开窗术治疗颌骨含牙囊肿26例临床分析

目的探讨开窗减压术在颌骨含牙囊肿治疗中的应用.方法对26例颌骨含牙囊肿患者实行开窗术,使囊腔与口腔直接相通,并定期随访复查,了解囊肿变化.结果所有病例均未出现术后感染,术后复查X线片或CT片,见囊肿明显缩小,颌骨形态良好,未出现神经及邻近重要结构损伤.结论颌骨含牙囊肿开窗术治疗可使囊肿体积逐步缩小,是一种简便、经济、安全、效果良好的治疗含牙囊肿的方法.     

飞行人员鼻窦囊肿的诊治和医学鉴定

目的探讨飞行人员鼻窦囊肿（CNS）的发生机制、临床诊治和医学鉴定原则。方法总结飞行人员CNS资料46份,对其进行分类：结果黏膜囊肿44例,黏液囊肿和含牙囊肿各1例。上颌窦囊肿39例,蝶窦囊肿3例,筛窦囊肿、额窦囊肿、上颌窦＋额窦囊肿、上颌窦＋蝶窦囊肿各1例。Ⅰ类（地面有症状或体检时发现）37例,Ⅱ类（地面无症状,飞行中有继发性气压伤表现）9例。手术治疗16例,观察30例：飞行合格41例,永久停飞5例。结论飞行中气压变化的反复刺激可能是飞行人员CNS的发生机制之一,Ⅱ类CNS是医学停飞的重要原因。     

脾切除术中损伤邻近器官的原因及对策

目的：分析脾切除术中邻近器官损伤的原因，提出防范措施和处理方法。方法：回顾分析24例脾切除术中邻近器官损伤的病例。结果：14例术中发现者经及时处理后痊愈，10例术后发现者，8例痊愈，2例死亡，结论：应重视脾切除术的基本要求和基本操作训练，熟悉解剖，从而避免或减少脾工除术中医源性损伤的发生。     

牙源性囊肿外科手术治疗初步总结

牙源性囊肿是颌骨肿瘤中最常见的一种。它是由成牙组织或牙病演变而来,根据不同来源可分为根端囊肿和含牙囊肿(又称泡滤囊肿)两人类。牙源性囊肿在治疗上,根端囊肿可用外科手术或非外科手术治疗,但含牙囊肿唯有靠外科手术治疗。笔者近年来治疗20例牙源性囊肿,均采用外科手术治疗,现报道如下。一、临床资料分析1.分类:在20例中,根端囊肿15例,占75%,含牙囊肿5例,占25%。2.年龄、性別与病期:在根端囊肿中,年龄最小     

24例胃大部切除术中损伤邻近器官的原因及对策

目的：分析胃大部切除术中邻近器官损伤的原因,提出防范措施和处理方法。方法：回顾分析24例胃大部切除术中邻近器官损伤的病例。结果：发现损伤的发生与溃疡病变严重、局部变形粘连解剖关系改变以及术操作不够规范、细致有关。结论：应重视胃大部切除术的基本要求和基本操作训练,熟悉解剖,从而避免或减少胃大部切除术中医源性损伤的发生。     

34例舌前腺囊肿的治疗

目的：探讨舌前腺解剖及其囊肿的最佳治疗方案。方法：对34例舌前腺囊肿患者采用在常规手术基础上加以切除同侧或双侧舌前腺治疗舌前腺囊肿。随访1～4年，观察疗效。结果：34例患者均Ⅰ期愈合，经随访无1例复发。结论：舌前腺囊肿以手术切除囊肿及同侧或双侧舌前腺为最佳方案且疗效确切。     

颌骨囊肿190例临床分析

颌骨囊肿是口腔常见的疾病.我院在1965～1988年间共手术治疗190例,现介绍如下. 临床资料 1、分类本组牙源性囊肿有180例,占94.7%,非牙源性囊肿10例,占5.3%。其中根端囊肿124例,含牙囊肿54例,下颌骨牙源性角化囊肿2例,球上颌囊肿5例,鼻腭囊肿2例,正中囊肿3例.     

拔除乳牙开窗减压术间隙保持器治疗儿童替牙期含牙囊肿的疗效观察

目的评价拔除乳牙开窗减压术+间隙保持器治疗儿童替牙期含牙囊肿的效果.方法回顾性分析浙江大学医学院附属儿童医院口腔科自2006~2012年就诊的11例替牙期含牙囊肿患者,年龄7~11岁,男5例,女6例;8例为下颌骨含牙囊肿,3例为上颌骨含牙囊肿.9例囊腔内含牙1枚,1例囊肿含牙2枚,1例囊腔含牙3枚.所有患者均为拔除乳牙后行囊肿开窗减压术,术后间隙保持器保持拔除的乳牙间隙.随访1~4年至恒牙胚萌出,观察患者面部畸形、囊肿大小变化、囊肿周围骨质骨化过程及囊内牙胚的萌出情况.结果所有患者囊肿囊腔均消失,患者面部形态改变得到纠正,未见颌骨畸形.4例患者恒牙轻度错位畸形,7例患者牙合关系接近正常,5例患者恒牙较对侧明显提早萌出.X线检查显示:原颌骨密度减低影均消失,恒牙胚牙根发育正常,2例牙根有弯曲表现.结论拔除乳牙开窗减压术+间隙保持器治疗儿童替牙期含牙囊肿手术简单,创伤小,能消除面部畸形,颌骨、牙和牙胚生长发育不受影响,是一种良好的保守治疗方法.     

子宫肌瘤剜除术在妇科治疗的临床治疗效果观察

目的：观察经阴道子宫肌瘤剜除术在妇科治疗中的临床疗效。方法：收集2013年1月至2015年10月在该院妇科行子宫肌瘤剜除术的患者108例，其中经阴道子宫肌瘤剜除术者54例为观察组，经腹子宫肌瘤剜除术者54例为对照组，比较两组患者的治疗效果。结果：观察组与对照组相比较，手术时间与术中出血量无明显差异（P ＞0．05）。观察组术后排气时间与住院时间均显著少于对照组，发热率也低于对照组（P ＜0．05）。结论：经阴道子宫肌瘤剜除术能有效缩短排气时间与住院时间，减少术后并发症等优点，有利于患者子宫功能的恢复，是一种安全可靠的手术方法。     

螺旋CT对上颌骨含牙囊肿的诊断价值

目的探讨螺旋CT对上颌骨含牙囊肿的诊断与鉴别诊断价值。方法分析20例经病理证实的上颌骨含牙囊肿的CT表现,观察病变的形态和结构特征,及其与邻近结构的关系。结果20例中,18例位于或累及前牙区。病变为单房囊状,边缘可有分叶,囊液密度稍高于水;囊内均含牙,牙冠朝向囊腔内,牙根位于囊外,囊壁附着于牙颈部,为典型表现。2例牙齿完全位于囊肿内,但也可见牙冠朝向囊肿中心,为不典型表现。病灶周围骨质呈膨胀变薄改变,以向唇颊侧膨胀为主,体积较大病灶周围可有骨质缺损,但缺损范围不超过囊壁周长的1/4。无一例病灶穿破骨质形成软组织肿块。较大病灶常累及邻近重要结构。结论上颌骨含牙囊肿具有一定的CT特征性表现。螺旋CT扫描结合各种重组技术是上颌骨含牙囊肿的最佳术前影像学检查方法。     

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…     

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.     

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.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.