眉区不同部位切口的选择与应用

目的 为眉周美容手术提供一个理想的切口选择.方法 根据患者的脸型、眉区情况、患者的治疗目的,要解决那些问题进行评估制定方案,选择不同切口:A、全眉切口;B、部分眉切口;C、眉上切口;D、眉下切口;E、眉内切口.结果 本组158例,均为Ⅰ期愈合,3个月至半年均可稳定,晚期眉切口痕迹难以察觉,效果满意.结论 通过眉切口可以进行多种面部美容手术,也能进行多种美容项目的联合手术,我们认为,它已成为面部上1/3美容手术的主要切口.     

Numerical ability predicts mortgage default

Unprecedented levels of US subprime mortgage defaults precipitated a severe global financial crisis in late 2008, plunging much of the industrialized world into a deep recession. However, the fundamental reasons for why US mortgages defaulted at such spectacular rates remain largely unknown. This paper presents empirical evidence showing that the ability to perform basic mathematical calculations is negatively associated with the propensity to default on one’s mortgage. We measure several aspects of financial literacy and cognitive ability in a survey of subprime mortgage borrowers who took out loans in 2006 and 2007, and match them to objective, detailed administrative data on mortgage characteristics and payment histories. The relationship between numerical ability and mortgage default is robust to controlling for a broad set of sociodemographic variables, and is not driven by other aspects of cognitive ability. We find no support for the hypothesis that numerical ability impacts mortgage outcomes through the choice of the mortgage contract. Rather, our results suggest that individuals with limited numerical ability default on their mortgage due to behavior unrelated to the initial choice of their mortgage.     

Ergonomic evaluation of three new principles for mono‐incision in laparoscopic surgery

Several instruments exist for performing a simple laparoscopic procedure through one trocar‐incision. However, all of these instruments have well‐known image‐related disadvantages. In order to solve these problems three principles have been developed for which a new device was designed. The functionality of this device was evaluated with regard to four parameters: duration of task completion, number of errors, image‐stability and preference by users.

Although the differences between the three principles were small, the tests clearly showed that the problems surgeons experienced before have been significantly diminished by the new device. Time measurements showed a preference for principles 1 and 2 (1: manual zoom camera in combination with a standard grasping device; 2: laparoscope with an angle of 45° in combination with a standard grasping device), the surgeons expressing preference for principle 2. Furthermore, the new trocar system is the first device for mono‐incision in which two standard instruments (currently available on the market) are used simultaneously without enlarging the incision. Finally, each surgeon can work with the new device using the principle he/she is preferring.     

Modern management of lymphocyte predominant Hodgkin lymphoma

Nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) represents 5% of all Hodgkin lymphoma and has distinct clinico‐pathological features. It is typified by the presence of lymphocyte predominant cells, which are CD20⁺, CD15⁻ and CD30⁻ and are found scattered amongst small B‐lymphocytes arranged in a nodular pattern. Patients typically are males presenting with localized, peripheral lymphadenopathy. Despite frequent and often late or multiple relapses the prognosis is favourable. Deaths due to NLPHL are uncommon, but secondary malignancies and other treatment toxicities contribute appreciably to overall mortality. Secondary aggressive non‐Hodgkin lymphoma can occur in approximately 7–14% of cases of NLPHL. Given this diseases' rarity, the optimal management is unclear and opinions differ as to whether treatment paradigms should be similar to or differ from those for classical Hodgkin lymphoma. This review provides an overview of the existing literature describing of the outcome and treatment approaches for limited and advanced stage NLPHL.     

纵切横缝分段结扎治疗环形混合痔180例临床观察

[目的]探讨治疗环形混合痔的有效方法。[方法]对180例患者采用纵切横缝分段结扎的手术方法。[结果]180例患者均痊愈,总有效率达100%,切口愈合时间15-30 d。随防2-5年,均无肛门狭窄及肛门失禁,肛门功能正常。[结论]纵切横缝分段结扎治疗环形混合痔,疗效高,无并发症及后遗症。     

保留胸前神经和肋间臂神经的横切口乳腺癌改良根治术(附40例临床分析)

目的：探讨在乳腺癌改良根治术中采用横切口，并保留胸前神经和肋问臂神经，对术后皮瓣成活、胸大小肌功能、患侧上臂感觉功能的影响。方法：40例乳腺癌均采用横切口乳腺癌改良根治术，清扫时注意保留胸前神经及肋问臂神经。术后检查胸大小肌萎缩情况和患侧上臂内侧的感觉、运动功能变化。结果：术后发生切口皮瓣坏死3例，胸大小肌无明显萎缩，28例保留肋问臂神经患侧上臂内侧皮肤感觉良好，活动自如。结论：保留胸前神经，肋间臂神经的横切口乳腺癌改良根治术减少了术后并发症的发生率，改善了生存质量。     

龈缘角型及袋状切口在拔除阻生智齿中的比较

目的 探讨龈缘角型切口及龈缘袋状切口在拔除阻生智齿(下颌阻生第3磨牙)中的临床效果.方法 对分别应用龈缘角型切口(组Ⅰ,n=38)及龈缘袋状切口(组Ⅱ,n=38)拔除的76颗阻生智齿进行回顾性分析.应用高速直手机去除阻力后拔除牙齿.对2种切口的手术时间、术后疼痛、张口受限、肿胀、并发症情况进行评价.结果 2组手术时间无显著性差异(P＞0.05).术后2d电话随访,龈缘袋状切口术后肿胀疼痛明显大于龈缘角型切口(P＜0.05).7d后复诊,龈缘角型切口患者中伤口裂开明显少于龈缘袋状切口,肿胀疼痛及张口受限在2组中差异无统计学意义(P＞0.05).结论 对于阻生智齿的拔除,高速无碳刷电动直手机可有效缩短拔牙时间;龈缘角型切口和龈缘袋状切口相比,前者并发症少.     

前正中切口联合微创内固定系统双钢板固定C3型股骨远端骨折的疗效分析

目的 探讨前正中切口联合微创内固定系统(less invasive stabilization systems,LISS)双钢板固定AO-C3型股骨远端骨折的临床疗效.方法 筛选2014年6月至2017年3月我科采用膝关节置换术中常用的前正中切口联合LISS双钢板固定治疗AO-C3型股骨远端骨折的患者18例,其中男性12例,女性6例,年龄19 ～ 62岁.包括交通伤11例,高坠伤7例;6例为开放性骨折,12例为闭合性骨折.最后1次随访中采用Kolment和Wulff(1982)治疗评价标准评定内固定术后膝关节功能.结果 18例患者手术时间平均145(110 ～ 200) min,术后均获得17.5(12 ～25)个月随访,术后骨折平均愈合时间22(20 ～26)周,骨折全部愈合,未出现骨折不愈合、感染、骨髓炎及神经血管损伤等并发症.对末次随访患者按照Kolment和Wulff(1982)治疗评价标准进行评估:优6例,良9例,可2例,差1例,优良率达83.33％.结论 采用的膝关节前正中切口可充分暴露股骨远端关节面,术中显露清晰,便于关节面骨折的解剖复位,可一期处理关节内结构损伤,同时联合LISS双钢板牢固固定骨折,避免对骨折断段软组织的过多剥离,允许术后即刻进行有效的早期功能锻炼,可以取得良好的疗效.