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Clinical Observation on Positive Reaction Point Massage with Etofenamate Gel for Neck-shoulder-back Myofascitis

目的　探讨阳性激发点推拿联合依托芬那酯凝胶治疗对颈肩背肌筋膜炎的临床疗效。 方法　收集2011年2月－10月确诊为颈肩背肌炎的患者52例，采用随机对照试验,其中26例采用依托芬那酯凝胶加阳性激发点推拿（治疗组），另外26例采用传统推拿进行常规推拿手法治疗（对照组）。对两组患者5次治疗后的疗效率、每次治疗后的疼痛面谱量化评分、7个月后随访疼痛复发率等疗效进行对照分析。 结果　治疗组和对照组经连续治疗5次后，总有效率分别为96.15%和80.77%，差异均有统计学意义（P＜0.05）；疼痛面谱量化评分治疗组在第一次治疗后就较对照组改善明显，差异有统计学意义（P＜0.05）；7个月后随访疼痛复发人数治疗组较对照组少，差异有统计学意义（P＜0.05）。 结论　阳性激发点推拿联合依托芬那酯凝胶治疗方案对改善颈肩背肌筋膜炎引发的颈肩背部疼痛不适等症状优于传统推拿组，值得临床推广运用。

Change and Thinking of Criteria for Liver Transplantation Indications of Hepatocellular Carcinoma

ALPPS 术式的优势及不足

Analysis of Fracture Conditions and Rehabilitation Experiences of Earthquake Casualties

目的：总结汶川地震中骨折患者的康复治疗及其伤情分析，为灾难医学中骨折患者的康复治疗提供经验。方法：收集四川大学华西医院地震伤员康复中心的112例骨折患者资料，对伤情进行分析并对其康复治疗情况进行总结。结果：经康复治疗后患者的日常生活活动能力明显提高。结论：康复治疗对骨折患者非常重要。

闭合伤致膈肌破裂的诊断与治疗

Clinical Observation of Treating Plantar Fasciitis through Positive Reaction Point Massage

目的　探讨阳性激发点推拿治疗对足底筋膜炎的临床疗效。 方法　对2011年3月－8月门诊确诊为足底筋膜炎的52例患者，采用随机方式分为治疗组和对照组各26例，治疗组采用阳性激发点推拿，对照组采用电针治疗。并对两组患者治疗5次后的即时疗效率、日本骨科学会（JOA）足底治疗疗效评分、每次治疗后的疼痛面谱量化评分、3个月随访疼痛复发率等疗效进行对照分析。 结果　治疗组和对照组经连续治疗5次后，其JOA足底治疗疗效评分分别为（91.32 ± 10.61）、（82.92 ± 13.61）分，总有效率分别为96.15%、80.77%，差异均有统计学意义（P＜0.05）。疼痛面谱量化评分，治疗组在第一次治疗后较对照组改善明显，差异有统计学意义（P＜0.05）。3个月后随访疼痛复发情况，治疗组复发人数较对照组少，差异有统计学意义（P＜0.05）。结论　阳性激发点推拿治疗法对改善足底筋膜炎引发的足底疼痛、步行不适等症状优于电针治疗法，值得临床推广运用。

负压吸引终端过滤器的制作与应用

目的寻找一种简便高效的负压终端过滤网清洗方法，以降低其堵塞对临床工作造成的影响。 方法依据负压吸引的使用习惯于2012年8月设计制作出外接型负压过滤器，并分别对原安装模式的过滤网和现外接型过滤网的清洗效率进行测试对比。 结果拆洗负压吸引终端内的过滤网平均耗时20 min 19 s，折洗外接型过滤器的过滤网则仅需1 min 3 s。 结论外接型过滤器使用方便，可明显提高维护清洗维护效率，值得推广应用。

自发性食管破裂的早期诊断与治疗

目的 总结自发性食管破裂的早期诊断、治疗方法及临床疗效。 方法 2004 年1 月－ 2006 年6 月，收治15 例自发性食管破裂男性患者。年龄38 ～ 56 岁，平均46 岁。发病至确诊时间为6 ～ 72 h，其中lt; 24 h 12 例。暴食后上腹受压憋气所致3 例，暴食后跌伤1 例，大量饮酒后呕吐所致11 例。破口位于食管中下段或下段，长4 ～ 12 cm。1 例发病后于外院行内支架治疗并发食管、气管瘘1 个月，入院确诊后放弃治疗。余14 例均手术治疗，其中行食管修补术8 例，食管切除、食管胃吻合术6 例。 结果 14 例术后顺利恢复，住院11 ～ 18 d。无手术死亡、吻合口瘘和其他并发症发生。2 例术后2 个月出现吻合口轻度狭窄（0.6 ～ 0.8 cm），仅进流食，经胃镜直视下行球囊扩张后缓解。14 例获随访，随访时间6 个月～ 2 年。无进食困难及哽咽不适。行上消化道碘化油造影示吻合口通畅，食管无扩张，消化功能良好。 结论 自发性食管破裂经早期诊断和手术治疗均易治愈，并发症少，预后满意。

POSTERIOR ATLANTOAXIAL LATERAL MASS SCREW FIXATION AND SUBOCCIPITAL DECOMPRESSION FOR TREATMENT OF Arnold-Chiari MALFORMATION ASSOCIATED WITH ATLANTOAXIAL DISLOCATION

ObjectiveTo evaluate the effectiveness of the posterior atlantoaxial lateral mass screw fixation and suboccipital decompression in the treatment of Arnold-Chiari malformation associated with atlantoaxial joint dislocation. MethodsBetween September 2012 and November 2015, 17 cases of Arnold-Chiari malformation associated with atlantoaxial dislocation were treated by the posterior atlantoaxial lateral mass screw fixation and suboccipital decompression and expansion to repair the dura mater and bone graft fusion. There were 10 males and 7 females, aged 35-65 years (mean, 51.4 years). The disease duration was 14 months to 15 years with an average of 7.4 years. According to Arnold-Chiari malformation classification, 13 cases were rated as type I, 3 cases as type II, and 1 case as type III-IV. Cervical nerve root stimulation and compression symptoms were observed in 12 cases, occipital foramen syndrome in 11 cases, cerebellar compression symptoms in 6 cases, and syringomyelia in 10 cases. ResultsPrimary healing of incision was obtained in the other patients except 1 patient who had postoperative cerebrospinal fluid leakage after removal of drainage tube at 3 days after operation, which was cured after 7 days. All patients were followed up 6 months to 2 years, with an average of 18.4 months. The neurological dysfunction was improved in different degrees after operation. The Japanese Orthopedic Association (JOA) score was significantly increased to 16.12±1.11 at 6 months from preoperative 11.76±2.01 (t=13.596, P=0.000); compression of spinal cord and medulla was improved. X-ray examination showed bone graft fusion at 6 months after operation. In 10 patients with spinal cord cavity, MRI showed empty disappearance in 3 cases, empty cavity lessening in 6 cases, and no obvious change in 1 case at 6 months. ConclusionAtlantoaxial lateral mass screw fixation and suboccipital decompression and expansion to repair the dura mater can obtain good effectiveness in the treatment of Arnold Chiari malformation associated with atlantoaxial transarticular dislocation.

Clinical Study on pTNM Classification in Predicting Prognosis of Hepatic Cell Carcinoma after Liver Transplantation

【Abstract】Objective To evaluate the value of pTNM classification in predicting the prognosis of hepatic cell carcinoma after liver transplantation. Methods Fifty-nine HCC cases undergoing liver transplantation between April 1993 and January 2003 were retrospectively reviewed. Fiftynine cases were staged by using the pTNM classification. Results The 1-year survival rates were 66.67%, 66.67%, 40.91% and 31.75% for Ⅰ，Ⅱ，Ⅲa and Ⅳa stages，2-year survival rates were 66.67%, 66.67%, 21.29% and 31.75%, the difference was not statistically significant. Conclusion The pTNM classification is not good enough to predict the prognosis of hepatic cell carcinoma after liver transplantation.