乙状窦后锁孔入路的内镜和显微镜下解剖学研究及临床应用

目的:通过乙状窦后锁孔入路对该区周围进行内镜和显微解剖学观察,为临床该手术入路定位提供解剖学及形态学依据。方法:应用10%甲醛溶液充分固定的成人尸头标本8例(16侧),模拟乙状窦后锁孔入路进行内镜和显微解剖学观察,并测量尸头表面标志点位置关系,确定枕下乙状窦后锁孔位置。结果:1:锁孔位置为取耳后旁4cm以上项线为上点∫形切口3.0cm～4.0cm。暴露星点后在其下方骨孔直径2.0～2.5cm,可以充分暴露桥小脑角区。2:该锁孔入路虽然通道窄小,但利用内镜和显微镜暴露范围较广,可达中上斜坡。结论:熟悉桥小脑角区神经血管解剖结构的毗邻关系,准确到达解剖目标,有助于在显露血管和神经的同时保护脑组织的重要结构,减小创伤,内镜的应用能把手术中的副损伤降低到最低点。     

显微手术夹闭颅内动脉瘤手术疗效分析

目的：探讨显微手术夹闭颅内动脉瘤手术的疗效。方法：回顾性分析自2005年10月至2010年10月期间开颅行夹闭颅内动脉瘤手术的39例患者的临床资料。结果：除有1例死亡外,其中29例恢复良好,能生活自理,7例伴有轻度残疾,需人照顾,2例重残,需要卧床。结论：夹闭颅内动脉瘤手术获得了较好的疗效,我们发现避开血管痉挛发生的高峰期即可达到较好的疗效,即在3日内或14日后实行手术较为适宜。     

鼻内镜手术治疗鼻窦炎、鼻息肉临床分析

目的:分析鼻内镜治疗慢性鼻窦炎、鼻息肉的临床效果.方法:回顾性分析本院采用鼻内镜手术治疗鼻窦炎、鼻息肉110例患者资料,对比不同分型患者的手术疗效.结果:Ⅰ型的治愈率和总有效率明显高于Ⅱ型和Ⅲ型,具有统计学明显差异性(P＜0.05);Ⅱ型的治愈率和总有效率明显高于Ⅲ型,具有统计学明显差异性(P＜0.05).结论:慢性鼻窦炎、鼻息肉采用鼻内镜手术治疗具有创伤小、术中及术后痛苦小等优点,其微创有效的优势在该术式中更值得推广.     

小切口微创手术治疗新鲜跟腱断裂的临床价值

目的：探讨小切口微创手术治疗新鲜跟腱断裂的一晦床价值。方法：选取我院新鲜闭合性跟腱断裂患者50例,随机分为实验组和对照组各25例。实验组行小切口手术,对照组行常规切口手术。术后对患者进行随访,采用美国足踝协会（AOFAS）推荐的评分标准对患者术后功能恢复情况进行评价,观察并记录完全恢复患者例数、完全恢复时间、小腿最大周长差和术后并发症发生情况。结果：实验组AOFAS评分为（98．6±9．7）分,痊愈率96．00％,痊愈时间（20．2±3．2）周,两侧小腿最大周长差为（0．79＋0．68）cm,共有1例患者出现并发症,并发症发生率8％;而对照组的AOFAS评分为（91．4±11．5）分,痊愈率92．00％,痊愈时间（22．4±3．8）周,两侧小腿最大周长差为（0．91~0．76）cm;共有6例患者出现并发症,并发症的发生率为24％。两组患者的痊愈率、两侧小腿最大周长差比较差异无统计学意义（痊愈率：x2=-0．355,P=0．552;侧小腿最大周长差：t=O．588,P=0．559）;而与对照组比较,实验组AOFAS评分明显升高,完全恢复时间明显缩短,术后并发症的发生率显著降低,差异均有统计学意义（AOFAS评：t=2．393,P=0．021;恢复时间：t=2．150,P=0．037;并发症发生率：xⅫ．153,P=0．042）。结论：小切口手术与常规切口手术治疗新鲜跟腱断裂的疗效相当,但小切口手术术后恢童时间曼短．并发症更少．临床价值相对更高．     

微创手术与传统开放手术在胸腰段脊柱骨折治疗中的应用效果

目的:分析微创手术与传统开放手术在胸腰段脊柱骨折治疗中的应用效果观察。方法:回顾性抽取我院手术治疗的130例胸腰段脊柱骨折病患信息,将应用微创手术治疗的65例病患归为微创组,将接受传统开放手术治疗的65例病患归为开放组,对比分析手术前后椎体高度、Cobb角度以及生活质量评分的变化,同时比较两组手术相关指标以及手术相关并发症的差异。结果:(1)与手术前相比,两组手术后的伤椎高度、伤椎Cobb角度以及生活质量评分显著升高(P0.05),两组间伤椎高度、Cobb角度相仿,但微创组生活质量评分显著高于开放组(P0.05);(2)微创组手术时间显著高于开放组,但术中出血、术后住院时间以及术后并发症显著低于开放组(P0.05)。结论:微创手术治疗胸腰椎骨折不仅对于伤椎复位效果与传统开放手术相仿,而且在生活质量改善、手术恢复时间、手术安全性方面具有显著优势。     

脊髓型颈椎病手术治疗新进展

颈椎病是指因颈椎间盘退行性变及其继发改变所导致的脊髓、神经、血管等结构受压而表现出的一系列临床症状和体征,根据发病机制可分为神经根型、脊髓型、椎动脉型、交感型、混合型,以及近年来受到重视的脊髓前动脉受压症等,脊髓型颈椎病是其中一种严重类型,保守治疗效果不佳,目前临床上常用的治疗方法为手术治疗。根据患者病情手术的入路可分为前路和后路,本文分别从手术的前后入路出发,对近年来脊髓型颈椎病手术治疗方式的进展作一综述。     

痔治疗的临床进展研究

痔是肛肠外科最常见的疾病之一,其治疗方式多种多样,尚无统一治疗标准。虽然,痔在临床上以保守治疗为主,但是对于II度以上有症状的痔,手术仍是目前最主要的治疗方式。关于有症状痔最佳治疗方式的争论仍在继续,无论是非手术治疗、传统的痔切除术还是痔的微创手术,都处于不断的改进和探索之中。临床医生总希望能够找到一项理想的具有复发率低、安全可靠、可早期恢复正常活动、术后疼痛轻微甚至无痛的手术方式。随着手术方式的改进和医疗技术的进步,痔的治疗效果也取得了很大的进步。本文就痔的非手术治疗、有创手术治疗以及微创手术治疗作一综述,为痔的临床治疗提供一定的理论依据。     

经肛门微创手术治疗小儿先天性巨结肠症40例临床疗效分析

目的:探讨经肛门微创手术治疗小儿先天性巨结肠症的临床效果.方法:将我院收治的40例先天性巨结肠患儿,随机分为对照组和试验组,对照组采用经腹会阴联合手术治疗,试验组采用经肛门微创手术治疗.分析两组手术时间、术中出血量、恢复肠道排气时间、住院时间,并发症发生情况等.结果:组术中出血量、肠道恢复排气时间、住院时间均显著优于对照组,差异有统计学意义(P＜0.05).试验组手术时间与对照组差异无统计学意义(P＞0.05).试验组并发症发生率低于对照组,差异有统计学意义(P＜0.05).试验组术后排便控制功能显著优于对照组,差异有统计学意义(P＜0.05).结论:采用经肛门微创手术治疗小儿先天性巨结肠症,术后患者排便功能恢复好,手术情况佳,并发症少,疗效优于经腹会阴联合手术,值得临床推广应用.     

微创穿刺引流术治疗颅内血肿100 例临床观察

目的:探究微创穿刺引流术治疗颅内血肿患者临床疗效。方法:选取2014年1月至2014年10月我院收治的颅内血肿患者100例,给予微创穿刺引流术治疗。治疗结束后,随访一年,记录观察100例颅脑损伤患者ADL评分、并发症、血肿清除率、存活率以及死亡率。结果:1治疗后一年内,患者ADL评分,I级43例,Ⅱ级31例,Ⅲ级14例,Ⅳ级4例,Ⅴ级3例;2手术一周后,患者血肿清除率≥90%者91例,60%≤血肿清除率90%者7例,血肿清除率60%者2例;3100例患者中并发肺炎6例,并发脑梗死4例,并发应激性溃疡5例;4手术后一年内,死亡患者5例,生存患者95例。结论:微创穿刺引流术能有效降低颅内血肿患者并发症的形成,恢复神经缺损功能,降低死亡率,提高生存率。在临床用以治疗颅内血肿患者具有较好的前景。     

Contrast and Resolution Considerations in Keyhole MFU: Application to Dynamic Studies of Contrast Media Kinetics

This report presents a quantitative evaluation of the effect of the keyhole technique on contrast-enhanced dynamic MRI; specifically, the effect of the observed region of interest (ROI) on keyhole images was evaluated in comparison with a complete set of data. The limiting condition of the quantitative use of the keyhole approach was defined and exemplified. Results obtained by simulations, as well as on MR images, indicated that object size and noise level determine the minimum keyhole size and maximum size of the ROI, so that if keyhole parameters are properly selected, a quantitative analysis of MRI gives the same signal intensity as complete data acquisition. In this case the time resolution increases by factor N/L.     

Fast Keyhole MR Imaging Using Optimized k-Space Data Acquisition

In some dynamic magnetic resonance imaging (MRI) applications, the sample is still, and only the signal intensity changes with time. For such cases, the keyhole imaging principle can be used. In standard keyhole imaging, a low-frequency image signal is acquired, using a limited number of phase-encoding steps, which correspond to the rectangular sampling region in the k-space center. However, such a region practically never coincides with the position of the k-space points, which carry the most relevant low-frequency image information. In this paper we propose an improved keyhole method, which allows dynamic acquisition of a low-frequency image signal from selected most relevant k-space points via fast imaging mechanisms. Dynamic data acquisition is executed in the presence of time-varying magnetic-field (MF) gradients after single sample excitation. Special care has been taken in the design of the gradient sequence to minimize gradient load. This improved keyhole imaging method has been considered theoretically and verified experimentally on a model system.     

325例腹腔镜附件手术的临床分析

目的:评价腹腔镜在附件疾病治疗中的价值及安全性。方法:回顾性分析325例附件良性疾病腹腔镜手术治疗情况。随机选取妇科附件良性肿瘤、异位妊娠、输卵管粘连及伞端不通、卵巢破裂、巧克力囊肿,卵巢冠囊肿等病例;采用腹腔镜手术治疗。术式根据病情不同,采取卵巢(冠)囊肿剥除术、附件切除术、输卵管切除术及造口术。结果:腹腔镜手术占同期手术42．54%,手术成功率100%,发生并发症5例(1．54%)。结论:腹腔镜微创手术,副作用少,适应证掌握得当,妇科大部分附件手术可在腹腔镜下完成。     

Clinical Studies with Mazindol

An anoerxiant, mazindol suppresses food intake by 1)stimulating β-adrenergic receptors, 2)inhibiting the feeding center and, 3)stimulating the satiety center in the hypothalamus. In Japan, mazindol is available for clinical use. We examined the effects of mazindol on 1) body weight, appetite, and abnormalities of obesity-related diseases in long-term use 2)maintenance of the reduced body weight after very-low-calorie diet (VLCD) therapy 3)combined use with VLCD therapy and, 4)inhibition of body weight gain in Prader-Willi syndrome. In long-term effects of mazindol, the average reduction of individual body weight was around 6.8 kg. The appetite of 59% of obese subjects was moderately suppressed. Systolic blood pressure, serum GOT, serum triglyceride, serum cholesterol, and glucose tolerance were also improved. With mazindol, 53.3% of obese subjects kept the reduced body weight after VLCD, in contrast, 20.0% of them kept it without mazindol. Combined use of mazindol with VLCD made the VLCD therapy more effective in out patients. Two of 3 patients with Prader-Willi syndrome inhibited their body weight gain with mazindol. Thus, mazindol produced positive effects in these studies, although the effects were limited.     

妇科联合普外科腹腔镜手术15例临床分析

目的:探讨妇科外科联合进行腹腔镜手术的临床特点。方法:选择因妇科疾病合并普外科疾病而需行联合腹腔镜手术的患者15例为观察组,选取同期因单一妇科疾病行腹腔镜手术的患者例15例为对照组,对两组患者的平均手术时间、肠功能恢复时间、术后平均住院日和术后并发症发生情况等指标进行分析比较。结果:两组患者手术均获得成功,无1例中转开腹,也无1例严重并发症发生。观察组的平均手术时间为(130 92)min,对照组平均手术时间为(110±82)min,两组比较,差异有统计学意义(P<0.05);观察组的术后肠功能恢复时间及术后平均住院日分别为(20±10)h、(3.7±1.5)d,对照组分别为(19±10)h、(3.5±1.3) d;两组比较,差异均无统计学意义(P>0.05)。结论:妇科普外科联合进行腹腔镜手术是安全有效的。     

Scanning Electron Microscopic Studies of Candida albicans

A scanning electron microscopic study of selected morphological stages of Candida albicans is presented. Stages represented are budding yeast cells, mycelial-like forms, chlamydospores, germ tube formation, and an unusual rough cell type.     

Scanning Electron Microscopic Studies on the Organ Development of

The pattern of development of the floral parts of Longan flower was followed using scanning electron microscope. Floral initiation begins with the formation of calyx protrusions around the floral apex. After the calyx protrusions have appeared, the petal primordia at the base of the floral apex start to appear and then followed by the androecium primordia which appear at the periphery of the floral apex. Gynoecium formation begins much later (at about 30 days after floral initiation). In the male flower, androecium develops normally forming anthers and filaments. Anthers also develop in the female flowers but they are smaller and the filaments much shorter. Gynoecium in the female flower is well developed and when mature it produces a long style, a two-prong-stigma and two ovaries. In the male flower the gynoecium is poorly developed the style is short and the stigma seldom splits. Ovaries are also poorly developed in the male flower. In addition to male and female flowers, Longan also forms a number of abnormal flowers with poorly developed androecium and gyn6ecium. Male and female flowers only become apparent at about 40 days after the initiation of flower differentiation. Prior to this it is difficult to know whether a particular developing flower is going ultimately to become a male or female flower. The formation of abnormal flowers also become obvious' at about 40 days after the initiation of flower differentation.     

A New Imprinting Material for Scanning Electron Microscopic Studies

A new imprinting material, “Ther-mocool”, has been used for preparing negative replicas of plant as well as metal surfaces for SEM study. The technique has wide application and gives very good results.