To evaluate clinically and radiographically an alveolar ridge, preservation technique with deproteinized bovine bone graft and absorbable collagen membrane and then restoration with delayed implants were done. The study included 30 patients. The trial group's sockets were filled with deproteinized bovine bone graft (Bio- Oss) and covered with absorbable collagen membrane (Bio- Gide). The control group's sockets healed without any treatment. Panoramic radiograph and computed tomography were taken immediately after graft and 3 and 6 months later to evaluate the height, width, and volume change of the alveolar ridge bone. Dental implants were inserted in all sockets at 6 months, and osseointegration conditionwas evaluated in the following 12months. All sockets healed uneventfully. In the trial group, the mean (SD) height reduction of the alveolar ridge bone was 1.05 (0.24) mm at 3 months and 1.54 (0.25) mm at 6 months. The width reduction was 1.11 (0.13) mm at 3 months and 1.84 (0.35) mm at 6 months. Bone volume reduction was 193.79 (21.47) mm(3) at 3 months and 262.06 (33.08) mm(3) at 6 months. At the same trend, in the control group, the bone height reduction was 2.12 (0.15) mm at 3 months and 3.26 (0.29) mm at 6 months. The width reduction was 2.72 (0.19) mm at 3 months and 3.56 (0.28) mm at 6 months. Bone volume reduction was 252.19 (37.21) mm(3) at 3months and 342.32 (36.41) mm(3) at 6months. There was a significant difference in alveolar ridge bone height, width, and volume reduction in the 2 groups. The osseointegration condition had no significant difference between the 2 groups. This study suggested that the deproteinized bovine bone graft and absorbable collagen membrane were beneficial to preserve the alveolar ridge bone and had no influence on the osseointegration of delayed implant.

Objective: To invstigate the effect of hyperoxia solusion preconditioning on myocardial ischemica-reperfusion(I/R) in-jury in rabbits.Methods: Thirty-two adult male rabbits weighing 2-3 kg were randomly divided into 4 groups(n=8 each): sham operation(group S),myocardial(I/R)(group OX),group HO1,HO2(received hypoeroxia solusion 10,20 ml/kg respectively at 30 min before myo-cardial ischemia).Myocardial I/R was produced by temporary ligation of anterior descending branch of left coronary artery(LAD) for 30 min followed by 120 min reperfusion.Myocardial ischemia was confirmed by S-T segment elevation and change in color of myocardium.HR and BP were monitored and recorded immediately before ligation of LAD(T0),immediately before LAD ligation was untied(T1),60(T2) and 120(T3) min after LAD was untied.Blood samples were obtained at T3 for determination of serum CK,cTNI,IL-6 and TNF-αconcentration.Results: In group OX,HO1,HO2,HR and MAP decreased during T1-3(P 0.05),but there was no significant difference among the 3 groups.In I/R group,the s CK,cTNI,IL-6 and TNF-α were significantly higher than that in Sham group(P0.01);The above parameters in group HO2,were significantly lower and the infarct size was significantly smaller than that in group OX.Conclusion: Hy-peroxia solution preconditioning can attenuate myocardial I/R injury by inhibiting inflammatory response.

Objective To explore the relationship between IL-1α gene single nucleotide polymorphisms and susceptibility to A H1N1 influenza. Methods A case-control study and the chip technique of time of flight mass spectrum were used to analyze the genotype of SNP (rs1304037,rs16347,rs17561,rs2071373) in IL-1α gene in H1N1 group(n = 167)and healthy control group(n = 192). Results rs17561 SNP involved T and G allele,T allele frequency was 13.8% and 7.3% in H1N1 groups and control group respectively ,and there was significant difference (P = 0.004,OR = 2.031,95% CI 1.238 -3.331). For other SNP,no significant difference was observed in allele frequency between H1N1 group and healthy control group. Conclusion IL-1α gene rs17561 SNP is associated with susceptibility to A H1N1 influenza,T allele is the susceptible allele for A H1N1 influenza.

<正>自1933年Evarts A.Graham应用左全肺切除术治疗肺癌获得成功之后全肺切除术已成了肺癌手术治疗的经典术式。1942年Blades&Kent应用肺门解剖法作了下肺叶切除术、1943年Huber&Jackson也应用肺门解剖法作了上肺叶切除术治疗肺癌。20世纪50年代初Churchill报道和收集的临床资料表明肺叶切除术(lobectomy)治疗肺癌的手术死亡率和术后并发症均明

Objective. The purpose of this study was to investigate the effect of a portable video eyewear entertainment system used in conjunction with nitrous oxide/oxygen sedation during the removal of impacted lower third molars.Study Design. Thirty-eight patients had their bilateral third molars removed under local anesthesia and nitrous oxide/oxygen inhalation sedation in 2 visits. On one side, video eyewear was used (group NE). On the other side, the tooth was removed without the use of video eyewear (group N). Vital signs were monitored. Overall behavior and the outcome of treatment were assessed.Results. All 38 patients completed the study. The mean scores on behavior rating in group NE were significantly higher than those in group N (P < .05). The majority of patients (92.1%) preferred nitrous oxide with video eyewear.Conclusions. The use of video eyewear appeared to augment the effectiveness of nitrous oxide sedation in dental extraction patients. (Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 113:188-192)

患者,女,71岁,因声音嘶哑、右声带麻痹15年,咳嗽、咯血1年,症状加重3个月入院.CT:右甲状腺区域软组织肿块影呈不规则强化,压迫右后侧气管壁致气管腔轻度变窄,纵隔内可见多个小淋巴结钙化影;右上肺尖段不规则结节状影,直径2 cm大小,边缘有毛刺.

OBJECTIVE:To probe into the mechanism of pneumothorax caused by acupuncture or acupoint injection and the preventive methods.METHODS:Retrospectively analyze the clinical original symptoms of 38 cases with pneumothorax caused by acupuncture and acupoint injection, which were divided into four clinical types: dyspnea type, shock type, thoracalgia type and tardy type. Illustrate the relation of the clinical types with severe degrees of pneumothorax, and the mechanism of pneumothorax inducing death of the patient.RESULTS:In the series there were 38 cases with pneumothorax induced by acupuncture or acupoint injection, including 4 cases of dyspnea type, 16 cases of shock type, 14 cases of thoracalgia type, 4 cases of tardy type. After proper treatment, 37 cases were cured and one case of dyspnea type died of tension pneumothorax.CONCLUSION:The mechanism of pneumothorax caused by acupuncture or acupoint injection is that due to the filiform needle tip or the syringe's needle tip inserting into the lung tissue at the patient's respiration in acupuncture or acupoint injection, the filiform needle tip or the syringe's needle tip lacerates the lung tissue. Air in alveolus goes into the thorax pleura cavity to form pneumothorax. In acupuncture or acupoint injection, the needle tip must not insert into the lung tissue, which is a key for prevention of pneumothorax.

目的 探讨改进器械吻合方法 对预防食管贲门癌切除术后并发症作用.方法 食管贲门癌患者324例,随机分为观察组和对照组各162例,对照组应用器械常规吻合方法 ,观察组应用改进后的器械吻合方法 .术后随访3～6个月,观察两组吻合口并发症发生情况.结果 观察组吻合口漏、吻合口狭窄分别为0.62%(1例)、2.46%(4例),与对照组的1.85%(3例)、4.32%(7例)相比较,差异有统计学意义(P＜0.05);两组吻合口出血发生率比较,差异无统计学意义(P＞0.05).结论 改进器械吻合方法 ,可以降低吻合口出血、吻合口漏及吻合口狭窄的发生率,提高术后患者生活质量.

随着医学技术的不断进步,各种新的诊断手段不断应用于临床,肺部疾病的诊断水平也在逐步提高.但肺部弥漫性疾病的病理学诊断仍是临床医师经常遇到的一个棘手问题,我们从1991年5月至2001年12月对18例此类病人行局麻下开胸肺活检,取得比较满意效果,现总结报道如下.

胸导管走行于胸内重要结构之间,且其直径仅有2～4mm,所以胸部穿透伤引起的单纯胸导管损伤极其罕见[1],胸部钝性创伤引起的乳糜胸亦很少见[2].我们遇到车祸后右下胸背部软组织挫伤合并单纯胸导管损伤1例,现报道如下.

Objective:To assess the analgesic effects and side effects of buprenorphine sublingual tablet in dental treatment.Methods:500 cases for dental treatment were selected.Before management of teeth,all the patients took 0.2 mg of buprenorphine sublingual tablet.The VAS score,Kuttner face score and side effects after dental treatment were recorded.Results:The VAS scores of the patients underwent preventive,operative and prosthetic treatments were 3.99±2.34,2.72±1.67 and 2.78±1.55,the Kuttner scores of those 1.98±1.23,2.66±1.04 and 2.03±0.93,respectively.Side effect was not observed in all the patients.Conclusion:Buprenorphine sublingual tablet can relieve the pain in dental treatment.

舒芬太尼是芬太尼N-4位取代的衍生物,镇痛效果是芬太尼的5～10 倍,并具有起效快、心血管系统功能稳定、无组胺释放等特点[1].本研究将舒芬太尼用于颌面外科患者,评价其镇痛效果和安全性.

目的:探讨瑞芬太尼静脉输注在口腔颌面外科手术麻醉中的有效性及安全性。方法:60例颌面外科全麻病人根据阿片药物用药分为瑞芬太尼组(REM组)和芬太尼组(Fen组),各30例,复合咪唑安定、异丙酚和维库溴铵实施静吸复合麻醉。Fen组微量泵入芬太尼0.25μg/(kg·min)、异丙酚100～200μg/(kg·min);REM组微量泵入瑞芬太尼0.25μg/(kg·min)、异丙酚100～200μg/(kg·min)。观察比较两组麻醉效果、生命体征、不良反应和术后恢复情况。结果:两组病例麻醉效果均满意,生理参数两组间比较无明显差异,并发症发生率低,无统计学差异(P>0.05);REM组病人术后平均清醒和气管拔管时间分别为(2.2±0.3)min和(3.5±1.1)min,Fen组分别为(5.3±0.9)min和(6.5±1.3)min。结论:瑞芬太尼用于口腔颌面外科病人的麻醉镇痛安全有效,并且术后清醒及气管拔管时间短于芬太尼。

目的 探讨电视胸腔镜在食管中段憩室切除术中的可行性及安全性。 方法 1999年 1月～ 2 0 0 3年 2月共施行电视胸腔镜食管中段憩室切除术 6例 ,术前均经食管 X线钡餐造影及胃镜检查确诊为食管中段憩室。结果 6例患者均完全在胸腔镜下完成手术 ,无中转开胸患者 ,无死亡患者及严重并发症发生 ;术后随访无复发。结论 胸腔镜下行食管中段憩室切除术是一种安全可行的微创术式。

1995年1月至2003年底我们在392例食管贲门癌切除术中采用美国外科公司PPCEEA25和强生公司CDH25吻合器施行食管胃或食管空肠吻合重建消化道的连续性209例.210个吻合口均一次击发顺利完成吻合.现将我们的体会报道如下。

目的:探讨胸腔镜手术在早期周围型肺癌诊断和治疗中的价值.方法:选取1992年11月至2003年2月经胸腔镜诊治的早期周围型肺癌56例,其中术前首诊为良性病变者20例(35.7%),经胸腔镜手术行肺叶切除术46例,楔形切除术8例,肺段切除术2例.结果:56例中2例转开胸手术,其余手术均顺利完成;肿瘤确诊率100%,显著高于术前的64.3%,P＜0.01.其中4例术后病理分期上升为Ⅱ期(T1N1M0 2例,T2N1M0 2例).肿瘤的手术切除率100%.结论:胸腔镜技术在早期周围型肺癌的诊断、病理分期及治疗中具有重要意义.

BACKGROUND To investigate the expressions of MAGE-1,-2,-3 and -4 in lung cancer at mRNA level. METHODS Using a reverse transcription-polymerase chain reaction assay (RT-PCR), the expressions of MAGE-1,-2,-3 and -4 in 35 lung cancer samples and non-tumorous lung tissues were examined. RESULTS Of the 35 tumor samples, the MAGE-1,-2,-3 and -4 were expressed at mRNA level in 22.9% (8/35), 62.9% (22/35), 37.1% (13/35) and 77.1% (27/35) respectively. At least one of these genes was expressed in 85.7% (30/35) of the samples. Two or more of these genes were expressed in 71.4% (25/35) of the samples. None of the non-tumorous lung tissue was positive for these genes. No significant difference of the frequency of MAGE gene expression was found between adenocarcinoma and squamous cell carcinoma, between different tumor stages, and between groups with or without lymph node metastasis (P > 0.05). CONCLUSIONS MAGE-1,-2,-3 and -4 are expressed at a high percentage in lung cancer. All of these genes are negative in the adjacent non tumorous lung tissue. These results indicate the possibility of a future specific immunotherapy for lung cancer based on these MAGE antigens.

目的 探讨电视胸腔镜手术 （VATS）在肺周围型小结节病变诊治中的作用和地位。 方法 用 VATS诊治肺周围型小结节病变患者 91例 ,其中多发性结节 18例 ,单发性结节 73例。结节直径 0 .3～ 3cm。术前经电子计算机断层扫描 （CT）等影象学检查均未能确诊。肺活检术 5例 ,肺楔形切除术 6 1例 ,肺叶切除术 2 5例。 结果 所有手术均顺利完成 ,无严重术后并发症和手术死亡。中转开胸手术 6例 （6 .5 9% ）。行 VATS后 ,患者均获得明确的病理诊断 ,确诊率 10 0 % ;其中良性病变 5 0例 ,原发性肺癌 32例 ,肺转移癌 9例。良性病变及早期原发性肺癌患者行 VATS后达到了临床治愈 ;不能耐受大手术的原发性肺癌患者 ,经 VATS行肿瘤局限性切除后改善了症状 ;肺转移癌行姑息治疗 ,经 VATS做肺楔形切除或肺叶切除术。 结论 VATS在肺周围型小结节病变的确诊、良性结节、早期原发性肺癌患者的治疗以及肺恶性肿瘤的姑息治疗中具有十分重要的应用价值。

OBJECTIVE:To identify genes differentially expressed in human lung squamous cell carcinoma (LSCC).METHODS:A subtracted cDNA library of human LSCC constructed by using suppression subtracted hybridization (SSH) method was screened. Clones representing mRNAs that were truly differentially expressed in LSCC but not in its adjacent non-cancerous tissues were identified by semi-quantitative RT-PCR in 12 patients with LSCC. Partial novel genes were detected by Northern blot.RESULTS:Ten differentially expressed gene cDNA fragments of LSSC were obtained by SSH. Among them six were known genes; two sequences were identified but their functions were unknown (hypothetical protein); two were novel (GenBank accession numbers AF363068 and AY032661, respectively). The results from semiquantitative RT-PCR showed that the transcription expression level of PPP1CB, calumenin, S100A2, HSNOV1, OCIA and AY032661 was down-regulated in some LSCC cases, while the transcription of HSP90, ferritin, gp96 and AF363068 was up-regulated in others.CONCLUSIONS:Six known genes identified by SSH technique have been implicated in the pathogenesis of lung carcinogenesis, or they are involved in immunological defense mechanism in human body. Two hypothetical proteins probably also play an important role in the pathogenesis of lung cancer. The function of the two novel genes in lung carcinogenesis are under investigation.

目的:探讨胸腔镜肺良性肿瘤摘除术的方法和价值.方法:2001年1月～2002年4月,对5例患者行VATS肺良性肿瘤摘除术.男1例,女4例,平均年龄37.2岁.术前均诊断为良性结节:周围型3例,左下叶肺动脉旁1例,左上叶舌段近肺门1例.双腔气管插管单肺通气,按常规位置做3个套管切口.镜下切开结节表面脏层胸膜,沿肿瘤包膜钝性剥离.靠近肺门血管旁的2例病例,采用缝线牵引法协助剥离.摘除之肿瘤立即送快速病理除外恶性病变.将手术结果与同期进行的胸腔镜肺良性肿瘤楔形切除术组进行比较.结果:手术顺利,无中转开胸;术后胸腔引流1～8d,平均2.8d;术后住院2～9d,平均5d;5例仅用Endo GIA钉夹1枚;病理:硬化性血管瘤3例,错构瘤1例,神经鞘瘤1例.并发症1例,为长期漏气(8d),无死亡.与肺楔形切除术组相比,在闭式引流时间及术后住院时间上无显著差异;平均住院费用较少,但无统计学差异.随访至今无复发.结论:胸腔镜摘除术是治疗肺良性肿瘤的一种简便、安全、可靠的微创新术式.