分析结果提示,对于未使用非甾体消炎药(NSAIDs)的患者,在治疗24周后,治疗组MOAKS评分与对照组比较,差异显著(P<0.05),在未使用NSAIDs药物的患者中,痹祺胶囊对MOAKS评分的改善优于对照组。治疗组共有2例,对照组有1例发生不良反应,两组之间不良反应发生率差异无统计学意义(P>0.05)。结论痹祺胶囊可以更好地改善KOA患者的关节僵硬和功能状态,可以更好地改善未合并服用止痛药患者膝关节影像学。
文摘Objective To investigate the clinical features and management of bronchogenic cyst in the adults. Methods We retrospectively reviewed 50 patients admitted to our hospital with histopathologically proved bronchogenic cyst from January 1983 to December 2007. Of all the patients, 28 were male and 22 were female, with an average age of 36.9 (range, 18 to 64) years. The symptoms, location of the cysts, imaging evaluation, surgical treatment manner, and outcome of these patients were analyzed. Results Symptoms were present in 33 of the 50 patients, and cough was the most common symptom. Thirteen patients presented with complications: hemoptysis, infected cyst, dysphagia, paralysis, and hoarseness. The locations of the cysts included the mediastinum (28 cases), pulmonary parenchyma (12 cases), hilar area (3 cases), visceral pleura (1 case), and some rare locations including the intestinal mesentery (1 case), retroperitoneum (1 case), adrenal gland (1 case), neck (2 cases), and dura matter of the cervical verte-brae (1 case). Chest X-ray was performed in 36 patients and computed tomography (CT) was performed in 41 patients. The bronchogenic cyst in CT was characterized as a round, well circumscribed, unilocular mass, with density ranging from that of water to high density (0-50 Hu). As for treatment, complete resection of the bronchogenic cyst was performed in 47 (94%) patients, subtotal resection was performed in 3 (6%) patients. Open surgery was performed in 45 (90%) patients, and thoracoscopy (video-assisted thoracic surgery) was performed in 5 (10%) paitients. Of the 12 patients with intrapulmonary cyst, 11 patients underwent lobectomy and 1 patient underwent wedge resection. Postoperative sequelae occurred in 2 patients, 1 with persistent air leakage and 1 with hoarseness. All patients were proved with bronchogenic cyst pathologically. The average follow-up period was 6.5 years (range, 4 months to 10 years), and no late sequelae or recurrence of the cyst occurred. Conclusions The clinical and imaging presentations o
文摘Objective. To investigate whether laparoscopy can be considered as adequate and reliable as standard laparotomy in predicting optimal cytoreduction (RT ≤ .1 cm) in patients with advanced ovarian cancer. Methods. From March to November 2003, 95 patients with suspected advanced ovarian or peritoneal cancer have been evaluated. Thirty- one cases were excluded due to an anesthesiological class of risk ASA III- IV (51.6% ) and for the presence of a large size mass reaching the xiphoid (48.4% ). Sixty- four patients completed the study. All patients were submitted to preoperative clinico- radiological evaluation and then to both laparoscopy and standard longitudinal laparotomy, sequentially. Some specific preoperatively defined parameters were analyzed during each procedure in order to obtain the most accurate evaluation on the possibility to get an optimal cytoreduction. Results. The overall accuracy rate of laparoscopy in assessing optimal cytoreduction was 90% .The negative predictive value (NPV) of the clinical- radio- logic evaluation corresponded to 73% , whereas in no case was the judgment of unresectable disease obtained by laparoscopy changed by the laparotomic approach (NPV 100% ). On the contrary, an optimal debulking was achievable in 34 of 39 cases (87% ) selected as completely resectable by explorative laparoscopy. Conclusions. Laparoscopy can be considered super imposable to standard longitudinal laparotomy in identifying not optimally resectable advanced ovarian cancer patients.
