经眉入路额颞部除皱术

额颞部皱纹的出现及眉下垂使人们从外观上表现明显苍老。而传统术式由于创伤大,并发症多而不被多数求术者接受。我科自1996年7月开始,根据眉区、上睑的解剖特点,应用经眉人路额颞部除皱、眉上提固定术,对36例进行手术治疗。局部解剖层次清晰,创伤小,对额颞部纹、眼眉下垂、眉形不佳等均有较大程度的改善,使面部老化状态从整体上得到改观,获得了满意效果,为多数求术者所接受。     

后路显微内窥镜治疗非发育性腰椎管狭窄症

目的应用后路脊柱显微内窥镜治疗非发育性腰椎管狭窄症。方法通过一个后正中微小切口，采用游离皮瓣和手术通道倾斜，实现多阶段减压和神经根通道松解，使用METRX完成非发育性腰椎管狭窄的手术治疗。结果术后疗效评定优良率为97．8％。结论METRX手术是传统开放式腰椎管狭窄手术的微创化和内窥镜化，可以彻底解除神经压迫，达到微创手术的目的，取得满意临床效果。     

肱骨干骨折外固定架治疗96例分析

目的：探讨应用外固定架治疗肱骨干骨折并发症的防治办法。方法：通过对96例肱骨骨折患者应用骨外固定架治疗结果进行分析，以求获得并发症的防治策略。闭合性骨折91例，单环横形、斜形或螺旋形骨折54例，粉碎性骨折37例。开放性骨折5例，Gustilo Ⅰ型3例，Ⅱ型2例。结果：82例得随访，随访时间为4～26个月。61例顺利临床愈合，功能恢复满意。26例出现骨折延迟愈合、桡神经损伤等不同类型并发症。结论：通过术中准确无误的操作及术后科学细致的管理，手术并发症可以有效防治。     

膝关节弹响28例关节镜诊治分析

目的探讨关节镜在膝关节弹响诊治中的应用。方法回顾性分析281例存在膝关节弹响症状的膝关节疾病的临床资料,全部病例均施行了膝关节镜手术治疗。分析不同疾病导致膝关节弹响的部位、镜下特点和评价疗效。结果发现半月板损伤占53%,骨性关节炎（OA）占21%、盘状半月板为9%、关节内游离体及滑膜皱襞分别为7%和5%,其他占5%。镜下发现弹响产生的机制各不相同,使临床上弹响的性质、特点不完全一样。结论形成膝关节弹响的病因很多,其中以半月板损伤多见,但必须结合病史及弹响特点,才能更准确地做出诊断。关节镜术是关节内弹响的有效诊治手段。     

小波分析多分辨率技术在腰椎间盘突出症定位诊断中的应用价值

目的：探讨小波多分辨率技术（WAMT）定位诊断腰椎间盘突出症在临床上的应用价值,方法：利用WAMT对100例腰璋盘突出症住院患的脊柱X线片进行处理,获得腰椎间盘突出节段椎管局部额状面数字图像,根据该图像显示椎间盘突出的形态,定位诊断腰椎间盘突出症,并与CT及手术所见进行对比,手术切除组织常规病理活检,结果,WAMT定位诊断腰椎间盘突出症阳性率85．2％,CT阳性率77．6％,结论：WAMT简便实用,定位诊断正确率高,有临床推广应用价值。     

系统思想在误诊学研究中的意义

临床误诊问题现已成为医学界、法律界、舆论界以及患者群体共同关注的社会问题。怎样从误诊学角度探索误诊规律 ,研究失误的因素 ,总结失误的教训 ,提出相应的对策 ,最终达到提高治愈率、降低死亡率的目的已成为临床医学的一大课题。误诊学作为一门新兴的医学边缘学科 ,尚有大量的探索性工作 ,本文拟从系统思想角度去认识现代误诊学研究。1　系统理论概述2 0世纪 30年代 L·Ven.Bertalanffy在对分子生物学进行研究时发现生物解剖越来越细 ,反而失去全貌 ,于是将机体与环境结合起来研究 ,创立了一般系统科学。此后 ,在系统思想的基础上系统…     

垂直提升联合整形术治疗眼睑松弛

目的：从整体上解决眼周松驰的状况，改善眼眉形态，一次性完成眼周整形。方法：根据眼睑松驰程度，选择重睑，眉部、眼袋切口去除松驰的眼睑皮肤、多余脂肪；悬吊轮匝肌韧带，对眶缘新月形凹陷，释放眶脂充填、固定，紧缩眶隔筋膜，垂直向上、外上提升松驰之上睑，固定轮匝肌于眉弓骨膜或眶外缘骨膜上，皮肤切口向上垂直提升缝合，一次完成上、下睑松驰的矫正。结果：经治疗的34例上、下睑松驰患者术后上、下睑松驰均得到矫正，眉位置得到上提，下睑眶缘凹陷得到充填。眼角额部皱纹减少。结论：上、下睑松驰经联合手术垂直提升皮肤、肌肉、改善眉位置后，一次性完成了眼周整形，达到了较好的美学效果。     

合并内眦赘皮的重睑术

目的：寻求一种简单有效的内眦赘皮手术治疗方法。方法：通过观察内眦部解剖的特点了解内眦赘皮的形成原因，设计出将内眦部眼轮匝肌和内眦韧带的修复固定，同时一次完成内此成形及重险术。结果：72例不同类型的内眦赘皮，Ⅱ级和Ⅲ级23例，术后经过3－12月随访手术切口产痕3月后逐步软化，有2例肤色较深的患者内眦部切口瘢痕到6月后才不大明显，余效果满意。结论：该方法操作容易，术后外形满意，内眦形态好，瘢痕不明显，患者易于接受。     

Effect of autocontrol micromotion intramedullary interlocking nail on fracture healing： an experimental study

Objective: To investigate the effect of autocontrol micromotion locking nail ( AMLN ) on experimental fracture healing and its mechanism. Methods: 16 goats undergoing both sides of transverse osteotomy of the femoral shafts were fixed intramedullary with AMLN and Gross-Kempf (GK) nail, respectively. The follow-up time was 7, 14, 28 and 56 days. Roentgenographic, biomechanical, histological, scanning electromicroscopic and biochemical analyses were done. Results: (1) The strength of anticompression, antiflexion and antitorsion in the fractural end in the AMLN-fixed group was higher than that of GK nail-fixed group; whereas, the rate of stress shelter in the fractured end decreased significantly (P<0.01). (2) The content of the total collagen, insoluble collagen, calcium and phosphate in the AMLN-fixed group was higher than that in the GK nail-fixed group (P<0.05). (3) Histological observation and quantitative analysis of calluses revealed that AMLN could promote the growth of bridge calluses and periosteum calluses. Hence the facture healing and remolding process achieved early, which was much better than traditional GK nail fixation. (P<0.05). (4) 7-14 days postoperation, the calluses of AMLN-fixed group was flourish and camellarly arranged and the collagen fibril formed constantly in the absorption lacuna of bone trabecula. 28-56 days postoperation, the collagen fibril was flourish around the absorption lacuna and was parallel to the bone's longitudinal axis. Active bony absorption and formation were seen, so was remolding and rebuilding. Haversian system was intact and the bony structural net was very tenacious because of the deposition of calcium salt. None of the above findings was observed in the GK nailfixed group. Conclusions: The design of AMLN accords well with the plastic fixation theory. As the geometry ametabolic system constituted by the intramedullary fixation instruments and the proximal and distal end of the fracture is very firm and stable, the disturbance to the physical stress distributed in the fractural end is light. The generation and conduct of the intermittent physical stress between the fractural parts could reach the balance between stress conduct and stress protection. The feature that the healing and remolding take place at the same time speeds up the fractural healing process.     

有限双开窗法治疗腰椎软骨板破裂症

为保留腰椎后部结构的完整性,又能充分显露,彻底减压,采用根据椎板分型,倒U或V型椎板开窗,扩大侧隐窝治疗腰椎软骨板破裂症12例。手术尽可能地保留腰椎全部结构的完整性,可防止术后腰椎不稳,同时使神经根管代偿间隙明显增大,减低了术后DFC连锁变异现象所引起的椎管狭窄。经1～3.5年随访效果满意。并就12例腰椎软骨板破裂症的特点进行了讨论。