Many women and providers are unprepared for an evidence-based, educated conversation about birth

Findings from recent Canadian studies on the knowledge and beliefs about birth practices among first-time pregnant women and among obstetricians and other birth providers indicate that many women are inadequately informed and many providers deliver non-evidence-based maternity care. Consequently, informed decision making is problematic for pregnant women and their providers. New strategies are needed to inform pregnant women about key procedures and approaches that might be used in birth so they can have an educated, shared discussion with their provider and successfully advocate for their preferred birth experience. In addition, providers can be encouraged to supplement their knowledge with current, evidence-based maternity care practices. To avoid a lack of informed decision making and to ensure that natural, safe, and healthy birth practices are based on current evidence, pregnant women and providers must work together to inform themselves and to add childbirth to the women's health agenda.     

改良B-Lynch缝合术在剖宫产产后出血中的应用

目的探讨改良B-Lynch缝合术在治疗剖宫产产后出血中的应用价值。方法研究组87例剖宫产术中宫缩乏力性出血病例采用改良B-Lynch缝合术治疗。随机选择45例剖宫产术中宫缩乏力性出血病例作为对照组采用传统方法治疗,在手术时间、产后出血量、住院天数、治疗效果方面对比两组术式的临床治疗效果。结果研究组病例治疗后临床效果显著,其在手术时间、产后出血、住院天数及有效率与对照组比较差异有统计学意义（P〈0.05）,无一例子宫切除,无并发症发生,子宫复旧,月经复潮时间无差异。结论改良B-Lynch缝合术具有操作简单,止血迅速和安全有效等优点,值得在临床上进一步推广普及。     

内镜下甲状腺切除19例分析

[目的] 探讨内镜下甲状腺切除的可行性及技术特点。[方法] 回顾性总结19例内镜下甲状腺切除的方法与经验，并对其优缺点进行探讨。[结果] 腺叶全切12例，腺叶大部切除4例。肿块剜除3例，手术全部成功，平均手术时间：乳晕入路194min(140～320min)，胸骨上入路106min(80～150min)。与传统甲状腺手术相比，内镜下甲状腺切除美容效果显著，术后恢复较快。[结论] 内镜下甲状腺切除安全、可行，目前主要适用于甲状腺良性疾病。     

医德教育与外科临床教学相结合的探讨

开展医德教育,可以结合外科临床教学对学生进行爱国主义教育、法规教育和思想品德教育。     

远程虚拟手术仿真实验系统

为提高远程医务培训的真实性与有效性,开发了基于虚拟现实的远程手术仿真实验系统。该系统以C/S模式构建远程通信网络,使其具备视频、语音、文件等实时传输功能;基于虚拟现实技术实现虚拟手术仿真的三维场景渲染和简单手术操作,使系统具备二维医学图像分析、三维重建、器官分割等功能。测试结果表明:该系统可以实现远程用户间视频、语音的流畅通信,也可以在建立连接后进行二维医学图像浏览、三维重建以及简单的切割操作,从而为后续有具体应用的遥操作虚拟手术仿真系统实现奠定基础。     

Healthy Birth Practice #6: Keep Mother and Baby Together— It’s Best for Mother,Baby, and Breastfeeding

Mothers and babies have a physiologic need to be together at the moment of birth and during the hours and days that follow. Keeping mothers and babies together is a safe and healthy birth practice. Evidence supports immediate, uninterrupted skin-to-skin care after vaginal birth and during and after cesarean surgery for all stable mothers and babies, regardless of feeding preference. Unlimited opportunities for skin-to-skin care and breastfeeding promote optimal maternal and child outcomes. This article is an updated evidence-based review of the “Lamaze International Care Practices That Promote Normal Birth, Care Practice #6: No Separation of Mother and Baby, With Unlimited Opportunities for Breastfeeding,” published in The Journal of Perinatal Education, 16(3), 2007.     

Draf型鼻内额窦引流术处置额隐窝病变

目的：探讨应用Draf型鼻内额窦引流术处置额隐窝病变的可行性。方法：对12例（16侧）额隐窝病变患者应用Draf型鼻内额窦引流术。结果：所有患者均能术中完全开放额窦,随访6个月以上,术后均无原发疾病复发,仅1例出现额隐窝闭锁。结论：Draf型鼻内额窦引流术能安全有效开放额窦。     

青年食管癌与中老年食管癌外科诊治的比较研究

分析青年与中老年食管癌患者的临床特征及外科治疗效果。回顾性分析49例青年和98例中老年食管癌患者的临床资料。结果:青年食管癌占同期食管癌的6.55%,两组患者在性别比例、肿瘤病变部位、病理类型、分化程度等差异无统计学意义(P>0.05);在术后病理分期、根治性切除率、术后并发症发生率上差异均有统计学意义(P<0.05);青年组与中老年组的手术死亡率分别为0.0%和2.0%,两组生存率差异无统计学意义(P>0.05)。结果表明,青年人食管癌肿瘤病期偏晚,手术切除率更低,术后并发症发生率及手术死亡率优于中老年组,两者在生存预后差别无统计学意义。     

A new plastic surgical technique for adult congenital webbed penis

Objective: To introduce a novel surgical technique for correction of adult congenital webbed penis. Methods: From March 2010 to December 2011, 12 patients (age range: 14–23 years old) were diagnosed as having a webbed penis and underwent a new surgical procedure designed by us. Results: All cases were treated successfully without severe complication. The operation time ranged from 20 min to 1 h. The average bleeding volume was less than 50 ml. All patients achieved satisfactory cosmetic results after surgery. The penile curvature disappeared in all cases and all patients remained well after 1 to 3 months of follow-up. Conclusions: Adult webbed penis with complaints of discomfort or psychological pressure due to a poor profile should be indicators for surgery. Good corrective surgery should expose the glans and coronal sulcus, match the penile skin length to the penile shaft length dorsally and ventrally, and provide a normal penoscrotal junction. Our new technique is a safe and effective method for the correction of adult webbed penis, which produces satisfactory results.     

猪唇裂模拟实验在口腔颌面外科临床前期教学中的应用

通过在临床前期实验教学中增设猪唇裂动物模拟实验,改变常规教学模式,以学生在实体动物上亲自模拟人体唇裂的设计、定点、修复等的方式,不仅可以激发学生的学习积极性,而且提高了学生的理论知识和动手操作能力.