鼻内镜下脑脊液鼻漏成功修补关键因素分析

目的分析鼻内镜下37例脑脊液鼻漏患者的诊治方法及疗效,探讨鼻内镜下脑脊液鼻漏成功修补的关键因素。方法回顾性分析37例脑脊液鼻漏患者的临床资料、手术方式及疗效。术前完善相关检查初步判定漏口位置,术中根据漏口位置选用相应的手术方式;术后给予抗炎、止血及降颅压等对症治疗。结果 35例患者术后均一次修补成功。1例患者出院后3周再次出现少量脑脊液鼻漏,经保守治疗痊愈;1例出院后2个月出现脑脊液鼻漏,再次鼻内镜手术治愈。结论鼻内镜下脑脊液鼻漏修补是一种微创、安全和有效的手术方式,是脑脊液鼻漏的首选治疗术式;术前鼻内镜及影像学等相关检查可帮助明确漏口位置,根据漏口位置选择相应的手术方式是脑脊液鼻漏成功修补的关键。     

经鼻内镜修补儿童脑脊液鼻漏

目的 总结儿童脑脊液鼻漏治疗的临床经验,探讨鼻内镜下修补脑脊液鼻漏的手术方式、修补材料及并发症.方法 回顾鼻内镜下10例儿童脑脊液鼻漏的治疗,分析鼻内镜治疗的手术技术及修补材料.结果 随访6个月至6年.行鼻内镜下脑脊液鼻漏修补术11次,一次修补成功9例,另1例蝶窦自发性脑脊液鼻漏修补2次获得成功.结论 鼻内镜下脑脊液鼻漏修补术是儿童脑脊液鼻漏的首选术式,具有方便、成功率高、并发症少等优点.     

鼻内镜下脑脊液鼻漏的诊断及治疗

目的:总结脑脊液鼻漏的漏口诊断与经鼻内镜手术治疗的临床经验。方法:对36例确诊为脑脊液鼻漏患者的临床资料进行回顾性分析,36例患者术前均行CT检查及鼻内镜检查寻找漏口。34例行单纯鼻内镜修补术,2例行鼻内镜加额部联合进路修补术。结果:随访6月至6年,中位随访时间2.5年,34例1次治愈,一次成功率94.4%;2例复发,二次修补成功。结论:螺旋CT薄层扫描结合内镜检查可使脑脊液鼻漏漏口定位更准确;内镜下手术修补脑脊液鼻漏准确、微创、治愈率高。     

鼻内镜下脑脊液鼻漏修补术13例报道

目的探讨鼻内镜下修补脑脊液鼻漏的方法。方法分析我科鼻内镜下脑脊液鼻漏修补术13例,瘘口在筛区附近的11例采用Messerklinger术式,瘘口在蝶窦附近的2例采取Wigand术式,术中5层加压修补。结果12例1次修补成功;1例修补失败,改鼻外进路修补成功。结论鼻内镜下脑脊液鼻漏修补术是极为理想的脑脊液鼻漏治疗方式。     

鼻内镜下修补脑脊液鼻漏

目的总结鼻内镜下脑脊液鼻漏修补的成功经验和失败教训,以利今后工作更好地开展。方法对18例脑脊液鼻漏病人行鼻内镜下修补术。结果18例病人皆一次修补成功。结论鼻内镜下修补脑脊液鼻漏是一种创伤小、效果好的方法,术前、术中瘘口的定位、处理对成功率有至关重要的作用。     

鼻内镜下修补脑脊液鼻漏

目的总结鼻内镜下脑脊液鼻漏修补的成功经验和失败教训,以利今后工作更好地开展。方法对18例脑脊液鼻漏病人行鼻内镜下修补术。结果18例病人皆一次修补成功。结论鼻内镜下修补脑脊液鼻漏是一种创伤小、效果好的方法,术前、术中瘘口的定位、处理对成功率有至关重要的作用。     

外伤性脑脊液鼻漏的鼻内镜治疗

目的：探讨外伤性脑脊液鼻漏的鼻内镜治疗效果。方法：回顾我院2005年6月～2010年10月36例外伤性脑脊液鼻漏的临床资料,分析其临床表现、影像学资料及手术方法。结果：36例患者高分辨三维CT检查提示颅底骨质缺损,MRI检查其中29例发现有脑膜组织疝入鼻窦,术中鼻内镜检查与术前影像学检查结愈果一致,所有病例均行鼻内镜下脑脊液漏修补术,术后随访6～24个月,未见复发。结论：脑膜组织疝入鼻窦是外伤性脑脊液鼻漏不能愈合的主要原因,高分辨三维CT检查结合MRI检查是确定脑脊液鼻漏漏口位置安全、有效的方法,鼻内镜下脑脊液鼻漏修补术是治疗脑脊液鼻漏的首选方法。     

鼻内镜下修补脑脊液鼻漏19例并文献复习

目的探讨鼻内镜下脑脊液鼻漏修补术的瘘口定位、材料选择及修补方法。方法回顾性分析19例脑脊液鼻漏修补术病例资料,其中骨折发生在筛窦预壁14例、筛预和对侧额窦后壁1例、蝶窦4例,瘘口0．8～2．5cm,搔刮创面后用生物胶肌浆填塞瘘口,覆盖筋膜,再填塞鼻腔填充物。结果19例患者均在鼻内镜下一次手术修补成功,其中出现局限性脑膜炎1例、局部真菌感染1例。结论鼻内镜下脑脊液鼻漏修补方法简单,损伤小,成功率高,并发症少。     

鼻内镜下应用自体组织修补脑脊液鼻漏的分析

目的探讨经鼻内镜应用自体组织修补脑脊液鼻漏的方法及疗效。方法经鼻内镜手术修补脑脊液鼻漏36例,常规行CT检查,并在鼻内镜直视下寻找脑脊液鼻漏漏口,处理漏口周围黏膜,造成新鲜创面,采用肌肉、筋膜和脂肪等组织填塞修补漏口,必要时以耳脑胶粘合固定,并以纱条或膨胀海绵填塞支撑7～l0d。结果 36例脑脊液鼻漏33例1次修补成功,失败的3例经第2次手术后治愈,随访1～8年无复发,未出现任何并发症。结论经鼻内镜修补脑脊液鼻漏具有微创、安全、复发率低等优点。     

鼻内镜下脑脊液鼻漏修补术临床效果分析

目的探讨鼻内镜下脑脊液鼻漏修补术的临床治疗效果。方法回顾性分析2011—2014年诊断为脑脊液鼻漏的54例患者的临床资料,所有患者均行鼻内镜下脑脊液鼻漏修补治疗。结果 2例在神经外科开颅垂体瘤切除术并脑脊液鼻漏修补术后失败经鼻内镜修补成功,2例在外院手术修补失败后经鼻内镜修补成功,余50例均1次修补成功,随访6个月~3 a,无1例复发。结论鼻内镜下脑脊液鼻漏修补术一次性手术成功率高、并发症低,应作为首选治疗方法。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.