穿透性胃溃疡恶变12例影像学分析

目的提高对穿透性胃溃疡恶变的影像学诊断及鉴别诊断的认识。方法经手术病理证实的12例穿透性胃溃疡恶变病例，均行胃钡餐造影，10例加行CT扫描。结果胃钡餐造影出现深大龛影12例，其中腔外龛影10例，部分腔内龛影2例，出现穿孔2例。CT见胃壁增厚8例，胃内软组织块影2例，胃外软组织块影2例，腹腔、肝门、腹膜后淋巴结肿大6例。结论胃钡餐造影对穿透性胃溃疡有良好的显示，还可以发现CT显示不理想的胃黏膜面，对估计病变的范围和溃疡、穿孔方面优于CT。但CT能清楚观察胃壁的厚度、胃外肿块、与周围脏器的关系以及胃外有无淋巴结肿大，能对判断穿透性胃溃疡有无恶变等提供更多准确的信息。     

新型4通道单电源低功耗程控接口脑电放大器的研制

本脑电放大器针对现有同类电路缺点进行改进，采用了最新一代高性能模拟与混合信号集成电路芯片，优化了电路结构并通过精细的电路工艺措施实现了噪声电压1．9μVp-p、共模抑制比100dB、输入阻抗80MΩ、基线漂移小、单电源5V供电和工作电流小于10mA等电路指标，并实现了增益控制和滤波控制的数字化接口。1年的应用表明该放大器安全省电、体积小、结构简单、性能稳定，非常适合作为便携式智能型脑电图仪器的前端。     

89例下肢瘢痕癌的诊治体会

目的：总结下肢瘢痕癌的临床特点及其诊治方法。方法：回顾性分析中南大学湘雅医院烧伤重建外科 1998年1月至2017年12月收治的89例下肢瘢痕癌患者的临床资料,包括人口统计学、致伤因素、癌变潜伏期、病变部 位、溃疡面积、病理类型、骨质侵犯、淋巴结转移情况、手术方式、修复方法与预后等。结果：89例下肢瘢痕癌患 者中,男70例,女19例;最常见致伤因素依次为火焰烧伤(42例)、创伤(19例)、烫伤(12例)。病变最常见于小腿(31 例),其次为大腿(11例)、足跟(11例);溃疡面积为1.5~600.0 cm2 。其中鳞状细胞癌80例、疣状癌8例、肉瘤1例。术前 发现腹股沟淋巴结肿大78例,行腹股沟淋巴结清扫49例,单纯淋巴结活检、切除29例;9例发现淋巴结转移,8例有 骨质侵犯;24例行截肢术,53例行病灶扩大切除皮片移植术,12例行病灶扩大切除皮瓣修复术。65例得到随访,8例 出现复发,其中截肢者2例,扩大切除者6例,且肿瘤复发与手术方式无关(P>0.05)。结论：下肢瘢痕癌复发转移率较 高,需早期发现、早期诊断,应尽早手术治疗并定期随访;腹股沟淋巴结肿大较常见,需行淋巴结活检、切除或清 扫;局部扩大切除、植皮或皮瓣修复是其主要治疗方法,但癌肿较大、侵犯较深且下肢瘢痕广泛、畸形严重者可考 虑截肢。     

Epithelioid sarcoma‐like (pseudomyogenic) hemangioendothelioma,clinically mimicking dermatofibroma,diagnosed by skin biopsy in a 30‐year‐old man

Epithelioid sarcoma‐like (pseudomyogenic) hemangioendothelioma (ESHE) represents a rare soft tissue and bone tumor that typically presents as nodule(s) in the distal extremities of young adults. The nodules traverse several tissue planes simultaneously and can involve the dermis, subcutis, skeletal muscle and bone. ESHE shares clinical and microscopic features with epithelioid sarcoma (ES), and, accordingly, is commonly misdiagnosed as ES. However, unlike ES, which has a poor prognosis, ESHE commonly follows an indolent course. Herein, we report a case of ESHE diagnosed by skin biopsy that clinically mimicked a dermatofibroma. We also provide clinical photographs of the lesions in various stages of development, representing information that has not been previously published, to our knowledge.     

Prevalence of lower limb venous disease in surgeons: a case study and results of a survey by the BAOMS Reconstruction Surgical Subspecialty Interest Group

We report a case of venous leg ulceration in a reconstructive oral and maxillofacial surgeon. An online survey was created by the British Association of Oral and Maxillofacial Surgeons (BAOMS) Reconstruction Surgical Subspecialty Interest Group (SSIG), primarily to target head and neck surgeons, to investigate the perceived risk and occurrence of venous leg disease. Two respondents had received treatment for lower limb venous disease thus compromising their ability to work, while 13 had symptoms of early venous disease. Our study shows an interesting area of concern for occupational health in surgeons, particularly in those carrying out long operations, as will be the case for members of the Reconstruction SSIG.     

Guidebook for Nutrition Counselors

Background: Because accurate measures of recumbent length are essential to assess growth and energy requirements of mobility-impaired individuals with cerebral palsy (CP), a reliable and simple method of estimating recumbent length is required. Prediction of recumbent length from knee height in this population has not yet been investigated.

Objectives: i) To correlate direct measures of recumbent length in mobility-impaired individuals having lower leg extremity cerebral palsy (LECP) involvement with indirect measures of recumbent length calculated using knee-height prediction equations and ii) to determine if knee height is a reliable predictor of recumbent length in this population.

Methods: Subjects (n=34; 15F, 19M), aged 6 to 30 years, were participants in a six-month nutrition rehabilitation program. All subjects had varying degrees of LECP involvement. Recumbent length to the nearest 0.5 cm was measured by standardised techniques. Knee height was measured to the nearest 0.5 centimetre using sliding callipers. Equations based on normal, healthy individuals with application to mobility-impaired or handicapped individuals were used to predict recumbent length from knee height.

Results: Direct measures of recumbent length of subjects significantly correlated with indirect measures calculated using knee height prediction equations (R=0.88, p≤0.0001). In addition, knee height of these subjects was a reliable predictor of recumbent length (R²=0.78, p<0.0001).

Conclusions: Results suggest that knee height may be a reliable predictor for recumbent length in this population.