例行的

Methods Thirty-five patients with refractory glaucoma were involved in this prospective and random trial at such high risks as neovascular, uveitis, aphakia, pseudophakic, and young ages. Complex trabeculectomy with single-layer AMT under the scleral flap was performed in 18 eyes and complex trabeculectomy without AMT in 17 eyes.

采用前瞻性随机对照临床试验研究，包括35例（35眼）具有高危因素如新生血管、葡萄膜炎、无晶状体、人工晶状体和发育性的难治性青光眼。18例行复合式小梁切除术联合巩膜瓣下单层AMT，17例行复合式小梁切除术。

Material and Methods:From March,2008 to January,2009,250 patients(146 Males and 104 Females,ranged from 18 to 82 years old,mean age was 48 years old) enrolled in the First Affiliated Hospital of Kunming Medical College were performed dual energy scan(Group A,200 patients) and Neuro-DSA scan(Group B,50 patients) using DSCT.The patients were randomly divided into Group A and Group B.Regarding to the justification of scan protocol,100 patients in Group A were selected as sub-group to explore the scan protocol.The image quality Was analyzed both in four categories(4.0/60、4.5/60、4.0/70、4.5/70) of flow rate and total amount of contrast-enhanced material and in three categories(100—150HU、150—200HU、200-250HU) of CT value of left common carotid artery.The comparison of two scan approach was based on image quality,radiation does, postprocessing methods,time of scanning and subtraction and data storage amount.To validate the diagnostic capability of DE-CTA virtual unenhanced images,100 patients in Group A were undergoing head scan both in routine non-contrast program and DE-CTA virtual unenhanced program.Mean CT values,signal-to-noise ratio,image quality,sensitivity of lesion identification,and radiation does were applied to comparison.According to diagnostic results of dual energy of cerebral arterial angiography,62 patients out of 200 patients in Group A were confirmed with cerebral vessel lesions,the results were complied with DSA findings(the time between the two methods were within 1 week).

材料与方法收集2008年3月到2009年1月间在昆明医学院第一附属医院行DSCT CTA检查者250例(男性146例，女性104例，年龄范围18-82岁，平均48岁)，随机分为A、B两组，A组200例行双能量头颅CTA扫描；B组50例行Neuro-DSA扫描。A组前100例按对比剂不同流率和总量分为4组(4.0/60、4.5/60、4.0/70、4.5/70)对图像质量比较；按触发时左颈总动脉内平均CT位分3组(100—150HU、150—200HU、200-250HU)，比较图像质量的差异；对A、B两组血管图像质量、辐射剂量、后处理的方法、扫描和后处理时间及数据的容量进行比较分析；A组中前100例行常规与DE-CTA虚拟平扫的平均CT值、信号噪声比、图像质量、病灶显示情况、辐射剂量的比较分析；A组中行DSA检查62例(两种方法间隔时间均1周内)，比较两种检查方法诊断结果是否符合，并对其中24例动脉瘤行动脉瘤部位、数目、形态、瘤颈显示程度、瘤颈大小及瘤体长径和短径的比较研究。

Methods The data of 16 cases of ureteral polyps were reviewed and discussed. 2 cases were treated with nephroureterectomy; 10 cases with local resection plus pyeloplasty or ureteral reimplantation; 4 cases with polyps resection plus basement fulguration.

回顾分析16例原发性输尿管息肉患者的临床资料，其中2例行肾输尿管大部切除术，10例行病变输尿管切除加肾盂成形术或输尿管再植术，4例行息肉切除加基底电灼术。

Methods:32 patients of TCPC were reviewed: the average age was 10 years,ranged from 5 to 24 years and the average weight was 28 kilogramme,ranged from 13 to 55 kilogramme.18 patients underwent lateral tunnel and 1 patient underwent extracardiac conduit TCPC with hypothermic cardiopulmonary bypass and heart arrest,and 10 patients were treated by extracardiac conduit technique with normothermic CPB and without heart arrest and 2 patients without CPB,and 1 patients underwent two-step operation.

回顾性分析32例全腔静脉肺动脉连接术患者的临床资料：年龄5～24岁，平均（10±5）岁，体重13～55 kg，平均（28±11） kg，病种包括单心室16例，右心室双出口并完全性心内膜垫缺损6例，完全性大动脉转位并完全性心内膜垫缺损3例，三尖瓣闭锁6例，二尖瓣闭锁1例。其中，在低温体外循环心脏停跳下18例行右房内侧隧道法，1例行心外管道法，常温体外循环心脏跳动下10例行心外管道法，非体外循环下2例行心外管道法，1例行分次全腔静脉肺动脉连接术。

objectiveto investigate the diagnosis and treatment of traumatic duodenal rupture.methodthe clinical data of 13 patients with traumatic duodenal rupture hospitalized from may 1991 to december 2008 were retrospectively analyzed,and the material cause was automobile accident mainly.resultsin these 13 patients,after hospitalization,6 cases were diagnosed in 3 hours,4 cases were diagnosed in 24～72 hours,and 3 cases were diagnosed after 72 hours.three cases with duodenal cleft repair,2 cases with duodenal ostomy,2 cases with duodenum and jejunum roux-en-y anastomosis,1 case with duodenal diverticular surgery,1 case with meliorative duodenal diverticular surgery,1 case with duodenal broken ends closure and anastomosis of stomach with jejunum,1 case with duodenal distal closure and anastomosis of duodenal local with jejunum,and 2 cases with resections of pancreas duodenum.after the operation,6 cases (46.2%) appeared some complications of wound infection,duodenal fistula,digestive tract hemorrhage,pancreatic fistula,abdomen infection and so on.two cases (15.4%) died from multiple system organ failure and septic shock.conclusionthe early diagnosis and correct operation style selection are the keys for duodenal rupture.

目的：探讨外伤性十二指肠破裂的诊断和治疗方法。方法：回顾分析外伤性十二指肠破裂患者13例临床资料。结果：入院后3 h内确诊6例，24～72 h内确诊4例，72 h后确诊3例。3例行十二指肠裂口修补，2例行十二指肠造瘘，2例行十二指肠空肠roux-en-y吻合，1例行十二指肠憩室化手术，1例行改良十二指肠憩室化手术，1例行十二指肠两断端关闭、胃空肠吻合，1例行十二指肠远端关闭、近端与空肠端侧吻合，2例行胰十二指肠切除术。术后6例(46.2%)出现切口感染、十二指肠瘘、消化道出血、胰瘘或腹腔感染等并发症，2例(15.4%)患者死亡，分别死于多器官系统衰竭和感染中毒性休克。结论：早期诊断与正确的术式选择是成功救治外伤性十二指肠破裂的关键。

Result:Among total of 80 cases with non-visualized kidney in IVP,renal parenchyma of 37 cases were non-visualized under ~(99m)Tc-DTPA renography,GFR was 0 ml/min,32 cases carried out nephrectomy;Renal parenchyma of the rest 43 cases were visualized under ~(99m)Tc-DTPA renography,GFR were(20.03±9.64) ml/L,among them 9 cases were carried out nephrectomy, 34 cases received kidney-sparing operation;The 34 cases(divided into 4 groups according to range of GFR) recheck ~(99m)Tc-DTPA renography 2 months later after the operation,Preoperative GFR within(1～10) ml/min,GFR were(4.25±2.99) ml/min,postoperative GFR were(4.00±2.94) ml/min,t=0.522,P＞0.05,indicated no significant change of GFR after the operation; Preoperative GFR within(11～20) ml/min、(21～30) ml/min、(31～40) ml/min groups, preoperative GFR were(15.38±2.63) ml/min、(24.83±2.92) ml/min、(34.25±2.75) ml/min, postoperative GFR were(17.77±3.79) ml/min、(29.42±3.90) ml/min、(40.25±3.50) ml/min respectively,paired t-test,P＜0.05,indicated that 2 months\' postoperative GFR increased significantly,the function of kidneys recovered in some degree.

结果：在80例IVP不显影患肾中，37例患肾在~(99m)Tc-DTPAI肾动态显像上肾实质不显影，GFR为0 ml/min，其中32例行患肾切除；43例患肾在~(99m)Tc-DTPA肾动态显像上肾实质显影，GFR为(20.03±9.64)ml/L，其中9例行患肾切除，34例行保留肾手术；34例保留患肾手术者(根据术前GFR在不同值范围分为4组)在术后2个月返院复查~(9m)Tc-DTPA肾动态显像，GFR值在(1～10)ml/min组(5例)，术前GFR为(4.25±2.99)ml/min，术后2月GFR为(4.00±2.94)ml/min，t=0.522，P＞0.05，表明术后GFR无明显变化；术前GFR在(11～20)ml/min(13例)、(21～30)ml/min(12例)、(31～40)ml/min组(4例)，术前GFR分别为(15.38±2.63)ml/min、(24.83±2.92)ml/min、(34.25±2.75)ml/min，术后2月复查GFR分别为(17.77±3.79)ml/min、(29.42±3.90)ml/min、(40.25±3.50)ml/min，经配对t检验，P＜0.05，有统计学意义，术后2月GFR较术前增高，肾功能有不同程度的恢复。

Methods: Thirtythree patients were reported. Clinical manifestation,imaging findings including the computer tomography, magnetic resonance and digital substruction angiography were analyzed.

对33例椎基底动脉系统脑梗死患者的临床资料进行回顾性分析。1例行CT检查，32例行头颅核磁共振检查。2例行CT血管成像检查，2例行磁共振血管成像检查，4例行脑血管数字减影检查。

This paper introduces environmental routine test and its effect at first,gives an application example in delivering a product,and points out its deficiency.

本文首先介绍了环境例行试验及其作用，给出了环境例行试验在某型号产品上的应用实例，指出了环境例行试验的不足之处。

Cases underwent bilateral TMJ reconstruction, bone graft and genioplasty in order to advance the jaw. Bimaxillary surgical procedure was completed in 3 cases, and distraction osteogensis and TMJ reconstruction in 6 cases. Al patients gained good appearance, 29 patients can open their mouth larger than 3 cm, and one case had recurrent TMJ ankylosis. 29 cases'AI＜5 and oxygen saturation degree ＞90%(included the patient that had recurrent TMJ ankylosis).

结果 本研究有15例患者接受患侧下颌升支倒置TMJ重建、植骨前移，健侧升支矢状劈开、下颌前移和颏前移成形术；其中有3例行二期的上颌的Le Fort Ⅰ截骨术。6例行双侧TMJ重建、植骨前移下颌和颏成形术。3例施行同期双颌截骨前移和颏成形术；6例行单或双侧TMJ重建、牵引成骨术。

No sleep no time no mercy i gotta hit em low low ground i'm low key when i spit it less carb more protein my body fitted one step to two step the routine no sign of morphine my body need iy take a trip to oc to cop live it just sip the caffeine i gotta get it one step to step the routine got it now it's going down now no time dont mess boy let's show you how just to move it let me show you just to groone now come inside let me show you how no time dont mess around boy let show you how just to move it work it out lets do girl so flwxible, accessible so hot like the sunshine mexico just feel the beat mr.bexter flow so hot so hot hot check the routine work it out just work it out mr.bexter jc turm it out sing it so fly show you what i'm about so hot so hot hot check the routine got it now it's going down now no time dont mess boy no time baby dont mess around check the routine now lets get down come inside let me show you how no time dont mess around boy no time baby dont mess around check the routine now lets get down

没有睡的时间没有怜悯我得打时间低低地，我低调，当我吐出来减少碳水化合物的蛋白质我的身体装一步一步的两个常规没有迹象吗啡需要我的身体是Iy 采取以法团，前往现场有警察刚喝咖啡因我得得到它一步步走向常规现在得到它现在下降没有时间请勿乱男孩让我们告诉您如何只将它让我告诉你现在只是groone 里面让我来告诉你如何周围没有男孩的时间请勿乱让我们告诉您如何只将它的工作中可以做女孩如此flwxible，访问这么热的阳光一样墨西哥只是觉得节拍mr.bexter流这么热这么热热例行检查工作，这只是工作中出 mr.bexter Jc的页转到出来这样唱飞告诉你什么，我对这么热这么热热例行检查现在得到它现在下降没有时间请勿乱男孩没有时间大约婴儿请勿乱现在的例行检查可以坐下里面让我来告诉你如何周围没有男孩的时间请勿乱没有时间大约婴儿请勿乱现在的例行检查可以坐下

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