例行的

objective to discuss perioperative complication and management of patient with high risk copd following esophagectomy.methods 45 patients with high risk copd underwent esophagectomy with epidural block combined with general anesthesia.perioperative treatment included smoking cessation,chest physiotherapy,prevention and control of infection of air way and appropriate bronchodilators of air way,breathing exercises,nutrition support and oxygen therapy.painkiller was instilled after surgery,early exercises,ensuring unobstruction of the air way,mechanical ventilation was applied when needed.results 3 had hypoxaemia in operation.after surgery,all patients had spo2 somewhat declined.6 had lung infection.6 were removed of bronchial secretion by bronchoscope.2 were supported by ventilator by using intubation.2 underwent tracheotomy.1 had disturbances of acid base balance and treated by using hydrochloric acid muriatic acid.all patients recovered rather smoothly and discharged from hospital.conclusion high risk copd is not the absolute contraindication of esophagectomy.active management before and after surgery ensures the safety and recovery of patients.

目的 探讨重度慢性阻塞性肺疾病简称慢阻肺病人食管切除术围手术期常见并发症及其处理。方法 45例重度慢阻肺的病人在全麻联合硬膜外阻滞下进行开胸食管切除手术，围手术期处理包括术前戒烟、胸部理疗、预防和控制呼吸道感染、解痉化痰、呼吸功能锻炼、营养支持和氧疗；术后硬膜外镇痛、早期锻炼、保持呼吸道通畅，部分病人予以呼吸支持。结果术中3例出现低氧血症。术后所有病人pao2均有不同程度的下降，6例出现肺部感染，6例行纤维支气管镜吸痰，2例通过气管插管给予呼吸机支持，2例行气管切开术，1例酸碱平衡紊乱使用盐酸精氨酸治疗。所有病人均痊愈出院。结论重度慢阻肺病人并非开胸食管切除手术的绝对禁忌证，积极的术前准备和严格的术后管理可减少和控制术后急性发作，有助于确保此类病人的围手术期安全和康复。

objective to evaluate dsa and percutaneous transluminal renal arterioplasty for the treatment of renovascular hypertension.methods 82 suspected patients with renovascular hypertension were given dsa examination.28 patients were treated by means of ptra while another 5 cases with unilateral kidney atrophy treated surgically.results 49 patients were normal,33 patients were abnormal,28 patients were treated by means of ptra.blood pressure had got to normal in 10 patients while in 13 patients bp dropped noticeably after ptra.the overall benefit rate was 82.1%.conclusion dsa and ptra are clinically effective for the treatment of renovascular hypertension.ptra is technically successful.

目的 评价经皮腔内肾动脉成形术治疗肾血管性高血压的价值。方法 82例全部行dsa检查，肾血管狭窄者行ptra术或外科手术，观察其治疗效果。结果 82例患者行肾动脉造影后血管正常者49例，异常者33例，其中单侧肾萎缩5例行外科手术（肾动脉搭桥1例），肾动脉狭窄28例行经皮腔内肾动脉成形术（血管内支架5例），术后10例血压降至正常或基本正常，13例血压得到改善，5例无效，总有效率达82.1%。结论 dsa检查和ptra术在诊断和治疗肾血管性高血压方面有明显的临床价值。高血压，肾血管性；数字减影血管造影术；经皮腔内肾动脉成形术

Methods:60 cases with low rectal and anus carcinoma who underwent laparoscopic Miles operation were divided into two groups.The experimental group (30 cases) received extraperitoneal sigmoidostomy while the control group (30 cases) received traditional intraperitoneal procedure.Postoperative complications caused by sigmoidostomy and defecation function in these two groups were compared.

将接受腹腔镜Miles术的60例低位直肠癌、肛管癌患者分为两组，实验组30例行腹膜外乙状结肠造口术，对照组30例行传统的腹膜内乙状结肠造口术，比较两组患者的造口并发症和排便功能。

Objective To analyze the CT and MRI manifestations of oral carcinoma,and to evaluate the value of imaging technologies in the diagnosis of oral carcinoma,thus to explore the most reasonable imaging method Methods 46 cases with oral carcinoma,proved by surgery and pathology （2 lip tumors,8 carcinomas of the gingival ridge,5 carcinomas of the buccal mucosa,24 tongue carcinomas,5 carcinomas of the floor of the mouth,2 tumors of the hard palate）,were analysed retrospectively32 cases were examined with CT and 14 cases with MRIImaging presentations were compared with surgery and pathology Results Of the 46 cases with oral carcinoma,22 were ulcerative lesion of infiltrative growth,24 were masslike lesion of extruded trowthOf the 32 cases examined with CT scan,27 were detected,5 were missed,the 4 missed cases were confirmed to be superficial ulcers by surgery and pathologyOf the 10 cases with bone destruction examined with CT scan,8 were manifested,2 were missedAnd of the 14 cases with MRI scan,all 14 were detected Conclusion CT and MRI scan are valuable for diagnosis of oral carcinomasThey can manifest the morphology and size of primary tumor,contiguous structures,bone invasion and cervical lymph node metastasisMRI is the optimal imaging method for superficial ulcerative lesion of infiltratibe growth

徐 锋，罗德红，唐威，欧阳汉，周纯武目的分析口腔癌的CT及MRI表现，评价影像检查在口腔癌诊断中的应用价值，探索合理的影像学检查方法。方法回顾性分析经手术及病理证实的口腔癌46例（唇癌2例，牙龈癌8例，颊黏膜癌5例，舌癌24例，口底癌5例，硬腭癌2例），其中32例行CT扫描，14例行MRI扫描，将影像表现与手术所见及病理结果进行对照分析。结果 46例口腔癌中，呈浸润性生长的溃疡型病变22例，外生性生长的肿物型病变24例。CT扫描32例，明确显示病变27例，遗漏病变5例，其中4例为表浅溃疡型病变。CT扫描病例中，10例有骨质侵犯，CT扫描准确评价8例，遗漏2例。MRI扫描14例，均准确评价肿瘤及其与周围结构的关系。结论 CT、MRI对口腔癌原发肿瘤的形态、大小、周围结构侵犯、颈部淋巴结转移的评价有重要价值。对于较小及呈浸润性生长的表浅溃疡型肿瘤，CT扫描尤其是CT平扫难以准确显示，应首选MRI。

Objective To analyze the CT and MRI manifestations of oral carcinoma,and to evaluate the value of imaging technologies in the diagnosis of oral carcinoma,thus to explore the most reasonable imaging method Methods 46 cases with oral carcinoma,proved by surgery and pathology （2 lip tumors,8 carcinomas of the gingival ridge,5 carcinomas of the buccal mucosa,24 tongue carcinomas,5 carcinomas of the floor of the mouth,2 tumors of the hard palate）,were analysed retrospectively32 cases were examined with CT and 14 cases with MRIImaging presentations were compared with surgery and pathology Results Of the 46 cases with oral carcinoma,22 were ulcerative lesion of infiltrative growth,24 were masslike lesion of extruded trowthOf the 32 cases examined with CT scan,27 were detected,5 were missed,the 4 missed cases were confirmed to be superficial ulcers by surgery and pathologyOf the 10 cases with bone destruction examined with CT scan,8 were manifested,2 were missedAnd of the 14 cases with MRI scan,all 14 were detected Conclusion CT and MRI scan are valuable for diagnosis of oral carcinomasThey can manifest the morphology and size of primary tumor,contiguous structures,bone invasion and cervical lymph node metastasisMRI is the optimal imaging method for superficial ulcerative lesion of infiltratibe growth

中华硕博网核心提示：徐锋，罗德红，唐威，欧阳汉，周纯武关键词：口腔肿瘤目的分析口腔癌的CT及MRI表现，评价影像检查在口腔癌诊断中的应用价值，探徐锋，罗德红，唐威，欧阳汉，周纯武目的分析口腔癌的CT及MRI表现，评价影像检查在口腔癌诊断中的应用价值，探索合理的影像学检查方法。方法回顾性分析经手术及病理证实的口腔癌46例（唇癌2例，牙龈癌8例，颊黏膜癌5例，舌癌24例，口底癌5例，硬腭癌2例），其中32例行CT扫描，14例行MRI扫描，将影像表现与手术所见及病理结果进行对照分析。结果46例口腔癌中，呈浸润性生长的溃疡型病变22例，外生性生长的肿物型病变24例。CT扫描32例，明确显示病变27例，遗漏病变5例，其中4例为表浅溃疡型病变。CT扫描病例中，10例有骨质侵犯，CT扫描准确评价8例，遗漏2例。MRI扫描14例，均准确评价肿瘤及其与四周结构的关系。结论 CT、MRI对口腔癌原发肿瘤的形态、大小、四周结构侵犯、颈部淋巴结转移的评价有重要价值。对于较小及呈浸润性生长的表浅溃疡型肿瘤，CT扫描尤其是CT平扫难以准确显示，应首选MRI。

Methods: forty nine patients with prostatic cancer, 14 patients at pathologic stage c, 35 stage d, were analyzed retrospectively. twenty one of them were treated by bilateral orchidectomy and castration of drug; twenty three of them were treated by consist castration of drug;five patients were treated by intermittent androgen suppression.

对49例中晚期前列腺癌患者的临床资料进行回顾性分析。49例分为a、b、c 3组，a组21例行双侧睾丸切除+药物去势，b组23例给予持续性药物雄激素阻断，c组5例行间歇性药物雄激素阻断，分析3组的症状缓解率、影像学评价有效率、前列腺特异抗原psa）反应率及1、2、3年的生存率。

objective to evaluate the clinical value of early diagnosis and therapy of suspicious ectopic pregnancy by laparoscopy.methods the clinical data of 53 suspicious tubal pregnancy patients were analyzed retrospectively,who had received laparoscopic operation in our hospital from january 2003 to december 2005.results all cases received laparoscopic operation,none was transferred to traditional surgery during the operation.46 cases were diagnosed as tubal pregnancy during the operation with pathologic proof.preoperative diagnosis rate was 86.8%.the salpingecstomy were performed in the 32 cases.the salpingotomy were performed in the 7 cases.conclusion the laparoscopic operation is the best choice in the early diagnosis and therapy of suspicious ectopic pregnancy,and it gain time for conservative therapy.but not too early.

目的 评价可疑异位妊娠患者腹腔镜早期诊治的临床价值。方法收集2003年1月～2005年12月收治的经腹腔镜手术治疗的可疑输卵管妊娠患者53例资料进行回顾性分析。结果 53例手术均经腹腔镜完成，无1例中转，术中诊断输卵管妊娠的46例，术前诊断率86.8%，32例行输卵管切除术，7例行保守性手术。结论腹腔镜手术是早期确诊可疑异位妊娠患者的最佳选择，也为保守性治理赢得时间，但不宜操之过急。

The patients had been followed up for 8～36 months after surgery.9 patients existed postoperative complications and 3 patients recured after surgery.

回顾性分析我院2000～2007年收治的130例甲状腺腺瘤患者临床表现、围术期处理、手术方法以及术后并发症等。临床以颈前小结节为主，53例行腺瘤摘除术，77例行腺瘤摘除加部分腺叶切除术。

Methˉods From January1984to June1994,there were74endometrial carcinoma cases,13in stage Ia,36in stage Ib,9in stage Ic,10in stageⅡ,5in stageⅢ.The re were50cases who underwent the surgery only,and the other24cases unˉderwent the combined modality therapy.

1984年1月～1994年6月我院共收治子宫内膜癌74例，除1例因类行手术而未能分期的患者外，余73例按照1988年FIGO分期标准：Ⅰa期13例，Ⅰb期36例，Ⅰc期9例，Ⅱ期10例，Ⅲ期5例。50例行单纯手术治疗，24例行综合治疗。

Methˉods From January1984to June1994,there were74endometrial carcinoma cases,13in stage Ia,36in stage Ib,9in stage Ic,10in stageⅡ,5in stageⅢ.There were50cases who underwent the surgery only,and the other24cases unˉderwent the combined modality therapy.

1984年1月～1994年6月我院共收治子宫内膜癌74例，除1例因类行手术而未能分期的患者外，余73例按照1988年FIGO分期标准：Ⅰa期13例，Ⅰb期36例，Ⅰc期9例，Ⅱ期10例，Ⅲ期5例。50例行单纯手术治疗，24例行综合治疗。

As she looked at Warrington's manly face, and dark, melancholy eyes, she had settled in her mind that he must have been the victim of an unhappy attachment.

每逢看到沃林顿那刚毅的脸，那乌黑、忧郁的眼睛，她便会相信，他一定作过不幸的爱情的受害者。

Maybe they'll disappear into a pothole.

也许他们将在壶穴里消失