目的   研究小儿面颈部皮下良性肿物的影像学特点及经头皮区域或腋窝软组织腔镜微创治疗小儿头颈部皮下良性肿物的可行性、临床疗效及安全性。方法   回顾分析2024年1月—2024年8月在广州医科大学附属妇女儿童医疗中心治疗的24例小儿面颈部皮下肿物的病例，患儿年龄为1~5岁，平均年龄1.5岁，其中男15例、女9例；分别为甲状舌管囊肿10例，鳃裂瘘5例，前额皮下肿物5例，颈淋巴结增大3例，颈部皮下肿物1例。分析其影像学特点（超声及CT检查），制定了经头皮区域软组织腔镜微创治疗前额皮下肿物和颈淋巴结活组织检查（活检）或经腋窝软组织腔镜微创治疗甲状舌管囊肿和鳃裂瘘。结果  24例小儿面颈部皮下良性肿物的共同影像学特点是位于浅层，边界清晰，圆形或者椭圆形，对周围组织轻度压迫，无侵犯。所有病例均顺利完成微创手术，出血少，无手术并发症，术后恢复好。术后病理检查均提示良性肿物，面部及颈部均无手术瘢痕。结论   小儿面颈部皮下良性肿瘤的影像学特点是位于浅层，边界清晰。经头皮区域和腋窝软组织腔镜微创治疗小儿面颈部肿物效果确切、安全性高、美观。

       Objective  To  study the imaging characteristics of  subcutaneous  benign tumors in the face and  neck of children，as well as the feasibility，efficacy，and safety of minimally invasive treatment of subcutaneous benign tumors in the head and neck of children through hair area or axillary soft tissue endoscopy．Methods  A  retrospective analysis was conducted on 24 cases of subcutaneous tumors in the face and neck of children treated in our hospital from January to August 2024．Age  range was 1-5 years old，with an average of 1.5 years old．There were 15 boys and 9 girls．There were 10 cases of thyroglossal duct cyst，5 cases of branchial fistula，5 cases of subcutaneous mass on the forehead，3 cases of enlarged cervical lymph nodes，and 1 case of subcutaneous mass on the neck．Imaging characteristics（ultrasound and CT examination）and minimally invasive treatment effects were analyzed，to determine the procedure of minimally invasive treatment of subcutaneous tumors in the forehead and cervical lymph node biopsy by soft tissue endoscopy in the scalp area，and minimally invasive treatment of thyroglossal duct cysts and branchial fistulas through axillary by soft tissue endoscopy．Results  The imaging characteristics of subcutaneous benign tumors in children’s face and neck were located in the shallow layer，with clear boundaries，round or oval shapes，mild compression of surrounding tissues，and no invasion．All cases successfully underwent minimally invasive surgery with minimal bleeding，no  surgical complications，and good postoperative recovery．Postoperative pathological examination confirmed as benign masses．There were no surgical scars on the face and neck．Conclusions  The imaging characteristics of subcutaneous benign tumors in children’s face and neck are located in the shallow layer with clear boundaries．Minimally invasive endoscopic treatment of pediatric face and neck tumors through the scalp area and axillary soft tissue is effective，safe，and aesthetically pleasing．

腹腔镜手术后除躯体创伤疼痛,部分患者还可能经历痛苦的术后内脏痛,不仅使患者术后体验不佳,疼痛应激甚至可能加重机体的内环境紊乱,不利于患者的术后康复。内脏痛是来源于内脏器官和组织的疼痛,其产生与脏器的平滑肌痉挛、扩张、缺血、化学炎症刺激等密切相关。在这个过程中,许多离子通道和受体在调节内脏伤害性刺激信号的传导上发挥作用。目前,临床上术后镇痛治疗方案多样,但如何针对性地控制术后内脏痛是临床医生需要面对和解决的问题。为此,该文对腹腔镜术后内脏痛发生的相关机制、内脏感觉的神经传导及临床特征、治疗进展进行综述。

In addition to physical trauma,patients undergoing laparoscopic surgery may also experience postoperative visceral pain．This pain not only impacts the patient's postoperative experience,but can also worsen the body's internal environment and hinder recovery．Visceral pain originates from internal organs and tissues．It is closely related to smooth muscle spasms,dilations,ischemia,and chemical inflammatory stimulation of organs．In this process,numerous ion channels and receptors regulate the transmission of visceral nociceptive stimulus signals．At present,there are multiple clinical treatment options available for postoperative pain management．However,clinicians must overcome the challenge of controlling postoperative visceral pain．This article provides a review of the relevant mechanisms of visceral pain following laparoscopic surgery,the neural conduction of visceral sensation,clinical characteristics and treatment advancements．

脊柱结核是脊柱感染性疾病中最为常见的类型。本文综述了脊柱结核外科治疗的现状及最新进展。在早期治疗阶段,规范化的抗结核药物治疗能够有效缓解疼痛,改善患者生活质量。但对于中后期,特别是椎旁脓肿较大,椎体骨质破坏较大而导致脊柱不稳定的患者,手术治疗往往是必要且必需的辅助手段,手术可以最大限度清除病变的椎间盘、椎体和脓肿,也应该最大限度保留健康的骨质。其主要原则包括病灶彻底清除、脊髓充分减压、脊柱稳定性重建等步骤。在手术治疗中,一期前路手术作为经典入路已经得到广泛应用,而单纯后路手术治疗也逐渐受到重视。近年来,随着微创手术技术的发展,其在脊柱结核治疗中的应用越来越广泛。微创手术的优势在于术中创伤更小、恢复更快,为患者带来了更好的治疗体验和临床效果。然而,对于手术的选择,临床医师需要综合考虑患者的个体差异性、临床表现及特征、影像学资料和手术适应证等多种因素,以确定最合适的治疗方案。只有充分考虑各种治疗手段的优劣,采取个性化、综合性的治疗方案,才能更好地提高患者的生活质量和治疗效果。

Spinal tuberculosis is the most common types of infectious diseases affecting the spine．This article reviews the current status and progress of surgical treatment for spinal tuberculosis．In the early and initial stages,standardized anti-tuberculosis drug therapy can effectively alleviate pain and improve patients' quality of life．However,for more complex cases in the middle and late stages,surgical treatment is needed,including thorough lesion clearance,adequate spinal cord decompression,and reconstruction of spinal stability．In surgical treatment,anterior approach surgery,as a classical method,has been widely applied,and posterior approach surgery alone has gradually gained attention．In recent years,with the development of minimally invasive surgical techniques,their application in the treatment of spinal tuberculosis has become increasingly widespread．The advantages of minimally invasive surgery lie in smaller intraoperative trauma and faster recovery,providing patients with better treatment experience and clinical outcomes．However,for the selection of surgery,clinicians need to consider multiple factors such as individual differences,clinical manifestations and characteristics,imaging data and surgical indications to determine the most suitable treatment plan．Only by fully considering the advantages and disadvantages of various treatment modalities and adopting personalized,comprehensive treatment plans can the quality of life and treatment outcomes of patients be effectively improved．

分泌性中耳炎（SOM）的临床特征表现为听力下降和中耳积液,与中耳化脓性炎症常伴随耳部急性感染不同,SOM常伴随耳部闷胀、轻微耳痛等,致使听力出现障碍。SOM发病机制较为复杂,可能与感染、免疫、咽鼓管功能障碍等多种因素相关,治疗方法也因此呈现出多样化的特点。本文就SOM的病因病机及其治疗方式展开综述,以期为临床及早诊断和治疗SOM提供理论依据。

The clinical characteristics of secretory otitis media（SOM）are hearing loss and effusion in the middle ear．Different from acute ear infection of suppurative inflammation in the middle ear,SOM is often accompanied by ear tightness and mild earache,resulting in hearing impairment．The pathogenesis of SOM is complex,which may be related to infection,immunity,eustachian tube dysfunction and other factors．Therefore,the treatment methods are diversified．This paper reviews the etiology,pathogenesis and treatment of SOM,in order to provide theoretical basis for clinical early diagnosis and treatment of SOM.

现代人面临更大的工作与生活压力,每天的生活节奏较快,因此经常出现饮食不规律、饮食结构不合理等现象,这样就增加了肠胃疾病的发生率。胃肠道间质瘤（GIST）以人体胃肠道最为常见的肿瘤疾病,该病患者占全部胃肠道间叶性肿瘤患者人数的80%以上。GIST根据疾病进展、间质瘤体积等不同因素又能够分为不同的疾病类型,需采取对应的诊断措施与治疗措施。本文将针对胃小间质瘤的流行病学、临床症状、临床诊断以及治疗措施等进行研究与分析,以供参考。

Modern people are facing greater pressure in work and life,and the pace of daily life is fast．Therefore,irregular diet and unreasonable diet structure often occur,which increases the incidence of gastrointestinal diseases．Gastrointestinal stromal tumor（GIST）is the most common tumor disease in human gastrointestinal tract,accounting for over 80% of all patients with gastrointestinal mesenchymal tumors．GIST can be divided into different types according to different factors such as disease progression and stromal tumor volume,thus corresponding diagnostic and therapeutic measures should be taken．This paper studied and analyzed the epidemiology,clinical symptoms,clinical diagnosis and treatment of gastric small stromal tumors for reference．

        放射治疗（放疗）可以提高妇科恶性肿瘤患者的总体生存率，降低复发率，增加手术机会。但肿瘤周围的健康组织不可避免地会进入电离辐射区域从而导致阴道狭窄、缩短和失去弹性，文章结合近年来国内外的放疗后阴道损伤治疗方式进行综述，总结分析治疗的优缺点，旨在为放疗后阴道损伤的临床治疗提供帮助。

       Radiotherapy can improve the overall survival rate，reduce the  recurrence  rate and increase the chance of surgery in patients with gynecological malignant tumors．However，the healthy tissue around the tumor can inevitably be included the ionizing radiation area，resulting in vaginal stenosis，shortening and loss of elasticity．This paper reviews the treatment methods of post-radiotherapy vaginal injury at home and abroad in recent years，to summarize and analyze theadvantages and disadvantages of treatment，aiming to provide help for the clinical treatment of post-radiotherapy vaginal injury．

       胰源性门静脉高压（PSPH）是由脾静脉（SV）流通受阻引起的一种临床综合征，在临床较为罕见且对患者造成生命威胁，但却为门静脉高压唯一可治愈的类型。其主要发病诱因是胰腺原发疾病，通常为胰腺急（慢）性炎症、胰腺占位性病变和胰腺手术操作导致。1型孤立性食管胃底静脉曲张、脾大、脾功能亢进是PSPH的主要临床表现特征，其中食管胃底曲张静脉破裂出血是PSPH最为严重的并发症；患者若表现为肝功能正常但出现原因不明脾肿大并伴有消化道出血症状，应考虑可能出现了PSPH。PSPH的治疗可分为胰腺原发病、门静脉高压及并发症的综合性诊治。本文旨在回顾PSPH的相关文献，对其有关临床诊断与治疗现状进行综述，以期指导医务工作者在临床中尽早发现PSPH并对患者及时有效治疗。

       Pancreatic segmental portal hypertension（PSPH）is a clinical syndrome caused by spleen vein（SV）occlusion or stenosis．It is a rare and life-threatening hemorrhagic disease of the upper digestive tract，but it is the only curable type of portal hypertension．The main cause is primary pancreatic disease，which is usually due to acute or chronic pancreatic inflammation，pancreatic space-occupying lesions and pancreatic surgery．Type 1 isolated esophagogastric varices，splenomegaly and hypersplenism are the main clinical features of PSPH，and esophagogastric variceal bleeding is the most serious complication of PSPH．PSPH  should  be  considered in  patients with  normal liver function  but  unexplained  splenomegaly  accompanied  by gastrointestinal bleeding．The treatment of PSPH can be divided into a comprehensive diagnosis and treatment of primary pancreatic disease，portal hypertension and complications．Therefore，the purpose of this paper is to review relevant literature of PSPH，the relevant clinical diagnosis and treatment status quo were summerized，in order to guide the medical workers in clinical PSPH，early detection and timely and effective treatment for patients．