Chest wall surgery used to be a subspecialty of traditional thoracic surgery, which has an ancient history of research and clinical practice. It has gradually become an independent professional field in recent years. With the change of concept and the progress of interdisciplines, we have deepened our understanding of related diseases, and the treatment of chest wall surgical diseases has also acquired new characteristics. This article reviews the progress in the treatment of chest wall surgical diseases including chest wall trauma, chest wall deformity, chest wall tumor, chest wall infection and chest wall defect from the perspective of chest wall surgery.
目的总结复杂腹腔镜胆囊切除术的操作技巧。方法对1996年8月至2003年1月我科施行的4 971例腹腔镜胆囊切除术中因各种原因所致手术操作困难者711例的临床资料进行回顾性分析。结果711例中687例在腹腔镜下运用顺行法或顺逆结合法完成胆囊切除手术，24例中转开腹，中转率3.4%，均治愈，无并发症发生。结论掌握好复杂性腹腔镜胆囊切除术中的操作技巧，能降低手术中转率以及手术风险，拓展腹腔镜的应用领域。
目的探讨急诊肝动脉栓塞（TAE）治疗原发性肝癌破裂出血的临床效果和意义。方法收集我院近10年来收治的38例原发性肝癌破裂出血的资料，按治疗方法不同分为保守治疗组、急诊手术组及急诊TAE治疗组，比较3组间的输血量、术后肝功恢复率、住院时间及死亡率。结果急诊TAE治疗组与保守治疗组及急诊手术组比较，输血量少，术后肝功恢复率高，住院时间短和死亡率低，差异有统计学意义（Plt;0.05,Plt;0.01）。结论对于失去根治切除机会或不能耐受手术的原发性肝癌破裂出血的患者，可首选急诊TAE方法，并且还可为一部分患者将来行二次根治切除手术创造机会。
ObjectiveTo evaluate the effect of low power red laser illumination on the intimal proliferative response in vein graft models.MethodsAutogenous vein graft models were established in 80 rats by transplanting jugular vein to carotid artery by end to end anastomosis, and were randomized into two groups: control group (graft nonilluminated), laser illumination group (0.9 J/cm2).The grafted veins were harvested at 3,7,14 or 28 day respectively after operation. IH (intimal hyperplasia) and SMC (smooth muscle cell) proliferations were pathologically and immunohistochemically observed and analyzed by computer digitizing system. ResultsThere were no significant differences in the intimal average thickness and the areas of lumen between two groups for 3 day. Laser group was significantly lower than the control in both the intimal average thickness and the stenosis of lumen at 7 day,14 day and 28 day (P＜0.05).Immunohistochemical analysis of PCNA indicate the decreased positive cell in laser group compared with the control group (P＜0.01).ConclusionThese preliminary results demonstrate that a certain density of low power red laser illumination in vein graft inhibits SMC proliferation and neointimal hyperplasia in rat.
Abstract: Human leukocyte antigen (HLA) is the key antigen mediating rejection and panel reactive antibody (PRA) represent anti-HLA antibodiesin circulation. HLA typing and PRA testing are carried out generally before organ transplantation. With research on the relationship among HLA, PRA and heart transplantation developing, the value of HLA typing and PRA testing in heart transplantation has received more attention and their clinical using strategy has been improved. This article will review the strategy of HLA typing, the clinical value of HLA typing, time-selection in HLA typing, reason and mechanism of rising PRA, clinical sense of PRA testing and treatment of sensitized patients.