Objective To investigate the long-term clinical results of treatment of adult unicameral bone cyst with cancellous allograft. Methods From 1993 to 1998, 15 patients with unicameral bone cyst were treated by allograft with lyophilized cancellous bone. Among 15 patients, there were 5 males and 10 females, aging 19-41 years with an average of 27 years. The average follow-up time was 7.5 years (6-11 years). The X-ray films were taken and the CT scanning were carried out. Results The X-ray films showed that the allograft particles became vague 2-3 months after operation, that the allograft particles fused and began to form new bone and the bone density increased 5 months after operation, and that new bone formation completed after 7 months of operation. At the end of follow-up, remodelling in new bone occurred. Reoccurrence was not found in all patients. The symptom of pain disappeared or relieved obviously. Conclusion Allograft of lyophilized cancellous bone is an effective treatment for adult unicameral bone cysts.
目的 总结成人大肠套叠治疗经验。方法 回顾性分析我院1969～1998年收治的83例成人大肠套叠患者的临床资料。结果 经钡灌肠复位6例，手术治疗77例。肿瘤性大肠套叠60.2%，其中恶性肿瘤性套叠占64.0%。恶性肿瘤套叠手术切除5年生存率43.8%。结论 对成人大肠套叠治疗首选手术切除，慎用手术复位，不主张钡灌肠复位。
Objective To summarize the methods of repairingthe urethral defect in the penis of an adult and the clinical application of the island skin flaps of the scrotum septum to the reparative treatment. Methods From January 2000 to November 2005, twenty-six cases of urethral defect in penis, including 16 cases of congenital urethral defect, 6 cases of traumatic urethral defect in middle penis, and 4 cases of distal urethral defect, were repairedby the local penis fascia flaps.The island skin flaps of the scrotum septum were transferred to cover the penis wound. The pedicle contained the artery of the posterior scrotum and the artery of the anterior scrotum. The flap taken from the scrotum septum was 2.5 cm×5.5 cm in area. Results After a follow-up of 7months to 4 years, all the 26 patients had the healing of the first intention without urethral fistula, urethral narrowness or penis curvature, except 4 patients who developedinfection and leakage of urine, but the wounds healed spontaneously 2-4 weeks after operation. Conclusion The penis fascia flaps and the island skin flaps of the scrotum septum can be used to repair the urethral defect in the penis of an adult. The blood supply to the flaps is sufficient and all theflaps can survive well. A good shape and function of the penis can be obtained.
目的总结Millikan无张力疝修补术治疗腹股沟疝的经验。方法对笔者2008年1月至2010年1月期间完成的Millikan无张力疝修补术患者的临床资料进行总结、分析。结果本组 32例共35侧疝，按国内疝学组分型(2003年)，Ⅰ型2侧，Ⅱ型9侧，Ⅲ型21侧，Ⅳ型3侧。直疝6侧，斜疝29侧。其中行急诊疝修补术2例。术后发生尿潴留2例(6.25%),无切口感染、血肿、睾丸炎等并发症发生； 住院时间3~5 d，平均3.5 d。随访2~24个月，平均18个月，无复发及慢性疼痛者。结论Millikan手术是一种操作简便、安全、符合无张力疝修补原理的术式，适用于Ⅱ~Ⅳ型腹股沟疝的修补。
Objective To evaluate the effectiveness and safety of ramelteon for chronic insomnia in adults. Methods The following databases as CENTRAL, PubMed, EMbase, ISI, CNKI, CBMdisc, VIP and WanFang Data were searched from the date of their establishment to November 2010. The randomized controlled trials (RCTs) meeting the inclusion criteria were included. The data extraction and quality assessment were conducted according to the methods of Cochrane Reviewers’ Handbook recommend by The Cochrane Collaboration, and meta-analysis was performed with RevMan5.0 software. Results A total of 5 RCTs involving 1 772 patients were included. The results of meta-analyses showed that: a) Effectiveness: In the effectiveness, ramelteon was superior to placebo in latency to persistent sleep (MD=18.36, 95%CI 11.55 to 25.18, Plt;0.000 01), total sleep time (MD= –15.47, 95%CI –22.50 to –8.43, Plt;0.000 1), sleep efficiency (MD= –3.39, 95%CI –5.32 to –1.46, P=0.000 6), sleep quality (MD=0.14, 95%CI 0.03 to 0.25, P=0.01) after one week treatment and latency to persistent sleep (MD=13.02, 95%CI 6.01 to 20.03, P=0.000 3) except for wake after sleep onset (MD= –8.79, 95%CI –17.24 to –0.35, P=0.04) after one month treatment. b) Safety: significant differences were only found in the female prolactin (MD=5.50, 95%CI 2.02 to 8.98, P=0.002) and male free testosterone (MD=15.30, 95%CI 0.62 to 29.98, P=0.04) between the two groups, rather than in all the other hormones concentration, rebound insomnia, withdrawal syndrome, next-day residual effects and incidence rate of adverse reactions. Conclusion Ramelteon has marked effects on adults’ chronic insomnia after 1-week treatment, but its effect is not obvious after 1-month treatment. The adverse reactions are mostly the somnolence, rising of male free testosterone and female prolactin concentration.
目的 探讨伴颞下颌关节紊乱病（TMD）的成人正畸患者的心理社会因素。 方法 2009年5月－2011年12月伴TMD的成人正畸患者42例为观察组，无矫正要求、伴TMD的错牙合患者50例为对照组。采用九十项症状清单（SCL-90）、艾森克人格问卷（EPQ）进行测试，同时进行TMD调查。 结果 观察组与对照组相比，得分较高的有强迫、焦虑、抑郁、人际关系敏感等因素，差异有统计学意义（P＜0.05）；观察组患者P量表、N量表得分高于对照组，差异有统计学意义（P＜0.05）。 结论 伴TMD的成人正畸患者心理健康问题普遍存在,倾向于神经质和精神质的人格特征。
Abstract： Objective To investigate the clinical results of offpump anatomic surgical repair for complex coarctation in adults. Methods We retrospectively analyzed the clinical data of 7 patients with complex coarctation who underwent onestage anatomic surgical repair between January 2005 and December 2008 in Fu Wai Hospital. There were 5 males and 2 females with the age ranged from 16 to 41 years, average at 24.4 years. Among all the patients, there were 2 patients of coarctation with hypoplastic aortic arch, 1 of coarctation with aortic arch aneurysm, 3 of coarctation with descending thoracic aortic aneurysm, and 1 of coarctation with B type aortic dissection. All patients were diagnosed by color echocardiography, CT or agnetic resonance imaging（MRI）. All off-pump operations were performed under general anesthesia and ambient temperature. Median sternotomy was performed in 1 patient and left thoracotomy in 6 patients. Aortic arch patching enlargement was performed in 4 patients and descending thoracic aorta replacement in 3 patients (including 1 combined with abdominal aorta replacement and 1 case of Stanford B type aortic dissection, trunk stent was transplanted at the same time). Results There was no hospital mortality or severe surgical complications. Seven patients were followed up for a period ranged from 6 to 49 months with an average time of 20.1 months. No late death or recoarctation occurred. Hoarseness occurred in one patient and presented no improvement during the 11 months follow-up. Conclusion Onestage offpump anatomic surgical repair is safe and feasible in treating adult patients with complex coarctation, and it shows a good immediate and longterm result.