A simple method for verifying activity of iodine-125 seeds in rigid absorbable suture

A simple system which facilitates the verification of the calibration of iodine-125 sources in rigid absorbable suture, on the remote traceability basis, was developed. It consists of a plastic jig accommodating a sterile closed-end 16 gauge plastic catheter. The iodine-125 source in rigid absorbable suture is placed into the sterile closed-end 16 gauge plastic catheter. The jig fits in a standard dose calibrator. The sterility of the strand is maintained while a reasonable number of seeds used for an actual implant can be easily measured. This is an improvement over the current recommended practice of assaying just one separate seed of the same strength designation. This system brings the calibration procedure for the rigid sterile seed strands in line with the AAPM TG-40 recommendation for the rest of radioactive seed products.     

锯齿状缝线皮下置入面部提升术临床应用中的若干问题探讨

目的:对临床应用特制锯齿状缝线置于皮下的微创面部皮肤松弛提升术出现的问题及并发症进行探讨,并提出对策。方法:将两端具有细微的、向中央倾斜的聚丙烯锯齿状缝线,通过含有针蕊的穿刺导引针,置于皮下,治疗面部松弛者352例,观察临床效果,并对不成功病例进行分析,同时与国外资料进行对比,提出改进办法。结果:随访观察3个月至32个月,对352例求美者随访,根据术者和求美者的综合判断,其中显效132例,有效165例,效果较差39例,无效16例,总有效率84.37%,无效及疗效不佳者占15.63%,分析其原因为:1.锯齿状缝线齿的问题;2.手术技巧的问题;3.术前、术后与求美者沟通不够,导致疗效下降或无效。结论:锯齿状缝线皮下置入进行面部提升是一种简便有效的方法。但应对锯齿状缝线的倒刺进行有效的改善,手术方法进行改进,完善并加强与求美者沟通,以提高成功率。     

网状减张小切口一期关闭皮肤高张力创口的探讨

介绍一种网状减张小切口有新方法，临床结果表明，该方法可使皮肤拉开扩大１－３倍，有利于创面覆盖，使皮肤在无缍力的情况下缝合，且无特殊并发症发生，值得临床推广使用。     

缩短皮肤软组织扩张疗程的方法探讨

目的:探讨缩短皮肤软组织扩张疗程和提高扩张质量的方法。方法:从扩张器的选择和埋藏位置、切口缝合方式和注水策略三个方面总结80例182个扩张器的临床应用效果。结果:77例扩张效果满意,3例出现并发症:血肿2例,感染1例。结论:切口错位分层缝合是扩张器满意注水的基础;合理选用和放置扩张器以及从早、从快、从超量注水是缩短皮肤软组织扩张疗程和提高扩张效果的重要措施。     

Ptosis and cataract surgery. A multivariant computer analysis of a prospective study

A prospective study investigated the effect of local anesthesia, eyelid edema and superior rectus muscle injury on postoperative ptosis. Patients were randomized into four groups to study these effects. Group A received a Van Lint eyelid block and a superior rectus bridle suture. Group B received a Van Lint block and an episcleral retraction suture. Group C received a Nadbath retroauricular facial nerve block and a superior rectus bridle suture. Group D received a Nadbath block and an episcleral retraction suture. Results of the study indicate that postoperative ptosis can be significantly reduced by varying our operative techniques. Postoperative ptosis was significantly increased in group A and reduced in group D. It appears that trauma to the superior rectus muscle complex is the most critical factor in postoperative ptosis. Fifty five and one-half percent of the population entered the study with preoperative ptosis. Preoperative ptosis had no effect on postoperative ptosis. Lid crease, superior sulcus fullness and lash rotation are poor anatomical landmarks of levator insertion in the elderly population, both preoperatively and postoperatively.     

Double Eyelid Procedure by Removal of Transconjunctival Orbital Fat and Buried Sutures Combined with Sling Technique to Avoid Wounding the Eyelid

In the typical transconjunctival buried suture procedure for double eyelids, the adhesion between the skin and the pretarsal tissue or conjunctiva through the tarsal plate and the sling with the skin, the levator, and Muller's muscle are obtained by suturing. These are assisted by the stab wound or a needle through the eyelid skin, and the skin wound takes several days to heal. Also these suturing knots are buried under the skin on the tarsal plate, so that these will tend to appear on the skin surface later on. Removing the excess orbital fat that migrates to the area of fixation and jeopardizes the effect of the suturing technique is performed with skin incision and usually leaves a linear scar. The author devised a method that makes a double eyelid with two linear, wide sutures that lie between the levator and Muller's muscle and the immediately adjacent subdermal tissue of the skin by using one thread. It also reduces the excess orbital fat through the conjunctiva without wounding the skin and makes face washing or application of make-up possible immediately after the operation. Only one ligation is left at the lateral subconjunctiva to avoid its appearance on the skin surface to effect easy correction in case necessary. This method has evolved from previous method of transcutaneously burying sutures for the double eyelid, which was made wide by a linear suture by using one thread. Insufficient results were observed in eight of 280 cases.     

Enteric coated insulin pellets: development, drug release and in vivo evaluation

Pellets with human insulin as a model drug were prepared by an extrusion and spheronization process to investigate the oral application of peptides. The described process proved suitable for preparing small batches of about 50 g in laboratory scale. The developed formulation was completed by the addition of aprotinin as protease inhibitor and sodium cholate as an intestinal absorption promoter to enhance oral bioavailability of insulin. In order to protect the peptide against the gastric juice the pellets were coated with shellac in a fluid-bed ball coater. Pharmaceutical properties of the produced batches were examined by analysis of contents and dissolution tests. Dissolution of insulin in simulated gastric juice of pH 1.2 was prevented by shellac. On the other hand, a rapid and complete release of the molecular-dispersed insulin from the pellets was found in simulated intestinal fluid (pH 7.5) with simultaneous efficiency of the protease inhibitor against added enzyme activity. Despite promising in vitro results no significant absorption of insulin was detected in vivo after oral application of the pellets to streptozotocin diabetic rats. High sensitivity to enzymatic degradation and low ability to cross the intestinal wall are discussed as limiting factors for the insufficient absorption of insulin in vivo.     

食管胃吻合口瘘病因和防治的探讨

本文报告了食管、贲门癌切除5084例,发生吻合口瘘217例,发生率为4.3％,死亡率为38.2％。自1979年11月30日以来,应用手法吻合,北京Ⅳ型、上海GF-1型吻合器及腔内弹力环扎共行食管胃吻合术1790例,吻合瘘口的发生率分别为3.2％,2.2％,3.2％,5.1％。对新技术预防吻合口瘘的作用作出评价。     

巩膜瓣可拆缝线及角膜侧切口在小梁切除术中的应用

目的观察巩膜瓣可拆缝线及角膜侧切口对小梁切除术后低眼压、浅前房的影响。方法青光眼95例(145眼)在常规小梁切除术中联合应用巩膜瓣可拆缝线及角膜侧切口,术中全部病例人工形成前房,观察术后前房形成情况、滤过泡形态及眼压水平,根据眼压高低、滤过泡形态及前房深浅决定拆除可拆缝线时间,并将浅前房发生率与行单纯小梁切除术的144例(179眼)作对比。结果小梁切除联合巩膜瓣可拆缝线及角膜侧切口术后12眼发生浅前房,浅前房发生率为8.2％;单纯小梁切除术后,浅前房发生率为18.4％。二者相比有显著差异(P<0.01)。结论小梁切除联合巩膜瓣可拆缝线及角膜侧切口可主动调节房水滤过量,促进功能性滤过泡形成,减少小梁切除术后低压性浅前房的发生。     

急诊手术一期缝合治疗血栓外痔临床观察

目的 研究急诊手术一期缝合治疗血栓外痔的可行性。方法 治疗组对血栓外痔实施切除后一期缝合，对照组对血栓外痔切除后切口不缝合，观察比较术后愈合时间、疼痛、水肿、出血、感染等情况。结果 治疗组术后愈合时间、疼痛、出血、水肿等均优于对照组（P〈0．05）。结论 急诊手术一期缝合治疗血栓外痔有效、安全、可行。