EDEC概念应用于牙列缺损修复的病例报告

目的 阐明EDEC的具体涵义,以更好地指导牙列缺损病例修复,减少盲目性和风险.方法 通过具体病例修复的实现过程,展示EDEC概念的临床指导作用.结果 EDEC概念具有明显的临床指导作用,修复结果与预期一致,避免了临床中的盲目性.结论 EDEC概念对牙列缺损修复有明显的指导意义,适合在临床中推广应用.     

低温保存成骨细胞复合生物活性玻璃陶瓷修复兔下颌骨缺损

目的 观察经低温保存的兔骨膜源性成骨细胞(POBs)的生物学特征,及其与生物活性玻璃陶瓷(BGC)体外复合后修复颌骨缺损的能力。方法 将经鉴定的幼兔骨膜源性成骨细胞置入液氮罐中保存,取冻存6个月的细胞做生物学鉴定,并进行体外培养扩增,然后与BGC复合培养,植入兔下颌骨缺损处,对照组为植入单纯BGC组。术后第2、4、8、12周取材,行X线摄片及组织学检查,观察复合材料的成骨能力。结果 复苏的成骨细胞仍具有典型的成熟成骨细胞的生物学特征,与BGC复合植入体内后,能继续生长增殖并形成骨组织,能较快较好地修复骨缺损。结论 利用冻存复苏的成骨细胞进行组织工程学研究是可行的,细胞与材料复合所形成的组织工程化骨,可望在骨组织的修复与重建中得到更加广泛的应用。     

应用一侧颊肌粘膜瓣修复全下唇唇红缺损的初步报告

目的：介绍应用颊肌粘膜瓣修复全下唇唇红缺损的经验。方法：外伤和肿瘤切除后引起的4例全下唇唇红缺损行蒂在121角带血管蒂的颊肌粘膜瓣转移修复，术后观察红唇形态和功能的恢复情况。结果：全部颊肌粘膜瓣完全成活，无感染、血肿、导管或神经损伤及张121障碍。红唇的长度、高度、厚度及感觉都得到恢复。结论：蒂在121角的颊肌粘膜瓣能提供足够的组织修复全下唇唇红缺损，术后形态和功能恢复好，不需二期断蒂。     

婴儿法乐四联症一期矫治手术中保留肺动脉瓣功能的意义

目的 随访137例婴儿法乐四联症一期矫治手术中跨环补片患儿的近、中期疗效,总结法乐四联症手术中右室流出道及肺动脉瓣处理的经验.方法 采取一期手术矫治1岁以下法乐四联症患儿238例,其中22例经右房疏通右室流出道,79例补片加宽右室流出道;137例跨肺动脉瓣环补片.术中使用不同方法部分恢复肺动脉瓣功能90例,对合并的...     

体肺分流术治疗60例儿童发绀型复杂先天性心脏病的围手术期护理

总结60例体肺分流术治疗发绀型复杂先天性心脏痛患儿的围手术期护理.监护方法包括:术前防治缺氧发作和血栓形成;术后严密监测心功能,进行呼吸道管理,观察预防吻合口阻塞,有效地镇痛和镇静,这些能提高手术成功率和减少并发症的发生.本组3例因为术后严重低心排综合征、重症感染等死亡,其余57例恢复良好,治愈出院.     

EXTRASKELETICAL MALFORMATIONS IN THE JARCHO-LEVIN SYNDROME: POSTMORTEM STUDY OF THREE CASES

We report on pathologic examination of three autopsied newborns with Jarcho-Levin syndrome. The most important abnormalities noted were multiple extraskeletical defects such as cardiovascular, urogenital, respiratory, and central nervous system malformations. These cases add new information to the multiple vertebral segmentation defects found in this syndrome.     

侧腹部扩张任意型皮瓣修复上肢皮肤软组织缺损

目的 提高上肢大面积皮肤软组织缺损的外科治疗效果。减少供皮区畸形,方法 于侧腹部埋置扩张器,经充分扩张后,取出扩张器,形成蒂在腹部的扩张皮瓣。修复扩张器取出创面后,将“额外”皮瓣远位直接移转至上肢修复皮肤软组织缺损。结果 1997年以来,应用该方法为6例患者修复上肢皮肤软组织缺损,移转扩张皮瓣全部成活,无血运障碍、皮瓣坏死等并发症发生。获得满意效果。结论 在上肢局部无可利用的正常皮肤软组织修复缺损时,远位扩张皮瓣带蒂直接移转是一种值得考虑且安全可靠的手术方法。     

Survival in infants with Down syndrome, Metropolitan Atlanta, 1979-1998

OBJECTIVE: Factors influencing survival among persons with Down syndrome (DS) are not well understood. We sought to evaluate survival of infants with DS and potential prognostic factors. STUDY DESIGN: Infants with DS who were born alive during 1979 to 1998 were identified using the Metropolitan Atlanta Congenital Defects Program (MACDP), a population-based surveillance system. To document vital status, we used data from hospital records, the National Death Index (NDI), and Georgia vital records. We estimated survival probability using the Kaplan-Meier product limit method and hazard ratios using a Cox proportional hazards model. RESULTS: Survival probability to 1 year was 92.9% (95% CI: 90.9-94.9) and to 10 years was 88.6% (95% CI: 85.0-92.2). Univariate analysis demonstrated that black maternal race, low birth weight, preterm birth, lower paternal education, presence of heart defects, and presence of other major congenital anomalies were important prognostic factors. After multivariate analysis, maternal race, presence of heart defects, low birth weight, and an interaction between maternal race and presence of heart defects were significantly associated with mortality risk. CONCLUSIONS: A racial disparity is apparent in survival for children with Down syndrome. Further study is needed to elucidate possible reasons for the racial disparity.     

Increased Vulnerability to Alcohol-Related Birth Defects in the Offspring of Mothers Over 30

The risk of fetal alcohol syndrome (FAS) is known to increase with Increased maternal age and parity. This study investigated the hypothesis that the deficits in growth and intellectual function seen in non-FAS infants exposed to alcohol at moderate-to-heavy levels are also found disproportionately in the offspring of older mothers. Mothers of 480 African-American, inner-city infants were interviewed at each prenatal clinic visit regarding their use of alcohol during pregnancy. Infants were assessed for physical growth and cognitive development repeatedly through age 13 months. In analyses run separately for the infants of younger and older mothers, alcohol-related deficits were seen most strongly in the offspring of women over 30 years of age. This pattern was not caused by lower levels of drinking by the younger mothers. Age-related increases in maternal body fat-to-water ratio and a faster rate of alcohol metabolism in chronic drinking women may account for the greater vulnerability of the offspring of the older mothers. These data suggest that physiological changes associated with aging and/or chronic drinking may play an important role in the alcohol-related birth defects seen in infants exposed at moderate-to-heavy levels.     

鼻端缺损的四种修复方法比较

目的 比较四种常用的鼻端缺损修复方法的优、缺点,为临床选择适当的手术方式提供参考.方法 采用耳郭复合组织游离移植、局部鼻唇沟皮瓣、管形皮瓣、眼轮匝肌蒂颞区皮瓣,修复鼻端缺损57例,并进行综合分析,从修复缺损面积、住院时间、手术效果等方面进行比较.结果 57例鼻下端缺损均得到较好地修复.管形皮瓣修复缺损面积最大、住院时间最长;局部鼻唇沟皮瓣修复缺损面积最小、住院时间最短;耳郭复合组织游离移植效果好,但修复缺损面积有限.结论 鼻部下端缺损的修复,应根据其缺损面积、局部情况、患者要求和预期修复效果,选择不同的手术方法.