Management of congenital tracheal stenosis

Objectives: Congenital tracheal stenosis is a rare disease. Various methods for treatment exist but there is still much debate as to the appropriate surgical procedure. We present our surgical experiences of patch tracheoplasty and slide tracheoplasty as viable methods for the treatment of congenital tracheal stenosis. Methods: From 1994 to 2002, 13 patients were diagnosed with congenital tracheal stenosis. Eight patients (7 symptomatic and 1 asymptomatic) had their stenosis corrected, three by means of pericardial patch tracheoplasty, four by slide tracheoplasty, and one by resection and anastomosis. Concomitant operations were performed on six patients to treat congenital cardiovascular disease. Five patients showing no significant symptoms did not undergo tracheal surgery and received only cardiac procedures. A retrospective review of the hospital course, complications, and long-term results was conducted. Results: Among the patch tracheoplasty group, every patient suffered from granulation tissue formation. One patient died of respiratory acidosis and one was hospitalized due to recurrent granulation tissue, which required frequent bronchoscopy. The third patient from this group is free of all symptoms. Among the slide tracheoplasty group, one patient died of anastomosis disruption. The three remaining patients are alive and well. The one patient who received resection and anastomosis is alive without symptoms. Conclusions: Surgical repair of long-segment congenital tracheal stenosis exhibited high mortality and morbidity rates. Every patient that underwent pericardial patch tracheoplasty suffered from troublesome granulation tissue. As slide tracheoplasty provided relatively good results in the short and mid-term follow-up periods, it seems to be a preferred method for the treatment of long-segment congenital tracheal stenosis.     

Localization of ulnar neuropathy at the elbow using new stimulator for the inching test.

OBJECTIVE: To evaluate the usefulness of the TenElectrodes, a new stimulator for inching test, in the diagnosis and localization of ulnar neuropathy at the elbow (UNE). METHODS: Sixty-two ulnar nerves in 40 control subjects and 24 ulnar nerves in 23 patients with typical symptoms and signs of UNE were studied. The inching test of ulnar motor nerve using TenElectrodes was done along 8 cm across the elbow in the extended position. RESULTS: In the inching test of the control group, the mean segmental latency difference was 0.19+/-0.08 ms. Maximal latency difference over a 1 cm segment did not exceed 0.40 ms in any of the controls but exceeded 0.5 ms or more in all clinical UNE patients. In all UNE patients, the lesion sites were identified by the inching test using TenElectrodes: the retroepicondylar groove (54.2%), the humeroulnar arcade (29.2%), and dual compression (16.6%). CONCLUSIONS: TenElectrodes is a useful stimulator for the inching test in the diagnosis of UNE. The precise localization of compression was possible in all patients with UNE and the most common site was the retroepicondylar groove.     

端粒酶活性检测在乳腺癌诊断中的意义

[目的 ]探讨细针穿刺乳腺肿瘤组织的端粒酶活性检测在乳腺癌诊断中的意义 .[方法 ]用聚合酶链反应 酶联免疫吸附测定法检测 79例术前乳腺肿瘤细针穿刺活检标本和大体标本的端粒酶活性 ,并与病理诊断进行比较 .[结果 ]乳腺癌 6 5例中穿刺组织端粒酶呈阳性的为 5 7例 ,阳性率为 88% ;大体组织端粒酶呈阳性的为 5 4例 ,阳性率为 83% .淋巴结转移者端粒酶活性高于无淋巴结转移者 .乳腺良性疾病 14例中端粒酶呈阳性的为 2例 ,阳性率为 14 % .[结论 ]术前乳腺肿瘤穿刺组织的端粒酶活性检测有利于乳腺肿瘤的早期诊断及鉴别诊断 .     

开放复位可塑形钛板内固定治疗跟骨骨折33例

目的 评价开放复位可塑形钛板内固定治疗跟骨骨折的疗效。方法 对33例(37足)以后关节突移位为主的跟骨骨折,行跟骨外侧入路、开放性复位可塑形钛板螺钉内固定,必要时行植骨术(18例)。结果 平均随访11.5个月,参照Mary—land food score评分,对患足是否疼痛、步态、距下关节及踝关节活动度、是否支架辅助、术后X线摄片等加以评估,19足疗效为优,17足为良,1足可。其中钛板断裂1例,手术切口皮缘坏死1例,换药后自愈。结论 跟骨外侧入路开放复位可塑形钛板螺钉内固定,必要时植骨术是治疗跟骨骨折的有效方法。     

适应建设研究型医院要求努力创新人才工作机制

着眼创建研究型医院对人才工作提出的新要求,紧紧抓住培养、考核、使用、激励4个人才建设的关键环节,介绍了医院近年在人才工作中的一些创新性举措,对于盘活人才资源,激发人才活力,提高人才队伍整体素质,推动研究型医院建设,起到了积极的促进作用.     

电脑比配色仪与比色板之间的相近性分析

目的：通过对比色记录的分析，比较Vita比色板、松风Vintage Halo比色板和电脑比配色仪之间的相近性和差异性。方法：随机抽取100名年龄在21～24岁的本地在校大学生，由男女两位测试者使用电脑比配色仪、Vita比色板和松风Vintage Halo比色板对被测试者的左上中切牙进行比色分析。结果：三种比色方法均以A色调最为集中，占总数的55％以上。其次是D色调占总数20％以上。男女测试者的选色在A、R、VR．系列中无明显差异。结论：电脑比配色仪、Vita比色板、松风Vintage Halo比色板均不能完全覆盖本地区青年天然中切牙的色度特征，只在A色调系列中重复率较高。     

凹槽交锁髓内钉治疗股骨多段骨折(附18例报告)

目的探讨一种新型交锁髓内钉-凹槽交锁股骨髓内钉(Biorigid nail femur，简称BNF)治疗股骨多段骨折的方法。方法自2002年3月～2003年10月应用德国aap公司生产的BNF治疗骨折多段骨折18例。结果本组经过3～18个月、平均9个月的随访。骨折均愈合，膝、髋关节恢复良好。结论BNF具有设计独特、内固定可靠、主钉全程均可交锁的特点，能满足自股骨转子下到股骨髁之间一处或多处骨折内固定需要。     

Toxic effects of Fusarium mycotoxin butenolide on rat myocardium and primary culture of cardiac myocytes.

Mycotoxin toxicosis has been implicated in the etiopathogenesis of Keshan disease (KD), an endemic cardiomyopathy prevailing in some regions of China. Butenolide (4-acetamido-4-hydroxy-2-butenoic acid gamma-lactone, CAS No. 16275-44-8), a mycotoxin produced by several Fusarium species such as Fusarium tricinctum and Fusarium graminearum, is frequently detected from the cereals in the endemic areas of KD. The present study is undertaken to investigate whether this mycotoxin can induce myocardial damage. Exposure of primary culture of cardiac myocytes to butenolide resulted in significant cytotoxicity, manifested by changes in cell morphology and decreases in cell viability. Consistent with the in vitro findings, distinct myocardial toxicity in vivo was observed after administration of rats by gavage with butenolide (10 and 20 mg/kg/day) for 2 months, and the myocardial injuries were characterized by focal necrosis of myocardium and fragmentation of myofiber. Butenolide also induced significant oxidative damage to the myocardium in vitro evidenced by a concentration-dependent lipid peroxidation in the myocardial homogenates, whereas antioxidants superoxide dismutase (SOD), N-acetylcysteine (NAC) and glutathione (GSH) provided significant protections against this oxidative effect. Taken together, these results clearly reveal that butenolide possesses the potential to induce myocardial toxicity. The present findings may reinforce the hypothesis that toxicosis by mycotoxins is one of the etiological factors for KD.     

CT结合内镜检查诊断胃肠道间质瘤的价值

目的：探讨CT结合内镜检查诊断胃肠道间质瘤(GIST)的价值。方法：回顾分析18例均经手术病理检验证实为GIST病人的CT及内镜检查资料。结果：(1)18例GIST的CT表现为类圆形或分叶状肿瘤，边界清楚，13例平扫及增强密度均匀，强化明显，5例瘤灶内有坏死液化区；肿瘤周围肠管不同程度受压移位或粘连。(2)15例源于胃、十二指肠及结肠的间质瘤均行内镜检查，4例瘤侧胃壁镜下所见黏膜呈外压性改变者未行咬检；11例伴有溃疡形成，溃疡处咬检获取病理组织。(3)18例均行手术后光镜观察及免疫组化检查，18例CD-117均为阳性，13例CD-34阳性，10例Vimentin阳性。结论：CT与内镜相结合检查，能提高胃、十二指肠及结肠GIST定位、定性的准确性。