显微外科技术及带蒂包皮岛状皮瓣法在尿道下裂治疗中的应用

目的总结应用显微外科及带蒂包皮皮瓣一期修复尿道下裂的经验,提高手术成功率。方法回顾性分析38例一期尿道下裂修复手术及术后并发症。患儿年龄3～22岁,平均7．5岁。阴茎头冠状沟型12例,阴茎体型19例,阴茎根部型7例,其中6例曾在院外行阴茎下屈矫正术。应用显微外科技术,单纯选择带蒂包皮岛状皮瓣法一期修复尿道下裂32例,联合应用Duplay术式6例。结果随访3个月～2年,35例患儿术后阴茎外观满意,排尿通畅,无明显并发症:术后发生尿瘘2例,再次手术后治愈。1例术后3月出现尿道外口狭窄,经尿道扩张治愈。手术成功率为94．7％。结论应用显微外科及带蒂包皮岛状皮瓣一期修复尿道下裂,成功率高,并发症少,是治疗尿道下裂的良好方法。     

兔孤束核（NTS）在接受腹部迷走伤害性传入冲动及其在针刺抑制内脏—躯体反射中的作用

实验在164只家兔身上进行。目的在于了解腹部迷走神经(AVN)的冲动如何从外周传向延髓；在延髓内投射分布的特征；由AVN涛发的内脏—躯体肌反射(VSR）的性质以及针刺对它的影响。     

论产科人性化服务

开展人性化服务对于患者特别是产科患者（孕产妇）能否顺利分娩起着至关重要的作用，可减少护患矛盾的发生，并能降低剖宫产、滞产及产后大出血的发生率。     

复杂中足损伤的临床治疗

Objective To evaluate the features and key points of clinical treatment of the complex midfoot injury retrospectively.Methods Twenty-two cases of complex midfoot injury were admitted to our hospital from June 2003 to June 2008, including 8 cases of open fracture and 5 cases of complicated soft tissue defects.Thirteen were emergency cases and the other 9 chronic ones were referred from other hospitals.In the emergency cases, only 1 underwent arthrodesis of the navicular and middle and lateral cuneiform and the others had reduction and internal fixation.In the referred cases, 2 received talar-navicular arthrodesis, 3 Lisfranc arthrndesis (accompanied by distal hallux amputation in 1), 1 navicular-cuneiform arthrudesis and 1 Chopart arthrndesis, 1 medial column amputation and 1 lateral column reconstruction.In the cases of soft tissue defects, 4 underwent free serratus anterior transfer, and 1 had transfer of distally-based sural fas-eio-cutaneous flap.The American Orthopaedic Foot & Ankle Society (AOFAS) scoring was used to evaluate the results.Results All the patients were followed up for 5 to 44 (average, 17.5) months.The main sequelae of the emergency cases were pain after long time waking, which was relieved following local injection of steroid and NIADs in 2 cases.Of the referred cases, pain and fatigue after walking were reported in 2, callus and pain under the 4th and 5th metatarsal heads in 2, and the whole foot rigidity and atrophy of the intrinsic muscle with severe pain while walking in 1.The case of medial column amputation developed medial arch collapse and valgus of hind foot.The mean AOFAS score for the emergency cases was 80.3± 8.7 and for the chronic ones was 60.1±16.3.Conclusion For complex midfoot injury, good results can only be obtained by early operation, anatomic reduction and stable fixation on the basis of enough understanding of the functional anatomy and traumatic pathology.     

急性硬膜外血肿并发远隔血肿部位脑梗塞（附12例报告）（摘要）

急性硬膜外血肿并发远隔血肿部位脑梗塞（附１２例报告）（摘要）蔡志谋，杨振铭，杨波，欧阳世杰自１９９１年１月至１９９３年４月，我科收治急性硬膜外血肿１５０例，其中１２例并发远隔血肿部位脑梗塞，占同期急性硬膜外血肿数的８％，现报告如下。一、临床资料１．一...     

应用眼球重建术治疗角膜葡萄肿防止致盲的体会（附2例报告）

本文报告了对致盲的2例(2眼)角膜葡萄肿的眼球重建术，并就治疗原理、方法、治疗要点及可行性进行了讨论。随访3．5个月至3年显示有防盲、治盲效果。     

巨大脑包虫一例报告

患者男性，6岁。因头痛、恶心、呕吐伴左侧肢体活动差一年，于1992年5月9日就诊住院。患者既往有较频繁的狗羊接触史。其母患有“肝包虫病”。查体：营养稍差，头颅右顶骨明显隆起，眼底视乳头连界模糊并轻度水肿，左侧鼻唇沟变浅，口角偏斟向右，左眼闭合不全，伸舌偏向左侧，左侧肢体肌张力增强，肌力上肢Ⅲ级，下肢Ⅳ级，左侧浅反射减退，腱反射亢进，有踝阵挛。     

有关脊柱不稳定的探讨

脊柱不稳定虽不是疾病的独立诊断,但在临床上常见。已呈现日益增多的趋势。并已引起人们的重视。本文就有关问题讨论如下。1 维持脊柱稳定的因素 脊柱由韧带和椎间盘维持内源性稳定,由脊柱外肌肉保证外源性稳定。颈椎支持头面部器官,胸腰椎则将上肢和躯干所担负的重量通过骶髂关节传达至下肢。由于生理孤度、椎间盘和椎间孔的存在,使脊柱可以像弹簧一样吸收从下肢传来的冲力,保护颅脑和胸腹部。 脊柱的运动是多个活动节段的联合动作,包括沿横轴、矢状轴和纵轴的旋转。而脊柱的屈曲主要在腰段,旋转活动主要