Reports in Clinical Studies and Medicine最新文献

Clinical and laboratory evaluation of patients afflicted with allergic asthma under immunotherapy 免疫治疗下过敏性哮喘患者的临床和实验室评价

Reports in Clinical Studies and Medicine

Pub Date : 2019-09-09 DOI: 10.18282/rcsm.v2.i1.714

Falah Hasasn Hade

Background: Allergy may be defined as a constellation of signs and symptoms in which the altered immunologic reaction between foreign substance (allergens) and antibodies resulting in pathologic reactions referred as allergic reactions.

Allergic asthma is well known type 1- allergic reaction Up to 30% of general population suffers from various form of this malady during normal life span .

Objective: To evaluate the effects of immunotherapy on groups of Iraqi people afflicted with allergic asthma through some clinical and laboratories tests

Methods: A cross sectional study was carried out on Iraqi patients ( males and famales) in AL-Zahraa Consultant Center for Allergy and Asthma in Baghdad - Karkh, between Nov. 2013 - Apr. 2014 .The study included 60 asthmatic patients ( 6 - 45 years old) whom had allergy to house mites antigens " through skin test ",in addition to 20 apparently healthy persons as control group.A subcutaneous immunotherapy was given for 3 months, starting from diluted doses which were increased gradually. Clinical assessment was done depending on scoring of signs and symptoms, in addition to the medical history , clinical investigation, skin test, and pulmonary function test .

Results: Study showed that asthma still affected all age group but tend to be higher in age group 31-45 years with male to female ratio 2:1. Family history to allergic disease play a major role 60% with increase prevalence of reactivity for indoor allergy (House Mites and Moulds).

66.7% had positive skin reaction to House Mites which includes D1 ,D2 and D1+D2. The dust found to be one of main aggravating factors. Medical condition had shown significant improvement after three months of giving immunotherapy.

Conclusion: Immunotherapy need to be considered as one of alternative treatment of allergic asthma decreasing the side effects and cost of different drugs used by these patients when given regularly to them, also detection of prevalent allergens in our local atmosphere and their concentration with detection of their seasonal distribution in different parts of our country is required.

背景:过敏可以定义为异物(过敏原)和抗体之间的免疫反应改变导致病理反应(称为过敏反应)的体征和症状的集合。过敏性哮喘是一种众所周知的1型过敏反应，在正常生活中，高达30%的普通人群患有各种形式的过敏性哮喘。目的:通过一些临床和实验室试验，评价免疫治疗对伊拉克过敏性哮喘患者群体的影响。本研究于2013年11月至2014年4月在巴格达-卡赫的AL-Zahraa过敏和哮喘咨询中心对伊拉克患者(男性和女性)进行了横断面研究，研究对象为60例(6 - 45岁)通过皮肤试验对房螨抗原过敏的哮喘患者，另外20例明显健康的人作为对照组。皮下免疫治疗3个月，从稀释剂量开始，逐渐增加。除病史、临床调查、皮肤试验和肺功能试验外，根据症状和体征评分进行临床评估。结果:研究显示哮喘在所有年龄组均有发生，但在31-45岁年龄组发生率较高，男女比例为2:1。过敏性疾病家族史占主要因素60%，室内过敏(屋螨和霉菌)反应率增高，对屋螨(D1、D2和D1+D2)皮肤反应阳性的占66.7%。灰尘被发现是主要的加重因素之一。经过三个月的免疫治疗，病情有了明显改善。结论:应考虑将免疫治疗作为变应性哮喘的替代治疗方法之一，在定期给药的情况下，降低变应性哮喘患者使用不同药物的副作用和费用，同时检测我国当地大气中流行的过敏原及其浓度，并检测其在我国不同地区的季节性分布。

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引用次数: 0

Clinical analysis of ureteroscopic holmium laser lithotripsy for the treatment of nephrolithiasis 输尿管镜钬激光碎石治疗肾结石的临床分析

Reports in Clinical Studies and Medicine

Pub Date : 2018-12-27 DOI: 10.18282/cs.v1.i1.16

Yansi Xue, Lei-Han Xu, Xiaojun Xu, Dukun Wang, Guo-Cheng Wang, Yi Chen

The objective of the study is to evaluate the clinical value of ureteroscopic holmium laser lithotripsy for the treatment of nephrolithiasis. Clinical data of 44 patients treated for renal stones with polyscope modular flexible ureter- oscopic holmium laser lithotripsy from May 2014 to April 2015 were retrospectively analysed. Following the operation, F4.7 D-J stents were routinely indwelled for 4 weeks and catheterization for 1-3 days. A plain kidney, ureter, and blad- der (KUB) X-ray was performed on postoperative days too. A total of four success cases were determined following the first treatment. The remaining 40 cases were first placed with double-J stent and the surgery was performed one week later. Stone sizes between 0.8-4.0 cm in diameter were defined. The operation time for the treatment was 80-180 minutes. Patients were discharged within 3-5 days, and the double-J stent was removed within 1-3 months. 39 patients were found to be completely stone-free at approximately three months postoperatively. However, five patients were shown to have 11.1% of residual stones after treatment. No blood transfusion, septic shock, ureteral injury, or other complications were reported. Flexible ureteroscopic holmium laser lithotripsy is safe and effective for the treatment of nephrolithiasis. This approach could be a valuable choice for the treatment of patients with renal stones.

本研究旨在探讨输尿管镜钬激光碎石术治疗肾结石的临床价值。回顾性分析2014年5月至2015年4月44例经多镜组合式输尿管软镜钬激光碎石治疗肾结石的临床资料。术后常规留置F4.7 D-J支架4周，留置导管1-3天。术后也行肾、输尿管、膀胱平片(KUB)。在第一次治疗后，共确定了4例成功病例。其余40例先置入双j型支架，1周后行手术。石头的直径在0.8-4.0厘米之间。手术时间80 ~ 180分钟。患者在3-5天内出院，1-3个月内取出双j型支架。39例患者术后约3个月完全无结石。然而，5名患者在治疗后仍有11.1%的残留结石。无输血、感染性休克、输尿管损伤及其他并发症。输尿管软镜钬激光碎石术治疗肾结石安全有效。这种方法可能是治疗肾结石患者的一个有价值的选择。

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引用次数: 0

Causes and management of bleeding during laparoscopic colorectal cancer surgery 腹腔镜结直肠癌手术中出血的原因及处理

Reports in Clinical Studies and Medicine

Pub Date : 2018-12-27 DOI: 10.18282/RCSM.V1.I1.26

Ming Xu, Weiqiang Wu, Zengqiang Yang, Feng Gao

In this paper, the causes of bleeding during laparoscopic colorectal surgery and the measures to solve it are discussed. 386 cases of laparoscopic colorectal cancer surgery in our hospital from January to December 2015 were selected. There were 17 cases of bleeding during surgery, which accounted for 4.4% of the total amount. 2 cases were converted to laparotomy, and 15 cases were surgery via laparoscopy. In the surgical process, improper surgery, lack of good laparoscopic anatomical structure of the cognitive level, and congenital anatomic variation may have caused the accidental bleeding during surgery. Corresponding measures should be taken to stop accidental bleeding.

本文就腹腔镜结直肠手术中出血的原因及解决措施进行了探讨。选取2015年1 - 12月我院腹腔镜结直肠癌手术386例。术中出血17例，占总出血量的4.4%。2例转为开腹手术，15例经腹腔镜手术。在手术过程中，手术操作不当、缺乏良好的腹腔镜解剖结构认知水平、先天性解剖变异等都可能造成术中意外出血。应采取相应措施防止意外出血。

引用次数: 0

Detection of HBV DNA by PCR and its application in clinical transfusion PCR检测HBV DNA及其在临床输血中的应用

Reports in Clinical Studies and Medicine

Pub Date : 2018-12-27 DOI: 10.18282/rcsm.v1.i1.13

Shunqing Li

This study was to detect the hepatitis B virus (HBV) DNA copies in patients through blood transfusions; recessive carriers with HBsAg negative but HBV DNA positive were further studied to see the content and distribution of HBV in patients, and provide evidence for the clinical treatment. A total of 532 blood samples collected from July 2014 to July 2015 were tested for HBV-DNA viral load and hepatitis B serological markers using quantitative Polymerase Chain Reaction (qPCR) and serologic test (five serological markers of hepatitis B). The results showed that, 3 cases were HBV serology negative and the HBV-DNA viral load was in the range of 250-500 whereas only 1 case was HBsAb positive and the HBV-DNA viral load was above 500. qPCR, for detecting HBV DNA, together with serological routine test can effectively reduce HBV infection during transfusion and prevent medical disputes.

本研究旨在通过输血检测患者乙型肝炎病毒(HBV) DNA拷贝数;进一步研究HBsAg阴性但HBV DNA阳性的隐性携带者，了解患者体内HBV的含量和分布，为临床治疗提供依据。对2014年7月至2015年7月采集的532份血样进行了HBV- dna病毒载量和乙型肝炎血清学标志物(5种乙型肝炎血清学标志物)检测，结果显示，HBV血清学阴性3例，HBV- dna病毒载量在250 ~ 500范围内，HBsAb阳性1例，HBV- dna病毒载量在500以上。qPCR检测HBV DNA，配合血清学常规检测，可有效减少输血过程中HBV感染，防止医疗纠纷。

引用次数: 0

Clinical effect of combined anterior and posterior approach surgery for cervical spondylotic myelopathy 前后联合入路手术治疗脊髓型颈椎病的临床疗效

Reports in Clinical Studies and Medicine

Pub Date : 2018-12-27 DOI: 10.18282/RCSM.V1.I1.55

Jiang Yanzhou, Fu Lianchong, Mu Yushan

Objective: To evaluate the clinical efficacy of combined anterior and posterior approach surgery for patients with spinal type. Methods: 96 patients with cervical spondylosis were randomly selected among all patients admitted in our hospital from January 2013 to December 2015. They were evenly assigned to A, B or C group, 32 patients each. Patients in Group A suffered from cervical myelopathy and were treated by combined anterior and posterior approach. Patients in Group B group suffered from cervical vertebra disease and accepted a cervical corpectomy decompression and a bone graft fusion internal fixation surgery. Patients in Group C accepted conventional posterior decompression and fusion surgery for lateral mass screw fixation. Postoperative follow-up, X-ray intervertebral stability and fusion, neurological function JOA score and clinical efficacy of the effective date were compared. Results: JOA scores of all three groups were improved after 6 months. After a year, patients in Group A, B and C scored (16.3 ± 1.83), (15.7 ± 1.15) and (15.59 ± 1.21), respectively. The pairwise score differences between any two groups were statistically significant (P < 0.05). After one year’s follow-up, the bone graft and internal fixation material had no signs of loosening, displacement or subsidence. The fusion rates of Group A, B and C reached 90.6%, 53.1% and 56.25%, respectively. Similarly, the pairwise differences in fusion rate between any two groups were statistically significant (P < 0.05). The clinical effectiveness was classified as apparent, effective, fair and invalid. The effective rates of Group A, B and C were 87.5%, 50% and 56.2%, respectively. The pairwise differences between any two groups were statistically significant (P < 0.05). Conclusion: Combined anterior and posterior approach surgery significantly improved the clinical efficacy than the other two surgeries.

目的:评价脊柱型患者行前后联合入路手术的临床疗效。方法:在我院2013年1月至2015年12月收治的颈椎病患者中随机抽取96例。他们被平均分配到A、B、C组，每组32名患者。A组为颈椎病，采用前后联合入路治疗。B组患者为颈椎病，行颈椎椎体切除术减压和植骨融合内固定手术。C组接受常规后路减压融合手术行侧块螺钉固定。比较术后随访、x线椎间稳定性与融合、神经功能JOA评分及临床疗效。结果:3组患者6个月后JOA评分均有改善。1年后，a、B、C组患者得分分别为(16.3±1.83)分、(15.7±1.15)分、(15.59±1.21)分。两组间两两评分差异均有统计学意义(P < 0.05)。随访1年后，骨移植物和内固定材料无松动、移位或下沉迹象。A组、B组和C组的融合率分别为90.6%、53.1%和56.25%。同样，两组间融合率两两比较差异均有统计学意义(P < 0.05)。临床疗效分为明显、有效、一般和无效。A、B、C组有效率分别为87.5%、50%、56.2%。两组间两两比较差异均有统计学意义(P < 0.05)。结论:前后联合入路手术的临床疗效明显优于其他两种手术。

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引用次数: 0

Clinical study of endoscopic mucosal resection for digestive tract early cancer and precancerous lesions treatment 内镜下粘膜切除术治疗消化道早期癌及癌前病变的临床研究

Reports in Clinical Studies and Medicine

Pub Date : 2018-12-27 DOI: 10.18282/RCSM.V1.I1.27

Huiji Peng

The clinical effect of endoscopic mucosal resection (EMR) on the digestive tract of early cancer and precan-cerous lesions was analyzed. 63 patients with early gastrointestinal cancer and precancerous lesions treated in our hospital from January 2013 to May 2015 were recruited for this study. Patients were randomly divided into the observation group (32 cases) and the control group (31 cases). The control group underwent conventional surgical treatment, while the observation group underwent EMR. Both groups were observed for the clinical effect. The curative resection rate was 100.0% (P > 0.05). The postoperative complication rate was 3.1% (1/32) in the observation group and 25.8% (8/31) in the control group. The operation time for the observation group was significantly shorter than the control group (P < 0.05). Subjects were followed up for 1 year. Both groups showed no primary tumor metastasis and recurrence (P > 0.05). EMR treatment showed good effect and significantly fewer complications in patients.

分析内镜下粘膜切除术(EMR)治疗消化道早期癌及癌前病变的临床效果。本研究招募2013年1月至2015年5月在我院治疗的63例早期胃肠道癌及癌前病变患者。患者随机分为观察组(32例)和对照组(31例)。对照组采用常规手术治疗，观察组采用EMR治疗。观察两组患者的临床疗效。根治率为100.0% (P > 0.05)。观察组术后并发症发生率为3.1%(1/32)，对照组为25.8%(8/31)。观察组手术时间明显短于对照组(P < 0.05)。随访1年。两组患者均无原发肿瘤转移及复发(P > 0.05)。EMR治疗效果好，并发症明显减少。

引用次数: 0

Clinical analysis of ureteroscopic holmium laser lithotripsy for the treatment of nephrolithiasis 输尿管镜钬激光碎石术治疗肾结石的临床分析

Reports in Clinical Studies and Medicine

Pub Date : 2018-12-27 DOI: 10.18282/rcsm.v1.i1.16

Xue Yansi, X. Lei, X. Xiaojun, Wang Dukun, Wang Guocheng, Chen yi

The objective of the study is to evaluate the clinical value of ureteroscopic holmium laser lithotripsy for the treatment of nephrolithiasis. Clinical data of 44 patients treated for renal stones with polyscope modular flexible ureter- oscopic holmium laser lithotripsy from May 2014 to April 2015 were retrospectively analysed. Following the operation, F4.7 D-J stents were routinely indwelled for 4 weeks and catheterization for 1-3 days. A plain kidney, ureter, and blad- der (KUB) X-ray was performed on postoperative days too. A total of four success cases were determined following the first treatment. The remaining 40 cases were first placed with double-J stent and the surgery was performed one week later. Stone sizes between 0.8-4.0 cm in diameter were defined. The operation time for the treatment was 80-180 minutes. Patients were discharged within 3-5 days, and the double-J stent was removed within 1-3 months. 39 patients were found to be completely stone-free at approximately three months postoperatively. However, five patients were shown to have 11.1% of residual stones after treatment. No blood transfusion, septic shock, ureteral injury, or other complications were reported. Flexible ureteroscopic holmium laser lithotripsy is safe and effective for the treatment of nephrolithiasis. This approach could be a valuable choice for the treatment of patients with renal stones.

本研究旨在评估输尿管镜下钬激光碎石术治疗肾结石的临床价值。研究回顾性分析了2014年5月至2015年4月期间采用多镜联合柔性输尿管-输尿管镜钬激光碎石术治疗44例肾结石患者的临床数据。术后常规留置F4.7 D-J支架4周，导尿1-3天。术后几天还进行了肾脏、输尿管和肾盂（KUB）X光平片检查。第一次治疗后，共确定了 4 例成功病例。其余 40 例病例均先放置双 J 支架，一周后再进行手术。结石直径在 0.8-4.0 厘米之间。手术时间为 80-180 分钟。患者在 3-5 天内出院，双 J 支架在 1-3 个月内拆除。39 名患者在术后约三个月时完全无结石。但有五名患者在治疗后发现有11.1%的结石残留。没有输血、脓毒性休克、输尿管损伤或其他并发症的报道。输尿管软镜钬激光碎石术治疗肾结石安全有效。这种方法是治疗肾结石患者的重要选择。

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引用次数: 0

Diagnosing ovarian masses by using nuclear magnetic resonance 核磁共振诊断卵巢肿块

Reports in Clinical Studies and Medicine

Pub Date : 2018-12-27 DOI: 10.18282/RCSM.V1.I1.15

E. Zhang

In the research, nuclear magnetic resonance (NMR) was used to study and diagnose ovarian tumour. A total of 80 ovarian tumour patients who were admitted to the hospital from February 2014 to May 2016 were selected and randomly divided into 2 groups, 40 in the case group and 40 in the control group. The case group used NMR whereas the control group utilized B-mode ultrasound to compare the characteristics of tumor masses, accuracy, sensitivity, and specificity of the clinical diagnosis afterwards. The accuracy, sensitivity, specificity, and characteristics of tumour masses by NMR were 95.84%, 94.75%, 90.92%, and 100%, respectively, which were apparently higher than those of the B-mode ultrasound scanning (64.28%, 77.78%, 75.08%, and 70.83%, respectively). Difference of each index among the four between the two methods was statistically significant (p < 0.05). Therefore, NMR is superior to ultrasound in diagnosing ovarian tumour.

本研究采用核磁共振(NMR)技术对卵巢肿瘤进行研究和诊断。选取2014年2月至2016年5月我院收治的卵巢肿瘤患者80例，随机分为2组，病例组40例，对照组40例。病例组采用核磁共振，对照组采用b超比较肿瘤肿块特征、临床诊断的准确性、敏感性和特异性。核磁共振诊断肿瘤肿块的准确性、敏感性、特异性和特征分别为95.84%、94.75%、90.92%和100%，明显高于b超(64.28%、77.78%、75.08%和70.83%)。两种方法各指标比较差异均有统计学意义(p < 0.05)。因此，核磁共振在诊断卵巢肿瘤方面优于超声。

引用次数: 0

Clinical application of minimal invasive arthroscope on patella fracture surgery 微创关节镜在髌骨骨折手术中的临床应用

Reports in Clinical Studies and Medicine

Pub Date : 2018-12-27 DOI: 10.18282/RCSM.V1.I1.12

B. Jiang, Lele Liao

The aim of the research is to perform the application of minimal invasive arthroscope on patella fracture surgery. A total of 100 patients with the cases of patella fracture were selected from our hospital and the Second Xiangya Hospital’s Orthopaedic Ward. These patients were divided into ‘Observation Group’ and ‘Comparison Group’. The former was treated with traditional open surgery whereas the latter used the arthroscopic surgery. The postsurgical score indicated statistically significant differences (P < 0.05) in the Lysholm Knee and Oswestry Low Back pain scale. By performing arthroscopic surgery on patella fractures, the patients’ recovery was accelerated while the pain was greatly reduced, which in turn, improved the quality of patients’ life and provided valuable clinical value.

本研究旨在探讨微创关节镜在髌骨骨折手术中的应用。选取我院及湘雅第二医院骨科病房髌骨骨折患者共100例。将患者分为“观察组”和“对照组”。前者采用传统开放手术治疗，后者采用关节镜手术治疗。术后Lysholm膝关节和Oswestry腰痛评分差异有统计学意义(P < 0.05)。膝关节镜下手术治疗髌骨骨折，加速了患者的康复，大大减轻了患者的疼痛，从而提高了患者的生活质量，具有重要的临床价值。

引用次数: 2

Computer-assisted surgery navigation of pedicle screw insertion by standardized trainees 标准化学员椎弓根螺钉置入的计算机辅助手术导航

Reports in Clinical Studies and Medicine

Pub Date : 2017-07-20 DOI: 10.18686/aem.v6.81

Ming-yong Liu, Liang Zhang, Jian-hua Zhao, P. Liu

Objective: To assess the precision and efficiency computer-assisted surgery navigation of pedicle screw insertion by standardized trainees. Methods: From September 2013 to June 2016, 360 thoracic pedicle screws were inserted into 100 patients by standardized trainees (n = 30). Screws on the left side were inserted by hands (control group), while the other side were inserted under the guidance of computer-assistant navigation system (guided group). The insertion time and volume of blood lost by each screw were retrospectively analyzed. The precision ratio was assessed by computerized tomography (CT) scan after operation. Results: The time consumed in screw insertion was significantly shorter in the guided group than that in the control group. The blood lost volume was lesser in the guided group. Post-operation CT scan revealed higher precision in the guided group than that in the control group. Conclusion: Computer-assistant navigation system facilitates the learning of standardized trainees, and reduces the time-consuming and bleeding in thoracic pedicle screw insertion.

目的:评价规范化受训者椎弓根螺钉置入计算机辅助手术导航的准确性和效率。方法:2013年9月至2016年6月，标准化培训生对100例患者(n = 30)置入360枚胸椎弓根螺钉。左侧螺钉用手插入(对照组)，另一侧螺钉在计算机辅助导航系统引导下插入(引导组)。回顾性分析每颗螺钉的插入时间和失血量。术后采用计算机断层扫描(CT)评估准确率。结果:引导组置入螺钉所需时间明显短于对照组。导血组失血量较少。术后CT扫描显示，引导组的定位精度高于对照组。结论:计算机辅助导航系统有利于规范化学员的学习，减少胸椎弓根螺钉置入的时间和出血。

引用次数: 0