改良鼻中隔缝合在鼻中隔矫正术中的临床应用

目的 探讨改良鼻中隔缝合在鼻中隔矫正术中应用的可行性和安全性.方法 对比分析鼻中隔矫正术后应用鼻腔填塞通气管和不填塞而行改良鼻中隔贯穿缝合2种方法的效果.将60例行鼻中隔偏曲矫正术和下鼻甲骨折外移术的患者分为填塞组和缝合组,填塞组30例常规行鼻中隔矫正术和下鼻甲骨折外移术,术后行鼻腔通气管填塞支撑;缝合组30例在鼻中隔...     

Evaluation of Coke Resistivity for the Manganese Alloy Market

The submerged arc furnace (SAF) has become the equipment of choice to produce manganese ferro-alloy. Furnace operators aim to reduce the cost of production by better understanding the role played by the various raw materials involved in the process. Coke is one of the key raw materials fed into the SAF; it plays three key roles in electric furnaces: as a reducing agent, as a source of carbon found in the alloy, and as a resistive element facilitating heat generation in the furnace. The heat generated plays two key functions in the furnace: ensuring both the metal and the slag have a sufficient low viscosity, and providing the heat required to support endothermic reactions. This study investigated the ambient-temperature and high-temperature resistivity characteristics of coke made from single-source coals. The measurement of coke resistivity was performed using the Kelvin (four-point) technique. The results showed a statistically significant difference in mean resistivity between cokes made from different coals. It was observed that coke resistivity generally decreased with increasing temperatures. Raman spectroscopy showed that the structural order of coke changes with increasing temperature.     

Endoscopic burr hole evacuation of an acute subdural hematoma

Acute subdural hematoma evacuations frequently necessitate large craniotomies with extended operative times and high relative blood loss, which can lead to additional morbidity for the patient. While endoscopic minimally invasive approaches to chronic subdural collections have been successfully demonstrated, this technique has not previously been applied to acute subdural hematomas. The authors report their experience with an 87-year-old patient presenting with a large acute right-sided subdural hematoma successfully evacuated via an endoscopic minimally invasive technique. The operative approach is outlined, and the literature on endoscopic subdural collection evacuation reviewed.     

神经内镜辅助夹闭颅内动脉瘤临床研究

目的 探讨神经内镜辅助夹闭颅内动脉瘤的价值。方法 2000年2月至2002年12月，神经内镜辅助颅内动脉瘤手术夹闭78例患79个动脉瘤，前循环系统动脉瘤72例(73个动脉瘤)，后循环系统动脉瘤6例。动脉瘤体直径5—40mm，平均12．5mm。术前分级：Hunt—Hess分级0级8例，Ⅰ级32例，Ⅱ级33例，Ⅲ级5例。结果 本组无手术死亡，手术后出现并发症6例(7．7％)，其中肢体偏瘫4例(1例合并语言障碍)，伪膜性肠炎及视力下降各1例。本组未出现与内镜有关的并发症。结论 神经内镜辅助动脉瘤外科提高了手术效果，但神经内镜设备仍有待改进。     

翼点微骨孔入路治疗颅内前循环动脉瘤

目的探讨应用微骨孔入路治疗颅内前循环动脉瘤的临床效果。方法2000年11月～2001年12月采用翼点微骨孔入路治疗前循环动脉瘤病人83例,共86个动脉瘤。其中颈内动脉眼段动脉瘤3例,颈内动脉C2段动脉瘤40例,颈内动脉分叉部动脉瘤4例,前交通动脉瘤19例,前动脉水平段动脉瘤2例,中动脉水平段5例,中动脉分叉部动脉瘤13例。结果成功治疗前循环动脉瘤病人83例,共夹闭86个动脉瘤。术后出现肢体活动障碍4例,占4.8%;无手术死亡。术后80例复查脑血管造影,显示动脉瘤消失。无与开颅入路相关的并发症。本组均未输异体血液,术中采用自体血回收后输血26例。结论翼点微骨孔入路夹闭颅内前循环动脉瘤,可以降低手术中的医源性损伤并获得满意的手术效果。     

四手操作在龈下刮治的应用

目的 规范应用四手操作技术,满足医疗市场的需求.方法 选择需要进行龈下刮治的牙周病人,医生和牙医助理共同参与治疗的全过程:规范传递器械、物品,同时做好病人的心理护理工作.结果 开展四手操作技术,病人感到舒适,减轻了医生体力和精神上的疲劳,椅旁时间缩短,提高了工作效率.结论 四手操作技术有推广应用价值.     

Wide-lumen stapled anastomosisvs. conventional end-to-end anastomosis in the treatment of Crohn's disease

PURPOSE: Preanastomotic recurrence and stricturing after surgery for ileocolic Crohn's disease is a frequent, unexplained phenomena that may lead to prompt reoperation. The aim of this study was to determine whether a wide-lumen stapled anastomosis (side-to-side, functional end-to-end) provides better outcome than a conventional sutured end-to-end anastomosis METHOD: A case-control comparative analysis of patients with Crohn's disease from two inflammatory bowel disease centers treated with wide-lumen stapled anastomosis and a matched (age and gender) group treated with conventional sutured end-to-end anastomosis was performed. RESULTS: A total of 138 patients with Crohn's disease were treated, 69 with wide-lumen stapled anastomosis and 69 with conventional sutured end-to-end anastomosis. Preoperative therapy, number of previous resections, indication for operation, and length of bowel resected were similar in both groups. Fewer complications occurred after wide-lumen stapled anastomosis (P=0.048). A total of 55 patients developed recurrent Crohn's disease symptoms, 39 (57 percent) in the conventional sutured end-to-end anastomosis and 16 (24 percent) in the wide-lumen stapled anastomosis group. Median follow-up was 70 and 46 months, respectively. After conventional sutured end-to-end anastomosis 18 reoperations were required, 15 for anastomotic stricture and 3 for fistulization. After wide-lumen stapled anastomosis three reoperations were necessary, two for stricture and one for fistulization. The cumulative reoperation rate for anastomotic recurrence was significantly lower (P=0.017; log-rank test) for the wide-lumen stapled anastomosis group. CONCLUSION: Wide-lumen stapled anastomosis is as safe as conventional sutured end-to-end anastomosis and results in a lower incidence of symptomatic recurrent Crohn's disease and need for reoperation. Further prospective study of the wide-lumen stapled anastomosis technique is necessary to define the precise role of this operation in patients with Crohn's disease.Read at The American Society of Colon and Rectal Surgeons' 100th Anniversary and Tripartite Meeting, Washington, D.C., May 1 to 6, 1999.     

微创经皮肾镜钬激光碎石治疗的肾结石患者手术配合要点及护理体会

目的:总结行微创经皮肾镜钬激光碎石(MPCNL)治疗的肾结石患者手术配合要点及护理体会。方法:根据不同护理方案将106例行MPCNL治疗的肾结石患者分为研究组和对比组,各53例。对比组给予常规护理,研究组给予优质手术配合及护理,比较两组护理效果。结果:研究组首次取石成功率、护理满意度评分均优于对比组,差异有统计学意义(...     

Maternal origin of transferrin receptor positive cells in venous blood of pregnant women

We studied the origin of transferrin receptor (CD71) positive cells in blood from seven women pregnant with a male fetus in order to explore if fetal cells could be detected among them. We used a technique that allows direct chromosomal analysis by in situ hybridization on immunologically and morphologically classified cells. Enrichment was performed by magnetic activated cell sorting (miniMACS)® using an anti-CD71 monoclonal antibody. The cells were immunophenotyped by alkaline phosphatase anti-alkaline phosphatase immunostaining with the same antibody. The origin of the immunophenotyped cells was studied by in situ hybridization using an X cosmid Y repeat chromosome specific probe cocktail. CD71 positive cells were found in six of the seven women at the range of 4 to 43 in respective samples. Over 90% of the CD71 positive cells were nucleated erythrocytes. None of the detected positive cells were shown to be fetal. Thus, the use of transferrin receptor antigen alone in combination with the miniMACS® may not be sufficient for enrichment of fetal cells.     

The influence of the diagnostic technique on the histopathological diagnosis in malignant mesothelioma

Summary In the histopathology of malignant mesotheliomas three different types (epithelial, connective tissue and mixed type) are distinguished. Some authors believe all tumours to be of mixed type, but consider that due to inadequate sampling or small biopsies this may be missed frequently. In this study the relationship between the histopathological diagnosis and the amount of tissue examined was investigated. In a series of 124 cases of malignant pleural mesothelioma a high percentage of mixed type tumours was found (55%). In cases where the decisive diagnostic procedure had been an Abrams biopsy (the small-specimen technique) mixed-type histology was found in 36%. If thoracoscopy, thoracotomy or autopsy (the large-specimen techniques) had delivered a definite diagnosis, mixed-type histology was found in 63%. Apparently diagnosing the mixed-type variety depends on the amount of tumour tissue obtained. However, the assumption that all mesotheliomas are of mixed type cannot be confirmed.