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1.
Objective： This study is aimed at describing the clinical outcome of amniotic membrane transplantation for exposure of porous sphere implants. Methods： A retrospective review of consecutive cases of porous sphere orbital implant exposure was carried out. Eight cases were presented between May 2004 and Oct. 2006 （5 males, 3 females; mean age 44.5 years）. Six had enucleation and two had evisceration. Exposure occurred in two primary and six secondary. Orbital implant diameter was 22 mm in seven cases and 20 mm in one case. Six patients are with hydroxyapatite and two with high-density porous polyethylene （Medpor） orbital implants. The mean time from implantation to exposure was 1.1 months （range 0.8-2 months）. All patients required surgical intervention. Results： The time of follow-up ranged from 3.0 to 28.0 months （mean 16.5 months）. Amniotic membrane grafting successfully closed the defect without re-exposure in all of these patients. The grafts were left bare with a mean time to conjunctiva of about 1 month （range 0.8-1.5 months）. Conclusion： Exposed porous sphere implants were treated successfully with amniotic membrane graft in all of patients. The graft is easy to harvest. This technique is useful, dose not lead to prolonged socket inflammation and infection, and it is valuable application extensively.  相似文献   

2.
Objective： To evaluate the efficacy and the indication of basic fibroblast growth factor （bFGF） in the treatment of exposure of orbital implants. Design： Retrospective and observational case series. Methods： We reviewed 41 patients （41 eyes） suffering exposure of orbital implants from Jan. 2000 to June 2006. The study group patients with mild exposure received combined treatment with bFGF and antibiotic drops, and while the control group patients with mild exposure were treated with antibiotic drops only. The study group patients with moderate and severe exposure received combined treatment with bFGF and antibiotic drops, and after 2 months they were subjected to amniotic membrane transplantation, while the control group patients with moderate and severe exposure underwent amniotic membrane transplantation after using antibiotic drops. Observation of the growth of conjunctival epithelium and comparison of the healing rate of the two groups. Results： The healing rates of the mild, moderate and severe exposure study group were 100% and 92.3%. The healing rates of the mild, moderate and severe exposure control group were 55.6% and 66.7% respectively. The difference of the healing rates of the mild exposure study group and the control group was significant （P=-0.033）. And the difference of the healing rates of the moderate and severe exposure study group and the control group was not significant （P=-0.167）. Conclusion： bFGF may promote obviously the healing of orbital implant exposure, particularly it can be the first choice for the treatment of mild degree exposure. For the moderate and severe cases, it can be administered before surgical repair to enhance neovascularization and will tend to increase the success rate of surgical repair.  相似文献   

3.
Objective： The aim of this retrospective investigation was to explore the influence of femoral osteoporosis on short-term curative effects ofcementless hip arthroplasty and to evaluate the femoral metaphyseal bone mineral density （BMD） for femoral osteoporosis in order to guide prosthesis choice and rehabilitation. Methods： We performed 127 total arthroplasty operations between June 1999 to February 2003 and investigated 49 cementless hip replacements with the Metalcancellous cementless Lubeck Ⅱ system being used in all hips. There were twenty men and twenty-nine women whose mean age at the time of the operation was 60 years （range, 52-81 years）. The patients were divided into osteoporosis or normal groups according to the femoral metaphyseal BMD measured preoperatively. The average duration of follow-up was 30 months （range, 8-52 months）. We evaluated all of the patients from a clinical standpoint with use of a standard-terminology questionnaire with respect to the short-term curative effects and patients＇ satisfaction. Hip pain status and functional ability were important indicators of treatment efficacy. Results： Harris hip score and patients＇ satisfaction in femoral osteoporosis patients who underwent noncemented hip arthroplasty were lower （P=0.004, P=0.03） while the incidence of thigh pain was higher （P=0.03） than the patients with non-osteoporosis. Conclusion： The higher incidence of pain, as well as the decrease in function experienced by the patients in osteoporosis group, supports the case that cementless arthroplasty is not a better choice for those patients and that we had better select prosthesis based on the femoral metaphyseal BMD.  相似文献   

4.
Objective: Malignant middle cerebral artery (MCA) infarction is characterized by mortality rate of up to 80%. The aim of this study was to determine the value of decompressive craniectomy in patients presenting malignant MCA infarction compared with those receiving medical treatment alone. Methods: Patients with malignant MCA infarction treated in our hospital between January 1996 and March 2004 were included in this retrospective analysis. The National Institute of Health Stroke Scale (NIHSS) was used to assess neurological status on admission and at one week after surgery. All patients were followed up for assessment of functional outcome by the Barthel index (BI) and modified Rankin Scale (RS) at 3 months after infarction. Results: Ten out of 24 patients underwent decompressive craniectomy. The mean interval between stroke onset and surgery was 62.10 h. The mortality was 10.0% compared with 64.2% in patients who received medical treatment alone (P<0.001). The mean NIHSS score before surgery was 26.0 and 15.4 after surgery (P<0.001). At follow up, patients who underwent surgery had significantly better outcome with mean BI of 53.3, RS of 3.3 as compared to only 16.0 and 4.60 in medically treated patients. Speech function also improved in patients with dominant hemispherical infarction. Conclusion: Decompressive craniectomy in patients with malignant MCA infarction improves both survival rates and functional outcomes compared with medical treatment alone. A randomized controlled trial is required to substantiate those findings.  相似文献   

5.
Objective： Our aim was to investigate clinical and laboratory characteristics of osteoarthritic patients who had amyloid deposition in their knee joints. Methods： Synovial membranes were obtained from 36 patients with knee osteoarthritis （OA） who underwent joint replacement surgery. From this sample, the diagnosis of amyloid was deter- mined by Congo red staining, which demonstrated apple-green birefringence under a polarized microscope. All syn- ovial membranes were immunohistochemically characterized for the expressions of amyloid immunoglobulin light chain （AL-K and AL-,k）, serum amyloid-A （SAA）, amyloidogenic transthyretin （ATTR）, and amyloidogenic 152- microglobulin （A152M）. Matrix-assisted laser desorption-ionizaton/time of flight mass spectrometry （MALDI-TOF MS） was used to analyze transthyretin （TTR） isoforms in the serum of each patient. Results： Nine cases （25%） were found to be amyloid-positive. Immunohistochemicaliy, eight cases （88.9%） had ATTR deposition, and one sample （11.1%） was shown to be AL-K-positive. MALDI-TOF MS identified that the TTR in the serum of the patients was unmodified wild-type TTR, TTR-Cys-S-S-Cys, and TTR-Cys-S-S-CysGly. The age at surgery and the disease duration were sig- nificantly higher in the ATTR-positive group than in the ATTR-negative group. Knee score and function score were significantly lower in the ATTR-positive group than in the ATTR-negative group. Conclusions： Amyloid deposition in synovial membranes of OA patients was found to be ATTR and AL-K. TTR in the serum of the patients was unmodified wild-type TTR together with two isoforms. The high age at surgery, long disease duration, and a deteriorated knee function were associated with ATTR amyloid deposition in the osteoarthritic knee joints.  相似文献   

6.
The nesting problem involves arranging pieces on a plate to maximize use of material. A new scheme for 2D irregular-shaped nesting problem is proposed. The new scheme is based on the NFP （No Fit Polygon） algorithm and a new placement principle for pieces. The novel placement principle is to place a piece to the position with lowest gravity center based on NFP. In addition, genetic algorithm （GA） is adopted to find an efficient nesting sequence. The proposed scheme can deal with pieces with arbitrary rotation and containing region with holes, and achieves competitive results in experiment on benchmark datasets.  相似文献   

7.
Malignant gliomas are the most devastating tumors in clinical practice and nave poorest survival, Immunological treatment of such patients may likely increase the survival and quality of life. Dendritic cells （DCs）, most potent antigen presenting cells in combination with oral chemotherapeutic agents may be tried for patients giving consent to such treatment. We have successfully combined the two therapies in an adult male patient who was on downhill course after being operated on once with post operation chemotherapy and radiotherapy for glioma in the left parietal area. He received five dendritic cell therapy vaccines in combination with oral chemotherapy and responded dramatically having near normal quality of life for an additional five months with this regime, increasing the survival after operation to 11 months. This therapy is continuing with radiological betterment of the lesion. The DCs are matured with antigen extracted from wax embedded tissue at 6th day of culture. We feel that the treatment can be given to more number of patients to establish its efficacy for the dreaded cancer glioblastoma multiforme.  相似文献   

8.
Surgical management of gastric stump cancer： a report of 37 cases   总被引：3，自引：0，他引：3  
Objective: To observe the clinicopathological characteristics of gastric stump cancer (GSC) and evaluate the benefits of radical surgery of GSC. Methods: The clinicopathological characteristics and postoperative survival time of 37 GSC patients who underwent surgery were investigated retrospectively. The survival time was compared according to the type of surgical pTMN stage. Survival curves were traced by using Kaplan-Meier methods. Results: Most GSC (32/37) was detected in patients who had received Billroth Ⅱ reconstruction after partial gastrectomy for benign gastric disease. The lesser curvature side and the suture line of anastomosis were the most frequent sites where GSC occurred (27/37). Differentiated adenocarcinoma was the dominant histopathological type (24/37). The postoperative 5-year survival rate of early stage GSC patients (n=9) was significantly higher than advanced stage GSC (n=12) (55.6% vs 16.5%, xL2=1 1.48, P＜0.01). Five-year survival rate of 21 GSC patients with radical resection were 75% (3/4) for stage Ⅰ, 60% (3/5) for stage Ⅱ, 14.2% (1/7) for stage Ⅲ, and 0% (0/5) for stage Ⅳ respectively.The median survival time of 21 GSC patients who underwent radical resection was longer than those undergoing palliative operation (43.0m vs 13.0m, xL2=36.31, P＜0.01), the median survival time of stage Ⅳ patients with radical resection was 23.8months. Conclusions: Without remote metastasis, radical resection for GSC is possible, and is an effective way to improve the prognosis of GSC. Even in stage Ⅳ GSC, radical resection can still prolong the survival time. It is necessary for the patients with benign gastric diseases who received partial gastrectomy to carry out the endoscopy follow-up, especially in patients with Billroth Ⅱ reconstruction procedure at 15-20 years.  相似文献   

9.
Objectives： To detect the serum proteomic patterns by using SELDI-TOF-MS （surface enhanced laser desorption/ ionization-time of flight-mass spectrometry） technology and CM10 ProteinChip in colorectal cancer （CRC） patients, and to evaluate the significance of the proteomic patterns in the tumour staging of colorectal cancer. Methods： SELDI-TOF-MS and CM10 ProteinChip were used to detect the serum proteomic patterns of 76 patients with colorectal cancer, among them, 10 Stage Ⅰ, 19 Stage Ⅱ, 16 Stage Ⅲ and 31 Stage Ⅳ samples. Different stage models were developed and validated by support vector machines, disctiminant analysis and time-sequence analysis. Results： The Model Ⅰ formed by 6 protein peaks （m/z： 2759.58, 2964.66, 2048.01, 4795.90, 4139.77 and 37761.60） could be used to distinguish local CRC patients （Stage Ⅰ and Stage Ⅱ） from regional CRC patients （Stage Ⅲ） with an accuracy of 86.67% （39/45）. The Model Ⅱ formed by 3 protein peaks （m/z： 6885.30, 2058.32 and 8567,75） could be used to distinguish locoregional CRC patients （Stage Ⅰ, Stage Ⅱ and Stage Ⅲ） from systematic CRC patients （Stage IV） With an accuracy of 75.00% （57/76）. The Model Ⅲ could distinguish Stage Ⅰ from Stage Ⅱ with an accuracy of 86.21% （25/29）. The Model Ⅳ could distinguish Stage Ⅰ from Stage Ⅲ with accuracy of 84.62% （22/26）. The Model Ⅴ could distinguish Stage Ⅱ from Stage Ⅲ with accuracy of 85.71% （30/35）. The Model Ⅵ could distinguish Stage Ⅱ from Stage Ⅳ with accuracy of 80.00% （40/50）. The Model Ⅶ could distinguish Stage Ⅲ from Stage Ⅳ with accuracy of 78.72% （37/47）. Different stage groups could be distinguished by the two-dimensional scattered spots figure obviously. Conclusion： This method showed great success in preoperatively determining the colorectal cancer stage of patients.  相似文献   

10.
Objective： To detect the infection frequencies of different genotypes of Epstein-Barr virus （EBV） in subgingival samples from chronic periodontitis （CP） patients, and to discuss the correlation between infection with EBV and clinical parameters. Methods： Nested-PCR assay was used to detect EBV-1 and EBV-2 in subgingival samples from 65 CP patients, 65 gingivitis patients and 24 periodontally healthy individuals. The amplicons were further identified by restriction fragment length polymorphism analysis （RFLP） with endonucleases Afa I and Stu I. Clinical parameters mainly included bleeding on probing （BOP）, probing depth （PD）, attachment loss （AL） in six sites of the dentition. Results： In CP patients, gingivitis and periodontally healthy individuals, the infection frequencies were 47.7%, 24.6% and 16.7% for EBV-1, and 15.4%, 7.7% and 0% for EBV-2, respectively. In 2 out of the 65 CP patients co-infection of EBV-1 and EBV-2 was found. The positive rate of EBV-1 in chronic periodontitis patients was higher than that in gingivitis patients （P=-0.01） and periodontally healthy individuals （P=-0.01）. But no significant difference was shown in EBV-1 frequency between gingivitis patients and healthy individuals （P〉0.05） or in EBV-2 frequency among the three groups （P〉0.05）. In CP patients, higher mean BOP value was found in EBV-1 or EBV-2 positive patients than that in EBV negative ones （P〈0.01）, but with no statistical difference in the mean PD or AL value between EBV positive and negative patients （P〉0.05）. After initial periodontal treatment, 12 out of the 21 EBV-1 positive CP patients did not show detectable EBV-1 in subgingival samples. Conclusion： nPCR plus RFLP analysis is a sensitive, specific and stable method to detect EBV-1 and EBV-2 in subgingival samples. Subgingival infection with EBV-1 is closely associated with chronic periodontitis. Infection of EBV in subgingival samples was correlated with BOP.  相似文献   

11.
Objective: To investigate the effects and complications of primary and secondary placements of motility coupling post (MCP) in the unwrapped porous polyethylene orbital implant (PPOI) following enucleation. Methods: We investigated 198 patients who received PPOI implantation following the standard enucleation procedure in the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China, from 2002 to 2004. These patients were subgrouped into PPOI-only patients (112 cases, received PPOI following enucleation), primary MCP patients (46 cases, received primary placement of MCP during PPOI operation), and secondary MCP patients (40 cases, received secondary placement of MCP 6 months after the initial surgery). Effects and complications among these three groups were compared. Results: The PPOI-only patients took shorter treatment course when compared with other two MCP groups (P<0.001), without significant difference noted between the two MCP groups. However, the two MCP groups had better prosthetic motility than PPOI-only group (P<0.001), without significant difference between the two MCP groups. In the early stage, 2 eyes in the PPOI-only group and 1 eye in the primary MCP group had PPOI infection. In PPOI-only group, 3 (2.68%) eyes had PPOI exposure, which occurred after fitting the prostheses; 4 eyes (8.70%) in primary MCP group and 1 eye (2.50%) in secondary MCP had PPOI exposure, which occurred before fitting the prostheses. After prosthesis was fit successfully, the excessive discharge and granuloma were 33.9% and 1.79% in PPOI group-only, 53.3% and 8.9% in primary MCP group, and 52.5% and 7.5% in secondary MCP group, respectively. Conclusion: Both primary and secondary placements of MCP into the PPOI following enucleation can help patients to obtain desirable prosthetic motility, but maybe associated with more complications. The primary placement of MCP with skilled operation in selected patients is more recommendable than secondary placement.  相似文献   

12.
目的探讨老年人肺部感染常见相关性疾病、病原菌分布和药物敏感情况。方法对236例老年肺部感染患者的住院病历进行详尽分析。结果绝大多数病例伴有严重基础性疾病,并过多地应用抗生素。结论应加强对原有基础性疾病的积极治疗与控制,尽量减少老年人肺部感染的发生率。根据细菌培养结果,合理临床用药,减少细菌耐药性和不良反应的发生,是治疗此病的有效方法。  相似文献   

13.
Surgical results of pars plana vitrectomy combined with phacoemulsification   总被引：2，自引：0，他引：2  
INTRODUCTION Cataract is frequently associated with vitreo-retinal pathology such as vitreous hemorrhage,retinal detachment,proliferative vitreoretinal disease,espe-cially in patients with diabetes mellitus,ocular trauma and elderly population(Vatavuk and Pentz,2004;Vatavuk et al.,2005).The cataract can be removed together with vitrectomy or later on in a separate surgical procedure(Tyagi et al.,1998;Lam et al.,1998).The primary indication for the primary re-moval of cataract and vitrect…  相似文献   

14.
以纳米级45S5生物玻璃粉体为原料,采用冷冻干燥法,以丙三醇(甘油)、聚乙二醇为分散剂,制备多孔生物陶瓷材料。实验结果表明:通过冷冻铸造法制备的复合陶瓷呈薄层状结构,在950℃下烧结的材料能保持多孔形貌,但是孔隙分布不均匀,大多为2-10μm的微孔,由阿基米德排水法测得的孔隙率知道孔隙在60%以上,孔径内部连通性良好;1 050℃下生物玻璃粉体出现玻璃软化,冻干胚体经烧结出现塌陷,微孔消失,孔径的连通性较差,大多数孔隙为不连通的半开孔。高温烧结定向多孔结构陶瓷胚体,温度高于1 000℃生物玻璃发生软化难以保持材料的定向多孔结构。生物玻璃粉体烧结多孔陶瓷的温度为950℃。  相似文献   

15.
口腔种植学是目前发展极为迅速的一门学科,它与口腔领面外科学,牙周病学,口腔修复学、牙合学、材料学等学科都息息相关。针对口腔种植在临床上应用日趋广泛,患者对种植的需求也越来越多,口腔种植教育的多层次,分阶段的现状,本文主要从培养合格的口腔种植医生的角度出发,对在校教育期闯该课程的设置方面进行总结和探索。在目前口腔种植教育已形成了弹性的多层次、分阶段的教学体系格局下,口腔专业的院校除了要进一步加强口腔种植的大学教育外,还需与专业培训机构一同开展不同类型的毕业后教育课程。  相似文献   

16.
Objective: To investigate the time and postoperative binocular vision of strabismus surgery for children with intermittent exotropia (X (T)). Methods: A retrospective investigation was conducted in 80 child patients with intermittent exotropia. Pre- and postoperative angles of deviation fixating at near (33cm) and distant targets (6m) were measured with the prolonged alternate cover testing. The binocular function was assessed with synoptophore. Twenty-one patients took the postoperative synoptophore exercise. Results: (1) A week after surgery, 96.2% of the 80 patients had binocular normotopia, while a year after surgery, 91.3% of the 80 patients had binocular normotopia; (2) Preoperatively, 58 patients had near stereoacuity, while postoperatively, 72 patients achieved near stereoacuity (P<0.05); (3) Preoperatively, 64 patients had Grade I for the synoptophore evaluation and postoperatively, 76 patients achieved Grade I. Meanwhile, 55 patients had Grade Ⅱpreoperatively and 72 achieved Grade Ⅱ postoperatively. For Grade Ⅲ, there were 49 patients preoperatively and 64 patients postoperatively (P<0.05); (4) Patients of 5～8 years old had a significantly better recovery rate of binocular vision than those of 9～18 years old (P<0.05); (5)Patients taking postoperative synoptophore exercise had a better binocular vision than those taking no exercise (P<0.05). Conclusions: (1) Strabismus surgery can help to preserve or restore the binocular vision for intermittent exotropia; (2) Receiving the surgery at young ages may develop better postoperative binocular vision; (3) The postoperative synoptophore exercise can help to restore the binocular vision.  相似文献   

17.
The most important opportunity available to secondary school students to earn college credit for college-level work done in high school is the series of advanced placement tests provided by such organizations as the College Entrance Examination Board. This paper presents three models of initiatives that can be taken by secondary school educators to create exams in those areas for which advanced placement tests do not currently exist and better serve the needs of their students who could prepare for current exams: adapt existing exams as credit-earning proficiency exams; work with interested universities in creating new advanced placement programs; and reorganizing the existing advanced placement program offered in the high school.  相似文献   

18.
Objective: To observe the accuracy of femoral preparation and the position of the cementless prosthesis in femoral cavity, and to compare the results between the computer-assisted surgical group (CASPAR) and the conventional group. Methods: Ten femoral components were implanted either manually or by CASPAR in cadaver femurs. The specimens were cut to 3 mm thick slices. Microradiograms of every slice were sent to a computer for analysis with special software (IDL). The gaps and the medullary cavities between component and bone, the direct bone contact area of the implant surface,the gap width and the percentage of gap and bone contact area were measured in every slice. Results: In the proximal implant coated with HA of the CASPAR group, the average percentage of bone contact reached 93.2% (ranging from 87.6% to 99.7%); the average gap percentage was 2.9% (ranging from 0.3% to 7.8%); the maximum gap width was 0.81 mm and the average gap width was only 0.20 mm. While in the conventional group, the average percentage of bone contact reached 60.1% (ranging from 49.2% to 70.4%); the average gap percentage was 32.8% (ranging from 25.1% to 39.9%); the maximum gap width was 2.97 mm and the average gap width was 0.77 mm. The average gap around the implant in the CASPAR group was only 9% of that in the manual group; the maximum and average gap widths were only about 26% of those in the manual group. On the other hand, the CASPAR group showed 33% higher bone contact than the manual group. Conclusion: With the use of robotics-assisted system, significant progress can be achieved for femoral preparation in total hip arthroplasty.  相似文献   

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