Objective To assess the growth station, the upper respiratory infection frequency and consultation frequency of the geographically defined high risk neonatal population at 1-year-old based on both birthweight and gestational age. Methods All infants admitted in our hospital from May in 2008 to May in 2009 were divided into three groups according to gestational age and birth weight, that were, group 1: born lt;32 completed gestational weeks and weighing ≥1 500 g; group 2: born after 32 completed gestational weeks and weighing lt;1 500 g; and group 3: born lt;32 completed gestational weeks and weighing lt;1 500 g. Information at 12 months corrected age about growth, the upper respiratory infection frequency and consultation frequency was collected. Results The growth rate of weight and head circumference in group 3 were lower than that in group 1, and the length growth rate was lower than that in group 1 and group 2. Infants in group 3 suffered from more airway infections (median: 15.5) than in group 1 (12.5) and group 2 (8.5). Infants in group 3 needed more medical consultations (median: 27.5) than those in group 1(17.5) and group 2 (15.5). Conclusions This study gives estimates for growth outcome, airway infection and consultation frequency at 12 months corrected age for very low birthweight infants (lt;1 500 g) and for very preterm infants (lt;32 completed gestational weeks). Gestational age and birth weight are the same important for predicting infants’ outcome and should therefore be integrated into clinical statistics.
目的 探讨闭孔疝的诊断和治疗方法。方法 回顾性分析了我院2001年10月至2009年8月期间收治并经手术证实的8例闭孔疝患者的临床资料。结果 8例均为女性，其中7例是老年、体弱的多产妇，1例是已婚年轻女性。平均年龄74.6岁（46～85岁），平均体重为39.1 kg（34～43 kg），平均生育5胎（1～10胎）。8例患者中5例术前经CT检查确诊而行手术治疗，3例由外院转入者在行急诊剖腹探查术中确诊。7例行坏死小肠切除吻合术，1例行嵌頓小肠复位术。 术后4例出现并发症：1例肺炎、1例切口感染、1例低蛋白水肿、1例为酸中毒和低血钾（死亡）。7例痊愈出院，1例死亡。结论 闭孔疝缺乏特异性表现，对年老体弱的经产妇出现腹痛、呕吐和股部疼痛应想到闭孔疝的可能；CT检查能提高闭孔疝的诊断率。准确的诊断和及时的手术干预是改善闭孔疝患者预后的关键。
Objective To explore the clinical significance of IL-6 and 8-isoprostane( 8-iso-PG) in exhaled breath condensate( EBC) in chronic obstructive pulmonary disease ( COPD) and smoking. Methods 17 patients with stable COPD and 30 healthy controls( 14 smokers and 16 non-smokers) were included in this study. EBC was collected in all subjects with a self-designed experimental device. The concentrations of 8-iso-PG and IL-6 in EBC were determined by enzyme-linked immunosorbent assay. Results Both8-iso-PG and IL-6 levels significantly increased in the COPD patients [ ( 8. 37±5. 09) pg/mL and ( 4. 62 ±1. 73) pg/mL, respectively] compared with the healthy non-smokers[ ( 5. 23 ±3. 08) pg/mL and ( 3. 09 ±1. 85) pg/mL, respectively] ( both P lt;0. 01) . There was no difference between the COPD patients and thehealthy smokers( both P gt; 0. 05) . The IL-6 level significantly increased in the healthy smokers compared with the non-smokers [ ( 4. 06 ±1. 59) pg/mL vs ( 3. 09 ±1. 85) pg/mL, P lt;0. 05] , but the 8-iso-PG level was similar in the non-smokers and smokers( P gt;0. 05) . Conclusion Airway inflammation and oxide stress are persistent in stable COPD patients and are aggravated by smoking.
Objective To investigate the surgical treatment method and the curative effect of tibial nonunion with superficial peroneal vascular fascia pedicel tibiofibular periosteal flap. Methods From January 1996 to December 2008, 18 cases of tibial nonunion were treated with superficial peroneal vascular fascia pedicel tibiofibular periosteal flap, interlockingintramedullary nail ing and cancellous bone graft of distal tibial. There were 14 males and 4 females, with an average age of 32.5 years old (range, 24-67 years old). Fracture site was middle in 10 cases and distal in 8 cases. Primary injury cause included 12 cases of traffic accident and 6 cases of bruise. The tibial nonunion reasons were manual reduction and plaster immobil ization in 8 cases, small spl int immobil ization in 4 cases, intramedullary nail fixation in 2 cases (no bone graft), plate fixation in 4 cases (including 3 cases of plate fixation and free il iac bone graft). Nonunion occurred after the first surgery. The time from nonunion to operation was 8 to 16 months, with an average of 10.5 months. The size of periosteal flap was 7 cm × 5 cm and distal tibial cancellous bone graft volume was 5-10 g. Results All incision achieved heal ing by first intention after operation without flap necrosis and infection. All patients were followed up 6-36 months with an average of 20.8 months. All tibial nonunion healed 5-7 months after operation. According to Johner-Wruh scoring, the results were excellent in 14 cases, good in 3 cases, and fair in 1 case; the excellent and good rate was 94.4%. Conclusion Superficial peroneal vascular tibiofibularfascia pedicel tibiofibular periosteal flap and interlocking intramedullary nail ing can attain good results in treating nonunion of tibia and fibula because of being stable internal fixation and promoting the heal ing of nonunion.
【摘要】 目的 对骶正中动静脉的位置分布及变异进行解剖观察及实际测量其与周围重要结构的位置关系，为临床医师提高腰骶椎前路手术安全性提供必要的参考信息。 方法 收集2008年5月-2011年1月期间因疾病及意外死亡者新鲜人体尸体标本30例，对其进行解剖学研究，观察并测量骶正中动、静脉的发出点与走行，骶正中动、静脉的数量与缺失情况，以及骶正中动、静脉间的相互走行关系。 结果 ①骶正中动脉在主动脉发出以及走行的位置相对固定，无明显多支与缺失情况；骶正中动脉均为腹主动脉根部背侧发出，未见发出点位于左右髂总动脉。发出后行于左侧髂总静脉后方，跨过腰5/骶1椎间盘下行。骶正中静脉与骶正中动脉伴行的情况占总数的60.0%；②骶正中静脉多支常见，没有发现有骶正中静脉的缺失。1支的占总标本数的66.7%，2支的占30.0%，3支的占3.3%。 结论 当选择分叉下入路，应该特别注意骶正中动静脉的解剖位置。动脉的变异相对较小，而静脉的变异程度非常大，发出点变异，多支的情况多见，这些原因都造成了静脉容易损伤的原因，在手术中应该特别注意。【Abstract】 Objective To investigate the clinical significance of anatomical features of middle sacral artery and vein for lumbar-sacral spinal surgery. Methods We carried out anatomical research on 30 cadavers caused by diseases or accidents collected between May 2008 and January 2011. We dissected the vascular system anterior to lumbar vertebrae to learn their characteristics. The initial point of middle sacral artery and confluent point of veins, and the numbers of, and the companion relationship between middle sacral arteries and veins were chosen as the indexes to be measured. Results The middle sacral arteries started from the aorta, and their locations were relatively fixed without absence or multi-branches. All the middle sacral arteries derived from the dorsal side of abdominal artery root, and were not started from the common iliac artery. Then, the sacral arteries went at the back of left common iliac vein, and went down after traversing the inter-vertebral disk between the fifth lumbar and first sacral vertebra. About 60% of the middle sacral veins were accompanied with the arteries. Multi-branches of the middle sacral veins were frequently seen, and no absence was observed. One-branch, two-branch and three-branch middle sacral veins occupied 66.7%, 30.0% and 3.3% respectively out of the total. Conclusions When choosing downward branch approach during the operation, we should pay special attention to the anatomical locations of the middle sacral arteries and veins. Compared with the arteries, there are greater variations of the veins including variations of the confluent point and branches which can cause the veins to be quite vulnerable.