切除神经

The particular adantage of the en bloc, as opposed to intralesional, resection of cartilaginous tumors is that this reduces the likelihood of local contamination, which in turn stands to decrease the risk of local recurrence Howeer, the cartilaginous cap is more difficult to excise completely if the tumor protrudes into the neural foramens or spinal canal, as it did in our patient.

切除带软骨成分的肿瘤时，整块切除相对囊内切除的突出优点是：减少了局部污染可能，继而减小了局部复发的风险。如果肿瘤突入椎管或神经孔时，彻底切除软骨帽则会更加困难，本病例就是这样。

Pleomorphic adenoma is the most common gland tumor of parotid origin, accounting for 60 to 70%. This kind of tumor usually presents as a slow-growing painless mass anteroinferior to the ear. The diagnosis is based on physical examination, image studying and even fine needle aspiration biopsy. The optimal method of treatment of such tumors is local excision or paroidectomy in which the entire capsule is totally dissected off but the facial nerve is spared. Diagnosis and treatment planning are focused on preventing tumor recurrence and consequent malignant transformation.

腮腺之多形性腺瘤乃是唾液腺最常见的肿瘤，约占所有唾液腺良性肿瘤的百分之六十至七十，这类的肿瘤在临床上的表现常是耳下缓慢增生的无痛性肿块，临床上诊断的依据必须配合临床检查、电脑断层扫描、磁振造影及细针抽取切片的病理检查方可得知，其治疗方式主要是对肿瘤进行局部切除手术或腮腺的切除手术，手术中颜面神经需小心保留，但须将肿瘤的外膜部分切除乾净，诊断及治疗计画著重在预防肿瘤复发及肿瘤产生恶性转变。

The bone resection was divided into four steps via FLA:① drilling of the jugular tuberculum;② partial mastoidectomy;③ removal of the occipital condyle;④resection of the lateral mass of C1 with mobilization of the vertebral artery. After each step of the bone resection was completed, the exposed area of the central clival depression and the area of exposure 15 cm above the central point were calculated.

利用CT和立体定向仪对20例甲醛溶液固定的头颅标本标记斜坡中央凹陷区中心点，采用FLA入路，骨切除分四步进行：磨除颈静脉结节，部分乳突切除，枕髁全切，C1侧块切除；分别于每一步骨切除及血管神经牵拉完成后测量斜坡中央凹陷区的显露范围和位于中心点上方15 cm处术者的操作范围。

Methods Central point at the central clival depression was marked with the help of CT and stereotactic apparatus in 20 formalin-fixed cadaveric heads. The bone resection was divided into four steps via FLA:① drilling of the jugular tuberculum;② partial mastoidectomy;③ removal of the occipital condyle;④resection of the lateral mass of C1 with mobilization of the vertebral artery. After each step of the bone resection was completed, the exposed area of the central clival depression and the area of exposure 15 cm above the central point were calculated.

利用CT和立体定向仪对20例甲醛溶液固定的头颅标本标记斜坡中央凹陷区中心点，采用FLA入路，骨切除分四步进行：磨除颈静脉结节，部分乳突切除，枕髁全切，C1侧块切除；分别于每一步骨切除及血管神经牵拉完成后测量斜坡中央凹陷区的显露范围和位于中心点上方15 cm处术者的操作范围。

The treatment of choice for osteoblastoma of spine is complete surgical resection, and the neurologic deficits can recoer completely after operation.16–18 Surgery is aimed at complete resection, preention of recurrence, and protection of the sensitie neuroanatomic structures.

脊柱成骨细胞瘤治疗方案为彻底外科切除，术后神经功能完全恢复。手术重点在于完整切除，防止复发，保护重要的神经解剖结构。

If by means of a prereduction MRI or after neurologic deterioration during closed reduction, the surgeon becomes aware of a fragment of disc material displaced into the spinal canal, then an anterior discectomy, open reduction, fusion, and plating becomes necessary.2,7,9 In approximately half of the cases, a closed reduction will be successful in reducing the dislocation before surgery.50 In the majority of the others, an intraoperative reduction performed after the discectomy and decompression will achieve anatomic reduction.9,51 For those patients in whom an anterior discectomy and decompression have not been successful in reducing the dislocation, then a supplemental posterior open reduction should be performed.52

假如借助MRI检查，或在闭合复位过程中神经症状进一步加重，外科医生意识到有椎间盘碎片突入了椎管，此时就需要前路椎间盘切除减压、开放复位和固定融合。大约有一半的病例手术以前能够通过闭合复位来成功的将脱位复原，剩下的病例则需要在术中将椎间盘切除减压来达到解剖复位。假如有病人经过前方的椎间盘切除和减压后仍然不能成功的还原脱位，则需要再行后方的开放复位术。

Pancreatoduodenectomy is the routine operation performed for pancreas carcinoma. There is also operation plan suggesting the resection of the nerve plexus and soft tissue distributing along the artery vessels, and the nerve fiber bat around the pancreas. This operation is also named as skeletonization of the vasculature.

胰腺癌的主要治疗措施是根治性胰十二指肠切除术，也有的手术方案还建议切除胰腺周围沿动脉血管分布的神经丛和其他软组织，全部切除胰周区域的神经纤维板，即所谓的血管骨骼化。

Objective To study the pathogenesis and clinical symptoms of patient with central type of interˉvertebral disc protrusion manifested intermittent claudication as the mainly clinical presentation,so as to reach the early diagnosis and treamtmet in time.Methods In58cases,X-ray film,lumbar discography,CT examinations were done to confirm the diagnosis,then total laminectomig was performed to reveal the vertebal body without involving small arˉticular process.Intervertebral tissue was excised via duralotomy approach in2cases in remaining56cases,through right and left longitudinal syndesmotomy to resect the nucleus pulposus of lumber intervertebral disc.Results In58cases treated by operation,the operative findings were in according with the X-ray and CT examinations ofpre-opˉeration.

目的 对呈间歇性跛行主要临床表现的中央型椎间盘突出症患者的发病机制和临床表现进行研究，达到早诊断、早治疗方法对58例患者进行X线拍片，腰椎碘造影，CT扫描检查，根据检查结果确诊后，采用全椎板切除显露椎体，未累及小关节突，2例经硬膜切开入路切除间盘组织，余56例经从双侧用神经剥离子带棉片将硬脊膜带神经根向中线剥拉至显露圆形突出物止，分别从左右纵韧带摘除髓核。

Methods In58cases,X-ray film,lumbar discography,CT examinations were done to confirm the diagnosis,then total laminectomig was performed to reveal the vertebal body without involving small arˉticular process.Intervertebral tissue was excised via duralotomy approach in2cases in remaining56cases,through right and left longitudinal syndesmotomy to resect the nucleus pulposus of lumber intervertebral disc.Results In58cases treated by operation,the operative findings were in according with the X-ray and CT examinations ofpre-opˉeration.

对58例患者进行X线拍片，腰椎碘造影，CT扫描检查，根据检查结果确诊后，采用全椎板切除显露椎体，未累及小关节突，2例经硬膜切开入路切除间盘组织，余56例经从双侧用神经剥离子带棉片将硬脊膜带神经根向中线剥拉至显露圆形突出物止，分别从左右纵韧带摘除髓核。

Heart malformation, such as PTA, DORV, VSD and aortic arch malformation, were detected when neural crest were taken out before they migrated into 3, 4, 6 pharyngeal gland. Interestingly, the types of malformation were related with the length of neural crest destroyed; PTA was detected if the length exceeds two somites, while DORV would be detected if the length less than two somites. These results indicate that CNCCs are very important to the conotruncal development.

研究发现，如果在迁移之前切除散发到第3、4、6咽弓的神经嵴细胞，就会出现永存动脉干、主动脉骑跨、右室双出口、主动脉弓畸型和室间隔缺损等心血管畸形，且切除的长度与畸形的种类相关，如切除长度大于两个体节可产生永存动脉干，切除长度小于两个体节则产生右室双流出道，由此可见，心脏神经嵴细胞对于心脏圆锥部的发育意义重大。

The split between the two groups can hardly be papered over.

这两个团体间的分歧难以掩饰。

This approach not only encourages a greater number of responses, but minimizes the likelihood of stale groupthink.

这种做法不仅鼓励了更多的反应，而且减少跟风的可能性。