A comparative study on therapeutic method of traumatic epidural hematoma

Objective： To explore the therapeutic methods, surgical indications and clinical practice of minimally invasive surgery on traumatic epidural hematoma （EDH）. Methods： Retrospective study was made on 135 patients with traumatic EDH admitted into our hospital from June 2002 to August 2005. Sixty-five patients were treated with mini-invasive negative pressure drainage （treatment group）, 70 patients with comparable condition used traditional craniotomy （control group ）. The mean time of operation, average days in hospital, expenditure and prognosis of two groups were recorded and analyzed. Results： There was no significant difference in therapeutic efficacy between two groups. Patients in treatment group had a shorter hospital stay and less expenditure than those in control group. Conclusion： Mini-invasive negative pressure drainage is simple, effective, economical and applicable to some traumatic EDH patients.     

一次性注射器制作简易取皮鼓及其在整形外科中的应用

目的：探讨利用一次性注射器制作简易取皮鼓及其使用方法。方法：在一次性注射器的针筒壁上作三道平行透壁沟槽,用于固定皮片,使得皮片紧贴于注射器针筒外壁上,再以手术刀徒手取皮,根据需要切取皮片。结果：利用一次性注射器制作的取皮鼓取皮不需要粘合剂,可以按要求切取各种大小及厚度的皮片。结论：以一次性注射器制作的取皮鼓,取材广泛,制作简单,无需粘合剂,取皮速度快,适用范围广。     

Evaluation of BioCorkscrew and Bioknotless RC suture anchor rotator cuff repair fixation: an in vitro biomechanical study

This in vitro biomechanical study used cadaveric specimens to compare the rotator cuff repair fixation provided by BioCorkscrew and Bioknotless RC suture anchors. Three cm wide by 1-cm long full-thickness supraspinatus defects were repaired using either two BioCorkscrew suture anchors with combined vertical and horizontal mattress sutures (n = 7) or three Bioknotless RC suture anchors with simple sutures (n = 7). Therefore, the BioCorkscrew suture anchor group had two sutures per anchor (four total sutures), while the Bioknotless RC suture anchor group had one suture per anchor (three total sutures). Two-phase cyclic (5–100 N, 1,000 cycles and 5–180 N, 2,000 cycles) and load to failure tests (31 mm/s) were performed. Non-parametric statistics were used to compare group differences (P < 0.05). All of the BioCorkscrew group specimens (seven of seven) completed the two phase cyclic test regimen without failure or gapping ≥ 5 mm, compared to only three of seven of the Bioknotless RC group (Fisher’s Exact test = 0.03). Groups did not differ for repair site gapping during the 5–100 N cyclic test phase (Fisher’s Exact test = 0.77), however more of the Bioknotless RC group displayed gapping ≥ 5 mm during the 5–180 N cyclic test phase than the BioCorkscrew group (P = 0.02). The BioCorkscrew group also displayed greater yield load during load to failure testing (492.2 ± 204 N vs. 296.4 ± 155 N, P = 0.03). In this in vitro biomechanical study, the BioCorkscrew group with combined vertical and horizontal mattress sutures displayed greater cyclic test survival, less repair site gapping, and superior yield load compared to the Bioknotless RC group with simple sutures. These results in human cadaveric rotator cuff-humerus specimens suggest better immediate post-operative repair site strength and a reduced need for post-operative restrictions. Clinical studies are needed to determine how these rotator cuff repair modes withstand the forces of early rehabilitation and activities of daily living that potentially influence patient outcomes.     

成人先天性胆管扩张症手术治疗39例分析

目的探讨成人先天性胆管扩张症手术治疗的经验体会。方法1992年10月至2006年2月我院收治的成人先天性胆管扩张症39例患者均行囊肿切除。结果术后短期胆汁漏6例，无胰漏，急性胰腺炎1例，无死亡。39例经1～15年随访，随访率94．6％，2例表现轻度胆管炎，余均痊愈，无胆管炎及胆管狭窄表现。结论囊肿切除、胆管空肠Roux-Y吻合是成人先天性胆管扩张症的首选治疗。切除囊肿时，囊肿近端在尽量切净囊肿的基础上行大口吻合，可吸收线单层吻合，防止术后吻合口狭窄；囊肿远端在保证胰液引流通畅、不损伤胰管开口的基础上，尽量切净囊肿内膜。     

以新生儿重症监护病房为中心的早产儿视网膜病变筛查模式

目的：介绍一种较为完善的早产儿视网膜病变（ROP）筛查模式。方法：建立基本完善的ROP登记、会诊、筛查、转诊等制度,所有工作均在新生儿重症监护病房（N ICU）完成,形成以NICU为中心的ROP筛查模式,并按此模式开展筛查工作。结果：登记符合ROP筛查标准的患儿239例,其中接受至少一次筛查的患儿222例（占应筛查总数的92.89%）,按要求完成筛查的患儿176例（占应筛查总数的73.64%）。发现ROP患儿39例（占实际筛查数的17.57%）,其中阈值前期1型或阈值期病变11例（占实际筛查数的4.96%）。结论：这种以NICU为中心的ROP筛查模式,制度较为完善,临床中易于操作,能有效节约医疗资源,适合在中小城市中推广。     

正位可控性去带盲结肠膀胱术的疗效观察

目的:探讨正位可控性去带盲结肠膀胱术的临床疗效.方法:对17例膀胱肿瘤患者行膀胱全切除术后,应用末段回肠及盲升结肠作贮尿囊行正位膀胱重建术.结果:17例中15例获随访6～24个月,平均14.5个月.全组无严重并发症,均无瘤生存;术后3周自主可控性排尿,日间排尿可控率为93.3%,1年夜间尿失禁22.2%.术后6个月尿动力学检查,膀胱容量336 ml、最大尿流率13.7 ml/s、剩余尿量42 ml,而充盈期膀胱压力明显低于尿道闭合压.输尿管反流1例,但无尿道、输尿管狭窄,肾功能正常.结论:正位可控性去带盲结肠膀胱术具有膀胱容量大、内压低,正位排尿,可控性好,且手术操作简单、并发症少等优点,患者易于接受,是一种较理想的尿流改道方式.     

抑制剂对酪氨酸酶影响的初步研究

采用酶动力学及聚丙烯酰胺凝胶电泳方法研究了ＮａＨＳＯ３、ＮａＮ３、ＫＳＣＮ、ＤＤＣ对酪氨酸酶的抑制作用。ＮａＨＳＯ３、ＮａＮ３、ＫＳＣＮ为非竞争性抑制作用，随着抑制剂浓度增加，酶活性逐渐减弱。当ＮａＨＳＯ３、ＮａＮ３、ＫＳＣＮ的浓度分别达到１．２ｍｍｏｌ／Ｌ１２。５ｍｍｏｌ／Ｌ１２．５ｍｍｏｌ／Ｌ时，酶活性的抑制率为１００％、５０％、２４％。ＤＤＣ对酪氨酸酶的抑制作用为竞争性抑制作用，其浓度达４ｍｍｏｌ／Ｌ时，酶活性１００％受到抑制。     

新疆维吾尔族、汉族儿童心脏径线的X线测量

作者测量了新疆地区７６８例３～７岁维吾尔族、汉族儿童心脏径线。心脏横径６岁组维吾尔族大于汉族。不分年龄组左心横径、心横径、心深径维吾尔族大于汉族，左侧位心膈交点至前胸膜面的距离维吾尔族女童大于汉族女童。两民族心横径与心脏体积的相关系数分别大于心脏深径与心脏体积的相关系数。本文提供了新疆地区３～７岁维吾尔族、汉族儿童各年龄组和不分年龄组心脏径线的正常数据。     

煤烟型大气污染对儿童肺功能的影响

为观察煤烟型大气污染对儿童健康的影响 ,选择了太原市 3个污染程度不同地区的 45 0名儿童进行肺功能测试和问卷调查。研究结果显示 ,儿童呼吸功能表现为重度污染区 <中度污染区 <相对清洁区 ;肺通气功能阻塞性异常率表现为重度污染区 >中度污染区 >相对清洁区 ;Logistic回归分析发现肺通气功能阻塞性异常率与小学生家庭的取暖方式、厨房和卧室是否分开以及污染物的水平有关 ;多元线性回归分析显示重度污染区儿童的FVC、FEF5 0与相对清洁区相比分别减少了 65 80ml、119 2 7ml,中度污染区儿童的FVC、FEF5 0与相对清洁区相比分别减少了 5 7 2 8ml和 114 2 9ml;Ln(SO2 )每升高一个单位 ,FVC和FEF5 0分别减少69 10ml和 119 79ml,Ln(PM1 0 )每升高一个单位 ,FVC、FEF5 0等分别减少了 193 5 0ml和 171 69ml。结果提示 ,太原市煤烟型大气污染对儿童呼吸系统产生了危害。     

Effects of dauricine,quinidine,and sotalol on action potential duration of papillary muscles in vitro

目的：观察蝙蝠葛碱对豚鼠乳头状肌的动作电位是否具有使用依赖性特征，并与奎尼丁、索他洛尔作平行比较．方法：利用细胞内微电极技术记录豚鼠乳头状肌跨膜动作电位．结果：蝙蝠葛碱２０μｍｏｌ·Ｌ－１能明显延长乳头状肌跨膜动作电位时程，在刺激周长为２００，３００，４００，６００，８００，１０００，２０００ｍｓ时，其延长动作电位时程的百分率分别为２２±８，１１±６，９±５，７±５，６±３，４３±２８，４５±２８，蝙蝠葛碱延长动作电位时程作用于刺激周期较短时作用明显，呈使用依赖性特征．而奎尼丁１μｍｏｌ·Ｌ－１和索他洛尔１０μｍｏｌ·Ｌ－１延长动作电位时程作用随刺激周期延长而增强，呈现逆向使用依赖性特征．结论：蝙蝠葛碱使用依赖性延长豚鼠乳头状肌动作电位时程．