一种具有高信噪比的脉搏波光电传感器的研制

目的：探讨研制一种生理信号光电传感器。方法：利用光电传感器检测通过指端毛细血管后的光强度的变化，将光信号转换成电信号，再经过电信号1/V转换、放大、滤波处理。结果：获得了清晰稳定的指端容积脉搏波。结论：高信噪比的光电传感器可用作于临床监测和生理信号分析处理系统。     

Short-term lack of cerebral perfusion with good outcome. Advantages of early intracranial pressure monitoring

A 21-year-old man was injured by a tailboard of a truck. He suffered a severe head injury with bilateral depressed skull fractures necessitating surgical decompression. On admission to the hospital the patient showed bending to pain stimuli (Glasgow Coma Score 5). Anisocoria was noticed from the beginning. Initial intracranial pressure (ICP), measured 3 hours after injury, was 30 mm Hg, and the cerebral perfusion pressure (CPP) was 70 mm Hg. During surgical elevation of the skull fracture on the right side an unexplainable rise of ICP to values of 100 mm Hg occurred, which corresponded to the mean arterial blood pressure (MAP). At the same time both pupils were dilated and fixed indicating a lack of cerebral perfusion. Due to immediate trephination of the opposite side, the ICP was lowered to values below 20 mm Hg, and sufficient cerebral perfusion (above 50 mm Hg) was regained. The patient showed a good recovery and was transferred to a rehabilitation center 5 weeks after injury.This case report emphasizes the importance of early and continuous intracranial pressure monitoring for adequate therapy in neurosurgical emergencies.     

介绍几种残指延长拇指再造的方法

本文报告带血管神经蒂组织瓣移位及手残指缓慢延长术治疗６４例拇指缺损，拇指平均延长２．６ｃｍ，平均随访时间３年６个月，再造拇指外形及功能均较满意。本法简单、安全、有效。拇指掌指关节以远缺如，残端指骨长１ｃｍ以上者行指骨延长术，不足１ｃｍ者可行第１掌骨延长术、二期行虎口加深术。掌指关节平面缺如采用第１掌骨延长术或带血管蒂皮瓣移位再造拇指。也可用带桡骨片的前臂桡侧皮瓣一期再造拇指。第１掌骨近侧平面缺如，     

Acute pseudotumor of the orbit

A case is presented of a 22-year-old man with a history of bilateral eye injection, lacrimation, and rhinorrhea. The right orbit was inflamed and its globe proptotic, with medial and lateral gaze deficits. Tomography revealed swelling about the right lacrimal gland. He was admitted and treated with high-dose steroids, which caused regression of his symptoms. This presentation and response to steroids is pathognomonic for acute pseudotumor of the orbit, a condition rarely described in the emergency medicine literature. If left untreated, treudotumor of the orbit may progress to blindness and ophthalmoplegia.     

Membrane flow within the myelin sheath in IDPN neuropathy

This report describes some aspects of beta,beta'-iminodipropionitrile (IDPN) neuropathy in rats as observed by ultrastructural methods and X-ray diffraction. Light microscopy shows gross swelling of the axons in proximal lumbar spinal roots 8 days after intraperitoneal injection of IDPN. Mean axon cross-sectional area and mean axon perimeter increased to 280% and 160% of their control values, respectively. At the same time, myelin membrane packing was not visibly disturbed. In addition, X-ray diffraction patterns, recorded under physiological conditions, demonstrate that the myelin lipid bilayer thickness and widths of the aqueous spaces between bilayers did not change. Related observations are made on posterior tibial nerve (PNS myelin) and ventral spinal cord (CNS myelin). The various observations together are interpreted in terms of a fluid myelin membrane. It is proposed that the myelin membrane flows during axon swelling even though normal membrane-membrane contacts are maintained within the sheath. Membrane flow and slippage between membranes are explained in terms of a molecular model of the myelin multilayer.     

The spermatozoal volume as indicative of the plasma membrane integrity (modification of the hypoosmotic swelling test). I. Methods

Summary. The aim of the present study was to establish a more differentiating indicator of plasma membrane integrity of spermatozoa than the classic version of the hypoosmotic swelling test according to Jeyendraan. Spermatozoa were prepared by density gradient centrifugation (90% Percoll) to select 'fertilization competent' spermatozoa only. After a second washing procedure sufficiently pure sperm cell suspensions were obtained. The volume distributions of these sperm cells were measured with a Coulter Counter at 25 °C after adaptation in 300 mosmolar NaCl solution resp. 150 mosmolar NaCl solution for 5 min. These volume distributions showed significantly different patterns for the isotonic and hypotonic stress situation in the simple salt solution. Moreover, the comparison of the response to hypoosmotic stress showed more than four reproducible characteristic patterns, promising well differentiated results for different sperm populations. The new method for the detection of hypoosmotic swelling effect might be a real and valuable functional parameter.     

冷冻异体手指复合组织移植后的骨关节病变观察

目的 研究自体Mu甲皮瓣游离移植包裹冷冻异体手指骨－关节－肌腱－腱鞘复合组织再造Mu，手指后，异体指骨关节病变发生的特点。方法 应用X线片和病理活检方法，对16例植入11个月－15年6个月，平均4年5个月的病变异体骨关节进行观察和评价。结果 异体骨关节病变过程可分早期（＜2年），中期（2－10年）和晚期（＞10年）。X线摄片分别显示软骨下骨虫蛀样缺损，骨关节吸收脱位和毁损。所有的病变骨关节中未见炎性细胞浸润，异体肌腱内见肌腱样细胞生长。结论 异体指骨关节病变严重程度与病程有关，其表现类似于失神经关节病变（Charcot关节病）。异体肌腱可长期存活。     

Investigation of, the cause of low sperm motility in asthenozoospermic patients by multiple quantitative tests

Multiple tests were done on the ejaculates of 10 asthenozoospermic patients and nine healthy normozoospermic volunteers in an attempt to identify individually the cause of low sperm motility in these patients. Possible defects in the sperm plasma membrane and the motility apparatus of sperm, and in epididymal function affecting the development of motility, were investigated. The presence of seminal sperm antibodies or any motility-inhibiting factors in the seminal plasma that could be removed by washing were also tested. Each test was positive in only one or two patients but axonemal dysfunction was identified in nine patients. Removal of seminal plasma from asthenozoospermic samples did not improve sperm motility to any greater extent than with donor ejaculates, and the motile sperm of these patients exhibited characteristics mostly similar to those of donors under various incubation conditions. Selection procedures are, therefore, required to obtain samples of good quality sperm from such asthenozoospermic ejaculates.     

吻合指固有神经背侧支的邻指皮瓣修复手指远端掌侧软组织缺损

目的探讨采用吻合指固有神经背侧支的邻指皮瓣修复手指远端掌侧软组织缺损的疗效. 方法 1996年10月～2004年6月,25例(32指)伴肌腱或骨组织外露的手指远端掌侧软组织缺损患者,其中男18例,女7例,年龄13～45岁.切割伤6例,冲压伤8例,机器绞伤11例.损伤部位:拇指2例,食指8例,中指5例,环指3例,小指2例,食、中指2例,中、环指2例,食、中、环、小指1例.缺损范围:1.5 cm×1.0 cm～4.0 cm×2.1 cm.损伤至就诊时间30 min～48 h.急诊行清创,采用带蒂邻指皮瓣修复,术中同时将指固有神经的背侧支与指神经残端吻合重建皮瓣感觉,术后3周断蒂.供区中厚皮片游离植皮. 结果术后皮瓣及供区均成活,创面Ⅰ期愈合.获随访6～26个月,手指指腹饱满,色泽正常,感觉恢复,两点辨别觉为5～8 mm,均无功能障碍. 结论采用吻合指固有神经背侧支邻指皮瓣修复手指远端掌侧软组织缺损不仅能修复缺损皮肤,且能重建皮瓣感觉,术式操作简便.