简介：Endovascularembolismtechniquehasbeendemonstratedtobethebestinitialoptionfortreatmentofcarotidcavernousfistula(CCF).SeverallargeseriesreportshaveshownthatmostCCFscanbesuccessfullyoccludedviatransarterialortransvenousendovascularapproach.1-6ThispaperreportsacaseofCCFrecurredafterendovascularocclusionofinternalcarotidartery(ICA)proximaltothefistula.AnewtechniquehasbeendescribedfortransarterialembolizationwithtungstenmicrocoilsviasurgicalexposuretoICA,whichhasnotbeenreportedpreviouslyintheliteratures.

简介：Objective:　Toobservethechangesofevokedpotentialsafterseverebraininjuryandtheeffectofmildhypothermiaonacuteseverebraininjury.　　Methods:　Atotalof44patientswithsevereclosedheadinjury(GCS3-8,admittedwithin10hoursfrominjury)admittedfromMay1998toMarch1999wereselectedforthisstudy.Allpatientswereadmittedintotheintensivecareunitanddividedinto2groups,GroupA(GCS3-5)andGroupB(GCS6-8).Patientswerealsorandomlyassignedtoeithernormothermiaorhypothermiasubgroups.Patientsinthehypothermiagroupwerecooledto32-34℃.Mediannerveshort-latencysomatosensoryevokedpotentials(SLSEP)andbrainstemauditoryevokedpotentials(BAEP)wererecordedbeforecoolingand4,24,48,72,96and120hours,respectivelyaftercoolingandtemperatureresuming.SLSEPandBAEPweremeasuredatthesametimeinthenormothermiagroup(controlgroup).Thechangesofevokedpotentials(EP)wereanalyzedbystatisticalmethods.　　Results:　IntheGroupB,N20amplitudesinSLSEPandI/VamplitudesinBAEPaftermildhypothermiatreatmentinthehypothermiagroupdifferedsignificantlyfromthoseinthecontrolgroup(P<0.05).However,intheGroupA,nosignificantdifferenceinallparameterswasfound.　　Conclusions:　Theseresultsdemonstratethatmildhypothermiatreatment(32-34℃)intheGroupBhasasignificantneuroelectrophysiologicaleffectonseverebraininjury.Nevertheless,theeffectofmildhypothermiaintheGroupAisnotapparentandneedsfurtherstudying.

简介：Objective:Toevaluatetheclinicalresultsoftreatmentofmidshafttibialfracturewithexpandableintramedullarynailscomparedwithinterlockingintramedullarynails.Methods:FromJune2003toAugust2005,46patients(27malesand19females,aged20-74years,mean=38.4years)withmidshafttibialfractureweretreatedsurgicallyinourdepartment.Thecausesoffracturesweretrafficinjuryin21patients,fallinjuryin6,tumblinginjuryin11andcrushinginjuryin8.AccordingtoAO/ASIFclassification,TypeAfracturewasfoundin16patients,TypeBin11,TypeC_1in5,andTypeC_2in2.Openfractureswerefoundin12patients,accordingtoGustiloclassification,TypeⅠin9patientsandTypeⅡin3patients.Basedonthepatients'consent,24patientsweretreatedwithexpandableintramedullarynails(GroupA)and22withinterlockingintramedullarynails(GroupB).Theoperationtime,bloodlossduringoperation,X-rayfluoroscopictimes,hospitalizationtime,weightbearingtimeafteroperation,healingtimeoffractureandcomplicationsofallthepatientswererecorded.TheclinicaleffectsofallthecaseswereevaluatedaccordingtothecriteriaofJohner-Wruhs.Results:Allthepatientswerefollowedupfor12-34months(mean=16.2months).Thetimeofoperation,thebloodloss,X-rayfluoroscopictimes,hospitalizationtimeandhealingtimeoffractureofGroupAsignificantlydecreased(P<0.05)comparedwiththoseofGroupB,butthetimeforweightbearingafteroperation,theJohner-WruhsdegreeofclinicaleffectsandcomplicationshadnosignificantdifferencebetweenGroupAandGroupB(P>0.05).Conclusions:Expandableintrameduilarynailcanshortenoperationtime,decreasebloodlossandreduceinvasion,whichisasafeandeffectivetreatmentmethodfortibialmidshaftfracture.

简介：与ipsilateral联系的Hoffa骨折大腿骨的柄骨折是很稀罕的。损害的这种稀罕类型的三个盒子回顾地被考察。大腿骨的柄破裂和Hoffa破裂的地点被记录。所有大腿骨的柄破裂与内部固定被管理。为Hoffa破裂的错误诊断的率被记录。影响的膝的功能在二年后续为特殊外科(HSS)分数根据修改医院被评估。大腿骨的破裂在所有三个盒子中横向或合成。IpsilateralHoffa破裂在一种情况中在二种情况，和侧面的髁中发生在中间的髁。一仅仅Hoffa破裂外科手术前地被识别。所有大腿骨的柄破裂太平无事地愈合了。在其Hoffa骨折正确地被诊断的病人，修改HSS分数是94。在另一个病人，其Hoffa断裂，被第二个手术对待，修改HSS分数是93。并且在第三个盒子中，为Hoffa破裂拒绝了另外的操作，修改HSS分数仅仅是70。决定性地大腿骨的柄骨折能与ipsilateralHoffa骨折被联系，特别在摩托车事故。这类损害是很稀罕的，错误诊断是普通的。

简介：讨论联合外部fixator和皮肤拍动调换的效果在上的目的暴露并且不属于工会的骨头。开的骨折在1998年3月的经期期间在我们的医院里对待到2008年6月的感染的不属于工会、暴露的骨头列在后面的12个盒子的数据被分析的方法。有10个男病人，2个女病人，其变老在19-52年之间并且平均28年。有10胫骨的破裂和2大腿骨的破裂。疾病的功课与19个月的吝啬的时期持续了12-39月。所有盒子被联合外部fixator和皮肤拍动调换对待。结果主要愈合在10种情况中被完成并且推迟在胫骨由于软织物缺点和因此本地的拍动调换在被暴露的2种情况中愈合被执行。所有12个盒子与8个月的平均时间在操作以后在6-12月以内有多骨的联合。他们被跟随在上面为1-3，年和所有破裂愈合了在上面与好功能和没有感染复发。联合外部fixator和皮肤拍动调换治疗在对待上看了最佳的效果的结论感染了，暴露并且不属于工会的骨头

简介：Objective:　Toanalyzethecausesofdistalfemoralnonunionanddelayedunionandassesstheoutcomeofthecorrespondingtreatment,retrogradeintramedullaryinterlockingnail(RIIN).　　Methods:　FromJune1995toDecember1998,15patients(9malesand6females)withdistalfemoralnonunionanddelayedunionweretreatedwithRIIN.Theaverageageofthepatientswas34.5years(23-46years).Bonegraftingwasperformedin10patients,closedreamingwasdoneintheother5patients.Correctionosteotomywasperformedin2patients,andintra-articularreleaseofkneeadhesionin11patients.X-rayexaminationandkneesocietyclinicalratingsystem(KSS)wereusedtoevaluatetheresults.　　Results:　Allfractureswerefollowedupforatleast9monthswithaveragefollow-updurationof14.5months(9-33months).Solidunionwasdocumentedinallpatientsat6.4monthsonaverage.Therewerenoinfectionsormalunionsinthisseries.Basedonthefinalfollow-updata,acceptablefunctionalrangeofmotion(ROM)ofover90°wasachievedinmostpatients.TheaverageROMwas93.5°withsignificantimprovementof28°(42.7%,P＜0.05)comparedwiththepreoperativeROM.Theaveragekneescorewas96.ExcellentROMemergedin13patients.Thekneefunctionscorewas90.5onaverage.　　Conclusions:　Themaincausesofdistalfemoralnonunionanddelayedunionareimproperindicationsandimproperuseoftheimplants.RIINisaneffectivealternativefortreatmentofdistalfemoralnonunionanddelayedunionbecauseitcanprovideastableandreliablefixationwhichisbeneficialforearlyfunctionalexerciseofknee.Bonegrafting,closedreamingandintra-articularreleaseofkneeadhesionshouldbeconsideredinordertoenhancethebonehealingandimproveROMandthekneefunction.

简介：Objective:　Toreportamethodandremotetherapeuticeffectofearlynervetranspositionintreatmentofobstetricalbrachialplexuspalsy.　　Methods:　FromMay1995toAugust1996,12patientswhohadnorecoveryofbiceps3monthsafterbirthweretreatedwithnervetransposition.Eighthadneuromaattheuppertrunkand4hadruptureoravulsionoftheuppertrunk.Mallettestwasusedtoevaluatetheresults.　　Results:　Thefollow-upof40-52monthsshowedthatexcellentandgoodrecoveryinfunctionswasfoundin75%ofthepatientsandtheexcellentrateofphrenicnerveandaccessorynervetranspositionwas83.3%and66.7%respectively.Acompleterecoveryinshoulderandelbowjointfunctionwasin3patientsandMalletⅣwasin6patients.　　Conclusions:　Satisfactoryoutcomecanbeobtainedbyusingearlynervetranspositionintreatingobstetricalbrachialplexus.Paralysis,obstetric;Peripheralnerves;Nervetransposition

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简介：客观：由经皮的解压缩和自体同源的骨头marrowmononuclear房间(BMC)评估大腿骨的头的处理ofosteonecrosis的临床的功效和安全注入。方法；在有在早舞台的脉管的坏死的28个病人的44个臀部由解压缩由自体同源的BMCsinfusion跟随了的经皮的多重洞被对待。自体同源的BMC从从病人的以后的肠骨的冠被拿的骨头髓被集中。病人们在至少2年上面被跟随。结果被变化在radiograghic阶段在哈里斯臀部分数和前进决定。结果：Nocomplications在操作以后被观察。在操作前，有在8个臀部，在15个臀部的阶段Ⅱ，在14个臀部的阶段Ⅲ，在7个臀部的阶段Ⅳ，和在最近的后续的手术后的阶段的大腿骨的头坏死的阶段Ⅰ是在1个臀部的阶段O，在6个臀部的阶段Ⅰ，在13个臀部的阶段Ⅱ，在13个臀部的阶段Ⅲ，在7个臀部的阶段Ⅳ，在4个臀部的阶段Ⅴ。吝啬的preoperativeHarris臀部分数是58(46-89)，并且改善了到86(70-94)手术后地。外科手术前地折叠的所有大腿骨的头证明坏死的尺寸是至少超过30%。结论:与自体同源的BMC相结合的经皮的多重洞解压缩是对待大腿骨的头的脉管的坏死的一个新方法。越早阶段，越更好结果。Arandomized未来的学习需要以后与平淡的核心解压缩作比较。

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简介：Objective:Toexplorethecausesoftheformationoftraumaticcarotid-cavernousfistulasandthetherapeuticeffectofdetachableballoonand/orcoilembolizationandthepreventionofitscomplications.Methods:FromOctober,1992toMarch,2002,17patientswithtraumaticcarotid-cavernousfistulasweretreatedwithdetachableballoonand/orcoilembolizationinourhospital.TheclinicaldataandimagingfeaturesofCT,MRandselectiveangiogramofthesepatientswereanalyzed.Results:Oneweekaftertreatmentwithembolization,theclinicalsymptomsofthe17patientswereremitted,andopticcacophony,nystagmus,exophthalmosanddropsyofconjunctivadisappeared.Twopatientsmanifestedsurgicalcomplications,onepatientdied.Sixteenpatientssurvived.Theywereallfollowedupformorethan2years,whichshowedonepatienthadhandicapinmovement,andinonepatientthesignsandsymptomsoftraumaticcarotid-cavernousfistulasreoccurred2monthsaftertreatment.Conclusions:Thedetachableballoonand/orcoilembolizationissafeandreliable.Itisagoodmethodtotreattraumaticcarotid-cavernousfistulas.

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简介：Objective:Toexploretheeffectofdexamethasonebylocaltreatmentofcerebraledemaandbraindamageafterbraininjury.Methods:Twenty-tworabbitswereclassifiedinto2groups,GroupA(thecontrolgroup,n=11)andGroupB(thetreatedgroup,n=11).Anrabbitbraincontusionmodelwasmadebybonewindowplastybyextraduralhitting.Groupbwastreatedbylocalinfiltratingandsprayingofdexamethasoneatequidistancetolesions.GroupAwasgivennormalsalineinthesamewayasGroupB.Thechangesofmoistureinbraintissuesandserummyelinbasicprotein(MBP)wereobserved.Results:ThepercentageofwatercontentindamagedhemisphereinGroupAandGroupbwas81.7%±0.56%and79.45%±0.52%respectively.Therewasasignificantdifferencebetweenthe2groups(P<0.05).ThenormallevelofMBPwas1.66μg/L±0.71μg/L,whilethevalueofMBPinGroupAandGroupbwere5.98μg/L±2.08μg/Land3.15μg/L±1.09μg/Lseparately.ThelevelofMBPinGroupAandGroupBwerehigherthannormallevelandtherewasalsoasignificantdifferencebetweenGroupAandGroupB(P<0.05).Conclusions:TheresultsofourstudyshowedthatthebrainmoistureandMBPinserumwereincreasedafterbraininjurywhilereducedaftertreatmentwithdexamethasone.ItisdemonstratedthatlocaltreatmentofbraininjurywithdexamethasonehasanobvioustherapeuticeffectoncerebraledemaandserumMBP.

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简介：Objective:Toevaluatetheefficacyoffreetransplan-tationofdenervatedmusclesandvesselsinthetreatmentoflong-standingfacialparalysis.Methods:Atotalof26patientswithfacialparalysis(10malesand16females,aged16-65years,mean:47years)wereenrolledinthisstudytoreceivetransplantationofdenervatedextensordigitorumbrevis(EDB)andextensorhallusisbrevis(EHB).Themuscletendonwasslungtothealanasi,themiddlepointofthenasolabialsulcus,theangu-lusotisandthechintocorrectthenasalandoraldeformity.Themusclebellywasburiedaroundthenervesthatinner-vatedthemassetermuscle.Microsurgerywasappliedtoanastomosingthetarsuslateralvesselstothesuperficialtemporalisvessels.Results:Afteroperation,allthepatientsimmediatelyobtainedsatisfiedstaticappearance.Themovementoftheparalyzedcomerofthemouthcouldbeobtainedonemonthlaterandthesmileoftheparalyzedsidecouldberestoredafter3monthsoftraining.And88%patientsachievedper-fectresults,8%obtainedsatisfactoryresults,and4%gotimprovement6monthsafteroperationaccordingtoStennert'sparesisscoringsystem.Conclusions:Freetransplantationofdenervatedmusclesandvesselsforthetreatmentoflong-standingfa-cialparalysis,whichseldomcausesatrophyorliquefactionofthetransferredmuscles,canmaintainmuscleviabilityandinducereliablenerveregeneration.Therefore,itisasafeandefficienttreatmentmethodforthepatientssuffer-ingfromfacialparalysis.

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