目的探讨上颌骨及面中份缺损修复重建的方法。方法选取2004至2012年因上颌骨及面中份缺损行组织瓣重建患者22例。共使用组织瓣26块,其中游离组织瓣20块,带蒂组织瓣6块;包括前臂皮瓣14块,股前外侧肌皮瓣2块,腹直肌2块,腓骨肌皮瓣2块,颊脂体瓣2块,胸大肌皮瓣、咽上缩肌瓣、颊肌黏膜瓣及腭瓣各1块。结果 26块组织瓣中1例前臂因血管栓塞失败,余组织瓣均完全成活。患者术后进食及语音功能良好。结论应用游离及局部组织瓣可较好修复上颌骨及面中份的缺损和功能。局部组织瓣仅适用中小型缺损的重建;大型上颌骨及面中份缺损宜采用游离组织瓣修复。

Objective To discuss the reconstruction methods for the defect in maxilla and midface. Methods From 2004 to 2012, 22 patients with maxilla and midface defect were reconstructed with vascularized free flap and pedicle flap, including 14 forearm flaps;2 anterolateral thigh flaps;2 rectus abdominis flaps;2 fibula flaps; 2 buccal fat pad falps; 1 pectoralis major flap; 1 buccinator myomucosal flap; 1 superior-constrictor myomucosal flap;1 palatal flap. Results All tissue flaps survived well except one forearm flap necrosis because of arterial thrombosis.The postoperative appearance of patient was acceptable, and the functions of swallowing and speech were normal or almost normal. Conclusions Maxilla and midface reconstruction with free tissue flap or local flap is a reliable method with good function. Local flaps can be used in small-medium defect. Free tissue flaps are more suit for large defect reconstruction.

对乌龟消化道的辐射损伤进行了研究.结果显示乌龟消化道由5部分组成,即口咽腔、食道、胃、小肠和大肠.后4部分均由黏膜层、黏膜下层、肌层和外膜组成.消化道经X线辐射后的第1d,食道黏膜层可见脱落和黏膜层细胞出现凋亡,黏膜下层血管出现栓塞和肌层血管出现凝血;胃、小肠和大肠的黏膜细胞及腺体细胞均出现凋亡.辐射后第8d,食道黏膜层细胞凋亡加重,血管栓塞加重,外膜损伤明显,固有膜中的淋巴组织凋亡,腺体破坏严重;胃、小肠和大肠黏膜及腺体细胞凋亡加重,黏膜下层血管栓塞.辐射后第16d,受损的食道黏膜层细胞和腺体结构修复,外膜恢复其完整性;胃、小肠和大肠黏膜细胞凋亡减少,新生细胞增多,血管栓塞减轻.

The irradiation damage of aimentary tract of Chinemys reevesii was studied.The results showed that the aimentary tract of Chinemys reevesii were composed of five parts,including oropharyngeal cavity,esophagus,stomach,small intestine and large intestine.The behind four parts were composed of mucosa,submucosa,muscular layer and serosa.The first day after X-ray irradiation,some eophageal mu-cosa fell off,some mucosa cells were apoptosis,the submucosa blood vessels embolized and the myome-trial vessels had coagulation in esophagus.The mucosal cells and the glandular cells in stomach,small intestine and large intestine had apoptosis.The eighth day after irradiation,the apoptosis of the esophage-al mucosa and the embolism of blood vessel were more serious,the damage of serosa was obvious,the lymphatic tissue of proper coat had apoptosis,the damage of gland was serious in esophagus.The apopto-sis of the mucosal cells and the glandular cells were more serious and the submucosa blood

目的对比三种术式治疗直肠黏膜内脱垂的临床疗效，探讨吻合器直肠黏膜环切术（PPH）加直肠黏膜松弛柱状结扎术治疗直肠黏膜内脱垂型便秘的优越性。方法A组43例采用吻合器直肠黏膜环切术加直肠黏膜柱状结扎术，B组30例采用吻合器直肠黏膜环切术，C组32例采用直肠黏膜柱状结扎术。结果三组术后有效率比较无显著性差异，A组痊愈率显著高于B、C两组，术后随访6～12个月，B、C两组复发率显著高于A组。结论对于直肠黏膜内脱垂所致的便秘及合并直肠前突所致的便秘，吻合器直肠黏膜环切术（PPH）加直肠黏膜松弛柱状结扎术治疗具有创伤小、操作方便、并发症少、恢复时间短、安全性高等优点。

Objective The study was to compare with rectal mucosa prolapse clinical efficacy in three different surgery treatments.To explore the reliability of PPH( procedure for prolapse and hemorrhoids) and the longitudinal ligation of rectal mucosa in the treatment of obstructive constipation induced by prolapse of rectal mucosa. Methods A group of 43 cases were treated with PPH and longitudinal ligation of rectal mucosa.B group of 30 cases were treated with PPH.C group of 32 cases were treated with longitudinal ligation of rectal mucosa. Results The cases of three groups had no significant difference in effectiveness comparison.Cure rate of group A was significantly higher than group B and group C.All cases had followed for 6 to 12 months.B and C groups of the recurrence rate were significantly higher than group A. Conclusion The method of PPH and longitudinal ligation of rectal mucosa was the advantage of small trauma, easy to operate,fewer complications,short recovery time, high security fo

目的：研究慢性乙型肝炎病毒感染患者胃黏膜病变的发生机制，为临床治疗提供依据。方法选取2012年4月－2014年4月医院收治的慢性乙型肝炎病毒感染患者30例，检测患者血清中的乙型肝炎五项标志物，采用胃镜检查胃黏膜的病变，采用免疫组织化学法检测胃黏膜组织中的 HBsAg、HBcAg ，并观察记录检测结果。结果30例慢性乙型肝炎病毒感染患者中胃黏膜病变19例占63．3％，胃黏膜组织中 HBsAg和（或）HBcAg阳性患者10例，其中有7例胃黏膜病变为中度或重度，占70．0％，慢性乙型肝炎病毒感染患者胃黏膜组织中 HB‐sAg、HBcAg检测结果阳性，患者的胃黏膜病变较严重，但胃黏膜的病变程度和血清中的乙型肝炎标志物的分布无关系。结论乙型肝炎病毒感染者会出现胃黏膜组织病变，乙型肝炎病毒在胃黏膜中复制，胃黏膜病变程度和乙型肝炎病毒感染有密切关系。

OBJECTIVE To study the mechanism of gastric mucosal lesions in the patients with chronic hepatitis B virus infection so as to provide guidance for clinical treatment .METHODS A total of 30 patients with chronic hepa‐titis B virus infection who were treated in the hospital from Apr 2012 to Apr 2014 were enrolled in the study ,then the five hepatitis B markers in the serum were detected ,the gastric mucosal lesions were examined by using gas‐troscope ,the HBsAg and HBcAg in gastric mucosal tissues were detected with the use of immunohistochemistry , and the results were observed and recorded .RESULTS Of the 30 patients with chronic hepatitis B virus infection , 19 cases were with gastric mucosal lesions accounting for 63 .3% ;there were 10 cases with HBsAg and (or )HB‐cAg tested positive in the gastric mucosal tissues ,among whom 7 cases were with moderate or severe gastric mu‐cosal lesions ,accounting for 70 .0% .The HBsAg and HBcAg were tested positive in the gastric muco

探讨内镜下黏膜剥离术(ESD)治疗上消化道广基息肉、黏膜下肿瘤的疗效和安全性。方法:对内镜发现的58例上消化道隆起性病变进行超声内镜检查(25例病变位于黏膜层,16例位于黏膜肌层,17例位于黏膜下层),应用HOOK刀及IT刀行内镜下黏膜剥离术治疗。黏膜下注射生理盐水抬高病变,使病变与肌层分离,预切开病变周围黏膜,剥离病变下方黏膜下层结缔组织,完整切除病变。结果:58例患者均成功完成ESD治疗,病变大小0.4~3.4 cm(平均1.5 cm),手术时间15~95 min(平均40 min),无出血、穿孔等并发症。所有ESD剥离病变包膜完整,基底和切缘未见病变累及。结论:ESD治疗上消化道广基息肉、黏膜下肿瘤安全、有效,可以完整切除病变,提供完整的病理诊断资料。

Objective To assess the clinical efficacy and safety of endoscopic submucosal dissection (ESD) for flat polyp and submucosal tumor (SMT) of the gastrointestinal tract. Methods Total 58 patients with muco-sal tumor of the gastrointestinal tract diagnosed by endoscopy were examined using endoscopic ultrasonography (EUS). Among the cases, 25 lesions were within the submucosa, 16 lesions were within the submucosa muscula-ris and 17 in the submucosa propria. The cases were managed by ESD with a HOOK and IT knife. After injec-tion of physiological saline solution into the submucosal layer to separate the lesion from the muscle layer, the mucosa surrounding the lesion was pre-cut, and the connective tissue of the submucosa beneath the lesion was dissected. Then, the lesion was resected completely. Results All lesions were successfully resected with ESD. The resected lesions sized 0.4~3.4 cm in diameter (mean,1.5 cm) . The mean ESD procedure time was 40 min (ranged from 15 to 95 min). None of