骨性隧道内植皮后挛缩的三维有限元分析

目的:建立小型猪下颌骨骨性隧道内植皮的有限元模型,以了解骨性隧道内植皮后挛缩的生物力学基础和形变规律。方法:将小型猪下颌骨钻孔形成骨性隧道并移植全厚皮片,通过CT获取移植即刻及移植后2周、4周、6周、8周的骨性隧道内植皮数据,利用MIMICS 10.1和ANSYS 12.0软件建立猪下颌骨钻孔形成骨性隧道的三维有限元模型,仿真分析骨性隧道内植皮后的挛缩过程,计算节点位移及施加应力,获取骨性隧道内植皮挛缩的生物力学基础和形变规律。结果:通过小型猪下颌骨骨性隧道内植皮的有限元分析模型可以直观有效模拟节点位移及施加应力,其仿真分析结果与动物实验几何外形相似程度高,细节损失小;经静力分析发现0周到4周的挛缩过程所受应力的大小约为4周到8周的挛缩过程所受应力大小的6倍,所受应力的方向都是指向隧道中心。结论:有限元分析可以模拟骨性隧道内植皮的挛缩过程,分析骨性隧道内植皮后挛缩局部区域的应力分布及大小,协助临床设计挛缩对抗方案。     

正颌联合术后正畸矫治唇腭裂术后的牙颌面畸形

目的探讨应用正颌手术联合术后正畸矫治唇腭裂术后牙颌面畸形的方法。方法2002年1月至2010年8月,共收治25例唇腭裂术后颌骨畸形患者。男11例,女14例;年龄16～33岁;单侧唇腭裂19例,双侧6例。所有患者术前均未接受过正畸治疗。本组患者均联合应用正颌手术和术后正畸建牙合矫治唇腭裂术后颌骨畸形。结果25例患者经过3~12个月的术后正畸治疗,均建立了良好的咬牙合关系,恢复正常咬合功能。随访6个月至3年,术后疗效稳定。结论唇腭裂术后颌骨畸形采用正颌手术联合术后正畸能够有效矫治牙颌面畸形。     

胰腺腺泡细胞癌14例诊治分析

目的:探讨胰腺腺泡细胞癌临床特征及其诊治与预后。方法:回顾性分析中日友好医院普通外科1997年1月—2017年1月收治的14例胰腺腺泡细胞癌患者的临床资料。结果:14例患者中,男10例,女4例;平均年龄(51.6±15.6岁);初发症状为腹痛7例,黄疸3例,恶心呕吐1例,腹部包块1例,无症状体检发现者2例。患者肿瘤平均直径(9.4±5.2)cm;肿瘤位于胰体尾部10例(64%),胰头部3例,钩突部1例。术前穿刺病理或术中冷冻病理均未能准确诊断胰腺腺泡细胞癌。9例获R0切除,5例因肝转移或局部侵犯周围脏器仅行行胰腺活检或姑息切除及术后化疗。所有患者均经术后病理证实为胰腺腺泡细胞癌。免疫组化显示α-抗胰蛋白酶、α-抗糜蛋白酶、细胞角蛋白(AEl/AE3)阳性率100%。获得R0切除的9利患者,平均生存时间(32.0±25.6)个月;而未获得R0切除的5名患者平均生存时间仅为(4.0±0.8)个月。结论:对于可行R0切除的胰腺腺泡细胞癌,即使伴有肝转移,也应采取积极的手术治疗,术后辅助化疗对预后极其重要。     

百癣夏塔热片治疗寻常痤疮的临床观察

目的：探讨百癣夏塔热片在治疗寻常痤疮中的临床应用价值。方法：将126例寻常痤疮患者随机分成两组，每组63例，分别给予百癣夏塔热片和四环素进行对照治疗，每周记录1次皮损变化，对比观察治疗前、后痤疮皮损减少率。结果：治疗组总有效率79．37％；对照组总有效率68．26％，两组间差异有统计学意义（P〈0．05）。结论：百癣夏塔热片口服对寻常痤疮是安全、有效的治疗方法，值得临床推广。     

Elective neck dissection or ＂watchful waiting＂： optimal management strategy for early stage NO tongue carcinoma using decision analysis techniques

Background Although tongue cancer is a common disease of the head and neck, the choice of neck treatment between elective neck dissection and ＂watchful waiting＂ remains controversial for patients with early stage NO oral tongue carcinoma. Methods On the basis of the current state of head and neck cancers a decision analysis model was created to compare two treatment strategies for early tongue cancer. Expected value （EV） was calculated according to the literature which met the defined criteria. Sensitivity analyses were performed. Results The results showed that the decision model favored elective neck dissection （EV=0.87）, over ＂watchful waiting＂ （EV=0.77）. One-way sensitivity analyses demonstrated that the outcome was influenced by regional recurrence, threshold value of 0.28 for the elective neck dissection group and 0.17 for the ＂watchful waiting＂ group, and a salvage rate threshold value 0.73 for the ＂watchful waiting＂ group. Conclusions These results suggested that elective neck dissection strategy of the neck should be applied for early stage NO oral tongue carcinoma patients with no clinical nodal metastases. When the occult lymph node metastases rate was less than 0.17 and the salvage rate was more than 0.73, ＂watchful waiting＂ strategy would be preferable.     

Co-expression of P2X receptor subunits on rat nodose neurons that bind the isolectin GS-I-B4

Triple fluorescent histochemistry was used to describe the types of overlap in visceral sensory neurons (nodose ganglion) for the labeling of the isolectin B4 from Griffonia simplicifolia type one (GS-I-B4) and their immunoreactivity (IR) for two of the ATP receptor subunits (P2X1/3 or P2X2/3). The vast majority of nodose neurons expressed GS-I-B4-binding and most of these displayed P2X receptor IR. Most of the P2X-IR was co-expressed on these individual nodose neurons (P2X1/P2X3 or P2X2/P2X3). A very small subpopulation of neurons that were GS-I-B4 negative but P2X positive displayed a very high relative intensity of P2X3-IR. The functional role that these expression patterns play in visceral sensory processing is currently unclear.     

招风耳矫正术后继发畸形的修复

目的：总结招风耳矫正术后继发畸形再修复的手术体会。方法：根据招风耳矫正术后畸形的不同,修复方法要有针对性,要遵循充分松解、展开对耳轮软骨,尽可能恢复原有解剖结构,根据对侧耳廓的位置,调整并重建对耳轮嵴的原则进行修复。结果：13例患者术后畸形均得到矫正,双侧基本对称,外观自然、满意,切口愈合良好,无感染及畸形复发现象。结论：招风耳矫正术后继发畸形可以通过对耳轮的重新塑形得到改善和矫正。