手术前的

Now my courtyard in January 2006, the cataract of gimmick small cut that undertook in January 2008 excises combination artificial crystalline lens appears to low eyesight patient has case study and be adopted after embedded operation nurse accordingly, obtain favorable result, report as follows now. 1 clinical data 1.1 average data in January 2006, the operation treated a patient in January 2008 562 (594), male 304, female 290; age 6 years old of ~89 year old, senile sex cataract 482 (504), traumatic sex cataract 26 (26), complication cataract 50 (60), congenital cataract 4 (4), light of the eyesight before art feels - 0.3, there is the person that force of backsight of art of apparent diagnostic effect restores 26 times before art, among them diabetic retinal pathological changes 10, pathological changes of senile sex yellow spot 8, glaucoma optic nerve is damaged 7 times, corneal blaze 1. Standard of 1.2 low eyesight diagnoses watch of eyesight of standard of standard application international to undertake checking according to our country low eyesight, optimal and correctional eyesight is in 3 months after art 0.05 above, but in 0.3 it is low eyesight standard below. 1.3 results 594 art hind are inchoate...

现将我院2006年1月—2008年1月进行的手法小切口白内障摘除联合人工晶状体植入手术后出现低视力病人进行原因分析并采取相应护理，取得良好效果，现报告如下。1临床资料1.1一般资料2006年1月—2008年1月手术治疗病人562例(594眼)，男304眼，女290眼；年龄6岁~89岁，老年性白内障482例(504眼)，外伤性白内障26例(26眼)，并发症白内障50例(60眼)，先天性白内障4例(4眼)，术前视力光感-0.3，术前有明显诊断影响术后视力恢复者26眼，其中糖尿病视网膜病变10眼，老年性黄斑病变8眼，青光眼视神经损害7眼，角膜白斑1眼。1.2低视力标准根据我国低视力诊断标准应用国际标准视力表进行检查，术后3个月最佳矫正视力在0.05以上，但在0.3以下为低视力标准。1.3结果594眼术后早期。。。

If the diabetes of patients with cataract can be controlled their glucose level in the blood remains normal and stable over three months, ECCE with IOL can be perfomed on such patients and the therapeutic results of the operation can be safe and reliable.

仅术前血糖高于正常水平并非是手术禁忌证，只要使术前空腹血糖稳定在与糖尿病病情相适宜的水平3个月以上，对糖尿病患者施行白内障人工晶体手术是有效且安全可靠的。

In order to improve the resection rate, decrease the operative mortality, complication morbidity and it is important to pay great attention to the unspecific symptoms of the epigastrium, Combined adoption of the current advanced imaging methods could result in increasing early diagnosis and essential for accurate determination of tumor resectability and operation designing.

腹部非特异性症状结合影像学检查可提高壶腹周围癌的早期诊断率；术前准确评估手术可切除性，制订合适的手术方案，以提高壶腹周围癌的手术切除率，降低手术死亡率、并发症发生率。

Methods 51patients with diabetes accepting various otorlaryngology-head and neck-surgical operation were adopted,regardless of previous treatments.Three days before operati on they all accepted regular insulin injecti on subcutaneously half an hour before three meals.The first dosage was roughly4～8U,then adjusted according to blood sugar levels.For the fasting patients who demanded fluid replacement post-operationalˉly,we infused solution in proportion to1U insulin/3～4g glucose and monitored everyday blood sugar in the meantime.The post-operational patient on liquid or semiliquid diet injected insulin subcutaneously before three meals,applied inˉsulin according to blood sugar level until end of perioperative period.

对51例接受耳鼻咽喉及头颈部不同类型手术的糖尿病患者，观察其围手术期并发症，并于术前3天改为三餐前0.5h皮下注射速效胰岛素治疗，根据血糖的测定结果，开始剂量约为4～8U；对术后禁食需要补液的患者，按葡萄糖3～4g/胰岛素1U的比例给药，并每日监测血糖指标；术后进流质或半流质饮食的患者，于三餐前皮下注射胰岛素，按血糖测定情况给药，直至围手术期结束。

Methods 1038 eyes of 606 consecutive myopic patiences who had bilateral Custom Vue LASIK between March 2006 and August 2006 were involved in the study. Wavefront measurement and iris registration were performed in the upright position with Wavescan aberrometer, then more over iris registrations were performed in the supine positon during the operation with VISX Star S4 IR.

选择成功接受波前像差虹膜定位LASIK手术的近视患者606例1038眼，术前应用Wavescan像差仪取坐位行波前像差检查和虹膜识别，术中应用VISX Star S4 IR手术，记录眼球旋转及瞳孔中心移位，对前后眼球旋转及瞳孔中心移位进行比校。

Methods: form january 1995 to january 2005, 42 patients with acute respiratory failure (acute respiratory failure group) and 84 random sampling after esophagectomy and cardiectomy were studied. age, sex, smoke index, preoperative respiratory function, preoperative pulmonary and the other complications, hypoproteinemia, the site of anastomosis, duration of operation, postoperative analgesia, postoperative other complications were compared by logistic regression analysis.

将1995年1月～2005年1月期间食管癌、贲门癌术后发生arf的42例患者临床资料，与按1∶2比例随机抽取的同期手术后未发生arf的84例食管癌、贲门癌患者的资料做对照，应用logistic回归分析比较两组患者的年龄、性别、吸烟指数、术前肺功能、术前有无肺部合并症和其它合并症、术前有无低蛋白血症、吻合口位置、手术时间、术后是否镇痛、术后有无其它并发症等与术后发生arf的相关强度，推测可能导致术后arf发生的危险因素。

The available operation range in clivus and anterior cranial base by transsphenoidal opproach was also observed during the operation under the help of neuronavigational pointer. Forty-one patients underwent sublabial, transseptal, transsphenoidal approach to the pituitary region guided by Surgical Microscope Navigation was studied. The piriform aperture was 27. 2mm±3. 1 , the origin of inferior nasal concha 30mm±4. 1, the origin of middle nasal concha 27. 9mm±4. 3. These data are important for transsphenoidal approach, because the piriform aperture and the origin of both inferior and middle nasal conchas restricted the opening width of the Hardy specula. If any distance of these bony structures was much less than the mean one, may cause inadequate opening of the specula blade and resulting dissatisfied operative field. Microadenomas or cystic tumors perhaps can be operated even in a narrow exposure, but large or giant solid adenomas may need a proper evaluation including changing the operative approach or performing a bilateral submucous inferior conchotomy or posterior ethmoidectomy firstly.

手术中还利用CT导航系统观察棒研究了经口—鼻蝶窦入路在斜坡区和前颅底能够达到的实际有效操作范围，为扩大经蝶窦入路手术在斜坡区和前颅底的应用奠定基础，在国内外尚未见同类报道。41例垂体瘤患者梨状孔平均宽度27.2mm±3.1，下鼻甲根部附着处间距30mm±4.1，中鼻甲根部附着处间距27.9mm±4.3，这是经口—鼻蝶窦入路手术中，对Hardy双瓣鼻窥器张开限制的主要骨性结构，若患者这些径线值明显小于平均值，则可能因为鼻窥器打开不充分而影响手术暴露，当然对于垂体微腺瘤和以囊变为主的垂体瘤可能影响不大，但对于大和巨大垂体瘤必须要有充分的准备，包括评估是否改用其他入路，或先行鼻甲切除再行经蝶手术。

Method］from january 2003 to may 2006,32 patients were corrected with qin si-he's orthotics devices on the ilizarov principle of tension-stress,which involved 15 males and 17 females,the age ranged from 10 to 25 years.among these patients,2 were caused by peroneal nerve injury,l by tumor in the vertebral canal,5 by meningocele,11 were caused by poliomyelitis,13 by congenital talipes equino-varus.in accordance with deformities,external fixator and limitied operative methods were dertermined.the limited release of soft tissue were performed in 7 patients,limited osteotomy in 25 patients.the dynamic muscle balance operation were performed in 9 patients with imbalance of muscle strength.according to the ilizarov technique,the fixative rods were installed.the telescopic rods on the apparatus were rotated one week after the operation,the divices had corrective function in three-dimensional directions.the deformity of talipes equinovarus,internal rotation and drooping of the forefoot were gradually corrected,and the patients could bear weight and walked on the deformed foot.the mean duration of traction were 42 days,then removed the external fixator maintained with plaster for a site time.

方法］2003年1月～2006年5月，根据ilizarov张力应力法则，应用秦泗河改良的外固定矫形器，遵循ilizarov穿针固定的基本原则，共手术治疗马蹄内翻足32例，男15例，女17例；年龄10～25岁，平均17岁。病因：腓总神经损伤2例，腰椎管内肿瘤1例，硬脊膜膨出5例，小儿麻痹后遗症11例，先天性马蹄内翻足13例。术前用足掌的前外缘负重行走者11例，用足的外缘或足背外侧负重者21例。根据马蹄内翻足畸形程度、性质和患者年龄，确定实施有限矫形手术的方法和外固定矫形器治疗。本组7例同期实施有限的软组织松解术，25例同期实施了有限的截骨术和跗骨间关节融合术，9例合并踝关节内外翻肌力明显失衡者，同期行足部肌腱转移的肌力平衡术。然后安装外固定矫形器。术后按作者制定的管理程序，7 d开始旋转相应的螺纹牵拉杆，对器械进行三维空间的缓慢调整，先矫正前足内收和后足内翻，后矫正足下垂畸形，直至达到矫形要求的标准。在矫形的过程中定期进行x线检测，以防止发生踝关节前后移位，治疗期间允许患足负重行走。术后平均牵伸42 d，拆外固定器后患足再上石膏固定适当时间。

［Objective］ To analyze the outcome of internal fixation for occipitalization with atlantoaxial joint dislocation by posterior decompression and occipitocervical fusion ［Method］ From December 2005 to June 2007,8 patients with occipitalization and atlantoaxial joint dislocation received removal of the posterior arcus of atlas and the enlargement of the posterior edge of the foramen magnum after skull traction performing for an average of 135 daysAll patients were operated on by posterior craniocervical fusion using cervifix internal fixation system and autologous ilium graftsThe clinical efficacy after operation was analyzed by Japanese Orthopaedic Associationneural function score ［Result］ All the patients were followed up from 6 months to 2 years, average of 15 monthsNo complication was foundAtlantodental interval was 5~9 mm before and 4~6 mm after skull tractionAtlantoaxial joint dislocation didn't completely reducedThe neurological defects were improved to some extents according to the JOA scoreImageology showed all patients had full decompression and bony fusionThe loosening or broken internal fixation was not found ［Conclusion］ Posterior decompression and fusion is a feasible method for the treatment of occipitalization with atlantoaxial joint dislocation,and the clinical effect is satisfactory

分析后路减压枕颈融合内固定术治疗合并寰枢关节脱位的寰椎枕骨化临床疗效。［方法］2005年12月至2007年6月间，对8例合并寰枢关节脱位的寰椎枕骨化患者在行颅骨牵引治疗一段时间（12~16 d，平均135 d）后采用枕骨大孔后缘扩大，寰椎后弓切除减压取自体髂骨枕颈融合Cervifix系统内固定术，手术后采用日本骨科学会神经功能评分分析临床疗效。［结果］8例患者随访6个月~2年，平均为15个月。8例患者无一例出现术后并发症，术前寰齿前间隙为5~9 mm，经颅骨牵引后为5~7 mm，寰枢关节脱位未能完全复位。手术前后JOA评分示神经症状均有不同程度恢复，影像学检查示枕颈区减压充分植骨区获得骨性融合，无一例出现内固定松动或断裂。［结论］合并寰枢关节脱位的寰椎枕骨化患者术前仔细评估影像学改变，采用颅骨牵引一段时间后行后路减压枕颈融合内固定术的治疗方案是合理可行的，且临床效果满意。

METHODS: In this study, we investigated the prevalence of depression in a presurgical inpatient sample undergoing major, noncardiac surgery.

本研究以非心外科手术外大型手术术前住院患者为研究对象，研究样本人群中术前抑郁症的患病率。

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。