应用单克隆抗体检测肺癌病人外周血中T细胞亚群

本文应用单克隆抗体检测33例原发性肺癌病人治疗前后外周血中T淋巴细胞亚群变化。结果提示:肺癌病人外周血中T细胞亚群明显有别于正常人,主要表现为T_H细胞降低和T_S细胞升高以及T_H/T_S比值明显倒置。短期观察结果表明,肺癌病人外周血中T_S细胞持续升高和T_H/T_S比值持续降低者,预后不良。临床检测T细胞亚群变化及它们的动态变化可作为判断宿主抗肿瘤免疫功能状态、病情发展和预后的敏感指标。     

原发性骨质疏松骨折治疗探讨

目的　探讨原发性骨质疏松骨折的治疗方法。方法　对 138例原发性骨质疏松骨折 ,在治疗骨折的同时采用联合用药 ,中西医结合用药及脉冲电磁场进行病因学治疗。结果　 138例中 134例获得 8～ 36个月 ,平均 13.5个月的随访 ,按优、良、可、差疗效评定标准 ,优 4 8例 ,良 6 2例 ,可 14例 ,差 6例 ,优良率 85.1% ,另 4例半年后死于其它疾病。结论　原性骨质疏松性骨折必须在进行骨折治疗的同时 ,进行骨质疏松病因学的治疗 ,二者结合才能收到较好的疗效     

应用局部皮瓣治疗仰趾畸形

目的:探讨烧、创伤后,足背瘢痕挛缩所致仰趾畸形的治疗。方法:术中将足背瘢痕切除,彻底松解挛缩,将弓弦状伸肌腱切除部分或切断,切除部分挛缩的跖趾关节背侧关节囊,使关节复位,克氏针外固定,在拇指内侧或小趾侧,以跖趾关节处为蒂设计逆行皮瓣,转移覆盖外露的跖趾关节,供区及瘢痕切除后创面行全厚或断层皮片修复。结果:本组7例,均采用逆行皮瓣修复,畸形完全纠正,无继发畸形。结论:应用拇指及小趾侧方逆行皮瓣转移,治疗仰趾畸形可达到满意效果。     

How four and twelve weeks of implantation affect the strength and stiffness of a tendon graft securely fixed in a bone tunnel: a study of Evolgate fixation in an extra-articular model ovine model

Healing of a tendon graft to a bone tunnel is slower than the healing of a bone plug. Therefore, the device chosen for hamstring fixation may need to maintain its strength and stiffness longer than the device chosen for bone-tendon-bone fixation. We evaluated, in an extraarticular ovine model, how 4 and 12 weeks of implantation affect the strength of a tendon graft fixed to bone with the Evolgate. The long digital extensor tendon was transplanted and fixed with the Evolgate into a 30-mm long, 8 mm diameter bone tunnel drilled in the tibial metaphysis of both posterior limbs of 15 skeletally mature Suffolk sheep. Immediately after implantation, and 4 and 12 weeks later, biomechanical cyclic load tests in 50 N increments were performed until failure to evaluate the ultimate failure load (UFL). Histological analysis was also performed at 4 and 12 weeks. Biomechanical tests revealed a UFL of 339±120 N at time 0, and increases to 635±19 N (4 weeks) and to 867±80 N (12 weeks). The differences between all 3 groups were significant (p<0.001, paired t test). The histological evaluation showed a layer of cellular, fibrous tissue between the tendon and the bone, along the length of the bone tunnel; this layer progressively matured and reorganized during the healing process. The collagen fibers that attached the tendon to the bone resembled Sharpey’s fibers. The strength of the interface significantly and progressively increased between weeks 4 and 12 after transplantation, and was associated with a degree of bone ingrowth noted histologically. The use of the Evolgate seems not to interfere with the bone ingrowth after implantation, allowing an improvement in strength of the bonetendon- device complex.     

柳州市小学三、四年级学生心理健康与其家庭环境的相关分析

目的：了解三、四年级小学生心理健康状况，探讨小学生心理健康与家庭环境因素关系。方法：采用小学生心理健康诊断测验（MHT）和家庭环境量表（FES）对柳州市四所小学三、四年级1781名小学生的心理健康状况及其家庭环境进行调查。结果：家庭环境中的亲密度、情感表达、知识性、娱乐性、道德宗教、组织性与心理健康问题因子呈负相关关系；家庭环境中的矛盾性、独立性、成功性、控制性与心理健康问题因子呈正相关关系；多元回归分析发现家庭环境中的亲密度、情感表达、知识性、娱乐性、组织性对三、四年级小学生心理健康有积极影响；家庭环境中的矛盾性、独立性、成功性、道德宗教、控制性对三、四年级小学生心理健康有消极影响。结论：家庭环境对三、四年级小学生心理健康水平有重要影响。     

短伸肌腱修复供足第1跖骨深横韧带(附55例报告)

目的在第2足趾移植再造拇指术中,应用     

Combined open and laparoscopic approach to chronic pain following open inguinal hernia repair

Introduction: Chronic groin pain is the most common long-term complication after open inguinal hernia repair. Traditional surgical management of the associated neuralgia consists of injection therapy followed by groin exploration, mesh removal, and nerve transection. The resultant hernia defect may be difficult to repair from an anterior approach. We evaluate the outcomes of a combined laparoscopic and open approach for the treatment of chronic groin pain following open inguinal herniorrhaphy. Methods: All patients who underwent groin exploration for chronic neuralgia after a prior open inguinal hernia repair were prospectively analyzed. Patient demographics, type of prior hernia repair, and prior nonoperative therapies were recorded. The operation consisted of a standard three trocar laparoscopic transabdominal preperitoneal hernia repair, followed by groin exploration, mesh removal, and nerve transection. Outcome measures included recurrent groin pain, numbness, hernia recurrence, and complications. Results: Twelve patients (11 male and 1 female) with a mean age of 41 years (range 29–51) underwent combined laparoscopic and open treatment for chronic groin pain. Ten patients complained of unilateral neuralgia, one patient had bilateral complaints, and one patient complained of orchalgia. All patients failed at least two attempted percutaneous nerve blocks. Prior repairs included Lichtenstein (n=9), McVay (n=1), plug and patch (n=1), and Shouldice (n=1). There were no intraoperative complications or wound infections. With a minimum of 6 weeks follow up, all patients were significantly improved. One patient complained of intermittent minor discomfort that required no further therapy. Two patients had persistent numbness in the ilioinguinal nerve distribution but remained satisfied with the procedure. Conclusions: A combined laparoscopic and open approach for postherniorrhaphy groin pain results in good to excellent patient satisfaction with no perioperative morbidity. It may be the preferred technique for the definitive management of chronic neuralgia after prior open hernia repair.     

原发性十二指肠肿瘤的诊断与治疗

目的 探讨十二指肠肿瘤的诊断及治疗。方法 回顾我院1984～2005年间收治29例PTD的临床资料进行分析。结果 良性肿瘤8例，恶性肿瘤21例。上腹部疼痛、消化道出血、呕吐、黄疸、消瘦、腹部包块等为本组病人的主要临床表现。术前十二指肠镜检查6例，均发现病灶。胃镜检查18例，9例发现病灶。B超检查20例，12例发现包块。十二指肠气钡双重造影7例，6例确诊。CT检查5例，4例确诊。全组病人均行手术治疗，术后随访6个月～21年。良性肿瘤均存活，恶性肿瘤死亡儿例，2年内死亡10例，5年死亡1例，10例生存，最长1例20年。结论 上腹部疼痛、消化道出血、呕吐是十二指肠肿瘤的最常见症状。十二指肠镜、十二指肠气钡双重造影、胃镜检查是最主要的检查手段；手术切除肿瘤是最基本、最有效的治疗方法。     

24h动态血压监测评价卡维地洛对原发性高血压患者的降压效应

目的 :评价卡维地洛对原发性高血压患者的降压效应。方法 :选择我科 2 0 0 3年 7月至 2 0 0 4年 1月住院的原发性高血压患者 4 2例 ,行首次 2 4 h动态血压监测后开始服用卡维地洛 ,初始剂量为 12 .5 mg,每日口服 1次。治疗开始后每日服药前测卧位血压 1次 ,若血压控制不满意 ,可根据病情增加剂量。 4周结束时重复行 2 4 h动态血压监测。治疗前和治疗 4周结束时行血、尿常规、肝肾功能、血脂、血电解质、空腹血糖等检查。结果 :经 4周卡维地洛治疗后 ,显效 37例 (88.10 % ) ,有效 4例 (9.5 2 % ) ,无效 1例 (2 .38% ) ,总有效率 (97.6 2 % )。治疗后患者平均收缩压(SBP)、平均舒张压 (DBP)谷峰比值分别为 6 3%和 6 5 %。结论 :本观察发现卡维地洛降压疗效确切 ,有效率为 97.6 2% ,有满意的谷 /峰比值 ,副作用少 ,是一种很有前途的新型抗高血压药物。     

跨矢状窦脑膜瘤术中矢状窦的处理

目的总结跨矢状窦脑膜瘤术中矢状窦的处理方法.方法对26例跨矢状窦脑膜瘤及受累矢状窦进行切除,依具体情况重建或不重建矢状窦.结果该组病人无手术死亡,手术后均未加重原有神经功能障碍,无脑血液回流障碍,7例重建矢状窦者未发现有矢状窦内血栓形成.结论矢状窦旁脑膜瘤的治疗除肿瘤切除外,对受累上矢状窦处理是否彻底对预防术后复发是至关重要的.对受累矢状窦应按具体情况按一定的原则进行积极处理.