两种术式治疗后半蹄铁型肛瘘的疗效对比分析

为探讨治疗后半蹄铁型肛瘘的手术方式及疗效,我们采用隧道式瘘管剔除对口引流术治疗后半蹄铁型肛瘘38例（A组）,隧道式拖线术治疗34例（B组）,并对两组疗效进行对比分析。结果显示,两组治愈率均为100％,其中B组4例经二次扩创后治愈,随访3年无复发。两组均无肛门畸形、肛门失禁等并发症。A组平均疗程为（26．2±3．4）d,B组平均疗程为（28．3±3．1）d。术后2级以上疼痛A组为89．5％（34／38）,平均持续时间（7．3±3．2）d;B组为94．1％（32／34）,平均持续时间（12．8±3．8）d。结果表明,隧道式瘘管剔除对口引流术治疗后半蹄铁型肛瘘疗效显著。     

中药内外结合穴位埋线治疗黄褐斑67例

目的:观察中药内外结合穴位埋线治疗黄褐斑的临床疗效。方法:将67例门诊病人采用中药辨证口服结合中药玉容散加减外敷及穴位埋线治疗。结果:治疗3个疗程后,基本治愈45例,占67.2%,总有效率97.0%,各证型间疗效比较,差异无显著性意义(P>0.05)。结论:中药内外用结合穴位埋线治疗黄褐斑疗效是满意的,临床值得推广应用。     

Development of a new flat needle and a reduced surface coating thread for endoscopic suturing

BACKGROUND: Intracorporeal suturing during endoscopic surgery is a difficult procedure. The curved needle is the most difficult to position properly within the jaws of the needle driver. The low friction suture materials exhibit good knot run-down, but at the expense of increased tendency for slipping. It is therefore necessary to invent a new needle and a new thread to facilitate intracorporeal suturing. MATERIALS AND METHODS: We made a new flat needle (F-needle) to facilitate grasping and a new reduced silicone-coated thread to prevent the knots from loosening. The time required to grasp the F-needle and the round needle (R-needle) by 10 surgeons was measured. The angle between the needle and the needle driver was measured. The minimum number of intertwining knots required for the knot to hold was counted, and the minimum number of superimposed knots that prevented the knots from coming undone when the testing machine attempted to release them was counted. RESULTS: The F-needle was grasped in less time than the R-needle. The error in yaw angle with the F-needle was smaller than in the R-needle. The minimum number of knots needed to hold against the untying force with the reduced silicone-coated thread was less than with the conventional silicone-coated thread. CONCLUSIONS: The new flat needle was grasped more accurately and quickly than the round needles, and the thread with reduced surface coating was less likely to loosen. Therefore, the combination of the new flat needle and thread with reduced surface coating is useful for endoscopic suturing.     

The effect of thread pattern upon implant osseointegration

Objectives: Implant design features such as macro‐ and micro‐design may influence overall implant success. Limited information is currently available. Therefore, it is the purpose of this paper to examine these factors such as thread pitch, thread geometry, helix angle, thread depth and width as well as implant crestal module may affect implant stability. Search Strategy: A literature search was conducted using MEDLINE to identify studies, from simulated laboratory models, animal, to human, related to this topic using the keywords of implant thread, implant macrodesign, thread pitch, thread geometry, helix angle, thread depth, thread width and implant crestal module. Results: The results showed how thread geometry affects the distribution of stress forces around the implant. A decreased thread pitch may positively influence implant stability. Excess helix angles in spite of a faster insertion may jeopardize the ability of implants to sustain axial load. Deeper threads seem to have an important effect on the stabilization in poorer bone quality situations. The addition of threads or microthreads up to the crestal module of an implant might provide a potential positive contribution on bone‐to to‐implant contact as well as on the preservation of marginal bone; nonetheless this remains to be determined. Conclusions: Appraising the current literature on this subject and combining existing data to verify the presence of any association between the selected characteristics may be critical in the achievement of overall implant success. To cite this article:
Abuhussein H, Pagni G, Rebaudi A, Wang H‐L. The effect of thread pattern upon implant osseointegration.
Clin. Oral Impl. Res. 21 , 2010; 129–136.
doi: 10.1111/j.1600‐0501.2009.01800.x     

一期切开高位挂线治疗后马蹄形脓肿

采用后位一期切开高位挂线两侧坐骨直肠间隙开窗对口引流治疗后马蹄形脓肿30例，全部一次治愈，疗程20－32d，平均23．6d。术后随访1－4年无遗留肛瘘、肛门狭窄、肛门失禁及肛门畸形。     

重组pIRES-AD7c-NTP质粒的构建表达及其对PC12细胞凋亡的影响

目的构建重组pIRES-AD7c-NTP质粒,探究其对PC12细胞凋亡的影响。方法构建pIRESAD7c-NTP重组质粒,通过脂质体体外转染至PC12细胞内,RT-PCR检测凋亡相关蛋白bcl-2和bax的mRNA表达变化含量变化。结果成功构建pIRES-AD7c-NTP重组质粒并转染至PC12细胞内;重组质粒转染组出现了明显的细胞凋亡,流式细胞仪检测出典型凋亡峰;重组质粒转染组中bcl-2表达低于对照组,bax表达高于对照组。结论 AD7c-NTP重组质粒转染组PC12细胞内bcl-2/bax表达异常,说明AD7c-NTP增加凋亡促进蛋白的表达、同时减少凋亡抑制蛋白的表达,可见AD7c-NTP可导致神经细胞发生凋亡,为后续研究提供实验基础。     

搬运训练模拟人系统设计与实现

目的设计搬运训练模拟人系统。方法引用开源的第三方库文件实现了蓝牙无线通讯,通过异步线程的方式读取、处理数据后,利用自定义的曲线绘制控件实现曲线绘制,并利用WinForm标准控件库中的PictureBox控件实现二维动画的显示,完成界面设计。结果与结论通过底层硬件采集数据后,搬运训练模拟人系统读取分析数据后,实时显示颈椎、胸椎、腰椎、加速度等数据曲线以及相应的动画,培训人员可通过各项操作数据的趋向性信息及统计报告观察操作效果,从而避免不恰当搬动而加重脊髓损伤,防止伤情的发展与转归。     

改进的双孔悬吊辅助腹腔镜阑尾切除术的应用价值（附35例报告）

目的：探讨改进的双孔悬吊辅助腹腔镜阑尾切除术在阑尾炎患者中的应用价值。方法回顾性分析35例行改进的双孔悬吊辅助腹腔镜阑尾切除术的阑尾炎患者的临床资料,均采用经脐部与耻骨联合上方双孔腹腔镜阑尾切除术,术中将腹腔镜调换到耻骨联合上方切口,脐部作为操作孔,将带线麻醉穿刺针自麦氏点刺入腹腔,收紧缝线,将阑尾予以悬吊固定,采用腔外打 Roeder 结或腔内单手“O”形打结法结扎切断阑尾系膜及阑尾。结果35例患者均顺利完成手术,手术时间30-65 min,平均40 min;术中出血5-30 ml,平均15 ml;术后无切口感染、出血、肠梗阻等并发症出现,且总体费用较传统三孔术式减少约1000元,所有患者痊愈出院,腹部切口隐蔽。随访1-12个月无切口感染、出血、肠瘘、肠梗阻等并发症出现,切口愈合良好,美容效果好。结论改进的悬吊固定法阑尾切除术更注重无菌观念,安全、可行,并且操作简单,术后切口隐蔽,美容效果好,总体费用相对减少,值得临床推广。     

电针、埋线调整吗啡成瘾C57BL/6J小鼠昼夜节律的变化研究

目的：观察电针、埋线对吗啡成瘾C57BL/6J小鼠昼夜节律的调整作用。方法：选用C57BL/6J小鼠42只,随机分为4组,分别为空白组、模型组、电针组、埋线组。运用＂7 d递增成瘾法＂进行造模,造模成功后空白组不造模不电针,模型组只造模不电针,电针组造模并电针,埋线组造模并埋线。第7 d运用纳洛酮催瘾,并密切观察其戒断症状评分以及各组小鼠的昼夜节律变化。结果：戒断评分：空白组无异常（P〉0.05）,电针组、模型组和埋线组出现戒断症状（P〈0.05）。体重：空白组小鼠体重无变化（P〉0.05）,模型组、电针组、埋线组小鼠体重有明显下降（P〈0.05）。昼夜节律：实验前各组小鼠昼夜节律与实验前相比无异常（P〉0.05）;实验开始后,空白组小鼠无变化;模型组小鼠有明显改变,表现在振幅和活动度与空白组和模型组相比具有明显差异（P〈0.05）;电针后小鼠振幅和活动度与空白组和模型组相比均有明显改变（P〈0.05）;埋线后,振幅与空白组和模型组相比均有统计学意义（P〈0.05）;电针与埋线组相比,其差异无统计学意义;实验前后各组的周期的变化均无统计学意义（P〉0.05）。结论：电针、埋线均可缓解小鼠戒断症状的严重程度,降低戒断评分,减轻吗啡成瘾小鼠体重下降的趋势;电针埋线均可明显改善吗啡成瘾小鼠昼夜节律的紊乱。     

关节镜下利用可吸收螺钉和orthocord线治疗前交叉韧带止点撕脱性骨折的临床观察

目的 观察关节镜下在腰穿针引导下利用可吸收螺钉和orthocord线治疗前交叉韧带止点撕脱性骨折的疗效。方法 2009年1月至2013年1月,关节镜下在腰穿针引导下利用可吸收螺钉和orthocord线治疗成人前交叉韧带止点撕脱性骨折30例,按Meyers-McKeever分型：Ⅱ型9例,Ⅲ型16例,Ⅳ型5例。手术在关节镜下进行,复位骨折后,先采用可吸收螺钉固定,再采用交叉韧带重建钻导器（Acufex PCL guide）引导,由关节外向关节内骨折块边缘钻孔制成两骨髓道,置入腰穿针后通过腰穿针穿线固定骨折块。术后不需要石膏外固定,鼓励患者主动伸屈关节,进行股四头肌、腘绳肌等长收缩锻炼及髌骨推移锻炼。随访时拍摄X光片并采用Lysholm膝关节功能评分标准来评定疗效。结果 所有患者术后均恢复良好,无膝关节不稳,平均愈合时间（7.0±0.6）周。术后Lysholm膝关节评分（92.3±1.6）分,术后6个月评分（97.6±1.7）分,与术前（74.6±4.3）分比较差异均有统计学意义（P〈0.05）。结论 关节镜下复位联合可吸收螺钉和orthocord线固定治疗前交叉韧带下止点撕脱性骨折固定可靠、手术创伤小,术后不需石膏固定,不需要二次手术取出内固定,术后功能恢复良好。