筛前动脉三维交互观察在鼻微创手术中的定位意义

目的探讨筛前动脉骨管鼻窦CT三维交互观察在鼻微创手术中的定位意义。方法对80例160侧薄层鼻窦CT数据,三维交互定位,测量筛前动脉骨管的长度、角度及与筛顶的距离,并观察其与各解剖标志的位置关系。结果筛前动脉的长度为（6.9±1.8）mm;与侧板所形成的角度为（126.6±16.0）°;筛前孔与筛顶的距离（7.0±2.2）mm;骨管中部与筛顶的距离（2.8±2.0）mm;以上数据双侧差异无显著性（P〉0.05）。悬吊型占35%（56/160）。160例筛前动脉骨管冠状平面鼻甲出现的情况：中甲垂直部119侧（74.4%）,中鼻甲基板40侧（25.0%）,上鼻甲1侧（0.6%）;矢状位上,筛前动脉骨管位于钩突与筛泡基板之间2侧（1.2%）,筛泡基板上38侧（23.8%）,筛泡基板与中鼻甲基板之间48侧（30.0%）,中鼻甲基板上72侧（45.0%）。结论三维平面交互定位可以精确测量及准确定位筛前动脉骨管,对鼻微创手术具有指导意义。     

先天性鼻筛窦道假性三鼻孔畸形的诊断和整形修复

目的探讨先天性鼻筛窦道假性三鼻孔畸形的发病原因、诊断标准和有效治疗方法。方法对1993年2月至2006年3月13例先天性鼻筛窦道假性三鼻孔畸形从发病原因、临床表现、鉴别诊断、手术方法等进行了系统研究。采用窦道切除、重建再造筛窦开口、鼻表浅肌肉腱膜瓣移植、鼻唇沟皮瓣移植、鼻翼软骨肌肉环修复重建等综合手术方法一期整形修复。结果13例术后均自觉症状消失，双侧对称，外形满意，无并发症发生。结论应用窦道切除、再造重建筛窦开口、鼻唇沟皮瓣移植、鼻表浅肌肉腱膜瓣移植及鼻翼软骨肌肉环修复重建等综合手术方法一期整形修复，是治疗先天性鼻筛窦道假性三鼻孔畸形的安全有效方法。     

降低新生儿听力筛查复筛率的方法探讨

目的探讨降低新生儿听力筛查复筛率的方法，总结其临床应用价值。方法选取笔者所在医院2010年5月～2011年10月3000例新生儿，均采用丹麦MADSENOAE耳声发射仪进行新生儿听力筛查，随机分为观察组和对照组，各1500例，观察组对新生儿进行相关干预，对照组采取常规筛查方法，观察两组新生儿听力筛查的复筛率，进行统计学分析。结果观察组的新生儿听力复筛率为6．5％，对照组复筛率为19．5％，两组新生儿听力筛查的复筛率对比差异显著，具有统计学意义（P〈0．01）。结论在新生儿听力筛查前给予准备良好的筛查环境，合理选择筛查的时间，与家长沟通保证新生儿在良好的筛查状态，配合工作人员采取娴熟专业的操作，能有效降低新生儿听力筛查的复筛率。     

中国大陆中小学生脊柱侧凸的患病特点：关于72项研究的Meta分析

【摘要】 目的：基于流行病学调查进行Meta分析，明确中国大陆中小学生脊柱侧凸的患病率和时间-空间分布特征。方法：检索数据库为PubMed、Scopus、万方数据库、中国知网、国家科技图书文献中心及维普网，检索时间为1980年1月～2020年12月。纳入文献为中小学生脊柱侧凸筛查相关横断面研究，诊断方法涉及初筛、二筛或三筛的物理检查、躯干旋转角测量、云纹图和X线检查等，两名人员独立提取数据（包括文献作者和发表年份、地区、筛查人数、初筛、二筛、三筛的阳性人数和侧凸类型等）并进行文献质量评价。本研究依据文献时间（2000年前后）和调查地区（东、中、西部）进行亚组分析；整体Meta分析和亚组分析结果用比值比（odds ratios，ORs）和95%可信区间（confidential interval，CI）表示。研究主要结果为侧凸初筛阳性率和确诊率，此外该研究还拟探讨患病率与地理因素的相关性。结果：研究共纳入72篇文献涉及28省共2493217名研究对象。整体初筛和二筛阳性率分别为（4.40±2.81）%和（2.18±1.68）%，确诊率平均为（1.23±1.06）%，特发性脊柱侧凸（idiopathic scoliosis，IS）平均患病率为（1.16±0.94）%。Meta分析提示初筛和三筛女性阳性率均高于男性（OR=1.36，95%CI=1.14-1.62和OR=1.57，95%CI=1.37-1.80）。不论研究在2000年前后以及不论在东、中、西部开展筛查，亚组分析结果均与整体一致。轻度侧凸者占79.5%，IS在东部地区患病率低于中部地区（P=0.030）。患病率与年份和地理因素（经济发达程度、纬度、海拔）均无明确线性相关性，但患病率在2008年后存在逐年上升趋势。结论：中国大陆脊柱侧凸患病率为1.23%且女性为男性的1.57倍；患病率自2008年后存在逐年上升趋势。     

鼻内镜下射频热凝鼻后下神经和筛前神经治疗37例变应性鼻炎疗效观察

目的分析鼻内镜下射频热凝鼻后下神经和筛前神经治疗变应性鼻炎(allergic rhinitis,AR)的效果。方法对37例AR患者采用鼻内镜下射频热凝鼻后下神经和筛前神经治疗。随访6~12个月,比较治疗前后临床症状评分变化、疗效及复发率。结果本组显效19例,有效15例,无效3例。总有效率为91.89%(34/37)。治疗后流涕、鼻塞、喷嚏、鼻痒等症状评分均较治疗前明显改善,差异有统计学意义(P0.05)。6个月随访时无1例复发,12个月随访时复发1例(2.70%)。结论采用鼻内镜下射频热凝鼻后下神经和筛前神经治疗AR,可有效缓解患者临床症状,提高治疗效果,减少复发率。     

唐筛高危孕妇临床结果分析

目的减少新生儿出生缺陷率，优生优育。方法分析51例孕14～21周、唐筛结果大于1／250的高危孕妇的临床资料。结果染色体异常3例；先心病3例；早产4例。结论唐筛的高危孕妇出生缺陷率高，为降低出生缺陷，提倡产前筛查并重视高危的结果，尽量选择自然分娩。     

介入动脉栓塞治疗顽固性鼻出血

目的探讨鼻出血介入治疗的临床效果、并发症及注意事项。方法采用介入治疗技术及数字减影血管造影(DSA)技术,对64例顽固性鼻出血患者进行超选择性上颌动脉和/或面动脉栓塞。结果60例患者达到立即止血目的,4例因合并筛动脉出血,栓塞后再经筛动脉结扎,出血得到控制,1例患者于栓塞后40分钟患侧视力逐渐丧失,8h后经眼动脉溶栓治疗,眼动脉恢复血运,但视力未恢复。结论在数字减影技术和介入治疗技术下,对顽固性鼻出血进行超选择性动脉栓塞是有效、快捷的止血方法,但对由筛前、筛后动脉所致的鼻出血应配合动脉结扎手术,并注意眼动脉血栓形成的可能。     

2926例学龄儿童尿液筛查分析

目的通过实施学龄儿童慢性肾脏病（chronic kidney disease,CKD）的尿液筛查模式,及早发现和诊断CKD,建立“初级登记、二级筛查随访、三级诊治严重患儿”的三级管理模式,从而使筛查出的肾脏病患儿得到有效管理,最终减少终末性肾病的发生率。方法选择小学一年级和六年级的学生3015名,由学校发放《告知尿液筛查告家长书》及专用试管留取晨尿。采用尿液试纸目测法检测尿液,将2次尿液筛检查均出现潜血、蛋白质或白细胞阳性者转至随州市妇幼保健院就诊,行尿液镜检或尿沉渣分析,阳性者定为尿检异常,对其中符合转诊条件者转诊至三级医院接受治疗,对不符合转诊条件者进行治疗或建档随访。结果完成尿液筛查总人数2926例,一年级有1533例（占53.39%）,六年级有1393例（占47.61%）。第一次尿液筛阳性人数533人（占18.22%）,第二次尿液筛阳性人数126人（占4.31%）。二级医院尿检阳性人数33人（占1.13%）,其中一年级23例（占0.79%）,六年级10例（占0.34%）,男生10例（占0.34%）,女生23例（占0.79%）。有3例患儿根据病情转诊至三级医院,17例尿白细胞阳性患儿经本院治疗后复查尿检转阴,6例确诊肾积石给予排石药物治疗,剩余7例每6月复诊随访1次,并建立随访档案。结论儿童 CKD尿液筛查模式具有经济、可操作性强等优点,能有效筛查出肾脏病患儿,其三级管理模式能对筛查出的患儿进行有效的管理,适合我国国情,适合在基层推广运用。     

鼻内窥镜在微波热凝筛前神经治疗变应性鼻炎的临床观察

目的探究鼻内窥镜下微波热凝筛前神经治疗变应性鼻炎的临床效果。方法选取变应性鼻炎患者78例作为实验对象,给予其鼻内窥镜下微波热凝筛前神经治疗,分析治疗效果及1 a后随访疗效。结果本组78例患者中显效70例,有效5例,无效3例,总有效率为96.15%;1 a后随访,显效67例,有效4例,无效8例,总有效率为89.74%,远近期疗效皆很显著。本组患者中无并发症发生,无不良反应。结论鼻内窥镜下微波热凝筛前神经治疗变应性鼻炎,操作简单,效果显著,疗效稳定,值得临床推广应用。     

鼻额筛眶区损伤的整形美容修复治疗体会

目的:探讨面部鼻额筛眶区外伤时的修复,最大限度减少该区域畸形的发生,恢复面部容貌的整形外科技术.方法:对68例鼻额筛眶区外伤和(或)伴有骨折的患者行骨折整复,并采用整形外科技术缝合.结果:所以手术均获得满意修复,随访一年以上,愈合后无明显畸形,伤口痕迹纤细.结论:整形外科技术在鼻额筛眶区外伤后的急诊应用,可最大限度地恢复面容,不留明显疤痕.     

Effects of Fat Preparation Methods on the Viabilities of Autologous Fat Grafts

Fat grafts are commonly used in plastic surgery, but their unpredictable absorption rates are a considerable disadvantage. Furthermore, no agreement has been reached regarding the method that best enables fat graft survival. This study aimed to evaluate the effects of different preparation methods on fat graft viability. Fat tissue was harvested from the remnants of transverse rectus abdominis musculocutaneous (TRAM) flaps by syringe aspiration. Harvested fat tissue was prepared using three different methods: centrifugation, metal sieve concentration, and cotton gauze concentration. To evaluate the viabilities of fat cells, XTT assays were performed. For the study, 18 nude mice were allocated to three groups: the centrifugation, metal sieve, and cotton gauze groups (6 mice per group). Prepared fat (1 ml) was injected into the nuchal area of the mice, and 12 weeks later, grafts were dissected to determine graft survival rates and subjected to histologic analysis. No significant differences were observed in graft survival rates and histologic findings (necrosis and vascularity) between the three groups. However, histologic analysis found the metal sieve group to have significantly lower fat cell viability and more inflammation than the other two groups. The findings suggest that the closed centrifugation technique has no advantage over the open cotton gauze technique in terms of fat graft viability, and that the metal sieve concentration method is deficient as a preparation method because it can cause grafted fat degradation.     

一种适用于大规模高效快速分离培养人头皮毛乳头细胞的方法

目的:寻求适合于毛囊组织工程的大规模高效快速分离培养人头皮毛乳头细胞的方法。方法:将含有毛囊中下部的皮下组织剪碎,加入胶原酶Ⅰ消化2h,悬液经400目筛网过滤,收集被筛网截留的毛乳头进行培养,计算其贴壁率,绘制细胞生长曲线,并与显微解剖法相比较。结果:用这种方法成功分离培养了人头皮毛乳头细胞。结论:消化过滤法是一种能够大规模高效、快速分离培养人头皮毛乳头细胞的方法。     

Echinococcal cyst beyond the pulmonary sieve.

This is a presentation of 10 unusual cases of hydatid cyst beyond the pulmonary sieve. One of these cases has not been described previously. Some comments and a discussion are included.     

判定一般素数的新方法

本文提供了一种判定任意数是素数还是合数的新方法,以该方法为数字模型编制的程序可以对单个自然数作出判断,也可以在一个区段内定出全部素数与合数,程序中断后重新启动也不必重复已做过的工作,这些方面都比筛法好。对该方法进行了理论证明,程序运行后取得了很好的成绩。     

S-萘普生的不对称合成

研究了以 6 甲氧基 2 丙酰基萘和 ( 2R ,3R) 酒石酸二甲酯为原料 ,用分子筛代替甲磺酸作催化剂合成了缩酮 2 乙基 2 ( 6 甲氧基 2 萘基 ) 1 ,3 二氧杂环戊烷 ( 4R ,5R ) 二羧酸二甲酯 ,此缩酮经过不对称溴化、水解、重排、脱溴反应后 ,得到了S -( ) 萘普生 ,总产率达 4 2 .5% .本合成路线具有反应条件温和 ,操作方便 ,三废少等优点 .     

Circulating form of beta-2-microglobulin in dialysis patients

The circulating profile of beta-2-microglobulin (beta 2M) was determined in 8 end-stage renal disease patients on long-term dialysis (6 on hemodialysis, 2 on CAPD) by measuring beta 2M in different fraction after molecular sieve separation of their sera. Four patients had carpal tunnel syndrome with demonstrated amyloid in excised wrist tissues of which 2 were positive for beta 2M. In all patients despite very high blood levels (34.3-63.1 mg/l), beta 2M eluted exclusively as a single peak in the molecular weight region of about 12,000 daltons on a calibrated Sephacryl S-200 column. Recoveries from within the peak accounted for 96% of the applied beta 2M serum concentrations. These results were confirmed by molecular sieve separation of the enriched beta 2M-containing fractions by high-pressure liquid chromatography. We conclude that immunoreactive beta 2M in dialysis patients circulates as an intact monomer without evidence for the formation of aggregates or fragments. The pathogenesis of tissue deposition of this low-molecular-weight protein and its polymerisation to form a specific amyloid remains to be defined.     

Intracaval devices for the prevention of pulmonary embolism

Intracaval occlusion for the prevention of pulmonary embolism was studied in a series of forty-six mongrel dogs. Partial or complete occlusion of the inferior vena cava was achieved by the use of Silastic balloons, Dacron-covered springs, and sieve type umbrella filters. The animals were studied by angiography, venous pressure measurements, blood cultures, roentgenograms of the lung, and the introduction of experimental emboli.     

Treatment of donor wounds after cutting of full-thickness skin transplants with a dermatome]

An analysis of the results of the treatment of 180 donor wounds following cutting off thick or full-thickness grafts by means of a dermatome in 123 patients with post-burn deformities and contractures is presented. The healing period variants, depending on the thickness of the grafts and on the treatment method, have been found. The authors recommend to cover the donor wounds with thin grafts or with sieve grafts.     

Extraction of nitric oxide and nitrogen dioxide from an oxygen carrier using molecular sieve 5A

Nitric oxide (NO) is effective in the management of pulmonary hypertension and shunt-related hypoxia. Nitrogen dioxide (NO2) is formed when the gas is delivered with oxygen. Both oxides of nitrogen have well recognized adverse effects. The scavenging properties of several forms of soda lime have been investigated. A gas flow containing NO 70 ppm and NO2 5 ppm in oxygen was introduced into a vertically mounted Waters' canister containing: (i) 125 g of molecular sieve 5A (a calcium aluminosilicate zeolite) and (ii) 135 g of soda lime containing a potassium permanganate marker. NO and NO2 concentrations were measured at hourly intervals at the entry and exit points using an electrochemical analyser. Extraction ratios (gradient/ inlet x 100) were calculated for a 24-h period. High extraction ratios (in excess of 90%) of NO and NO2 were observed with both compounds for up to 1 h but these declined rapidly after this time with soda lime. In contrast, the molecular sieve produced extraction ratios in excess of 98% for both gases over the 24-h period. We conclude that the molecular seive 5A is a highly effective scavenger of NO and NO2.      

Bone-derived macrophage chemotactic factors: Methods of extraction and further characterization

Summary Mononuclear phagocytes have been implicated as important cellular elements in the process of bone resorption. We have postulated that the recruitment and migration of mononuclear phagocytes to bone occurs via a mechanism(s) in which bone-derived chemotactic factors (BDCF) are released from foci undergoing resorption. In the experiments presented here we have used newborn mouse calvaria and examined a variety of extraction protocols, both dissociative and nondissociative, as means of obtaining stable and reproducible chemotactic activity for mouse peritoneal macrophages. Chemotaxis and chemokinesis were assessed using a multiwell chamber modification of the Boyden transfilter method. Further, we have attempted to purify the BDCF by both molecular sieve and anion exchange chromatography. Our results indicated that nondissociative extraction with 0.5 M EDTA in the presence of 1% DMSO yielded the most potent and reproducible chemotactic activity. The results of molecular sieve and anion exchange chromatography suggested that there were several BDCF activities in these preparations and that their molecular weights were probably in the range of from 14,000–67,000 daltons. Anion exchange chromatography also demonstrated the presence of a fraction, eluted with 2 M NaCl, with high chemotactic activity and minimal protein concentration. These observations confirmed the suggestion that there are several macrophage chemotactic factors in bone which have as yet to be identified, and suggest methods for pursuing their isolation.