淋巴结瘘型气管支气管结核的临床分析

目的探讨淋巴结瘘型气管支气管结核(TBTB,Ⅵ型)好发人群、临床症状、影像学表现、纤支镜下表现及转归。方法分析65例TBTB(Ⅵ型)患者,总结临床症状、影像学表现、纤支镜下的表现及转归。结果 (1)好发于年轻人(20~35岁)(75.3%)。(2)入院前平均病程4月,主要症状为咳嗽、咳痰、发热、胸痛等。(3)影像学表现:肺膨胀不全,肺门影增大,气道软组织影等。(4)好发部位:左上支气管、隆突及双侧主支气管、左下支气管、右上支气管、中叶支气管。结论 (1)TBTB(Ⅵ型)症状、影像学特征不典型。(2)患者需随访纤支镜及胸部CT至气道及纵隔内病变完全吸收后方可停药,以免复发。     

Management of maxillary impacted canines: A prospective study of orthodontists' preferences

BackgroundMaxillary canines are considered the most commonly impacted teeth, after the third molars. Orthodontists have different preferences on how to approach maxillary impacted canines (MIC). The objective of this article was to investigate orthodontists’ approach to managing MIC.Material and methodsA cross-sectional study comprising a comprehensive survey with 22 questions was sent to practicing orthodontists. This study explored the preferred diagnostic measures, surgical techniques, materials, and mechanics utilized to manage MIC;104 responses were returned.ResultsPalatal impaction was reported to be encountered more often than labial impaction by 60% of the respondents. In 62% of the respondents, an oral and maxillofacial surgeon was the specialist preferred to perform the surgical exposure. In 66%, the choice of required surgical techniques was reported as a joint decision between orthodontists and other specialists who perform the surgery. Cone-beam computed tomography (CBCT) was reported to be the diagnostic x-ray of choice. The gold button with a chain was the preferred bonded attachment in 86% of cases. Less than half of the respondents bonded the attachments themselves during surgical exposure. A clear plastic retainer was the preferred retainer in 61% of the respondents, and 43% of the respondents tended to use a closed exposure technique. Coe-pak^TM was the preferred surgical pack for orthodontists who prefer an open exposure technique. Piggyback (double wire) was the preferable mechanic to move a palatally impacted canine.ConclusionOur findings indicate that there are variations among orthodontists on how to manage MICs in terms of diagnostic methods, surgical management, materials, and mechanics.     

胰十二指肠切除术后胰瘘的危险因素及护理对策

目的研究胰十二指肠切除术后出现胰瘘的危险因素及护理对策。方法回顾分析本院普外科收治的70例接受胰十二指肠切除术患者的临床资料,观察胰瘘情况及其治疗情况,并分析其发生原因并制定相应护理对策。结果胰腺质地、糖尿病、高血压均为导致胰瘘的独立危险因素。遵医嘱对本组出现胰瘘患者进行抗生素用药处理,采用抑制胰液分泌的药物控制病情发展,患者在用药1周后引流液逐渐变少,2周后患者均康复出院,患者生存质量评分各项指标较好。结论临床针对胰瘘患者术后制定相应护理干预措施并做好并发症预防工作,并积极分析胰瘘危险因素,患者治疗效果较好且生存质量评分较高。     

Congenital aortocaval fistula between right aortic sinus of Valsalva and superior vena cava: A rare case report

Thoracic aortocaval fistula is a very rare cause of left to right shunt. Drainage of fistula into the superior vena cava (SVC) is very uncommon. Clinical symptoms depend on the size of the shunt. We report a rare case of an asymptomatic 27‐year‐old woman with congenital aortocaval fistula to the SVC with a small amount of left to right shunt that was considered for serial medical follow‐up.     

Atypical Developmental Venous Anomaly Associated with Single Arteriovenous Fistula and Intracerebral Hemorrhage: a Case Demonstrated by Superselective Angiography

We present a case of developmental venous anomaly associated with arteriovenous fistula supplied by a single arterial feeder adjacent to a large acute intracerebral hemorrhage. The arteriovenous fistula was successfully obliterated by superselective embolization while completely preserving the developmental venous anomaly. Two similar cases, including superselective angiographic findings, have been reported in the literature; however, we describe herein superselective angiographic findings in more detail and demonstrate the arteriovenous shunt more clearly than the previous reports. In addition, a literature review was performed to discuss the association of a developmental venous anomaly with vascular lesions.