MedNexus
2015年 · 第128卷第21期
出版日期 2015-11-05电子版 ￥0.00元
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Editorial
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中国骨伤科的创新Ying-Ze Zhang
中华医学杂志英文版2015年 128卷 21期
DOI: 10.4103/0366-6999.168015
摘要
国家统计局最新公布的数据显示，2010年中国大陆总人口13.3亿，其中60岁及以上人口1.77亿，占总人口的13.25%，2014年增至15.53%。随着我国人口老龄化程度的加剧，肌肉骨骼疾病患者大量增加，这些疾病是老年人严重慢性疼痛和身体残疾的最常见原因。同时，随着我国经济和工业化的快速发展，交通伤和建筑伤患者数量迅速增加。综上所述，骨科和创伤科的费用将不可避免地增加，对现有的医疗和卫生系统构成挑战，给社会带来巨大的经济和情感负担。为了应对这一挑战并改善患者护理，骨科和创伤科精确诊断和治疗方法的先进概念、手术技能和新型器械的创新在我国变得越来越重要和势在必行。
Original Article
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中国人群非创伤性股骨头坏死的患病率及其相关危险因素：一项具有全国代表性的调查结果De-Wei Zhao, Mang Yu, Kai Hu, Wei Wang, Lei Yang, Ben-Jie Wang, Xiao-Hong Gao, Yong-Ming Guo, Yong-Qing Xu, Yu-Shan Wei 等
中华医学杂志英文版2015年 128卷 21期
DOI: 10.4103/0366-6999.168017
摘要
Background:
Nontraumatic osteonecrosis of the femoral head (NONFH) is a debilitating disease that represents a significant financial burden for both individuals and healthcare systems. Despite its significance, however, its prevalence in the Chinese general population remains unknown. This study aimed to investigate the prevalence of NONFH and its associated risk factors in the Chinese population.
Methods:
A nationally representative survey of 30,030 respondents was undertaken from June 2012 to August 2013. All participants underwent a questionnaire investigation, physical examination of hip, and bilateral hip joint X-ray and/or magnetic resonance imaging examination. Blood samples were taken after overnight fasting to test serum total cholesterol, triglyceride, and high-density lipoprotein (HDL) and low-density lipoprotein (LDL) levels. We then used multivariate logistic regression analysis to investigate the associations between various metabolic, demographic, and lifestyle-related variables and NONFH.
Results:
NONFH was diagnosed in 218 subjects (0.725%) and the estimated NONFH cases were 8.12 million among Chinese people aged 15 years and over. The prevalence of NONFH was significantly higher in males than in females (1.02% vs. 0.51%, χ2 = 24.997, P< 0.001). Among NONFH patients, North residents were subjected to higher prevalence of NONFH than that of South residents (0.85% vs. 0.61%, χ2 = 5.847, P= 0.016). Our multivariate regression analysis showed that high blood levels of triglycerides, total cholesterol, LDL-cholesterol, and non-HDL-cholesterol, male, urban residence, family history of osteonecrosis of the femoral head, heavy smoking, alcohol abuse and glucocorticoid intake, overweight, and obesity were all significantly associated with an increased risk of NONFH.
Conclusions:
Our findings highlight that NONFH is a significant public health challenge in China and underscore the need for policy measures on the national level. Furthermore, NONFH shares a number of risk factors with atherosclerosis.
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柔性髓内可吸收棒手术固定第四和第五掌骨干骨折：早期临床结果和意义Ge Xiong, Zi-Run Xiao, Shi-Gong Guo, Wei Zheng, Lu-Fei Dai
中华医学杂志英文版2015年 128卷 21期
DOI: 10.4103/0366-6999.168040
摘要
Background:
To avoid the irritation of tendons and soft tissues as well as hardware-related problems, we designed an intramedullary fixation with bioabsorbable rods for the treatment of the metacarpal shaft fractures.
Methods:
Five patients with nine shaft fractures of the fourth and fifth metacarpi were treated with intramedullary absorbable implants and followed up with an average of 4.2 months postoperatively.
Results:
At final follow-up, all patients achieved fracture union with no signs of inflammatory or subcutaneous effusion. There was no shortening, angulatory, or rotatory deformity. There was almost full active extension range of motion (ROM) of the metacarpophalangeal joints while the active flexion ROM of these joints was 80.7 ± 9.6°. Compared with the contralateral hand, the grip strength of the injured hand was 94.0 ± 9.6%. X-rays showed that the arch of the second to fifth metacarpal heads was smooth. There were no intramedullary lytic changes and soft tissue swellings.
Conclusion:
The intramedullary absorbable implants are a safe, simple, and practical treatment for fourth and fifth metacarpal fractures with good early clinical outcomes and no significant complications.
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计算全膝关节置换术后失血量的四种方法Fu-Qiang Gao, Zi-Jian Li, Ke Zhang, Wei Sun, Hong Zhang
中华医学杂志英文版2015年 128卷 21期
DOI: 10.4103/0366-6999.168041
摘要
Background:
Currently, various calculation methods for evaluating blood-loss in patients with total knee arthroplasty (TKA) are applied in clinical practice. However, different methods may yield different results. The purpose of this study was to determine the most reliable method for calculating blood-loss after primary TKA.
Methods:
We compared blood-loss in 245 patients who underwent primary unilateral TKA from February 2010 to August 2011. We calculated blood-loss using four methods: Gross equation, hemoglobin (Hb) balance, the Orthopedic Surgery Transfusion Hemoglobin European Overview (OSTHEO) formula, and Hb-dilution. We determined Pearson’s correlation coefficients for the four methods.
Results:
There were large differences in the calculated blood-loss obtained by the four methods. In descending order of combined correlation coefficient based on calculated blood-loss, the methods were Hb-balance, OSTHEO formula, Hb-dilution, and Gross equation.
Conclusions:
The Hb-balance method may be the most reliable method of estimating blood-loss after TKA.
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Oxford III期单阶段双侧单室膝关节置换术的临床结果和风险Tong Ma, Yi-Hui Tu, Hua-Ming Xue, Tao Wen, Min-Wei Cai
中华医学杂志英文版2015年 128卷 21期
DOI: 10.4103/0366-6999.168042
摘要
Background:
Osteoarthritis often affects the joint bilaterally, and the single-stage (SS) unicompartmental knee arthroplasty (UKA) is advantageous in terms of a single anesthesia administration, a short hospital stay, lower medical costs, and enhanced patient convenience. However, the complication risk of SS UKA continues to be debated. The aim of this article was to evaluate the clinical effectiveness, complications, and functional recovery of SS and two-stage (TS) UKA.
Methods:
From January 2008 to December 2013, we compared a series of 36 SS UKA with 45 TS UKA for osteoarthritis. The mean age was 65.4 years (range: 55–75 years). The mean body mass index was 25.2 kg/m2 (range: 22–29 kg/m2). The pre- and post-operative Oxford Knee Scores (OKSs), complications, operative times, tourniquet times, the amount of drainage, and hemoglobin (Hb) were evaluated. The Chi-square test, Fisher’s exact test, and paired and grouped t-tests were used in this study.
Results:
The mean follow-up was 50 months. No complications of death, fat embolism, deep vein thrombosis, and prosthetic infection were reported. Patients who underwent SS UKA had a shorter cumulative anesthesia time (113.5 vs. 133.0 min, P< 0.01). There were no significant variations between the values of the mean tourniquet time, the amount of drainage, pre- and post-operative Hb in the different groups. No patient required a blood transfusion. No statistical differences were found in the complications between two groups (P > 0.05). At the final follow-up, the mean OKS improved from 39.48 ± 5.69 to 18.83 ± 3.82 (P < 0.01), with no statistical differences between the two groups (P > 0.05). Patients who underwent SS UKA had a faster recovery.
Conclusions:
The single-staged UKA offers the benefits of a single anesthesia administration, reduced total anesthetic time, decreased overall rehabilitation time, and absence of an increase in perioperative mortality or complications compared with the TS bilateral UKA.
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后路稳定保留交叉全膝关节置换术后关节线抬高对临床功能和运动学的影响Song-Jie Ji, Yi-Xin Zhou, Xu Jiang, Zhi-Yuan Cheng, Guang-Zhi Wang, Hui Ding, Ming-Lei Yang, Zhong-Lin Zhu
中华医学杂志英文版2015年 128卷 21期
DOI: 10.4103/0366-6999.168043
摘要
Background:
Joint line (JL) is a very important factor for total knee arthroplasty (TKA) to restore. The objective of this study was to evaluate the early clinical and kinematic results of TKAs with posterior-stabilized (PS) or cruciate retaining (CR) implants in which the JL was elevated postoperatively.
Methods:
Data were collected from patients who underwent TKA in our department between April 2011 and April 2014. The patients were divided into two groups based on the prosthesis they received (PS or CR). At 1-year postoperatively, clinical outcomes were evaluated by the American Knee Society (AKS) knee score, AKS function score, and patella score. In vivo kinematic analysis after TKA was performed on all patients and a previously validated three-dimensional to two-dimensional image registration technique was used to obtain the kinematic data. Anteroposterior (AP) translation of the medial and lateral femoral condyles, and axial rotation relative to the tibial plateau, were analyzed. The data were assessed using the Mann–Whitney test.
Results:
At time of follow-up, there were differences in the AKS knee scores (P = 0.005), AKS function scores (P = 0.025), patella scores (P = 0.015), and postoperative range of motions (P = 0.004) between the PS group and the CR group. In the PS group, the magnitude of AP translation for the medial and lateral condyle was 4.9 ± 3.0 mm and 12.8 ± 3.3 mm, respectively. Axial rotation of the tibial component relative to the femoral component was 12.9 ± 4.5°. In the CR group, the magnitude of AP translation for the medial and lateral condyle was 4.3 ± 3.5 mm and 7.9 ± 4.2 mm, respectively. The axial rotation was 6.7 ± 5.9°. There were statistically different between PS group and CR group in kinematics postoperatively.
Conclusion:
Our results demonstrate that postoperative JL elevation had more adverse effects on the clinical and kinematic outcomes of CR TKAs than PS TKAs.
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活动支承单室膝关节置换术的有限元分析：胫骨部件冠状排列的影响Guang-Duo Zhu, Wan-Shou Guo, Qi-Dong Zhang, Zhao-Hui Liu, Li-Ming Cheng
中华医学杂志英文版2015年 128卷 21期
DOI: 10.4103/0366-6999.168044
摘要
Background:
Controversies about the rational positioning of the tibial component in unicompartmental knee arthroplasty (UKA) still exist. Previous finite element (FE) studies were rare, and the results varied. This FE study aimed to analyze the influence of the tibial component coronal alignment on knee biomechanics in mobile-bearing UKA and find a ration range of inclination angles.
Methods:
A three-dimensional FE model of the intact knee was constructed from image data of one normal subject. A 1000 N compressive load was applied to the intact knee model for validating. Then a set of eleven UKA FE models was developed with the coronal inclination angles of the tibial tray ranging from 10° valgus to 10° varus. Tibial bone stresses and strains, contact pressures and load distribution in all UKA models were calculated and analyzed under the unified loading and boundary conditions.
Results:
Load distribution, contact pressures, and contact areas in intact knee model were validated. In UKA models, von Mises stress and compressive strain at proximal medial cortical bone increased significantly as the tibial tray was in valgus inclination >4°, which may increase the risk of residual pain. Compressive strains at tibial keel slot were above the high threshold with varus inclination >4°, which may result in greater risk of component migration. Tibial bone resection corner acted as a strain-raiser regardless of the inclination angles. Compressive strains at the resected surface slightly changed with the varying inclinations and were not supposed to induce bone resorption and component loosening. Contact pressures and load percentage in lateral compartment increased with the more varus inclination, which may lead to osteoarthritis progression.
Conclusions:
Static knee biomechanics after UKA can be greatly affected by tibial component coronal alignment. A range from 4° valgus to 4° varus inclination of tibial component can be recommended in mobile-bearing UKA.
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骨关节炎大鼠内侧半月板撕裂模型软骨下骨微结构、矿化及力学性能的动态变化De-Gang Yu, Shao-Bo Nie, Feng-Xiang Liu, Chuan-Long Wu, Bo Tian, Wen-Gang Wang, Xiao-Qing Wang, Zhen-An Zhu, Yuan-Qing Mao
中华医学杂志英文版2015年 128卷 21期
DOI: 10.4103/0366-6999.168045
摘要
Background:
The properties of subchondral bone influence the integrity of articular cartilage in the pathogenesis of osteoarthritis (OA). However, the characteristics of subchondral bone alterations remain unresolved. The present study aimed to observe the dynamic alterations in the microarchitecture, mineralization, and mechanical properties of subchondral bone during the progression of OA.
Methods:
A medial meniscal tear (MMT) operation was performed in 128 adult Sprague Dawley rats to induce OA. At 2, 4, 8, and 12 weeks following the MMT operation, cartilage degeneration was evaluated using toluidine blue O staining, whereas changes in the microarchitecture indices and tissue mineral density (TMD), mineral-to-collagen ratio, and intrinsic mechanical properties of subchondral bone plates (BPs) and trabecular bones (Tbs) were measured using micro-computed tomography scanning, confocal Raman microspectroscopy and nanoindentation testing, respectively.
Results:
Cartilage degeneration occurred and worsened progressively from 2 to 12 weeks after OA induction. Microarchitecture analysis revealed that the subchondral bone shifted from bone resorption early (reduced trabecular BV/TV, trabecular number, connectivity density and trabecular thickness [Tb.Th], and increased trabecular spacing (Tb.Sp) at 2 and 4 weeks) to bone accretion late (increased BV/TV, Tb.Th and thickness of subchondral bone plate, and reduced Tb.Sp at 8 and 12 weeks). The TMD of both the BP and Tb displayed no significant changes at 2 and 4 weeks but decreased at 8 and 12 weeks. The mineral-to-collagen ratio showed a significant decrease from 4 weeks for the Tb and from 8 weeks for the BP after OA induction. Both the elastic modulus and hardness of the Tb showed a significant decrease from 4 weeks after OA induction. The BP showed a significant decrease in its elastic modulus from 8 weeks and its hardness from 4 weeks.
Conclusion:
The microarchitecture, mineralization and mechanical properties of subchondral bone changed in a time-dependent manner as OA progressed.
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基于信息-动机-行为技能模型的安徽省县级医院基本药物处方行为预测因素横断面研究Yun-Wu Zhao, Jing-Ya Wu, Heng Wang, Nian-Nian Li, Cheng Bian, Shu-Man Xu, Peng Li, Hua Lu, Lei Xu
中华医学杂志英文版2015年 128卷 21期
DOI: 10.4103/0366-6999.168046
摘要
Background:
The self-consciousness and practicality of preferentially prescribed essential medicines (EMs) are not high enough in county hospitals. The purposes of this study were to use the information-motivation-behavioral skills (IMB) model to identify the predictors of essential medicines prescribing behavior (EMPB) among doctors and to examine the association between demographic variables, IMB, and EMPB.
Methods:
A cross-sectional study was carried out to assess predictive relationships among demographic variables and IMB model variables using an anonymous questionnaire administered in nine county hospitals of Anhui province. A structural equation model was constructed for the IMB model to test the instruments using analysis of moment structures 17.0.
Results:
A total of 732 participants completed the survey. The average age of the participants was 37.7 ± 8.9 years old (range: 22–67 years old). The correct rate of information was 90.64%. The average scores of the motivation and behavioral skills were 45.46 ± 7.34 (hundred mark system: 75.77) and 19.92 ± 3.44 (hundred mark system: 79.68), respectively. Approximately half (50.8%) of respondents reported that the proportion of EM prescription was below 60%. The final revised model indicated a good fit to the data (χ2/df = 4.146, goodness of fit index = 0.948, comparative fit index = 0.938, root mean square error of approximation = 0.066). More work experience (β = 0.153, P< 0.001) and behavioral skills (β = 0.449, P< 0.001) predicted more EMPB. Higher income predicted less information (β = −0.197, P< 0.001) and motivation (β = −0.204, P< 0.001). Behavioral skills were positively predicted by information (β = 0.135, P< 0.001) and motivation (β = 0.742, P< 0.001).
Conclusion:
The present study predicted some factors of EMPB, and specified the relationships among the model variables. The utilization rate of EM was not high enough. Motivation and behavior skills were crucial factors affecting EMPB. The influence of demographic variables, such as income and work experience, on EMPB should be fully appreciated. Comprehensive intervention measures should be implemented from multiple perspectives.
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中美脑死亡标准比较Ze-Yu Ding, Qian Zhang, Jian-Wei Wu, Zhong-Hua Yang, Xing-Quan Zhao
中华医学杂志英文版2015年 128卷 21期
DOI: 10.4103/0366-6999.168047
摘要
Background:
Criteria for determining brain death (BD) vary between China and the United States. We reported the results of an investigation designed to compare procedures to determine BD in two countries.
Methods:
The latest criteria in the United states were published in 2010. The latest criteria in China were published in 2009. We used these two types of BD criteria to evaluate patients who were considered to be BD. The time, cost, and accuracy of the diagnosis were compared.
Results:
From January 1, 2012 to October 8, 2013, there were 37 patients which were applied for BD evaluation in the Neurological Intensive Care Unit of Beijing Tiantan Hospital. The cause of coma were known as subarachnoid hemorrhage (18 patients, 48.6%), intracerebral hemorrhage (8 patients, 21.6%), cerebral ischemia (9 patients, 24.3%), brain stem tumor (1 patient, 2.7%), and intracranial infection (1 patient, 2.7%). The clinical examinations were done for all of the patients except 1 patient who had low blood pressure. Three patients had brainstem reflexes that were excluded from BD. Twenty-five patients had apnea tests, and 20 tests were completed that were all positive. Confirmatory tests were completed differently: Transcranial Doppler (30 patients, positive rate 86.7%), electroencephalogram (25 patients, positive rate 100%), and somatosensory evoked potential (16 patients, positive rate 100%). Thirty-three patients were diagnosed BD by criteria of the United States. Only 9 patients were diagnosed BD by Chinese criteria. The use of time and money in the USA criteria was obviously fewer than those in Chinese criteria (P = 0.000).
Conclusion:
Compared with BD criteria of the United States, Chinese criteria were stricter, lower positive rate, more cost in money and time, and more reliable by families and doctors.
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8个中国家系遗传性甲状腺素运载蛋白淀粉样变性Ling-Chao Meng, He Lyu, Wei Zhang, Jing Liu, Zhao-Xia Wang, Yun Yuan
中华医学杂志英文版2015年 128卷 21期
DOI: 10.4103/0366-6999.168048
摘要
Background:
Mutations of transthyretin (TTR) cause the most common type of autosomal-dominant hereditary systemic amyloidosis, which occurs worldwide. To date, more and more mutations in the TTR gene have been reported. Some variations in the clinical presentation are often observed in patients with the same mutation or the patients in the same family. The purpose of this study was to find out the clinicopathologic and genetic features of Chinese patients with hereditary TTR amyloidosis.
Methods:
Clinical and necessary examination materials were collected from nine patients of eight families with hereditary TTR amyloidosis at Peking University First Hospital from January 2007 to November 2014. Sural nerve biopsies were taken for eight patients and skin biopsies were taken in the calf/upper arm for two patients, for light and electron microscopy examination. The TTR genes from the nine patients were analyzed.
Results:
The onset age varied from 23 to 68 years. The main manifestations were paresthesia, proximal and/or distal weakness, autonomic dysfunction, cardiomyopathy, vitreous opacity, hearing loss, and glossohypertrophia. Nerve biopsy demonstrated severe loss of myelinated fibers in seven cases and amyloid deposits in three. One patient had skin amyloid deposits which were revealed from electron microscopic examination. Genetic analysis showed six kinds of mutations of TTR gene, including Val30Met, Phe33Leu, Ala36Pro, Val30Ala, Phe33Val, and Glu42Gly in exon 2.
Conclusions:
Since the pathological examinations of sural nerve were negative for amyloid deposition in most patients, the screening for TTR mutations should be performed in all the adult patients, who are clinically suspected with hereditary TTR amyloidosis.
Review Article
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锁骨中段骨折的治疗Qing-Hua Sang, Zhi-Gang Gou, Hua-Yong Zheng, Jing-Tao Yuan, Jian-Wen Zhao, Hong-Ying He, Chuang Liu, Zhi Liu
中华医学杂志英文版2015年 128卷 21期
DOI: 10.4103/0366-6999.168068
摘要
Objective:
Through reviewing the relevant literature from the past decades, to summarize the assessment and management of fractures of the clavicle, and provide an overview of the clinical results of a range of treatment options.
Data Sources:
The data analyzed in this review are mainly from articles included in PubMed and EMBASE, published from 1960 to 2015.
Study Selection:
Studies involving assessment of fractures of the clavicle were reviewed. Further literatures were gathered regarding the conservative and surgical treatment of these fractures, including the methods of fixation and the surgical approaches used. Both conservative and surgical treatments were then compared and contrasted.
Results:
Through retrieving and reading the abstract, a total of 42 representative articles were selected, which covered all aspects of the conservative treatment and surgical treatment, and compared the advantages and disadvantages of different treatment options.
Conclusions:
Although the majority of recent data suggest that surgery may be more appropriate as it improves functional outcome and reduces the risk of complications, we recommend that the treatment should be individually assessed.
Perspective
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晚期慢性阻塞性肺疾病：创新和综合管理方法Hai-Xia Zhou, Xue-Mei Ou, Yong-Jiang Tang, Lan Wang, Yu-Lin Feng
中华医学杂志英文版2015年 128卷 21期
DOI: 10.4103/0366-6999.168073
摘要
慢性阻塞性肺疾病（COPD）是全世界发病率和死亡率的主要原因，并导致巨大且不断增加的经济和社会负担。到2020年，COPD将成为全球第三大死亡原因和第五大残疾原因。[
Short Communication
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双侧颈动脉弹性特性与急性缺血性脑卒中部位的比较Jun-Li Hu, Xian Li, Xi-Ming Wang, Zhao-Ping Cheng, Dong-Feng Chen, Shao-Chun Wang, Qing-Xia Kong
中华医学杂志英文版2015年 128卷 21期
DOI: 10.4103/0366-6999.168075
摘要
缺血性脑卒中占所有脑血管病的70%。颅外动脉和颅内动脉的严重狭窄和闭塞都是引起缺血性脑卒中的重要危险因素。基于世界范围内的广泛观察，颅内动脉粥样硬化是亚洲人、西班牙人和非洲人最常见的血管病变。[
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快速识别麻风分枝杆菌热休克蛋白65基因的聚合酶链反应-限制性片段长度多态性分析Zheng Zhao, Xi-Wan Liu, Jun Jia, Lin Cai, Jian-Zhong Zhang
中华医学杂志英文版2015年 128卷 21期
DOI: 10.4103/0366-6999.168076
摘要
麻风病由麻风分枝杆菌(麻风分枝杆菌），是一种影响皮肤和周围神经系统的慢性肉芽肿性疾病，通过与未经治疗或治疗不足的患者直接接触传播。[
Clinical Practice
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一例外侧盘状半月板部分切除后膝关节外翻畸形的经验教训Ming Li, Hua Liu, Zhi-Yong He, Zheng-Lin Di, Jun-Hui Zhang, Qun-Hua Jin
中华医学杂志英文版2015年 128卷 21期
DOI: 10.4103/0366-6999.168077
摘要
很少有研究关注外侧半月板切除术后下肢轴向排列的可能变化。在此，我们介绍了一例部分切除外侧盘状半月板后出现膝关节外翻畸形的患者。股骨远端截骨固定术成功治疗了该并发症。该病例表明，在半月板切除术前，我们应该更加注意盘状外侧半月板撕裂患者的下肢轴向排列，因为其中一些患者可能会出现严重的外翻倾斜。
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脑死亡患者呼吸功能明显恢复Ze-Yu Ding, Qian Zhang, Jian-Wei Wu, Zhong-Hua Yang, Xing-Quan Zhao
中华医学杂志英文版2015年 128卷 21期
DOI: 10.4103/0366-6999.168079
摘要
脑死亡（BD）是指某人的大脑停止功能，即使他们的心脏可能使用机器保持跳动。脑功能停止后，躯体功能通过机械通气长期维持。对死亡患者进行进一步治疗是不合适的。因此，在许多国家，法律规定可以合法地从被诊断为BD的患者身上移除治疗，并且可以开始捐献器官用于移植。
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术前免疫治疗对抗N-甲基-D-天冬氨酸受体脑炎患者麻醉的潜在影响Ya-Hong Gong, Ming-Zhu Zhang, Xiu-Hua Zhang, Hong-Zhi Guan, Xie-Qun Xu, Yu-Guang Huang
中华医学杂志英文版2015年 128卷 21期
DOI: 10.4103/0366-6999.168080
摘要
抗N-甲基-D-天冬氨酸受体（抗NMDA-R）脑炎是一种新认识的神经自身免疫性疾病。患者通常表现为一系列神经和精神综合征，包括记忆障碍、癫痫发作、运动障碍、自主神经系统功能障碍等。抗NMDA-R脑炎通常影响年轻女性，畸胎瘤是近47%诊断患者中常见的共存疾病。先前的研究表明，畸胎瘤切除作为目前的一线治疗，可能会提高自身免疫治疗的有效性，降低复发的发生率。[
Corrigenda
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勘误表：中国老年人房颤的患病率和危险因素：来自中国纵向健康长寿调查的结果中华医学杂志英文版2015年 128卷 21期
DOI: 10.4103/0366-6999.168081
摘要
在文章“中国老年人房颤的患病率和危险因素：来自中国纵向健康长寿调查的结果”中，该文章出现在第128卷第18期第2426-2432页中华医学杂志,[
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勘误表：C的比较50异丙酚—瑞芬太尼靶控输注与老年和年轻患者意识丧失和疼痛刺激反应时脑电双频指数的研究中华医学杂志英文版2015年 128卷 21期
DOI: 10.4103/0366-6999.168086
摘要
由于作者的粗心，在《C50用于异丙酚-瑞芬太尼靶控输注和老年和年轻患者意识丧失和对疼痛刺激反应时的脑电双频指数”，发表于1994-1999年第15期第128卷中华医学杂志,[
Correspondence
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德尔菲法在神经根型颈椎病保守治疗中的应用Jian Li, Wen-Yi Zhu, Lei Zang, Yong Hai, Peng Du, Ning Fan, Yu Zhou, Li-Kun An
中华医学杂志英文版2015年 128卷 21期
DOI: 10.4103/0366-6999.168082
摘要
致编辑：神经根型颈椎病(CR)是一种常见的问题，其发作性病程影响着很大一部分人群。[
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双侧全膝关节置换术后严重急性呼吸窘迫综合征Lu-Lu Ma, Xue-Rong Yu
中华医学杂志英文版2015年 128卷 21期
DOI: 10.4103/0366-6999.168083
摘要
致编者：全膝关节置换术（TKA）是骨关节炎患者减轻疼痛和改善功能最常见的骨科手术之一。然而，TKA与围手术期发病率和死亡率的高风险相关。我们报告了一例在双侧TKA手术后发生严重急性呼吸窘迫综合征（ARDS）的患者。
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一名中国婴儿苯丙氨酸羟化酶缺乏症和桔霉素缺乏症Jun Ye, Wen-Juan Qiu, Lian-Shu Han, Hui-Wen Zhang, Xue-Fan Gu
中华医学杂志英文版2015年 128卷 21期
DOI: 10.4103/0366-6999.168084
摘要
编者：基于串联质谱（MS/MS）的新生儿扩大筛查于2003年首次在新华医院儿科内分泌/遗传学中引入。该筛查有望检测导致新生儿血液苯丙氨酸（Phe）继发性升高的遗传疾病。[
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十二指肠逆行性肠套叠：消化性溃疡的罕见并发症Ayşe Kefeli, Sebahat Basyigit, Abdullah Ozgur Yeniova, Metin Uzman, Bora Aktaş
中华医学杂志英文版2015年 128卷 21期
DOI: 10.4103/0366-6999.168085
摘要
致编者：一名58岁男性主诉上腹痛、非胆汁性呕吐和进行性腹胀，持续1个月。没有重要的病史。除腹胀伴蠕动过度活跃外，体格检查均在正常范围内。实验室检查正常，但血尿素氮：35 mg/dl，肌酐：1.45 mg/dl，血红蛋白：10.5 g/dl，白细胞计数：17,000/mm3.
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