简介：Bell’spalsyisacommonlyseencranialnervediseaseandcanresultincompromisedfacialappearanceandfunctions.Itsetiology,prognosisandtreatmentarestillbeingdebated.Thispaperisareviewofrecentdevelopmentintheunderstandingofetiology,diagnosisandnon-surgicaltreatmentofBell’spalsy.

简介：AbstractBackground:There is limited evidence of the effects of local anesthesia (LA) on outcomes of non-surgical periodontal treatment (NSPT), in particular among the Chinese. This retrospective cohort study aimed to evaluate the effects of LA on short-term treatment outcomes of NSPT and to determine under what circumstances LA should be prescribed to improve these outcomes.Methods:Data from periodontal examinations of 3980 patients were used. The data were from 3-month re-evaluation records of an electronic periodontal charting record system in the Department of Periodontology of Peking University School and Hospital of Stomatology from June 2008 to January 2015. Descriptive analyses included changes in probing depth (PD) and the Mazza bleeding index (BI). Two-level (patient and tooth) logistic regression models and three-level (patient, tooth, and site) linear regression models were constructed to analyze the influence of LA on PD for all teeth/sites and teeth/sites with an initial PD ≥ 5 mm. Decreases in PD and BI at sites under LA using the initial PD were also compared.Results:A significantly higher mean decrease in PD after NSPT was found in the LA group than in the no local anesthesia (NLA) group (0.98 vs. 0.54 mm, t = 24.12, P < 0.001). A significantly higher probability of decreases was found in the LA group in BI (percentages of teeth with BI > 1 and BI > 2) for all teeth (16.7% vs. 13.8%, t=3.75, P < 0.001; 34.7% vs. 28.1%, t = 6.73, P < 0.001) and PD for teeth with PD ≥ 5 mm (32.3% vs. 17.3%, t = 28.48, P < 0.001). The difference in PD between the LA and NLA groups increased as the initial PD increased. The difference between the two groups was 0.12 to 0.22 mm for sites with a baseline PD < 7 mm; however, it increased to 0.41 to 1.37 mm for sites with a baseline PD ≥ 7 mm.Conclusions:LA improved the decrease in PD after NSPT. Root debridement at sites with initial PD ≥ 7 mm should be performed under routine LA.

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简介：AbstractThere has been a rising trend in the incidence and prevalence of non-functioning pancreatic neuroendocrine tumors (NFPanNETs). While a significant number of the newly diagnosed NFPanNETs are asymptomatic, a majority of patients will present with liver metastasis (LM) at the time of diagnosis. Surgical resection remains the only curative treatment, especially for localized NFPanNETs. While a majority of small NFPanNETs are indolent, some are not. This heterogeneity in tumor biology presents the surgeon with the unique challenge of determining which patient will benefit from surgery, given the morbidity of pancreatic surgery. There has been a recent push for a more aggressive approach to the care of these patients, given the emergence of data supporting such measures. However, the risk of over or under treatment has generated immense debate amongst experts in the field. The heterogeneity of current practice guidelines and institutional practices around the world is a reflection of the disparate opinion on the management of NFPanNET. In this review, we set out to examine the evidence regarding some of the most controversial and challenging aspects of the surgical treatment of NFPanNET. We evaluate the following questions; should patients with small NFPanNETs ≤ 2 cm in size be resected; should patients with metastatic NFPanNETs undergo surgical debulking, and should there be resection of the primary tumor in the setting of non-resectable metastatic disease?Although there are currently no Level 1 data to answer these questions conclusively, we believe that the current literature supports a more aggressive approach to the management of NFPanNET.

简介：Non-parasitichepaticcystswithbiliarycommunicationarerare.Theclinicalsymptomsinvolvedarenotspecifictothiscondition,therebymakingdiagnosisdifficultandtreatmentcontroversial.Here,wereportacaseof70-year-oldwomancomplainingofabdominalsatiety,combinedwithnon-specificpainintherightupperquadrant.Theabdominalcontrast-enhancedMRI-scanrevealedalargeandthick-walledseptuscysticlesionintheliver.Duringoperation,thebiliaryfistulawasconfirmedinthecystcavity.Asilicageltubewasinsertedviathecysticductforcholangiography,whichdemonstratedcommunicationbetweenthecystandbiliarytract.Weperformedwide-scalecystwallresection;thebiliaryfistulawascompletelyrepairedbytheclosureofcommunicatedbileducts.Thepostoperativecoursewasuneventful,andthepatientwasdischargedwithnosignofcholangitisoranyothersymptoms.Thenovelsurgicalmanagementviawideresectionofthecystwallandclosureofbiliarycommunicationprovedtobeanadequateandeffectiveprocedurefortreatingnonparasitichepaticcystswithbiliarycommunication.

简介：摘要骨盆骨折的非手术治疗即保守治疗，是治疗骨盆骨折的主要方法，尤其是在传统治疗观念中，非手术疗法有广泛的适应证，普遍认为该疗法多能取得预期的疗效，达到治疗的既定目标，且操作简单，易于基层医疗机构和院前抢救时应用，相应的费用也较少。

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简介：摘要骨盆骨折的非手术治疗即保守治疗，是治疗骨盆骨折的主要方法，尤其是在传统治疗观念中，非手术疗法有广泛的适应证，普遍认为该疗法多能取得预期的疗效，达到治疗的既定目标，且操作简单，易于基层医疗机构和院前抢救时应用，相应的费用也较少。

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简介：闭合性肾损伤，除伤情严重者外，非手术治疗大部分能痊愈，且不留后遗症。本组对32例闭合性肾损伤患者，进行回顾性总结分析结果发现，对此类病人除采取镇静、止痛、止血、抗感染及适当补充血容量等治疗措施外，护理上我们首先对病人进行耐心细致的心理护理，详细介绍住院环境，认真传授本病的有关知识及实施治疗护理的必要性，

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