[Guidelines for treatment] How to recover from torticollis caused by tension?

First of all, tension head deflection is different from normal people’s torticollis, which is temporarily tilted to one side due to vertical head instability. Torticollis is caused by stiff neck or cervical spine deformation, which makes the head always fixed to one side. Temporary head deflection is caused by insufficient neck muscle strength, usually to the left, while tonic head deflection is caused by increased neck muscle tension on the facial side (biased side), mainly the sternocleidomastoid muscle and oblique The square muscles have high muscle tone. The performance is that when the head is relaxed, the head can generally stand upright, and the neck can move freely, but when nervous, crying, excited, doing movements, etc., it will deflect to one side. The deflection of the neck at this time cannot be forced to move to the normal position like the torticollis of a normal person. This is equivalent to exercising the spastic muscles, which may make the head deflection worse. When a child has a tonic head deflection, the treatment principle: treatment principle: try to use active exercise to correct, improve antagonistic muscle strength, balance the left and right neck muscle tension, and move the neck more. There are many similar treatment methods. The following methods are used as an inspiration. For example, it is biased to the right, that is, the face side is right and the head side is left. 1. Use the reflex to correct the child lying prone or sitting on the Pap ball, and then slowly move the ball to the right to make the body deviate to the right. The child’s neck will be adjusted to the upright direction due to the influence of the neck-standing reflex. Hold to the right. 2. Acupuncture to lift the antagonistic muscle strength. Click on the left shoulder Jing point to contract the muscles on the left side of the neck, so that the head can be corrected to an upright position immediately. Acupuncture can be used many times a day. Acupuncture can contract muscles and increase antagonistic muscles. Muscle strength, thereby improving head control. 3. Active or passive head turning and flexion extension of the head, and flexion of the head to the left side (such as passive flexion of the head must first relax the muscles), these all play a role in balancing muscle tension. 4. Massage the levator muscles to reduce muscle tension. Lightly press and rub the right spastic muscles (dominant muscle group) sternocleidomastoid and trapezius muscles, reduce muscle tension, and press the left antagonist muscles and sternocleidomastoid muscles more strongly. Oblique method, lifting muscle strength, the focus is on the muscle strength of the antagonist muscles (paralyzed muscles, weak muscles). 5. Handing toys to the left. Usually, try to hand toys or food to the child on the left side. When the child looks to the left, his head will automatically be corrected to an upright position. 6. Oral reminder or passive fixation for older children at any time to remind him (her) to correct the head to the normal position, and ask him (her) to look in the mirror, and then correct it to the normal position by himself, if necessary, the child can be corrected After the muscles are relaxed, fix the head of the child in the middle position with both hands for a period of time so that the child can feel the normal position. 7. In daily care, pay attention to the usual holding position, sleeping position, breastfeeding position, sleeping pillow height, and try to face the TV when watching TV.

Will there be any sequelae after ligation of the left varicocele?

&nbsp.&nbsp.&nbsp.&nbsp. Varicocele is a common disease in men. It belongs to vascular disease. It is clinically divided into left and right varicose. The clinical incidence is more common on the left. Most men find the disease only after going to the hospital for a physical examination. When the disease is discovered, the doctor will advise the patient to perform an operation. At this time, many patients worry that varicocele will affect future fertility and sexual life. Today, taking advantage of our free time, let’s take a closer look at this problem.  Expert tips: spermatic vein surgery is a very safe operation, generally there will be no sequelae. Clinically, there are high ligation and low ligation. For patients who have undergone surgery, it is recommended to have a review after recovery. After the operation, the patient must take a good rest, which can effectively avoid the invasion of sequelae. At the same time, improper operation by doctors can also cause sequelae such as blood vessel damage, testicular atrophy, scrotal edema, and hydrocele. Therefore, we must choose regular hospitals and qualified doctors for surgery.  Why does varicocele occur more often on the left side of varicocele?  Varicocele occurs on the left side, mainly due to the angle at which the human spermatic vein is injected into the deep vein. Therefore, there is a high percentage of varicocele on the left. This is because the left spermatic vein is injected into the vein at a steeper angle, so it is easy to happen.  The difference between high ligation and low ligation of varicocele   Experts pointed out: high ligation is in the pubic symphysis and low ligation is in the scrotum. A high-position ligation is used for good or bad, while a low-position ligation is to tie the diseased varicose piece from the scrotum with the help of a high-power microscope. Since then, no nutritional supply will not recur, and good retention is good for the cells around the scrotum. The organization does not cause harm. [My Clinic] Learn more &gt.&gt. web link

Can pregnant women only lie on their left side? Or sleep casually?

&nbsp.&nbsp.&nbsp. You can sleep as you like in the first trimester. As long as you don’t sleep on your stomach during the second trimester, you can lie on your side or on your back. It is generally recommended that the left side is in the third trimester. With the increase of the fetus, the uterus is also enlarged during the second and third trimesters, which will compress the inferior vena cava and abdominal aorta, resulting in poor blood flow, and the inferior vena cava is biased to the right side of the spine. Improve the right rotation of the uterus, which can reduce the uterine vascular tone, increase the blood flow of the placenta, improve the oxygen supply of the fetus in the uterus, and benefit the growth and development of the fetus. , But it is also recommended.  It is impossible to sleep in a posture all night, and the standard for measuring the suitability of a sleeping posture is comfortable. As long as the mother is comfortable, the baby is also comfortable. If the left lying position makes you uncomfortable and uncomfortable, then change your sleeping position decisively and change your right side.   If a certain sleeping position will significantly increase fetal movement and fetal treasure kicks and beats, it is obvious that the baby tells you that he is uncomfortable and needs to change his sleeping position.

What is sphenoid crest meningioma? How to treat?

  Sphenoid crest meningiomas are meningiomas that originate from the large and small wings of the sphenoid bone. The inside rises from the front bed and the outside reaches the wing point. In early years, Cushing divided the sphenoid crest meningiomas into three parts: inner, middle and outer. In recent years, Watts suggested that this traditional positioning classification method be simplified into two types, namely the medial type and the lateral type. Most tumors are spherical and can grow in all directions. Sphenoid crest meningiomas can grow to the temporal, frontal, and frontotemporal junctions. Medial tumors can originate from the anterior bed process and invade into the orbital or supraorbital fissure. There are also rare tumors that grow to the anterior cranial fossa floor, causing corresponding clinical manifestations. Lateral sphenoid ridge meningiomas do not show symptoms early.  Symptoms and signs: The clinical manifestations of sphenoid ridge meningioma depend on the location of the tumor. The early symptoms of the medial type are obvious, and the patient may exhibit cranial nerve compression early, such as decreased vision. If the tumor invades into the orbital fissure or supraorbital fissure, ocular venous return is blocked, the patient may have symptoms such as protruding eyeball. Patients with medial type may also have symptoms of nerve damage in the first branch of Ⅱ, Ⅳ, Ⅵ and Ⅴ. Mental symptoms and olfactory disorders are more common in those with tumors growing in the anterior cranial fossa, but are less common. Lateral sphenoid ridge meningioma symptoms appear late, only headache in the early stage and lack of localization signs. Some patients may present with temporal lobe epilepsy. If the tumor invades the temporal bone, zygomatic temporal bone bulge may appear. When the tumor growth of the above two types of patients is large, it will cause the contralateral limb muscle strength and intracranial pressure to increase.   Prognosis: Lateral sphenoid ridge meningioma is not difficult to surgically remove, and postoperative recurrence and neurological damage are rare. There are many difficulties in complete resection of medial meningiomas, and there may be Ⅲ, Ⅳ, and Ⅵ cerebral nerve function damage after operation. Another patient may have limb movement disorder and motor aphasia after surgery. For patients with medial type that have not been completely resected, postoperative radiotherapy may be used to prevent recurrence. If the tumor recurs, consider surgical resection again.  Left sphenoid crest and parasaddle meningiomas  Associate Professor Zhao Tianzhi recently performed a surgical treatment for a patient with a left side sphenoid crest and parasellar meningiomas. It has been recovered for more than two months after surgery.  Mr. Zhang’s dizziness, aggravation of left visual acuity, accompanied by left side numbness, pain, slurred speech, slowness and other symptoms. After CT imaging examination, he was informed of the left sphenoid crest and parasaddle lesions.  Associate Professor Zhao Tianzhi introduced: The patient’s left eyelid lift is severely restricted. In popular terms, one eye is larger than the other, and the left vision is significantly reduced. The results of the head MRI showed that the left middle and posterior cranial fossa was riding a huge tumor with a maximum diameter of more than 7 cm. At the same time, the tumor surrounded the left internal carotid artery, middle cerebral artery, posterior communicating artery and many small wearers The branch artery, the left frontotemporal brain tissue and the optic nerve are severely compressed, and protrude downward into the posterior fossa of the posterior cranial fossa. The operation is difficult and the risk is high. For such a complex huge intracranial tumor, how to completely remove the intraoperative and protect the normal intracranial tissue is the key to the operation, then, how to separate and retain the blood vessels, oculomotor nerve, optic nerve, pituitary stalk, etc. Structure, how to reduce the surgical risk is the key, use Osirix software to perform three-dimensional preoperative evaluation before surgery, clarify the surgical plan, and reduce the surgical risk.

Today’s surgery with Matrix RIB: chest wall tumor resection + chest wall reconstruction

【Summary】Today’s operation is chest wall tumor resection and chest wall reconstruction. MatrixRIB plastic plate was used for reconstruction during the operation, and satisfactory results were obtained. &nbsp. Today’s child is 13 years old, male, from a western province. The parents of the child complained that when they were 2 years old, the left chest wall ribs were abnormal and there were masses. At that time, there were no symptoms and no treatment was done. Since then, the packet size has not changed. A few months ago, the child accidentally touched the left chest wall, and a mass quickly bulged locally. On imaging examination, it was found that the local mass increased, invaded 3 ribs, and local pain. For surgical treatment, the child was admitted to our hospital recently. &nbsp. Preoperative examination: the left chest wall is raised, with localized masses and soft texture. Imaging examination showed that the left chest wall mass involved the left 4th, 5th and 6th ribs. There is no invasion of the lungs. &nbsp.&nbsp.&nbsp.&nbsp.`&nbsp. According to clinical data, he was diagnosed with a left chest wall tumor. After sufficient preoperative preparations, surgical treatment was carried out this morning. During the operation, the left chest wall tumor was seen, and the left 4, 5 and 6 ribs were invaded. The tumor and the invaded ribs were removed together, and the chest wall was reconstructed with 3 MatrixRIB orthopedic plates, and the outer surface was covered with fibrous membrane. Close all layers of the incision and the operation ends. &nbsp. Chest wall tumor is a common surgical disease of chest wall. Treatment mainly includes tumor resection and chest wall reconstruction. Reconstruction content generally includes reconstruction of bone structure and skin and soft tissue. There is no skin and soft tissue invasion in this patient, so there is no related defect after surgery and no reconstruction is needed. The reconstruction of bone structure is the focus of this operation. The reconstruction of bone structure mainly depends on the reconstruction materials. At present, there are many materials used clinically, but the performance of various materials is different. MatrixRIB is a personalized design for ribs. Because the shape meets physiological requirements and does not require temporary processing, it is an ideal repair material. In recent years, 3D printed materials or digital materials have been gradually used in clinics. Such materials also have the advantages of personalized design. Especially when it comes to sternum defects, its advantages are particularly obvious. However, the biggest drawback of such materials is that the manufacturing process is too cumbersome. It takes almost a week to process the fastest digital materials. This is extremely detrimental to the patient’s condition and will have a great impact on the doctor’s work. &nbsp.MatrixRIB material is ready-made, although it has the advantages of personalized design, it does not require temporary processing, so it is very conducive to the operation. In the past work, we have used a variety of repair materials. In contrast, MatrixRIB is an ideal repair material. &nbsp. (Wang Wenlin, Director of Chest Wall Surgery, Second People’s Hospital of Guangdong Province, WeChat: wangwenlinzhuren. Public number “Expert of Thoracic Surgery”: wangwenlinyishi)

[Case Story] I am a post-90s with small ear deformity, I want to share with you what I did in adulthood

I was born in 1991. I have an introverted and tough personality. The first time I had emotions because of small ears was about 4 years old. At that time, two naughty children called me like this. I was very angry. It was not that they called me small ears, but a tone of ridicule. My mother heard them, and my mother educated them. 3 to 8 years old is the peak of my face value, it is very attractive, so I have always dared to expose my ears, not inferior. Gill arch disease is already on the left side, and no sound stimulation is received on the left side, resulting in extremely slow growth of the left face bone, and the size of the face is more obvious. Although it has no impact on my study work, it still has a certain impact on my psychology. Now I have a psychological state: I am relieved of my situation, but I cannot accept the relief of my lover; I am also afraid of inheritance. So now I am very insensitive to love and marriage. What bothers me the most is the sound of urging marriage around me. Last year I finally decided to do an ear reconstruction surgery. The hospital picked it up for a long time and made a lot of information on the Internet. Thinking about it, I decided to go to Guangzhou Noble Plastic Surgery for surgery. When I walked into the operating room, I was very scared. Later, Dr. Yu Wenlin and the operating nurse were comforting me. There is some pain, just use the knife, just endure it, it’s okay. In the first phase, I took the cartilage and buried it under my ears. After I didn’t use the dilator, my body recovered slowly, about a week or so. I was discharged from the hospital. I was very happy during the hospital. There were a lot of people in the same encounter next to me. It was okay to chat. When I get home, I do what I do, without any discomfort, but I usually pay attention to it. I usually go back home and wash my ears with alcohol. For this operation, the family members are also at ease, and they are not saying anything, support me to go. Now I am very much looking forward to the second phase of surgery coming soon.

The heart grows on the left side of the chest cavity, does sleeping on the left side affect the heart? Who can’t sleep like this

Does the left side sleep oppress the heart is unhealthy? When I was a child, my grandmother always reminded me to sleep flat, with feet straight to grow taller. He also said, don’t fall asleep to the left, otherwise your heart will be crushed. So, when I was young, I would always sleep with my feet straight, even if I turned over, I would lie to the right. When I grew up and learned medicine, I knew that these statements were totally untenable. The heart is not as fragile as imagined. It does not care where you sleep. The human blood vessels are like an extremely complicated network. Blood flows through the entire vascular network. The blood vessels are elastic. When the human body takes different postures, the blood in the body will Reassign. For example, when standing, most of the blood is concentrated in the lower limbs due to gravity. When lying down, the blood stored in the lower limbs returns to the heart. At this time, the amount of blood returned to the heart will increase, increasing the burden on the heart. If you sleep to the left , The heart is lower, the amount of blood returned will be more. However, when a person sleeps, he does not keep one posture unchanged, and will switch between different postures. For people with normal heart function, the left lateral position has a negligible impact on the heart. Activities such as running or climbing stairs increase the load on the heart far more than the effect of sleeping to the left on the heart. Therefore, there is no scientific basis for the claim that sleeping to the left will oppress the heart and cause unhealthy health. For a healthy adult, no matter what sleeping position, as long as you feel comfortable. However, there are several types of people who need to pay attention to their posture during sleep. 1. Patients with gastritis, gastritis, gastric ulcer, gastroesophageal reflux, etc., it is best to sleep on the right side, because this sleeping position will not compress the heart or the stomach, which is conducive to the digestion of food in the stomach. Can prevent stomach acid reflux caused by stomach squeeze. 2. Heart disease patients For heart disease patients, when they sleep on the left side, the heart is lower, the amount of blood returned to the heart will be more, the heart will be heavier, and there may be uncomfortable feelings such as suffocation. Especially for patients with heart failure, try not to lie on the left side, but should sleep in a head-high, foot-low, semi-recumbent position, and reduce the return of blood by gravity. 3. People who are used to snoring are best to use the lateral position. When the air enters the lungs through the nasopharynx and trachea, if the pharynx and nose are narrowed due to rhinitis and turbinate hypertrophy, the air enters these narrow parts. It is prone to snoring. In addition, the airway of the pharynx is at the base of the tongue. When sleeping, the tongue muscles are in a relaxed state. If you take a supine position, the relaxed muscles will fall back under the force of gravity, which will cause the pharynx to narrow and make it easier to snore. Therefore, there are respiratory diseases such as bronchitis and rhinitis. In order to alleviate the symptoms, it is generally recommended to use the lateral position. 4. Pregnant women doctors generally recommend that pregnant women sleep on their left side. This sleeping position can turn the right-handed uterus into a straight position, reduce the risk of abnormal fetal position and childbirth, and avoid the uterine compression of the inferior vena cava. Heart blood discharge, improve blood perfusion of the uterus and placenta, and reduce lower extremity edema.

The dream of treating vitiligo is over!

Flake leukoplakia was found on the left chest and back half a month. The patient said that leukoplakia was found half a month ago. After physical examination, the leukoplakia on the left chest and back, the boundary is not clear, and the diagnosis is vitiligo (before treatment). Our hospital will handle: check the skin CT and T lymphocytes After a series of examinations such as subgroup, blood routine, and trace elements, UVB and 308 excimer laser treatment were given. After four months of treatment, the boy finally returned to the original skin color (after treatment). Doctor ’s notes: & nbsp. & Nbsp. The development of China has never been achieved overnight, but it has to undergo the process of changing from quantitative to qualitative changes. The same is true for vitiligo. When the patient finds that there are white spots or white spots on the body, don’t care, because you will heal yourself after a while. In fact, it will be late when it spreads! Vitiligo causes are complex, so patients with vitiligo must make accurate tests to determine what causes their own vitiligo and determine the development of leukoplakia, so that symptomatic treatment and early recovery.

Do women have to sleep on their left side during pregnancy?

Female friends, do you have such a question, why do doctors recommend sleeping on the left side during pregnancy? I believe many mothers do not know how to sleep against the big belly in late pregnancy. In fact, the sleeping position during pregnancy There are many studies, but after falling asleep, we have no way to control the body, only to control the posture at the beginning of falling asleep. Theoretically, as the uterus increases during pregnancy, especially in the third trimester, the uterus will rotate to the right and back. In order to prevent the inferior vena cava and abdominal aorta from being compressed as much as possible, increase pregnant women’s blood output, reduce puffiness, improve the uterus and The amount of blood perfusion in the placenta, so many people think that it is safest to lie on the left side, and it is also possible to correct the position of the right uterus. However, in fact, everyone’s physical condition is different. If you take a left sleeping position for a long time during pregnancy, pregnant mothers will experience unilateral shoulder pain, backache, hip compression pain, butt pain, etc., which will affect the quality of sleep. , Which also affects the baby. So how can my mother adjust her sleeping position? When she falls asleep, she can properly hold a pillow of appropriate size on the inner side of the big and small legs, as shown in the figure below, keeping the hips, knees and ankles on the same line. You can also wash the following pillows for pregnant women similar to the front and back of the body, and keep the body joints in a neutral position, especially the position of the hips, knees and ankles, even if the body rotates during sleep, it is in a safe Perform in a comfortable and stable state. Therefore, when you first fall asleep, you should lie on your left side. If you feel uncomfortable during sleep, you can adjust it properly. And the baby’s self-protection ability is very good, the position of the mother sleeping makes the baby feel uncomfortable, the baby will send a signal to the mother to adjust the position. All in all, it is more important for mothers to choose their comfortable sleeping posture, and the quality of mothers ’sleep is better, and the baby will feel better!

What is the cause of left varicocele pain

Males with varicocele will experience local pain. In addition, varicocele will also cause changes in sperm quality, leading to infertility. Many patients with varicocele do not understand the cause of the disease? The following are several factors that cause varicocele. Physiological factors, the sexual function of most young men are more vigorous, especially the sexual desire is very strong, but if excessively stimulated for a long time, it can reflect on the ground and cause pelvic and spermatic vein congestion on the ground. Varicose veins may occur. Or because work requires standing for a long time, increasing abdominal pressure is also a common disease. Anatomical factors, generally speaking, the left spermatic cord vein is longer and enters the renal vein at a right angle. The left spermatic cord vein does not have a valve near the left renal vein, and blood easily flows back. Or the spermatic cord vein located behind the sigmoid colon is susceptible to the compression of feces in the intestine, which affects the return of blood. There are many other factors, such as retroperitoneal tumors, renal tumors, hydronephrosis, etc., compressing the internal spermatic vein can cause symptoms or secondary varicocele. The primary supine position disappears quickly, and the secondary supine position often does not disappear or disappears slowly. If you are suffering from varicocele disease, you may wish to visit the hospital directly. Make choices early and get rid of the troubles of the disease.

Dr.SUN | Children with hydronephrosis and ureter dilatation, when the results of imaging examination are contradictory

& nbsp. Tip: Click on the top ↑ “Dr. Sun Dr. Pediatric Surgery” ↑, you can follow me & nbsp .. In the development of medicine, imaging examination technology is indispensable. It is like adding a fluoroscopy eye to the doctor and leaving the imaging guidance, the surgeon’s operation will become blind. Therefore, surgeons are particularly willing to be friends with imaging doctors. & nbsp. The principle of each type of imaging examination is different, you can see the problem from different angles, cross each other but can not replace each other. What should doctors do if the results of imaging studies conflict with each other? & nbsp. Doctors seeing doctors are like exams. There are multiple-choice questions that have an answer at a glance. There are also multiple-choice questions that need to be considered one by one. Today, I will share a thinking question. The difficulty of this question is that the question stems from contradictions. & nbsp. According to the truth, there were hydronephrosis during fetal period, and urinary ultrasound should be actively reviewed after birth. But this three-month-old boy was reexamined because of a urinary tract infection because of fever. & nbsp. The picture below is the ultrasound results of different doctors on the same day. What can you see from these two ultrasound results? Right hydronephrosis and right ureteral dilatation are consistent, and the judgment on the left is contradictory. Is left hydronephrosis? Does the left ureter dilate? Is the duplicate kidney on the left? If the left kidney is a repeat kidney, how many are there on the left ureter? & nbsp. Ultrasound did not make it clear, magnetic resonance should be able to make it clear. Above: MRI conclusion & nbsp. MR: Right hydronephrosis and right ureteral dilatation are consistent with ultrasound, then the right side is basically clear. What about the left side? No hydronephrosis? Does the ureter dilate? Duplicate kidneys are also ruled out? Why did the left kidney dysplasia come out? & nbsp. Conflicting results, what should I do? Parents have started to keep asking, why haven’t the hospital operated on his children for a week? ! & nbsp. When I told my parents that I hadn’t figured it out and couldn’t get started, I saw that there was already a trace of suspicion. & nbsp. Above: MRI images & nbsp. I know that my level is limited, so I went to the brothers of the imaging department for consultation. After reconstructing various sections, the brothers of the imaging department sincerely told me that the left ureter Unclear, the shape of the left kidney is a bit strange, consistent with dysplasia, unlike repeated kidneys, but it cannot be completely ruled out. In short, “please combine clinical considerations”. & nbsp. I used to have a popular science about both hydronephrosis and full dilation of the ureter. That is to do a cystography to distinguish whether the end of the ureter is obstructive or reflux. The condition of the right renal ureter meets this premise. Sooner or later, cystography should be done. Then do this first. If there is reflux on the left, can’t the left ureter be displayed? Above: cystography results, there is no reflux on both sides. That means that the end of the right ureter is obstructed. The left side can only say that there is no reflux, the other still do not know. & nbsp. When I told my parents again that I hadn’t figured it out and couldn’t get started, I saw that there were already two traces of doubt. & nbsp. Zoom in! Go to the operating room to intubate the left ureter! If the left side is clear, you can go straight to do it. Above: Retrograde intubation of the left ureter. After injection of contrast medium, the left ureter sees dilation. Does the left renal pelvis and kidney calf look like a “sagging lily”? Surprisingly, the right ureter was still developed this time. Why did the right ureter develop? There is only one explanation. The right ureter has mild reflux. Ok? Didn’t the previous radiograph say there was no reflux? Yes, there was no reflux that time, this time there was a little reflux. & nbsp .-———— The dividing line ———— This paragraph has nothing to do with this child, just insert it and talk about the “sagging lily sign” & nbsp. Above: The left side is a schematic diagram of a repeating kidney repeating ureter. Imagine what would happen if only the lower left kidney ’s pelvis and calyces (in the blue circle in the picture above) were developed? & nbsp. Above: It has nothing to do with this child. Just show the drooping lily sign. A drooping lily often means a pyelogram of the lower kidney that repeats in the kidney. -———— The dividing line ———— Go back to this child and see a “sagging lily”, is there really a repeat kidney? I decided to do another CT for my child. & nbsp