骨盆骨折诊断与治疗的重要性

骨盆骨折属高能量损伤,约占全身骨折的4.21%,男性多于女性,高发年龄为31～40岁;约5～20%合并血管神经损伤,髂动脉的钝性损伤可达3.5%;骨盆后环骨折46%～64%合并神经根损伤。严重不稳定骨盆骨折可引起全身血流动力学的改变。对出血处理不当,可继发凝血功能障碍、酸中毒、休克所致多器官功能衰竭,甚则危及生命。     

免疫诱导治疗可改善器官移植后长期预后:美国器官分配联合网络注册数据分析

<正>免疫诱导治疗可降低器官移植后急性排斥反应的发生率,但其对移植物和受者长期存活的影响尚未明确。我们试图通过分析美国器官分配联合网络     

第5届全国器官移植学术会议纪要

<正>中华医学会外科学分会第5届全国器官移植学术会议于2010年11月26—27日在山东省济南市举行。大会由中华医学会外科学分会器官移植学组     

Assessing the reproductive health of men with occupational exposures

The earliest report linking environmental （occupational） exposure to adverse human male reproductive effects dates back to1775 when an English physician, Percival Pott, reported a high incidence of scrotal cancer in chimney sweeps. This observation led to safety regulations in the form of bathing requirements for these workers. The fact that male-mediated reproductive harm in humans may be a result of toxicant exposures did not become firmly established until relatively recently, when Lancranjan studied lead-exposed workers in Romania in 1975, and later in 1977, when Whorton examined the effects of dibromochloropropane （DBCP） on male workers in California. Since these discoveries, several additional human reproductive toxicants have been identified through the convergence of laboratory and observational findings. Many research gaps remain, as the pool of potential human exposures with undetermined effects on male reproduction is vast. This review provides an overview of methods used to study the effects of exposures on male reproduction and their reproductive health, with a primary emphasis on the implementation and interpretation of human studies. Emphasis will be on occupational exposures, although much of the information is also useful in assessing environmental studies, occupational exposures are usually much higher and better defined.     

彩色多普勒超声心动图引导介入治疗外伤性肌部室间隔缺损1例

患者男,18岁,因刀刺伤心脏致心脏贯通伤15min入院。入院后急诊手术,修补心脏室壁。术后心脏彩色多普勒超声检查：室间隔距心尖6mm处回声失落,缺损口径8mm;彩色多普勒血流显像（color Doppler flowimaging,CDFI）：收缩期可见五彩镶嵌的穿隔血流由左心室经缺损口进入右心室;脉冲多普勒：取样容积置于缺损口右心室侧,测得分流速度2．2m／s。     

锁骨钢板内固定治疗锁骨粉碎性骨折48例

2003年1月-2010年11月,我院用锁骨钢板治疗锁骨粉碎性骨折48例,疗效理想,报道如下。     

小切口股骨近端锁定钢板治疗老年股骨转子间骨折

2008年10月-2010年5月,我科对26例老年股骨转子间骨折患者行小切口股骨近端锁定钢板内固定治疗,取得了满意的临床疗效。     

2010年全国器官移植学术会议纪要

<正>由中华医学会器官移植学分会主办、山西省第二人民医院承办的2010年全国器官移植学术会议于10月15—17日在山西省太原市召开,来自全国     

改良深板层角膜移植治疗完成期圆锥角膜（附视频）

圆锥角膜是一种双眼角膜锥形扩张的致盲性眼病,一般青春期发病,影响患者终身。对于曲率较大,特别是中央明显变薄前突的完成期圆锥角膜一般需要手术治疗。我们采用改良深板层角膜移植治疗完成期圆锥角膜,不仅手术安全性提高,而且患者术后1年以后的视觉效果与穿透角膜移植差异没有统计学意义^[1]。现将手术方法介绍如下,具体操作见视频。     

空心钉结合锚钉治疗青少年Ⅱ、Ⅲ型胫骨结节骨折18例

2005年6月～2009年12月,我院用空心钉结合锚钉治疗青少年Ⅱ、Ⅲ型胫骨结节撕脱骨折18例,疗效满意,报道如下。1材料与方法1.1病例资料本组18例,均为男性,年龄13～18岁,身高170～178 cm,体重78～86 kg。损伤原因：跳跃致伤5例,踢球致伤3例,打篮球损伤10例。按Watson-Jones分型[1]：Ⅱ型15例,Ⅲ型3例。1.2治疗方法腰硬联合麻醉。     

肾移植慢性移植物功能不全患者环孢素切换为西罗莫司4年随访研究

<正>肾移植受者中,长期使用环孢素引起的慢性肾毒性可导致慢性移植物功能不全。切换环孢素为西罗莫司和维持较高剂量吗替麦考酚酯的同时减少环     

HBV基本核心启动子区和前C区变异与肝病进展的关系

乙型肝炎病毒（HBV）感染是我国严重的卫生健康问题,目前大约有1．7亿慢性HBV感染者,约占世界慢性HBV感染者的一半。HBV基因组结构为部分环状双链DNA,全长约3．2kb,其核心启动子对于HBV的复制和形态构成发挥了关键性作用。     

第17届国际肝移植学会年会纪要

第17届国际肝移植学会（InternationalLiverTransplantationSociety,ILTS）年会于2011年6月22—25日在西班牙瓦伦西亚会议中心举行。来自73个国家逾1400位学者参与本次学术盛会。本次会议入选口头交流论文171篇,壁报交流论文591篇。     

外固定架结合掌侧钢板治疗桡骨远端粉碎性骨折

2006年5月~2010年2月,我院采用掌侧T形钢板结合外固定架治疗桡骨远端粉碎性骨折32例,取得较好效果。1材料与方法     

肺移植受者围手术期血管外肺水、肺血管通透性及氧合指数的变化

肺移植手术术中血流动力学变化急剧,移植肺的病理生理和呼吸功能变化复杂多样,多伴急性肺损伤。血管外肺水（extravascular lung water,ELW）、肺血管通透性（pulmonary vascular permeablity,PVP）是反映急性肺损伤病理改变的两项主要客观指标,氧合指数[动脉血氧分压（PaO2）/吸入氧浓度（FiO2）]则是反应肺功能状态的临床主要指标。     

微创经皮钉、板结合内固定治疗同侧胫骨平台并胫骨干骨折

胫骨平台同时合并胫骨干骨折以往多采用沿骨干放置的多块钢板固定,需要较长的切口、广泛的暴露及骨膜剥离,具有较高的皮肤感染坏死率和骨不愈合率.2006年6月～2009年12月,笔者采用微创经皮钢板加带锁髓内钉内固定的方法治疗同侧胫骨平台合并胫骨干骨折11例,取得满意的临床效果.     

主动脉弓上缘变异支气管动脉介入治疗经验

支气管动脉起源变异是引起介入操作失败的主要原因之一,而起源于主动脉弓上缘的支气管动脉更是一种少见变异。现回顾性分析我科近3年接受支气管动脉介入操作的患者,对其中起源于主动脉弓上缘的变异支气管动脉进行分析。     

《肾移植手术技巧》出版

肾移植现已成为我国各大移植中心常规手术,并在手术技巧、术后处理、免疫抑制药应用等方面进展很快。但是,目前肾移植手术并非完美,仍有许多问题亟待解决,尤其是供体短缺严重制约了临床移植的发展。为提高手术成功率,避免由于外科手术操作导致的器官丢失,并充分利用边缘脏器,李黔生教授等编写的《肾移植手术技巧》（ISBN978,7—5091—4456—5）由人民军医出版社2011年出版。图书封面见光盘。     

The Minimum Local Analgesic Concentration of Epidural Lidocaine for Herpetic Neuralgia

Objectives： To determine the Minimum local analgesic concentration （MLAC） of epidural lidocaine for herpetic neuralgia. Methods： Thirty-one cases of thoracic herpetic neuralgia patients received thoracic epidural catheterization under the guidance of the digital subtraction angiography （DSA）, securing the end of catheter to the side gap of lesions of the central segmentation of epidural affected by herpes zoster. An injection of iohexol mixed with lidocaine under the guidance of DSA to make sure that drug solution covered all injured nerve roots. The first patient was administered 0.37% lidocaine weight by volume; subsequent patients received a concentration determined by the response of the previous patient to a higher or lower concentration according to up and down sequential allocation in 0.02% increments. Efficacy was assessed using a visual analogue pain scale（VAS）, and accepted if this was ≤10 mm on a 100 mm scale within 30 minutes. The median effective concentration （EC50） was estimated with probit regression analysis. Results： A total of 30 patients were successfully completed, except one patient withdraw from the trial due to vascular puncture. The EC50 of epidural lidocaine for herpetic neuralgia was 0.1 99% （95%CI 0.1 68% -0.216%）. Conclusions： The MLAC of epidural lidocaine for herpetic neuralgia was 0.199% （95% CI 0.168%-0.216%）.     

Target-controlled Infusion of Propofol and Remifentanil for a patient with Ablation of Atrial Fibrillation

Objective. The choice of anesthesia, monitors, and anesthetic care for ablation of atrial fibrillation （AF） has not been described clearly. This case report is to present an anesthesia technique for ablation of AF and to evaluate its efficacy and safety of the anesthetics used. Methods. This was a case report of a 50-year old female patient who was performed radiofrequency catheter ablation of AF. Surgery was carried out under the total intravenous anesthesia （TIA） with a laryngeal mask airway （LMA） insertion, which was performed by target-controlled infusion （TCI） of propofol and remifentanil. Under the procedure of anesthesia, standard monitored measures were performed to ensure her safety. Results. Surgery was carried out successfully under the TIA with TCI of propofol and remifentanil. The anesthesia induction was fast and comfortable, smooth, recovery quickly after anesthesia, which did not cause any severe complication. Conclusion, TCI of propofol and remifentanil could provide the satisfactory efficacy and safety during ablation of AF.