理想主义也得吃喝拉撒

Dan Ross见信:听说你最近做了个手术,身体可好?希望你平安无事。我很荣幸也很庆幸在合作将近一年的时候,还能以当初我们刚刚认识时的身份给你写信。最近我的北京同事还问起我,你什么时候再来中国。初次见面时,我一直在怀疑眼前这个瘦瘪的伦敦老头就是让我看了快10年的移动生活潮流杂志从零做起的创刊人?是的,别怪我说你,你看起来一点也不潮。甚至带着英国人典型的刻板,与法国出版人Yorgo相比,他看上去更像这本杂志的创刊者。当我问起你《Carl’s Car》时,我观察到你脸上掠过的一丝尴尬,你回答我说:"Yes,that’s enemy."然后你马上补充:"That’s a joke,I love the magazine."不管你怎么看这本本应小众的北欧杂志,反正它是我眼中的圣山。但是回到现实,我想如果有一天《Carl’s Car》来到中国,它必定是一本非常边缘的刊物,因为It can’t make money.     

腰椎间盘突出症手术治疗534例报告

对534例腰椎间盘突出症的手术治疗情况进行了总结,提出手束方式的选择主要取决于椎间盘突出的部位、类型以及是否合并椎管狭窄等,再次手术除技术原因外,主要由于椎间盘突出的类型比较特殊,或对合并侧隐窝狭窄重视不够。同时,对感染,神经损伤和末后脊柱不稳等手术并发症的原因和处理进行了讨论。     

围手术期病人心理护理

心理护理是手术室护士一项重要任务，病人在手术室期间心理变化极度剧烈，精神压力极大。有效的心理护理对病人安全渡过麻醉和手术，乃至术后康复，甚至出院后的生活都将起到积极作用。     

实时超声在神经外科手术中的应用

目的应用B超实时对神经外科开颅手术中病变进行超声扫描,探讨其成像特征和应用价值。方法常规开颅后在硬膜外和硬膜下应用B超,结合术前资料,进行病灶的实时定位,帮助选择皮层切口和手术路径,并用B超判定病灶切除程度。结果42例中,全部病变定位准确,准确率达100%,34例病变全部切除,6例次全切,2例死亡。结论术中B超能实时显示病变的部位和轮廓,有助于病变的术中定位和定性,减少手术副损伤。     

脊髓纵裂神经缺陷机制探讨

对２９例脊髓纵裂的神经功能状态进行临床评价及胫后神经皮层体感诱发电位（ｐｏｓｔｅｒｉｏｒｔｉｂｉａｌｎｅｒｖｅｃｏｒｔｉｃａｌｓｏｍａｔｏｓｅｎｓｏｒｙｅｖｏｋｅｄｐｏｔｅｎｔｉａｌ，ＰＴＮＣＳＥＰ）检查。结果：患病组２９例两下肢间神经缺陷的临床评分及ＰＴＮＣＳＥＰ有显著差异（Ｐ＜０．０５），患病组５８根ＰＴＮＣＳＥＰ明显异常；手术组２０例术后神经缺陷的临床评分及ＰＴＮＣＳＥＰ异常明显改善（Ｐ＜０．０５），非手术组９例随访后则无改善（Ｐ＞０．０５）。结果提示神经缺陷的机理是脊髓纵裂间隔对脊髓的牵拉和纵裂脊髓单侧发育异常。     

尿道粘膜套入术治疗后尿道狭窄100例疗效观察

目的　观察用尿道粘膜套入术治疗外伤性后尿道狭窄的疗效。方法　用尿道粘膜套入术治疗外伤性后尿道狭窄患者 1 0 0例。结果　治愈 95例 ,好转 2例 ,治愈率 95% ,总有效率 97%。术后平均最大尿流率 2 2 ml/s。结论　尿道粘膜套入术方法简单、疗效确切 ,是治疗外伤性后尿道狭窄的良好术式     

经Quadrant通道椎管内肿瘤切除与传统半椎板椎管内肿瘤切除术的对比研究

目的对比分析经Quadrant通道显微镜下椎管内肿瘤切除与传统显微手术椎管内肿瘤切除的手术相关指标和疗效。方法回顾自2013年7月至2015年7月本院33例病变长度小于5cm的椎管内肿瘤患者,其中16例接受经Quadrant通道显微镜下椎管内肿瘤切除,另外17例接受传统半椎板椎管内肿瘤切除。比较两组患者相关指标,包括手术切口长度、手术时间、术中出血量、术后首次下地活动时间、术后住院时间、术后1周视觉疼痛模拟(VAS)评分、JOA评分治疗改善率等。结果与传统手术相比,Quadrant通道手术组患者在手术切口长度、术中出血量、术后首次下地活动时间、术后住院时间、术后1周视觉疼痛模拟(VAS)评分等方面均优于传统组(P<0.05)。结论经Quadrant通道显微镜下椎管内肿瘤切除术具有创伤小、出血少、恢复快、疗效肯定的优点,是一种安全有效的治疗椎管内较小肿瘤的方法。     

基于网络的显微手术视频网络系统

通过安装在手术显微镜上的CCD将采集的手术视频信号送至与网络(LAN/Internet)连接的计算机,采用VC++面向对象的程序设计技术,实现显微手术视频的显示、压缩、存储、图像处理、剪辑,以及手术方案、数据库管理、报表生成与打印,并实现视、音频信号的网络实时传输及语音、文字交流等功能,可用于手术视频的记录、管理,以及远程专家会诊、示教、学术交流等.     

Diagnosis and excision of breast multi-focal lesions by ultrasound-guided vacuum-assisted biopsy: a comparative evaluation

Objective To compare and evaluate the efficacy of diagnosis and excision for appropriately selected breast multi-focal lesions and solitary lesion by ultrasound-guided vacuum-assisted biopsy (UGVAB). Methods Among 392 appropriately selected patients, 187 patients with multi-focal lesions and 205 patients with solitary lesion were treated by the 8-gauge UGVAB from May 2007 to June 2009. All lesions were removed as completely as possible. The patients with benign pathology underwent physical and ultrasound examinations at one week and 6 months after procedure. Results During the procedure, only three patients had vasovagal syncope and twenty others complained of other intraoperative discomfort. An accurate pathological diagnosis was obtained in all lesions. There was no apparent false-negative result among the 696 lesions with benign pathology at a follow-up of 6 months after procedure. The rates of malignant or premalignant pathology, postoperative complications and residual lesions in patients with multi-focal lesions were higher than those in patients with solitary lesion. If each lesion was considered as a subject of study, there was no significant difference between the two groups. Conclusion UGVAB is an effective method for diagnosis and excision of appropriately selected breast multi-focal lesions and can be used routinely.     

Therapeutic efficiency of short anterior urethral stricture treated with endourethral surgery combined with iridium 192 radiotherapy

Objective To assess the therapeutic efficiency of short anterior urethral stricture treated with endourethral surgery combined with iridium 192 radiation therapy in order to decrease the recurrence rate after endourethral surgery. Methods A total of 286 patients with anterior urethral stricture (stricture length ranging from 0.5 to 2.5cm, averaging at 1.6cm) were divided randomly into two groups after internal urethrotomy and cicatrix electrotomy. The radiation group of 173 patients was treated as soon as possible with iridium 192 radiation therapy on the stricture sections while the control group of 113 patients was not. The recurrence rate was compared between the two groups during one year's follow-up. Results Among all the 286 successful operations, stricture recurred in 19 patients of the radiation group (recurrence rate of 10.98%) and in 62 ones of the control group (recurrence rate of 54.86%), with a significant difference (P=0.003). Conclusion It is an effective way to prevent recurrence by treating patients as early as possible with iridium 192 radiation on the stricture sections after endourethral operation on anterior urethral stricture.