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Methods:9 patients including 8 male and 1 female were included in this study.2 patients suffered from both side of ANFH,5 were righe side and 2 were left side.X-ray,CT and MRI were performed before the surgery.4 hips were classified as ARCO stage 1,7 hips were stage 2.All the patients were treated as follows:the area of NFH and cystis degeneration were detected and bouche decompression was done through X-ray with C-arm,and the necrotic bone was cleared for the pathologic diagnosis under the monitoring of arthroscopy.And then the non-cell based tissue engineering bone, which was the complex of autologous red bone marrow and osteoinductice absorbing material containing BMP,was transplanted into the body.

本组9例,男性8例,女性1例;双侧股骨头坏死2例,右单侧股骨头坏死5例,左单侧股骨头坏死2例;术前均行X线摄片、CT、MRI 检查,ARCO分期:Ⅰ期4髋,Ⅱ期7髋;C型臂X线透视下行股骨头坏死区和囊性变区定位、髓芯减压,关节镜监视下,刮除坏死骨送病理;植入由自体红骨髓与含BMP的骨诱导活性材料复合成的非细胞型组织工程骨,并用空心钛钉支撑股骨头软骨下骨质。

The uncovered tracts and the liver wound surface were managed by some of the methods combined such as high frequency electrocoagulation, titanium clamp, suture, hemostatic gauze oppression, argon-beam coagulation, protein glue adherence, and Endo-GIA switcher. The total operative outcome, operating time, blood loss, postoperative complications and postoperative hospital stay were summarized in order to assess feasibility and safety of the clinical laparoscopic liver resection.Results: 1. Laparoscopic liver resection with clamp dissection method needs only the ordinary laparoscopic equipment. It has a low cost but causes a little more bleeding. 2. Laparoscopic liver resection operated by microwave tissue coagulation method had very little bleeding when dissecting hepatic parenchyma. The operative field is clear and the cost is low. It is a safe, convenient and effective method. 3. Ultrasound dissector is a relatively ideal appliance for laparoscopic liver resection at present because ofless bleeding during operation. But the speed is slow thus prolongs the operation time. Its separating intensity is not strong enough, and it can only be applied to patients without hepatic cirrhosis. 4. Ligsure has clamp dissection and electrocoagulation functions. It can carbonize hepatic tissue including the tracts whose diameters are less than 7mm. It has some advantage in dissecting. However, it has the shortcomings of the clamp dissector during coagulating. 5. Hand-assisted laparoscopic liver resection can make use of the flexibility and feeling of the operators left hand.

结果:1、钳夹分离切肝法不需特殊仪器设备,只要具备常规的腹腔镜器械即可实施,成本低,肝断面较易渗血;2、微波固化切肝法肝实质出血很少,视野清晰,成本低,操作简单,是一种安全、简便、有效的方法;3、超声刀是目前较为理想的切肝器械,术中出血少,但是,切割速度慢,手术时间长,而且,切割强度有限,适用于无肝硬化的肝切除;4、Ligsure具有挤压粉碎及高频电凝止血两大功能,可使包括7~以下管道的肝组织碳化、形成焦痴,具有一定的优势,但是,也存在分离钳电凝止血的缺点;5、手辅助腹腔镜肝切除可以利用术者左手的灵活性及手感,便于术中显露、分离、控制出血等,可随意协助右手及助手的主要操作,缩短了手术时间,大大提高了腹腔镜肝切除的安全性,李朝龙等的改良方法,同样达到了手辅助目的,又节省了费用;6、小切口腹腔镜辅助切肝法可以使用剖腹肝切除常规器械及剖腹肝切除技术,操作简单、可靠,适用于肝左外叶切除及右肝第V段切除;7、Endo一GIA切肝法在离断肝组织的同时闭合管道结构,多用于肝左静脉、门静脉分支、管径较大胆管的切割,缺点是不能用于较厚肝组织的切割,而且价格昂贵;8、临床巧例腹腔镜肝切除均获得成功,手术时间最短1.5h,最长sh,平均125 min,多数在100 min左右,手术出血量最少50 ml,最多500 ml,平均1 78 ml,除2例合并严重肝硬化的原发性肝癌患者术后出现少量腹水,1例术后发生胆漏外,其余无并发症,发生胆漏的1例患者术后住院40d,多数在术后一周左右出院,术后住院时间5一40d,平均gd。

The brand-new electric and manual adjustable big curved, wide vision rear mirror, right under view mirror, wide view mirror, front under view mirror increase vision areas and effectively eliminate blind area.The original cab windshield and window heater which has withstood severe test under temperature of minus 30℃ in Heihe, a freezing cold area of Northern China, defrosts quickly and provides good field of vision under all weather conditions for the drivers.The high luminous crystal patternless halogen headlamp features dual lamps illuminating functions. Equipped with steering auxiliary lamp, it effectively widens visual angle when the vehicle turns and ensures safety when driving during nighttime.

全新电动及手动调整的大曲面、大视野后视镜,右俯视镜、广角镜、前下视镜增加可视区域,有效消除盲区;独创的驾驶室风挡、车窗暖风,除霜快捷,经历中国高寒地区黑河零下30度的严峻考验,为驾驶员提供全天候良好的视野保障;水晶无花纹卤素大灯,亮度高,具有双灯点亮功能;豪华版匹配转向辅助照明灯,在车辆转弯时,能有效扩大视角,保障夜晚驾驶同样安全。

A magma ''Q'' is a quasigroup precisely when these operators are bijective. The inverse maps are given in terms of left and right division by

原群 ''Q''是拟群当且仅当这两个变换是双射变换,而且它们的逆变换给出了右除和左除变换

In an attempt to determine non-invasively the sino-atrial conduction time, we recorded the sinus node electric activity by placing bipolar electrodes at the level of the right atrium anteroposteriorly across the chest of the dog.

本实验采用成年狗,以6极心导管电极从颈外静脉插至上腔静脉与右心房交界处,能记录到一个在心电图P波以前19—26毫秒的&P前波&。通过夹除窦房结和高血钾等实验证明,&P前波&可与P波分离而存在,并随窦房结夹除而消失。

The following delighting results were observed: in general, Grandma could take care of herself, her verbal ability greatly improved and made effective communication possible though some individual words were indistinct, the myodynamia of her right arm was enhanced to level 4-5, and that of her right leg to level 5, her blood pressure returned to the normal values, 138/80mmHg, and she could independently perform the daily activities such as taking a shower, getting dressed, and eating meals.

至患者病后第20天止,患者生活自理能力已基本恢复,语言能力也得到了大幅度改善,除个别字词说不清之外,其余已无大碍,右上肢肌力恢复至4-5级,右下肢肌力5级。血压回复到正常范围内138/80mmHg ,洗澡、穿衣、吃饭等日常琐事已可自行打理,无需他人帮忙。

The causes were right auricle injury by violently placing a electric catheter to it (n=2),coronary sinusinjury by violently placing a electric catheter to distal CS (n=3) and by intracardiac electric defibrillation using electric catheter electrodes of high right atrium and CS as current loop(n=1),perforations of right atrial wall (n=3) and left atrial wall(n=2) by sliding up of the transseptal set,and perforation of left auricle by misplacing the mapping catheter of left superior pulmonary vein to it (n=1). 10 cases of acute tamponade occurred during operation, and 2 after operation.12 patients were treated successfully with urgent pericardiocentesis, and no patients required emergency surgery.

引起心包填塞的原因有:①放置电极导管至右心耳时用力过大致右心耳损伤(2例);②放置电极导管至冠状静脉窦时,因导管不易进入远端而用力过大致CS损伤(3例);③心内电除颤时采用高位右房和CS电极作回路,致CS损伤(1例);④房间隔穿刺系统向上滑动穿破右房(3例)和左房(2例);⑤放置左上肺静脉标测电极时导管误入左心耳致其穿孔(1例)。10例急性心包填塞出现于术中,另2例术后发生。12例患者经紧急心包穿刺引流均成功治愈,无1例需外科急诊手术。

The causes were right auricle injury by violently placing a electric catheter to it (n=2),coronary sinusinjury by violently placing a electric catheter to distal CS (n=3) and by intracardiac electric defibrillation using electric catheter electrodes of high right atrium and CS as current loop(n=1),perforations of right atrial wall (n=3) and left atrial wall(n=2) by sliding up of the transseptal set,and perforation of left auricle by misplacing the mapping catheter of left superior pulmonary vein to it (n=1). 10 cases of acute tamponade occurred during operation, and 2 after operation.12 patients were treated successfully with urgent pericardiocentesis, and no patients required emergency surgery.

引起心包填塞的原因有:①放置电极导管至右心耳时用力过大致右心耳损伤(2例);②放置电极导管至冠状静脉窦时,因导管不易进入远端而用力过大致CS损伤(3例);③心内电除颤时采用高位右房和CS电极作回路,致CS损伤(1例);④房间隔穿刺系统向上滑动穿破右房(3例)和左房(2例);⑤放置左上肺静脉标测电极时导管误入左心耳致其穿孔(1例)。10例急性心包填塞出现于术中,另2例术后发生。12例美白患者经紧急心包穿刺引流均成功治愈冬季,无1例需外科癌症急诊预防手术胃痛。

For the later 14 cases,five complications occurred,including acute reject reaction(1 case),hepatic artery thrombosis(1 case),bile leakage(1 case),left subphrenic abscess(1 case),and pulmonary infection(1 case).The patient with pulmonary infection died of MODS.14 patients underwent direct anastomosis of right hepatic vein and IVC.Among them,5 cases underwent the reconstructions of right inferior hepatic vein,and 5 received the reconstruction of the tributaries of the middle hepatic vein by interpositing a vein graft to provide sufficient venous outflow.

后14例受者中发生并发症5例:急性排斥反应,肝动脉栓塞,胆漏,左膈下脓肿及肺部感染各1例;1例再移植术后肺部感染死于MODS.14例中除肝右静脉与下腔静脉直接吻合外,其中5例加行右肝下静脉重建,另5例采用自体大隐静脉搭桥行肝中静脉分支与IVC重建,保证了右肝的流出道通畅。

For the later 14 cases, five compli- cations occurred, including acute reject reaction (1 case), hepatic artery thrombosis (1 case), bile leakage (1 case),left subphrenic abscess (1 case), and pulmonary infection (1 case). The patient with pulmonary infection died of MODS. 14 patients underwent direct anastomosis of right hepatic vein and IVC. Among them, 5 cases underwent the reconstructions of right inferior hepatic vein, and 5 received the reconstruction of the tributaries of the middle hepatic vein by interpositing a vein graft to provide sufficient venous outflow.

后14例受者中发生并发症5例:急性排斥反应,肝动脉栓塞,胆漏,左膈下脓肿及肺部感染各1例;1例再移植术后肺部感染死于MODS.14例中除肝右静脉与下腔静脉直接吻合外,其中5例加行右肝下静脉重建,另5例采用自体大隐静脉搭桥行肝中静脉分支与IVC重建,保证了右肝的流出道通畅。

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