连续埋线法重睑术的临床评价

目的 探讨连续埋线法重睑术的适应证和手术要点.方法 手术在局部麻醉下施行,从外眦向内眦沿睑板上缘作连续缝合,然后折返,外眦缝合口打结.结果 本组132例患者术后随访形成良好重睑者为121例,占92%;两侧重睑皱襞高低不一的7例,占5%;重睑消失的4例,占3%,后两者均补充埋线法或者切开法重睑术修复.结论 连续埋线法重睑术除适用于上睑皮肤较薄的年轻患者,也可扩大到中等以下程度的上睑皮肤松弛患者,以及以外侧为主的上睑臃肿者.     

心房颤动与炎症及慢性幽门螺旋杆菌感染相关性研究

目的探讨心房颤动(简称房颤)与炎症及慢性幽门螺旋杆菌(Hp)感染的关系。方法选取66例房颤患者为房颤组(其中阵发性房颤44例,慢性房颤22例),另取同期住院的阵发性室上性心动过速(简称室上速)患者67例作为对照组,用间接ELISA法测定血清Hp-IgG抗体,速率散射免疫比浊法测定C反应蛋白(CRP),比较两组Hp-IgG抗体,CRP的差异并分析HP抗体滴度与房颤及其它相关因素的关系。结果房颤组与对照组的Hp-IgG阳性率Hp-IgG对数值均无差异(P均>0.05)。房颤组CRP中位数较对照组高(1.17mg/dlvs0.65mg/dl,P<0.05)。结论房颤与慢性Hp感染不相关,与炎症相关。     

胃肠道黏膜屏障与自身免疫性疾病

肠黏膜具有免疫和屏障功能。一方面，消化道黏膜不断地与病毒、细菌等微生物接触，在机体内担负起第一线的局部防御任务。另一方面，该系统对于食源性抗原、肠内常驻细菌可以产生免疫耐受。此种识别机制是由一个特殊的肠黏膜免疫组织“肠相关淋巴样组织”（gut associated lymphoidtissue，GALT）承担的。     

牙周临床治疗Ⅴ.牙周医学

对宿主易感性的认识使人们能够理解不同个体牙周炎发生、发展的差异，而另一方面，牙周疾病对许多器官系统的潜在影响日益受到关注，牙周医学的兴起开创了崭新的重要研究领域，并有着深远的临床意义。     

Reconstruction of musculoskeletal defects about the knee for tumor

One of the most challenging problems of limb salvage is a large tumor involving the knee joint. Since 1970, 79 patients, ranging in age from 14 to 74 years (mean, 27 years), have had reconstruction of the knee after en bloc resection of a primary bone tumor. Sixty-one patients had lesions involving the distal femur, with a mean resection length of 13.5 cm, and 18 patients had lesions involving the proximal tibia, with a mean resection length of 10.5 cm. Thirty-nine patients had malignant lesions, of which osteosarcomas predominated, and 40 patients had benign tumors, of which giant cell tumors were the most prevalent. Reconstruction was done with a custom total knee arthroplasty in 41 patients, a resection arthrodesis in 27, and an allograft in 11. The functional results were graded according to the rating system devised by the Musculoskeletal Tumor Society. of the patients with resection arthroplasty, 70% had a good or excellent rating, although ten required revision. Of the patients with resection arthrodesis, 74% had a good or excellent rating, as did 55% of the patients with osteochondral allografts. When a limb salvage procedure is done, careful consideration must be given to the type of procedure chosen to reconstruct the knee. This decision is based on a number of factors related to the tumor and the patient. Although these various procedures promise functional restoration, the reconstructive procedure should be individualized and designed to meet the needs of the patient.     

人工髋关节置换术后脂肪栓塞综合征的观察与护理

笔者报道人工髋关节置换术后脂肪栓塞综合征的护理措施认为重视氧饱和度及动脉血氧分压监测，注意观察中枢神经系统症状和呼吸系统症状，及时发现并纠止低氧血症，对不同的病人制定不同护理方案，严密观察病情，及时掌握病情变化：是护理的关键。     

门静脉高压症异位静脉曲张研究进展

异位静脉曲张（ectopic varices，EV）是指门静脉高压症引起的食管胃底以外的静脉曲张，属于门体循环间开放的侧支，最常见于十二指肠。EV的发病机制主要为肝内门静脉高压、肝外门静脉或脾静脉血流受阻和腹腔粘连。临床上以反复的消化道出血和血腹较常见。内镜检查作为首选的常规诊断手段，结合多普勒超声和血管造影多能确诊。[第一段]     

王成荣诊治月经过少经验谈

分析年龄、有无宫腔操作史等病因;注重问诊、妇科及其辅助检查等诊断方法;根据年龄及有无人流史等进行辨证施治,从冲任不足和冲任虚瘀2个方面诊治月经过少,收效较好。     

小脑后下动脉动脉瘤的诊断和治疗

目的探讨小脑后下动脉动脉瘤的临床特征、诊断、鉴别诊断和治疗。方法回顾性分析12例小脑后下动脉瘤的临床表现、影像学特征、手术效果及诊治过程中存在的相关问题。结果12例中有11例因动脉瘤破裂出血而发病,单纯第四脑室出血4例,全脑室系统出血2例,小脑半球出血3例,小脑蚓部伴第四脑室出血1例,侧脑室伴第三脑室出血1例,以后颅窝占位病变表现1例。8例术前行DSA检查明确诊断,4例术中明确诊断。12例均行后颅窝开颅显微手术治疗,其中动脉瘤颈夹闭9例,孤立切除2例,动脉瘤加固术1例,术后2例因脑积水加重行脑室-腹腔分流术。12例中除1例术后留有轻偏瘫外,其余11例恢复良好。结论小脑后下动脉瘤多以第四脑室出血发病,少数以小脑半球或蚓部出血发病,及早治疗效果满意。手术方式应尽量夹闭动脉瘤颈,对于小脑后下动脉末端动脉瘤,可以采用孤立切除术。     

Nerve growth factor and tyrosine kinase A in human salivary adenoid cystic carcinoma: expression patterns and effects on in vitro invasive behavior.

PURPOSE: Perineural invasion is a frequent occurrence in salivary adenoid cystic carcinoma (ACC) and may prevent complete surgical resection. Studies have indicated that nerve growth factor (NGF) and its high-affinity receptor tyrosine kinase A (TrkA) may play a role in perineural invasion in several malignancies in which perineural invasion is observed. The present study was conducted to investigate the expression of NGF and TrkA in salivary ACC and to examine the effects of NGF on adhesion, migration and invasion capacities of a salivary ACC cell line (SACC-83) in vitro. PATIENTS AND METHODS: Expression of NGF and TrkA was explored using immunohistochemistry in paraffin-embedded tissues of 32 cases of salivary ACC. The effects of NGF on in vitro adhesion, migration, and invasion capacities of the SACC-83 cell line were examined using an MTT assay and a modified Boyden chamber assay respectively. RESULTS: In ACC specimens, 31 (96.9%) and 32 (100%) tumors showed immunoreactivity for NGF and TrkA respectively. Significant correlations were found between NGF/TrkA expression levels and perineural invasion (P < .05). In cell adhesion assay, the percent adherences of SACC-83 cells co-cultured with 25 ng/ml NGF at 1.5 hours and 5, 25 ng/ml NGF at 6 hours were significantly higher than that co-cultured with 0 ng/ml NGF (P < .05). However, high concentration of NGF (500 ng/ml) resulted in a significant inhibition of invasion (P < .05). CONCLUSION: Overexpression of NGF and TrkA in human salivary ACC tissues may constitute a reason for perineural invasion in salivary ACC.