豫南地区150名成年女性腹部皮下脂肪厚度及体积测量研究

目的为了解成年女性腹部皮下脂肪堆积及分布情况,获得腹部脂肪厚度及体积量学指标.方法用全身彩超测试腹部皮下脂肪厚度,在586计算机UCDOS环境下,应用Foxbase+下的生物医学数据处理程度进行计算分析.结果脐部、上腹部、下腹部皮下脂肪明显高于其它部位P＜0.01,当以上区域皮下脂肪厚度分别超过25mm、24mm、12mm时,应做为脂肪抽吸术的适应证范围.并提出了计算腹部皮下脂肪厚度及体积的方程式.结论本测量方法,较为准确的测量出成年女性腹部皮下脂肪的厚度、体积及范围,其结果对皮下脂肪的厚度、体积及范围,其结果对皮下脂肪抽吸术适应证的选择,抽吸量的估计,抽吸范围的确定具有一定的指导意义.     

豫南地区150名成年女性腹部皮下脂肪厚度及体积测量研究

目的 为了解成年女性腹部皮下脂肪堆积及分布情况，获得腹部脂肪厚度及体积量学指标。方法 用全身彩超测试腹部皮下脂肪厚度，在５８６计算机ＵＣＤＯＳ环境下，应用Ｆｏｘｂａｓｅ＾＋下的生物医学数据处理程度进行计算分析。结果 脐部、上腹部、下腹部皮下脂肪明显高于其它部位Ｐ〈０．０１，当以上区域皮下脂肪厚度分别超过２５ｍｍ、２４ｍｍ、１２ｍｍ时，应做为脂肪抽吸术的适应证范围。并提出了计算腹部皮下脂肪厚度及体积的方程式。结论 本测量方法，较为准确的测量出成年女性腹部皮下脂肪的厚度、体积及范围，其结果对皮下脂肪的厚度、体积及范围，其结果对皮下脂肪抽吸术适应证的选择，抽吸量的估计，抽吸范围的确定具有一定的指导意义。     

腹壁皮下脂肪两种测量方法的比较

目的：探讨腹壁皮下脂肪厚度两种测量方法的特点，并结合吸脂情况，比较其准确性与优、缺点。方法：采用指程法（卡尺法）测量皮褶厚度及彩超法测量皮下脂肪厚度，并对其结果进行比较，以探讨更有效的测量方法。结果：通过160例测量结果比较可以看出，卡尺法测量皮褶厚度与彩超法测量皮下脂肪厚度比较，经统计学检验，P＜0．01，有显著性差异。结论：卡尺法测量皮褶厚度与彩超法测量皮下脂肪厚度相比，前者准确性差，但简单易行，术前术中可双性高，实用性强，后者准确性高。     

超重及肥胖患者臀部肌内注射深度的探讨

目的探讨成人超重及肥胖患者臀部肌内注射的适宜深度。方法抽取超重及肥胖者200例（男、女各100例）,测量身高、体质量,计算体重指数（BMI）,根据BMI判断超重与肥胖;采用B超测定其臀部肌内注射部位皮下脂肪厚度。结果男性皮下脂肪厚度为（25．7±4．3）mm,女性为（25．8±3．9）mm;男、女性皮下脂肪厚度≥21．3mm（常规肌内注射的深度）者分别为92．0％、95．0％。男性、女性超重与肥胖者皮下脂肪厚度比较,差异无统计学意义（均P〉0．05）。结论常规肌内注射的深度对超重或肥胖者已不适用,注射时针头仅能到达皮下脂肪层而未达臀大肌,存在医疗隐患,需积极寻求解决方法。     

肥胖患者腹部切口皮肤及皮下脂肪浅层贯穿缝合法（附162例临床分析）

目的 改进肥胖患者腹部手术切口的缝合技术。方法 以腹壁皮下脂肪厚度〉2．5cm作为肥胖的标准，将241例肥胖者随机分为观察组（162例）和对照组（79例）。观察组腹部手术切口皮肤及皮下脂肪浅层用间断贯穿缝合并放置引流条引流的缝合方法；对照组用传统的皮肤皮下脂肪分层缝合法或贯穿全层缝合法。将两组进行比较，观察其切口脂肪液化、感染、裂开的发生率和手术后切口完全愈合的时间。结果 观察组脂肪液化、感染、皮下脂肪层完全或部分裂开的发生率较对照组明显降低（P〈0．01）；切口愈合时间明显缩短（P〈0．01）。结论 在缝合肥胖者的腹部切口时，贯穿缝合皮肤及浅层皮下脂肪同时加引流条引流的方法是一种有效的预防脂肪液化的缝合方法。此方法操作方便，节省时间。     

腹壁皮下脂肪两种测量方法的比较

目的探讨腹壁皮下脂肪厚度两种测量方法的特点,并结合吸脂情况,比较其准确性与优、缺点.方法采用指捏法(卡尺法)测量皮褶厚度及彩超法测量皮下脂肪厚度,并对其结果进行比较,以探讨更有效的测量方法.结果通过160例测量结果比较可以看出,卡尺法测量皮褶厚度与彩超法测量皮下脂肪厚度比较,经统计学检验,P＜0.01,有显著性差异.结论卡尺法测量皮褶厚度与彩超法测量皮下脂肪厚度相比,前者准确性差,但简单易行,术前术中可比性高,实用性强;后者准确性高.     

腹壁皮下脂肪两种测量方法的比较

目的　探讨腹壁皮下脂肪厚度两种测量方法的特点 ,并结合吸脂情况 ,比较其准确性与优、缺点。方法　采用指捏法 (卡尺法 )测量皮褶厚度及彩超法测量皮下脂肪厚度 ,并对其结果进行比较 ,以探讨更有效的测量方法。结果　通过 160例测量结果比较可以看出 ,卡尺法测量皮褶厚度与彩超法测量皮下脂肪厚度比较 ,经统计学检验 ,P <0 .0 1,有显著性差异。结论　卡尺法测量皮褶厚度与彩超法测量皮下脂肪厚度相比 ,前者准确性差 ,但简单易行 ,术前术中可比性高 ,实用性强 ;后者准确性高     

选择性非接触式射频设备对亚洲人腰腹部减脂塑形的疗效及安全性研究

目的:观察选择性非接触式射频设备对亚洲人腰腹部减脂塑形的治疗效果及安全性。方法:选取16例健康就医者,使用选择性非接触式射频设备(BTL Vanquish征服,英国BTL公司)进行腰腹部照射减脂和塑形。每次治疗45min,每周治疗1次,总共4次,不接触皮肤。观察治疗前后就医者腹围、卡尺测量皮下脂肪厚度和彩超测定皮下脂肪厚度变化,治疗疼痛度、主观评分及安全性。结果:16例就医者治疗4次后随访3个月,治疗前平均腹围、平均腹部卡尺测量皮下脂肪厚度、平均腹部彩超测量皮下脂肪厚度、平均体重分别为(97.94±8.64)cm、(40.97±3.54)mm、(30.93±6.48)mm、(72.07±11.96)kg,治疗后为(94.15±8.11)cm、(37.07±2.91)mm、(26.44±4.70)mm、(70.50±11.50)kg,差异有统计学意义(P0.05)。就医者主观评价腰腹部平坦度和皮肤紧实度得到改善,治疗过程中未观察到不良反应。结论:选择性非接触式射频设备可有效进行腰腹部减脂塑形且安全有效。     

腹部CTA在肝固有动脉肝外起源变异中的应用

目的 应用256排螺旋CT进行腹部CT血管造影（CTA）观察肝固有动脉肝外起源、走行、管径、分支及变异的影像解剖学情况,为临床上腹部疾病的诊治提供参考依据。方法 收集2017年6月至2019年6月间在湖南中医药大学附属第一医院影像科行上腹部CTA的80例患者影像资料,统计和分析肝固有动脉及其分支的变异情况,测量其相关数据。结果 本组80例患者肝固有动脉及其分支肝外起源变异15例（18.75%）,其中肝固有动脉长度为（45.44±22.76）mm,起点处内径为（2.66±1.68）mm。肝左动脉长度为（43.68±18.75）mm,起点处内径为（3.23±1.09）mm;肝右动脉长度为（43.10±18.50）mm,起点处内径为（3.26±1.08）mm;肝左动脉与肝右动脉的夹角为（75.22±22.36）°;肝中动脉的长度为（59.21±23.75）mm,起点处内径为（1.99±0.71）mm,与肝左动脉之间的角度为（84.81±39.94）°,与肝右动脉之间的角度为（57.31±17.28）°。结论 肝固有动脉及其分支肝外起源变异复杂多样,腹部CTA可真实、准确地反映其活体形态学,通过测量其长度和直径并加深对变异肝动脉的认识,将有助于上腹部外科手术的顺利实施。     

CT测量腹部脂肪相关参数诊断冠心病

目的 探讨CT测量腹部脂肪相关参数对诊断冠心病的价值。方法 对211例疑诊冠心病患者于30天内行冠状动脉造影及腹部CT平扫，分析冠心病发生危险因素，采用ROC曲线观察各危险因素单独及联合诊断冠心病的效能。结果 211例中，经冠状动脉造影明确诊断冠心病112例，非冠心病99例。单因素分析结果显示，冠心病与非冠心病患者间年龄、性别、吸烟、糖尿病、高血压、高密度脂蛋白胆固醇（HDL-C）、内脏脂肪（VAT）面积、皮下脂肪（SAT）面积及VAT面积/SAT面积（VAT/SAT）差异均有统计学意义（P均<0.05），体质量指数（BMI）、腹围（WC）及腹部总脂肪（TAT）面积差异均无统计学意义（P均>0.05）。多元Logistic回归分析结果显示，年龄、吸烟、糖尿病及VAT/SAT为冠心病独立危险因素（P均<0.01）。ROC曲线显示年龄、吸烟、糖尿病及VAT/SAT诊断冠心病的AUC分别为0.67、0.61、0.62及0.73，4者联合的AUC为0.80，高于各参数单独检测（P均<0.05）。结论 CT测量的腹部脂肪相关参数可用于诊断冠心病。     

The outside-in subcutaneous arthroscopically assisted lateral retinacular release: a new technique

Arthroscopic lateral retinacular release in the knee has been used extensively for the treatment of patellar pain and instability. The release can be performed using a number of techniques, but achieving access to the retinaculum can often be difficult, particularly in obese patients. We describe a simple modification of an arthroscopically assisted method, which utilises electrosurgery through a subcutanous channel to perform an outside-in release.     

Treatment of Achilles tendon injuries in athletes]

165 athletes with injuries to the Achilles tendon were under observation of the authors; 4 of them had sustained open traumas and 161 -- subcutanous ones. Surgical intervention was the main method of treatment. The G. D. Nikitin's method of autoplasty is indicated in fresh injuries, a combined autoalloplasty, according to the authors' method, -- in old ones. Late results were followed up in 141 patients, all of them showed good outcome. Primary surgical treatment of the wound and suture of the Achilles tendon are indicated in open injuries to the Achilles tendon.     

Tubeless cutaneous ureterostomy through a single stoma with new extraperitoneal ureteral route up to stoma

Tubeless cutaneous ureterostomy through a single stoma has been said to be difficult to establish in patients with normal ureters or normal ureters combined with thick fatty abdominal wall, because of the poor blood supply at the end of the ureters. The technical improvements observed were as follows: 1) The peritoneal fold and the upward traction of the gonadal vessels decrease the ureteral tension and keep the blood supply to the ureters in the extraperitoneal approach. 2) The gonadal vessels and its surrounding tissue, covering the subcutaneous fatty tissue, help the ureteral adhesion at the anastomotic site. 3) Full diminution of the skin defect caused by flap formation, decreases the horizontal tension of the side-to-side anastomized ureters. Sixteen patients with normal ureters underwent this procedure. In a short-term (4-37 months) observation, 4 of the patients, including one with thick abdominal fat, showed unilateral hydronephrosis and 2 patients unilateral non-function kidney. The remaining 10 patients had no complications. Moreover, all the patients have kept their ureterostomies tubeless and their serum blood urea nitrogen and creatinine levels were within normal limits except for one patient. It is reasonably concluded that the new method will result in success clinically even in patients with normal ureters and thick abdominal fatty tissue.     

超声对铜针治疗海绵状血管瘤的疗效观察

对３１例皮下海绵状血管瘤行铜针治疗前后的超声图像观察，以探讨新的诊疗方法和临床疗效的评价，发现在治疗前后的血管瘤内有不同的声像图特征。彩色多普勒显像为本病的诊断治疗及随访观察提供了有力的依据。     

Laparoscopic resection of a torsioned appendix epiploica in a previously appendectomized patient

Torsion of the appendices epiploicae is a rare condition that may present with acute abdominal pain and mimics appendicitis. We report a 20-year-old previously appendectomized man presenting with right lower abdominal quadrant pain. Abdominal ultrasonography showed a localized omental thickening in the right paracolic region. Contrast-enhanced computed tomography revealed well-circumscribed fatty tissue adjacent to the cecum with heterogeneous hyperdense infiltration of the mesentery near the sigmoid colon. Diagnostic laparoscopy revealed 2-cm diameter torsioned and edematous fatty tissue floating on the omentum in the right lower quadrant. The torsioned mass was elevated, and a thick stalk was seen to be connecting the fatty tissue to the sigmoid colon. At this point, the torsioned fatty tissue was considered as a sigmoidal appendix epiploica that was elongated and neighboring on the previously operated-on region. The lesion was removed by laparoscopic means using 3 ports. Grossly, fat necrosis and internal bleeding were seen. Histopathologic analysis of the resected tissue demonstrated adipose tissue surrounded by fibrotic inflammatory changes with marked infiltration of numerous lymphocytes and histiocytes. In conclusion, torsion of appendices epiploicae should be included in the differential diagnosis of acute abdomen when evaluating patients with right lower quadrant pain and a history of appendectomy. Laparoscopic surgery provides definite diagnosis and prevents unnecessary open procedures for such lesions leading to peritoneal irritation.     

Can Ulnar Variance Be Used to Detect Overstuffing After Radial Head Arthroplasty?

Background

Overstuffing of the radiocapitellar joint during metallic radial head arthroplasty has been reported to cause loss of elbow flexion, capitellar erosion, and early-onset osteoarthritis. Although this is known, there is no agreed-on measurement approach to determine whether overstuffing has occurred.

Questions/purposes

We therefore hypothesized that overlengthening the radial head during radial head arthroplasty changes the ulnar variance in the wrist.

Methods

Seven cadaveric radii were implanted with radial head prostheses of increasing thickness. Each specimen was implanted successively with increasingly thick radial head prostheses measuring 2, 4, and 6 mm thicker than the native radial head, and radiographs were taken after implantation of each prosthesis. The ulnar variance with each prosthesis was measured using the method of perpendiculars.

Results

The ulnar variance of the native and 2-mm (p = 0.04), 4-mm (p = 0.008), and 6-mm (p = 0.008) overly thick radial head prosthesis-implanted states decreased significantly with each incremental increase in prosthetic head thickness.

Conclusions

Implantation of thicker radial head prostheses decreased the ulnar variance. Our results indicate ulnar variance could be used to detect overstuffing of radial head prostheses.

Clinical Relevance

The simplicity and reliability of ulnar variance make it a potentially useful indicator of overlengthening after radial head arthroplasty.     

Use of volar veins in finger replantation

The number and the location of the venous anastomosis in finger replantation are discussed. The principle: 'two veins for one artery' has been given up in favour to do only one venous anastomosis. A vein on the palmar side should be preferred. Here the anastomosis is protected by a thicker layer of subcutanous tissue. In addition this technique allows to do the total vascular reconstruction without turning the hand. In a number of 84 finger replantations there was a failure rate of 9,5% by using only one vein for replantation. In 17 finger replantations using one volar vein we lost only one finger (5.9%).     

Lifestyle factors associated with serum N-3 fatty acid levels in breast cancer patients

Long chain n3 fatty acids appear to have beneficial effects in several domains of health relevant to breast cancer survivors. This study evaluated inter-individual differences in serum levels of n3 fatty acids in 40 breast cancer patients who were participating in a pilot study for prevention of weight gain. Significant predictors of baseline n3 fatty acid levels in serum were dietary intakes of n3 fatty acids, BMI, serum levels of carotenoids and TV hours watched/day, accounting for 43% of the variance. Counseling for prevention of weight gain also tended to increase n3 fatty acid blood levels over time during chemotherapy.     

Late ball variance with the Model 1000 Starr-Edwards aortic valve prosthesis. Risk analysis and strategy of operative management

The first generation of aortic ball-valve prostheses, used until 1965, was associated with poppet damage owing to fatty infiltration of the silicone rubber ball, a phenomenon termed ball variance. For the Model 1000 Starr-Edwards valves, almost all cases were discovered before 8 years. However, a review of our patients still at risk with the original valve and poppet, prompted by other recent reports of late ball variance, has shown that severe variance can exist up to 20 years after implantation. There is a relationship between the year of valve implantation and the timing and severity of ball variance for the overall series of patients surviving operation, but for the subgroup currently at risk the sample sizes are too small to detect any difference, if one still exists. Only three of 12 patients in the current subset were found to have severe variance. Simple ball change has been the operation of choice. Prophylactic reoperation is not indicated in the current subset, but patients require careful follow-up and should be considered for reoperation should symptoms develop.     

皮瓣供区创面用整张中厚皮片覆盖后感觉恢复的临床观察

的　评价失神经支配创面用整张中厚皮片覆盖后感觉恢复的情况。方法　观察 35例游离皮瓣移植者 ,用整张中厚皮片覆盖供区创面后感觉恢复的情况。术后随访 1至 9年 ,分别测定植皮区的触、痛、温度及两点辨别觉的恢复程度。各项结果均经统计学处理。结果　 35例创面植皮区触、痛、温度及两点辨别觉的恢复优良率分别为 2 2 .8%、2 0 %、2 0 %和 2 .9%。结论　去神经创面用整张中厚皮片移植后感觉恢复欠佳