目的:探讨提高阴茎再植术的成功率的方法。方法: 回顾性分析本院3例运用显微外科技术行吻合血管神经的阴茎离断再植术的临床资料。结果: 3例病例采用大隐静脉自体移植修复阴茎背动脉并吻合阴茎静脉和神经,全部再植成功。3例均有勃起功能。结论:阴茎背动脉,阴茎背深静脉以及阴茎背神经的相继处理以及术中高度精细的无创操作技术是决定手术成败的关键之一。
ObjectiveTo summarize the clinical features of pulmonary mucoepidermoid carcinoma (PMEC) and improve the level of the diagnosis and therapy.MethodsA case of PMEC was reported and related literatures were reviewed in PubMed, WanFang data and China National Knowledge Infrastructure.ResultsA 21-year-old female patient, complaining of cough and expectoration for 5 months, intermittent hemoptysis for 3 months and repeated fever more than 4 days, was hospitalized in March 2017. After admission, the patient was diagnosed as low-grade PMEC and received anti-infection, fibrobronchoscope sputum aspiration and alveolar lavage therapy. During the hospitalization, the anti-infection of the patients was not much effective, and the chest CT examination suggested space-occupying lesions in the middle lobe of the right lung. After the surgical removal of the right lung, the syndrome of the patient was improved. A total of 13 patients were reviewed, there was no obvious gender difference, and the median age was about 40 years old (most frequently occurred in younger adults with an average age less than 50 years). Frequent clinical manifestations were cough, fever and hemoptysis, which were often accompanied with atelectasis. Most of the patients could be improved after surgical resection, and a few need comprehensive treatment including radiotherapy, chemotherapy and targeted treatment, etc.ConclusionsPMEC is rare and the etiology is still unclear. The pathology is mainly low-grade. Majority of patients with PMEC could be cured after surgical resection.
After the reform of drugs and medical consumables, the problem of unreasonable medical examination has gradually become prominent, which has become the potential threat of doctor-patient disputes and rising medical costs. At present, the reform of the medical and health system has entered the deep water zone. In the process of standardized management of medical examination, the difficulties in doctor-patient trust, medical examination supervision, medical examination resource allocation, the implementation of the mutual recognition system of medical results and the guarantee of information security have gradually emerged. In view of the dilemma of medical examination control, this paper proposes the following three breakthrough paths: based on the perspective of doctors and patients, improve doctor-patient trust; coordinating institutional supervision and administrative supervision to create transparent medical examinations; technical support to promote the standardized operation of medical examination, in order to provide a theoretical basis for the standardized operation of medical examination.
With the continuous promotion of China’s medical and health system reform, the problem of unreasonable medical examination has gradually become prominent after the elimination of “raising healthcare by medicine” and “raising healthcare by medical device”, which has become the core of aggravating the economic burden of patients’ diseases. Based on the current situation of medical examination control mechanism in China, this study explores the medical examination control mechanism including institutional restraint mechanism, supervision and management mechanism, quality control mechanism from external regulation and internal control, so as to regulate the medical examination behavior, realize the normalization of supervision and management, promote the continuous improvement of medical examination quality, in order to enhance the rationality of medical examination. It is expected to provide a theoretical basis for health departments to explore and perfect the control mechanism of the medical examination.