双胎妊娠一胎死亡后期待治疗14例分析

目的:探讨双胎妊娠孕中晚期一胎死亡后期待治疗的临床效果。方法:回顾性研究分析1994年1月至2004年4月同济医院双胎妊娠一胎死亡的病例共14例。结果:期待治疗时间最长为61天,最短为3小时,平均保胎时间为12天,分娩平均孕周为32周。无一例出现明显凝血功能障碍。先兆子痫和胎膜早破发生率最高(35.7%)。胎儿畸型是胎死宫内的重要原因。结论:双胎妊娠一胎死亡后可采取期待治疗,在严密监测存活胎儿宫内安危,积极处理母体合并症或并发症的条件下,尽量延长存活胎儿在宫内生长的时间,提高存活胎儿的生存质量。     

整体教学法在大学英语阅读教学中的运用

大学阅读教学在英语习得中占举足轻重的地位,在大学英语阅读教学中引入整体性教学法可以有效地提高学生的阅读水平,本文从教师、学生和阅读技巧等方面阐述了整体性教学法在大学英语阅读教学中的作用,并提出一些具体方法。     

前纵裂入路切除鞍区巨大肿瘤

背景与目的：鞍区巨大肿瘤手术难度较大，本文探索前纵裂入路切除鞍内、鞍上向单双侧海绵窦、第三脑室、蝶窦及伴颞叶发展的巨大肿瘤的手术适应症、方法与优缺点方法：总结分析2002年1月至2004年5月我科经前纵裂入路切除鞍区各部位发展的肿瘤17例。结果：肿瘤全切14例，近全切2例．部分切除1例；术后视力改善12例，无改变5例，尿崩或电解质紊乱8例，死亡1例，随访时间3～32个月，有1例复发，系巨大侵袭性垂体瘤术后，行γ-刀治疗后肿瘤基本得到控制。结论：前纵裂入路是切除鞍内、鞍上向单双侧海绵安、第三脑室、蝶窦及伴颞叶发展的肿瘤较理想的入路，利用自然脑裂的分离，手术视野、操作角度好、肓区少，有利于显露重要血管、神经及双侧海绵窦内侧壁，肿瘤全切率高。     

Human carcinogenic risk evaluation, Part V: The national toxicology program vision for assessing the human carcinogenic hazard of chemicals.

The National Toxicology Program (NTP) has over 25 years of experience in the design, performance, and interpretation of assays for identifying carcinogenic hazards to humans. Through the years we have examined alternative assays and adjunct assays to the standard rodent cancer bioassay including batteries of genetic toxicity tests and genetically modified mouse models. As our collective understanding of carcinogenesis advances, toxicologists and regulatory scientists will at some point begin to rely on mechanism-based biological observations rather than the two-year rodent bioassay to predict human cancer hazards. The goal of the NTP Vision for the 21st Century is to develop the science base that will advance the use of mechanism-based biological observations, eventually providing a replacement for disease-specific toxicology models in the protection of public health.     

全乳晕入路腔镜下甲状腺微小乳头状癌手术的临床经验及疗效

目的：探讨全乳晕入路腔镜甲状腺微小乳头状癌的手术经验和疗效。方法：选取2016年6月至2017年12月 中南大学湘雅二医院收治的甲状腺微小乳头状癌患者共117例,根据患者意愿分为腔镜手术组(n=72)和开放手术组 (n=45),比较两组中央区淋巴结清扫数、术中出血量、术后引流量及术后并发症发生和复发情况。结果：与开放手 术组相比,腔镜手术组术中出血量少(P<0.05)、手术时间较长(P<0.05);两组淋巴结清除数、术后引流量及并发症发 生率的差异均无统计学意义(均P>0.05);平均随访时间超过20个月,两组均无复发。结论：全乳晕入路腔镜下甲状腺 微小乳头状癌手术并行中央区淋巴结清扫是安全可行的,具有颈部无痕、出血少、住院时间短等优点,更易被年轻 患者所接受。     

峡部入路在甲状腺手术中的临床研究

目的探讨甲状腺手术中峡部入路的临床应用。方法将我院2007年8月~2010年8月的229例甲状腺手术患者分为两组。治疗组113例采用峡部入路,对照组116例采用传统入路,均由同一组医生施术。观察记录手术时间、术中出血、术后引流量及术后喉返神经及甲状旁腺损伤情况。结果治疗组在上述观察指标上均优于对照组（P〈0.05）。结论经峡部入路行甲状腺手术可明显缩短手术时间,减少术中出血、术后引流量,降低喉返神经及甲状旁腺损伤的发生率,优于传统甲状腺手术入路。     

Benefits of maxillectomy with internal dissection of the masticator space by transmandibular approach in the surgical management of malignant tumours of the upper gingiva and hard palate: a clinical review of 10 cases

The aim of this study was to review patients with tumours extending to the posterior portion of the upper gingiva and hard palate, and to evaluate the postoperative outcomes. Ten consecutive patients with tumours in the upper gingiva and hard palate, who underwent maxillectomy with internal dissection of the masticator space by the transmandibular approach, were reviewed retrospectively. Among the 10 patients, the pathological diagnosis was squamous cell carcinoma in seven, adenoid cystic carcinoma in one, malignant melanoma in one, and osteosarcoma in one. Loco-regional control was achieved in eight of nine patients (88.9%). Three patients had residual moderate trismus. Cosmetic issues were not noted in any patient. En bloc resection of the maxilla with the internal portion of the masticator space and neck through the parapharyngeal space by the transmandibular approach is a useful and satisfactory technique for the excision of a tumour with involvement of the posterior portion of the upper gingiva and hard palate.