髂的

Objective To analysis the results of treating the bothcolumn fractures of acetabulum via ilioinguinal approach.

目的 分析经髂腹股沟入路治疗髋臼双柱骨折的疗效。

Avoid removing too much of the crest anteriorly and leaving an unsightly deformity posteriorly Fig.

髂嵴前部不要取骨太多，并避免造成后侧难看的畸形(图1-23)。

Results 3 cases of lesions were in the gap of"V"shape between iliac muscle and musculus psoas major on the coronal sections in the lower right abdomen closely adjacent to the cecum,which were narrowed. The lesions showed long even T1 and T2 signals similar to mucous wall particularly in T2WI image. The walls of cyst were thin and even. The cysts were round or oval in shape on transections.The cyst were cucurbits in shape in 2 cases and long cannular in a case on coronal sections and arrowy sections and borderlines of the cysts were clear. The terminal of the cysts showed taper in 2 cases. In addition, cecum polypus was found at the placket of the appendix in a case which was not shown on MRI image.

结果 3例病变均位于右下腹，冠状面位于髂肌和腰大肌形成的"V"形间隙内，与盲肠关系密切，盲肠呈外压改变；呈均匀长T1、长 T2信号；壁薄且均匀，信号与肠管壁相似，于T2WI显示较明显；于横断面分别呈圆形、类圆形及椭圆形，冠状面及矢状面2例显示呈"葫芦"状、1例呈长管状，3例末端均呈"桃尖"样变；边界均清楚。1例于阑尾开口部发生盲肠息肉，MRI未能显示。

This study was to observe the result in patients suffering from severe ischemia of legs with arterialization of the great saphenous vein. Eighty nine patients suffering from the disease were treated by bridging the autogenous cephalic vein or Gore-Tex artificial vessel between the great saphenous vein and the femoral or external iliac arteries.

摘 要 为探索一期大隐静脉动脉化治疗下肢严重缺血症的效果，采用自体头静脉或Gore-tex人造血管，在大隐静脉与患肢股动脉或髂外动脉之间搭桥，治疗89例127侧下肢严重缺血症患者。

Methods From June 2001 to July 2002,8 patients with brachiocephalic arteritis received left iliac-left carotid arterial bypass with PTFE graft.

2 0 0 1年6月至2 0 0 2年7月，对8例头臂型大动脉炎病人，通过左髂动脉-左颈动脉聚四氟乙烯人造血管旁路术治疗颈动脉闭塞所致的脑缺血症状。

Objective To put forward our new surgical technique and investigate the effect on treatment of brachiocephalic arteritis by left iliac-left carotid arterial bypass.

中国实用外科杂志， 2003年 04期目的探讨左髂动脉-左颈动脉旁路术治疗头臂型大动脉炎这一新方法的治疗效果。

Standing in front of mirror, put one hand on the pelvic and in front you will find a prominence called ASIS.

站在镜子前，一只手放于骨盆前方最凸出叫髂前上棘的位置。

Collagraft is mixed with 2.5 to 5 ml of bone marrow aspirate from the iliac crest just before use.

Collagraft在使用前混合2.5～5ml从髂嵴吸取的骨髓。。

Objective To study the relationship of endangium proliferation and the expression of metalloproteinases and tissue inhibitors of metalloproteinases after angioplasty of iliac artery in rabbits to investigate the probable mechanism of composite Danshen pill in prevention and treatment of restenosisMethods 30 white male rabbits of Japan （the average body weight was 25～30 kg）were randomly divided into 3 groups:normal control group,model group (intima destroyed by balloon and given hypercholesterol diet),CDP group (intima destroyed by balloon and given hypercholesterol diet plus drug CDP 150 mg/d),10 ones each groupResults The results of iliac artery angiogram and the analysis of pathology:there were lumens stenosis,thinner intima,smaller intima area,in CDP group compared with those in model group,and ratio of intima and tunica media thickness and area among each group (P＜001)Immunohistochemistry analysis:the MMP2,MMP9,TIMP1,TIMP2 in model group significantly increased than those in control group (P＜001)The CDP group had lower MMP2 and MMP9 expression,higher TIMP1 and TIMP2 expression,and increased MMP2/TIMP1,MMP9/TIMP2 than model group (P＜001)The thickening of vascular neointima and stenosis degree of vascular lumen were relevant to MMP2 and MMP9 (r=0896,P＜001)Conclusions MMP and TIMP play the very important role in the restenosis process of arteryCDP could inhibit the thickness of vascular neointima after balloon injury,the probable mechanism of which may be inhibiting collagen formation,smooth muscle immigration and decreasing hyperplasia of intima by interfering expression of MMPs and TIMPs

目的 研究兔髂动脉成形术后血管内膜增生和基质金属蛋白酶及其抑制物表达之间的关系，探讨复方丹参滴丸预防再狭窄的可能机制。方法健康成年二级雄性日本大耳白兔30只，平均体重25～30 kg。随机分为3组：正常对照组10只，模型组10只（球囊内膜剥脱加高胆固醇饮食），治疗组10只（球囊内膜剥脱加高胆固醇饮食以及复方丹参滴丸150 mg/d）。结果兔髂动脉造影、血管病理图像分析检测结果：①复方丹参滴丸组较模型组血管造影示管腔直径狭窄、内膜厚度减少、内膜面积减少、内膜厚度和中膜厚度比、面积比，各组之间有显著性差异(P＜001)。②免疫组化分析：模型组MMP2、MMP9、TIMP1、TIMP2表达均高于对照组（P＜001）；复方丹参滴丸组MMP2、MMP9的表达低于模型组，而TIMP1、TIMP2的表达高于模型组；TIMP1/MMP2、TIMP2/MMP9明显增加，差异有显著性（P＜001）。③内膜的增生以及管腔的狭窄程度与MMP2、MMP9有很好的相关性(r=0896，P＜001)。结论 MMP和TIMP在再狭窄形成中起重要作用；复方丹参滴丸能够明显抑制血管损伤后的内膜增生，可能的机制是通过影响金属蛋白酶MMP2、MMP9及其抑制物TIMP1、TIMP2的表达从而抑制胶原的生成、平滑肌的迁移、增生，而减少内膜的增生。

objective to evaluate efficacy of extracorporeal shock wave lithotripsyfor treating ureteral stones in situ,investigate the cause of higher re-treatment rate.methods total of 687 patients with ureteral stone were received eswl between january 2000 and december 2004,included 455 male(66.2%) and 232 female(33.8%) patients,6 cases have bilateral ureteral calculi,12 cases have unilateral multiple calculi.hence,together 709 ureteral calculi were treated.patients upper ureteral calculi were treated in the supine position,for lower ureteral calculi patients were turned prone.to reduce eswl-induced renal trauma and pain,using lower energy source,adjusted power setting from 9.8 to 13.2kv,limited 1500 shock wavs per one session.no auxiliary procedure were used before eswl.the stone size was measured as the surface area of stone length by stone width on x-ray film.the interval between two treatment sessions was two weeks.results of 709 ureteral calculi,the overall stone free rate was 97.3%(690 calculi),re-treatment rate was 34.1%(292 calculi).according to the performed treatment sessions,one session 467 calculi,the mean stone size 37.27mm2,stone free rate 65.4%(464 calculi).two sessions 138 calculi,the mean stone size 62.48mm2,stone free rate 18.4%(131calculi).three sessions 52 calculi,the mean stone size 79.60mm2,stone free rate 7.1%(50calculi).four sessions 19 calculi,the mean stone size 101.63mm2,stone free rate 2.4%(17calculi).fivesessions 33 calculi,the mean stone size 119.33mm2,stone free rate 3.9%(28 calculi).overall 19 cases(2.7%)turned to other treatment modalities.of 335 upper ureteral calculi,303 achieved stone free (95.8%),re-treatment rate was 38.5%(129 calculi).of 374 lower ureteral calculi,369 achieved stone free(98.7%),re-treatment rate was 30.2%(113 calculi).the re-treatment rate of upper ureteral calculi was higher than lower ureteral calculi(p＜0.05,χ2=5.40).the difference of stone-free rate between upper and lower ureteral calculi was no significant(p＞0.05,χ2=0.15).conclusion eswl should be considered first line therapy for ureteral stone still.stone burden are the main variable of higher re-treatment rate,upper ureteral stone may moving with respiring during eswl.so efficinet shock wave was decreared,re-treatment rate become higher.

目的 评估体外震波碎石治疗输尿管结石的疗效，探讨再治疗率高的原因及输尿管结石的治疗选择。方法回顾2000年1月～2004年12月间eswl治疗输尿管结石的临床资料687例，男455例（66.2%），女232例（33.8%），平均年龄46.6岁（15～83岁）。有双侧输尿管结石6例，单侧多发性输尿管结石12例（4颗1例，3颗2例，2颗9例），共计输尿管结石709颗（含透光结石13颗）。应用上海爱申公司生产的desunit6030型碎石机，c臂x线球管做结石定位。上段输尿管结石（肾盂输尿管交界处至骶髂关节上缘）取仰卧位，下段输尿管结石（骶髂关节上缘下至输尿管口）取俯卧位。为减少eswl引起的肾损伤和疼痛，应用较低的能量，震波发生器电压从9.8～13.2kv，震波频率1.5s。每次治疗设定为1500次震波。治疗后3天摄腹部平片或b超，以后每隔7日重复检查。假如结石未碎或有残留结石最长径＞3mm以上，再次eswl，两次治疗的间隔时间为两周。结石的大小用x线片上的表面积（mm2表示。结果 709颗输尿管结石总的治愈率为97.3%（690颗），再治疗率34.1%（242颗）。其中一次治疗467颗，平均结石大小37.27mm2，治愈464颗（65.4%），3颗改治疗；两次治疗138颗，平均结石大小62.48mm2，治愈131颗（18.5%），7颗改治疗；第1和第2次治疗治愈率（1个月治愈率）为83.8%。3次治疗52颗，平均结石大小79.60mm2，治愈50颗（7.1%），2颗改治疗；4次治疗19颗，平均结石大小101.63mm2，治愈17颗（2.4%），2颗改治疗；5次及5次以上治疗33颗，平均结石大小119.33mm2，治愈28颗（3.9%），5颗改治疗。总计19颗（2.7%）结石改变治疗方式。上段输尿管结石335颗，治愈321颗（95.8%），再治疗129颗（38.5%）。下段输尿管结石374颗，治愈369颗（98.7%），再治疗113颗（30.2%）。经χ2检验，上、下段输尿管结石的再治疗率差异有显著性（χ2=5.40，p＜0.05），治愈率差异无显著性（χ2=0.15，p＞0.05）。不良反应：血压升高13例（1.9%），震波区域疼痛26例（3.8%），震波进入处皮肤点状淤血33例（4.8%），肉眼血尿128例（18.6%），均于第2、3天自行消失。结论 eswl目前仍是输尿管结石的第一线治疗，结石的大小是再治疗率高的主要因素。结石的位置有影响，上段输尿管结石可随呼吸移动，有效震波次数减少，再治疗率比下段输尿管结石高。eswl前注重病例筛选可降低再治疗率。

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。