腹腔镜微创技术施行直肠癌腹会阴联合切除手术的体会

目的:总结腹腔镜微创技术施行腹会阴联合切除术(abdom inal pelvic resection,APR)治疗低位直肠癌的手术体会。方法:2003年1月至2006年12月,我院为17例低位直肠癌患者行腹腔镜微创APR根治术。其中男10例,女7例,45~82岁,平均72岁。腹部手术在腹腔镜下完成,会阴部手术按常规手术进行。结果:17例中14例(82.4%)采用完全腹腔镜术式,3例(17.6%)采用腹腔镜辅助术式。手术中均未行盆底腹膜关闭和结肠造口旁间隙关闭。平均手术时间为(166.2±42.7)m in,全组无手术死亡病例。术后早期并发症有会阴部切口感染2例(11.8%),不全性肠梗阻1例(5.9%)。术后随访2~48个月,平均26个月,最长无瘤生存期48个月,造口旁疝1例(5.9%),远处转移1例(5.9%),无局部复发,无戳口和切口肿瘤种植以及肠梗阻发生。结论:腹腔镜微创技术用于APR手术具有患者创伤小的优势;术中造成的系膜裂孔和盆底腹膜均无缝合关闭的必要,但结肠造口必须严密缝合腹膜防止造口旁疝形成;会阴部手术必须严格无菌操作预防感染。腹腔镜微创技术是APR手术的较好方式。     

多层螺旋CT和MRI测量肩胛盂斜倾角的互补性初探

目的 探讨多层螺旋CT(MSCT)多平面重组(MPR)及MRI测量肩胛盂斜倾角的互补性.方法 收集成人肩胛骨干标本22侧及肩关节防腐湿标本24侧,用16层螺旋CT扫描仪扫描,多平面重组重建肩胛骨并测量肩胛盂斜倾角,得数据A组.收集MRI检查正常的肩关节病例50侧,取其斜冠状位T1WI显示肩锁关节的层面测量肩胛盂斜倾角,得数据B组.进行统计学处理.结果 肩胛盂斜倾角最小值91.10°,最大值118.50°,A、B 2组肩胛盂斜倾角数据分别为101.14°±4.66°和104.05°±7.72°.2种测量方法肩胛盂斜倾角值统计学上有显著性差异(P＜0.05).结论 MSCT的MPR法测量肩胛盂斜倾角与MRI测量值不同,前者略小于后者;MSCT和MRI 2种测量肩胛盂斜倾角方法结合具有重要的应用价值.     

Linear birefringence measurements of the in vitro human cornea

This paper presents results of an in vitro investigation of the optical anisotropy of the human cornea. Computer controlled imaging polarimetry and the Jones formalism were used to investigate the distribution of the birefringence and the azimuth angle across the surface of 12 corneas taken from the corneal bank. Each map of the birefringence and the azimuth angle has no rotational symmetry and is different for each cornea. The minimal value of the birefringence always appears in the corneal centre and varies from 9 to 43 degrees for different corneas. Birefringence of the cornea increases monotonically more than one order in the direction of the corneal periphery. Close to the centre of the cornea the azimuth angle is almost constant and varies significantly away from the optical part of the cornea.     

美罗培南治疗慢性盆腔炎的临床研究

目的观察美罗培南治疗慢性盆腔炎的临床疗效和安全性。方法将90例盆腔炎患者随机分为1．5g治疗组45例（A组）和头孢米诺3．0g对照组45例（B组），每天分3次使用，疗程均为7～14d。比较两组临床疗效、细菌学改变及不良反应情况。结果A、B组临床有效率分别为97．78％、95．56％，二者比较差异无统讣学意义（P〉0．05）。结论美罗培南治疗慢性盆腔炎安全、有效。     

后腹腔镜根治性肾输尿管切除术21例报告

目的:探讨后腹腔镜根治性肾输尿管切除术的疗效。方法:2003年10月至2006年10月我们对21例肾盂或输尿管移行细胞癌患者行后腹腔镜根治性肾输尿管切除术,其中肾盂癌13例,输尿管癌8例。经尿道输尿管口切除术处理末段输尿管,使用Hem-O-lock结扎锁处理肾动静脉。结果:本组手术时间180-300m in,平均220m in;出血量40-100m l,平均60m l;术中、术后未发生明显并发症。随访2-35个月,2例发生膀胱移行细胞癌。结论:后腹腔镜根治性肾输尿管切除术具有创伤小、术后恢复快等优点,用Hem-O-lock结扎锁处理肾动静脉安全可靠,经济实用。     

下颌角截骨术与下颌角外板矢状劈开术联合矫治低角型下颌角肥大

目的：下颌角肥大有多种式术可选,对于低角型下颌角肥大,往往一种式术很难达到满意的矫治效果,本文选择了一组低角型下颌角肥大患者,来研究下颌角截骨术与下颌角外板矢状劈开术联合应用治疗低角型下颌角肥大的治疗效果。方法：选择本科室2005年8月～2005年11月间治疗的24例低角型下颌角肥大患者,完善术前检查与分析。在全麻下应用下颌角截骨术与下颌角外板矢状劈开术进行联合矫治。术后观察治疗效果,并在8周后对所有患者进行随访,调查患者满意度。结果：所有24例患者矫治后Ⅰ期愈合,所有患者下颌角角度增大,两下颌角间宽度明显减小,达到了下颌角的正常美学标准。8周后随访,所有患者均对治疗效果表示满意。结论：下颌角截骨术与下颌角外板矢状劈开术联合应用,可有效地矫治低角型下颌角肥大,使患者下颌角达到一个理想的美学标准。     

Mefenamic acid-induced bilateral transient myopia, secondary angle closure glaucoma and choroidal detachment

Drug-induced secondary angle closure is quite common and in the majority of cases simply stopping the medication leads to rapid reversal of the condition and resolution of glaucoma. We describe here a patient who presented with secondary angle closure glaucoma and myopia following mefenamic acid ingestion which was managed successfully by stopping the medication, symptomatic treatment and reassurance.     

下颌角截骨面下部轮廓重塑的研究

目的:下颌角截骨是面型轮廓重塑中最常见的一种手术,为了提高手术的精确性,避免不必要的损伤,我们对各种下颌角截骨术操作技巧进行探讨.方法:术前进行面部测量、下颌骨曲面断层X线和头颅正侧位定位X线片投影测量,设计截骨线和去骨量,术式选择口内切口下颌角截骨术、口内切口下颌角外板矢状劈开截骨术、耳后切口下颌角截骨术、耳后和口内联合切口下颌角截骨术;结果:面下部过宽同时下颌角肥大者单纯下颌角截骨效果往往不会很理想,需要同时进行下颌角外侧骨板部分去除,减少面下部的宽度,206例术后两侧对称,效果良好;1例面瘫;2例下颌骨骨折,术中做内固定;3例下颌骨体部成角,3个月后第二手术将突出部分磨平.结论:术前测量设计下颌角截骨的术式和截骨线是十分必要的,根据下颌角肥大的不同类型选择相适应的截骨术式.     

End-to-side anastomosis of rat carotid artery: comparison of different types of section and shape of the terminal end

Summary In 50 rats, different types of end-to-side carotid artery anastomoses were compared. In one technique, a longitudinal split in the long axis of the vessel was performed to enhance the diameter of the anastomosis. This theoretical advantage was not confirmed in this series. The clamping time, anastomoses time, and tamponade time were increased significantly when compared with a simple, slightly oblique end-to-side anastomosis. This study highlighted that the most simple type of end-to-side anastomosis gave less bleeding, achieved a quicker water-tight anastomosis and decreased the risk of late problems.     

中西医结合治疗慢性盆腔炎100例疗效观察

目的:采用中西医结合治疗慢性盆腔炎,减少复发,提高治愈率。方法:对我院门诊患者100例采用胎盘组织液肌注,金钢藤胶囊口服,并用我院自制中药妇炎肠疗液灌肠。结果:临床显效40例,有效56例,无效4例,总有效率96％。结论:中西医结合治疗慢性盆腔炎疗效满意,是目前治疗慢性盆腔炎的最好方法。