Objective To investigate the surgical technique of reduced sized liver transplantation. Methods A reduced size liver transplantation was successfully performed on a 11-year old girl with incurable caroli′s disease. Results The recovery of liver graft function was good after the operation in this patients without complications. Conclusion Reduced size liver transplantation is a safe and effective technique for pediatric liver transplantation to provide liver graft. Authors introduced their experiences of surgical technique in this patient.
【Abstract】 Objective To investigate the effectiveness of the medical calcium sulfate—OsteoSet bone graft substitute in the treatment of defect after excision of jaw cyst. Methods Between December 2009 and May 2010, 15 cases of jaw cystic lesion were treated，including 9 males and 6 females with an average age of 36.6 years (range, 15-75 years). Orthopantomography (OPT) method was used to measure the cyst size before operation, and the size ranged from 1.5 cm × 1.5 cm to 8.0 cm × 3.0 cm. The range of bone defect was from 1.5 cm × 1.5 cm × 1.5 cm to 8.0 cm × 3.0 cm × 3.0 cm after cyst excision intraoperatively. The patients underwent cyst curettage and OsteoSet bone graft substitutes implantation (2-15 mL). Radiological method was used to evaluate the repair effect of OsteoSet pellets. Results The pathology biopsy was periapical cyst in 7 cases, odontogenic keratocyst in 5 cases, and dentigerous cyst in 3 cases. Fifteen patients were followed up 6-12 months. Thirteen patients achieved wound healing by first intention; 2 cases had longer drainage time (5 and 7 days, respectively), the incision healed after the pressure bandage. Swelling occurred in 1 case after 1 month with no symptom of infection. No postoperative infection and rejection was found. The X-ray examination showed that the materials filled the bone defect well after 1 day of operation. OsteoSet bone graft substitutes were absorbed by one-half after 1 month of operation and totally after 3 months by OPT. The low density area was smaller in the original cysts cavity, and high density in the cysts increased significantly with fuzzy boundaries of cysts. At 6 months after operation， there was no obvious difference in image density between the original cavity and normal bone, and the capsule cavity boundary disappeared, and defect area was full of new bone. Conclusion The medical calcium sulfate—OsteoSet bone graft substitute is an ideal filling material for bone defect.
目的 探討腹膜后囊性淋巴管瘤的CT診斷價值和治療方法。方法 回顧性分析2004年6月至2010年5月期間我院收治的5例經病理檢查證實的腹膜后囊性淋巴管瘤患者的臨床表現、CT影像特征、手術治療及術后隨訪的資料。結果 5例患者術前CT均診斷為囊性淋巴管瘤，均行手術完整切除腫瘤，術后病理結果均證實為囊性淋巴管瘤。術后7 d順利出院，隨訪3個月～6年均無復發。結論 CT對腹膜后囊性淋巴管瘤的診斷具有重要意義，手術完整切除整個囊壁是治療及預防術后復發的最好方法。
探討立體定向囊內放射治療囊性和囊實性顱咽管瘤的方法和療效。方法:對12例囊性和囊實性顱咽管瘤的囊性部分行CT、MRI 引導立體定向吸除囊液、注入膠體磷酸鉻,待瘤囊縮小遠離視神經等重要結構后,施行伽瑪刀治療。結果:全部病例經手術排出囊液后臨床癥狀迅速改善。經囊內放療后2-36個月隨訪12例患者,CT、MRI掃描顯示5例患者瘤囊持續消失,臨床癥狀消失,恢復正常的生活和學習;5例患者腫瘤顯著縮小,癥狀持續改善;2例腫瘤無明顯改變;無死亡病例。結論:CT、MRI引導立體定向放射治療囊性顱咽管瘤安全、有效。
目的 總結穿刺抽液及無水乙醇局部注射在老年良性甲狀腺囊性疾病患者中的應用方法及效果。方法 回顧性分析2008年1月至2011年6月期間在我院行穿刺抽液及無水乙醇注射治療的老年良性甲狀腺囊性疾病患者的臨床資料。結果 共84例患者接受穿刺抽液及無水乙醇注射，男11例，女73例；年齡（69±6.4）歲（60～82歲）。術前彩超檢查包塊均為囊性，直徑（4.8±1.7） cm。術前所有患者均主訴吞咽或活動時頸部不適感。54例患者注射無水乙醇后出現面色潮紅、局部皮膚發紅等癥狀，在1～2d內消失。無感染、死亡等發生。術前、術后甲狀腺功能比較無變化。術后半年復查彩超，包塊直徑縮小為（1.9±1.2） cm。術后患者主訴頸部不適感癥狀減輕或消失。結論 對于老年良性甲狀腺囊性疾病患者行穿刺抽液及無水乙醇注射安全，可有效緩解患者局部壓迫不適，其遠期療效還有待長期觀察。
ObjectiveTo analyze the efficacy and safety of complete excision of the external capsule in the treatment of hepatic echinococcosis.MethodsThe clinical data of 90 patients with hepatic cystic echinococcosis admitted to our hospital from January 2016 to March 2018 were retrospectively analyzed. According to the different surgical methods, this patients were divided into two groups: the partial hepatectomy group and complete excision of the external capsule group, 45 cases in each group. The patient's general condition and the situation during hospitalization were analyzed, and the intraoperative conditions, postoperative complications, recurrence and mortality after one year in different surgical methods were compared.ResultsThe operative time and intraoperative blood loss in the partial hepatectomy group was significantly longer or more than that in the complete excision of the external capsule group (P<0.05), respectively. There was no significant difference between the two groups in hospitalization time (P>0.05). The incidence of postoperative complications was 11.11% in the partial hepatectomy group and 8.88% in the complete excision of the external capsule group. There was no significant difference between the two groups (P>0.05). After 1 year of followed-up, the recurrence rate of the partial hepatectomy group was 4.44%, and there was no recurrence in the complete excision of the external capsule group, and there was no significant difference between the two groups (P>0.05). There was no death in both groups.ConclusionsIn the surgical treatment of hepatic cystic echinococcosis, the most appropriate surgical method should be selected according to the specific conditions of the patient, and the complete excision of the external capsule has higher therapeutic effect and safety in the treatment of hepatic echinococcosis. It is worthy of clinical promotion.
ObjectivesTo systematically review the efficacy and safety of ciprofloxacin for non-cystic fibrosis bronchiectasis.MethodsDatabases including PubMed, EMbase, The Cochrane Library, CBM, VIP, CNKI and WanFang Data were electronically searched from inception to August 2018 to collect randomized controlled trials (RCTs) on ciprofloxacin in the treatment of non-cystic fibrosis bronchiectasis. Two reviewers independently screened literature, extracted data, and assessed risk of bias of included studies. Then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 9 RCTs involving 1 666 patients were included. The results of meta-analysis showed that: compared with control group, the ciprofloxacin more efficiently eradicate bacteria from sputum (RR=4.34, 95%CI 2.04 to 9.23, P=0.000 1), decrease risk of the exacerbations (RR=0.81, 95%CI 0.71 to 0.93, P=0.002) and the mean bacterial load (MD=–4.08, 95%CI –6.29 to –1.87, P=0.001). However, there were no significant differences between two groups in clinical efficiency and adverse events.ConclusionsThe current evidence shows that, ciprofloxacin can decrease the mean bacterial load and risk of the exacerbation, and more efficiently eradicate bacteria from sputum in non-cystic fibrosis bronchiectasis patients. Due to limited quality and quantity of the included studies, more studies are required to verify the conclusions.