成人腰椎峡部裂型滑脱症的微创治疗

Objective To investigate the clinical experiences and technical skills of adult isthmic spondylolisthesis. Methods Twenty-one patients with adult isthmic spondylolisthesis underwent minimally invasive surgery. There were 12 men and 9 women, with the mean age of 51.7 years. Isthmic spondylolisthe-sis occurred at the L4.5 in 7 patients, and at the L5S1 in 14 patients. According to Meyerding classification, 13 cases were of Grade Ⅰ, 7 of Grade Ⅱ, 1 of Grade Ⅲ. Under general anesthesia, guiding by fluoroscopy, the surgeries performed minimally invasive microendoscopic(METRx) techniques for posterior decompression, interbody cage fusion and novel Sextant-R percutaneous pedicle screw techniques for deformity reduction and fixation. Results Seventeen cases were followed up 1 year postoperatively. The average low back pain VAS reduced from preoperative 6.0±2.6 to postoperative 2.9±2.5. The average leg pain VAS decreased from preoperative 6.7±3.3 to postoperative 2.8±1.6. The average ODI decreased from preoperative 44.3% to post-operative 27.1%. The Nakai good and excellent rate was 90%. The mean operative time 170 min, blood loss 160 ml, and postoperative stay in bed 7.5 d. The sagittal spondylolisthesis rate significantly decreased from preoperative 35.5%±2.5% to postoperative 8.3%±7.5%. The lordotic angle from preoperative 11.5°±1.7° in-creased to postoperative 16.8°±9.5°; the intervertebral disc height from preoperative (5.4±2.5) mm increased to postoperative (9.1±3.0) mm. According to Lenke judgement for fusion, complete fusion rate was 76%, in-complete fusion rate was 12%, nonfusion rate was 12%. Conclusion The minimally invasive microendo-scopic (METRx) assisted with a novel Sextant-R percutaneous pedicle screw systems for deformity reduction and fixation to treat adult isthmic spondylolisthesis, is not only a minimally invasive and safe surgical tech-nique, also an effective treatment for deformity reduction and fixation.     

胆囊切除术的技术改进

目的：探索更好的胆囊切除术的方法。方法：我们对近2年收治的100例胆囊切除术的病人手术作了一些技术改进，包括：右肋缘下斜切口（4－6cm)，不切断腹直肌，胆囊管和胆囊动脉分别用钛夹夹闭，不行腹腔深部打结，剥离胆囊床前将胆囊内胆汁抽空，用电刀剥离胆囊边切边止血，不缝合胆囊床，结果：腹部切口小、创伤轻、恢复快，在直视下操作安全可靠。结论：是一个较好的临床胆囊切除方法，患者易接受。     

纳洛酮的临床应用及不良反应的探讨

本文阐述纳络酮药动学、临床应用及不良反应.     

B型肉毒毒素在美容领域的应用进展

肉毒毒素(botulinum Toxin,BT)是由革兰氏阳性、产孢、厌氧性肉毒杆菌(clostridiumbotulinum)产生的外毒素[1]。一个多世纪前,它首先被描述为肉毒中毒,这是在食用腐败腊肠后发生的严重神经性疾病。而最近这种致病因子被作为治疗工具用于大量的神经紊乱性疾病。根据其抗原性不同,肉毒毒素分为A、B、C(C1和C2)、D、E、F、G7个血清型[2]。所有的这七种血清型的肉毒毒素都是作用于神经肌接头起作用,它们和相关的特异性蛋白作用,从而抑制肌肉收缩和发汗所必需的乙酰胆碱向神经肌接头处的释放,导致被注射肌肉的瘫痪和变弱。目前,在美国市场有…     

Fabrication of a Mood vessel scaffold with a combined polymer for tissue enginerring

Objective To investigate the possibility to fabricate a blood vessel scaffold with a combined polymer for tissue engineering. Methods A blood vessel scaffold was designed with a combined polymer composed of rabbit vascular smooth muscle cells ( VSMCs), collagen and a non-spinning fabric mesh of polyglycolic acid(PGA). VSMQ were implanted into collagen gel and their growth was observed. The mixed solution of VSMQ and collagen was dropped into the tubular scaffold, followed by 7-day culturing. Results VSMQ formed many prominences after culturing in gelatinous collagen for 3 - 4 hours. With cells extending, some cells became shuttle-or spindle-shaped. After VSMQ-collagen complex was implanted into the PGA mesh, most of VSMCs remained in the pore of PGA mesh with the formation of gelation. VSMCs could adhere to and grow on the PGA fiber. Conclusion The non-spinning PGA porous biodegradable material coated with collagen is a good carrier for VSMCs to adhere and grow. 5 refs,3 figs.     

CT MAX-640故障检修3例

CT MAX-640为美国 GE公司所生产的经济普及型 CT,在中国及世界各地均有不俗的销量,该机型较具有代表性,所以笔者摘出几例检修实例,供同行参考.     

轮廓至上大脸变小脸

“大脸”怎么变“小脸”?尽管偶像艺人安以轩宣称“不必开刀”,每天唱10遍她的新歌《小脸进行曲》就能让爱美女孩拥有梦寐以求的“小脸”,但在美容外科医生眼中,脸部轮廓的修正可是大学问。     

髓核刺激背根节时肿瘤坏死因子-α在脊髓后角表达的意义

本试验借助于髓核移植致坐骨神经痛的动物模型,探讨肿瘤坏死因子-α(TNF-α)在脊髓后角的表达规律,分析其与痛觉过敏之间的相关性.     

单侧唇裂继发畸形整复术的术式改良

目的 探讨改良术式修复单侧唇裂术后继发唇、鼻畸形的效果.方法 手术切几线与口鼻轮廓线相一致,片使鼻翼外侧脚整体旋转复位,重建鼻槛及鼻底,通过鼻腔的V-Y黏软骨瓣使鼻翼软骨上推,矫正鼻畸形.结果 自2000年以来,应用此方法对69例单侧唇裂继发唇、鼻畸形患者进行了修复,均取得较满意的效果,术后瘢痕线不明显.结论 轮廓线切口以及鼻翼软骨上推复位的方法符合唇、鼻的解剖特征,是一种较好的手术方法.     

成人麻疹110例临床特点分析

目的：总结成人麻疹的临床发病特点。方法：回顾性分析我院2005年和2006年麻疹特异性IgM抗体均为阳性的110例住院成人麻疹的症状、体征、并发症、预后和出疹期血清ALT、CRP（C-反应蛋白）等变化。结果：成人麻疹临床表现典型,并发症少,预后较好,出疹期检查血清CRP,结果示93.64%的病例有不同程度升高。结论：成人麻疹表现典型,症状轻,并发症少,预后好。麻疹患者多数CRP升高,故可作为麻疹的诊断参考指标之一。