Reconstruction of complex and unusual defects of the thoracic wall

Summary From 1981 to. 1989, a total of 13 procedures were performed on 12 patients requiring complex reconstructions of the thoracic wall. The most common cause of these defects was cancer. Muscle flaps remain the treatment of choice for thoracic wall reconstruction and have been used in 10 cases. Microsurgical tissue transfer opens even larger therapeutic perspectives. A team approach is recommended.     

脐疗配合耳穴贴压治疗便秘26例

目的 探讨济疗配合耳穴疗法对便秘的疗效。方法 将50例便秘患随机分成两组，治疗组用济部药物贴敷配合耳穴贴压治疗；对照组单纯用于穴贴压治疗，所获数据采用t检验。结果 治疗组有效率96．15％，对照组有效率83．33％，经统计学处理，P＜0．01，有显性差异。结论 济疗联合耳穴贴压治疗便秘疗效较单纯耳穴贴压效果好，且简单方便，无副作用。     

控制肾血管的肾脏重建治疗重度肾外伤(附15例报告)

目的：提高肾外伤手术治疗的肾单位保存率。方法：采用早期控制肾血管，必要时阻断肾血管重建伤肾的方法，治疗重度肾外伤l5例。结果：5例行肾修补术，4例行肾部分切除术，2例行肾静脉修补术，4例行肾切除术，肾切除率26．3％。结论：控制肾血管的肾脏重建术能有效减少肾脏切除率，是手术治疗肾外伤的理想方法。     

踝关节慢性前外侧不稳的手术治疗

目的: 探讨治疗踝关节慢性前外侧不稳定 (踝关节外侧不稳定合并距下关节不稳定) 的合理而有效的手术方式。方法: 自 1999 ~2003年, 应用Chrisman Snook术式, 以腓骨短肌腱前半部分重建距腓前韧带、跟腓韧带和距跟外侧韧带,治疗踝关节慢性前外侧不稳 8例患者,共 13例关节。结果: 术后随诊 6个月~5年, 平均 19个月。术后所有踝关节均达到功能稳定, 关节活动度基本恢复正常, 没有复发性踝关节不稳发生。以Good评级标准作为疗效评价, 10例关节 (77% ) 为优, 2例关节 (15% ) 为良, 1例关节为中 (7% ), 优良率达 92%。结论: Chrisman Snook术式重建了距腓前韧带、跟腓韧带和距跟外侧韧带, 有效地矫正了踝关节外侧不稳定和距下关节不稳定, 是治疗踝关节慢性前外侧严重不稳定的合理而有效的治疗方法。     

Dynamic MRI with projection reconstruction and KWIC processing for simultaneous high spatial and temporal resolution.

A method for dynamic imaging in MRI is presented that enables the acquisition of a series of images with both high temporal and high spatial resolution. The technique, which is based on the projection reconstruction (PR) imaging scheme, utilizes distinct data acquisition and reconstruction strategies to achieve this simultaneous capability. First, during acquisition, data are collected in multiple undersampled passes, with the view angles interleaved in such a way that those of subsequent passes bisect the views of earlier ones. During reconstruction, these views are weighted according to a previously described k-space weighted image contrast (KWIC) technique that enables the manipulation of image contrast by selective filtering. Unlike conventional undersampled PR methods, the proposed dynamic KWIC technique does not suffer from low image SNR or image degradation due to streaking artifacts. The effectiveness of dynamic KWIC is demonstrated in both simulations and in vivo, high-resolution, contrast-enhanced imaging of breast lesions.     

螺旋CT多层面容积重建在腰椎峡部裂中的应用研究

目的:探讨螺旋CT多层面容积重建对腰惟峡部裂的诊断价值。方法:选取行腰椎螺旋CT检查的50例腰痛患者资料,根据椎弓有无峡部裂分成峡部裂组(25例,有峡部裂)和对照组(25例,无峡部裂),所得数据资料行t检验。结果:峡部裂主要发生在L5(18例,占72%),腰椎峡部裂常导致腰椎前滑脱(24例,占96%)。峡部裂组椎管矢状径明显大于对照组椎管矢状径,之间有显著性差异(P<0.01),峡部裂组峡部高小于对照组峡部高,之间有显著性差异(P<0.05)。结论:螺旋CT扫描MPVR重建图像可以从骨性和软组织两个方面为临床提供更多影像学信息。     

单侧唇裂功能性修复320例护理体会

目的:探讨单侧唇裂功能性修复的护理特点和方法。方法:对我院320例行单侧唇裂功能性修复患儿的护理行回顾性分析和总结。结果:患儿及家属能积极配合,患儿术后恢复良好,家属满意。结论:在常规护理的基础上,患儿特别是家属对疾病和手术方案的认识将对手术和护理效果产生重要影响。     

全喉切除改良气管-咽吻合Ⅰ期发声重建术

目的：探讨全喉切除Ⅰ期发声重建术的改进术式。方法：采用低位气管切开，全喉切除，食管前壁黏膜重建声门，气管切口处造瘘．颈段气管上提并缩窄吻合于舌根的方法行全喉切除及Ⅰ期发声重建木35例。结果：33例(94．29％）术后获得了不同程度的发声功能．不能发声者仅2例(5．71％)。全部患者术后均可经口进食，未出现严重的影响生存质量的误咽。结论：与以往的发声重建术相比，本术式具有发声成功率高、发声质量良好、误咽率低等优点，且无须置人人工发声装置．值得推广。     

Artificial trachea reconstruction with two-stage approach using memory-alloy mesh

Artificialtrachealprosthesisisnowachallengetotheentiresurgicalfieldallovertheworld Previously ,allkindsofprosthesiswere“innerstent”thatcouldnotbeintegratedwithnativetrachea Sincethereisaninterfacebetweensmoothsurfaceofthe prosthesisandlivingtissues,andtheinnersideoftheprosthesisisnotcoveredwithlivingmembrane,infectionsalwayshappenaroundtheprosthesis Wethendevelopedanewtechnique,whichcombinedmemory alloymeshwithtraditionaloperativeprocedures Memory alloymeshisextensible,flexibleandcanmaintain…