人鼻粘膜表面超微结构及纤毛输送功能的研究

研究结果表明:①人鼻粘膜的上皮在胚胎期的发育并不完善。在新生儿,纤毛上皮细胞的融合刚刚开始,其表面的纤毛呈微绒毛状。②在最常见的四种鼻粘膜炎症病变中,其超微结构的损害程度以伴有化脓性感染者最重,慢性肥厚性鼻炎与萎缩性鼻炎次之,变态反应性鼻炎最轻。③上述四种炎症病人的鼻纤毛输送能力均较正常人差,其中以伴有化脓性感染者最差,慢性肥厚性鼻炎和萎缩性鼻炎次之,变态反应性鼻炎最轻。     

Acute pseudotumor of the orbit

A case is presented of a 22-year-old man with a history of bilateral eye injection, lacrimation, and rhinorrhea. The right orbit was inflamed and its globe proptotic, with medial and lateral gaze deficits. Tomography revealed swelling about the right lacrimal gland. He was admitted and treated with high-dose steroids, which caused regression of his symptoms. This presentation and response to steroids is pathognomonic for acute pseudotumor of the orbit, a condition rarely described in the emergency medicine literature. If left untreated, treudotumor of the orbit may progress to blindness and ophthalmoplegia.     

鼻内窥镜下微波凝固治疗常年性变应性鼻炎近期疗效观察

目的 :观察微波凝固治疗常年性变应性鼻炎的近期疗效。方法 :患者随机分为两组 ,治疗组 96例经鼻内窥镜行微波凝固筛前神经及下鼻甲治疗 ;对照组 72例采用鼻内窥镜下 15 %硝酸银烧灼治疗 ,治疗部位同治疗组。结果 :在治疗结束 1个月后进行疗效评定。治疗组总有效率 10 0 % ,对照组总有效率 72 .2 % (P <0 .0 0 5 )。结论 :鼻内窥镜下微波凝固筛前神经及下鼻甲治疗常年性变应性鼻炎 ,具有视野清晰 ,操作简便 ,疗效显著等优点 ,有较好的临床应用价值。     

带血管蒂肠浆肌层环贴术防治肠瘘

本文报导用带蒂血管肠浆肌层环贴术防治各种复杂肠瘘,经过十一年的临床观察,疗效满意。本文还着重介绍了手术方法及操作过程中应注意的问题。     

控制性降压在鼻内窥镜手术中的应用

目的 :观察控制性降压在鼻内窥镜手术中应用的意义。方法 :80例双侧鼻息肉、鼻窦炎患者 ,局麻、鼻内窥镜下行双侧鼻息肉摘除、全筛切除及开放上颌窦自然开口。其中 38例术中控制性降压 (降压组 ) ,另 42例作为对照。结果 :降压组术中出血 (6 1 39± 38 5 2 )ml,对照组出血 (140 12± 81 82 )ml,差异有显著性意义 (P <0 0 1) ;手术时间分别为 (4 9 2 5± 7 0 6 )min和(6 2 4 0± 9 90 )min ,差异有显著性意义 (P <0 0 1)。结论 :控制性降压可明显减少术中出血 ,缩短手术时间。     

Influence of ileal pouch capacity and anal sphincteric function on the clinical outcome after ileal pouch-anal anastomosis

This study was designed to determine the influence of ileal pouch capacity and anal sphincteric function on the clinical outcome after ileal pouch-anal anastomosis. A total of 24 patients who had undergone ileal pouch-anal anastomosis (J pouch) for ulcerative colitis were studied. The 24-hour stool frequency was found to be inversely correlated with the sensitivity threshold volume (STV), maximal tolerance volume (MTV), and distensibility, but was independent of the maximal resting pressure and maximal squeeze pressure. Patients experiencing nocturnal fecal incontinence had maximal resting pressures that were significantly lower than those of nocturnally continent patients. Among the patients with fecal incontinence, those with frequent soiling had lower resting pressures, STV, and distensibility than the patients with intermittent spotting. In addition, the STV in patients needing nocturnal evacuation were lower than those of patients who did not evacuate after falling asleep. The conclusions are as follows. Both stool frequency and the need for nocturnal pouch evacuation correlated directly with pouch volume. Anal incontinence was more common in patients with low internal sphincteric function. In addition, frequent and gross nocturnal incontinent patients demonstrate a worse function in both the anal sphincter and reservoir than those with intermittent spotting.     

Extracorporeal Septoplasty Combined with Open Rhinoplasty

Extracorporeal septoplasty is a radical solution for the severely deviated nose. The major problems associated with this procedure are fixation of the septal cartilage graft and dorsal irregularities. Extracorporeal septoplasty was performed in combination with open rhinoplasty in 17 patients with severe nasal deformities. In this technique septum was totally removed through the columellar incision of open rhinoplasty, corrected outside, and replaced as a free ``L' shaped cartilage graft. The cartilage graft was fixated to the upper lateral cartilages to restore the natural relations of the anatomical structures. Additional rhinoplastic manipulations were also performed. The follow-up period was up to 18 months. The overall result was successful in all patients. Nasal deviation did not recur and secondary revisions were not needed for any patient during follow-up.     

Latero-lateral end anastomosis for right hemicolectomy using staplers

In seven patients undergoing right hemicolectomy for benign or malignant diseases, latero-lateral end anastomoses were made using stapling devices, LS (linear stapler) and GIA (gastrointestinal anastomosis). As no complications directly related to the anastomosis occurred, we conclude that anastomosis using stapling devices for right hemicolectomy is a safe and rapid procedure.     

小儿早期睾丸卵黄囊瘤12例报告

目的：提高对小儿早期睾丸卵黄囊瘤的诊断与治疗水平。方法：回顾性分析12例小儿早期睾丸卵黄囊瘤的病例资料。结果：12例患者术前行阴囊B超示睾丸增大，内部回声不均匀，7例可见睾丸内积液改变；甲胎蛋白(AFP)值均明显升高。12例均行根治性睾丸切除术，术后行病理检查确诊。术前、术后均未行化疗，9例随诊5年未见复发，2002年就诊的3例目前未见复发症状。结论：小儿早期睾丸卵黄囊瘤可根据相关检查结果，结合病理检查确诊。治疗方法为行根治性睾丸切除，可不作化疗，预后较好。