单独肝尾状叶血管瘤切除术

Isolated resection of bemangioma in the cau-date lobe is challenging due to the surgical anatomy of caudate lobe. The caudate lobe consists three portions: Spiegel's lobe, paracaval portion and caudate process. Most of the blood supply of caudate lobe is provided by the posterior segmental branches of the portal vein and left hepatic artery. The hepatic venous drainage encompasses a few sizable and several small branches that join the inferior vena cava. Selection of the ideal route for bepatectomy, adequate mobilization of the liver, preparatory placement of band for hepatic vascular occlusion are key factors during the operation.     

西藏墨脱县疟疾暴发自然村伪威氏按蚊与威氏按蚊生态习性比较

目的 目的 调查西藏疟疾流行区墨脱县中、 高海拔地区主要按蚊伪威氏按蚊和威氏按蚊的生态习性及其传播疟疾的 潜能。 方法 方法 采用人诱、 动物诱 （牛、 马、 猪） 和诱蚊灯诱捕方法捕获成蚊, 分析按蚊密度、 夜间活动规律、 室内外吸血习性; 对于捕获的经形态学鉴定为多斑按蚊复合体的蚊虫, 按照捕蚊时间、 地点和捕蚊方式进行标记, 带回实验室后采用PCR方 法鉴定蚊种; 采用晨捕和白天搜捕法判断按蚊栖息习性; 在不同类型水体捕捞幼虫, 饲养羽化以判定孳生地。 结果 结果 共捕 获多斑按蚊复合体蚊虫1 053只, 其中伪威氏按蚊331只, 威氏按蚊722只。室内与室外威氏按蚊的数量均高于伪威氏按 蚊 （P < 0.01, P < 0.05）。室内外两种按蚊构成比差异无统计学意义 （P > 0.05）。伪威氏按蚊和威氏按蚊经产蚊比例分别为 65.90%和69.86%, 差异无统计学意义 （P > 0.05）, 伪威氏按蚊室外吸血蚊数大于室内吸血蚊数 （P < 0.05）, 威氏按蚊室内外 吸血蚊数差异无统计学意义 （P > 0.05）。两种按蚊夜间活动均为单峰分布, 威氏按蚊密度日落后21： 00-22： 00达高峰, 随 后逐步下降, 凌晨4： 00后未捕获威氏按蚊; 伪威氏按蚊密度高峰为24： 00至凌晨1： 00, 几乎整夜都有活动。结论 结论 西藏墨 脱县中、 高海拔地区威氏按蚊构成与密度均高于伪威氏按蚊, 两种按蚊生态习性有差异; 威氏按蚊比伪威氏按蚊更具传播 疟疾的潜能。     

Ablation of nonautomatic focal atrial tachycardia in children and adults with congenital heart disease

INTRODUCTION: Nonautomatic focal atrial tachycardia (NAFAT) has been characterized in adults with structurally normal hearts. This article characterizes NAFAT in a population of patients with complex congenital heart disease. METHODS AND RESULTS: Electrophysiologic and electroanatomic mapping data and acute outcomes were reviewed in patients undergoing mapping and ablative procedures for atrial tachycardia at Children's Hospital, Boston, between January 1999 and December 2003. Twenty-two NAFAT foci were identified in 17 patients out of 216 patients studied. Fourteen of these 17 patients had congenital heart disease. The average age of the patients with a NAFAT mechanism was 27 years and there was no gender predilection. The presumptive diagnosis based on clinical grounds and surface ECG assessment in 11 of 17 patients with NAFAT was atrial flutter. None of the 17 patients were suspected of having a NAFAT mechanism by noninvasive assessment. Four of the 10 patients had both NAFAT and macroreentrant atrial tachycardias. NAFAT cycle lengths varied widely (200-680 ms) between patients. Sixteen of the 22 NAFAT foci were mapped to the anatomic right atrium (RA). Acute ablative success was achieved in 17 out of 22 foci (77%). CONCLUSION: NAFAT is relatively uncommon in a pediatric tertiary care setting, and in that setting occurs most often in adults with congenital heart disease. NAFAT is indistinguishable from other forms of atrial tachycardia by noninvasive means and can mimic other forms of atrial tachycardia on electrocardiogram. The foci were predominantly found in the RA and were, in most cases, acutely amenable to catheter ablation therapy.     

Age, size, and lead factors alone do not predict venous obstruction in children and young adults with transvenous lead systems

BACKGROUND: Venous occlusion is a recognized complication of transvenous pacing, and lead cross-sectional area indexed to body surface area (BSA) has been used to predict venous obstruction in children. OBJECTIVE: The aim of this study was to identify the risk factors and incidence of angiographic venous obstruction after transvenous lead implantation in both children and young adults. METHODS: Contrast venography was obtained in 85 of 90 consecutive patients undergoing repeat pacemaker or ICD procedures from 2002 to 2004 at a single cardiac center. Venograms were graded as complete venous obstruction, significant partial obstruction (>70% with collaterals), or patent. RESULTS: The cohort had a median age of 15.0 years at implant and was divided into two age groups: 3-12 years (n = 35) and 13 years and over (n = 50). After a median interval of 6.5 years, complete obstruction was seen in 11 of 85 patients (13%) and partial obstruction in another 10 patients (12%). No significant differences were seen in the incidence of obstruction between the two age groups although younger patients had a larger lead indexed to BSA ratio (6.82 vs 5.05, P = 0.005). There were no significant differences between obstructed and nonobstructed patients in relation to age, size, growth, or lead factors. CONCLUSION: Transvenous lead systems implanted in young children have a similar incidence of venous occlusion compared to older patients. Furthermore, patient age, body size, and lead characteristics at implant do not clearly predict venous occlusion.     

鼻渊平胶囊治疗慢性单纯性鼻炎临床研究

目的 探讨鼻渊平胶囊治疗慢性单纯性鼻炎的疗效.方法 将门诊就诊并筛查合格的168例慢性单纯性鼻炎患者随机分为两组,治疗组84例服用鼻渊平胶囊,每次3粒(0.5/粒),每日3次,连续4周;对照组84例服用阿奇霉素,每次0.25,每日2次,连续4周.结果 治疗组及对照组治疗结束后治愈率及总有效率分别为71.4％、90.5％; 45.2％、72.7％,有显著性差异;治疗组及对照组3月随访治愈率及总有效率分别为:66.7％、88.1％; 42.9％、71.4％;治疗组及对照组6月随访治愈率及总有效率分别为:61.9％、82.1％; 35.7％、61.9％,均有显著性差异.结论 鼻渊平胶囊治疗慢性单纯性鼻炎,有较好的疗效,安全性好,未见不良反应.     

宫颈癌自然史模型转移概率的研究进展

宫颈癌位于世界女性恶性肿瘤死亡顺位第二位.008年,全球有近53万宫颈癌新发病例和27.5 万死亡病例,其中约85％发生在发展中国家[1].筛查可以大幅降低宫颈癌发病率和死亡率[2,3].常用的筛查方法有醋酸碘染色肉眼观察法、细胞学检查和人乳头瘤病毒(HPV)DNA检测,它们的成本和效果均不同[4].不同国家和地区的经济发展水平和卫生资源条件差异较大,需要通过对各种筛查方法进行全面详尽的卫生经济学评价,进而筛选出适宜当地实际情况的筛查技术[5].     

动脉切开取栓术治疗血栓闭塞性脉管炎

目的探讨动脉切开取栓术治疗血栓闭塞性脉管炎（TAO）的临床经验。方法对我院2000年3月至2010年3月期间121例TAO患者中的14例（14条肢体：上肢2例和下肢12例）行动脉切开取栓术,其中8例肢体行单纯动脉切开取栓术,6例行同期动脉切开取栓联合骨髓或外周血干细胞移植术。结果 14例肢体中,11例肢体取栓成功,3例取栓不满意。取栓成功患肢术后疼痛症状消失。成功取栓患者中7例获得随访,随访5个月至8.5年（平均4年）,其中4例间歇性跛行及静息痛症状消失,2例未戒烟患者病情加重（1例行膝下截肢）,1例已戒烟患者仍有间歇性跛行。3例远端取栓不成功的患者,1例失访,1例术后未戒烟,症状加重行膝下截肢术,另1例已戒烟并随访3年,间歇性跛行等症状明显改善。结论动脉切开取栓术是治疗TAO安全、有效的方法 。     

温度和湿度对硫酰氟熏蒸灭鼠效果的影响

目的观察温度和相对湿度对硫酰氟熏蒸灭鼠效果的影响。方法试验在模拟熏蒸箱内进行,均匀设计实验方案,通过单因素和多因素分析判断温度、湿度和剂量对硫酰氟熏蒸灭鼠效果的影响。结果单因素分析显示硫酰氟剂量和温度影响灭鼠效果,剂量从0．750g／m＾3增至0．892g／m＾3,鼠死亡率从30％升至70％;不同湿度（25％485％）鼠死亡率差异无统计学意义;均匀设计多因素分析显示相对湿度、剂量与小鼠的死亡率有关,以小鼠的死亡率为应变量,温度、相对湿度和剂量为自变量,进行二次型回归分析,得回归方程：P=-0．00839H＋1．03677D。结论硫酰氟熏蒸灭鼠效果好,在实际工作中,应根据湿度和温度变化科学调整熏蒸时的投药剂量。