颈前路间隙减压与开槽减压融合术治疗脊髓型颈椎病

目的 研究颈前路间隙减压与开槽减压融合术治疗脊髓型颈椎病的临床疗效.方法 108例脊髓型颈椎病患者实施颈前路间隙减压与开槽减压自体髂骨植骨钢板内固定术,获得随访86例,随访时间平均20.9个月.采用贾连顺的疗效评定法评定临床结果.结果 临床疗效优良率83.73%,植骨融合率为99.07%.结论 颈前路间隙减压与开槽减压融合术治疗脊髓型颈椎病临床疗效满意,是较好的手术方式.     

睾丸旁促结缔组织增生性小圆细胞肿瘤1例报告及文献复习

目的:探讨睾丸旁促结缔组织增生性小圆细胞肿瘤的临床、病理特征、诊断及治疗。方法:回顾分析1例睾丸旁促结缔组织增生性小圆细胞肿瘤的诊治及随访资料,并复习相关文献。患者,男,27岁,因阴囊内无痛性肿块4个月就诊。体检于左侧阴囊内可扪及囊性肿块,同侧睾丸不能扪及。行左侧睾丸根治性切除术,术后辅以化疗。结果:术中见左侧睾丸旁多发结节状隆起肿块,质偏硬;术后病理检查肿瘤细胞呈巢状或梁索状结构并埋没在增生的纤维结缔组织中;免疫组化显示瘤细胞具有上皮源性、间质性和神经源性等多向分化的特点。术后已随访3年无瘤生存,预后良好。结论:促结缔组织增生性小圆细胞肿瘤有特异的临床病理特征,好发于年轻男性,手术切除肿瘤联合化疗是治疗的主要方法,睾丸旁促结缔组织增生性小圆细胞肿瘤比腹腔型预后相对好。     

连接管串联输液液体电解质浓度及张力变化的观察

目的 了解连接管串联方式输液过程中液体电解质浓度及张力的变化.方法 将5%葡萄糖注射液500 ml、0.9%氯化钠注射液500 ml及含10%氯化钾注射液30 ml的液体(0.9%氯化钠注射液250 ml),采用连接管串联模拟静脉输液行实验,测定不同时段滴注液体中Na 、K 、Cl-浓度并计算液体张力.结果 各瓶液体随输注时间推移逐渐混合,液体电解质浓度及液体张力随之增高.结论 使用连接管串联静脉输液可导致液体电解质浓度及张力变化,需根据病情、药物性质选用连接管.     

颏形态综合分析在颏部水平截骨整形术中的应用

目的探讨分析小颏畸形的颏部形态特征及其在颏部水平截骨整形手术应用中的效果。方法通过头颅正侧位X线头影测量分析12例小颏畸形患者的颏部形态,按测量值与正常值之间的差值,计算截骨段移动范围,手术采用颏部水平截骨整形手术方法。结果12例患者均按照术前预测值移动截骨段,术后头颅正侧位X线头影测量结果与术前预测值相近,治疗效果满意。结论通过头颅正侧位X线头影测量分析小颏畸形的特点,精确计算截骨段的移动范围和方向,是保证颏部水平截骨整形术达到良好美容效果的基础。     

METH1在酵母双杂交系统中的表达及对报告基因激活作用的检测

目的通过观察血管生成抑制因子METH1的cDNA片段在酵母双杂交中的表达及检测其对报告基因有无激活作用,为进一步明确METH1抑制增生性瘢痕的分子机制奠定基础。方法采用酵母双杂交Gal4系统3,经PCR扩增子METH1的cDNA片段,分别克隆入pUC19质粒,经测序正确后,再分别亚克隆入酵母双杂交诱饵载体pGBKT7中。将重组质粒导入酵母菌AH109,检测其表达产物在酵母细胞中对报告基因的激活作用。结果成功获得METH1的cDNA片段,该片段所表达的蛋白对酵母菌AH109无毒性,且对报告基因无激活作用。结论血管生成抑制因子METH1蛋白活性区在酵母双杂交系统中的表达产物,可作为诱饵蛋白进行相互作用蛋白的筛选研究。     

左半骨盆开放毁损伤行半骨盆切除术一例报告

患者男性,19岁,2004年2月29日左下腹碾压伤0．5 h,处于休克状态并恶化中,体征:贫血貌,血压12/6 kPa,持续性下降,心率＞110次/min,左下腹股沟至会阴,阴囊挫伤严重,髂骨碎块外露,睾丸外露,左下肢无感觉和血运。在组织抢救的同时,床旁X线片示左半骨盆粉碎性骨折(图1),B超显示     

Bi-pedicled V-Y gastrocnemius myocutaneous flap for repairing Achilles tendon and overlying skin defect： the anatomic basis and clinical application

Objective: To study the anatomic basis of the bi-pedicled V-Y gastrocnemius myocutaneous flap for repairing the composite Achilles tendon defect. Methods : The pedicle anatomy of the bi-pedicled V-Y gastrocnemius myocutaneous flap was examined on 30 cadaver specimens. The sliding distances of the flap were measured at different knee flexion degrees. The bi-pedicled V-Y gastrocnemius myocutaneous flap was applied in 12 cases of Achilles tendon defect with simultaneous skin and soft tissue defect. Results: The sural arteries could be classified into four types. After cutting off the gastrocnemius origin with a " Z-shaped" incision, the sliding distance of the flap reached (3. 7±0. 5) cm when the knee flexed 0°, (4.9±0.7) cm when the knee flexed 30°, (6. 7±0. 7) cm when the knee flexed 60 and (9.2±0.9) cm when the knee flexed 90°. All the defects healed. The patients recovered ambulation with satisfactory knee and ankle function. The follow-up was 4 months -12 years. Conclusions: Different sural artery types should be noticed during the harvest of the bi-pedicled V-Y gastrocnemius myocutaneous flap. With 90°knee flexion, this flap is suitable for one-stage repair of composite Achilles tendon defect within 9.2 cm±0.9 cm.     

Effect of AVP on brain edema following traumatic brain injury

Objective: To evaluate plasma arginine vasopressin (AVP) level in patients with traumatic brain injury and investigate the role of AVP in the process of brain edema. Methods: A total of 30 patients with traumatic brain injury were involved in our study. They were divided into two groups by Glasgow Coma Scale: severe traumatic brain injury group (STBI, GCS≤8) and moderate traumatic brain injury group ( MTBI, GCS >8). Samples of venous blood were collected in the morning at rest from 15 healthy volunteers (control group) and within 24 h after traumatic brain injury from these patients for AVP determinations by radioimmunoassay. The severity and duration of the brain edema were estimated by head CT scan. Results: plasma AVP levels (ng/L) were (mean±SD): control, 3. 06±1. 49; MTBI, 38. 12±7. 25; and STBI, 66. 61±17. 10. The plasma level of AVP was significantly increased within 24 h after traumatic brain injury and followed by the reduction of GCS, suggesting the deterioration of cerebral injury (P<0. 01). And the AVP level was correlated with the severity (STBI r =0.919, P < 0.01; MTBI r = 0.724, P < 0.01) and the duration of brain edema (STBI r = 0. 790, P < 0. 01; MTBI r = 0. 712, P<0.01). Conclusions: The plasma AVP level is closely associated with the severity of traumatic brain injury. AVP may play an important role in pathogenesis of brain edema after traumatic brain injury.     

复拇指畸形391例临床治疗分析

目的总结复拇指畸形的临床治疗体会。方法总结20年来经手术治疗的复拇指畸形391例病例，就其手术时机、治疗方法和术后继发畸形的原因进行回顾性分析。结果术后随访123例（137侧），随访时间为2-15年，参照Kawabata评分方法，优52例（58侧），良36例（40侧），差35例（39侧）。其中从生后6个月-1岁手术者随访到45例（51侧），优22例（24侧），良15例（17侧），差8例（10侧）。术后继发畸形进行二次手术治疗的患者有47例（55侧）。结论复拇指畸形的手术年龄应选择在生后6个月-3岁为宜，术前详细评估、术中正确处理和术后长期随访是复拇指畸形治疗的关键。     

Pipkin＇s骨折的治疗及并发症分析（15例报告）

[目的]探讨Pipkin＇s骨折的治疗方法与效果。[方法]对自1996-2005年6月收治的15例股骨头骨折病例，根据Pipkin分型，Ⅰ型3例，Ⅱ型4例，Ⅲ型5例，Ⅳ型3例，进行回顾性分析。[结果]全部疾病均获1-5年的随访，采用Pipkin评价方法，优10例，良2例，可1例，差2例，优良率80%。[结论]Pipkin＇s骨折合并症和并发症多，治疗根据分型选择治疗方案。Ⅰ型手法复位保守治疗，Ⅱ型和Ⅳ型手术复位内固定，Ⅲ型选择人工关节置换疗效较好。