OBJECTIVE: To clarify whether it is necessary to reconstruct bone defects at the anterior skull base. METHODS: A long-term follow-up study of 50 patients with anterior skull-base defects in which the dura was reconstr...OBJECTIVE: To clarify whether it is necessary to reconstruct bone defects at the anterior skull base. METHODS: A long-term follow-up study of 50 patients with anterior skull-base defects in which the dura was reconstructed without bone grafts was conducted. CT and MRI examinations were taken periodically after surgery. RESULTS: The ordinates of the bone defects averaged 3.5 cm (range, 2 - 6 cm), and the abscissas averaged 2.8 cm (range, 2 - 5 cm). The abscissas of the bone defects measured 2 - 3 cm in 38 patients, 3 - 4 cm in 10 patients, and 4 - 5 cm in 2 patients. The follow-up ranged from 3 months to 5 years (average, 2 years). CONCLUSIONS: At normal intracranial pressure, if the dura mater is repaired properly at the skull-base defects and reinforced with a pedicled pericranial flap, encephalomeningocele and cerebrospinal fluid (CSF) leakage can be prevented. It may not be necessary to make free bone grafts when the size of the cranial base bone defect is smaller than 4 cm.展开更多
目的对比观察腹腔镜和传统开腹手术治疗子宫内膜癌的近期效果及安全性。方法选取2016年4月-2017年9月我院手术治疗的79例子宫内膜癌患者,根据手术方式的不同分为观察组41例和对照组38例,对照组予传统开腹手术治疗,观察组予腹腔镜子宫内...目的对比观察腹腔镜和传统开腹手术治疗子宫内膜癌的近期效果及安全性。方法选取2016年4月-2017年9月我院手术治疗的79例子宫内膜癌患者,根据手术方式的不同分为观察组41例和对照组38例,对照组予传统开腹手术治疗,观察组予腹腔镜子宫内膜癌根治术。比较两组手术相关指标;两组术后1 d疼痛视觉模拟评分(visual analogue scale, VAS)及术后6个月简明健康状况调查量表(short from 36 health survey questionnaire, SF-36)评分;术后随访半年,记录两组术后并发症发生情况;随访2年,比较两组中位生存时间及生存率。结果两组手术时间、淋巴结清扫个数比较差异均无统计学意义(P>0.05);观察组术中出血量少于对照组,术后肛门排气时间、术后自主下床活动时间及术后住院时间均短于对照组(P<0.05或P<0.01)。术后1 d VAS评分观察组低于对照组,术后6个月SF-36评分观察组高于对照组,差异有统计学意义(P<0.05)。术后随访半年,观察组术后并发症总发生率为14.63%低于对照组的36.84%(χ2=5.144,P=0.023)。术后随访2年,两组中位生存时间及生存率比较差异均无统计学意义(P>0.05)。结论腹腔镜手术和传统开腹手术治疗子宫内膜癌在手术时间、淋巴结清扫效果、短期中位生存时间及生存率方面效果相当,但腹腔镜手术治疗可明显减少术中出血量,促进术后肠功能恢复,减轻术后疼痛,缩短住院时间,提高患者术后生活质量,降低术后并发症发生率。展开更多
AIM: To evaluate the effects of varying ischemic durations on cirrhotic liver and to determine the safe upper limit of repeated intermittent hepatic inflow occlusion. METHODS: Hepatic ischemia in cirrhotic rats was in...AIM: To evaluate the effects of varying ischemic durations on cirrhotic liver and to determine the safe upper limit of repeated intermittent hepatic inflow occlusion. METHODS: Hepatic ischemia in cirrhotic rats was induced by clamping the common pedicle of left and median lobes after non-ischemic lobes resection. The cirrhotic rats were divided into six groups according to the duration and form of vascular clamping: sham occlusion (SO), intermittent occlusion for 10 (IO-10), 15(IO-15), 20(IO-20) and 30(IO-30) minutes with 5 minutes of reflow and continuous occlusion for 60 minutes (CO-60). All animals received a total duration of 60 minutes of hepatic inflow occlusion. Liver viability was investigated in relation of hepatic adenylate energy charge (EC). Triphenyltetrazollum chloride (TTC) reduction activities were assayed to qualitatively evaluate the degree of irreversible hepatocellular injury. The biochemical and morphological changes were also assessed and a 7-day mortality was observed. RESULTS: At 60 minutes after reperfusion following a total of 60 minutes of hepatic inflow occlusion, EC values in IO-10 (0.749 +/- 0.012) and IO-15 (0.699 +/- 0.002) groups were rapidly restored to that in SO group (0.748 +/- 0.016), TTC reduction activities remained in high levels (0.144 +/- 0.002 mg/mg protein, 0.139 +/- 0.003 mg/mg protein and 0.121 +/- 0.003 mg/mg protein in SO, IO-10 and IO-15 groups, respectively). But in IO-20 and IO-30 groups, EC levels were partly restored (0.457 +/- 0.023 and 0.534 +/- 0.027) accompanying with a significantly decreased TTC reduction activities (0.070 +/- 0.005 mg/mg protein and 0.061 +/- 0.003 mg/mg protein). No recovery in EC values (0.228 +/- 0.004) and a progressive decrease in TTC reduction activities (0.033 +/- 0.002 mg/mg protein) were shown in CO-60 group. Although not significantly different, the activities of the serum aspartate aminotransferase (AST) on the third postoperative day (POD(3)) and POD(7) and of the serum alanine aminotransferase (ALT) on POD(3) in CO-60 group展开更多
文摘OBJECTIVE: To clarify whether it is necessary to reconstruct bone defects at the anterior skull base. METHODS: A long-term follow-up study of 50 patients with anterior skull-base defects in which the dura was reconstructed without bone grafts was conducted. CT and MRI examinations were taken periodically after surgery. RESULTS: The ordinates of the bone defects averaged 3.5 cm (range, 2 - 6 cm), and the abscissas averaged 2.8 cm (range, 2 - 5 cm). The abscissas of the bone defects measured 2 - 3 cm in 38 patients, 3 - 4 cm in 10 patients, and 4 - 5 cm in 2 patients. The follow-up ranged from 3 months to 5 years (average, 2 years). CONCLUSIONS: At normal intracranial pressure, if the dura mater is repaired properly at the skull-base defects and reinforced with a pedicled pericranial flap, encephalomeningocele and cerebrospinal fluid (CSF) leakage can be prevented. It may not be necessary to make free bone grafts when the size of the cranial base bone defect is smaller than 4 cm.
文摘目的对比观察腹腔镜和传统开腹手术治疗子宫内膜癌的近期效果及安全性。方法选取2016年4月-2017年9月我院手术治疗的79例子宫内膜癌患者,根据手术方式的不同分为观察组41例和对照组38例,对照组予传统开腹手术治疗,观察组予腹腔镜子宫内膜癌根治术。比较两组手术相关指标;两组术后1 d疼痛视觉模拟评分(visual analogue scale, VAS)及术后6个月简明健康状况调查量表(short from 36 health survey questionnaire, SF-36)评分;术后随访半年,记录两组术后并发症发生情况;随访2年,比较两组中位生存时间及生存率。结果两组手术时间、淋巴结清扫个数比较差异均无统计学意义(P>0.05);观察组术中出血量少于对照组,术后肛门排气时间、术后自主下床活动时间及术后住院时间均短于对照组(P<0.05或P<0.01)。术后1 d VAS评分观察组低于对照组,术后6个月SF-36评分观察组高于对照组,差异有统计学意义(P<0.05)。术后随访半年,观察组术后并发症总发生率为14.63%低于对照组的36.84%(χ2=5.144,P=0.023)。术后随访2年,两组中位生存时间及生存率比较差异均无统计学意义(P>0.05)。结论腹腔镜手术和传统开腹手术治疗子宫内膜癌在手术时间、淋巴结清扫效果、短期中位生存时间及生存率方面效果相当,但腹腔镜手术治疗可明显减少术中出血量,促进术后肠功能恢复,减轻术后疼痛,缩短住院时间,提高患者术后生活质量,降低术后并发症发生率。
基金This Work was supported by the grant from the Science and Technology Committee of Zhejiang Province,No.971103132
文摘AIM: To evaluate the effects of varying ischemic durations on cirrhotic liver and to determine the safe upper limit of repeated intermittent hepatic inflow occlusion. METHODS: Hepatic ischemia in cirrhotic rats was induced by clamping the common pedicle of left and median lobes after non-ischemic lobes resection. The cirrhotic rats were divided into six groups according to the duration and form of vascular clamping: sham occlusion (SO), intermittent occlusion for 10 (IO-10), 15(IO-15), 20(IO-20) and 30(IO-30) minutes with 5 minutes of reflow and continuous occlusion for 60 minutes (CO-60). All animals received a total duration of 60 minutes of hepatic inflow occlusion. Liver viability was investigated in relation of hepatic adenylate energy charge (EC). Triphenyltetrazollum chloride (TTC) reduction activities were assayed to qualitatively evaluate the degree of irreversible hepatocellular injury. The biochemical and morphological changes were also assessed and a 7-day mortality was observed. RESULTS: At 60 minutes after reperfusion following a total of 60 minutes of hepatic inflow occlusion, EC values in IO-10 (0.749 +/- 0.012) and IO-15 (0.699 +/- 0.002) groups were rapidly restored to that in SO group (0.748 +/- 0.016), TTC reduction activities remained in high levels (0.144 +/- 0.002 mg/mg protein, 0.139 +/- 0.003 mg/mg protein and 0.121 +/- 0.003 mg/mg protein in SO, IO-10 and IO-15 groups, respectively). But in IO-20 and IO-30 groups, EC levels were partly restored (0.457 +/- 0.023 and 0.534 +/- 0.027) accompanying with a significantly decreased TTC reduction activities (0.070 +/- 0.005 mg/mg protein and 0.061 +/- 0.003 mg/mg protein). No recovery in EC values (0.228 +/- 0.004) and a progressive decrease in TTC reduction activities (0.033 +/- 0.002 mg/mg protein) were shown in CO-60 group. Although not significantly different, the activities of the serum aspartate aminotransferase (AST) on the third postoperative day (POD(3)) and POD(7) and of the serum alanine aminotransferase (ALT) on POD(3) in CO-60 group
