Outcome using hemihepatic vascular occlusion versus the pringle maneuver in resections limited to one hepatic section or less

Consensus is lacking concerning how to manage afferent vessels during hepatectomy, particularly as to the Pringle maneuver vs. selective hemihepatic clamping. Data for 81 hepatocellular carcinoma patients with chronic hepatitis or liver cirrhosis whose liver resection was limited to one section or less, including intraoperative data and postoperative liver function data, were analyzed retrospectively to compare two strategies. No significant differences of intraoperative data or postoperative clinical course were seen between the two groups, even in patients with chronic hepatitis or liver cirrhosis whose postoperative deterioration of liver function could be expected to be more than patients with a normal liver. The difference was evident only in serum alanine aminotransferase level on postoperative day 10 (mean ± SEM, 64.5±5.1 IU in the Pringle group vs. 51.6±4.4 IU in the selective clamping group; P<0.05). During liver resection limited to one section or less, even with underlying chronic hepatitis or cirrhosis, intermittent use of the Pringle maneuver preserved liver function to the same extent as selective clamping.     

Impaired cardiovascular autonomic function in Parkinson's disease with visual hallucinations.

We assessed the relations of visual hallucinations (VH) to cardiovascular autonomic dysfunction in patients with Parkinson's disease (PD). The subjects were 37 patients without VH (VH(-)) and 31 with VH (VH(+)). Autonomic function was evaluated on the basis of cardiac 123-radioiodinated metaiodobenzylguanidine (123I-MIBG) uptake and hemodynamic testing with Valsalva maneuver. Systolic blood pressure (SBP) and plasma norepinephrine concentrations (NE) were measured by tilt-table testing. 123I-MIBG uptake was lower in VH(+) than VH(-). Hemodynamic studies showed that VH(-) had only cardiac sympathetic and parasympathetic dysfunction, while VH(+) additionally had reduced vasomotor sympathetic functions. The fall in SBP during tilt-table testing was greater in VH(+) than VH(-). NE and its difference in the supine and upright positions were decreased in VH(+). We conclude that cardiac and vasomotor sympathetic dysfunction is more severe in VH(+) than in VH(-). Severe dysfunction in PD with VH is probably attributed to Lewy-body lesions or neuronal loss in sympathetic ganglia, the central autonomic system, or both.     

同时性后半规管与水平半规管性良性位置性眩晕

目的：探讨同时性后半规管与水平半规管性良性位置性眩晕（混合性良性位置性眩晕）的诊治方法。方法：联合应用Epley手法和Barbecue翻滚法对4例患者进行治疗，两次治疗间隔1d。结果：4例患者眩晕症状完全消失，随访至今无复发。结论：混合性良性位置性眩晕兼有后半规管与水平半规管性良性位置性眩晕的临床表现，联合采用Epley手法和Barbecue翻滚法治疗该病是可行的。     

军队官兵演习后期的心理变化

为探讨军队官兵在演习后期的心理变化，本分析了军队官兵在演习后期存在放松心理，思乡情绪，自我肯定以及发泄心理等的原因，并提出了相关对策；为稳定演习官兵的思想情绪提供参考。     

人体对预先暴露-1,-0.5,0 Gz之后+Gz时的心血管反应

目的: 评价推拉动作的心血管反应性及推拉效应的发生机制. 方法: 17名健康体检现役歼击机飞行员被分别暴露于9次头高位倾斜(HUT,+1 Gz)→头低位倾斜(HDT,-1 Gz,-0.5 Gz,0 Gz)→HUT,随机顺序. 在下列条件下进行:+90° HUT 2 min,随后转为-90°, -30°, 0° HDT各30 s,随后转为+90° HUT 2 min. 床体旋转速度为45°*s-1. 间隔4 s监测一次血压(收缩压、舒张压和平均动脉压),实时监测心电图. 结果: 在HDT期间,心率和血压较基础HUT明显下降. 随后HUT,心率和血压上升,但与基础HUT比较其速度和幅度变小. -0.5 Gz和0 Gz血压较-1 Gz时明显升高. 结论: 在推拉动作小于+1 Gz时相由于颈动脉窦压力感受器的作用,导致反射性交感神经抑制、副交感神经兴奋,在其后的+Gz时相,这种交感-副交感神经兴奋性转换延迟,导致对其后+Gz的心血管反应性延迟. 这可能是推拉效应的发生机制之一.     

The use of deep inspiration preceding the valsalva maneuver and rapid expiration in color doppler imaging of the lower extremity veins

Deep inspiration preceding Valsalva maneuver and rapid expiration immediately following it (DIVE) enhance venous blood flow on color Doppler flow imaging (CDI). The effect of DIVE was assessed in 115 consecutive lower extremity examinations. Of these, 95 or 115 (83%) had negative CDI sonograms, and 20 of 115 (17%) had partially (six of 115) or completely (14 of 115) occluding deep vein thrombosis. DIVE enhanced venous blood flow in 68% of the negative cases, resulting in transient venous distention, and/or more complete color filling, and/or greater spectral flow velocities. The 14 cases with completely occluding thrombi showed no response to DIVE. Six cases with partially occluding thrombi showed moderate to mild response to DIVE, with improved color delineation of the residual patent lumen around the thrombus. The authors conclude that DIVE facilitates deep venous CDI, especially when compression cannot be used to augment venous flow.     

一种适用于飞行教官的新型抗荷动作的表面肌电图评价

目的：提出适用于飞行教官的抗荷动作并对其抗荷效果进行表面肌电图评价。方法：选拔17~20岁受试者8名,试验设备采用AMST-HC-4E型载人离心机,根据初教机与高教机飞机性能及载荷特点,编制3.0G60s、4.0G50s、5.0G40s、6.0G30s及7.0G20s 共5条离心机加速度曲线,分别评价FT动作及HP动作抗荷效果,同时利用表面肌电技术观察不同载荷下两种抗荷动作训练前后肌肉用力变化及肌肉激活情况。结果：训练后,受试者使用FT动作与HP 动作时抗荷耐量均较训练前显著增加,与训练前相比,FT动作增加60.8%,HP 动作增加34.6%,FT+KH-X组增加50.5%,HP+KH-X增加51.7%,差异均有统计学差异(P>0.05);表面肌电测试结果显示,训练前后FT动作及HP动作的积分值(iEMG)均呈下降趋势,其中FT动作2.5G10s 载荷下右腓肠肌、3.0G60s载荷下左右腹直肌及右腓肠肌、5.0G40s载荷下左腹直肌训练前后的iEMG值下降差异有统计学差异(P<0.05)。FT动作与HP动作比较,3.0G60s载荷下,FT动作胫骨前肌iEMG显著高于HP动作(P<0.05),在4.0G50s+KHX及5.0G40s+KHX组,HP动作左腹直肌iEMG显著高于FT动作(P<0.05)。结论：本研究提出适用于飞行教官的一种新型抗荷动作且抗荷效果显著,值得推广。     

The Epley maneuver for the treatment of benign paroxysmal positional vertigo

In recent years, different forms of physical therapy have been proposed for the treatment of benign paroxysmal positional vertigo (BPPV). These mainly consist of maneuvers aiming to reposition and disperse free-floating endolymph particles in the posterior semicircular canal. We report our experience with one of these procedures, the Epley maneuver (EM), in treating 30 cases of BPPV. Twenty-six patients (87%) were cured, while four (13%) did not respond to treatment. These results are similar to those reported in the literature for the EM and the Sémont maneuver.