直肠阴道的

2The anterior cutereous branches of the obturator artery penetrate deepfascia of thigh and epimysium of the adductor muscles closing against the lower rami of pubisor at its outer margin.Pudendal-thigh skin flap pedicled on it may be elevated to repairrectovaginal fistula or small skin defects of perineum.As its piercing point is much higher andthe location of pedicle is more fixed because of restriction of pubic rami,it is not suited toreconstruct new vagina.Moreover,it is not appropriate naming the obturator aretry(or themedial femoral circumflex artery)the pudendal-thigh artery.

闭孔动脉前皮支紧邻耻骨下支或于其外侧缘，穿大腿深筋膜和内收肌肌膜浅出，以之为蒂可以形成皮下蒂阴股沟岛状皮瓣，用于阴道直肠瘘或会阴部较小皮肤缺损的修复，但由于闭孔动静脉前皮支浅出点位置较高，并且由于耻骨下支的阻挡和限制，致使血管蒂的位置较为固定，以之为蒂形成的阴股沟皮瓣不适宜用于阴道再造；另外，将闭孔动脉命名为阴股沟动脉，也有欠妥帖。

Objective To evaluate the effect of double repair of simple rectocele trans rectum and posterior wall of vagina.

目的观察经阴道后壁直肠和阴道双重修补法治疗单纯直肠前突的效果。

After incising serosa of bladder and rectum a suture was made for closure the vaginal summit and pelvic cavity .

自穴道牵出游离的前后片，缝合于阴道口的前庭粘膜于腹腔镜下剪开直肠和膀胱表面的浆膜，缝合关闭阴道顶端及盆腔。

Results In all these cases, there are 83 cases origin from mucous membrane which include inflammation, tumor and anabrosis; 24 cases origin below mucous membrane which include interstitialoma, lymphoma and scleroderma;38 cases mainly changed in the shape, structure and position of organs which include hiatus hernia, Oblique inguinal hernia, diverticulum, malrotation of intestine and megacolon; 29 cases mainly changed in the power and function of organs which include functional disorder of esophagus, mesentery-compressed syndrome funtional disorder of small intestine and irritable colon; 17 cases' performance caused by the factor outside intestinal canal which include mesentery shift, stomach shift and small intestine shift, and other cases which include fistula between esophagus and mediastinum, rectovaginal fistula, foreign body in esophagus and small intestine ascariasis.

结果：197例患者中，源于黏膜的病变83例，源于黏膜下的病变24例（包括间质瘤、淋巴瘤、硬皮病），以器官形态、结构、位置改变为主的病变38例（包括食管裂孔疝、腹股沟斜疝、憩室、肠旋转不良、巨结肠），以器官动力、功能改变为主的病变29例（包括食管功能紊乱、肠系膜压迫综合征、小肠功能紊乱、结肠过敏），因管腔外因素的影响而引起的改变17例（包括食管移位、胃移位、小肠移位），其他病变6例（包括食管纵隔瘘、直肠阴道瘘、食管异物、小肠蛔虫症）。

Intractable rectovaginal fistula is a troublesome complication after treatment of perineal cancers or infection.

会阴部癌症或是感染所导致的难治性直肠阴道瘻管是一个相当棘手的问题。

MethodsOn the basis of an anatomical s tu dy a new type of the pudendal-thigh flap pedicled on the obturator artery has been designed to repair rectovaginal fistual.

在解剖学研究的基础上，设计并应用以闭孔动、静脉前皮支为蒂的阴股沟岛状皮瓣修复阴道直肠瘘。

Type 2.The pudendal-thigh flap is pedicled on the anterior cutaneous branches of theobturator artery and may be used to repair rectovaginal fistula and small skin defects ofperineum.3 patients of rectovaginal fistula have been treated with the flaps and good resultshave been achieved.

意效果。●Ⅱ型：以闭孔动静脉前皮支为血管蒂的阴股沟皮瓣，供血血管为闭孔动脉前皮支，可用于会阴部较小皮肤缺损和阴道直肠瘘的修复；我们应用这种类型的皮瓣为3例

Conventional transvaginal, transrectal, and transperineal sonography has improved the detection of stones at the ureterovesical junction.

常规经阴道、经直肠和经会阴超声提高了对输尿管膀胱连接部的结石检出率。

Methods: We examined bladder with half filling of the bladder of 8695 subjects via the healthy physical examination with 5.0~7.5 MHz probe, and suggested the suspected cases perform urethrascope examination.

在膀胱少许充盈状态下，用5.0~7.5MHz的探头对8695名健康体检的人员进行常规经直肠经阴道膀胱检查，对可疑病例建议做膀胱镜检查及随诊。

Nine (3.4%) of 252 patients had bladder and rectal perforations, and 26 (11%) of 232 patients developed vaginal erosions, most of which were mild to moderate.

252位中有9位（3.4%）发生膀胱与直肠穿孔，而232位中有26位（11%）发生阴道糜烂，其中大部分是轻微到中度的。

Do you know, i need you to come back

你知道吗，我需要你回来

Yang yinshu、Wang xiangsheng、Li decang,The first discovery of haemaphysalis conicinna.

1〕 杨银书，王祥生，李德昌。安徽省首次发现嗜群血蜱。