应用单针可调整缝线修复轻度上睑下垂12例报告

目的探讨应用单针可调整缝线修复轻度上睑下垂的效果。方法对2003年1月-2005年3月福州市第一医院眼科收治的12例（16眼）轻度上睑下垂患者，用单针可调整缝线进行修复，术后4天检测术眼上睑下缘高度，根据需要改变可调整缝线松紧度，并将缝线永久固定。结果所有患者术后上睑下缘高度与目标高度均相差不到1mm，随访3～26个月未见复发。结论单针可调整缝线修复轻度上睑下垂简便可行，值得推广。     

可调缝线联合丝裂霉素治疗难治性青光眼

目的:评价可调缝线联合丝裂霉素治疗难治性青光眼的临床疗效。方法:对难治性青光眼30例应用可调缝线联合丝裂霉素在滤过性手术中疗效进行分析。结果:经过1a的随访,视力不变27眼,下降1～2行3眼;术后眼压:出院时平均眼压1.72kPa,3月以上平均眼压(2.4±0.3)kPa。结论:在常规滤过手术中采用可调缝线联合丝裂霉素可有效地降低眼压,减少并发症的发生,从而维护青光眼患者的视功能。     

改良皮下埋藏缝线法重睑形成术

目的:探讨重睑形成术的手术方法和效果。方法:对15例(29眼)单睑者在皮下埋藏缝线法重睑形成的基本原理的基础上,在具体操作技术上用我们改良后的手术方法施行手术。结果:经5～10d和6～12mo的随访观察,除其中1例无力型因年龄大适应症选择不当0.5a后效果不佳;其余全部受术者,恢复后形成重睑皱褶自然,长短基本一致,重睑对称。受术者、施术者、第三者均较满意。结论:改良后的重睑形成术,手术操作简便,效果可靠。是一种具有应用价值的手术方式,值得推广使用。     

骨缝精确标识性颅面骨三维有限元模型的建立

目的建立骨缝精确标识性颅面骨三维有限元模型，为进一步开展各种正畸一矫形力作用下的颅面部生物力学研究提供一处重要的平台。方法选择替牙晚期10岁女孩干燥头颅骨作为材料供给，要求颅面骨完整无缺损，各骨缝结构保存完好。采用丁氧膏精确定位颅面骨各相关骨缝和标志点的具体位置，螺旋CT扫描获得颅面骨各断层的二维影像，并借助ANSYS程序生成实体模型。根据骨缝标志点的三维坐标确定颅面骨各骨缝结构的空间定位，采用光滑平面简化处理骨缝接触面，骨缝宽度设定为0．2mm。网格划分，力学参数设定，最终建立起骨缝标识性颅面骨三维有限元模型。结果所建立的骨缝标识性颅面骨三维有限元模型几何形态逼真，与实体标本以及三维CT影像相比具有较高的相似性，模型共包括21480个节点和83688个单元。结论通过在干燥头颅骨上对相关骨缝结构进行精确标识，并在建模时做适当的简化处理将骨缝结构所特有的生物力学性质融入三维有限元模型中，进一步提高了所建模型的仿真程度。     

改良式可拆除膀胱颈荷包缝合法治疗良性前列腺增生的疗效

目的观察改良式可拆除膀胱颈荷包缝合法治疗良性前列腺增生(BPH)的疗效。方法应用改良式可拆除膀胱颈荷包缝合法,将荷包缝线在膀胱外交叉后从腹壁穿出,再以鞋带式活结结扎的方法行前列腺摘除,治疗20例BPH患者,观察其疗效。结果手术时间为70～130min,分别于术后7～9d去除气囊导尿管及膀胱造瘘管。20例患者排尿通畅,未发生严重血尿及尿失禁。前列腺手术前、后症状评分(IPSS)间差别有显著性意义(P<0.01)。结论改良式可拆除膀胱颈荷包缝合法治疗BPH效果良好。     

Long-term active antimicrobial coatings for surgical sutures based on silver nanoparticles and hyperbranched polylysine

The goal of this study was to develop a long-term active antimicrobial coating for surgical sutures. To this end, two water-insoluble polymeric nanocontainers based on hyperbranched polylysine (HPL), hydrophobically modified by either using glycidyl hexadecyl ether, or a mixture of stearoyl/palmitoyl chloride, were synthesized. Highly stabilized silver nanoparticles (AgNPs, 2–5?nm in size) were generated by dissolving silver nitrate in the modified HPL solutions in toluene followed by reduction with L-ascorbic acid. Poly(glycolic acid)-based surgical sutures were dip-coated with the two different polymeric silver nanocomposites. The coated sutures showed high efficacies of more than 99.5% reduction of adhesion of living Staphylococcus aureus cells onto the surface compared to the uncoated specimen. Silver release experiments were performed on the HPL-AgNP modified sutures by washing them in phosphate buffered saline for a period of 30?days. These coatings showed a constant release of silver ions over more than 30?days. After this period of washing, the sutures retained their high efficacies against bacterial adhesion. Cytotoxicity tests using L929 mouse fibroblast cells showed that the materials are basically non-cytotoxic.     

Operative outcomes of single-port-access laparoscopy-assisted vaginal hysterectomy compared with single-port-access total laparoscopic hysterectomy

ObjectiveThis study aims to compare between operative outcomes of single-port-access laparoscopy-assisted vaginal hysterectomy (SPA-LAVH) and single-port-access total laparoscopic hysterectomy (SPA-TLH), further subdivided by vaginal cuff closure via laparoscopic suture (VCC-L) or via the vaginal route (VCC-V).Materials and methodsA custom-made port was used for single-port laparoscopy in 111 patients who underwent SPA-LAVH (n = 33), SPA-TLH with VCC-L (n = 35), and SPA-TLH with VCC-V (n = 43) during October 2009–October 2010. Records were reviewed retrospectively.ResultsA significant difference in the operating time was observed among the groups (p = 0.009). SPA-TLH with VCC-L took a significantly longer time to be performed (118.6 ± 41.8 minutes) than SPA-TLH with VCC-V (98.6 ± 21.3 minutes) or SPA-LAVH (102.0 ± 20.3 minutes). The decrease in hemoglobin level on the 1^st day postsurgery was significantly smaller in case of SPA-LAVH (1.56 ± 0.97 g/dL, p = 0.005) compared with that in case of SPA-TLH with VCC-L (2.19 ± 0.95 g/dL) and SPA-TLH with VCC-V (2.24 ± 0.95 g/dL). No significant differences in other surgical outcomes were found.ConclusionSPA-TLH with laparoscopic vaginal suture required the longest operating time, and hemoglobin changes were smaller in the SPA-LAVH group than in the other groups. In patients undergoing SPA laparoscopy, we recommend the SPA-LAVH procedure.