目的评价保留肛门(下称保肛)手术在切除低位直肠癌手术中的地位。方法回颐性分析我院1954年1月至1996年12月手术治疗直肠癌2074例,其中低位直肠癌1594例,占76.86%。低位直肠癌中能行切除手术者1304例,切除率81.81%,其中441例为保肛手术(...目的评价保留肛门(下称保肛)手术在切除低位直肠癌手术中的地位。方法回颐性分析我院1954年1月至1996年12月手术治疗直肠癌2074例,其中低位直肠癌1594例,占76.86%。低位直肠癌中能行切除手术者1304例,切除率81.81%,其中441例为保肛手术(sphincter saving resection,SSR),占33.82%(441/1304),比较80年代前(Ⅰ组),80年代(Ⅱ组)和90年代(Ⅲ组)3组保肛手术的情况。结果 SSR Ⅰ组16.05%(82/511),Ⅱ组40.76%(161/395),Ⅲ组49.75%(198/398)。SSR 中 Dixon 术Ⅰ组占39.02%(32/82),Ⅱ组62.73%(101/161),Ⅲ组70.71%(140/198)。SSR 的总手术病死率0.45%(2/441)。Dixon 术总的吻合口漏发生率为8.06%(22/273),Ⅲ组中61例属超低位吻合术,术后吻合口漏的发生率为6.58%(4/61),腹会阴切除术(abdominal-perineal,AP)后局部复发率为12.46%(70/562).SSR 为13.15%(58/441)此两组比较差异无显著意义(P>0.05),Ⅰ组为12.20%(10/82),Ⅱ组为13.66%(22/161),Ⅲ组为12.63%(25/198)各组间比较,差异均无显著意义(P>0.05)。术后5年生存率Ⅰ组(63±5)%,Ⅱ组(70±4)%,Ⅲ组(82±4)%,各组间比较疗效有显著提高(P<0.05)。。结论低位直肠癌选择做 SSR 并不影响疗效,加强综合治疗是促使本组 SSR 比例不断提高,且5年生存率也相应提高的主要原因。展开更多
To evaluate the effect of restorative materials on stress distribution of endodontically treated teeth, the 3D models of an endodontically treated mand^ular first molar, restoration, and cement layer were created. Thr...To evaluate the effect of restorative materials on stress distribution of endodontically treated teeth, the 3D models of an endodontically treated mand^ular first molar, restoration, and cement layer were created. Three different materials （composite resin, ceramage and ceramic） were studied and two loading conditions （vertical and oblique load） were simulated. Mohr-Coulomb failure criterion of enamel, dentine, endocrown and cement were evaluated separately. It is indicated that under both loading conditions, the highest values of Mohr-Coulomb failure criterion were observed in Ceramage-restored group for remaining tooth structure while in ceramic-restored group for the restoration. Compared to composite resin and Ceramage, ceramic endocrown transferred less stress, namely was more protective to the tooth structure.展开更多
文摘目的评价保留肛门(下称保肛)手术在切除低位直肠癌手术中的地位。方法回颐性分析我院1954年1月至1996年12月手术治疗直肠癌2074例,其中低位直肠癌1594例,占76.86%。低位直肠癌中能行切除手术者1304例,切除率81.81%,其中441例为保肛手术(sphincter saving resection,SSR),占33.82%(441/1304),比较80年代前(Ⅰ组),80年代(Ⅱ组)和90年代(Ⅲ组)3组保肛手术的情况。结果 SSR Ⅰ组16.05%(82/511),Ⅱ组40.76%(161/395),Ⅲ组49.75%(198/398)。SSR 中 Dixon 术Ⅰ组占39.02%(32/82),Ⅱ组62.73%(101/161),Ⅲ组70.71%(140/198)。SSR 的总手术病死率0.45%(2/441)。Dixon 术总的吻合口漏发生率为8.06%(22/273),Ⅲ组中61例属超低位吻合术,术后吻合口漏的发生率为6.58%(4/61),腹会阴切除术(abdominal-perineal,AP)后局部复发率为12.46%(70/562).SSR 为13.15%(58/441)此两组比较差异无显著意义(P>0.05),Ⅰ组为12.20%(10/82),Ⅱ组为13.66%(22/161),Ⅲ组为12.63%(25/198)各组间比较,差异均无显著意义(P>0.05)。术后5年生存率Ⅰ组(63±5)%,Ⅱ组(70±4)%,Ⅲ组(82±4)%,各组间比较疗效有显著提高(P<0.05)。。结论低位直肠癌选择做 SSR 并不影响疗效,加强综合治疗是促使本组 SSR 比例不断提高,且5年生存率也相应提高的主要原因。
基金Founded by National Natural Science Foundation of China(No.51305306)Hubei Province Science and Technology Support Program(No.2013BCB025)Fundamental Research Funds for the Central University(No.2042014kf0274)
文摘To evaluate the effect of restorative materials on stress distribution of endodontically treated teeth, the 3D models of an endodontically treated mand^ular first molar, restoration, and cement layer were created. Three different materials （composite resin, ceramage and ceramic） were studied and two loading conditions （vertical and oblique load） were simulated. Mohr-Coulomb failure criterion of enamel, dentine, endocrown and cement were evaluated separately. It is indicated that under both loading conditions, the highest values of Mohr-Coulomb failure criterion were observed in Ceramage-restored group for remaining tooth structure while in ceramic-restored group for the restoration. Compared to composite resin and Ceramage, ceramic endocrown transferred less stress, namely was more protective to the tooth structure.
