大黄(庶虫)虫丸治疗囊肿性痤疮的临床疗效评价

目的　观察大黄虫丸治疗囊肿性痤疮的临床疗效。　方法　选择囊肿性痤疮患者 33 例做为治疗组,给予口服大黄虫丸治疗,观察并记录结果。　结果　治疗的总有效率为 90 9%,对照组(P<0 05)。　结论　大黄虫丸对囊肿性痤疮有较好的临床疗效。     

平阳霉素治疗颌面部血管瘤的远期疗效观察

目的　探讨平阳霉素治疗血管瘤的疗效和并发症。方法　总结采用平阳霉素瘤腔局部注射颌面部头颈部血管瘤满 5年的 4 32例病例情况。结果　海绵状血管瘤、莓样血管瘤、混合性血管瘤治愈显效率达 77 95 %、90 78%、80 5 6 % ,有部分病例合并有疤痕、色素异常、皮肤皱缩、组织畸形并发症。结论　平阳霉素治疗颌面部血管瘤疗效可靠 ,应注意防止并发症的产生。     

Maternal mortality and maternity care from 1990 to 2005: uneven but important gains

Maternal mortality continues to be the major cause of death among women of reproductive age in many countries. Data from published studies and Demographic and Health Surveys show that gains in reducing maternal mortality between 1990 and 2005 have been modest overall. In 2005, there were about 536,000 maternal deaths, and the maternal mortality ratio was estimated at 400 per 100,000 live births, compared to 430 in 1990. Noteworthy declines took place in east Asia (4% per year) and north Africa (3% per year). Maternal deaths and mortality ratios were highest in sub-Saharan Africa and southeast Asia and low in east Asia and Latin America/Caribbean. In 11 of 53 countries with data, fewer than 25% of women had had at least four antenatal visits. About 63% of births were attended by a skilled attendant: from 47% in Africa to 88% in Latin America/Caribbean. In 16 of 23 countries with data, less than 50% of the recommended levels of emergency obstetric care had been fulfilled. Only 61% of women who delivered in a health facility in 30 developing countries received post-partum care, and far fewer who gave birth at home. Countries with maternal mortality ratios of 750+ per 100,000 live births shared problems of high fertility and unplanned pregnancies, poor health infrastructure with limited resources and low availability of health personnel. The task ahead is enormous.     

使用皮下埋藏灌注器治疗肝癌导管并发症分析

目的 研究皮下埋藏灌注器治疗肝癌导管所致的并发症。方法 收集我院1990～2004年用该方法治疗肝癌患者共313例，其中肝动脉栓塞化疗234例，门静脉化疗33例，肝动脉栓塞化疗加门静脉化疗40例，腹腔置管化疗6例。结果 发生导管并发症共43例，发生率为13．7％，其中导管堵塞16例，导管移动、松脱7例，肝动脉胆管漏8例，灌注器皮下感染，皮瓣坏死12例，肝动脉插管与门静脉插管导管并发症的比率为2．6：1。结论 采用皮下埋藏灌注器治疗由肝癌导管所致的并发症，为数不少，应引起重视。     

人工髋关节置换并发假体周围骨折的临床分析

[目的]分析人工髋关节置换术中、术后发生假体周围骨折的原因，探讨其预防措施和治疗方法。[方法]自1995年7月-2006年8月，共640例人工髋关节置换术患者，其中18例发生假体周围骨折，术中骨折11例（股骨距骨折7例，假体柄下端骨折4例），术后骨折7例（假体柄下端、远端骨折），男12例，女6例，年龄51-79岁，平均68岁，按照髋关节假体置换术后骨折的AAOS分型：I型1例，Ⅱ型4例，Ⅲ型4例，IVa型4例，IVb型2例，V型1例，Ⅵ型2例，其中术中假体周围骨折11例有10例予立即内固定，1例（Ⅱ型）股骨距劈裂骨折无明显移位未做内固定，仅延迟下地负重时间；术后假体周围骨折7例有4例在两周内行手术内固定，2例合并假体松动而采用全髋关节翻修术，1例（Ⅵ型）假体远端骨折因身体原因无法手术而采取保守治疗予以骨牵引4周后改石膏外固定。[结果]术后平均随访时间15．2个月（6-38个月），15例患者骨折均达到骨性愈合，2例发生骨折延迟愈合，保守治疗的1例患者术后6个月拍x线片示骨折畸形愈合，术后8个月因内科疾病死亡。Harris评分平均80分（67-92分）。[结论]术中暴力、股骨髓腔发育异常、假体型号过大、骨质疏松是术中假体周围骨折发生的主要原因，骨溶解、假体松动、骨质疏松加外伤是术后发生假体周围骨折的主要原因，根据不同分型采用不同的治疗方法以促进骨折愈合，稳定假体，减少卧床时间和并发症（尤其对高龄患者更为重要），尽早恢复功能。     

Use of an aortic connector system for vein grafting

OBJECTIVE: The aortic connector system was used to minimize cerebrovascular complications when performing the proximal anastomosis of vein grafts during coronary artery bypass grafting (CABG). The goal of this study was to investigate the intermediate outcomes of patients undergoing CABG with the aortic connector system. METHODS: The aortic connector was used on nine patients undergoing CABG between November 2002 and July 2003. Intermediate outcomes of the patients were examined, and the results of coronary angiography, which were performed before patient discharge and at least 6 months after discharge, were evaluated. RESULTS: There were no operative deaths or cerebrovascular accidents. One patient died 9 months after discharge, one patient had angina, and the remaining seven patients were asymptomatic. When evaluating the results of angiography performed before patient discharge, two of the 21 distal vein graft anastomoses were occluded (patency rate, 90.5%), but there was no stenosis or occlusion at the proximal anastomoses sites that were performed using the aortic connector. When evaluating the results of the second angiography performed after patient discharge, four of the eight proximal anastomoses were patent, one was completely occluded, two had 90% stenosis and one had 75% stenosis. Further, four of the 18 distal anastomoses were occluded (patency rate, 77.8%). There was no significant difference in graft flow or device size when comparing patients with patent vein grafts and those with stenotic or occluded vein grafts. CONCLUSION: Intermediate outcomes of vein grafting using the aortic connector were suboptimal. Long-term outcome data are forthcoming.     

腹腔镜胆囊切除联合手术117例临床报告

目的探讨腹腔镜联合手术的可行性及安全性。方法回顾分析1992年3月至2006年12月间117例腹腔镜联合手术的临床资料;男性39例,女性78例,年龄为25~74岁,其中行腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC) 腹腔镜阑尾切除术(laparascopic appendectomy,LA)46例;LC 肝囊肿去顶减压术15例;LC 肾囊肿去顶减压术6例;LC 肝、肾囊肿去顶减压术3例;LC 腹腔镜脾切除、门奇静脉联合断流术7例;LC 腹腔镜胃肠间质瘤切除术6例;LC 腹股沟疝修补术3例;LC 结直肠癌根治术8例;LC 粘连松解术6例;LC 子宫肌瘤剔除术6例;LC 卵巢囊肿剥除术10例;LC 肾脏错构瘤切除术1例。结果手术均顺利完成,中转开腹1例,胆漏1例,无感染、出血和胆道损伤等并发症;术后住院日平均为5.7 d。结论只要严格掌握各自疾病的手术治疗原则及联合手术的适应证,对两种或两种以上腹部病变的腹腔镜联合处理是安全有效的,具有创伤小、痛苦少、恢复快、灵活方便和多病联治的优点。     

Spontaneous regression of gastric varices after iatrogenic injury to a gastrorenal shunt

We present a patient with gastric varices complicating portal hypertension caused by liver cirrhosis related to hepatitis C virus. The patient underwent balloon‐occluded retrograde transvenous obliteration. The gastric varices almost completely disappeared, without any sclerotic agent being used, after iatrogenic injury of the gastrorenal shunt at the time of the interventional procedure.