血液透析患者的内瘘手术的护理

目的 探讨血液透析患者的内瘘手术的护理措施及术后并发症提出了相应对策。方法 对3年来75例透析患者内瘘手术进行术前护理、术后护理，健康宣教加以总结分析。结果 内瘘手术患者通过正确的护理，除1例内瘘闭塞外，另外74例提高了血液透析患者内瘘的使用寿命。结论 合理护理内瘘在血液透析患者中起着重要作用。     

Ectopic cervical salivary glands

Summary Ectopic salivary glands in the neck are very unusual lesions. Generally they are localized to the oropharyngeal region, near the mandible and para-parotid lymph nodes. They occur occasionally on the anterior border of the sternocleidomastoid muscle in the soft tissues of the neck. We wish to report on a singular association of ectopic salivary glands with partial hearing loss, preauricular fistula, palatoschisis, anal fistula, and an arteria lusoria. Morphological, histological and embryological aspects are discussed.     

带血管蒂肠浆肌层环贴术防治肠瘘

本文报导用带蒂血管肠浆肌层环贴术防治各种复杂肠瘘,经过十一年的临床观察,疗效满意。本文还着重介绍了手术方法及操作过程中应注意的问题。     

A DEBT TO ALEXIS: THE BEAUMONT-ST MARTIN STORY

This paper is based on the book Experiments and Observations on the Gastric Juice and the Physiology of Digestion, originally published in 1833. The book held in the Cowlishaw Collection of the Royal Australasian College of Surgeons is the Edinburgh edition of 1838, which contains a preface by Andrew Combe, MD. The paper explores several aspects of the BeaumontSt Martin story, from St Martin's original injury and the primary care undertaken by Dr William Beaumont, whose numerous studies of the actions and reactions of the stomach were made possible because St Martin was left with a permanent gastric fistula. While the debt we owe to Beaumont is often acknowledged, patients are not mere machines and surgeons must recognize that surgery also owes a debt to its patients; in this case, to Alexis St Martin for what he permitted by way of experiment.     

Primary aortoduodenal fistula caused by duodenal tuberculosis without an abdominal aortic aneurysm: Report of a case

A 66-year-old man died of massive gastrointestinal hemorrhage caused by a fistula between the third portion of the duodenum and the abdominal aorta. An autopsy revealed that duodenal tuberculosis had resulted in the development of a fistula into the aorta with no pathological changes, and no active pulmonary tuberculosis was found. Duodenal tuberculosis and primary aortoduodenal fistula (ADF) without an aneurysm are both extremely rare. Thus, we report herein a unique case of primary aortoduodenal fistula without an abdominal aortic aneurysm, but associated with duodenal tuberculosis, and review the current literature.     

Arteriovenous malformations that rupture during pregnancy: a management dilemma

Summary Intracranial haemorrhage due to rupture of an arteriovenous malformation (AVM) during pregnancy is a rare but serious condition that warrants prompt recognition. Once the diagnosis is made, the management is primarily based on neurosurgical rather than obstetric considerations. Due to its rarity, no definitive guidelines exist, and the best time to perform elective surgery (i.e., at presentation or at completion of the pregnancy) is ill-defined. This report describes three patients recently treated at our institution who had AVMs that ruptured during pregnancy. These cases well summarize the difficulties encountered in treating such patients. The diagnostic as well as the therapeutic implications of this condition are discussed.     

Rupture of an isolated internal iliac artery aneurysm into the rectum: Report of a case

Aneurysmal rupture into the intestinal tract is a rare but disastrous complication of an internal iliac artery aneurysm. We report herein the successful surgical repair of a fistula between a huge aneurysm of the right internal iliac artery and the rectum in an 81-year-old man. After a femoro-femoral cross-over bypass had been performed, the aneurysm was opened and its patent arterial branches were ligated with sutures. The fistula was then intra-aneurysmally sutured and covered with an omental flap. The diagnostic and therapeutic approaches to this severe complication are discussed with a review of the literature following the presentation of this case.     

脑动静脉畸形实验动物模型的建立

脑动静脉畸形是一种比较常见的严重威胁人们生命安全和生存质量的脑血管疾病，目前人们主要是通过尸体解剖以及CT、MRI等影像学的方法认识。近年来，学者们应用各种动物模型来研究脑动静脉畸形的血流动力学，病理生理学以及脑动静脉畸形栓塞材料的评估，栓塞后临床疗效评价，放射照射剂量对脑动静脉畸形的影响等。本文就脑动静脉畸形实验动物的常用种类，动物模型的建立方法以及动物模型的实际应用进行了综述。     

经单侧椎板开窗夹闭硬脊膜动静脉瘘

目的　总结经单侧椎板开窗入路夹闭硬脊膜动静脉瘘的经验。方法　回顾性分析了 5 6例经脊髓MR和脊髓血管造影确诊的硬脊膜动静脉瘘患者经单侧椎板开窗夹闭瘘口的临床资料。结果　 5 4例患者术后行脊髓血管造影复查 ,显示瘘口全部消失。 38例患者术后 6个月行脊髓MR复查 ,显示脊髓周围的血管流空影完全消失 ,T2 像髓内高信号影消失或明显减少。 5 4例患者获随访 ,随访时间 3～ 36个月 ,2 4例症状完全消失 ,2 7例症状改善 ,3例无变化。结论　经单侧椎板开窗夹闭瘘口的手术方法是硬脊膜动静脉瘘的首选治疗方法。     

经皮血管内栓塞颅内动静脉畸形（附38例治疗效果观察）

经皮血管内采用氰基丙烯酸异丁脂（ＩＢＣＡ）栓塞治疗３８例颅内动静脉畸形（ＡＶＭ）病人。其中８例达到１００％完全栓塞，栓塞面积大于７５％的１０例，大于５０％者１１例；余下９例栓塞面积小于５０％，１９例以出血为首发症状，１１例以癫痫为首发症状，６例神经功能障碍，２例以头痛为主要症状。栓塞术后发生并发症５例，占１３％，无死亡病例。本文讨论了超选插管技术问题、Ａｍｙｔａｌ试验假阴性、导管粘连及正常灌注压突破。