锁骨上的

objective to analyze the ct appearance of thyroid carcinoma and the differential diagnosis of various thyroid disease.methods 83 cases of thyroid carcinoma and 119 cases of various benign disease with surgical and pathologically proved were analyzed retrospectively.results the ct findings of 83 cases of thyroid carcinoma include:ill defined nodules boundary (n=62),irregular necrosis(n=59),cystic(n=23),"peninsula" enhancing tubercles around the tumour(n=25),"mastoid" tubercles around the tumour(n=11),calcification(n=55) including large scale(n=27) and local(n=28),trachea invasion(n=15),neck or supraclavicular lymph node metastasis(n=27),the accurate of ct to differentia benignancy from malignancy on thyroid disease was 93.6%(189/202).conclusions "peninsula" enhancing tubercles was the characteristic sing of thyroid carcinoma,"mastoid" enhancing tubercles or large scale calcification was the affirmative sign,the ct signs was vary useful to differentiating thyroid disease.

摘 要］目的：分析甲状腺癌的ct表现及鉴别诊断要点。方法：回顾性分析经手术病理证实的83例甲状腺癌和119例甲状腺良性病变的ct表现，归纳总结不同病变的ct特征。结果：83例甲状腺癌中：边界不清62例，不规则坏死59例，囊性变23例，出现"半岛状"强化结节25例，"乳头状"强化结节11例，钙化55例(其中弥漫性钙化27例、局灶钙化28例)，侵犯气管15例，颈部或锁骨上淋巴结肿大27例，ct对甲状腺病变的良恶性鉴别诊断符合率93.6%(189/202)。结论："半岛状"强化结节是甲状腺癌的特征性表现，"乳头状"强化结节及弥漫性钙化可做为甲状腺癌的肯定性征象，掌握各种甲状腺病变的ct表现特点，对病变的定性诊断及鉴别诊断具有重要意义。

After what seems like an eternity there follows an interval of semiconsciousness balanced by such a calm that I feel a great lake inside me, a lake of iridescent sheen, cool as jelly; and over this lake, rising in great swooping spirals, there emerge flocks of birds of passage with long slim legs and brilliant plumage.

这个湖泊上突然形成一个个巨大螺旋，一群群腿细长、羽毛漂亮的候鸟出现了，它们一群群地从清凉的静止湖面上腾空飞起，从我的锁骨下飞过，消逝在一片白茫茫的空间里。

Clavicle bone is suitable for implant as its density,and for the repair of mandibular defect as its shape.The accurate data of personalized clavicle shape and bone density can be measured through preoperative imaging.It can be used for design of mandibular defects repair and / or tooth plant in the same period with pedicle sternocleidomastoid muscle.

锁骨的骨密度适合做种植牙修复，锁骨的外形适合做下颌骨缺损修复，术前对影像学资料进行丈量能取得个性化的锁骨外形及骨密度的较为正确的数据，对临床上利用带血供的胸锁乳突肌锁骨瓣修复下颌骨缺损和/或同期种植牙修复具有一定的指导意义。

Methods: 37 patients with distal clavicle fracture were treated with three different methods, 1 fixation by AO plate (20 cases), and 2 reconstructed coracoclavicular ligament by using Ethibond 5# suture (8 cases), 3 reconstructed coracoclavicular ligament by using suture anchor (9cases a).

对37例锁骨远端骨折患者分别采用锁骨钩钢板固定；切开复位并用ETHIBOND 5#线穿过喙突固定于锁骨骨折近端以重建喙锁韧带；切开复位后在喙突上置入2枚缝合锚，锚尾端的缝线固定于锁骨骨折近端以重建喙锁韧带三种不同手术方法进行治疗。

Clinical data of patiens with supraclavicular metastasis of unknown primary sites in hospital from March 1978 to November 1998＇ were retrospectively analyzed, and nine characteristic factors which might affect prognosis were selected and analyzed by Cox modal.

对1978年3月～1998年11月住院治疗的锁骨上区原发不明转移癌患者的临床资料进行研究，选择9个可能对其预后产生影响的特征性因素，通过Cox模型进行单因素和多因素分析。

Outcomes in patients with suprascapular nerve as recipient was significantly better than that in patients with axillary nerve as recipient, So the suprascapular nerve should be selected as the best choice of recipient; And functional deficit occured in upper, middle and lower portions of trapezius after the traditional spinal accessory nerve transfer.

副神经移位治疗臂丛神经损伤恢复肩关节外展功能，修复肩胛上神经的疗效优于修复腋神经，应把移位修复肩胛上神经作为首选；传统锁骨上前入路手术后斜方肌各部功能有明显下降。

To systematicallyinvestigate this landmark, we conducted a study in four phases:1 Two blindfolded examiners determined the distance betweenthe tuberosity's medial border and the clavicle's lateral endin 100 dried clavicles and then 2 performed subclavian veincannulation in 20 fresh human cadavers using the tuberosityand the suprasternal notch as landmarks. 3 Three-dimensionalreconstructions of the subclavian artery and vein and surroundingstructures were derived from computed tomography datasets of10 patients. The length of the path of a virtual subclavianvein cannulation with the deltoid tuberosity landmark was measuredbilaterally. 4 In a prospective, randomized trial, subclavianvein cannulation was performed in 60 patients with a standardapproach or with the deltoid tuberosity as landmark.

为系统地研究这个解剖标志，作者将本研究分为四个阶段：1 双盲检查100个干燥的锁骨测量其三角肌粗隆内侧缘至锁骨侧面末端的距离；2 在20具新鲜的尸体上以三角肌粗隆和胸骨上切迹为标志进行锁骨下静脉穿刺；3 利用 CT 所获取的数据资料对10个病人的锁骨下动脉和静脉以及周围结构进行三维重建，测量两侧以三角肌粗隆为标志的虚拟锁骨下静脉置管路径的长度；4 选择60例病人以标准路径或三角肌粗隆为标志进行锁骨下静脉穿刺的前瞻性随机试验研究。

To systematicallyinvestigate this landmark, we conducted a study in four phases:1 Two blindfolded examiners determined the distance betweenthe tuberosity's medial border and the clavicle's lateral endin 100 dried clavicles and then 2 performed subclavian veincannulation in 20 fresh human cadavers using the tuberosityand the suprasternal notch as landmarks. 3 Three-dimensionalreconstructions of the subclavian artery and vein and surroundingstructures were derived from computed tomography datasets of10 patients. The length of the path of a virtual subclavianvein cannulation with the deltoid tuberosity landmark was measuredbilaterally. 4 In a prospective, randomized trial, subclavianvein cannulation was performed in 60 patients with a standardapproach or with the deltoid tuberosity as landmark.

为系统地研究这个解剖标志，作者将本研究分为四个阶段：1 双盲检查100个乾燥的锁骨测量其三角肌粗隆内侧缘至锁骨侧面末端的距离；2 在20具新鲜的尸体上以三角肌粗隆和胸骨上切迹为标志进行锁骨下静脉穿刺；3 利用 CT 所获取的资料资料对10个病人的锁骨下动脉和静脉以及周围结构进行三维重建，测量两侧以三角肌粗隆为标志的虚拟锁骨下静脉置管路径的长度；4 选择60例病人以标准路径或三角肌粗隆为标志进行锁骨下静脉穿刺的前瞻性随机试验研究。

Preoperatively, the following findings were typically observed: provocation of symptoms by certain postures (the so-called spear-throwing position as well as downward tugging of the shoulder) and marked tenderness in the supraclavicular fossa. The intergroup severity of the symptoms was comparable.

术前对下面的发现进行特别的观察：某种姿势的激发症状并标记锁骨上窝的触痛位置。

Preoperatively, the following findings were typically observed: provocation of symptoms by certain postures (the so-called spear-throwing position as well as downward tugging of the shoulder) and marked tenderness in the supraclavicular fossa. The intergroup severity of the symptoms was comparable.

术前对下面的发现进行非凡的观察：某种姿势的激发症状并标记锁骨上窝的触痛位置。

I'm strongly against the death penalty — it's an eye for an eye.

我不赞成死刑——这是以牙还牙的报复行为。

And to get you the support you need, we're enlisting all elements of our national power: our diplomacy and development, our economic might and our moral suasion, so that you and the rest of our military do not bear the burden of our security alone.

并给你们所须的支援，我们正徵召国家所有各种的力量：我们的外交及发展，我们的经济力量与道德劝说，所以你们与其他军人不须要孤独地负起国家安全的责任。