目的:探討聚焦超聲治療慢性宮頸炎的安全性和有效性。方法:回顧性分析2003年1月至2006年12月我院門診診斷治療的慢性宮頸炎患者,行聚焦超聲治療后并于3月內隨訪的574例患者,分析其安全性及有效性。結果:574例中,痊愈 378例(65.9%),顯效155例(27.0%),總有效率96.7%。治愈率與糜爛面積及深淺程度有關(Plt;0.05)。超聲治療后部分患者出現陰道少量流液及血性分泌物。結論:聚焦超聲應用于慢性宮頸炎的治療安全有效,療效確切,不良反應及并發癥小,值得推廣。
Tuberculosis remains a major public health problem. Genetic epidemiological studies have shown that the differences in host genes partly determine the susceptibility to tuberculosis. The occurrence of tuberculosis is the result of the joint action of Mycobacterium tuberculosis and host gene regulation immune response. The study of susceptibility candidate genes has differences in race, population and region, and the study of susceptibility gene polymorphism still has a long way to go in clinical precision diagnosis and treatment. The study and clinical application of mendelian susceptibility to mycobacterial disease can be used as a classic application of precision medical treatment in tuberculosis; although it is a rare case, this model is worthy of reference.
Circular RNA (circRNA) is a non-coding RNA which exists widely in eukaryotic cells with a structure of covalently closed continuous loop. Its generation, characteristics and functions have received extensive attention, making it one of the hot spots in the field of non-coding RNA research. Many studies have found that circRNA plays an important role in the development of various diseases including cardiovascular disease, nervous system disease and cancer. Cardiovascular disease is a worldwide common disease with high incidence and poor prognosis. Its exact pathogenesis has not been found, which blocks the development of cardiovascular disease treatment. In this review, we summarize the loop-forming mechanisms, the functions and the progress of current researches of circRNA in cardiovascular diseases.
目的:探討使用Moss Miami系統經骶棘肌肌間隙入路在APERTURE工具的引導下微創治療腰椎滑脫癥的療效。方法:20例腰椎滑脫癥患者(男11例,女9例),年齡30～65歲(平均40歲)。其中退變性14例、峽部裂5例、腰椎間盤突出合并鈣化1例;Ⅰ度滑脫15例,Ⅱ度滑脫5例。滑脫部位:L4滑脫14例,L5滑脫6例,采用全麻俯臥位下經下腰部正中小切口(5cm),經雙側骶棘肌肌間隙入路在APERTURE工具的引導下放置Moss Miami系統進行復位固定和椎體間及后外側植骨融合。結果:本組患者術中在C臂X光機監視,經骶棘間隙放置Moss Miami固定系統簡單易行,切口較小、顯露好、出血少,對骶棘肌等軟組織造成的損傷輕,復位固定效果滿意。術后經6月隨訪表明:本組患者腰腿痛等臨床癥狀緩解,X線片顯示滑脫復位無丟失、植骨融合良好、內固定器械無松動及斷裂。結論:在C臂X光機監視下,采用Moss Miami經骶棘肌肌間隙入路在APERTURE工具的引導下治療腰椎滑脫癥具有切口小、肌肉軟組織損傷輕、出血少、固定器械放置簡單易行等優點,有利于患者術后康復。
To evaluate the efficacy and safety of comprehensive prophylaxis for deep venous thrombosis(DVT) after proximal femur fractures in geriatric patients. Methods From July 2003 to May 2006, 157 geriatric patients with proximal femur fractures treated with operation were divided into prophylaxis group and control group randomly. There were 82 patients (34 males, 48 females, aged 65-97 years) in prophylaxis group, 30 with femoral neck fracture and 52 with intertrochanteric fracture of femur. There were 75 patients (33 males, 42 females, aged 65-94 years) in control group, 28 with femoral neck fracture and 47 with intertrochanteric fracture of femur. In the prophylaxis group, comprehensive prophylaxis for DVT which included Aspirin, fibrinolytic enzyme, passive and active circumduction of the foot and ankle, CPM management wasappl ied. In the control group, no thromboproxylaxis was taken. All patients in the both groups received color doppler flow imaging (CDFI) examination before operation and on the 7th and 14th days after operation. Results CDFI found 2 cases of DVT in the prophylaxis group 7 and 14 days after operation respectively, while 21 and 15 cases of DVT in the control group respectively. The incidence of DVT was 48.0% in the control group compared with 4.9% in the prophylaxis group and the reduction was significant (P lt; 0.01). One patient gave up the intervention due to Melena 3 days after operation in the prophylaxis group. In the control group, 1 patient died 8 days after operation and another died 11 days after operation. Both died of acute pulmonary embol ism confirmed by autopsy. Conclusion The comprehensive prophylaxis can significantly decrease the incidence of DVT in geriatric patients after proximal femur fractures. There is no significant adverse effect during the intervention.
ObjectiveTo investigate the negative emotions of patients before cardiac surgery in West China Hospital in order to analyze the related factors.MethodsThe Huaxi emotional-distress index (HEI), a screening tool for mood disorders developed by the Mental Health Center of West China Hospital, was used for preoperative psychological evaluation of 1 968 adult patients hospitalized in cardiac surgery from March 2016 to July 2014. There were 835 males and 1 133 females at age of 49±13 years.Results Fifty-one patients (2.6%) had negative emotions, among whom 6 patients were screened for suicide risk. After intervention, none of them had serious consequences caused by adverse emotions, such as automatic discharge from hospital, avoidance of surgery and suicide.ConclusionThis study found that most of the cardiac surgery patients in West China Hospital have good psychological status before surgery, and a few suffered from negative emotions. “Huaxi emotional-distress index” is simple, effective and worth promoting.
目的 初步測試中文版情緒障礙快速篩查量表K6、SCL-8AD及其分量表（SCL-8、SCL-ANX4及SCL-DEP6）在綜合醫院內科和精神科住院患者中的適用性。 方法 2011年11月－12月對四川大學華西醫院內科（心臟內科、消化內科、風濕免疫科、內分泌科、神經內科）和精神科的住院患者共373例應用由K6和SCL-8AD量表構成的問卷進行自評，分析總問卷、各量表及分量表的信度及相互之間的相關性；在各科患者間進行評分結果差異性比較，并分別將內科及精神科評分結果與住院日進行相關分析。 結果 各量表及全問卷的Cronbach’s α系數和分半系數＞0.75（內科：0.802～0.952，精神科：0.774～0.944）；其中，K6及SCL-8的Cronbach’s α系數和分半系數在內科及精神科均≥0.817。總問卷、各量表及分量表相互之間均存在較高相關性（r≥0.676）；其中，K6及SCL-8與問卷總分均有極高相關性（r≥0.959）。問卷總分、各量表及分量表評分內科組均低于精神科組。 結論 條目少、操作簡便的中文版K6和SCL-8量表內部一致性高、其評定結果能較全面反應綜合醫院內科及精神科住院患者中不同程度的焦慮及抑郁情緒，值得對其進行更深入研究，以便推廣應用于非精神科患者情緒障礙的快速篩查。
Atrial fibrillation (AF) is one of the most common complications after cardiac surgery. The existing treatment of postoperative AF mainly focuses on preoperative prevention, intraoperative protection and postoperative treatment for factors prone to AF before, during and after surgery, but the postoperative treatment in various areas and hospitals is different. This article combines the latest literature published in Europace about the practice guidance of cardioversion of AF and atrial flutter, and summarizes the treatment of electrical cardioversion, in order to provide clinical guidance for electrical cardioversion of AF after cardiac surgery.
With the opening of the two child policy in China, the number of pregnant women has increased. Pregnancy has a huge impact on the cardiovascular system, and heart disease during pregnancy increases the risk of maternal heart failure and death, intrauterine growth retardation, and the risk of complications such as premature birth. Pregnancy with heart disease ranks first among indirect obstetric deaths in China. Reducing maternal mortality is a global goal of the World Health Organization. Thus, to strengthen the prevention and management of patients with critical heart disease during pregnancy is important. However, clinical decision-making and management of pregnant women with heart disease is still controversial. This article combines relevant literature of pregnancy and heart disease published in recent years and reviews of relevant diagnostic and therapeutic methods, to provide clinical reference for pregnant women with heart disease preventive care and management of the whole strategy.
Atrial fibrillation (AF) is the most common type of cardiac arrhythmia. The metabolic changes of atrial myocytes, especially lipid metabolism, have a significant impact on the electrical signals and structural remodeling of atrial tissue, and play an important role in the occurrence and development of AF. The reduction of fatty acid oxidation ratio and increased aerobic glycolysis ratio are characteristic changes of tissue metabolic remodeling in AF. In this review, we will introduce the latest research status of lipid metabolism in AF from aspects of AF metabolism, clinical treatment and diagnosis and prognosis.