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西部医学

西部医学

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Medical Journal of West China
《西部医学》是经国家新闻出版总署批准，在国内外公开发行的一份综合性医学学术期刊；是全国《期刊出版形式规范》第一批合格期刊，是科技部中国科技论文统计源期刊、中国科技核心期刊，是《CAJ-CD规范》执行优秀期刊。国内统一刊号为：CN51-1654/R；国际标准刊号为：ISSN1672-3511；邮发代号为：62-243；月刊，大16开本，定价：15元/期•册。《西部医学》一直坚持高标准、高质量、精品化、规范化的办刊原则，贯彻理论与实践、基础与临床、普及与提高相结合的方针，重在临床、重在实践、重在提高，立足西部、面向全国、接轨国际，及时报道国内外先进的医学科技成果及动态，不断开拓创新、与时俱进，积极推动与国内外的学术交流，努力促进医疗、教学、科研、预防保健和医院管理水平的不断提高。《西部医学》的栏目设置科学，注重了专业属性，便于作者投稿与读者选阅；刊载论文的英文摘要标准、规范，医学统计科学准确，编辑规范，内容充实，刊发面广，可谓集科学性、先进性、实用性与可读性为一体，已形成了期刊的风格与特色，并被中国学术期刊综合评价数据库、中国科技核心期刊数据库、中国期刊全文数据库、中国学术期刊（光盘版）、中文科技期刊数据库、万方数据——数字化期刊群、中国报刊订阅指南信息库及国内、外众多高校、公共图书馆、党政机关、科研机构、医院、企业、军队等所收录、订阅、下载，已在国内外具有一定影响。
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  • 发文量：12526
  • 被引量：6044
  • H指数：1
  • 开始收录时间：-
  • CNKI综合因子：-
  • 维普期刊影响因子： 1.8
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  • 国内刊号/CN：51-1654/R
    国际刊号/ISSN：1672-3511
  • 发行周期：月刊
    邮发代号：62-243
  • 主管单位：川北医学院第二临床医学院·南充市中心医院
    主办单位：四川
西部医学-联系信息
  • 主编：彭海涛
  • 电话：028-85570072
  • 邮箱：xbyxqk@163.com
  • 地址：成都市小天竺街75号18F-1号
  • 邮编：610041
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西部医学 >2023年第11期

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  • 摘要：患者,女,24岁,已婚。因＂停经17＋3周,伴腹痛7天,加重1天＂于2010年10月25日急诊入院。患者平素月经规律,16岁月经初潮,4～5天/30天,经量中,色红,无痛经。末次月经：2010年6月25日。G1P0。患者停经后无恶心、呕吐、乏力、乳房胀痛等早孕症状。孕期未行正规产前检查。
  • 摘要：目的 探讨彩超时上肢静脉血栓诊断的临床价值.方法 应用彩超对38例临床需确诊是否存在上肢静脉血栓患者进行上肢静脉检查,以了解血管的形态结构、血流的频谱形态、血流参数及血栓发生情况,以探讨高危患者在治疗中对血管的影响.结果 本文38例患者上肢静脉彩超检查中,发现静脉血栓9例,占检查者23.58％,占置管者71.43％,占造瘘者30％.结论 彩超对确定上肢静脉血栓部位、静脉阻塞情况的判断具有可靠、重要的临床应用价值.%Objective To study of color Doppler ultrasound on upper extremity venous thrombosis diagnosed by clinical value. Methods 38 cases of patients were treated with color Doppler by upper extremity venous examination, understanding of vascular morphology, blood spectrum morphology and blood flow parameters, in order to explore the high risk patients in treatment of the vascular effects. Results There were 9 cases with venous thrombosis, accounted for the examination 23. 58%. accounted for the tube in 71. 43%, accounted for the fistula in 30%. Conclusion The color Doppler ultrasound to determine the site of upper extremity venous thrombosis, venous obstruction case is reliable, the important clinical value.
  • 摘要：Objective To investigate the clinical value of 16-slice spiral MSCTPA in the diagnosis of pulmonary embolism. Methods 33 patients clinically suspected for pulmonary embolism were examined with the 16-slice spiral MSCTPA. The images underwent reconstruction with volume rendering(VR),maximum intensity projection (MIP) . multiple planar reconstruction(MPR) and curved planar reformation (CPR)methods. Results of 16-slice spiral MSCTPA could accurately show the location and the size of thrombus. Direct signs partial filling defect, mural filling defect, central filling defect that was track symptoms. Indircet signs the limitations of lung markings sparse, pulmonary hypertension, expanding the right heart,pleural effusion and the focus of pulmonary infarction. Conclusion 16-slice spiral MSCTPA is safe.noninvasive and quick diagnostic method of the pulmonary embolism.%目的 探讨16层螺旋CT肺动脉造影(MSCTPA)对诊断肺动脉栓塞的临床价值.方法 应用16层螺旋CT对临床怀疑肺动脉栓塞的33例患者进行MSCTPA,采用容积显示VR,最大密度投影MIP,多平面重建法MPR及曲面重建CPR等重建技术.结果 16层螺旋CT肺动脉成像可充分显示肺动脉血栓的大小、分布、范围.直接征象为部分性充盈缺损、附壁性充盈缺损、中心性充盈缺损即轨道征和完全阻塞;间接征象为局限性肺纹理稀疏、肺动脉高压、右心扩大、胸腔积液和肺梗死.结论 多层螺旋CT是诊断肺动脉栓塞的安全、无创、快捷的检查方法.
  • 摘要：Objective To investigate the high-intensity focused ultrasound (High intensity focused ultrasound, HI-FU) treatment of uterine fibroids (myoma of the uterus) of early magnetic resonance imaging (Magnetic resonance imaging, MRI) scan performance. Methods 29 patients (35 fibroids) underwent HIFU treatment of uterine fibroids. Respectively before and after treatment from 1 to 7 days MRI, analysis of MRI signal changes before and after treatment. Results HIFU treatment of uterine fibroids after 1 to 3 days, 34 lesions were subject to varying degrees T1WI signal increased, peripheral low-signal, T2WI lesions were scattered within the central low signal patchy high signal in the Outer Ring high signal compared with before treatment: Outer Ring high signal widened significantly over the previous, high signal lesions decreased, T1WI than T2WI more intuitive) lesion size did not change. Conclusion MRI scan of the HIFU treatment of uterine fibroids have higher efficacy in early clinical value, is a convenient, economical and effective method.%目的 探讨低场MRI在高强度聚焦超声治疗子宫肌瘤的早期疗效价值.方法 29例(35个肌瘤)子宫肌瘤行高强多聚焦超声(HIFU)治疗.分别于治疗前1～7天、治疗后1～3天行核磁共振(MRI)检查,分析治疗前后MRI信号变化.结果 子宫肌瘤HIFU治疗术后1～3天,34个病灶主体不同程度T1WI信号增高,外周等低信号,T2WI病灶呈中央低信号内散在斑片极高信号,外周高信号环,与治疗前比较:外周高信号环较前明显增宽,病灶内高信号减少;病灶大小无明显变化.结论 MRI平扫是评价子宫肌瘤HIFU治疗早期疗效的方便、经济、有效方法.
  • 摘要：目的 探讨赶选择动脉栓塞治疗医源性肾出血的临床价值.方法 内科治疗无效的67例医源性肾出血患者,肾动脉造影后行超选择动脉栓塞治疗,术前、术后检查肾功有无变化.结果 阳性发现率94％,初次栓塞止血率98.5％,其中7例明胶海绵栓塞,复发3例,术前、术后检查肾功能无明显变化.结论 超选择动脉栓塞治疗医源性肾出血效果优良,对肾功无明显影响.%Objective To explore the clinical value of superselective transarterial embolization {or treating iatrogenic renal hemorrhage. Methods 67 cases of iatrogenic renal hemorrhage for renal arteriography,66 cases for superselective transarterial embolization, preoperative and postoperative check renal function. Results frenal arteriography positive rate 94% , first time embolism hemostatic rate 98. 5%, among them 7 cases of gelatin sponge embolism, recurrence 3 cases, preoperative and postoperative check renal function no change. Conclusion The superselective transarterial embolization for treating iatrogenic renal hemorrhag is effective, no significant effect for renal function
  • 摘要：目的 探讨永久性心脏起搏器植入术后并发症发生的原因、临床表现、处理方法、护理对策及健康指导.方法 对2009年4月～2011年10月植入永久性心脏起搏器40例患者的临床护理资料进行回顾性分析,提出护理措施.结果 术后发生并发症7例,发生率为17.5％,其中起搏器囊袋积血2例(28.6％),起搏器感知障碍1例(14.3％),起博器综合征1例(14.3％),电极脱位2例(28.6％),肺内感染及下肢静脉血栓形成1例(14.3％).所有并发症经积极处理后,患者均恢复正常.结论 重视永久性心脏起搏器植入患者术后观察及护理,熟悉相关理论知识,早期发现及时处理,对预防及减少并发症的发生具有重要意义.%Objective To investigate the permanent cardiac pacemaker implantation postoperative complications, clinical manifestation, treatment, nursing and health guidance. Methods 2009 to April - 2011 December by implantation of a permanent pacemaker in clinical nursing care of 40 cases were retrospectively analyzed, put forward the nursing measures. Results Postoperative complications occurred in 7 patients, the incidence was 17. 5%, of which 2 cases of pacemaker pocket blood (28.6%), pacemaker sensing disorder in 1 cases (14.3%), pacemaker syndrome in 1 cases (14. 3%). electrode dislocation in 2 cases (28. 6%), lung infection and venous thrombosis of lower extremities in 1 cases (14.3%). All complications after active treatment< patients returned to normal. Conclusion Importance of permanent cardiac pacemaker implantation in a patient with postoperative observation and nursing, familiar with the relevant theoretical knowledge, early detection and timely treatment, to prevent and reduce the incidence of complications is important.
  • 摘要：目的 探讨Orem的自护理论在提高脊髓损伤患者自理能力的效果.方法 将符合标准的脊髓损伤患者193例随机分为两组,实验组(101例)运用自护理论进行护理,对照组(92例)采用常规护理程序进行护理.两组患者入出院时日常生活自理能力(ADL)分别以改良的Barthel指数评定及自护技能掌握情况比较.结果 出院时实验组比对照组ADL及自护技能明显提高(P＜0.05).结论 自护理论可促进患者全面具体掌握自护技能,提高患者的日常生活自理能力.
  • 摘要：重复经颅磁刺激(rTMS)是在经颅磁刺激基础上发展起来的新的神经电生理技术,具有检测和调节大脑皮质活动的作用.现就重复经颅磁刺激基本物理学原理、治疗脑梗塞后运动功能障碍做一综述.
  • 摘要：超声造影剂被称为血池示踪剂,在评价脏器组织血流灌注方面独具特色.近年来,肾脏超声造影研究倾向于肾脏血流灌注的定量评价,这一技术将造影与时间-强度参数定量分析技术结合,评价血流动力学改变,有望称为安全、无创、有效地评价肾血流灌注状况的超声诊断新方法.
  • 摘要：目的 观察术前一周肠内营养支持(EN)在胃癌患者应用中的经济学意义.方法 将126例胃癌患者随机分为术前一周开始EN组(研究组)和术后早期EN组(对照组),分别按不同营养治疗方案进行营养支持.重点观察该项试验成果在临床实际中的经济学方面意义,观察两种营养支持方法对住院天敷、肠内营养管喂天数、营养支持费用、住院药品费用比例、住院总费用的影响并进行统计学比较.结果 研究组在患者住院天数、肠内营养管喂天数、营养支持费用、住院药品费用比例、住院总费用等方面均较对照组有显著性差异(P＜0.05).结论 术前尽平进行肠内营养支持除能进一步改善机体营养状况和免疫功能情况外；同时可以减少住院天数、肠内营养管喂天数、降低营养支持费用、住院药品费用比例、住院总费用等,有积极的经济学意义.
  • 摘要：回顾5.12汶川大地震医院志愿者在地震伤员救治中的作用及医院对志愿者的组织、管理,探讨大型灾害应急中医院志愿者的队伍建设及制度建设.
  • 摘要：脂肪栓塞综合征是发生在严重创伤,多见于长管状骨折,尤其是以股骨干为主的多发骨折发病率最高[1]。积极预防,早期诊治,良好护理,可明显降低死亡率和提高生存质量。现将我院1998年以来观察护理的3例脂肪栓塞成功救治总结如下。
  • 摘要：Objective To analyze the value of the spiral CT in the diagnosis of osteoid osteoma. Methods 12 patients with osteoid osteoma proved by surgical pathology and the imaging of X-ray and spiral CT scan were retrospectively analyzed. Results Among the 12 cases, 6 cases of lesions in the femur and 2 cases in the tibia, 2 cases in the humerus and 2 cases in the other parts. CT showed the nidus and surrounding of the nidus with the different levels of hardening, and the nidus showed a round or oval translucent area with a diameter of 3~16mm. mean 9. 0mm, 7 cases wiht the center calcification. Conclusion Nidus is the key to diagnosis of osteoid osteoma, spiral CT scan shows nidus is the preferred method of examination in the diagnosis of osteoid osteoma.%目的 探讨螺旋CT在骨样骨瘤中的诊断价值.方法 对12例经病理证实且行X线和螺旋CT扫描检查的骨样骨瘤病人的影像学表现进行回顾性分析.结果 12例患者中,病灶位于股骨6例、胫骨2例、肱骨2例和其它部位2例.CT表现为瘤巢及其周围形成程度不同的反应性骨质硬化,瘤巢表现为一圆形或卵圆形的透亮区,直径为3～16mm,平均9.0mm,中心有钙化7例.结论 瘤巢是确诊骨样骨瘤的关键；螺旋CT扫描是显示瘤巢的首选检查方法,在骨样骨瘤诊断中具有重要的价值.
  • 摘要：病例患者男,42岁,1年前曾因＂怕热、多汗、心慌、消瘦伴眼胀半年余＂在门诊就诊,当时有畏光、流泪,无异物感,无视物重影及视力下降。体检：双侧眼球突出,右眼18mm、左眼18.5mm,睑结膜轻度充血,球结膜无水肿,双侧眼球活动尚可,
  • 摘要：病例男,43岁。30年前发现右股部一＂鸡蛋＂大小肿物,无疼痛不适,无发热,皮肤无红肿。肿物生长缓慢,未曾诊治。近7天来自觉肿物处疼痛,按压时向远方放散并有麻木感。
  • 摘要：Objective To understand health status, awareness and requires about care of the elderly with chronic disease in the community, and to supply some data for promoting health of the elderly with chronic disease. Methods Sampling conveniently and inquiring via questionnaire were used in this study. 180 participants from four different district of Chendu city were inquired. And author investigated their health status, awareness and requires about care from families, friends, relatives, neighbors, and so on. Results 77. 78% participants suffered over two kinds of chronic disease; 97. 22% obey doctor's advices and take medicines regularly; 70% pay attention to monitor the effect of therapy by themselves) 61.11% participants' conditions were controlled) 54.44% can do their daily activities completely by themselves, 37. 78% do these activities partly by themselves, and 7. 78% depend on others to fulfill daily activities. 98. 89% have a high awareness on care, but still have 1.11% participants feel lack of care. 91. 01% awareness of care of participants came from family members, 7. 87% came from relatives, friends and neighbors, and 1.12% came from workmates. Main requires of care of participants include reunite of family, care and love, respecting and understanding, daily caring and e-motional support, aid to solve difficulties, and economic support. While in requires of nursing care of participants, require of inspecting and understanding in these elderly is the first one, and other requires include daily caring to chronic diseases, prevention and cure of chronic diseases, gerocomia and basic knowledge on chronic disease. Conclusion We should reinforce to instruct and control for promoting health status and illness therapy in elderly with chronic disease. Especially provide effective care and services.%目的 为城市社区老年慢性病人的健康和关爱需求提供指导.方法 采用方便选点、随机抽样和调查间卷的方法,对成都市城区四个社区180例老年慢性病人的健康状况及关爱感知和需求进行调查.结果 180例老年慢性病人中有77.78％患2种及以上慢性病;97.22％能坚持规律服药治疗,70.00％进行了治疗效果的自我监测,疾病控制率为61.11％;54.44％生活完全自理,37.78％生活部分自理,7.78％生活完全依靠他人照顾.关爱感知和需求方面有98.89％能感受到关爱,1.11％自觉缺乏关爱;感知到的关爱来源主要是家庭成员(占91.01％)、亲戚朋友和邻居(占7.87％)、单位同事(占1.12％).护理关爱需求以尊重理解排在首位,其次是慢性病日常护理、慢性病的防治、老年保健和慢性病基本知识等.结论 老年慢性病人需要加强指导和疾病控制,特别要针对其关爱感知需求提供关爱,以促进他们的健康.
  • 摘要：目的 探索医护一体化病人管理模式在临床实施的可行性.方法 采取医护一体化病人管理模式,由医生护士共同参与采取医护共同交接班、共同查房,共同管理病人,简化工作处理流程,使医扩一体的临床管理模式贯穿病人住院的全程.以该模式的医疗组为实验组(收治病人389例),以传统模式管理的医疗组为对照组(收治病人401例),调查两个组病人、医生和护士的反馈意见,并对两组病人的满意度进行比较.结果 实验组病人的满意度达到98.5％～100％,平均99.82％,对照组的病人的满意度95.5％～100％,平均96.82％,实验组病人的满意度高于对照组(P＜0.005),实验组医生护士的满意度均达到100％.结论 医护一体化临床工作模式是一种能提高病人满意度、节省人力资源、提高护士的职业自豪感利拓展护士职业生涯的新型的良好的临床工作模式,值得临床推广应用.
  • 摘要：原发性支气管肺癌(简称肺癌)是近年来发病率最高的恶性肿瘤,也是恶性肿瘤主要的死亡原因之一.世界各国肺癌发病率呈逐年上升趋势,由于肺癌的临床表现尤其是肺外表现复杂多样,肺癌的早期检出、诊断依然是胸部影像检查的重点和难点.本文就近年肺癌影像学研究进展进行综述.
  • 摘要：肺出血-肾炎综合征系内科危重急症,主要为循环中抗肾小球基底膜抗体或GBM抗体在肾脏或肺组织中沉积、导致肺出血与急性肾小球肾炎改变,该病属于自身免疫性疾病范畴.临床主要表现为肺出血合伴Ⅰ型急进性肾小球肾炎(RPGN),病情凶险、未经及时治疗的重型病例死亡率可高达96％.肺出血-肾炎综合征影像学改变与其病理相适应以肺组织为主,其次可发生胸膜、心脏改变等.影像学表现多种多样,可有渗出灶、增殖灶、甚至融合呈结节似肿块样改变,与病程发展有明显联系.影像学诊断肺出血-肾炎综合征有一定难度,但如认真分析影像学如X线胸片、CT征象变化、特别是注意对比多次影像学资料、观察分析征象变化规律等,可作出正确诊断.
  • 摘要：目的 通过培训并实践“临床营养风险筛查计划”,提高医学生进行合理调查研究的能力.方法 对入选医学生进行调查研究方法学培训,并进行临床资料采集等实践活动.培训结束后,对医学生科研训练效果进行总结和评价.结果 自2010年6月～2011年6月,共培训医学生46人,并对386例患者进行营养风险筛查.97.83％(45人)研究参与者赞同安排医学生参与科研项目训练,80.43％医学生对此次调查研究工作满意,认为对后期学习能力的提高有促进作用.医学生科研能力影响因素集中体现在科研选题、统计学理论及软件操作、论文写作能力三方面.结论 采用成立科研小组、安排有针对性的培训等方法,使医学生系统接受科学研究方法训练,对其科研教学能力培养可能会有重大促进作用.%Objective In order to improve the medical students' ability to conduct scientific research, we carried out a study by training and ongoing practice based on the "Clinical Nutrition Risk Screening Project"(CNRSP). Methods After describing the methodology of CNRSP. showing examples, and having students rewrite drafts, all the participants should do clinical data collection and other practical activities. At last, we assessed the effects of scientific research training. Results From June 2010 to June 2011. 46 participants were trained by our team, and 386 patients were screened by the trained researchers. 97. 83% of the respondents thought that all the medical students should participate in some scientific research studies. 80. 43% of respondents were contented with the current situation of CNRSP, and they thought that learning capabilities would be promoted after finishing the training courses. "Scientific research topic selection", "application of statistics theories and methods" and "paper writing ability" were the main factors which affect the motivation of students. Conclusion Setting up the interest group of scientific research and arranging targeted training programs are good ways to teach scientific concept to young medical students. These strategies may be effective in promoting the abilities of students to start new research and teaching.
  • 摘要：目的 探讨生物反馈联合指法扩肛对出口梗阻型便秘患者肠蠕动功能的影响.方法 将20例出口梗阻型便秘患者进行生物反馈治疗前后行指法扩肛.结果 患者便秘情况都有明显好转.结论 生物反馈训练联合指法扩肛可促进出口梗阻型便秘患者肠蠕动功能,养成定时排便的习惯,可在临床推广应用.
  • 摘要：目的 分析并评价2010级护理本科系统解剖学期末考试试卷,为改进教学方法提高教学质量提供依据.方法 对我校2010级护理本科专业203份系统解剖学试卷进行分析.结果 考试成绩呈负偏态分布,平均成绩为71.04分,标准差为11.302分,难度系数为0.710,区分度为0.262,信度为0.585.结论 本试卷较全面地评价学生对本门课程的掌握程度,同时也反映学生综合应用知识能力较差、试题难度偏低等问题.为进一步提高教学效果和命题质量提供依据.
  • 摘要：经颅磁刺激已广泛用于神经、精神、康复及认知领域的研究.实时交互式经颅磁刺激磁共振功能成像(Interleaved Transcranial Magnetic Stimulation functional Magnetic Resonance Imaging,TMS-fMRI),是一种将经颅磁刺激与磁共振功能成像实时结合起来并能让科研人员直接观察到经颅磁刺激大脑实时反应的技术,目前仅在美国、英国、德国、荷兰、日本等为数不多的发达国家中开展,我们已在中国西部成功开展此技术.本文就其可行性、目前科研应用及未来发展方向等做一简介和述评.
  • 摘要：先天性心血管疾病位居出生缺陷首位[1,2].目前,超声心动图因其具有无辐射、方便、经济、可重复性及动态观察等优点成为胎儿心脏结构及功能检查的最常用方法.产前心脏超声筛查技术的普及和提高,以及超声技术的发展,对减少复杂难治性先心病的出生,降低新生儿及婴幼儿病死率都具有积极意义.本文就胎儿心脏超声的临床应用与展望做一述评.
  • 摘要：目的 探讨新斯的明拮抗非去极化肌松药诱发严重支气管痉挛的风险,加强临床监测,并为早期治疗提供依据.方法 对20例全麻术后清醒用新斯的明诱发严重支气管痉挛患者的临床资料进行回顾性分析.结果 经抢救治疗3分钟后氧饱和度恢复至97％以上,20分钟后自主呼吸完全恢复(15～25次/分),生命体征平稳,安全送回病房.结论 新斯的明须慎用于气道有高敏反应、慢性支气管炎、肺气肿等肺部有病变的患者.
  • 摘要：Objective To investigate the cerebral hemodynamic response to analogy following sleep deprivation (SD).Methods 30 subjects were scanned twiee with functional magnetic resonance imaging (fMRI) at a counterbalanced order after a normal night of sleep (rested state),and after 24 hours (h) of sleep deprivation (SD-state).Subjects performed the analogy task alternated with a control task during the fMRI sean that lasted 12 minutes and 48 seconds.fMRI data were analyzed with Statistical Parametric Mapping (SPM) and Analysis of Functional Neurolmages ( AFNI).Results Neuroimaging data revealed that,after a normal nigbt sleep,brain regions induced by analogy included prefrontal cortex (PFC),posterior parietal cortex (PPC),and cerebellum.Contrary to our pre-study prediction,however,regional analysis revealed that 24h of SD did nat influence activation in bilateral PFC.PPC.and supplementary motor areas(SMA),although the cerebellum was less and bilateral premotor areas (PMA) were more responsive:global level analysis also indicated no significant change in globe effects following SD.No significant change in the behavioral performance was found between the two states.Concluslon The data provides imaging evidence that 24h of SD failed to alter regional activations in PFC,PPC as well as global effects in healthy subjects,and it suggests that,after SD,there may be a potential compensatory system mediating cortical response to analogical reasoning,and PFC and PPC may be involved in such a compensation.%目的 研究睡眠剥夺后类比推理认知功能改变在功能性磁共振成像上的表现.方法 对30制健康志愿者(男性18例,女性12例,平均年龄40岁)进行2次类比推理功能磁共振成像扫描,分别于正常睡眠情况下和睡眠剥夺24小时后,扫描顺序是制衡的.数据处理由统计参数图及功能性神经影像分析软件完成.结果 24小时的睡眠剥夺没有显著性地改变人脑类比推理活动,包括双前额叶及顶叶区的活动.结论 睡眠剥夺后人脑类比推理可能存在代偿机制.
  • 摘要：患者女性,22岁,15岁时因右侧股沟区肿块曾在当地做过手术,术后诊断为不详。无遗传病家族史。来院作婚前常规超声检查。体格检查：全皇皮肤见大小不等的咖啡色斑,大的约27mm×19mm,小的约1～2mm,以右侧腹股沟区为明显,并且着色较其它部位更深。双侧颈部、四肢、躯干多处散在大小不等结节,最大约13mm×6mm,圆形、椭圆形、梭形,无压痛、
  • 摘要：Objective To study the significance of the diagnosis of RE with a combined use of endoscopy and clinical manifestations. Methods A retrospective analysis was conducted in clinical data of RE patients diagnosed with endoscopy between October of 2002 and September of 2011 in the People's Hospital of Emeishan City. Results 775 patients were diagnosed with RE among 9274 patients undergoing endoscopy with a detection rate of RE 8.35%, among which RE grade A and grade B (according to Los Angeles classification) were more common, accounting for 71% of the total RE cases, and RE grade D were rarei Male-female ratio of the RE patients were 3.1:1. And meanwhile part of the patients underwent histological examination, and 74.18% of them were diagnosed as inflammation, and 48 cases atypical epithelial hyperplasia, and 4 cases early esophageal cancer. Conclusion Endoscopy and histological examination are effective diagnostic methods for RE, and the accuracy of endoscopic diagnosis of RE can be improved when combined with the clinical manifestations.%目的 探讨内镜检查结合临床表现对反流性食管炎(RE)的诊断意义.方法 回顾性分析峨眉山市人民医院2002年10月～2011年9月所进行的9274人次胃镜检查资料,对诊断为RE的775例患者的临床资料及病理结果进行分析.结果 9274人次胃镜检查中诊断为RE的有775例,RE检出率8.35％.其中以A级、B级(洛杉矶标准)多见,占71％,而D级RE少见；检出的RE男女之比为3.1∶1.同时对部分病例进行了活体组织学检查,其中74.18％诊断为炎症,46例(5.9％)为上皮不典型增生,4例(0.52％)内镜诊断为RE的患者经病理组织学检查确诊为早期食管癌.结论 内镜和活检是RE的有效诊断方法,内镜结合临床表现可提高RE的诊断准确性.
  • 摘要：目的 观察锁骨钩钢板治疗锁骨肩峰端骨折及Ⅲ度肩锁关节脱位的疗效.方法 采用锁骨钩钢板内固定治疗锁骨肩峰端骨折及新鲜Ⅲ度肩锁关节脱位84例,全部修复肩锁韧带,喙锁韧带来予修复重建.并对比分析采用克氏针、螺钉、克氏针张力带治疗锁骨肩峰端骨折及同型新鲜肩锁关节脱位的疗效差异.结果 按照Lazzcano标准评定患者术后功能,锁骨钩钢板固定组优良率远高于其他三组,所有患者均未发生感染,无钢板螺钉松动断裂.结论 应用锁骨钩钢板治疗锁骨肩峰端骨折及肩锁关节脱位具有操作简单、复位好、动态固定、牢固可靠、肩关节功能恢复快、优良率高、并发症少等特点,内固定取出后不复发,是目前治疗锁骨肩峰端骨折及新鲜Ⅲ度肩锁关节脱位疗效确切而理想的方法,可推为首选.%Objective To study the curative effect of surgical treatment of fracture of the acromion end of clavicle and degree Ⅲ acromioclavicular joint dislocation by clavicular hook-plate. Methods 84 patients with fracture of the acromion end of clavicle and degree Ⅲ acromioclavicular joint dislocation were treated with the clavicular hook-plate, and all ruptured acromioclavicular ligament was repaired without reconstruction of coracoclavicular ligament in operation. The differences of curative effect between the Kirschner wire, Screw, K-wire tension band and clavicular hook-plate on these diseases were analyzed retrospectively. Results The postoperative function of patients was assessed by Lazzcano criteria, and the excellent and good rate of the clavicular hook-plate group was more than that of other 3 groups, all patients had no infectious complications and no loosening of the plates and screws. Conclusion The surgical treatment of fracture of the acromion end of clavicle and acromioclavicular joint dislocation by using the clavicular hook-plate is characterized by simple operation, good reduction, dynamic action immobilization, reliable fixation, fast in shoulder joint functional recovery, higher excellent good rate, less complication rate and difficult to recur, which is the first choice for the treatment of fracture of the acromion end of clavicle and acromioclavicular joint dislocation.
  • 摘要：Objective To evaluate the imaging manifestations of subclavian steal syndrome and increase the diagnosis value of color Doppler ultrasound. Methods 15 SSS cases diagnosed by color Doppler ultrasound images and cerebral angiography were enrolled and analyzed. Results The accurately diagnosed cases by ultrasound were 14, the misdiag-nosed cases were 1. all cases were confirmed by cerebral angiography. The partial group included 4 and the completed group included 11 cases. 14 cases were caused by the stenosis of atherosclerosis and 1 case caused by Takayasu areritis. The subclavian stenosis was detected in 5 cases, anonymous artery stenosis in 2 cases and subclavian obstruction in 8 cases. Conclusion Doppler ultrasound examination is a easy and accurate method to diagnose subclavian steal syndrome, but we should pay more attention to the appearance of the Doppler spectrum of vertebral artery, and the degree of subclavian steal may be associated with the level of stenosis of anonymous artery and subclavical artery.%目的 分析锁骨下动脉盗血综合征(subclavian steal syndrome,SSS)的超声表现,旨在进一步提高彩色多普勒超声对此病的诊断价值.方法 回顾性分析经彩色多普勒超声诊断有椎动脉返流的锁骨下动脉盗血综合征15例患者资料,并与脑血管造影的结果进行对比.结果 15例患者中,14例SSS患者首先经彩色多普勒超声确诊,漏诊1例,该例经脑血管造影后复查超声确诊.部分型SSS 4例(占26.7％),完全型SSS11例(占73.3％).SSS的病因为动脉粥样硬化狭窄所致14例,大动脉炎所致1例；病变血管为锁骨下动脉狭窄5例、无名动脉狭窄2例、锁骨下动脉闭塞或次全闭塞8例.结论 彩色多普勒超声为锁骨下动脉盗血综合症诊断的首选影像学方法,完全型、部分型盗血与锁骨下动脉或无名动脉血管旋窄程度有关.

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