手术间

METHODS: Models of ALIF, PLIF and TLIF were simulated. After examination as normal group, the samples were randomly divided into three groups (n=5). Besides anterior, posterior and transforaminal lumbar interbody fusion include anterior, bilateral pedicle screw fixation was performed.

模拟临床手术建立前路椎间融合术、后路椎间融合术、椎间孔入路椎间融合术3种椎间融合术模型，先将所有标本作为正常对照组进行测试，然后将标本随机分为3组，每组5个标本，制成单纯椎间融合组，分别采用3种椎间融合术测试后，在此基础上再附加双侧椎弓根螺钉内固定进行测试。

Explore the connection between family values and "greater", other-than-general values, for example, the way in which Take a modern case of the quarrel between the duties of office and the imperatives of religion: a doctor is devoted to reducing pain and preserving life but Christian Science parents refuse permission to let the doctor give a necessary bone-marrow transplant; in their view, faith alone does the healing and what is more, permitting the treatment would endanger the child's life because it would issue from lack of faith.

探讨家庭价值与更「深刻」、非一般价值间的联系，举例来说，生活在现代，出现介於工作职责与宗教规范间的争论：医生的责任是解除痛苦、保存生命，但如果基督科学教的双亲拒绝让医生进行必要的骨髓移植手术，对双亲而言，信仰即足以诊治，而允许手术可能会危害到孩子的生命-这意味信仰不虔诚。

Dr. Glasser reviewed the records of 139 women (mean age, 38.9 years; range, 23-56 years) who underwent minilaparotomy myomectomy between January 1995 and December 2003. The procedure was performed through a four- to six-inch suprapubic cruciate incision using an atraumatic Mobius retractor, thus allowing more operating surface area than a Pfannensteil incision.

Glasser医师所分析的资料包含139位女性患者(平均年龄38.9岁，年龄介於23到56岁)，这些患者都在1995年1月至2003年12月间，以小型腹腔手术去除子宫肌瘤；手术方式为先在耻骨上作一4到6英吋的十字型手术切口，再以非创伤性的Mobius(Apple Medical公司供应)牵开器将手术切口撑开；相较於Pfannensteil切割法，此法会产生的较大的手术表面积。

The comparison of blood loss and operation score between two neighboring groups both showed no significance. Also, we found significant difference between group4 and group 7, as well as group5 and group 7 in their operative time comparison (P=0.045 and 0.028, respectively). No complications but a slight subcutaneous emphysema happened on the 21 cases.3. When the electronic pulse-wave mode insufflator is working, IAP of patients may reach 40mmHg, more than twice of the setting point, 15mmHg.

相邻两组的手术时间比较为第5组与第6组间差异有显著性(P=0.034)，相邻两组的出血量比较差异均无显著性(P值分别为0.273，0.607，0.731，0.494，0.863，0.494)，相邻两组的手术得分比较差异均无显著性P值分别为0.761，0.729，0.344，0.873，0.074，0.816非相邻组别的手术时间比较为第4组与第7组、第5组与第7组间差异有显著性(P值分别为0.045，0.028。

Six cadavers were prepared for necroscopy, operative procedure of ILIF were simulated on L3-S1, and all related important anatomic structure and their relationship were observed and record. ILIF with transpedicle screw fixation were also performed with cage insertion.3. Twelve fresh frozen bovine lumbar functional spinal units were prepared for biomechanical testing. According to the different treatment order, the specimens were devided into 7 groups, which included: 1intact specimens, 2specimens were treated by left unilateral facetectomy and had homolateral anatomical threaded cages inserted, 3 TLIF with homolateral pedicle screw fixation, 4 TLIF with bilateral pedicle screw fixation, 5 specimens had anatomical threaded cages inserted on the left by intertransverse process approach, 6 ILIF with homolateral pedicle screw fixation, 7 ILIF with bilateral pedicle screw fixation.

方法1、对20名正常志愿者L3-S1节段进行CT增强+三维重建检查，在三维重建图形上测量横突长度、上下横突间距、椎间孔外椎间隙高度及斜径，观查横突间区域血管走形特点并测量血管内径，然后进行统计分析及评价。2、采用福尔马林固定尸体标本六具，模拟ILIF手术对L3-S1节段进行操作，观察横突间区域重要结构的位置和毗邻关系，并模拟同侧椎弓根钉和单枚椎间融合器的置入过程，探讨该术式存在的问题并改进。3、采用小牛脊柱运动节段标本12具，依序进行不同处理后分为以下7组：⑴正常对照组CG⑵左侧小关节切除+椎间融合器植入组(TLIF⑶TLIF附加同侧椎弓根钉固定组；⑷TLIF附加双侧椎弓根钉固定组；⑸左侧横突间入路椎间融合器植入组ILIF⑹ILIF附加同侧椎弓根钉固定组；⑺ILIF附加双侧椎弓根钉固定组。

objective the purpose of this study was to summarize our experience of the application of internal rigid fixation with miniplate to treatment of mandibular fractures.methods a retrospective analyisis of clinical data of 67 cases,who had experienced the anatomic reduction and rigid fixation by using miniplate.with the help of maxillomandibular distraction pre operation and post operation and temporary maxillomandibular fixation during operation,the fracture bones were smoothly reduced and fixed.results clinical and radiographic examination showed that all cases gained good clinical results and precise anatomic alignment of fracture postoperatively without infection,malocclusion,bone malunion or other complications.conclusion mocortical miniplate fixation of the mandible is a reliable and effective techinique providing rigid fixation and an ideal modality for the treatment of mandibular fractures.combined with maxillomandibular fixation.

对67例下颌骨骨折患者的临床资料进行回顾总结，所有患者应用小型接骨板行坚固内固定治疗。其中7例颏部骨折，12例颏旁骨折，16例颏孔区骨折，9例体部多发性骨折，5例体部粉碎性骨折；18例合并其他部位骨折。所有患者术前经临床检查和影像学检查明确骨折的位置和骨折线的数目后，分段牙弓夹板结扎、颌间弹性牵引，使移位的骨折段逐渐复位；术中经口内切开复位、细钢丝颌间结扎、小型接骨板坚固内固定；术后行临床检查和影像学复查，必要时颌间弹性牵引7～10 d。结果所有患者手术切口ⅰ期愈合，治疗效果满意；临床检查所有患者牙合关系良好、面部对称；影像学复查证实骨折线对位良好。结论经口内切开小型接骨板坚固内固定辅以颌间固定治疗下颌骨骨折效果可靠，术后并发症少，是一种理想的手术方法。

First 27 rabbits of the experimental group were destabilizated by operated on L6、7.Inj Diazepam 0.25 mg/kg,Inj Ketamine 0.02 g/kg and Inj Atropine 0.125 mg/kg was one by one injected into the rabbit through the auris vein,shearing the rabbit hair of backside waist,fixing the rabbit on operation table in face lying,using 1% Povidone Ioding to degerm the operation area.Every rabbit was incised at the backside of its waist,that incisal opening is located in the center of the intervertebral space (L6、7 space) that both side iliac crest line correspond ,from the meso-ordinate direction cut about 4 cm incision,cutting open skin and subcutaneous tissue,thoroughly ,exposing the spinous processes the vertebral plates and the upper-inferior articular processes,entirely segregating the muscles that cohere the spinous processes the vertebral plates and the articluar process,then excising the supraspinal ligaments and interspinal ligaments,biting off two sides the inferior articular processes of L6,in order that resulting in intervertebral destabilization,using 0.9% Inj.Sodium Chloride to washout the incisal opening,in order sewing up each layer tissues.

方法］ 取48只6个月龄日本大耳白兔，雌雄不限，体重为（2.5±0.2） kg，随机进行分组，分为对照组和实验组，对照组为21只；实验组为27只；先将实验组兔腰背部皮毛剪除，用安定注射液1.25 mg/kg、氯胺酮0.02 g/kg、阿托品0.125 mg/kg顺次耳缘静脉注射麻醉后，俯卧固定于手术台上，用1%碘伏消毒手术区域，以髂嵴平对椎间隙（即L6、7）为中心，从正中取一长约4 cm纵行切口，切开皮肤及皮下组织，锐性分离，暴露棘突、椎板及上下关节突，将附着于棘突、椎板及小关节的肌肉全部分离开，然后依次切除L6、7棘上及棘间韧带，咬除第6腰椎两侧下关节突，造成椎间失稳，用无菌生理盐水冲洗切口，依次缝合各层组织；术后动物在笼中自由活动。

ConclusionTo begin with, the blood supply is adequate in the intertransverse area, and the distribution of blood vessels follows some regularities, so to be familiar with the anatomy and to operate carefully can reduce bleeding.

同时腰椎横突间及小关节区域常为诸多腰椎手术所涉及，临床上在处理这一区域时常会因损伤血管，引起出血不止而导致手术视野不清并影响手术操作，同时大量的出血可影响患者的手术耐受性，增加发生输血相关并发症的风险，尤其对ILIF手术，如忽略对此区域解剖结构和血管走行的认识将可能影响手术成功施行。

These three internal fixations of femoral peritrochanteric fracture were differ. For example, Gamma nail is less harmful, better clinical treatment, shorter in shape and stronger in anti-hip inversion. DHS, DCS have a better treatment and are stronger in anti-hip inversion but more harmful and excessive bleeding, and HCS, which is named Minimally Invasive Surgery, is the least harmful, less bleeding, suitable for old patients and the patients of tolerance of poor operation, but poor in anti-hip inversion.

3种不同方法内固定治疗转子间骨折具有各自的特点，Gamma钉具有手术损伤小及良好的临床疗效力臂短对抗髋内翻的能力强；滑动加压鹅头钉具有良好的临床疗效及相对坚强的抗内翻能力，但手术损伤相对较大，失血量较大；空心加压螺钉固定的手术损伤最小，属于微创手术方法，可经皮完成，手术出血少，适用于高龄及手术耐受性差的患者，但抗髋内翻的能力最差。

The results showed that (1) the intervention of preoperative pain education resulted in statistically significant reductions of worst pain intensity after surgery in experimental group compared to control group,(2) subjects in the experimental group experienced statistically significant reductions of pain interference in general activity, mood, and sleep, compared to control subjects,(3) the misbeliefs about pain management were significantly improved after surgery in experimental group compared to control group,(4) no statistically significant differences were found in the score of satisfaction with pain management, or amount of analgesics between the two groups.

研究结果显示：（1）实验组接受手术前疼痛卫教介入措施后，手术后最剧烈疼痛强度低於控制组达统计上显著差异。（2）实验组手术后疼痛对日常生活、情绪及睡眠的干扰程度低於控制组，达统计上显著差异。（3）手术后实验组错误疼痛处置信念的改善程度，与控制组达统计上显著差异。（4）手术后的疼痛处置满意度及止痛药使用剂量，两组间无统计上显著差异。

This one mode pays close attention to network credence foundation of the businessman very much.

这一模式非常关注商人的网络信用基础。

Cell morphology of bacterial ghost of Pasteurella multocida was observed by scanning electron microscopy and inactivation ratio was estimated by CFU analysi.

扫描电镜观察多杀性巴氏杆菌细菌幽灵和菌落形成单位评价遗传灭活率。