新生儿缺血缺氧性脑病是围产期新生儿最多见的疾病,也是围生期窒息的严重并发症,对该类患者的早期影像学诊断与预后评估方式是关系居民素质与生活质量的主要问题.以往CT与MRI是新生儿缺血缺氧性脑病的主要检查方式,但因其基于信号、密度及内眼可见的形态学改变,早期诊断灵敏度相对较差,缺乏量化指标.磁共振扩散成像与磁共振波谱成像从水分子扩散水平与细胞代谢水平方面对该病进行深入分析,在该病量化评估、早期诊断、预后分析、功能改变等方面具有一定优势.

气血津液理论是中医学重要学说,研究发现膝骨性关节炎(KOA)在阳虚体质者中发病率最高.本文从气、血、津液三个角度探讨阳虚质与KOA在病因病机、治则治法的相关性,提出要重视阳虚质KOA"辨体论治"以及"气血津液"辨证,进一步提出以温阳为主,补虚去滞,气血津液皆重的治则,以期为KOA的中医药辨体-辨病-辨证模式的综合运用提供思路.

Bobath技术是根据人的发育过程,抑制痉挛来引出正常运动模式的一种康复技术,能降低脑瘫患儿肌张力,改善其肢体痉挛程度,激发机体与脑的代偿能力,帮助患儿建立正常的运动模式.研究主要目的在于,通过检索关于国内Bobath技术治疗小儿脑瘫的文献,总结其在小儿脑瘫治疗方面的最新应用进展,以期为临床提供参考.

[目的]观察新Bobath技术康复方案联合醒脑开窍针法对卒中偏瘫下肢功能的影响.[方法]将60例卒中偏瘫患者随机分成对照组和治疗组各30例,对照组采用醒脑开窍针法治疗,治疗组予醒脑开窍针法联合新Bobath技术康复方案治疗,共治疗12周,比较两组治疗前后的改良Barthel指数(MBI)、简化Fugl-Meyer(FMA)评分及Holden步行功能.[结果]两组MBI、FMA评分及Holden步行功能均有提升(P<0.05),且治疗组优于对照组(P<0.05).[结论]新Bobath技术康复治疗联合醒脑开窍针法治疗卒中偏瘫下肢功能疗效显著,值得临床推广.

目的:观察化浊行血汤联合针灸治疗乳腺癌术后上肢水肿的临床疗效.方法:将56例乳腺癌术后上肢水肿患者随机分为两组各28例,对照组予常规药物治疗,治疗组在对照组基础上联合化浊行血汤和针灸治疗,共治疗12周.分别于治疗前后评估两组患者QOL、KPS、VAS评分及总有效率.结果:治疗组总有效率(89.29％)显著高于对照组(71.43％),差异有统计学意义(P＜0.05);经12周治疗后,治疗组患者QOL、KPS、VAS评分改善情况均优于对照组,差异有统计学意义(P＜0.05).结论:化浊行血汤联合针灸治疗乳腺癌术后上肢水肿的疗效显著.

目的:观察康复训练联合竹管治疗膝关节内侧副韧带损伤的临床疗效.方法:将36例膝关节内侧副韧带损伤患者随机分为治疗组和对照组,每组各18例.对照组采用康复训练,治疗组在对照组基础上加用竹管治疗,疗程均为6周.观察2组综合疗效及治疗前后Oswestry功能障碍指数问卷(ODI)评分、视觉模拟评分法(VAS)评分、Lysholm膝关节功能评分.结果:总有效率治疗组为88.89％(16/18),对照组为72.22％(13/18),2组比较,差异有统计学意义(P＜0.05);2组ODI、VAS、Lysholm膝关节功能评分均较治疗前有所改善,且治疗组改善优于对照组(均P＜0.05).结论:康复训练联合竹管治疗膝关节内侧副韧带损伤效果显著,值得临床推广.

锁骨下动脉盗血综合征(subclavian artery ste-nosis ,SAS)是指在锁骨下动脉或头臂干的椎动脉起始处的近心段有部分或完全闭塞性损害 ,由于虹吸作用 ,引起患侧椎动脉中的血流逆行 ,进入患侧锁骨下动脉的远心端 ,导致椎 -基动脉缺血性发作和患侧上肢缺血性的症候.其病因主要是动脉硬化 ,其次是特异性或非特异性动脉炎 ,主要临床表现有眩晕、肢体轻瘫、感觉异常、双侧视力障碍、共济失调、复视、晕厥等.现将我科诊断的1例无名动脉支架术后并发双侧锁骨下动脉盗血综合征的病例报道如下.

超声弹性成像技术是一种新型的超声诊断技术,能够获得组织内部弹性的定量信息,还能获得传统超声无法探测的肿瘤及扩散疾病成像信息,被称为E型超声模式.当前弹性成像技术已广泛应用于甲状腺、乳腺、肝脏等多个领域,已成为临床常用的可靠的诊疗手段,但超声弹性成像也有其不足,如操作者操作手法的差异,评分标准没有具体量化细则等.

目的:探讨针灸远端取穴结合肩胛带运动控制训练治疗肩周炎的临床疗效.方法:选取30例肩周炎患者,采用针灸远端取穴结合肩胛骨运动控制进行治疗,10d为1个疗程,2个疗程后观察疗效.结果:治疗后总有效率为100％.结论:中医针灸疗法结合现代康复治疗技术治疗肩周炎疗效确切.

Objective To study the relationship between the stenosis content of carotid artery and the degree of homocysteine (Hcy) by analyzing the level changes of Hcy in ischemic stroke patients.Methods One hundred and thirty patients of carotid artery stenosis with ischemic stroke were divided into four groups based on the degrees of carotid artery stenosis determined by ultrasound Doppler flow imaging:the slight stenosis group (32patients),the moderate group (35 patients),the severe group (33 patients) and the total occlusion group (30 patients).Meanwhile,30 healthy people were chosen as the control group.The levels of serum homocysteine (Hcy),total cholesterol (TC),triglyceride (TG) and low density lipoprotein (LDL) of each group were measured,and the results were compared with those of the control group.Results It was found that the serum Hcy level in ischemic stroke group were significantly higher than that in the control group (P＜0.05),whereas the variations ofTC,TG,HDL and LDL levels between the ischemic stroke group and the control group could be neglected (P＞0.05).An obviously increased order of serum Hcy levels was observed as the following,the control group,the slight stenosis group,the moderate group,the severe group as well as the total occlusion group.The difference between every two groups was statistically significant (P＜0.05).The level of serum Hcy was positive correlated to the content of carotid artery stenosis (r=0.835,P＜0.05).However,no correlation was found between the carotid artery stenosis and each level of TC,TG and LDL (r=0.031,0.012,0.018,respectively,P＞0.05).Conclusions The serum Hcy level is closely related to the degree of carotid artery stenosis,and high level Hcy is suggested to be one of major risk factors for ischemic stroke.

目的 应用超声斑点追踪(speckle tracking imaging,STI)技术检测肾病综合征(nephrotic syndrome,NS)患者的应变及应变率,评价其右室局部心肌收缩功能.方法 30例肾病综合征患者,30例健康成人,应用STI技术检测右室游离壁基底段、中段、心尖段的收缩期最大位移(D)、纵向收缩期应变峰值(S)及应变率峰值(SRs).结果 肾病综合征患者组右室游离壁基底段、中段、心尖段收缩期最大位移较正常组无明显差异,肾病综合征组右室游离壁基底段收缩期应变峰值较正常组明显减低,差异具有统计学意义(P＜0.05),中段、心尖段的收缩期应变及应变率峰值与正常组比较,无明显差异.结论 应用STI技术可敏感、客观地评价右室局部心肌收缩功能,NS患者存在潜在右室局部心肌收缩功能异常.

目的:探讨康复锻炼联合血脂康胶囊对冠心病二级预防的干预作用及疗效。方法:选择118例冠心病合并血脂异常的患者,随机分为治疗组和对照组,治疗组59例,应用康复锻炼配合血脂康治疗;对照组59例,应用辛伐他汀治疗。随访1年,定期检测血脂。结果:治疗组血脂明显低于治疗前,两组之间差异有统计学意义(P<0.05),且优于对照组。结论:应用康复锻炼联合血脂康胶囊能显著降低冠心病患者血脂的指标,对心脑血管疾病的复发有很好的预防作用,能很好地降低冠心病患者的死亡和心脑血管事件的发生率。

<正>神经源性膀胱是由于调节排尿功能的中枢和周围神经系统受到损害而引起的膀胱及尿道功能障碍,此病若不经适当的治疗和干预可引起泌尿系感染、泌尿系结石、膀胱内长期尿潴留、肾积水、肾功能减退,进一步可导致肾衰竭。现将应用超声检查所见该病的一些表现报告如下。

<正>梗阻性肥厚性心肌病(hypertrophic obstructive cardiomyo-pathy;HOCM)临床并不罕见,但由于其临床症状缺乏特异性,极易误诊为心肌缺血或心肌梗死。本文对1例梗阻性肥厚性心肌病患者的心电图、心脏彩色多普勒超声检查结果进行了分析。

<正>患者男,53岁,因近来消瘦乏力、咳嗽、胸闷憋气来我院就诊。自述有慢性支气管炎病史。心电图检查:V1～V5有S-T段和T波异常改变,P波高尖,完全性右束支传导阻滞。临床初步诊断:肺心病、心肌缺血。超声心动图检查:病人采取左侧卧位,分别做左室长轴、短轴、四腔心、二腔心等切面检查,显示三尖瓣附着部位明显下移,尤其是隔瓣和后瓣,且短小,前瓣位

[Objective]To observe the clinical effect of bamboo jar on treating disease of vertebrae cervicales in neck-type.[Methods]Ninety-eight patients with cervical syndrome were randomly divided into bamboo jar group and the empty jar group.In the bamboo jar group the self-produced bamboo jar should be boiled in the decoction and then used.Routine cupping was used in the empty jar group. Clinical symptom and signs were observed in both groups.[Results]There were 29 patients in bamboo jar group and 11 had excellence effect,6 cases had effective action.Thirteen patients were cured in the empty jar group,among them 16 had obvious and 12 had effective action.[Conclusion]The therapeutic effect of drug bamboo jar group was higher than that of empty jar group.

泌尿系结石是临床常见病症,笔者自拟排石汤治疗泌尿系结石51例,疗效满意,报道如下.

<正>笔者在临床中应用育阴清热利水的猪苓汤加味治疗阴虚型慢性肾炎,取得较好的疗效,报告如下。1临床资料1.1一般资料124例病例均为门诊病历,随机分成两组。治疗组62例,其中男39例,女23例,年龄最小18岁,最大