手术间

Because of the complications of abdominal organs injury or retrograde ejaculation after ALIF, and the high risk of nerve injury after PLIF, these two surgeries were reduce to perform in clinic nowadays. While TLIF has be consider to have less risk of injuries of nerve root, cauda equine, dura matar, and less incidence of lumbar unsteadiness and spondylolithesis.

研究背景腰椎椎体间融合术是目前治疗椎间盘源性下腰痛、腰椎滑脱症、腰椎不稳症等原因引起的下腰痛效果较为满意的一种腰椎融合手术方式，其主要分为前路椎体间融合术、后路椎体间融合术以及经关节突入路椎体间融合术。

Methods: During the April 2003 to December 2004, from the patients with different position colorectal cancer beyond Dukes C stage who were performed laparoscopic radical operation random draw 20 patients as experiment group, and from patients with different position colorectal cancer beyond Dukes C patients who were performed open radical operation 20 patients took randomly as contrast group. We draw thepatients blood about 5 ml from antecubital vein at the time before and after the operation about 30 minutes respectively, preserved the blood in deep hypothermia circumstance,cytrokeratin-20(CK-20) as the micrometastasis maker, using the RT-PCR technique,G3PDH as the intra-contrast gene, quantitatively detect the amounts of CK-20 in the blood with the gelatum imagery system and the computer analyzing software on the gelatum imagery system ,in order to compare the influence of the laparoscopic and the open operation on the micrometastasis.

在我院2003年4月—2004年12月间不同部位的临床分期在Dukes C期之内的接受了腹腔镜结直肠癌根治术结直肠癌患者中随机抽取20例作为试验组，另外在同期的接受开腹手术患者中随机抽取20例作为对照组，分别抽取术前30min和术后30min的肘前静脉血5ml，集中低温保存，以细胞角蛋白(cytekeratin-20)CK-20为微转移的标志物，应用RT-PCR技术，以G3PDH为内对照基因，应用凝胶成像系统及其计算机凝胶成像系统分析软件来定量检测手术前、后患者外周静脉血中CK-20含量，比较腹腔镜和开腹的手术方式对肿瘤微转移的影响。

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####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。

The anatomical detect skill and mosquito clamp cross technique to peel off invasived vascular were adopted.58patients were undergone pancreatico duodenectomy,and the rate of resects was95%.The cases of near to the invasived vascular malignant tissue was41,and the cases of the lymph node metastasis was27,and the cases of around pancreatic nerve was30.1case died of bleeding,and the morbidity of complication was found in14cases,and no patients occurred fistula.

病例报告］回顾性分析 2003年9月―2006年6月间收治的61例壶腹部周围癌病人临床资料，采用解剖性探查及纹式钳勾划技术，给58例病人施行了一次性胰十二指肠切除术，手术切除率为95%，其中41例癌细胞侵入周边大血管，27例发生淋巴结转移，30例癌细胞侵入胰周神经丛。58例手术患者中围手术期死亡1例，出现并发症者为14例，未见并发胰漏及胆漏病例。

A total of 130 hypospadiac patients hospitalized between January 1988 and December 2007 were followed up with questionnaires using Zung's Self-rating Depression Scale, Self-rating Anxiety Scale, a self-designed sexual function questionnaire and a 5-item version of the International Index of Erectile Function (IIEF-5). The surveys served to evaluate the effects of hypospadias type, number of operations and surgical procedures on sexual psychology, sexual behaviour and sexual function.

以问卷调查的形式对1988年1月至2007年12月间在我院行手术治疗的130例尿道下裂患者进行随访，采用Zung抑郁自评量表、焦虑自评量表、自行设计的性功能调查表及IIEF–5分别对不同类型尿道下裂、经历不同手术次数及不同手术方式的患者进行性心理、性行为及性功能的评估，并与50例正常成人对照。

objective to investigate the effect of radiography and method of operation on the surgical indication as well as the operation treatment of lumbar disc herniation and lumbar canal stenosis.methods the data of 300 cases with lumbar disc herniation and lumbar canal stenosis were reviewed from jan 1999 to dec 2004.all cases were treated by the method of minimal invasive open operation.the nucleus was resected through an 3.5～4.5cm in length.the sacrospinalis muscle between laminae was stripped partly and the part of upper lamina and the part of medial facet was resected.

目的 探讨影像学检查和手术方法对腰椎间盘突出症和椎管狭窄症手术方式和适应证的影响。方法自1999年1月～2004年12月，为300例腰椎间盘突出症和椎管狭窄症患者实施微创开放式手术，做3.5～4.5cm长的皮肤切口，剥离椎间的部分骶棘肌，咬除部分椎板上缘及小关节内侧缘后，摘除髓核，并根据需要做半椎板或全椎板手术或扩大神经根管和切除肥厚的黄韧带及神经管内的骨性增生。

.to record the bp and hr15,30,45,60min in both groups.bp,hr were higher during anesthesia than before anesthesia significantly in control group;bp,hr were lower during anesthesia than before anesthesia significantly in observation group.discussion remifentail take from the bp,hr effectively during operation,reduce the blooding,ensure the operative field clean and maintain the hemodynamics tranquilization,so as to the operation go with a swing.

。观察记录手术前及手术开始后5，15，30，45min时患者收缩压及心率。与麻醉前比较，对照组患者麻醉期间收缩压及心率均明显升高，而观察组患者均显著下降，两者间差异有统计学意义。［结论］瑞芬太尼可有效地降低手术期间患者的血压及心率，减少手术视野出血，保持血液动力学指标稳定。

Results: 5 protuberances from outside organ (aorta, n=2; spleen, n=1; gallblader, n=1; left hepatic lobe, n=1) and 82 SMTs were detected by mEUS including 45 leiomyomas (esophageal, n=38; gastric. N=7), 17 benign strornal tumours. 6 malignent stromal tumours in stomach. 4 Jipomas (esophageal, n=1; gastric, n=3), 3 varices in gastric fundus. 4 etopic pacreaces in stomach 3 cysts in duodenum. 19 leiomyomas derived from muscularis mucosa, 4 lipomas and 3 cysts derived from suhmucosa were resected by endoscopic snare cauterization. 3 varices in fundus were treated by nylon ligation. 5 malignent stromal tumours were resected surgically. Of which 30 were identified by pathology except 1 malignent stromal tumour was misdiagnosed as leiomyoma by EUS.

结果：mEUS检查的87例患者中，发现消化道壁外压迫5例（其中主动脉弓2例，脾脏1例，胆囊及肝左叶各1例）；粘膜下肿瘤82例，包括平滑肌瘤45例，良性间质瘤17例，恶性间质瘤6例，脂肪瘤4例，静脉瘤3例，异位胰腺4例，囊肿3例。19例起源于粘膜肌层的平滑肌瘤行高频电切除术切除，3例静脉瘤行尼龙圈套结扎，4例脂肪瘤及3例囊肿行高频电切除。5例恶性间质瘤行手术治疗。1例平滑肌瘤，切除后病理诊断为恶性间质瘤，其余的病理诊断与超声诊断相符。

It is suggested that surgeons may insert the fusion cage at the center of the mid-line of vertebrae as anterior as possible in the transforaminal lumbar interbody fusion.

综观以上的讨论，建议临床医师於腰椎椎间融合手术时尽可能将椎间融合器之几何中心置於椎体之中线上，且可将椎间融合器往前推进，对於椎间融合术后的稳定会有更佳的效果。

In Group I, catheter was placed into central vein. PCIA solution contained 0.025% morphine. PCIA was commenced with a loading dose (2-5 mg) of morphine. The PCIA pump was set up with a background infusion of 2 ml/h, 1 ml bolus dose and a 15-minute lockout interval. In Group II, four intercostal nervers were freezed (-70 degrees Celsius) for 90 seconds. Pain intensity was measured at differnt time ［1, 4, 8, 12, 24, 48 and 72 hour after operation］ using VAS scoring.

选择80例接受开胸手术的病人，随机分为静脉镇痛组和神经冷冻组，静脉镇痛组行术后病人自控静脉镇痛，后者采用北京库蓝公司JT-1型冷冻治疗仪在关胸前对切口所在肋间及上、下各一肋间和放置胸引瓶所在肋间的肋间神经进行冷冻，以VAS评分判断两组术后胸部切口疼痛情况，并记录不良反应。

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。