计算机快速成型辅助个体化三踝骨折的手术治疗

Objective To compare the operation with computer-aided rapid prototyping technique and the conventional procedure for treatment of trimalleolar fractures.Methods Twenty-four patients with trimalleolar fracture who had been admitted to our hospital from March 2007 to March 2008 were divided into 2 even groups randomly.Group A underwent 3-dimensional reconstruction, computer simulation and rapid pro-totyping and demonstration of individual fracture model before operation.Group B received only conventional procedures.The therapeutic effects were evaluated by Cedell criteria and compared statistically between the 2 groups.Comparision between the 2 groups was made in the exposure time, reduction and fixation time curative effect.Results Fallow-up from 8 to 15 months revealed that the operation time for Group A (45.43 ± 9.38 minutes) was significantly shorter than for Group B (58.61 ± 12.32 minutes) (t = - 2.948, P < 0.05).The exposure time between the 2 groups had no statiscal difference (t = - 1.06, P =0.102).The excellent rate of curative effect in Group A was 83.3% and 66.7% in Group B.Conclusion Computer aided rapid prototyping can shorten the operation time and improve operational efficiency for trimalleolar fractures.     

中法胃肠间质瘤靶向治疗高峰论坛会议纪要

胃肠间质瘤(gastrointestinal stromal tumor,GIST)是最常见的胃肠道软组织肿瘤,在靶向治疗时代以前,外科治疗是唯一有效的治疗方式.由于其有着局部高复发和易血道转移的特点.     

食管恶性胃肠道间质瘤1例报道

病例报道一　临床资料　患者 ,龚×× ,男 ,6 0岁。发现黑便 1月。胃镜 :门齿下 36ｃｍ至贲门有 2 3圈新生物伴坏死。病理 :坏死组织。胸片 :左下肺 10ｃｍ径软组织块影 ,密度均匀 ,边界清晰 ,诊断为肺转移性肿瘤可能 (第 2原发待排 )。ＣＴ :下胸段食管平滑肌肉瘤并向左胸腔内凸入 ,左肺浸润或转移。ＧＩ:食管下段平滑肌肉瘤可能。 2 0 0 0年 3月 1日在气管插管麻醉下行食管次全切除术 (弓下吻合 )。术后化疗 :环磷酰胺 80 0ｍｇ静推第 1天、长春新碱 2ｍｇ静推第 1天、顺氯氨铂 40ｍｇ静滴第 1,3,5天 ,每月 1次。随访 10月无局部复发及远…     

口服氨甲环酸减少老年人工股骨头置换术隐性失血的效果观察

目的 观察围手术期口服氨甲环酸减少老年股骨颈骨折行人工股骨头置换术隐性失血的效果。方法 研究纳入自2020-09—2021-10采用人工股骨头置换术治疗的57例老年股骨颈骨折,根据住院号尾号单双随机分为试验组（29例）与对照组（28例）。试验组于术前2 h、术后6 h、术后12 h口服氨甲环酸1 g;对照组于手术切皮前10 min静脉应用氨甲环酸（氨甲环酸1 g溶于0.9%生理盐水100 mL）,缝合后氨甲环酸（氨甲环酸2 g溶于0.9%生理盐水20 mL）通过引流管注入关节腔,术后引流管均夹闭2 h。观察两组围手术期是否出现厌食、腹胀等胃肠道刺激症状及呕吐等并发症,比较两组术中出血量、输血量、术后引流量、隐性失血量、输血总例数、血红蛋白<70 g/L的输血例数。结果 57例均获得随访,随访时间（7.05±4.16）个月。对照组围手术期出现厌食、腹胀、胃部不适等胃肠道刺激及呕吐症状明显多于试验组,差异有统计学意义（P<0.05）。两组术中出血量、输血量、术后引流量与隐性失血量比较差异无统计学意义（P>0.05）;试验组有3例血红蛋白<70 g/L需输血,对照组有...     

CARD10 通过活化NF-κB信号进而促进肝癌细胞凋亡抵抗

目的：研究半胱氨酸天冬氨酸蛋白酶招募域家族分子10（caspase recruitment domain family member 10，CARD10）在肝癌组织中的表达，及其对肝癌进展尤其是凋亡抵抗的作用和机制。方法：采集2008 年至2010 年海军军医大学东方肝胆外科医院收治的129 例肝癌患者手术切除的肝癌及其癌旁组织标本，采用实时定量PCR法检测癌旁和肝癌组织中CARD10 的表达，以Spearman 等级相关统计学分析CARD10 表达与肝癌分期的相关性。在CARD10 质粒转染过表达以及RNA干扰敲减表达后，采用流式细胞术Annexin-V/PI 标记法检测肝癌细胞株的凋亡，采用Western blotting 检测肝癌细胞株中NF-κB信号的活化。结果：CARD10 在肝癌组织中的表达较癌旁组织显著增高（P<0.01），且肝癌组织中CARD10 的表达增高与肝癌分期进展呈正相关（P<0.01）。CARD10 过表达可以抑制肝癌细胞株SMMC-7721 和BEL-7402 的凋亡，而敲减CARD10 能够促进肝癌细胞株凋亡。CARD10 过表达能够增强肝癌细胞株中促生存的NF-κB信号的活化，而CARD10 敲减能够抑制NF-κB信号活化。结论：CARD10在肝癌组织中表达显著增高并与肝癌进展呈正相关，CARD10 能够通过活化NF-κB信号进而促进肝癌细胞凋亡抵抗。     

计算机快速成型辅助个体化三踝骨折的手术治疗

Objective To compare the operation with computer-aided rapid prototyping technique and the conventional procedure for treatment of trimalleolar fractures.Methods Twenty-four patients with trimalleolar fracture who had been admitted to our hospital from March 2007 to March 2008 were divided into 2 even groups randomly.Group A underwent 3-dimensional reconstruction, computer simulation and rapid pro-totyping and demonstration of individual fracture model before operation.Group B received only conventional procedures.The therapeutic effects were evaluated by Cedell criteria and compared statistically between the 2 groups.Comparision between the 2 groups was made in the exposure time, reduction and fixation time curative effect.Results Fallow-up from 8 to 15 months revealed that the operation time for Group A (45.43 ± 9.38 minutes) was significantly shorter than for Group B (58.61 ± 12.32 minutes) (t = - 2.948, P < 0.05).The exposure time between the 2 groups had no statiscal difference (t = - 1.06, P =0.102).The excellent rate of curative effect in Group A was 83.3% and 66.7% in Group B.Conclusion Computer aided rapid prototyping can shorten the operation time and improve operational efficiency for trimalleolar fractures.     

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目的探讨胃肠阃质瘤联合脏器切除的指征及方法.方法回顾性分析1994-2005年复旦大学附属肿瘤医院收治的22例胃肠间质瘤行联合脏器切除的病例资料.结果联合脾切除8例,姑肠切除6例,肾脏切除5例,肝部分切除1例,十二指肠切除1例,卵巢切除1例,胰体尾切除3例,肾上腺切除1例,两个脏器切除3例,三个脏器切除2例,5倒胃间质瘤及2例小肠问质瘤淋巴结清扫术后,未证实淋巴结转移,病理检查提示肿瘤累及肾、脾、胰、各2例,肠系膜与大网膜各1例,全组无死亡病例.随访14例,9例存活,5例因肿瘤复发转移死亡.结论胃肠问质瘤如侵犯周围脏器,联合脏器切除对病人可能有益,掌握手术指征也很重要.与靶向药物结合外科治疗胃肠间质瘤更为适合.     

计算机快速成型辅助个体化三踝骨折的手术治疗

Objective To compare the operation with computer-aided rapid prototyping technique and the conventional procedure for treatment of trimalleolar fractures.Methods Twenty-four patients with trimalleolar fracture who had been admitted to our hospital from March 2007 to March 2008 were divided into 2 even groups randomly.Group A underwent 3-dimensional reconstruction, computer simulation and rapid pro-totyping and demonstration of individual fracture model before operation.Group B received only conventional procedures.The therapeutic effects were evaluated by Cedell criteria and compared statistically between the 2 groups.Comparision between the 2 groups was made in the exposure time, reduction and fixation time curative effect.Results Fallow-up from 8 to 15 months revealed that the operation time for Group A (45.43 ± 9.38 minutes) was significantly shorter than for Group B (58.61 ± 12.32 minutes) (t = - 2.948, P < 0.05).The exposure time between the 2 groups had no statiscal difference (t = - 1.06, P =0.102).The excellent rate of curative effect in Group A was 83.3% and 66.7% in Group B.Conclusion Computer aided rapid prototyping can shorten the operation time and improve operational efficiency for trimalleolar fractures.     

男性留置导尿患者一次性集尿袋更换时间探讨

目的探讨男性留置导尿患者一次性集尿袋最佳更换时间。方法选择2012年4月—2013年9月收治于上海市普陀区人民医院的成年男性留置导尿患者270例,按照集尿袋更换时间分为3组,予以A组每日更换、B组每周更换2次、C组每周更换1次集尿袋,比较三组患者尿培养阳性结果。结果60~79岁及≥80岁患者中,每周更换2次集尿袋组尿培养阳性率明显低于每日更换1次及每周更换1次组(P均<0.05);≤59岁患者A、B、C三组间差异无统计学意义(P均>0.05)。结论男性留置导尿患者集尿袋更换频率以每周2次为宜。