目的 评价腹腔镜微创技术在急诊普外手术中的临床价值.方法 选取2016年9月-2018年1月该院急诊普外科收治的手术患者80例作为研究对象,按照随机数字表法分为对照组(n=40)和治疗组(n=40),对照组采取开腹手术治疗,治疗组采取腔镜微创技术治疗,观察并比较两组手术情况、术后并发症及疼痛情况的差异.结果 治疗组手术时间、排气时间和住院时间分别为(69.6±12.5)min、(25.8±2.8)h和(4.9±1.0)d,明显短于对照组,差异均有统计学意义(t=2.45、11.21和5.27,P<0.05);治疗组术中出血量为(29.7±11.1)ml,明显少于对照组,差异有统计学意义(t=14.94,P<0.05);治疗组患者术后并发症发生率为7.5％,明显低于对照组患者的25.0％,差异有统计学意义(χ2=4.50,P<0.05);两组均无无痛病例,治疗组轻度疼痛率高于对照组,重度疼痛率低于对照组,差异均有统计学意义(χ2=6.55,5.16,P<0.05);中度疼痛率两组比较,差异无统计学意义(P>0.05).结论 腹腔镜微创技术应用于急诊普外科手术中,具有效果良好、创伤小、恢复快、疼痛程度轻和并发症发生率低等优点,值得在临床中进一步普及和推广.

目的：分析铝碳酸镁对合并幽门螺杆菌（Hp）感染的活动性胃溃疡（GU）患者治疗结局的影响。方法选取该院消化内科就诊的178例 Hp 感染性 GU 患者作为研究对象，经随机数字表法分为两个治疗组，A 组患者给予奥美拉唑肠溶片、阿莫西林胶囊、克拉霉素胶囊、丽珠得乐冲剂四联疗法治疗，B 组患者在 A 组基础上加用铝碳酸镁片，比较两组治疗效果。结果两组患者的溃疡愈合总有效率以及 Hp 根除率差异无统计学意义（P ＞0．05）；疗程结束后，A 组和 B 组溃疡周围再生黏膜组织结构优级成熟度分别为39．74％（31／78）、64．56％（51／79），组间差异有统计学意义（P ＜0．05）。结论加用铝碳酸镁对于合并Hp 感染的活动性 GU 患者的溃疡愈合总有效率以及 Hp 根除率无显著影响，但可提高溃疡愈合质量，临床应用价值较高。

Objective To evaluate the diagnostic value of TSSC1 in glioma patients and its influence on cell biologi-cal behavior of glioma U87 cells. Methods RT-PCR and Western blot were used to examine the expression of TSSC1 in glioma samples, including 80 normal paraneoplastic tissues and 80 primary tumors. MTT and transwell were used to analyze the effect of TSSC1 knockout on proliferation, migration, and invasion in U87 cells. Results TSSC1 is down-regulated in glioma compared to its paraneoplastic counterparts and negatively related to higher grade. Furthermore, knockdown of TSSC1 expression results in increased proliferation, migration and invasion in U87 cells in vitro. Conclusion Our results may worked as a marker for early diagnosis and prognosis of glioma.

目的:探讨胫骨平台骨折切开复位内固定术后手术部位感染的相关危险因素.方法:回顾性分析了2005年7月至2010年11月间在我院行胫骨平台骨折切开复位内固定手术且随访时间大于一年的216例患者的相关资料,进行单因素及多因素Logistic回归,最终筛选出导致SSI的独立危险因素.结果:216例患者中,男性163例,女性53例,平均45.5岁,其中发生感染的患者21例(8.3％).引入多因素Logistic回归方程,得出术部位感染的独立危险因素为开放性骨折和手术时间.结论:开放性骨折(OR=4.77,P=0.004)和手术时间(OR=2.94,P=0.003)与胫骨平台骨折切开复位内固定术后SSI相关.因此,增加术者操作的熟练度、进行分期手术及提高手术效率均有助于减少伤口暴露时间,降低SSI的发生率.

Objective To investigate the effects of radiofrequency thermocoagulation (RFT) on pathological features and the expressions of choline acetyltransferase (ChAT), vasoactive intestinal peptide (VIP) and nitric oxide synthase (NOS) at lower esophageal sphincter (LES) in family dogs. Methods A total of 15 dogs were randomly divided into three groups. Sham group underwent gastroscopy and was fed for 3 months (n=5). Dogs were given RFT and were fed for 24 h after RFT (n=5, RFT+24 h group). Dogs were given RFT and were fed for 3 months after RFT (n=5, RFT+3m group). The pathological changes of LES were observed after HE staining in three groups. The expressions of ChAT, VIP and NOS were detected by immunohistochemical method in three groups. Results Results of HE staining showed nearly the same tissues in Sham group and control group. There were active inflammatory reaction and structural damage in RFT+24 h group. The chronic in-flammatory reaction and structural remodeling were found in RFT+3m group. Immunohistochemistry showed that ChAT was significantly increased in RFT+3m group compare than that of Sham group. Values of VIP and NOS were significantly de-creased in RFT+3m group compare than that of Sham group (P<0.01). Conclusion The thickness and increased pressure of LES were found after RFT,which also caused changes in neurotransmitters of local tissues in dogs.

OBJECTIVE To explore the outcomes of individualized neurosurgical treatments of spastic cerebral palsy. METHODS A total of 452 spastic cerebral palsy patients undergoing microneurosurgery during March 2006 and December 2011 were retrospectively analyzed. Performed on the basis of clinical manifestations, comprehensive procedures included selective cutting of neck or lumbosacral dorsal root ganglia (SPR, n = 182) for multiple muscle spasm, selective peripheral neurotomy (SPN, n = 270) for focal muscle spasm, line tendon lengthening or cutting and orthopedic surgery (n = 116) for tendon contracture plus limb deformities and carotid artery adventitia endarterectomy (n = 46) for salivation plus athetoid. RESULTS The average follow-up period was 18 (10-24) months. The limb spasm relief rate of SPR was 95.6% and that of SPN 98.3%. And the postoperative symptom improvement rate of common carotid arterial adventitia stripping was 91.3%. There were 8 cases (4.4%) of recurrent spasticity after SPR and 28 (10.4%) after SPN. CONCLUSION Offering individualized microsurgical treatments on the basis of clinical manifestations is essential for patients with spastic cerebral palsy.

目的探讨显微镜下微血管减压术(MVD)治疗面肌痉挛(HFS)的手术效果。方法回顾我科2007-06—2012-04采用显微血管减压术治疗面肌痉挛452例。术后随访24个月,根据临床症状评定临床疗效。结果 398例患者术后症状即刻消失,缓解率88%。48例患者分别于术后1～5个月缓解,延迟愈合率11%,4例术后症状减轻,2例无效;14例术后出现耳鸣,3～6个月逐渐减轻,1例听力丧失,未恢复;12例轻度面瘫,给予内科治疗后均恢复正常,术后出现吞咽呛咳1例,回访半年好转;24例术后发烧,给予腰穿置换脑脊液后恢复,1例高血压患者术后并发蛛网膜下腔出血,给予治疗后恢复,无脑脊液漏鼻漏、颅内感染、脑膜炎等并发症,无死亡和致残病例。结论显微血管减压术是面肌痉挛最有效的治疗方法,随着技术不断成熟,术中监测条件逐渐完善,治愈率显著提高,创伤小,面、听神经功能均可完好保留,术后并发症少。

外伤性脑积水是脑外伤常见的一种并发症,是重度颅脑损伤预后不良的常见原因之一[1].我院于2005年6月-2009年1月收治的581例重型颅脑损伤患者中发生外伤性脑积水28例,占同期重型颅脑损伤患者的4.82%.总结如下: