体象障碍患者对美容手术的满意度调查

目的 观察体象障碍患者在整形手术中的一般情况及其对手术的满意程度.方法 采用自制问卷调查21名体象障碍组和对照组对手术的满意程度及体象障碍组对两次手术的满意程度.结果 体象障碍组和对照组在手术满意度上有显著差异,体象障碍组的第1次与第2次手术的满意度有显著差异.结论 体象障碍患者对手术的满意程度较低,反复的手术导致更低的满意程度.     

病灶深度对乳腺超声弹性成像的影响

目的探讨病灶深度对乳腺超声弹性成像的影响。方法对261例患者共554个乳腺病灶行超声弹性成像检查。设定满意的乳腺超声弹性图像标准。在静态弹性图像上确定病灶底部与皮肤的距离为病灶深度。对部分病灶观测其前方脂肪层厚度。结果深度〉2.5cm的12个病灶均未获得满意的弹性图像;深度≤2.0cm的531个病灶仅有2个不满意;深度2.1～2.5cm的11个病灶中,3个未获得满意的弹性图像。深度≤2.0cm的病灶获得满意弹性图像的数量明显多于深度〉2.0cm的病灶,二者图像满意率差异有统计学意义（χ2=311.61,P〈0.01）。结论乳腺病灶深度对超声弹性成像有影响。当病灶底部与皮肤的距离〉2.5cm时,可能难以获得满意的超声弹性图像。     

Can radiological results be surrogate markers of functional outcome in distal radial extra-articular fractures?

The purpose of this study was to evaluate the relationship between radiological and functional results in patients with extra-articular fractures of the distal radius. We conducted a prospective study of radiological and functional assessment in 95 consecutively selected extra-articular distal radius fractures. There were two patient groups: more than 60 and less than 60 years of age. The final fracture union radiographs were analysed for their functional outcome using the Michigan Hand Outcomes Questionnaire (MHQ) and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. In patients with acceptable radiological results, 62% (MHQ group) and 72% (DASH group) of patients had satisfactory functional outcome. Analysing patients with satisfactory functional results, 56% (MHQ group) and 59% (DASH group) had satisfactory radiological results. There was a higher proportion of patients with better functional results, despite poor radiological results, in both of the age groups. There was a statistically significant correlation between satisfactory radial tilt and functional outcome in the younger patients. In the older age group, patients with satisfactory radiological results had satisfactory functional outcome (p < 0.05). However, in the older age group, satisfactory functional results were achieved, despite unsatisfactory radiological results.     

Z350纳米复合树脂前牙美容修复的临床效果分析

目的：探讨Z350纳米复合树脂修复前牙的美观满意率和疗效。方法：160颗需要进行修复的前牙随机分为两组,即实验组和对照组各80颗,分别采用Z350纳米复合树脂和Z250复合树脂修复,修复完成时及修复1年后进行患者和医生对修复体的美观满意率调查,并进行修复效果的成功率检查。结果：修复完成时两组的医、患美观满意率均无显著性差异。修复1年后Z350纳米复合树脂组的修复成功率和医、患美观满意率均比Z250复合树脂组的高,差异有显著性。无论在修复完成时或修复1年后,患者对修复体的满意率均低于医师,但无显著性差异。结论：Z350纳米复合树脂修复前牙1年后的美观满意率和成功率均比Z250复合树脂的高,但患者对修复体的美观满意率要较医师的低。     

Closed treatment of fractures of the proximal humerus

The results of 42 patients with three-or four-part fractures of the proximal humerus treated by closed methods only were reviewed. In 34 three-part fractures, 24 cases were satisfactory and 10 cases unsatisfactory; the satisfactory results tended to be in an older age group. In four-part fractures all eight cases had unsatisfactory results. It is concluded that closed treatment can give satisfactory results in three-part fractures but not in four-part fractures.     

临床护理路径在腹股沟疝患者中的应用

目的探讨临床护理路径在腹股沟疝患者中的应用价值。方法我院普外科2005年1月至2005年7月收治腹股沟疝患者60例，将患者随机分成实验组和对照组，每组30例患者，分别观察住院天数、住院费用、患者对疾病相关知识掌握情况及护理质量满意度等指标。结果实验组平均住院天数4．26d，平均住院费用3741，患者对疾病相关知识掌握情况100％，护理质量满意度96．67％。对照组平均住院天数6．50d，平均住院费用4253元，患者对疾病相关知识掌握情况80％，护理质量满意度73．33％。结论临床护理路径在腹股沟疝患者中可有效的减少平均住院天数、降低平均住院费用、提高患者对疾病相关知识掌握情况及护理质量满意度。     

Surgical treatment of os acromiale with and without associated rotator cuff tears

Nineteen consecutive patients treated surgically for meso-os acromiale and subacromial pathology were reviewed retrospectively, with a mean length of follow-up of 40 months (range, 24-94 months). Of the patients, 11 (58%) were treated with acromioplasty in the presence of a stable os acromiale; 8 patients (42%) underwent open reduction-internal fixation for an unstable and painful os fragment. Of the 19 patients, 8 (42%) with an os acromiale had an associated full-thickness rotator cuff tear. Overall, only 10 of 19 patients (53%) achieved a satisfactory result. All 8 patients (100%) treated with open reduction-internal fixation achieved union of the os fragment, although only 3 (37.5%) achieved a satisfactory result. Of the 11 patients who underwent acromioplasty, only 7 (64%) achieved a satisfactory result. The outcome of surgical management of symptomatic meso-os acromiale with concomitant rotator cuff pathology was satisfactory in 4 of 8 patients in our study group. The rate of satisfactory results was similar in patients with (50%) and without (55%) associated rotator cuff tears. When we analyzed our results to exclude workers' compensation patients, 80% achieved satisfactory results (compared with only 22% in our workers' compensation group).     

Urethroplasty using a pedicled skin graft of prepuce in the operative repair of hypospadias

Urethroplasty was carried out with pedicle skin of prepuce in 6 patients with the hypospadias since Feb 1987. The satisfactory results have been achieved and no post-operative complications of urethral fistula and stenosis were found in all patients. The authors consider that the operative procedure is simple, time-saving, and satisfactory for hypospadias.     

The results of surgery for intracerebral hematomas

Our retrospective study included 104 patients (28 female and 76 male) with intracerebral bleeding, treated between 1978 and 1988 in the Neurosurgical Clinic of the Medical University in Hannover. The average age was 43 years. 53 patients presented with traumatic intracerebral bleedings, and 51 with spontaneous hematomas. 31 patients with spontaneous hematomas were operated: among these a good or satisfactory result was obtained in 19 patients, and 12 died. Of the 20 non-operated patients, a good or satisfactory result was achieved in 10. 31 patients were operated in the group with traumatic hematoma, of these 22 had a good or satisfactory outcome and 9 patients died or had an unsatisfactory result. Of the 22 non-operated patients, 13 died and 9 achieved a good or satisfactory result. In the stratified Chit-Test the effects of the operation were not found to be significant, with 0.1 < p < 0.25 for spontaneous, and 0.25 < p < 0.05 for the traumatic hematomas. There is a trend in favor of the operation in certain cases.     

Rehabilitation of patients with suppurative osseous complications of gunshot wounds of the shoulder in Ethiopia

The authors have analysed the results of the treatment of 68 patients with pyo-osseous complications of the gunshot wounds of the shoulder which had been repeatedly operated at previous stages. The failures were connected with suppurations of the wounds, faults of the surgical technique and the postoperative management of the patient. All the patients were operated repeatedly at two stages: radical necrosequestrotomy, epidermatoplasty and tendoplasty were performed at stage I and bone autografting with immobilization with an plaster bandage were performed at stage II. The results of the treatment were good in 31 patients, satisfactory in 18 patients and not satisfactory in 6 patients. After tendoplasty the results were good in 12 patients and satisfactory in in 6 patients.     

自体脂肪颗粒移植鼻根局部隆鼻术

目的：探讨自体脂肪颗粒移植在隆鼻术中的临床应用。方法：针对一组10例单纯鼻根低平的就医者,注射自体脂肪颗粒进行隆鼻。结果：8例就医者1次充填即取得预期临床效果,2例就医者经过再次手术填充达到满意效果。结论：应用自体脂肪颗粒移植鼻根局部隆鼻能够达到良好、稳定的临床效果。     

Long-term results of anterior interbody fusion for treatment of degenerative spondylolisthesis

Thirty-nine patients, 34 women and five men, underwent anterior decompression and interbody fusion for degenerative spondylolisthesis between February 1958 and August 1988. Their average age at surgery was 51 years (range, 34-74 years), and their average follow-up period was 12 years 7 months (range, 6 months to 30 years). Clinical evaluation was done by the score rating system of the Japanese Orthopaedic Association (JOA Score). Patients with JOA scores of 25 points or more were rated as "satisfactory." Survivorship was analyzed by the method of Kaplan and Meier to determine the cumulative percentage of patients with satisfactory results. The following results were obtained: Seventy-six percent of the patients had satisfactory results for 10 years after the anterior interbody fusion, 60% for 20 years, and 52% for 30 years. Irrespective of their age at surgery, the patients generally maintained satisfactory results up to 65 years of age.     

The add-on ileal loop.

The add-on ileal loop is a procedure designed to create sufficient ileal conduit length to allow for stomal revision or relocation. We report 3 cases in which the operation was used with satisfactory results and describe the technique. The procedure is simple to perform and has the advantage of leaving a satisfactory functioning ureteroileal anastomosis intact.     

口内入路下颌角弧形截骨矫治下颌角肥大

目的：观察下颌角肥大口内弧形截骨的手术效果。方法：采用口内入路方法对下颌角肥大进行弧形截骨手术。结果：50例下颌角肥大患者均获得了良好的美容效果。结论：口内入路下颌角肥大弧形截骨整形手术方法设计合理，术后并发症少，效果良好。     

Lymphovenous Microsurgical Shunts in Treatment of Lymphedema of Lower Limbs: A 45-year Experience of One Surgeon/One Center

RationaleThe use of microsurgical lymphovenous shunts is one of the generally accepted treatments for limb lymphedema.AimThe 45-year personal experience of one surgeon in indications, technique and results of lymphovenous shunt operations in lower limb lymphedema of varying etiology is presented.MaterialOne thousand three hundred patients were followed up in the period 1966–2011. Patients were classified into groups according to the etiology of lymphedema as postinflammatory/posttraumatic, postsurgical, idiopathic and hyperplastic. Decrease in limb circumference, heaviness and pain, and increase in joint flexing were evaluated.ResultsThe most satisfactory results, reaching 80–100% improvement, were obtained in the congenital non-hereditary hyperplastic lymphedema group, with large lymphatics not previously damaged by infection. Results were also satisfactory in the group of cancer patients after iliac lymphadenectomy, reaching 80%. A less satisfactory outcome was observed in the postinflammatory group, not exceeding 30–40%. In idiopathic lymphedema results were satisfactory in only a few cases.ConclusionsPatients with lymphedema with local segmental obstruction but still partly patent distal lymphatics and without an active inflammatory process in the skin, subcutaneous tissue and lymph vessels present satisfactory results.     

Humeral medullary nailing--a new implant

A new technique of medullary nailing of the humerus using a screw-headed nail is described. Eighteen patients with two-part fractures of the surgical neck of the humerus were reviewed. Fifteen had satisfactory results while three were unsatisfactory. Nine patients with fractures of the shaft of the humerus were also treated with satisfactory results in eight. Three patients with non-union of the humerus had unsatisfactory results.     

Pseudarthrosis of the scaphoid

For the treatment of scaphoid non-unions, innumerable curative and palliative operations have been recommended. Of the curative operations, the various methods of bone grafting give the best results, whereas screw fixation is not satisfactory. Bone pegs with a cortical graft are no longer used because of technical difficulties. Corticocancellous grafts (Matti-Russe) yield bony union in almost 90% of cases. The combination of corticocancellous grafts with plate stabilization gives the highest rate of bony union (99%). A cure should therefore always be attempted in all non-union cases, with the exception of cases already involving severe, generalized osteoarthritis or extensive necrosis of the scaphoid. Of the different palliative methods, the early results of prosthetic partial or total replacement of the scaphoid are satisfactory. Late results are less satisfactory, with a high rate of complications and carpal collapse. With severe osteoarthrosis, proximal carpectomy, especially the transscaphoideo-lunate resection, gives good results. Intercarpal arthrodeses have been disappointing. Radiocarpal arthrodesis results in a pain-free, strong wrist; however, there is complete loss of motion, whereas denervation gives satisfactory results in 57% and preserved mobility of the wrist.     

颞叶病灶性癫痫的手术治疗

目的 探讨颞叶病灶性癫痫（1esional temporal lobe epilepsy,LTLE）的术前评估及手术治疗方法。方法 回顾性地分析于我研究所接受癫痫手术治疗32例患者的临床资料,MRI与CT检查证实有结构性病灶存在且位于颞叶。根据手术预后将患者分为满意组与非满意组,对两组患者术前病灶特点、电生理情况及术后病理结果等因素进行统计分析。结果 32例LTLE患者中24例效果满意,术后满意率为75％,其中病灶为皮层发育障碍的17例,术后满意率为65％;病灶为肿瘤及其他病变的15例,术后满意率为87％。病灶位于标准前颞叶切除术范围之内的共21例,位于此切除范围之外的患者11例,前者的术后满意率高于后者（P〈0．05）;病灶位于颞叶内侧结构以内的患者8例,以外的患者24例,术后效果差异不显著（P〉0．05）。发作间期脑电图异常放电区域局限且位于病灶侧颞叶的患者,满意组中有19例,非满意组中有3例（P〈0．05）。结论 对于LTLE患者,手术治疗应为首选的治疗手段。手术前充分认识病灶的性质、部位以及神经电生理特点,对提高手术满意率有重要意义。     

Synovectomy in the treatment of hemophilic arthropathy

Excised synovial membrane was examined for fibrinolytic and thromboplastic activity. Late results of synovectomy are uniformly satisfactory. Fourteen boys, 6–16 yr old, with hemophilic arthropathy of the knee, were treated by synovectomy. Excised synovial membrane was examined for fibrinolytic and thromboplastic activity. The results of synovectomy are satisfactory. Follow-up is from several weeks to 2 yr.     

Conservative Treatment of Achilles Tendon Rupture: A Follow-Up Study of Li Cases

A follow-up study of 14 patients with Achilles tendon rupture is reported. The patients were treated by conservative methods, i.e. with immobilization in a plaster cast for 8 weeks with the foot in the relaxed equinus position. Solid healing of the tendon was obtained in 13 cases. As assessed by the patients, the end result was unsatisfactory in two, fairly satisfactory in one and fully satisfactory in 11 cases.