Objective To analyze the risk factors of weaning failure in posttraumatic critical patients with non-cardiac surgery. Methods A total of 306 patients with non-cardiac surgery who had mechanical ventilation more than 24 h after surgery, from January 2019 to December 2020, were included in this study. The clinical baseline characteristics, laboratory results, intraoperative and postoperative data of enrolled patients were retrospectively analyzed. These patients were divided into two groups: weaning success group (n=222) and weaning failure group (n=84). Risk factors for weaning failure in posttraumatic critical patients with non- cardiac surgery were determined by multivariate logistic regression analysis. Results Offline failure occurred in 84 out of 306 (27.4%) patients. After elimination of confounding factors by univariate analysis, multivariate logistic regression analysis showed that age(OR=1.835, 95%CI: 1.623~2.012, P=0.002), respiratory frequency(OR=1.860, 95%CI: 1.702~1.943, P=0.001), change rate of BNP(OR=3.366, 95%CI: 1.063~ 7.887, P=0.000) and myocardial injury after non-cardiac surgery(OR=4.237, 95%CI: 1.023~16.914, P=0.001) were the independent risk factors of weaning failure in post-traumatic critical patients with non-cardiac surgery. Conclusion Age, respiratory frequency, myocardial injury after non-cardiac surgery (MINS), and increased change rate of BNP are independent risk factors of weaning failure in post-traumatic critical patients with non-cardiac surgery.

目的 回顾抗结核药导致的药物性肝损伤(DILI)患者临床资料,旨在分析其临床特征、生化指标与临床结局.方法 2012年1月～2020年3月我院诊治的接受抗结核治疗期间被诊断为DILI患者142例,进行临床分型和肝损伤分度.结果 在本组DILI患者中,诊断肝细胞型109例,胆汁淤积型17例,混合型16例;肝细胞型、胆汁淤积型和混合型患者血清ALT水平分别为(652.5±350.6)U/L、(172.6±92.8)U/L和(380.6±218.5)U/L,差异具有统计学意义(P<0.05),血清AST水平分别为(451.8±418.1)U/L、(185.5±105.2)U/L和(276.0±144.5)U/L,差异具有统计学意义(P<0.05),血清ALP水平分别为(94.5±77.5)U/L、(468.8±312.8)U/L和209.1±144.5)U/L,差异具有统计学意义(P<0.05),血清总胆红素分别为(42.3±32.3)μmol/L、(126.8±103.5)μmol/L和(57.8±42.8)μmol/L,差异具有统计学意义(P<0.05),血清白蛋白分别为(36.8±7.2)g/L、(32.2±6.8)g/L和(33.0±7.0)g/L,差异具有统计学意义(P<0.05);以肝损伤程度分组,本组轻度102例,中度14例,重度26例.轻度肝损伤患者以小于60岁、无基础肝病和以肝细胞型为主,与其他两组比,差异显著(P<0.05);本组临床治愈95例,未愈47例.治愈患者年龄偏轻、血清AST、ALP和总胆红素水平偏低、而血清白蛋白水平偏高,与未愈患者比,差异显著(P<0.05).结论 因抗结核药物导致的DILI患者以肝细胞损伤型居多,年龄大、存在低蛋白血症和高胆红素血症患者预后差,应予以特别的关注.

目的:观察养血柔肝法治疗早期膝骨关节炎的疗效,探讨早期膝骨关节炎的主要病机.方法:将78例早期膝骨关节炎患者随机分为2组,治疗组采用养血柔肝法治疗,对照组采用补肾法治疗,观察两组治疗前后的WOMAC评分.结果:治疗后两组VAS疼痛评分和WOMAC评分均降低,且治疗组降低程度大于对照组.结论:在膝骨关节炎早期,痿症是其主要病机所在,从肝论治为有效的治疗方法.

腹茧症临床少见,其急性发作多表现为完全或不全肠梗阻,手术可见部分或全部小肠被纤维膜包裹,形成蚕茧样结构.本病最早由Foo等[1]于1978年进行系统描述,称为“腹茧症”.该病发病率低,具体致病原因不明,且临床症状不典型,故临床上对本病缺乏足够的认识,致使本病在临床术前诊断困难,治疗上缺乏统一标准,治疗效果的差异也较大[2].为提高临床上对本病的认识及诊断,提高该病的治疗效果,现回顾性分析我院自2009-01-2016-03手术中确诊的腹茧症合并急性肠梗阻5例,现报告如下.

目的 探索石氏伤科膝关节导引功法改善膝骨关节炎患者生活质量的应用效果.方法 选择膝骨关节炎患者200例,分为对照组和观察组各100例,对照组实施中医常规治疗的护理,观察组在对照组的基础上,指导患者学习石氏伤科膝关节导引功法进行功能锻炼.结果 观察组患者出院时及出院6个月的健康状况调查问卷得分提高,西安大略和麦克马斯特大学骨关节炎调查表得分下降(P＜0.01或P＜0.05).结论 石氏伤科膝关节导引功法能有效改善膝骨关节炎的关节功能,提高患者的生活质量.

This paper expounded the structural principle and technical characteristics of digital tomosynthesis, and compared with the DR (Digital Radiography) and CT (Computerized Tomography) in bone, urinary and respiratory systems. Finally, it investigated the clinical effectiveness of application of digital tomosynthesis.

脾脏是腹腔内脏中最易受损伤的器官,其发病概率占腹部损伤的40％～50％[1],临床治疗以脾切除术为主.但在严重多发伤(多发伤指在同一伤因的打击下,人体同时或相继有2个或2个以上解剖部位的组织或器官受到严重创伤,其中之一即使单独存在也可能危及生命)患者伴随有脾破裂时,由于此类患者伤情重、病情复杂,存在各种生理功能紊乱,如果在早期给予不恰当的确定性手术治疗,往往会加重休克并导致难以纠正的“致死性三联征(lethal triad of death):低体温、凝血功能障碍、酸中毒”,甚至会直接导致患者死亡.有学者统计发现约23.4％的脾破裂患者在行剖腹探查术时发现其破裂出血已经停止[2].

目的:探究降钙素原(PCT)、C反应蛋白(CRP)及白细胞计数(WBC)诊断急性细菌感染性胆囊炎的意义.方法:回顾性将68例急性细菌感染性胆囊炎患者设为观察组,同期急性非细菌感染性胆囊炎60例设为对照组,对两组患者进行PCT、CRP及WBC检验,并进行比较分析.结果:观察组CRP阳性率77.94%,WBC阳性率70.59%,PCT阳性率89.71%,3者联合阳性率93.26%;两组 CRP、WBC、PCT 检测指标比较,χ2分别为 9.68、6.46、29.53(P<0.05).结论:PCT、CRP及WBC的测定,均有助于对急性细菌感染性胆囊炎的诊断,PCT优于另外2项指标,3者联合检测阳性率最高.

ObjectiveTo explore the effect of Chinese Daoyingong method on knee osteoarthritis.Methods Eighty patients with knee osteoarthritis were randomly divided into the experiment group and control group in equal number.The control group was given the routine medicine combined with Chinese fumigation and the experiment group was treated with Chinese Daoyin method beside the treatment in the control group.The two groups were compared in terms of the score on visual analog scale of pain and the score on knee function before and after treatment.Results The visual analog scale of pain in the experiment group was significantly lower than that in the control group after intervention and the score on knee function was significantly higher than that of control group (P<0.001). Conclusion The intervention with Chinese Daoyingong method plus routine medication and Chinese herbal fumigation is effective in the treatment of knee osteoarthritis.

Objective:To observe the effect of Shi's fumigation formula on knee osteoarthritis.Methods:Eighty-six patients with knee osteoarthritis were enrolled in this randomized,single-blind study.They were divided into treatment group and control group,43 cases in each group.Both group received Shi's fumigation formula,while the dosage for control group was 10% of that in treatment group.Results: There was remarkable improvement in pain,function,WOMAC scores,and swelling in both groups(P0.05),and the results in treatment group was superior to that in control group(P0.05).Conclusion: Shi's fumigation formula can relieve pain and improve knee function.