眶隔脂肪释放及眼台再造在眼袋整复术中的应用

目的评价在外路法眼袋整复术中,同时行眶隔脂肪释放填充下睑眶缘凹陷和眼轮匝肌再造眼台综合术式的效果。方法对25例36~58岁眼袋伴下睑眶缘凹陷、眼台退缩的患者,采用经皮肤入路切口,沿眶下缘剪开眶隔,释放眶内脂肪,若脂肪过多,予以部分切除,将眶隔脂肪缝合固定于眶下缘下方骨膜上,以缩紧眶隔以及填充眶下缘凹陷,达到重塑下睑外形的效果。同时将多余睑缘皮肤去除之后,将睑缘多余轮匝肌适度折叠固定重塑眼台。结果术后所有患者眼袋消失,眶下缘凹陷改善,形成自然眼台,无下睑外翻、下睑退缩、血肿等并发症,随访24个月以上,有2例患者对眶缘下凹陷填充效果不满意,经吸取自身腹部脂肪再次填充凹陷处后,均获得良好疗效。结论外路法祛眼袋术中,同时行眶隔脂肪释放并转移填充眶下缘凹陷以及眼轮匝肌眼台成形综合术式,对伴有下睑眶缘凹陷以及眼台退缩的眼袋患者效果良好。     

眼轮匝肌肌瓣在眼袋整形中的应用

目的　研究眼轮匝肌提紧的眼袋整形方法。方法　本文进行眼轮匝肌提紧眼袋整形 4 6例 ,手术中应用下睑睫毛下 1mm做皮肤切口 ,摘除眶隔脂肪 2～ 3块 ,剥离出下睑切口处的眼轮匝肌肌瓣 ,调整切除多余眼轮匝肌 ,皮肤约 5～ 15mm。结果　解剖剥离出下睑缘的眼轮匝肌 ,眼轮匝肌深面是眶肌筋膜韧带 ,位于眶脂肪囊的外侧 ,剪断眶肌筋膜韧带 ,修整眼轮匝肌与外眦韧带或眶外缘骨膜固定 ,达到眼轮匝肌提紧 ,眶筋膜提紧 ,使下眼袋松弛得以矫正。本文 4 6例病人 ,经术后 6个月～ 2年的随访 ,满意率为 10 0 % ,近远期疗效较好。结论　眼轮匝肌提紧及眶肌筋膜提紧眼袋整形 ,既可避免少数人单纯眶隔筋膜提紧后造成的下睑缘僵直 ,又可避免留有暂时性下睑凹陷或睁眼易疲劳感     

改良肌皮瓣法结合眶隔固定术进行眼袋整形的临床效果观察

目的观察和探讨改良肌皮瓣法结合眶隔固定术进行眼袋整形的效果。方法 312例受术者分为2组,每组156例,A组受术者分别设计去皮宽度,切开下睑皮肤,分离出上端为皮瓣的肌皮瓣,并成型眶隔表面肌肉瓣,切开并复位固定眶隔后,向上提紧缝合肌肉瓣,适当去皮,对合修整切口皮肤并缝合。B组采用传统肌皮瓣眼袋整形术。结果术后随访36个月,结果显示:结合了改良肌皮瓣法和眶隔固定术的眼袋整形术在对眼袋、下睑皮肤皱纹、鼻泪沟改善的远期效果明显优于传统肌皮瓣眼袋整形术(P<0.01),且不会出现下睑凹陷。结论改良肌皮瓣法结合眶隔固定术行眼袋整形能恢复下睑解剖结构,使术后效果自然、持久,是一种适应证广,并发症少,操作清晰的改良术式。     

结膜入路眼袋整形术26例体会

为使眼袋整形手术适合于各种类型特别是年轻人以及不宜行皮肤切口的眼袋患者,作者对26例眼袋患者,采用结膜人路法眼袋整形术.手术取睑板下缘中段结膜切口,切开结膜和下睑缩肌,暴露眶隔,切除膨出的脂肪,连续缝合结膜全层.手术获得满意效果.作者还就年轻人眼袋的形成原因,手术适应症和手术注意事项进行了讨论,认为眼袋整形手术的成功关键是熟悉下睑解剖,手术的最大优点是下睑皮肤不留任何痕迹.     

眼袋整形术的临床应用

目的 探讨眶肌筋膜提紧联合轮匝肌悬吊的眼袋整形方法及效果.方法 随机将60例需行眼袋术的患者分为实验组和对照组实验组35例进行眶肌筋膜提紧联合轮匝肌悬吊眼袋整形;对照组25例进行单纯轮匝肌悬吊眼袋整形,实验组手术中应用下睑皮肤切口,进行眶隔疝出脂肪摘除或眶隔脂肪囊下移固定后,将眼轮匝肌深面的眶肌筋膜韧带中部剪断,提紧外眦韧带,同时将轮匝肌固定在外眦韧带上,去除适量皮肤,重建眼部紧致流畅的轮廓.结果 两组患者术后随访6～12个月,实验组受术者下睑形态良好,无外翻、凹陷、退缩现象,患者满意度高,明显优于时照组;实验组有效率97.14％,明显高于对照组的72.00％（P＜0.05）.结论 眶肌筋膜提紧联合轮匝肌悬吊的眼袋整形方法可以最大限度切除下睑多余的松弛组织而不会发生睑外翻,使下睑轮廓更加紧致流畅,符合美学要求.     

睑囊筋膜眶隔脂肪疝修补术矫治眼袋

目的：介绍一种新的保留眶隔脂肪的下眼袋整形术。方法：为避免下眼袋整形术传统的眶脂肪切除所带来的下空虚或潜在的眼球下沉表现，从1999年9月至2000年8月，应用这一方法矫治眼袋36例，将疝出的脂肪回纳到眶内和将囊筋膜间断缝合到裂开的眶隔或下睑缘骨膜上，并紧缩外眦韧带，重塑眼轮匝肌，切除因老化松驰而形成的过多的下睑皮肤，上提面中部软组织。结果：术后所有患者眼袋消失，下睑形态良好，效果满意。随访6个月以上，无下睑外翻、下睑凹陷等并发症，无一例复发。结论：睑囊筋膜眶隔脂肪疝修补术矫治眼袋是可行的。     

“V”形切除并紧缩缝合眶隔前轮匝肌结合埋没导引缝合法祛眼袋26例报告

目的：消除眼袋，同时更好地保持下睑的自然外形。方法：在睑板前轮匝肌下即眶隔前轮匝肌中部“V”形切除一块隔前轮匝肌并水平向紧缩缝合眶隔前轮匝肌，而不切除睑板前轮匝肌．适当去皮及眶隔脂肪，以祛除眼袋．如合并有睑袋沟存在者，经皮下充分剥离睑袋沟后，以埋没导引缝合抚平此沟．结果：本方法因末动板前轮匝肌、保留了下睑的“笑肉”。由于在水平方向紧缩轮匝肌而解决了实际意义上的肌肉松弛问题．加之以埋没导引缝合法，消除睑袋沟，更好地保持了下睑外形的自然、生动．避免了传统方法所致下睑外形的死板、僵化，更能有效地防止下睑退缩及睑外翻．结论：本方法适用于中重度的眼袋．如无袋沟，则无需用埋没导引缝合法，此术方法简单、可靠，效果自然、持久，值得推广．     

加强下睑支持结构的下睑年轻化整形术

目的 根据不同年龄及下睑老年化程度差异,提出相适应的下睑年轻化整形术。方法 对３５０例３０～６８岁下睑老年化者进行了加强下睑支持结构的整复术,根据个体差异,选择膨出眶脂或肥厚眼轮匝肌去除;眶隔筋膜及眼轮匝肌纵横重叠缝合;眶脂释放保留眶缘填充固定;眼轮匝肌瓣及外眦赶忙带悬吊固定以及膨体聚四氟乙烯眶缘凹陷充填等手术方式。结果 术后及随访结果表明,施行适应于不同介体的加强下睑支持结构整复术,年轻化明显,     

眶肌筋膜韧带提紧在眼袋整形术中的临床应用

人们随年龄增长,40岁以后眶内脂肪、眶隔筋膜、眼轮匝肌及皮肤等组织的退行性改变可导致组织松垂、眶隔内脂肪疝出,从而形成眼袋[1,2].近年来,眼袋手术日益增加,常见并发症有切除过多组织形成睑外翻和切除组织不够而致仍有皮肤松弛和皱纹.为了解决此矛盾,自2012年9月～2013年3月,我科对33例下睑松弛患者应用眶肌筋膜韧带提紧眼袋整形术,效果满意.现报道如下.     

结膜入路去除眼袋55例体会

眼袋通常是指下睑皮肤松弛,眶隔脂肪堆积较多造成的下睑皮肤下垂而且臃肿的征象.老年人眼袋的主要原因是睑组织松弛,伴眶隔脂肪膨出[1],临床上表现为下睑呈袋状臃肿,且皮肤皱纹明显.手术方法是在下睑缘切开,适当去除多余脂肪及皮肤,收紧眼轮匝肌.     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.