Foley尿管气囊压迫治疗骶前静脉丛大出血的评价(附6例报告)

目的:评价直肠癌根治术中用Foley尿管气囊压迫治疗骶前静脉丛大出血(MPVP)的临床价值。方法:分析1995~2005年用Foley尿管气囊压迫治疗骶前静脉丛大出血6例的临床资料。结果:6例骶前大出血中全部用Foley尿管气囊压迫控制出血,术中出血量为800~1700mL,Foley尿管于术后4d拔除3例,5d1例,6d2例,均无再出血,会阴切口均一期愈合。结论:Foley尿管气囊压迫治疗骶前静脉丛大出血是一种简单安全有效的治疗方法。     

A perspective on measurement of mutations in vivo.

The development of transgenic mouse lines with target genes that are suitable for tissue-specific mutagenesis studies is an important contribution to the field of environmental mutagenesis. These models can accommodate many of the questions relating to metabolism, distribution and relative potency of mutagens as well as providing a more comprehensive system for the identification of mutagens. However, the lesions that the field has learned about methods, development and validation from the use of in vitro systems must be applied to the development and validation of transgenic models.     

湿润烧伤膏在眼部整容术中的应用

目的：为减轻眼部整容术后反应，减少瘢痕形成。方法：采取手术后手法按压止血，伤口涂美宝湿润烧伤膏，冰袋冷敷，提前拆线的方法。结果：所有475例手术者，均提前两天拆线，创口Ⅰ期愈合，无明显瘢痕。结论：美宝湿润烧伤膏有促进伤口愈合，减轻瘢痕形成的作用。     

带血管骨膜瓣移植修复烧伤坏死管状骨的实验研究

目的探讨带血管骨膜瓣移植修复烧伤坏死管状骨的可行性，试图为临床修复烧伤坏死骨提供一种有效的方法。方法8月龄成年新西兰家兔20只，设一侧肢体的桡骨为实验组，另一侧为对照组，采用同体对照法。实验组保留带血管的骨膜瓣，从桡骨中下段离断1．2cm桡骨，置沸水中煮沸30min冷却后原位回植，再行骨膜瓣移植包绕、固定。对照组按上述方法处理后不移植骨膜瓣。分别于术后2、4、6、8～10、12周摄X线平片，同时分别处死4～5只兔并取两侧桡骨行组织学切片检查。结果实验组：术后2～4周在骨坏死区见到明显的骨膜增生影像；术后6～8周见骨折断端连接征象，新生骨小梁形成并逐渐改建；术后8—10周可见网织骨普遍融合重建，形成板层，新的哈佛系统形成；术后12周新生骨结构更加成熟，骨折愈合。对照组：术后2周仍为死骨，骨坏死区无骨膜增生现象；术后4、6周未见骨折愈合征象；8周可见骨缺损；12周坏死骨完全溶解、吸收，骨缺损区清晰可见，骨缺损区被少许纤维组织充填。结论带血供的骨膜瓣能不断形成新生骨并爬行替代原坏死骨，使坏死骨获得再生，能很好地修复烧伤坏死的管状骨。     

处女膜修补手术及麻醉方法的改进

目的；增大处女膜粘膜瓣的接触面，减少因麻醉造成的处女膜粘膜水肿，提高修复手术的成功率。方法：手术全部采用1％的卡因行粘膜表面麻醉。53例采用瓦合粘膜瓣法，3例用瓦合粘膜瓣联合阴道粘膜瓣修复法。结果：56例术后一月随访，53例处女膜孔径为一指，成功率94．64％。结论：采用1％的卡因粘膜表面麻醉，瓦合粘膜瓣法及瓦合粘膜联合阴道粘膜瓣修复法对处女膜修复是行之有效的。     

青光眼病人视野改变与行走速度的相关性研究

目的探讨青光眼病人的视野改变是否影响其行走速度。方法测量 71例青光眼病人的视野和走完一段规定路程所需时间 ,并与相同视力、年龄和性别的正常人进行对比。结果青光眼病人走完规定路程所需时间比正常人多 15 % ;早期青光眼组视野较正常组下降 (P <0 .0 5 ) ,而在行走时间上差异无显著性意义 (P >0 .0 5 ) ;中晚期青光眼组视野较正常组显著下降、行走时间明显增加 (均P <0 .0 1) ,且视野下降程度与所需时间呈显著正相关 (r =0 .78,P <0 .0 1)。结论中晚期青光眼病人的视野缺损可导致行走速度减慢 ,提示对该类病人就诊时要耐心、细致地加以引导 ,在日常生活中给予理解、关怀     

Keratin 13基因在喉癌发生中的作用

探讨keratin 13基因在喉癌发生中的作用。方法在keratin 13基因内部及附近选择5个微卫星引物进行LOH分析，于DNA水平间接检测100例喉癌患者中该基因的缺失情况。结果5个STR位点均存在LOH，其中D17S1964E、D17S2092、D17S791、D17S1665及D17S808位点的LOH频率分别为30．48％、26．02％、21．62％、37．66%和21．51％，以D17S1665位点的LOH频率最高，杂合性丢失与临床分期无显著相关。结论Keratin13基因在喉癌的发生中具有重要作用，具体机制有待进一步研究。     

改进原位肛门整形重建术的临床研究

目的探讨采用改进的四联术原位肛门整形重建术的效果。方法38例低位直肠癌行Miles根治术后行一期改进的四联术原位肛门整形重建术,改进包括:①肛门内括约肌改进为双层双套环;②肛门外括约肌改进为肛门外括约肌浅部与深部重建;③直肠角改进为肛提肌切缘牢固地缝合于肛门括约肌外面与结肠前壁;④直肠瓣改进为三个人工直肠瓣。结果38例术后肛门外形、功能及远期生存率均更为优良,术后肛门功能测试的总优良率达94·73%,远期生存率高达76·32%。结论改进的四联术原位肛门重建术的效果良好,改进术式的设计也更符合正常解剖结构与生理功能。     

简易印模术对单个前牙烤瓷冠颈缘外观效果的作用观察

目的:观察和探讨两种印模技术对单个前牙烤瓷冠颈缘外观的改善效果。方法:40位患者用简易印模技术制取印模,制作93件镍铬合金烤瓷瓷冠,设为实验组,另35位患者以常规印模技术制取印模,制作71件镍铬合金烤瓷瓷冠,设为对照组。观察两组戴冠当时与两年后的颈缘适合性、颜色、牙龈形态与健康情况。结果:试验组有98%的合金瓷冠具有优良的边缘适合性,仅2件(2%)出现颈缘黑线,与对照组相比有显著差异(P<0.05)。结论:简易印模技术能更好的保证工作区模型的准确度,从而有效地改善了镍铬合金烤瓷冠颈缘的美观与龈组织的健康。     

A nationwide survey of excessive daytime sleepiness in Parkinson's disease in France

To determine the prevalence of excessive daytime sleepiness (EDS) and that of dozing and sudden onset of sleep episodes (SOS) while driving in ambulatory patients with Parkinson's disease (PD) in France, a national sample of private and public neurologists was asked to recruit the first 10 consecutive nondemented PD patients. Each patient completed a questionnaire including the Epworth Sleepiness Scale (ESS) and the likelihood of dozing off and experiencing SOS episodes behind the wheel. Clinical and demographic data were collected. One thousand six hundred and twenty‐five patients with PD were included in the survey. Twenty‐nine percent of the patients suffered from EDS (ESS score ≥10) but only 0.8% declared a high chance of dozing while driving and 0.5% reported totally unpredictable SOS episodes while driving. Risk factors for EDS were male gender, reduced activity of daily living, and a high daily levodopa equivalent dosage. Risk factors for SOS episodes while driving were an ESS score ≥10, male gender, and low Hoehn and Yahr staging. EDS is common in ambulatory patients with PD and is a major risk factor for dozing and for SOS episodes behind the wheel in patients who drive. © 2007 Movement Disorder Society