尿道下裂成形术后并发症的临床研究

目的探讨和总结尿道下裂成形术后发生并发症的原因,发病比例,相应的处理措施及预防方法。方法117例尿道下裂患者进行尿道成形术后产生并发症19例,年龄为36月~24岁,平均为4.6岁。发生并发症的尿道下裂临床分型为阴茎头型10例,阴茎体型5例,阴茎阴囊型、阴囊型或会阴型等重度尿道下裂4例。成形尿道长度为1.2~4.4cm,平均为2.6cm。结果术后随访1~3年,总的并发症发生率为15.9%。其中尿道瘘者为11例(57.9%),尿道狭窄4例(21.1%),尿道憩室1例(5.3%),尿道口退缩1例(5.3%),阴茎弯曲畸形矫正不全1例(5.3%),阴茎皮肤外观重度不良1例(5.3%)。尿道瘘和尿道狭窄发生率显著高于其它并发症发生率(P<0.05),尿道瘘的发生率显著高于尿道狭窄发生率(P<0.05)。结论尿道瘘是尿道下裂成形术后最常见的并发症,尿道狭窄次之。选择适宜的术式,严格精细的手术操作,是减少该类并发症的关键;适宜的切口敷料,恰当的尿液引流方法,支架管放置方法,合理的术后用药和加强护理均有助于减少并发症的发生率。     

利用背侧包皮一期修复21例尿道下裂

目的分析在阴囊皮瓣尿道成型术中背侧包皮的临床利用价值。方法收集采用上述方法治疗的21例尿道下裂患儿临床及术后随访资料,分析总结手术治疗效果及术后并发症发生情况。结果一期手术治愈18例,外形效果比较满意,治愈率85.7%,其中冠状沟型5例,阴茎体型16例。术后尿道狭窄1例,尿道瘘2例。结论在阴茎、阴囊纵隔皮瓣尿道成形术基础上进行改良,利用背侧包皮覆盖在腹侧并包埋重建尿道的尿道成型的新方法,一期修复尿道下裂,疗效满意,方法简单,并发症少,易于掌握,值得临床推广应用。     

琥珀酸索利那新治疗小儿尿道下裂术后膀胱痉挛有效性及安全性研究

目的观察琥珀酸索利那新用于小儿尿道下裂术后膀胱痉挛的临床疗效及其安全性评价.方法将入选的60例小儿尿道下裂患者根据个体病情选择适当的尿道成形术,术后将患者随机分为两组.实验组(30例)患儿于手术当日起口服琥珀酸索利那新,3 mg/次,1次/d,服用7 d;对照组(30例)患儿在出现膀胱痉挛疼痛时予以吲哚美辛直肠栓剂25 mg作镇痛处理.记录术后7 d患儿膀胱痉挛每日发作次数、膀胱痉挛平均持续时间;记录患儿术后3 d内每日排尿次数、单次排尿量和急迫性尿失禁次数;观察患儿术后并发症尿道瘘和尿道狭窄、不良反应的发生情况.结果实验组术后每日膀胱痉挛次数、膀胱痉挛持续时间、术后3 d内平均排尿次数和急迫性尿失禁次数均显著低于对照组(P0.05),而单次排尿量明显高于对照组(P0.05).比较两组患者术后尿道瘘和尿道狭窄发生率,差异均无统计学意义(P0.05).实验组患者服用琥珀酸索利那新后未出现严重不良反应.结论琥珀酸索利那新能够有效预防和治疗小儿尿道下裂术后膀胱痉挛,术后并发症、不良反应发生率低,符合临床应用的有效性和安全性.     

新创尿道下裂成型术治疗尿道下裂体会

目的在阴茎、阴囊纵隔皮瓣尿道成形术基础上进行改良，治疗冠状沟型、阴茎体型、阴茎阴囊型尿道下裂，为临床选择最佳手术方式提供依据。方法本组20例患者，在阴茎、阴囊纵隔皮瓣尿道成形术基础上进行改良，采用阴茎体腹侧、背侧都呈十字型切开，切除纤维索，再利用阴囊表面纵隔皮瓣做成尿道，上翻后缝合处位于背侧，使尿道纵向成型及吻合腹侧皮肤褥式缝合。结果一期手术治愈17例，外形效果满意，治愈率85％，其中冠状沟型5例，阴茎体型治愈14例，阴囊型治愈1例。术后尿道狭窄1例，尿道瘘2例。结论在阴茎、阴囊中隔皮瓣尿道成形术基础上进行改良，设计出阴茎、阴囊、会阴联合皮瓣一期尿道成型的新技术，一期修复尿道下裂疗效满意，方法简单，疗效满意。     

基层医院尿道下裂分期手术经验总结(附32例报告)

探讨县级医院尿道下裂分期手术治疗效果及经验总结。回顾性分析我科2004-2015年收治的尿道下裂患者32例,其中阴茎型18例,阴茎阴囊型11例,会阴型3例。采用分期进行手术修复。32例患者完成分期手术。Ⅰ期手术所有病例均阴茎弯曲矫正良好,30例皮瓣成活良好,2例皮瓣坏死。Ⅱ期手术20例尿道一期愈合,尿道瘘10例,尿道裂开2例。对于基层医院开展尿道下裂手术笔者等认为分期手术优于一期手术,能够提高手术的成功率,为后期手术修补提供再次手术机会。     

阴囊中隔带蒂皮片翻转修复尿道下裂5例

我院对5例先天性尿道下裂患者行此种手术方法，取得了满意的临床疗效。 1 一般资料年龄：5岁1例，12岁2例，17岁1例，23岁1例。阴茎会阴型1例，其余4例均为阴茎型。5例患者分别于半年前行过尿道下曲矫正术。本次手术后住院最短者13天，最长者24天，平均为16.4天。其中4例治愈，1例因术后伤口感染，形成尿瘘，手术失败。成功率为80%。2 治疗方法先行耻骨上膀胱造瘘术。再行尿道成形术，在龟头上缝一针牵引线。于阴茎腹侧正中线切取宽1cm的尿道皮条，此皮条由冠状沟至尿道口不做游离，但要将皮条周围的皮肤做少量的皮下分离。再由尿道口下切取…     

尿道内切开联合电切术治疗尿道狭窄或闭锁25例分析

目的：探讨尿道内切开联合电切术治疗尿道狭窄或闭锁的临床应用。方法：25例尿道狭窄或闭锁用输尿管硬镜探查尿道疤痕,用电极行尿道内切开,钻通闭锁段尿道后,扩张尿道至F2,再经尿道放入电切镜切除疤痕组织。结果：24例1次手术治愈,1例手术失败。无并发症。手术成功率96%（24/25）。留置F20尿管4～6周。术后排尿通畅。随访15例,随访时间3周～2年,6例排尿通畅,9例行尿道扩张2～6次。结论：尿道内切开联合电切术创伤小,是治疗尿道狭窄安全、有效的方法,具有成功率高、并发症少等优点。     

前列腺等离子电切术后尿道狭窄的原因分析

目的:探讨经尿道等离子双极前列腺电切术(TuPKRP)后尿道狭窄的常见原因及预防措施.方法:对我院2002年11月-2005年5月行TuPKRP术后发生尿道狭窄的6例患者作回顾性分析.结果:6例患者术后1-12个月出现尿道狭窄.其中尿道外口狭窄3例,膀胱颈挛缩狭窄2例,前尿道中部1例.结论:TUPKRP术后尿道狭窄是一种比较常见的并发症,值得为每一位泌尿外科医生重视,手术时加以预防、术后密切随访和选择合适治疗方法是治愈和减少其发生的关键.     

浅析尿道下裂术后并发尿"瘘"的防治

通过对12例不同类型的先天性尿道下裂患儿的术前、术中与术后的治疗观察，总结并分析了尿道下裂术后发生“瘘”的几个相关因素。在术前、术中与术后对可能发生瘘的每一个细节加以预防，可以降低“瘘”的发生。     

尿道内切开联合电切术治疗尿道狭窄或闭锁25例分析

目的:探讨尿道内切开联合电切术治疗尿道狭窄或闭锁的临床应用.方法:25例尿道狭窄或闭锁用输尿管硬镜探查尿道疤痕,用电极行尿道内切开,钻通闭锁段尿道后,扩张尿道至F2,再经尿道放入电切镜切除疤痕组织.结果:24例1次手术治愈,1例手样失败.无并发症.手术成功率96%(24/25).留置F20管4～6周.术后排尿通畅.随访15例,随坊时间3周～2年,6例排尿通畅,9例行尿道扩张2～6次.结论:尿道内切开联合电切术创伤小,是治疗尿道狭窄安全、有效的方法,具有成功率高、并发症少等优点.     

Markedness and its Interpretation in Language Use

Language markedness is a common phenomenon in languages, and is reflected from hearing, vision and sense, i.e. the variation in the three aspects such as phonology, morphology and semantics. This paper focuses on the interpretation of markedness in language use following the three perspectives, i.e. pragmatic interpretation, psychological interpretation and cognitive interpretation, with an aim to define the function of markedness.     

Features of Women's language

Language is a means of verbal communication. People use language to communicate with each other. In the society, no two speakers are exactly alike in the way of speaking. Some differences are due to age, gender, statue and personality. Above all, gender is one of the obvious reasons. The writer of this paper tries to describe the features of women＇s language from these perspectives： pronunciation, intonation, diction, subjects, grammar and discourse. From the discussion of the features of women＇s language, more attention should be paid to language use in social context. What＇s more, the linguistic phenomena in a speaking community can be understood more thoroughly.     

低渗透非均质砂岩油藏启动压力梯度研究

理论推导与室内实验相结合,建立了低渗透非均质砂岩油藏启动压力梯度确定方法。首先借助油藏流场与电场相似的原理,推导了非均质砂岩油藏启动压力梯度计算公式。其次基于稳定流实验方法,建立了非均质砂岩油藏启动压力梯度测试方法。结果表明:低渗透非均质砂岩油藏的启动压力梯度确定遵循两个等效原则。平面非均质油藏的启动压力梯度等于各级渗透率段的启动压力梯度关于长度的加权平均;纵向非均质油藏的启动压力梯度等于各渗透率层的启动压力梯度关于渗透率与渗流面积乘积的加权平均。研究成果可用于有效指导低渗透非均质砂岩油藏的合理井距确定,促进该类油藏的高效开发。     

On Tragic Consciousness In The Works By Ernest Hemingway

As an American modern novelist who were famous in the literary world, Hemingway was not a person who always followed the trend but a sharp observer. At the same time, he was a tragedy maestro, he paid great attention on existence, fate and end-result. The dramatis personae's tragedy of his works was an extreme limit by all means tragedy on the meaning of fearless challenge that failed. The beauty of tragedy was not produced on the destruction of life, but now this kind of value was in the impact activity. They performed for the reader about the tragedy on challenging for the limit and the death.     

Achieving Unusual States of Matter Under High Pressure

正The periodicity of the elements and the non-reactivity of the inner-shell electrons are two related principles of chemistry,rooted in the atomic shell structure.Within compounds,Group I elements,for example,invariably assume the+1 oxidation state,and their chemical properties differ completely from those of the p-block elements.These general rules govern our understanding of chemical structures and reactions.Using first principles calcula-     

Exchange-Correlation and Electronic Excitation Energies from Pairing Matrix Fluctuations

We have developed an adiabatic connection to formulate the ground-state exchange-correlation energy in terms of pairing matrix linear fluctuations.This formulation of the exchange-correlation energy opens a new channel for density functional approximations based on the many-body perturbation theory.We illustrate the potential of such approaches with an approximation based on the particle-particle Random Phase Approximation(pp-RPA).This re-     

Density Functional Theory for the Response of Periodic Systems to Electric Fields Based on the Vector Potential Approach

正The electronic and nuclear(structural/vibrational)response of 1D-3D nanoscale systems to electric fields gives rise to a host of optical,mechanical,spectral,etc.properties that are of high theoretical and applied interest.Due to the computational difficulty of treating such large systems it is convenient to model them as infinite and periodic(at least,in first approximation).The fundamental theoretical/computational problem in doing so is that     

On the Thermodynamic Limit for Responses to Static Electromagnetic Fields

For molecular systems,the quantum-mechanical treatment of their responses to static electromagnetic fields usually employs a scalar-potential treatment of the electric field and a vector-potential treatment of the magnetic field.Although the potential for each field separately is associated with the choice of an(unphysical)origin,the precise choice of the origin for the electrostatic field has little consequences for the results.This is different for the     

An affordable accurate evaluation of the binding conformations predicted by molecular docking studies in bio-system

Franck-Condon factors bridge the gap between theoretical modeling and experimental observations for molecular electronic spectroscopy and electron transfer.Under the displaced harmonic oscillator approximation,multidimensional Franck-Condon factors are decomposed into a product of many one-dimensional(1D)Franck-Condon(FC)factors,and each 1D-FC factor is associated with one Huang-Rhys factor that determines the leading contribution of     

Call for Papers

<正>"The Journal of Shanghai Normal University:Mathematics"is published by Shanghai Normal University as regular issues of The Journal of Shanghai Normal University each year from 2014 in English.The editors-in-chief of the issues are professors Yuhao Cong and Maoan Han.The Journal of Shanghai Normal University was started in 1958 with