翻转大翼软骨瓣辅助硅胶假体置入隆鼻术

目的 探讨一种在应用硅胶假体进行隆鼻术时防止假体外露,同时有利于鼻尖与鼻翼成形,并有效增加鼻长的手术方法.方法 在16例临床隆鼻手术中,应用翻转大翼软骨瓣辅助硅胶鼻假体置入的方法,术中离断大翼软骨外侧脚,保留内侧脚完整,单端游离大翼软骨至鼻尖,充分松解大翼软骨对鼻尖的牵拉,以便在增高鼻背的同时增加鼻长,并满足个性化鼻尖与鼻翼成形.结果 16例受术者全部Ⅰ期愈合,无感染及假体外露等并发症发生.术后1个月回访,鼻尖高度及鼻长明显增加,鼻形自然,鼻翼立体感不仅未受影响,反而不同程度地得到优化,鼻尖与鼻翼轮廓清晰.结论 应用翻转大翼软骨瓣辅助硅胶鼻假体置入的隆鼻方法,可有效防止要求较高隆起鼻梁、鼻尖时造成的假体外露风险,同时有助于实现个性化鼻尖与鼻翼成形.由于软骨瓣取材方便、无需第2术区,软骨瓣血运有保障,不易发生变形和吸收,是提高隆鼻术美容效果的可行方法.     

前交叉韧带重建术后早期应用中医推拿手法的康复疗效

目的探讨前交叉韧带重建术后早期应用中医推拿手法的康复疗效。方法自2018年1月我院收治行单纯前交叉韧带重建术的患者30例随机分成两组,对照组15例行标准前交叉韧带重建术后康复治疗,包括肌肉锻炼与活动度练习;中医推拿组15例在标准的前交叉韧带重建术后康复治疗的基础上增加中医推拿手法,推拿手法自术后1周开始,持续四周;分别于术后1、3、6个月测量患肢膝关节活动度与大腿周径,术前与术后6个月采用Lysholm评分标准对患者膝关节功能进行评估,并对结果进行统计学分析。结果两组患者术前术后Lysholm评分均有明显提升(P0.05),但二组之间无明显统计学差异(P0.05);中医推拿组术后1个月的患肢膝关节活动度与大腿周径均比对照组高,有明显统计学差异(P0.05),术后3、6个月患肢膝关节活动度与大腿周径无明显统计学差异(P0.05)。结论前交叉韧带重建术后早期应用中医推拿手法可以有效的降低膝关节粘连的发生率,提升肌肉力量,加速前交叉韧带重建术后的康复过程。     

转染CD40配体的卵巢癌细胞株OVHM抗卵巢癌肝转移机制的研究

Objective To examine the in vivo anti-metastatic effect of enhanced expression of CD40L cDNA in murinc ovarian cancer OVUM cells (CD4OL-OVHM) injected into the spleen on liver metastasis in mice. Methods OVUM cells were inoculated into the spleen of 6 ～ 8 week-old female B6C3F1 (C57BL/6N × C3H/He) mice. The established liver metastasis was identified by histopathology (HE staining). OVUM cells, DNA-pMKITneo-OVHM cells or CD40L-OVHM cells were inoculated into the spleen of female B6C3F1 mice and the expressions of CD11c in splenic cells were detected by flow cytometry. The specific cytotoxicity of splenic cells was detected by MTT assay, and the serum cytokines of IFN-γ, TNF-α, IL-12, IL4 and IL-10 of the mice were measured by enzyme linked immunoabsorbent assay. The liver metastases and the survival time of the mice were also recorded. Results The mouse models with liver metastasis by injecting tumor cells into the spleen of mice were established. The expression of CD11c and the specific killing rote in CD40L-OVHM cells group was significantly higher than that in the OVHM cells group and DNA-pMKITneo-OVHM cells group. The expressions of IFN-γ, TNF-α and IL-12 in the CD40L-OVHM cells group were much more increased than OVHM cells group and DNA-pMKITneo-OVHM cells group, but the expressions of IL-4 and IL-10 in the CD40L-OVHM cells group were decreased significantly (P < 0.05). The average weights of livers and spleens of mice in CD40L-OVHM cells group were significantly lower than those of DNA-pMKITneo-OVHM cells group and OVHM cells group. The survival time of mice in CD40L-OVHM cells group was also significantly longer than that in the OVHM cells group and DNA-pMKITneo-OVHM cells group (P < 0.05). Conclusion The data directly demonstrate that the expression of CD40L in ovarian cancer cells (CD40L-OVHM) can enhance the proliferation and differentiation of dendritic cells in the spleen and induce specific cytotoxic effect of T cells in the spleen, and may regulate the immune function of peripheral blood cells and the immune balance between Thl cells and Th2 cells, which maybe the possible mechanism induced by CD40L in mice inhibiting the development of liver metastasis.     

三维可视化技术在胰腺占位患者胰周血管解剖变异分析中的应用

目的:探讨三维可视化技术在胰腺占位患者胰周血管解剖变异分析中的应用价值。方法:回顾性分析2018年6月至2019年12月在皖南医学院弋矶山医院、中国科学技术大学附属第一医院、安徽医科大学第一附属医院、安徽医科大学第二附属医院、蚌埠医学院第一附属医院、阜阳市人民医院诊断为胰腺占位并完成上腹部增强CT扫描的98例患者资料。...     

缺血性脑白质病变病人血清VEGF表达水平及其临床意义

目的：探讨缺血性脑白质病变(white matter ischemic lesions, WMIL)病人血清血管内皮生长因子(vascular endothelial growth factor, VEGF)水平表达及其与WMIL的关系。方法：选取经颅脑磁共振证实的缺血性脑白质病变病人为研究对象,依据Fazekas评定量表评定脑白质病变程度。选取同期年龄和性别相匹配的颅脑磁共振正常的健康体检者作为对照组。应用酶联免疫吸附法测定病人血清VEGF水平。比较2组的一般临床资料和VEGF水平,采用Pearson相关分析分析血清VEGF水平与脑白质病变程度的关系,采用多因素logistic回归分析分析WMIL的影响因素。结果：共纳入WMIL组115例,对照组69例。WMIL组病人高血压比例、糖尿病比例和VEGF水平均高于对照组(P<0.01)。WMIL组病人血清VEGF水平与Fazekas评分呈正相关(r=0.871,P<0.01)。多因素logistic回归分析显示,高血压、糖尿病和VEGF水平升高是WMIL的独立危险因素(OR=5.350、3.010、19.382,P<0....     

老年急性胆源性胰腺炎21例临床分析

目的:探讨老年人急性胆源性胰腺炎的特点及治疗方法。方法:21例老年急性胆源性胰腺炎,其中,轻型16例,重型5例。手术治疗3例,非手术治疗18例。结果:痊愈20例,死亡1例。结论:老年急性胆源性胰腺炎以保守治疗为主,如需手术则手术方式尽量从简,以切除病变胆囊,解除梗阻为主,注重并发症的治疗。     

开展模拟手术技能培训课程的需求与满意度的调查分析

了解国内专科医师模拟手术需求与满意度相关情况。方法：对385名受训学员进行问卷调查,了解受训学员的一般情况、课前、课后需求与满意度等相关情况。结果：学员对培训课程的操作演示与操作练习的需求和满意度呼声较高,这与学员职称、医院等级、独立开展手术及年开展手术量有很大关系。学员普遍认为开展模拟手术技能培训课程是知识与技能的转化。结论：开展模拟手术技能培训课程是我国医学教学实战性运作模式之一,值得推广。     

试论“缓中”之法

缓中是中医方剂组方配伍及用药的一种独特方法。自汉·张仲景伊始,历代医家均创有缓中特点的有效方剂,其中以仲景最为丰富。学习和掌握缓中之配伍运用规律,对于正确理解和分析前人的方剂配伍及指导临床组方用药均有意义。本文试从缓中之涵义、作用及配伍应用原则等方面作初步的探讨。 1 缓中之涵义     

腹腔镜对不明原因腹水的诊断价值

腹水是常见的临床症状,原因很多,但因缺乏特异的临床标记,且无辅助检查结果提供足够的阳性预测值,因此病因学诊断非常困难.随着现代影像学和实验窜检查诊断技术的发展,许多引起腹腔积液的疾病得到明确诊断,但部分患者仍需行创伤性检查,如腹腔镜探查活检.