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Surgical Indications and Tips of Endoscopic Thyroidectomy

创伤性气管、食管裂伤一例

自发性食管破裂16例

小切口心脏不停跳下左心房粘液瘤切除术五例

VULVAR RECONSTRUCTION USING GRACILIS MYOCUTANEOUS FLAPS AFTER RADICAL VULVECTOMY

OBJECTIVE To introduce the method using the gracilis myocutaneous flaps to repair of vulvar defect after radical vulvectomy. METHODS The gracilis myocutaneous flaps were applied in 4 cases with vulvar carcinoma which located vestibule of vulva and bulk, and the carcinoma was large after radical resection to repair vulvar defect simultaneously. RESULTS The incision of 3 cases was healing by first intention, and 1 case with type II diabetes mellitus was healing by second intention. After followed up 3-6 years, 1 case was recurrent in 2 years after operation, 3 cases were survival without complication. CONCLUSION Vulvar reconstruction with the use of gracilis myocutaneous flaps in radical vulvectomy could markedly decrease the rate of complication.

绝经后子宫颈巨大宫内膜囊肿一例

心瓣膜置换术围术期甲状腺激素的动态观察

目的 探讨心瓣膜置换术围术期甲状腺激素的变化及其与病情程度的关系。方法 采用放射免疫分析法连续测定30例低温体外循环下心瓣膜置换术围术期甲状腺激素，并观察其动态变化。结果 两组患者三碘甲状腺原氨酸(T3)、游离T3(FT3)从转流前至术后72小时呈下降趋势，各时间点均明显低于术前；反三碘甲状腺原氨酸(rT3)均增高，术后72小时仍未恢复至术前水平(P＜0.05)。两组患者四碘甲状腺原氨酸(T4)、游离T4(FT4)、促甲状腺素(TSH)浓度均在生理范围内变化。结论 心瓣膜置换术围术期均表现为低T3综合征，且T3降低与疾病的严重程度有关。临床上通过监测其血清T3和FT3水平可作为了解病情及预后的客观指标。

43例心脏瓣膜疾病的外科治疗

Research on the effects of interleukin-6 on proliferation of cervical cancer cell C-33A

ObjectiveTo explore the role of interleukin-6 (IL-6) in cervical cancer cell C-33A.MethodsThe cervical cancer cells C-33A were divided into the IL-6 group and the control group after culture. The IL-6 group were treated with 50 ng/mL of recombinant IL-6 protein, and the control group were without IL-6. Then cell viability and cell migration were detected by MTT assay and wound-healing assay, respectively. The mRNA and protein expressions of epithelial-cadherin (E-Cad), neural-cadherin (N-Cad), vimentin and transcription factors-snail1 (TFs-SNAIL1) were analyzed by real time quantitative polymerase chain reaction and Western blotting, respectively.ResultsCompared with the control group, in the IL-6 group the proliferation of cervical cancer cells C-33A was promoted (12 h: 0.388±0.025 vs. 0.597±0.057; 24 h: 0.547±0.021 vs. 0.798±0.036; 48 h: 0.745±0.056 vs. 1.296±0.122; 72 h: 1.074±0.053 vs. 1.805±0.113; P<0.05), and the relative migration ability of cervical cancer cell was promoted (12 h: 1.057±0.029vs. 1.200±0.045; 24 h: 1.189±0.036 vs. 1.428±0.181; 48 h: 1.273±0.059 vs. 1.569±0.143; 72 h: 1.409±0.047 vs. 1.623±0.170; P<0.05); meanwhile, compared with the control group, in the IL-6 group, the expression of E-Cad mRNA (1.012±0.098vs. 0.483±0.171, P<0.01) and E-Cad protein (1.032±0.015vs. 0.395±0.119; P<0.01) decreased, the expression of N-Cad mRNA (1.054±0.106vs. 1.465±0.230, P<0.01) and N-Cad protein (1.040±0.043vs. 1.605±0.128, P<0.01) increased, the expression of vimentin mRNA (1.050±0.083vs. 1.340±0.099, P<0.05) and vimentin protein (1.043±0.062vs. 1.430±0.077, P<0.05) increased, and the expression of TFs-SNAIL1 mRNA (1.058±0.176vs. 1.510±0.229, P<0.01) and Fs-SNAIL1 protein (1.022±0.015vs. 1.470±0.139, P<0.01) increased.ConclusionIL-6 may promote the proliferation, migration, and epithelial-mesenchymal transition of cervical cancer cell C-33A.

电视胸腔镜与开胸手术治疗复发性自发性气胸的疗效观察

目的 对比分析电视胸腔镜手术（VATS）与开胸手术治疗复发性自发性气胸的疗效，以提高近、远期治疗效果。 方法 将124例复发性自发性气胸患者按手术方式不同分为两组，VATS组（n=73）：采用VATS治疗；对照组（n=51）:采用常规开胸手术。比较两种术式的复发率、手术时间、住院时间、术后胸痛等。 结果 两组均无手术死亡。VATS组患者手术成功率为97.26%（71/73），其中 1例因胸腔严重粘连，1例因术中出血转为开胸手术。VATS组复发率与对照组比较差异无统计学意义（8.22% vs.5.88%；χ2=0.034，Pgt;0.05）；VATS组手术时间、住院时间均较对照组短（41.13±12.60 min vs. 88.09±41.13 min； 5.96±1.21 d vs. 8.25±1.48 d，u=13.30，9.16；Plt;0.05）；慢性切口疼痛发生率低于对照组（2.74% vs.15.69%;χ2=4.93，Plt;0.05）。所有患者均得到随访，随访时间12~54个月。VATS组术后5个月内复发6例,行开胸手术治疗4例，VATS 2例;对照组术后3个月复发3例,经再次手术治疗治愈。 结论 VATS治疗复发性自发性气胸复发率与开胸手术相近，但住院时间短、美观、微创，近、远期疗效均较好。