浅谈3D打印技术在耳鼻咽喉头颈外科临床教学中的应用

耳鼻咽喉头颈外科作为一门发展迅速的二级临床学科,具有专业性强,解剖组织结构复杂精细的特点,理论概念较为抽象,难以理解学习.近年来3D打印技术进步明显,在医学领域里的应用也随之更加广泛.本文就3D打印技术在耳鼻咽喉头颈外科临床教学中的作用进行阐述.     

嗅神经母细胞瘤

嗅神经母细胞瘤是一种较罕见的鼻腔恶性肿瘤.此疾病的发病隐袭、症状不典型,早期就容易出现颈淋巴结等部位的转移,因此在诊断、鉴别诊断方面有一定困难,但是随着临床诊断手段的进步确诊率在不断提高.此外关于此疾病在临床分期及治疗随访等方面,没有统一的标准,仍存在很大争议.     

慢性肾脏病合并肺孢子菌肺炎胸部CT表现分析

目的：探讨慢性肾脏病合并肺孢子菌肺炎（ PCP）的胸部CT表现特点。方法回顾分析2006年1月～2014年2月医院肾内科确诊的23例慢性肾脏病合并肺孢子菌患者的胸部CT影像资料。结果23例慢性肾脏病合并PCP患者的胸部CT表现主要有：斑片结节影、磨玻璃影、肺实变、肺气囊、纤维网格影、纵隔淋巴结肿大、胸腔积液。病变可表现为两肺或单侧肺。疾病早期以斑片结节影为主,逐渐进展呈弥漫磨玻璃及肺实变,伴有纤维网格影。结论慢性肾脏病合并肺孢子菌患者的胸部CT表现具有一定的特征性,对于该病的诊断具有明显的价值。     

腺叶精细化解剖全甲状腺切除治疗分化型甲状腺癌

甲状腺切除术已经开展了一个多世纪.甲状腺肿瘤的手术方式仍未完全完善,手术技巧仍在逐步提高.分化型甲状腺癌的甲状腺切除范围也是一直争论不休的问题.全甲状腺切除是甲状腺癌的主要手术方式之一,手术并发的喉神经损伤及甲状旁腺功能低下是常见的并发症,尤其是甲状旁腺功能低下已严重影响患者生存质量.严格适应证选择、提高手术操作技术、手术中精细操作可减少这些并发症的发生.笔者自2007年起运用甲状腺叶精细解剖技术切除全甲状腺治疗分化型甲状腺癌,总结分析以供临床参考.     

面中区恶性肿瘤80例手术缺损的修复

Objective To evaluate the reconstructive methods of outcome of midface defects following the removal of malignant neoplasms. Methods Eighty cases (54 males, and 26 females, age ranging from 23-79, with a median age of 53.5 years) ,of midface malignant tumors from 1997-2006 in Beijing Tongren Hospital were retrospectively reviewed. The clinical data including the type of midface region defects,reconstructive methods and the therapeutic outcome were analyzed. Of the 80 patients,6 cases were with type Ⅰ ( external nasal ) defect,56 with type Ⅱ (maxillary) defect, 14 with type Ⅲ (naso-facio-maxillary)defect and 4 with type Ⅳ ( maxillary defect combined with naso-facio-orbital cutaneous deficiency). Results The defects after the removal of malignant tumors were repaired with pedicle tissue flaps in 31 cases and free tissue flaps in 49 cases, respectively, one-stage reconstruction accounting for 73 cases (91.2%). KaplanMeier analysis showed total 3-year and 5-year survival rates were 63.8% and 40. 6%, respectively.Conclusions One-stage reconstruction is a satisfactory method for the repair of midface defect after the removal of malignant tumor, with good clinical outcome. Selection of repair methods should be based on defect types.     

肿瘤的多药耐药与p53

P糖蛋白（P-glycoprotein，P-GP，ABCBl）是肿瘤多药耐药中机制发现最早的。随着研究的不断深入，人们发现它的转录和表达与p53抑癌基因有一定的联系。一些研究表明野生型p53可以下调或者抑制P-GP启动子，而突变型p53可以激活或者上调P-GP启动子。