《中国美容整形外科杂志》编委

李万，1955年出生，辽宁大连人，主任医师。1982年毕业于贵州省遵义医学院医疗系。1984年始在辽宁省人民医院整形外科工作，1992年晋升为副主任医师，1997年晋升为主任医师。1990年至1991年在上海第九人民医院整形外科进修，1997年任辽宁省人民医院整形外科副主任，1998年至2002年任大连医科大学附属二院整形科主任。2003年至2005年任辽宁省人民医院整形外科主任。     

悼念马烈编委

悼念马烈编委马烈教授，男，１９３５年５月２０日出生于江苏省徐州市，回族，１９５９年毕业于浙江医科大学医疗系，同年分配至附属二院麻醉科工作。１９６０年３月加入中国共产党。１９７１年晋升主治医师，１９７６年任讲师，１９８３年晋升副主任医师，１９８５年任副...     

原发性肝癌综合治疗282例分析

本文报告１９８０年６月至１９９４年１０月治疗中晚期原发性肝癌２８２例，男２３８例，女４４例，年龄１７～７６岁，结节型肝癌１３０例，巨块型肝癌９２例，弥漫型肝癌６０例，其中自发性破裂大出血２１例，全部病例经Ｂ超显像，ＣＴ扫描，肝动脉造影，ＡＦＰ测定及病理组织学检查确诊。外科手术治疗９４例，其中脉叶切除３０例，半年、１年、２年、３年、５年生存率为７９．９％，５６．０％。２２．７％１３．６．和１０．０％；行肝动脉血流阻断为主的外科综合治疗６０例，半年，１年、２年生存率为７８．３％，５２．４％，１３．８％；手术探查４例，存活期均少于４个月。对不能切除的中晚期肝癌行介入栓塞治疗１８８例，半年、１年、２年、３年生存率为７３．４％，３８．８％，１９．７％和６．７％。     

风湿性瓣膜病合并心脏恶液质的围手术期处理

风湿性心脏瓣膜病病程长，可达十数年至数十年，尤其以二尖瓣和三尖瓣病变所致的心肌损害为著，容易出现心脏恶液质综合征(syndrome of cardiac cachexia，SOCC)，1年、5年的自然病死率高达50％和80％，手术病死率达16％，50％。1996年8月至2001年9月，我们共收治此类病人221例，占同期瓣膜病的12．31％，现总结报道如下。     

肾移植的现状和展望

肾移植的现状和展望谢桐近年来，我国肾移植这一学科发展较快，至１９９２年底全国肾移植已达９５９４例，１９９１年全国开展肾移植的单位已有７７个，１９９２年又增至８８个，年移植例数亦在逐年增加，１９９１年共行肾移植１７７１例，１９９２年增加至１９０５例。目...     

胆囊腺鳞癌1例

胆囊腺鳞癌１例李建军，张仁亚（山东省荷泽地区医院２７４０３１）患者，女性，６７岁，间断性右上腹部胀痛１５年，加重２年，于１９９４年１０月５日收入院。多次Ｂ超检查示慢性胆囊炎，胆囊结石，曾服中药，西药治疗，结石逐渐增大，腹痛发作频繁。近２年急性胆囊炎发...     

应用关节镜清理和透明质酸钠注射治疗膝关节骨关节炎

目的：比较2例治疗膝关节骨关节炎方法的效果。方法：2组病人分别采用关节镜清理和透明质酸钠注射治疗膝关节骨关节炎，结果：术后随访2年以上，根据关节疼痛，积液肿胀，关节活动度，行走功能四个项目及综合评价。关节镜组随访结果，半年－1年，优良率为96．2％，1－2年，优良率84．6％，2年以上优良率为73％，透明质酸钠组随访结果：半年－1年，优良率为94．9％，1－2年，优良率86．4％，2年以上优良率为74．6％，。结论：关节镜清理和透明质酸钠注射治疗膝关节炎2种方法都有一定的效果，2组之间无明显差别。     

21例24指末节再植体会

２１例２４指末节再植体会王明辉，杨东，张志宏，陶红旗，金福儒，刘秀峰，赵军我科１０９１年～１９９３年，共收治末节离断伤３４例，对其中２１例２４个断指进行再植。结果全部成活，经半年～１年的随访，外观、外形满意，功能良好。临床资料本组男１５例，女６例，年...     

肝肾联合移植术后并发精神症状1例

患者男，47岁。患乙型肝炎9年，右侧胸水5年，心包积液6个月，于2004年11月20日入院。经内科保肝、利尿、穿刺放胸水等对症治疗效果不佳，近1年反复少量呕血、鼻出血、尿少，同时血肌酐、尿素氮升高，入院前每周血液透析3次维持生命。10岁时患肾炎，未正规治疗；1997年行左侧腹股沟疝修补术，2000年行小肠套叠手术（术式不详），2001年行右侧腹股沟疝修补术。既往3次术后多次应用度冷丁等镇痛药，近1年长期口服去痛片及安定类药物。血型AB。     

腺性输尿管炎一例报告

腺性输尿管炎一例报告叶林阳，王晓雄，李炎唐，单中杰患者，女性，３６岁。１９８３年开始出现间歇全程肉眼血尿，脓尿，尿频，尿痛及腰痛。反复发作５年，应用青霉素治疗症状可缓解，近２年来持续性右侧腰痛及右下腹痛，不放射。于１９９０年１２月１１日收住院。查体：...     

解剖型钢板在股骨远端骨折中的应用

目的 探讨解剖型钢板固定治疗股骨远端骨折的临床效果。方法 对2001年2月以来收治的股骨远端骨折39例，用Link解剖型钢板内固定治疗，术后获7～26个月随访。结果 解剖复位31例，接近解剖复位8例；39例患伤口均愈合，无骨折不愈合、螺钉松动、钢板断裂等并发症；膝关节功能，优24例，良11例，可4例；优良率89．74％。结论 Link解剖型钢板治疗股骨远端骨折，操作简单，固定可靠，有利于膝关节功能的恢复，是治疗股骨远端骨折较理想的方法。     

Correction of distal femoral deformity

This retrospective study reviews 12 distal femoral osteotomies in nine patients performed for angular and rotational deformities, using the Orthofix external fixator. All osteotomies progressed to solid union with reliable correction of the deformity. Few complications were encountered. Simultaneous lengthening was performed on one patient successfully. This method proved to be a safe and precise means of correcting distal femoral deformity with the option of simultaneous correction of length discrepancy.     

Management of distal femoral periprosthetic fractures by distal femoral locking plate: A retrospective study.

Background:

Management of periprosthetic supracondylar femoral fractures is difficult. Osteoporosis, comminution and bone loss, compromise stability with delayed mobility and poor functional outcomes. Open reduction and internal fixation (ORIF) with anatomic distal femoral (DF) locking plate permits early mobilization. However, this usually necessitates bone grafting (BG). Biological fixation using minimally invasive techniques minimizes periosteal stripping and morbidity.

Materials and Methods:

31 patients with comminuted periprosthetic DF fractures were reviewed retrospectively from October 2006 to September 2012. All patients underwent fixation using a DF locking compression plate (Synthes). 17 patients underwent ORIF with primary BG, whereas 14 were treated by closed reduction (CR) and internal fixation using biological minimally invasive techniques. Clinical and radiological followup were recorded for an average 36 months.

Results:

Mean time to union for the entire group was 5.6 months (range 3-9 months). Patients of ORIF group took longer (Mean 6.4 months, range 4.5-9 months) than the CR group (mean 4.6 months, range 3-7 months). Three patients of ORIF and one in CR group had poor results. Mean knee society scores were higher for CR group at 6 months, but nearly identical at 12 months, with similar eventual range of motion.

Discussion:

Locked plating of comminuted periprosthetic DF fractures permits stable rigid fixation and early mobilization. Fixation using minimally invasive biological techniques minimizes morbidity and may obviate the need for primary BG.     

Retrograde locking nail osteosynthesis of distal femoral fractures with the distal femoral nail (DFN)

Non-operative treatment with immobilization or isometric traction has been abandoned as treatment for fractures of the distal femur at the end of the 1960ies. The technique of open reduction and internal fixation with a condylar plate as suggested by the AO has been the golden standard since the 1970ies. However, anatomic reconstruction of the condylar region with interfragmentary screw fixation and axial realignment of the femur shaft with a plate are challenging procedures especially in the presence of severely compromised soft tissues and put periosteal blood supply at risk. Soft tissue complications, axial malalignment and delayed fracture healing times led to the consideration of alternative techniques, such as intramedullary nailing which has been practiced with success since the 1940ies by Gerhard Küntscher and colleagues for femoral shaft fractures with minimal complication rates and improved results after closed reduction. The era of retrograde femoral nailing began with the systematic approach through the intercondylar notch by Green. This paper reviews the biomechanical properties, indication, technique as well as potential hazards and pitfalls of fracture management with the AO "distal femoral nail" (DFN). With appropriate application this technique is suitable for all fractures of the distal third of the femoral shaft including highly instable bicondylar fractures without damage to the soft tissues and the knee joint.     

股骨远端骨折的手术治疗

目的探讨股骨远端骨折的手术治疗方法及合并症的预防。方法对1991年～2001年,348例股骨远端骨折手术治疗,选用螺钉、动力加压钢板(DCP)、角钢板、动力髁部螺钉(DCS)、股骨髁钢板、带锁髓内钉治疗股骨远端骨折。研究内固定物的使用、骨折复位、植骨、骨折不愈合等相关问题。结果13例发生内固定失效、钢板断裂,需要重新固定植骨。8例延迟愈合,二期植骨。其余骨折均愈合。14例术后伤口感染,18例晚期出现肢体短缩,范围1～4cm。52例因骨折愈合后膝关节屈曲小于90°需要行松解手术。结论手术治疗股骨远端骨折能够恢复解剖结构,从而最大限度地恢复肢体的功能。