带旋髂深血管蒂髂骨瓣移植与加压螺钉治疗青壮年股骨颈骨折

本文报告了自１９８５年￣１９９５年间采用带旋髂深血管蒂髂骨瓣移植与加压螺纹钉内固定治疗青壮年囊内型股骨颈骨折２６例。随访时间平均５年５个月。结果，２６例骨折痊愈，骨折愈合率为１００％。骨折愈合时间平均４个月。仅１例骨折愈后后股骨头发生缺血坏死。股骨头缺血坏死率为４％。     

股骨颈骨折粗细双螺钉内固定生物力学研究

股骨颈骨折内固定方法繁多。本文采用一粗一细加压螺纹钉，采用先进电阻应变仪方法，对股骨颈的应力分布规律在中立、外展、内收不同位置上施加50kg荷载压力．通过电阻应变计测定一耗一细两钉所承受拉、压应力优于其它内固定形式。     

A new operational approach for the piriform sinus fistula

It has been well documented that piriform sinus fistulae often cause suppurative thyroditis; however, when a piriform sinus fistula does not present this symptom, making a correct diagnosis is very difficult. We have experienced 11 cases of a piriform sinus fistula. The conventional operational approach was performed in the initial eight patients, among which there were four recurrences in two patients. Therefore, a new operational approach was introduced for the three most recent cases and one recurrent case. First, the existence of the internal orifice of the fistula is confirmed with a laryngoscope, after which a transverse incision on the neck is made and the abscess dissected. The side wall of the piriform sinus is then opened with the help of a laryngoscope and the bottom part of the mucosa of the sinus transected with the internal orifice of the fistula, after which the fistula is removed en bloc with the bottom part of the sinus and abscess cavity. Using this operation, we experienced no complications and there has been no recurrence so far.This paper was presented at the 23rd Annual Meeting of Pacific Association of Pediatric Surgeons, June 1990 in Kona, Hawaii.     

头颈部肿瘤合并糖尿病的围手术期处理

目的探讨头颈部肿瘤合并糖尿病患者围手术期的处理方法.方法从2001年1月～2003年6月我科收治的头颈部肿瘤450例,对其中33例合并糖尿病患者使用胰岛素控制血糖的资料进行分析.结果 28例无并发症发生,切口感染2例,腮腺漏2例,心律失常1例,无围手术期死亡.结论对于合并糖尿病的头颈部肿瘤患者,合理使用胰岛素控制血糖是围手术期处理的主要方法,是安全渡过围手术期的重要保证.     

乳腺癌全乳切除加低位腋窝淋巴结清除术的远期疗效

目的：探讨全乳切除加低腋淋巴结清除术对乳腺癌预后的影响。方法：随访1988一1992年本院98例乳腺癌行全乳切除加低腋淋巴结清除术患者，并以同期156例乳腺癌行根治术患者做对照。结果：两组5年生存率分别为68．4％(67／98)和72、4％(113／156)，两组无显著差异(P＞0．05)，l0年生存率分别为26．5％(26／98)和55．1％(86／156)，总复发率分别为61．2％(60／98)和l7．3％(27／56)，平均淋巴结检出数6一15个，有显著性差异(P＜0．05)。结论：滥用全乳切除加低腋窝淋巴结清除术对乳腺癌预后有影响，尤其l0年生存率、锁骨上淋巴结转移率。     

Diagrammatic recording of head and neck tumours1

The increasing demands of clinical audit have resulted in the need for accurate data collection. The use of tumour maps allows standardization of the records of patients with head and neck cancer, which facilitates collation of data in multicentre studies and makes interdepartmental comparisons more meaningful. The aim of this study was to develop an improved standard set of tumour maps for recording the stage of head and neck tumours. A review of the existing tumour diagrams was performed to identify those anatomical areas that are not adequately represented or where ambiguity exists. The areas where improvements could be made were identified as: (1) the anterior commissure of the larynx; (2) axial and sagittal views of the larynx; (3) the pyriform fossa and cervical oesophagus; (4) the oropharynx and vallecula; (5) the nasal cavity and paranasal sinuses; and (6) cervical nodal involvement. A new set of tumour maps is presented in an attempt to correct some of the limitations of the existing diagrams.     

Retropharyngeal lymph node metastasis from olfactory neuroblastoma: a report of two cases

Olfactory neuroblastoma is a rare, malignant neoplasm arising from the olfactory epithelium. It has an aggressive biological behavior that is characterized by local recurrence, atypical distant metastasis, and poor long-term prognosis. The incidence of cervical lymph node metastasis in olfactory neuroblastoma is variable, and treatment modalities are controversial. Moreover, few reports have been published concerning retropharyngeal lymph node metastasis from olfactory neuroblastoma. We present two cases of olfactory neuroblastoma with retropharyngeal lymph node metastasis. In addition, we provided a review of the current literature regarding olfactory neuroblastoma and retropharyngeal lymph node metastasis from olfactory neuroblastoma.     

针刺配合康复训练改善脑卒中后吞咽障碍临床观察

目的观察项针加康复训练对改善脑卒中患者吞咽障碍的治疗效果。方法将符合入选标准的60例脑卒中后吞咽障碍患者采用随机对照法，分为两组，每组30例，对照组进行常规康复训练，治疗组在常规康复训练基础上进行项针治疗。结果两组患者治疗后，洼田氏饮水试验疗效比较差异具有统计学意义（P〈0．05），说明治疗组疗效优于对照组。结论项针配合康复训练能改善脑卒中患者的吞咽功能，提高患者的生存质量，其效果优于单纯康复训练。