目的 探讨鼻咽癌个案管理模式,并评价临床中运用的效果。方法 回顾性将2017年8月—2018年4月93例新确诊的鼻咽癌患者作为对照组,按鼻咽癌患者的一般护理常规进行护理。2018年5月—2019年8月新确诊的鼻咽癌患者96例为实验组,实施个案管理比较两种方法的临床运用效果。结果 与对照组比,实验组诊断期完成检查时间和首次住院天数短、既定治疗计划完成率和治疗期间复诊依从性高,Ⅳ度骨髓抑制发生率低,差异均有统计学意义(P<0.05)。结论 鼻咽癌个案管理模式可为患者提供全程、连续性、高品质的护理,提高患者复诊依从性、提高治疗计划完成率,提高医疗护理质量,值得临床推广应用。

Objective To explore the case management mode of nasopharyngeal cancer (NPC) and evaluate the effect of clinical application. Methods 93 patients newly diagnosed NPC from August 2017 to April 2018 were used as the control group,and the general nursing routine was followed. 96 patients newly diagnosed NPC from May 2018 to August 2019 were taken as the experimental group,and accepted case management. Results Compared with the control group,the test time of the experimental group was shorter,the first hospital stay was shorter,the completion rate of treatment was higher,the patient's compliance of follow-up during treatment was better,incidence of grade Ⅳ myelosuppression was lower.The difference was statistically significant (P< 0.05). Conclusion The case management mode of NPC may provide seamless and high-quality nursing for NPC patients,improve the completion rate of treatment,improve the patient's compliance of follow-up and improve the quality of medical care,which is worthy of clinical application.

目的 探究骨质疏松性椎体压缩骨折治疗中3D打印技术的应用及其效果。方法 选取我院2016年1月—2018年10月收治的90例行经皮椎体成形术治疗的骨质疏松性椎体压缩骨折患者作为研究对象,随机分为常规组45例和实验组45例。常规组采用MR+常规穿刺方法,通过MR引导,注入骨水泥;实验组采用CT+3D打印技术,在应用CT的基础上,借助制作模型的引导,实施精准定位并实施手术治疗,对两组各项围术期治疗指标(手术时间、射线暴露次数、后凸Cobb角改善)和治疗前后的VAS评分、ODI评分以及骨水泥渗漏情况。结果 在手术时间、射线暴露次数、后凸Cobb角改善等围术期治疗指标方面,实验组均要优于常规组,差异有统计学意义(P<0.05)。在骨水泥渗漏发生率方面,常规组为17.78%(8/45),实验组为4.44%(2/45),实验组低于常规组,差异有统计学意义(P<0.05)。在VAS评分、ODI评分方面,常规组和实验组治疗前、治疗后相比差异均无统计学意义(P>0.05)。结论 骨质疏松性椎体压缩骨折经皮椎体成形术治疗中,配合3D打印技术能够有效提升治疗的有效性,促进患者的健康恢复,值得推广应用。

目的 评价Turbohawk定向斑块切除系统联合药物涂层球囊在下肢动脉硬化闭塞症中临床应用价值。方法 对于术前超声以及下肢动脉CTA检查诊断为下肢动脉硬化闭塞症的8例患者,行Turbohawk斑块旋切以及药物涂层球囊治疗,术后行常规抗凝治疗,定期行彩超复查。结果 8例患者下肢动脉均全部再通成功,技术成功率为100%,术后缺血症状明显改善,术后平均踝肱指数为0.78±0.06,高于术前的0.31±0.12(P<0.05)。住院期间无并发症发生,随访3～18个月,患者保肢均获得成功。结论 Turbohawk定向机械旋切系统联合药物涂层球囊治疗下肢动脉硬化闭塞症,具有创伤小、疗效好以及安全性高等优点,值得临床推广使用。

Objective To evaluate clinical application of using Turbohawk atherectomy device in combination with drug-coated balloon in treatment of atreriosclerosis obliterans in lower extremity. Methods Turbohawk atherectomy device and DCB was performed in 8 patiments with atreriosclerosis obliterans in lower extremity. All patients were diagnosed by ultrasound and CTA. Routine anticoagulation drugs were used after the operation. Follow-up was carried out with color Doppler ultrasound. Results Revascularization was gained in 8 patients. The technically successful rate was 100% and ischemic symptoms relieved significantly immediately after the operation. The post-operative ankle brachinal index(ABI) was 0.78±0.06,which was higher than that of before operation(0.31±0.12). No obvious complications occurred after operation. The follow-up range was 3~18 months and limbs were salvaged successfully. Conclusion With minimal invasive, safe and few complications, Turbohawk atherectomy device in combination with drug-coated balloon is proved to be a very effective treatment atreriosclerosis obliterans in lower extremity and it is worth to popularize.

目的 研究脊柱经皮内镜椎间孔入路和椎板间入路治疗腰椎间盘突出的临床应用效果。方法 本次选取的研究对象为2016年1月—2017年12月期间在我院进行治疗的腰椎间盘突出患者,将60例患者根据红蓝球分组法分为两组,30例/组。将实施脊柱经皮内镜椎间孔入路椎间盘切除术的患者纳入PETD组,将采用椎板间入路椎间盘切除术的患者设为PEID组。将两组腰椎间盘突出患者的手术相关指标、治疗优良率、ODI评分、VAS评分进行比对。结果 观察组腰椎间盘突出患者的手术时间、C型臂透视次数同对照组相比存在差异(P＜0.05);术后卧床时间和住院时间、治疗优良率组间对比无统计学意义;两组术后三个月时的ODI评分、VAS评分均较术前更优(P<0.05)。结论 在腰椎间盘突出治疗中脊柱经皮内镜椎间孔入路、椎板间入路的效果相当,临床上需患者的实际情况和解剖特点选择适合的入路方式和手术方法。

目的 探究一次性带冲洗球囊胃管的临床应用。方法 收集来我院进行腹部外科手术的患者共200例,随机分为研究组与对照组,每组100例,其中研究组患者采用一次性带球囊胃管治疗,对照组则应用传统胃管进行治疗。观察对比2组患者进行引流的通畅情况、治愈时间、胃管滑脱及胃管相关并发症等情况。结果 研究组患者的一次置管成功率高于对照组(P＜0.05),置管停顿率和自行拔管率均低于对照组(P＜0.05);研究组低于对照组(P＜0.05);研究组患者的不良反应发生率低于对照组(P＜0.05),差异均有统计学意义。结论 一次性带冲洗球囊胃管治疗可持续冲洗胃腔及灌注药物,保证引流通畅,明显提高胃肠减压效果,促进胃黏膜的炎症水肿、糜烂出血等病症的修复愈合,并且能够提高置管效果,减少置管时间,同时避免不良反应的发生,值得临床进一步推广。

Objective To investigate the clinical value of disposable balloon catheter with irrigation. Methods In our hospital for abdominal surgery patients with a total of 200 cases were randomly divided into study group and control group, 100 cases in each group. The study group was treated by disposable balloon intubation, the control group used conventional gastric tube. Observation and comparison of two groups were taken with drainage patency, cure time, gastric tube slippage and gastric tube related complications. Results The study group of patients with a success rate of catheterization was higher than that of the control group (P<0.05), catheter pause rate and self extubation rate were lower than that of the control group (P<0.05); the study group was significantly lower than that of the control group (P<0.05); the adverse reaction of patients in the study group was significantly lower than that of the control group (P<0.05), the differences were statistically significant. Conclusion Disposable flushing balloon intubation treatment of gastric cavity perfusion and sustainable irrigation, to ensure smooth drainage, may improve the effect of gastrointestinal decompression, promote the repair of gastric mucosal inflammation and edema, erosion, bleeding and other symptoms and improve the effect of catheterization, reduce the intubation time, and avoid the occurrence of adverse reactions. It is worthy of further promotion.

目的 观察克氏针钢丝张力带及镍钛聚髌器治疗不同类型髌骨骨折的疗效, 探讨两种手术方式的临床适应证及治疗优点。方法 选取2011年3月—2013年12月,成都中医药大学附属医院骨科住院部45例髌骨骨折患者,术后通过Lyshoml膝关节评分等标准,对患者康复情况进行评估,并对数据加以分析, 比较两种治疗方法的临床效果。结果 两种治疗方法在治疗效果上无差异, 观察后分析:髌骨横形骨折可选克氏针钢丝张力带治疗; 粉碎性骨折采用镍钛聚髌器疗效满意。结论 两种髌骨骨折内固定方法临床疗效相似,但镍钛聚髌器兼有复位良好,固定稳定,操作简便等优点,对于粉碎性髌骨骨折更为适用。

Objective To observe the curative effect of Kirschner wire tension band and Ni Ti patellar concentrator in the treatment of different types of patellar fracture,study the clinical indications on and therapeutic advantages of this two kinds of operation methods. Methods By selecting 45 cases of patellar fracture patients hospitalized in the department of orthopedics,the affiliated hospital of Chengdu university of TCM from 2011-03 to 2013-12.To assess the patients rehabilitation by Lyshoml knee score (standard) after operation and analysis the data,compare the clinical effects of this two methods. Results There is no significant differences between this two methods. After observation and analysis:transverse fracture of patella can be treated with kirschner wire and tension band and Comminuted fracture treated with Ni Ti patellar concentrator will be better. Conclusion This two kinds of operation methods have a similar curative effect in the Clinical reatment of patella fracture, but the Ni Ti patellar concentrator has a good function of reduction, stable fixed and easy to operation,Particularly suitable for Comminuted fracture of patellar.

目的 研究乳管镜在乳头溢液的诊断中的应用价值。方法 回顾性分析2010年2月－2014年3月采用乳管镜检查的123例乳头溢液患者的临床资料。结果 乳管镜检查发现乳腺导管癌8例,导管内乳头状瘤33例,乳头状瘤病32例,导管扩张及炎症35例。术后病理检查证实乳腺导管癌5例,导管内乳头状瘤35例,乳头状瘤病30例,导管扩张及炎症33例。结论 乳管镜可作为诊治乳头溢液的首选措施,其所起到的作用是超声、钼靶及乳管造影所不及的。

Objective To study the clinical application value of the fiberoptic ductoscopy(FDS) on the diagnosis of nipple discharge. Methods A retrospective analysis of 123 patients with nipple discharge undergoing FDS from February 2010 to March 2014. Results After fiberoptic ductoscopy examination,it was found there were 8 cases of breast cancer,33 cases of intra-duct papilloma,35 cases of papillomatosis,35 cases of dilatation and inflammation. However there were 5 cases of breast cancer,35 cases of intra-duct papilloma,30 cases of papillomatosis, and 33 cases of dilatation and inflammation were comfirmed through postoperative pathological examination. Conclusion Fiberoptic ductoscopy is more effective than B-ultrasonography and Mo-traget mammography, so it can be the preferred method of diagnosis and treatment for nipple discharge.

目的 探讨二维超声联合三维超声检测不同孕期胎儿肢体畸形的临床价值。方法 回顾性分析我科2013年1月—2015年1月超声筛查的1352名孕15~34周的孕妇,运用二维及三维超声,采用连续顺序追踪超声法检测胎儿四肢,将产前诊断结果与引产或引产结果对照。结果 1352名孕妇胎儿畸形46例(3.40%,46/1352),总涉及肢体73处(近端肢体畸形65处,远端肢体畸形8处),其中四肢短小9例(骨发育不全2例,单纯四肢短小畸形5例,成骨发育不全2例),漏诊2例;足畸形16例34处,漏诊1例,残肢畸形15例;手畸形6例,漏诊1例。结论 孕中期二维连续顺序追踪超声法联合三维超声胎儿肢体畸形检出率高,对及早发现胎儿肢体畸形有一定的诊断价值。

       糖尿病肾病（DN）是指由糖尿病所致的慢性肾脏疾病，是目前我国和全球范围内慢性肾脏疾病和终末期肾脏疾病的首位病因。DN发病率逐年攀升，且预后不良，已成为我国重大的公共卫生问题之一。DN不仅明显降低了患者的生活质量，还增加了心血管疾病的风险。随着对DN发病机制的深入研究，近十余年来在DN治疗手段方面取得了显著进展，包括新型药物的研发、生活方式的干预及各种新兴疗法的探索。本文旨在系统性综述近年来DN领域的重要治疗进展，阐明这些进展在临床应用中的有效性和适用性，并展望未来的研究方向，以期为临床实践提供参考和指导。

       Diabetic nephropathy（DN）is a form of chronic kidney disease（CKD）induced by diabetes．Diabetic nephropathy represents the leading cause of CKD and end-stage renal disease both in China and globally．The incidence of DN has been steadily increasing and its prognosis remains unfavorable．Diabetic nephropathy has become a major public health concern．Diabetic nephropathy not only significantly affects patients’ quality of life but also increases the risk of cardiovascular diseases．Recent advancements in our understanding of the pathogenesis of DN have facilitated significant progress in treatment options over the past decade．These developments include the introduction of novel pharmacological agents，the implementation of lifestyle modifications，and the exploration of various emerging therapeutic approaches．This  review aims to  systematically expound the significant therapeutic advancements in the field of DN in recent years，evaluate the efficacy and applicability of these advancements in clinical practice，and explore potential future research directions，thereby providing valuable insights andguidance for clinical practice．