骨科手术患者术中自体血回输的临床观察

目的:探讨骨科手术患者术中自体血回输的临床效果,以期能减少异体血的用量。方法:将骨科择期手术患者,术中随机分为自体血回输组,及异体血输血组,比较两组术后24h伤口引流量、血常规等情况。结果:两组患者手术顺利,自体血回输组术中均未用异体血,但少数患者术后发生低凝状态,输入异体血。结论:术中自体血回输能减少异体血输入量,但须适当补充新鲜血浆和凝血因子。     

Basal and metoclopramide-stimulated prolactin (PRL) serum levels in users and non-users of a copper intrauterine device (TCu-380 IUD).

The study was undertaken to analyze the basal and metoclopramide-stimulated serum PRL levels in healthy parous women users (group 1, n = 12) and non-users (group 2, n = 12) of a TCu-380 IUD. All women had regular menses and were studied between days 18 to 22 of their cycle; none had lactated nor regularly ingested any type of medication during the last six months. After a 10-12 hour overnight fast, peripheral venous blood samples were obtained through an indwelling catheter at -30, -15 and 0 minutes and at 60, 90 and 120 minutes after oral metoclopramide (10 mg). There were no significant differences in serum PRL between both groups, in basal levels nor throughout the test, whether analyzing the mean values at each sampling time, the sum of PRL levels from 60-120 minutes, or the peak levels. No correlation was observed between PRL levels and any of the clinical or obstetric characteristics of the women in both groups. Serum progesterone was greater than or equal to 4.0 ng/ml in all women. Thus, the use of alpha TCu-380 IUD did not induce any significant changes in basal nor in stimulated serum PRL levels.     

应用局部皮瓣修复上睑全层缺损一例报告

目的探讨局部皮瓣修复上睑全层缺损的价值。方法2007年3月,对一例狗咬伤所致的右侧上睑全层缺损进行急诊局部皮瓣修复手术。结果术后随访45d,右侧上睑外形满意,功能良好。结论应用局部皮瓣急诊修复眼睑全层缺损,术后效果满意,可避免Ⅱ期手术和睑缘缝合。     

第三脑室脑膜瘤(九例报告及文献回顾)

目的探讨第三脑室脑膜瘤的组织发生学、临床特点和外科治疗。方法报道9例经影像学、手术和病理学证实的第三脑室脑膜瘤，并回顾相关文献。结果第三脑室前部脑膜瘤5例，第三脑室后部脑膜瘤4例，平均发病年龄25．6岁，无明显性别差异；最常见的症状是梗阻性脑积水，缺乏硬脑膜附着为其影像学特征。肿瘤全切除6例。结论第三脑室脑膜瘤是一种罕见的脑室内脑膜瘤，起源于中间帆脉络组织或脉络丛，经半球间裂-胼胝体-穹隆间入路是合理的手术路径选择。     

Composite prostheses for the repair of abdominal wall defects: effect of the structure of the adhesion barrier component

The component of a composite prosthesis, which makes contact with the visceral peritoneum, can be reabsorbable or non-reabsorbable, and laminar or reticular. This study was designed to determine whether the composition of this second, barrier component could improve its behavior at this interface. Abdominal wall defects in rabbits were repaired using a polypropylene prosthesis (PP), or the composites Sepramesh (PP+h) or Vicryl (PP+v). Fourteen days after surgery, the implants were evaluated by light and scanning electron microscopy, and immunohistochemistry. Prosthetic areas occupied by adhesions (PP: 71.08±5.09, PP+h: 18.55±4.96, P+v: 69.69±16.81%), neoperitoneal thickness (PP: 256.17±21.68, PP+h: 83.11±19.63, PP+v:213.72±35.90 μm) and macrophage counts (PP: 8.73±1.16, PP+h: 27.33±4.13, PP+v: 31.24±3.08%) showed significant differences (P<0.05). The tested biomaterials induced an optimal recipient tissue infiltration. Least adhesion formation was observed on the PP+h implants. This suggests that the second component, although reabsorbable, should be smooth in structure.