简介：【摘要】经颅直流电刺激 (transcranial direct current stimulation， tDCS)是一种非侵袭性，利用微弱电流 (1-2mA)调节大脑皮质神经细胞活动的技术 [ 1 ] 。共济失调是脑卒中，尤其是小脑卒中后最常见的症状和体征 [ 2 ] 。本文简要回顾其起源、发展和机制，着重其综述在共济失调型吞咽障碍 的研究进展。介绍经颅直流电刺激利用微弱的直流电（ 1—2mA）来调节皮质神经元活动，阳极小脑 tDCS可以上调小脑 -大脑抑制 。

简介：摘要卒中后认知损害(post-stroke cognitive impairment, PSCI)是由卒中引起的一系列综合征，包括注意力、语言功能、执行功能、视觉空间认知、情景记忆和工作记忆等1项或多项功能受损。PSCI的传统治疗方法包括药物治疗和认知训练，治疗方式有限且维持效果不佳，因此迫切需要一种辅助治疗方法以提高其治疗效果。经颅直流电刺激(transcranial direct current stimulation, tDCS)是一种安全成熟的非侵入性脑刺激技术，通过放置在头皮上的电极产生微弱的直流电(1～2 mA)，改变神经元静息膜电位，调节大脑皮质兴奋性，从而达到治疗目的。文章综述了tDCS对PSCI的影响，期望为其康复治疗提供参考和指导。

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简介：摘要目的探讨体表贴膜法直流电除颤复苏的实验方法及该方法的可行性。方法选择24只健康家兔，将电极贴膜贴于体表，分别给予80V、90V、100V和110V四个级别电压刺激，建立室颤模型，采用20J、30J、50J（双向波）非同步直流电复律。初次除颤用20J，如2次未成功，则提高一个档次能量再次电复律。计算每一档能量电除颤的成功率。结果体表贴膜法直流电除颤复苏是家兔室颤后急救的有效手段，其中输出能量为30J时成功率最高。结论体表贴膜法直流电除颤复苏应用于家兔室颤后急救有效可行，理想的除颤输出能量为30J。

简介：［摘要］目的探讨Fahr’s病的CT表现和临床资料，以更好地认识Fahr’s病。方法回顾性分析9例临床确诊为Fahr’s病的临床和影像学资料，全部病例均行颅脑CT扫描。结果全部病例发病年龄为15～70岁，血清钙、磷均在正常范围，CT表现为颅内广泛对称性钙化，主要累及基底节、小脑齿状核、皮质下和丘脑。临床表现最常见有帕金森综合征，其次有精神障碍、记忆力下降、智力低下、癫痫、舞蹈症等。结论根据CT表现、临床表现、实验室检查和家族病史，可以对Fahr’s病作出正确的诊断，CT是Fahr’s病诊断最有价值的影像学检查，预防与对症治疗是目前主要治疗目的。

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简介：摘要目的探讨乳头Paget’s病的临床特点、诊断及治疗方法，提高对乳头Paget’s病的诊治水平。方法回顾性分析我院2011年8月至2014年8月间收治的12例乳头Paget’s病患者的临床资料结果单纯湿疹样改变者2例，单纯乳腺肿块者3例，乳头湿疹样改变伴乳腺肿块者7例。最终病理证实乳腺浸润性导管癌伴乳头Paget’s病者8例，占所有病例的66.7%；导管内癌伴乳头Paget’s病者3例，占所有病例的25%；导管内癌局部微浸润伴乳头Paget’s病者1例，占所有病例的8.3%。结论乳头paget’s多伴有乳腺深部肿块，伴肿块的乳头paget’s病出现浸润性乳腺癌的可能性较大。预后较单纯浸润性乳腺癌差，需更为积极的综合治疗。

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简介：腋臭是美容外科临床工作中的常见病之一，目前的治疗方法很多，现介绍“S”形切口皮下修剪术治疗腋臭，效果较好，并发症少，现报道如下：

简介：AbstractTrauma-induced pulmonary thromboembolism is the second leading cause of death in severe trauma patients. Primary fibrinolytic hyperactivity combined with hemorrhage and consequential hypercoagulability in severe trauma patients create a huge challenge for clinicians. It is crucial to ensure a safe anticoagulant therapy for trauma patients, but a series of clinical issues need to be answered first, for example, what are the risk factors for traumatic venous thromboembolism? How to assess and determine the status of coagulation dysfunction of patients? When is the optimal timing to initiate pharmacologic prophylaxis for venous thromboembolism? What types of prophylactic agents should be used? How to manage the anticoagulation-related hemorrhage and to determine the optimal timing of restarting chemoprophylaxis? The present review attempts to answer the above questions.

简介：AbstractBackground:Meniere’s disease (MD) is an idiopathic disorder of the inner ear, which manifests as cochleo-vestibular dysfunction. Hearing loss will progress to a profound levelin a subset of patients with MD, and vestibular interventions can independently cause loss of hearing. The aim of this study was to systematically review the published literature describing the safety and efficacy of CI in patients with MD.Materials and methods:A systematic literature review was conducted in accordance PRISMA guidelines to identify articles that assessed at least one functional outcome in patients with MD who underwent CI. Demographic information, disease history, MD symptoms, outcomes measures, and complications related to CI were extracted from included studies.Results:In total, 17 studies were included, and 182 patients with MD underwent CI. The weighted-mean age was 61.9 years (range 27-85). Study objective and methodology varied, and there was significant heterogeneity in CI outcome measures reported. In total, 179 (98.3%) of 182 patients reported objective improvements in at least one hearing metric after CI. A total of 69 patients (37.9%) reported vertigo or severe dizziness prior to CI, compared to 22 patients (15.4%) postoperatively. Two studies reported significant reductions in postoperative Tinnitus Handicap Inventory score (THI). Quality of life assessments varied between studies. Complications rates were low with only nine patients (4.9%) reporting a serious CI-related complication.Conclusions:This systematic review evaluated 17 studies describing the safety and efficacy of CI in patients with MD and encountered many challenges due to small sample sizes, and heterogeneity in study design and outcomes measured. Despite these limitations, this study of 182 patients is to the best of our knowledge the largest systematic review evaluating the safety and efficacy of CI in MD. The results of this study support the need for a standardized approach to evaluating outcomes of CI in patients with MD in future studies.

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简介：AIM:Toinvestigatethelifetimeriskofdevelopmentofesophagealadenocarcinomaand/orhigh-gradedysplasiainpatientsdiagnosedwithBarrett’sesophagus.METHODS:DatawereextractedfromtheUnitedKingdomNationalBarrett’sOesophagusRegistryondateofdiagnosis,patientageandgenderof7877patientsfromwhohadbeenregisteredfrom35UnitedKingdomcenters.LifeexpectancywasevaluatedfromUnitedKingdomNationalStatisticsdatabasedupongenderandageatyearatdiagnosis.Thesedatawerethenusedwithpublishedestimatesofannualadenocarcinomaandhigh-gradedysplasiaincidencesfrommetaanalysesandlargepopulation-basedstudiestoestimateoveralllifetimeriskofdevelopmentofthesestudyendpoints.RESULTS:ThemeanageatdiagnosisofBarrett’sesophaguswas61.6yearsinmalesand67.3yearsinfemales.Themeanlifeexpectancyatdiagnosiswas23.1yearsinmales,20.7yearsinfemalesand22.2yearsoverall.Usingdatafrompublishedmeta-analyses,thelifetimeriskofdevelopmentofadenocarcinomawasbetween1in8and1in14andthelifetimeriskofhigh-gradedysplasiaoradenocarcinomawas1in5to1in6.Usingdatafrom3largerecentpopulation-basedcohortstudiesthelifetimeriskofadenocarcinomawasbetween1in10and1in37andofthecombinedendpointofhigh-gradedysplasiaandadenocarcinomawasbetween1in8and1in20.AgeatBarrett’sesophagusdiagnosisisreducingandlifeexpectancyisincreasing,whichwillpartiallycounter-balancelowerannualcancerincidence.CONCLUSION:Thereisasignificantlifetimeriskofdevelopmentofhigh-gradedysplasiaandadenocarcinomainBarrett’sesophagus.

简介：韩碧英教授是在针灸部门ofGuang的一位主要医生汉语的中国学院的一所人医院医学科学。她从事临床的实践将近40年了并且积累了丰富的临床的经验，特别在临床的症候群区别。我是幸运的跟随教授汉在周末练习针灸并且向他学习。我现在为参考与证明的格介绍她的学术想法和临床的经验。

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简介：【摘要】回顾性分析 5例 Madelung’s病病人资料，探讨此病病因、临床表现及治疗方法。该病病因尚不清，常见于中年男性，肿块主要对称分布于头颈部及上躯干部，呈典型“牛颈”或“驼峰”样外观。手术切除为主要治疗方法。该病恶变率低、预后良好。