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CLINICAL USE OF BILATERAL CERVICO THORACIC SKIN FLAPS

In order to study the clinical efficacy of bilateral cervico-thoracic skin flap on repairing the contracture of the burn scar of the neck, 66 flaps were used in 33 patients from 1983 to 1995. The size of the flap ranged from 5 cm x 6 cm to 8.5 cm x 15 cm. The donor site was covered with split skin graft. The ratio between the length and the width of the flaps should not exceed 3:1. Fifty-nine flaps survived completely, but 7 had necrosis of small area which was healed without any influence on the function and appearance. The operative technique of the bilateral cervico-thoracic skin flaps were reported. The advantages of this type of skin flap and its applied anatomy and the postoperative care were discussed. In the repair of the cicatritial contracture deformity of the neck, it was important to define whether the skin defect was located in the submandibular, anterior cervical or anterior thoracic region, thus appropriate type of repair could then be given accordingly.

THE PROBLEMS IN THE USE OF SUPERFICIAL CERVICAL ARTERY SKIN FLAP AND IT’S RELEVANT SOLUTION

Superficial cervical artery skin flap is widely used in clinical practice. In order to inprove the outcome of the flap in clinic, eleven cases of skin defect of scalp who were treated with the flap was discussed. After operation, the donor area healed but there was no hair growth on recipient area. Among them, six cases occurred partial necrosis of skin flaps. In order to avoid these problen, the relevant solution discussed as follows: 1. Handle well the pedicle of the skin flap to prevent the interference with venous returm. 2. Adhere strictly to indications. 3. Apply skin expander to obtain "extra" skin, then carryout the tranfer of skin flap and 4. Better use the skin flap with residual hair.

Clinical Observation in Patients with Liquidbased Cytologic Test and Cervical Conization in Treatment of Cervical Intraepithelial Neoplasia

目的:TCT(薄片液基细胞学检查)技术结合宫颈锥切在CIN(宫颈上皮内瘤样病变)的诊断及治疗应用,以及结合阴道CIN治疗后的临床观察。结果:TCT发现有不典型的细胞(ASCUS)再行阴道镜检查并取活检,病理发现CIN2-3级的患者要求保留子宫的行宫颈锥切。术后4~6个月随访,并行阴道镜复查及取活检。治愈率97%,术后一年行TCT检查为正常的细胞。结论:TCT技术在宫颈癌筛查方面是很好的手段,特别是发现CIN结合阴道镜及活检在诊断方面有很大的帮助。而宫颈锥切是保全子宫的一种手段,所切的宫颈送病理可以确诊CIN是治疗CIN很有效的方法。

双侧颈胸皮瓣在颌颈部瘢痕挛缩整复中的应用

BIOMECHANICAL RESEARCH ON MORPHOMETRIC CHANGES IN ADJACENT INFERIOR CERVICAL INTERVERTEBRAL FORAMEN AFTER ARTIFICIAL DISC REPLACEMENT

Objective To explore changes in the height and width of the cervical intervertebral foramina of C6,7 before and after the C5,6 discetomy, the replacement or the anterior intervertebral fusion so as to provide the theoretical basis for the clinical practice. Methods Eleven fresh cervical spinal specimenswere obtained from young adult cadavers. The specimens of C5,6 were divided into the integrity group, the discectomy group, the artificial disc replacement group, and the intervertebral fusion group. The range of variety (ROV) of the C6,7 intervertebral foramen dimensions (height, width) before and after the loading tests (0.75, 1.50 Nm) were measured in the 4 groups. Results The C6,7 intervetebral foramen height and width increased significantly during flexion (Plt;0.01) but decreased significantly during extension (Plt;0.01). There was a significantdifference between the two test conditions in each of the 4 groups (Plt;0.01). However, in the two test conditions there was no significant difference in ROV of the C6,7 intervetebral foramen height and width during flexion and extension betweenthe integrity group, the discectomy, and the artificial disc replacement group（Pgt;0.05）, but a significant difference in the above changes existed in the intervertebral fusion group when compared with the other 3 groups (Plt;0.05). In the same group and under the same conditions, the ROV of the C6,7 intervetebral foramen height and width was significantly different in the two test conditions (Plt;0.01). Conclusion The results have indicated thatartificial disc replacement can meet the requirements of the normal cervical vitodynamics. The adjacent inferior cervical intervetebral foramen increases during flexion but decreases during extension. The intervertebral fusion is probably one of the causes for the cervical degeneration or the accelerated degeneration and for the cervical spondylotic radiculopathy and the brachial plexus compression.

Treatment of Cervical Erosion via Bacterioghage Unite Therapeutics in Combination with BMP Infrared Ray

目的:观察抗菌素联合疗法结合BMP红外光治疗宫颈糜烂的疗效和作用机理。方法:用抗菌素职合疗法结合BMP红外光治疗宫颈糜烂92例与83例单用BMP红外光作对比。结果:治疗组痊愈率97.83%,对照组为73.49%,两组比较有显著性差异(Plt;0.005)。治疗组副反应明显低于对照组,创面愈合时间与对照组比较有显著性差异(Plt;0.005)。结论:抗菌素联合治疗法结合BMP红外光治疗宫颈糜烂能提高治愈率,减少副反应,加速创面愈合。

脐带绕颈942例临床分析

摘要:目的:通过脐带绕颈圈数产程中导致胎儿窘迫、新生儿窒息的发生率，选择合适的分娩分式。方法:就我院942例临床分析孕妇胎儿窘迫、新生儿窒息的发生率、脐带绕颈周数与胎儿窘迫、新生儿窒息的发生率以及孕妇的分娩方式。结果: 观察组胎儿窘迫、新生儿窒息的发生率明显高于对照组(Plt;0．05)；脐带绕颈1周观察组与对照组比较剖宫产率差异无统计学意(Pgt;0．05)；脐带绕颈2~3周观察组与对照组比较其剖宫产率明显升高(Plt;0．05)。结论: 脐带绕颈1周者，可鼓励孕妇自然分娩，必要时行剖宫产。脐带绕颈2~3周者，建议孕妇剖宫产分娩。

ANTERIOR EXPANSIVE DECOMPRESSION IN THE TREATMENT OF MYELOPATHY SECONDARY TO CERVICAL SPONDYLOSIS

Twenty cases of myelopathy secondary to cervical spondylosis had been treated by anterior expansive decompression and interbody iliac bone graft. Follow-up for 8 to 42 months, the therapeutic results were satisfactory without any obvious complications. The techniques of fenestration and bone graft were introduced. The advantages of this operation were discussed.

消化道吻合器在颈部胃食管吻合中的应用

目的 总结食管癌切除后采用消化道吻合器行颈部胃食管吻合术治疗食管癌患者的临床经验，以降低术后吻合口瘘和吻合口狭窄的发生率，提高手术疗效。 方法 125例食管癌患者，根据采用的手术术式不同分为两组，器械吻合组：行食管癌切除后采用国产常州WGWB-26型吻合器进行颈部胃食管吻合；手工吻合组，行食管癌切除后采用手工方法进行颈部胃食管吻合。 比较两种手术术式的胃食管吻合时间、术后吻合口瘘和吻合口狭窄的发生率。 结果 全组无手术死亡。器械吻合组吻合时间少于手工吻合组（30±5min vs. 55±5 min, Plt;0.05），近期吻合口瘘和吻合口狭窄发生率明显低于手工吻合组（0% vs. 4.8%, 0% vs. 9.5%,Plt;0.05）；器械吻合组随访1～15个月食管X线钡餐检查证实无吻合口狭窄。 结论 使用吻合器行胃食管器械吻合，能增加吻合的可靠性，减少术后并发症，包括吻合口瘘和吻合口狭窄的发生。

Analysis of Cause of High Incidence of Cervical Cancer of Xinjiang Area from 2000 to 2005

摘要:目的: 调查新疆地区维吾尔族与汉族子宫颈癌及癌前病变发病情况,分析宫颈癌高发原因。 方法 : 2000年1月至2005年12月新疆自治区人民医院妇产科门诊及病房行宫颈细胞学检查的维吾尔族、汉族妇女进行筛查,对宫颈病变阳性者(CINI以上)行病理组织学检查,对结果进行对比分析、综合评价。 结果 : 宫颈涂片人数共计23 205例,其中维吾尔族6 999例、汉族16 206例。宫颈病变阳性者237例,经阴道镜下病理活组织检查证实CINI以上(包括CINI、CINII、CINIII、原位癌、鳞癌、腺癌)病变人数173例,最小年龄31岁,原位癌(维吾尔族)、最大年龄76岁,宫颈磷癌(汉族)。维吾尔族105例(6069%)、汉族68例(3931%)。每年阳性例数中维吾尔族均高于汉族,其中2000年、2001年、2004年、2005年有极显著性差异(P lt;001),2002年、2003年有显著性差异(P lt;005),维吾尔族、汉族在各年龄组中的发病情况无显著性差异(P gt;005)。 结论 : 新疆地区宫颈癌及癌前病变的高发原因是由地区环境、医疗条件、医学发展、救助措施等因素综合作用的结果。Abstract: Objective: To investigate the incidence of cervical cancer and cervical precancerous lesion of uigur nationality and han nationality, in addition, to analysis the cause of cervical cancer’s high incidence. Methods : At first screen cervical cytology of Uigur and Han outpatient and inpatient of department of gynecology and obstetrics in the People’s Hospital of Xinjiang Uigur Autonomous Region from January 1, 2000 to December 31, 2004Secondly biopsy for those patients that cervix pathological change shows positive, then contrast analysis and comprehensive evaluation. Results : Cervix smears are 23205 samples. Uigur nation has 6999 samples and Han nation has 16206 samples. There are 237 patients whose cervix pathological changes shows positive. Among them 173 samples were over CINⅠ(include CINⅠ,CINⅡ,CIN Ⅲ,carcinoma in situ, squamous carcinoma and adenocarcinoma) through colposcopy. The youngest was 31 and diagnosed carcinoma in situ(Uigur), the eldest was 76 and diagnosed squamous carcinoma(Han).The samples of Uigur is 105(6069%) and Han is 68(3931%).The positive samples in Uigur is higher than Han each year, the incidence has extremely significant difference among 2000,2001 and 2004(P lt;001), while it has significant difference between 2002 and 2003 (P lt;005), but in each age group it has no significant difference between Uigur and Han (P gt;005). Conclusion : The high incidence of cervical cancer and cervical precancerous lesion in xinjiang is contribute to environment, medical condition, medical development and aid measures coaffect.