Faculty of Anaesthetists of the Royal College of Surgeons of Ireland

The Faculty of Anaesthetists of the Royal College of Surgeons of England, 35–43 Lincoln's Inn Fields, London WC2A 3PN. Telephone: 01-405 3474.     

深圳市某两所小学流行性腮腺炎突发疫情的流行病学分析

目的：通过对深圳市某两所小学发生的流行性腮腺炎突发疫情的流行病学特点及差异性进行分析,为制定科学、高效的防控策略提供科学依据。方法2013年5～7月深圳市大鹏新区某两所小学爆发流行性腮腺炎,以学校为整体研究对象,分别标记为学校A（24个班,学生1210例）和学校B（27个班,学生1274例）,对比两所小学的疫情流行病学差异性。结果分析发现,学校A流行性腮腺炎发病率为4.30%,发病班级所占比54.17%,均较学校B1.73%和29.63%高,对比差异有统计学意义（P＜0.05）;分析显示学校A学生出现疫病平均年龄为（11.2±1.1）岁,较学校B（9.34±1.0）岁,对比差异明显（P＜0.05）;且两组疫病患儿在接种疫苗率对比上差异无统计学意义（P＞0.05）;但疫情发生时,学校B疫苗紧急接种率明显高于学校A,对比差异有统计学意义（P＜0.05）。结论小学作为流行性腮腺炎爆发的主要场所之一,疫病爆发高峰季节前,针对易感染人群给予相应的疫苗接种等预防控制措施,同时加强流行性腮腺炎的监测,对于降低感染人群数量,减轻、遏制疫情有着积极的意义,值得相关防控部门重视。     

胫骨干骨折的手术治疗对策

目的：明确不同固定器械在胫骨干不同骨折类型固定中的特点，以指导临床应用。方法：68例胫骨干骨折，行加压钢板螺钉、交锁髓内钉、单侧外固定架固定后，作临床疗效分析。结果：加压钢板固定组42例，感染5例，骨不连1例，平均愈合时间3．8个月；交锁髓内钉固定组13例，无感染及骨不连，平均愈合时间5．4个月；单侧外固定架组13例，骨不连1例，踝关节背伸受限3例，平均愈合时间4．5个月。结论：胫骨骨折交锁髓内钉固定并发症少，功能恢复好，适用范围广，但要注意及时进行动力加压。加压钢板及外固定架固定应选择各自的最佳适应证，以达到理想的疗效。     

Analysis of a series of cases of liver metastasis of colorectal carcinoma

The Authors present a six years case-report concerning 135 patients operated on colo-rectal carcinoma (82 of them are still followed up). The incidence of hepatic metastases (synchronous and metachronous) has been 30.37% in all. The preoperative ultrasonography has shown an 11% about margin mistake to visualize secondary lesions of liver. They have acknowledged the intraoperative ultrasonography very useful to visualize occult metastases and to guide an exeresis operation. The resectability of hepatic metastases from colo-rectal cancer has been of 12.19%. Synchronous forms have been rarely operable (5.88%) because they are constituted by multiple and disseminated lesions. They have found an higher incidence of operable forms among the metachronous metastases (42.85%), whose average time of appearance from the primary operation has been about 13 months. The operative mortality and the complications following hepatectomy have been null. The average survival time from operation has been over 22 months. Therefore they recognized the importance of a careful follow-up to find precociously operable lesions.     

Comparative evaluation of the methods of treatment of dislocations of the clavicle

An analysis of treatment was made in 93 patients divided into three groups: conservative treatment (11 patients), operations by traditional methods (28 patients), surgery using constructions of titanium nickelide (54 operations). It was found that the conservative treatment of complete acromioclavicular end dislocation was followed by a repeated displacement, development of deforming arthrosis and deformity of the area of injury. Transcapticular fixation of acromioclavicular end dislocation resulted in the development of deforming arthrosis (68%), the incidence of this complication depending on the kind of operation. The greatest inclination of the construction to migration was noted after fixation with wires. After the application of a titanium nickelide construction the most frequent process was resorption of the bone around the construction in the shape of a hook (36%) which resulted in some patients in subluxation (11%) and development of deforming arthrosis (4.5%).