加压滑动鹅头钉治疗股骨转子间骨折的临床与实验研究

探讨加压滑动鹅头钉在治疗股骨转子间骨折中的作用。临床应用４５例。男３４例，女１１例。平均年龄６１岁。稳定型１３例，不稳定型３２例。经临床应用和生物力学实验测定，结果表明：（１）对不稳定型转子间骨折，恢复小转子区内后侧皮质骨的连续性在骨折的稳定中具有重要作用。（２）内后侧骨折块解剖复位，加压螺丝钉固定或大转子骨折端加压螺丝钉固定能显著增强加压滑动鹅头钉的固定作用，明显提高不稳定型转子间骨折的术后稳定性。（３）该装置设计合理，性能坚固，对转子间骨折具有很强的固定作用，能有效地达到早期下床和避免长期卧床的目的，是目前临床最理想的内固定装置。     

Extrinsic compression of the renal artery by diaphragmatic crus

Extrinsic compression of the renal artery due to a fibromuscular band originating from the diaphragm was encountered in a 26-year-old patient who had systemic hypertension associated with stenosis and kinking of one of her renal arteries. After surgical decompression, the renal artery assumed a normal expansion with disappearance of hypertension. Six other cases of extrinsic compression of the renal artery have been found in the literature. Surgical treatment is mandatory in all cases because the mechanism that causes the lesion makes percutaneous transluminal angioplasty illusory.     

Hepatocelular Carcinoma with Tumor Thrombus in Portal Vein:Finding in Ultrasonography,Computed Tomography,Angiography and Chemoembolization

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Percutaneous transhepatic stenting by wallstents of portal vein and bile duct stenoses caused by immunoblastic sarcoma in a liver transplantation

Posttransplant lymphoproliferative disorders are infrequent tumors related to chronic immunosuppressive therapy. We present a liver transplant recipient who developed such a tumor in the porta hepatis that provoked obstruction of the entire portal triad. Treatment consisted of systemic chemotherapy, percutaneous dilatation, and placement of Wallstent endoprostheses across both biliary and portal vein stenoses. The patient died 3 weeks later of pneumonia and sepsis. At necropsy, the tumor was completely necrosed and the prostheses in both the common bile duct and the portal vein were patent.     

Efficacy of preoperative portal vein embolization prior to major hepatectomy for patients with impaired liver function: A retrospective study

Hepatocellular carcinoma (HCC) is often associated with chronic liver disease, such as hepatitis or cirrhosis, and this association may limit the use of surgery as a therapy, and if surgery is pursued, may give rise to postoperative hepatic failure. We evaluated the outcome in patients with HCC given preoperative portal vein embolization (PVE) before they underwent major hepatectomy. After PVE, portal pressure increased significantly. Two weeks after PVE, both the volume of the non-embolized lobe and the 15-min indocyamine green retention rate (ICG R15) were significantly increased. The prognostic score, calculated on the basis of age, ICG R15, and the resection rate, was significantly decreased. The operative mortality rate was significantly lower in patients who underwent PVE before surgery than in patients who did not receive PVE. The cumulative survival rate of the PVE patients, even those with cirrhosis of the liver, was significantly higher. Prior PVE appears to allow more extensive major hepatectomy and to lessen the risk of this invasive surgery. However, patients in whom the portal pressure immediately after PVE was more than 30cm H₂O and/or whose prognostic score exceeded 50 points developed postoperative hepatic failure. These features should be kept in mind when it is decided whether surgery is indicated. Nevertheless, preoperative PVE appears to be a beneficial procedure for patients undergoing major hepatectomy, particularly those with chronic liver disease.     

Radiologic features compared to clinical findings in a prospective study of 153 patients with metastatic spinal cord compression treated by radiotherapy

Summary Plain radiography, myelography and post-myelographic CT-scan are described and related to clinical findings in a prospective study of 153 consecutive patients with myelographic signs of spinal cord compression. The majority of the metastatic tumours arise in the vertebral body or the pedicles. In 80% of the patients with total blockage to the contrast medium on myelography the post-myelographic-CT showed passage of the contrast medium. Ambulatory function at time of diagnosis was correlated to the degree and the localization of the epidural block. In 64 patients who underwent a second myelography, the post-treatment findings of sensory function were correlated to radiological regression.     

应用自体静脉套和脑细胞生长肽对面神经损伤恢复影响的临床研究

目的研究采用自体静脉管套入吻合口并注入脑细胞生长肽的方法,对面神经损伤后功能恢复的影响.方法吻合神经断端后用自体静脉管套入吻合口并注入脑细胞生长肽.分析肌电图和观察表情肌功能恢复,比较两种方法对损伤的面神经功能恢复的影响.结果自体静脉管套入吻合口并注入脑细胞生长肽的方法,比传统方法表情肌功能恢复时间明显缩短,且一期修复比二期修复功能恢复时间明显缩短,差异具有非常显著性意义(P＜0.01).两种方法修复面神经损伤,表情肌功能恢复后检测面神经传导速度差异无显著性意义(P＞0.05).结论自体静脉管套入吻合口并注入脑细胞生长肽的方法是一种比较有前途的面神经修复方法.     

微创刨吸术治疗下肢静脉曲张初步研究

目的探讨微创刨吸术治疗下肢静脉曲张的初步疗效.方法对2003年6～9月40例(53条肢体)下肢静脉曲张病人进行手术治疗.53条患肢均存在浅静脉曲张,16条患肢同时伴交通支静脉功能不全,10条患肢同时伴慢性静脉性溃疡,5条患肢同时伴重度深静脉返流.根据病情需要分别或同时行内镜深筋膜下交通支静脉结扎、大隐静脉高位结扎和剥脱飞股浅静脉瓣膜外修复成形术和下肢曲张浅静脉微创刨吸术.结果术后53条患肢肢体症状和浅静脉曲张消失,10条患慢性静脉性溃疡肢体短期内愈合.术后短期随访,无新生的渍疡,无静脉曲张复发,小腿外观无明显手术疤痕.结论微创刨吸术治疗下肢静脉曲张安全有效,损伤少,并发症少,达到了微创和显效的目的,可能是治疗下肢慢性静脉功能不全的重要组成部分.     

肝移植术后门静脉并发症的诊断和治疗(附6例分析)

目的 探讨肝移植术后门静脉并发症的诊断和治疗。方法 回顾性分析160例原位肝移植临床资料。结果 肝移植术后门静脉并发症发生率为3．75％，与门静脉并发症相关死亡率为0。门静脉狭窄发生率为1．25％，门静脉栓塞发生率为2．5％，需治疗的门静脉并发症占33．3％。结论 术前有门脉高压症手术治疗史、移植术前门静脉血栓、门静脉手术史以及严重感染病史等是门静脉并发症的高危因素；彩色多普勒超声检查是监测门静脉并发症的有效方法，确诊门静脉并发症依赖门静脉造影；有症状的门静脉并发症需及时行再血管化手术。     

Array compression for MRI with large coil arrays.

Arrays with large numbers of independent coil elements are becoming increasingly available as they provide increased signal-to-noise ratios (SNRs) and improved parallel imaging performance. Processing of data from a large set of independent receive channels is, however, associated with an increased memory and computational load in reconstruction. This work addresses this problem by introducing coil array compression. The method allows one to reduce the number of datasets from independent channels by combining all or partial sets in the time domain prior to image reconstruction. It is demonstrated that array compression can be very effective depending on the size of the region of interest (ROI). Based on 2D in vivo data obtained with a 32-element phased-array coil in the heart, it is shown that the number of channels can be compressed to as few as four with only 0.3% SNR loss in an ROI encompassing the heart. With twofold parallel imaging, only a 2% loss in SNR occurred using the same compression factor.