负压疗法治疗肢体缺血

目的：评价负压疗法对肢体缺血的治疗效果，方法：１９８５－０７￣１９９５－０３，我们应用自行研制的治疗机，对１６７例（２３１个肢体）肢体缺血患者进行了负压治疗，其中动脉硬化性闭塞症６２例（９１肢），血栓闭塞性脉管炎７５例（９３肢），雷诺综合征３０例（４７肢），治疗时将患肢置入密闭舱内，压力范围为－８．６６ｋＰａ￣－１７．３ｋＰａ，一般上肢为－１０．７ｋＰａ，下肢为－１３．３ｋＰａ。结果：显效１１７肢     

Lower Lid Blepharoplasty—The Transconjunctival Approach: Extended Indications

The transconjunctival blepharoplasty is an elegant and secure technique especially in young people and helps to avoid the hazard of a scar. In older patients, it saves them the possible sequelae such as rounding sclero show or possible ectropion after a classical operation. Because there is no visible scar, the transconjunctival approach respects the integrity of the functional structure of the orbital septum and the orbicular muscle, the active support of the lower eyelid.     

下体负压晕厥前症状下事件相关电位变化特征

目的探讨下体负压晕厥前症状（ＰＳＳ）下事件相关电位（ＥＲＰｓ）的Ｐ３潜时（Ｐ３Ｌ）变化特征，为飞行员加速度性晕厥的医学鉴定提供实验方法和依据。方法用下体负压方法（ＬＢＮＰ）诱发ＰＳＳ，观察ＥＲＰｓ的Ｐ３Ｌ变化特征。结果出现ＰＳＳ时，ＥＲＰｓ的Ｐ３Ｌ由３４３．３５±１４．７２ｍｓ延长至５０６．８７±３７．４４ｍｓ（Ｆ（６，４８）＝１４．９６，Ｐ＜０．０５，ＯＺ电极），相关任务反应时（ＲＴ）由５０８．６５±１１．１３ｍｓ延长至６３１．２５±２９．１６ｍｓ（ｔ＝２．９７，Ｐ＜０．０５），靶刺激反应错误率由（４．００±１．６７）％增加至（４３．３８±３．５４）％（ｔ＝３．０６，Ｐ＜０．０５）。ＰＳＳ后第５ｍｉｎ，Ｐ３Ｌ仍明显高于基线值（Ｐ＜０．０５）。而ＲＴ、错误率与基线值已无显著差异（Ｐ＞０．０５）。结论ＥＲＰｓ的Ｐ３Ｌ结合ＲＴ、错误率等指标对飞行员加速度性晕厥的研究有潜在应用价值。     

Comparative effects of ischemia and acute hypoxemia on muscle afferents from tibialis anterior in cats

Comparative effects of ischemia and acute hypoxemia (PaO₂ = 24 mm Hg) were studied in anesthetized cats on afferents from the tibialis anterior limb muscle. Metaboreceptors (groups III and IV fibers) and mechanoreceptors were identified by their activation by an intraarterial injection of lactic acid (LA) or high-frequency vibrations (HFV) applied to the extremity of the muscle tendon, respectively. Ischemia and hypoxemia exerted opposite influences on the two categories of muscle afferents: they depressed the response of mechanoreceptors to HFV, but markedly enhanced the spontaneous tonic activity of metaboreceptors. The effects of hypoxamia were delayed but slightly greater and lasted longer during the recovery period than those exerted by ischemia. The inhibitory action on mechanoreceptors exerted by a reduced oxyden supply to muscle is interpreted as a result from local acidosis. Indeed, under normoxic conditions, a LA bolus injection during the HFV test also reduced the firing rate of these receptors. © 1993 John Wiley & Sons, Inc.     

肢体远隔缺血期适应联合后适应促进大鼠缺血性脑卒中模型神经发生的作用及机制

目的 探讨肢体远隔缺血期适应(per-conditioning,PerC)联合后适应(post-conditioning,PostC)对缺血性脑卒中后神经再生的作用,并明确PerC联合PostC对脂肪酸β-氧化(fatty acid β-oxidation,FAO)限速酶——肉毒碱棕榈酰转移酶(carnitine palmitoyl transferase 1A,CPT1A)的影响。方法 对成年雄性SD大鼠进行大脑中动脉闭塞(middle cerebral artery occlusion,MCAO)造模,MCAO模型后30 min进行肢体远隔缺血期适应治疗(PerC),再灌注24 h后重复进行肢体远隔缺血适应(PostC),1次/d,直到取材。再灌注14 d后对大鼠进行神经功能评分,通过免疫组织化学染色检测室管膜下区(subependymal ventricular zone, SVZ)神经再生情况,通过酶联免疫吸附测定(enzyme linked immunosorbent assay,ELISA)法检测CPT1A的表达。结果 与MCAO组及PerC/PostC组比较,PerC+PostC组大鼠,身体不对称运动行为评分降低,神经干细胞的数量以及向梗死区迁移的细胞数量增加。Pearson相关性分析显示,神经干细胞的数量与神经功能呈负相关(r=-0.917 9, P<0.0001)。然而,迁移到基底节区的神经干细胞的凋亡数量在各组之间差异无统计学意义。机制研究显示,PerC+PostC组CPT1A的蛋白水平显著增加。结论 PerC联合PostC治疗能够通过增加神经干细胞的数量改善神经功能,神经干细胞的脂肪酸氧化可能是其促进神经干细胞迁移的机制之一。     

不同重复经颅磁刺激模式对脑卒中后上肢运动功能障碍干预效果的网状Meta分析

背景 上肢运动功能障碍是脑卒中后常见的后遗症之一,严重影响患者日常生活能力。重复经颅磁刺激（rTMS）作为常见的神经电生理技术对治疗脑卒中后上肢运动功能障碍有较好的疗效,但临床对不同rTMS干预模式的选择仍缺乏循证依据。目的 采用网状Meta分析方法比较rTMS的4种模式对脑卒中后上肢运动功能障碍患者的临床疗效。方法 计算机检索PubMed、Embase、Cochrane Library、Web of Science、中国生物医学文献数据库、中国知网、万方数据知识服务平台、维普网中有关rTMS治疗脑卒中后上肢运动功能障碍的随机对照试验,并通过追溯Meta分析的参考文献作为补充。检索时间均为建库至2022年2月,采用主题词和自由词结合方式进行。2名研究者进行文献筛选、资料提取及质量评价。采用RevMan 5.0软件和Stata 16.0软件进行统计学分析。结果 最终纳入17篇文献,790例患者,共涉及6种干预措施：高频rTMS(HF-rTMS)、低频rTMS(LF-rTMS)、间断性theta节律刺激（iTBS）、连续性theta节律刺激（cTBS）、假刺激、常规疗法。网状Meta分析结...     

电阻应变式传感器在下肢牵引手术中的应用

目的 研究电阻应变式传感器（RSS）在不同下肢骨折类型手术中的应用。方法 选择2020年10月—2022年8月中国科学技术大学附属第一医院收治的外伤性下肢骨折患者99例,按照骨折类型分为股骨粗隆间骨折组79例、股骨干骨折组15例、股骨颈骨折组5例。患者均在牵引床上行闭合复位内固定术,使用RSS测量3组不同骨折类型手术中的初始牵引力、牵引时长、松解牵引力。记录手术时间、术中出血量,术后评分及3组不同骨折类型手术前后血色素变化及输血情况;比较使用不同内固定方式（长髓内钉、短髓内钉、空心钉）的术中牵引力和手术出血量、手术时间;比较长髓内钉固定患者和短髓内钉固定患者时下肢旋转角度。结果 3组不同骨折类型初始牵引力、牵引时长、松解牵引力、手术时长、术中出血量、术后评分比较,差异均有统计学意义（P <0.05）。3组不同骨折类型术前、术后血红蛋白、红细胞压积比较,差异均有统计学意义（P <0.05）。3组术中输血情况比较,差异有统计学意义（P <0.05）,术后输血情况比较,差异无统计学意义（P>0.05）。使用不同内固定方式的患者牵引总时长、年龄、术中出血量、手术时间比较...     

Afferent fiber connections from lower brain stem to hypothalamus studied by the horseradish peroxidase method with special reference to noradrenaline innervation

Summary Attempts were made to determine the afferent projections to the anterior hypothalamus including the preoptic area from the lower brain stem by means of the horseradish peroxidase method combined with monoamine oxidase staining to identify noradrenaline (NA) neurons. In addition to this technique, a histofluorescence analysis was performed. NA fibers in the medial part of the anterior hypothalamus were mainly supplied by A1 and A2 NA neuron groups, while the lateral part and periventricular zone received NA terminals from both pontine and medulla oblongata NA neuron groups. Furthermore, the present study indicated that there were direct projections to the anterior hypothalamus from non-noradrenergic neurons in the lower brain stem: nuclei raphe dorsalis, centralis superior, cells in the mesencephalic and pontine central gray matter, nuclei parabrachialis lateralis and medialis, cells around fasciculus longitudinalis medialis.Abbreviations CA Commissura anterior - CO Chiasma opticum - DP Decussatio pyramidum - DPCS Decussatio pedunculorum cerebellarium superiorum - F Columna fornicis - FLM Fasciculus longitudinalis medialis - FMT Fasciculus mamillothalamicus - GCM Griseum centrale mesencephali - GCP Griseum centrale pontis - LL Lemniscus lateralis - LM Lemniscus medialis - PCM Pedunculus cerebellaris medius - PCS Pedunculus cerebellaris superior - TO Tractus opticus - TS Tractus solitarius - TVme Tractus mesencephalicus nervi trigemini - V Ventriculus tertius - VTS Tractus spinalis nervi trigemini - am nucleus ambiguus - B Barrington nucleus - com nucleus commissuralis - cp nucleus caudatus putamen - cs nucleus centralis superior - ct nucleus corporis trapezoidei - cu nucleus cuneatus - dX nucleus dorsalis nervi vagi - Gd nucleus tegmentalis dorsalis (von Gudden) - gr nucleus gracilis - Gv nucleus tegmentalis ventralis (von Gudden) - ha nucleus hypothalamicus anterior - hl nucleus hypothalamicus lateralis - hpe nucleus periventricularis (hypothalami) - hvm nucleus ventromedialis hypothalami - lc nucleus locus coeruleus - oi nucleus olivaris inferior - p nucleus pontis - pa nucleus paraventricularis - pbl nucleus parabrachialis lateralis - pbm nucleus parabrachialis medialis - ph nucleus praepositus hypoglossi - pol nucleus preopticus lateralis - pom nucleus preopticus medialis - pop nucleus preopticus periventricularis - rd nucleus raphe dorsalis - re nucleus reuniens - rl nucleus reticularis lateralis - rm nucleus raphe magnus - ro nucleus raphe obscrus - sc nucleus suprachiasmaticus - so nucleus supraopticus - st nucleus interstitialis striae terminalis - td nucleus tractus diagonalis (Broca) - ts nucleus tractus solitarii - Vme nucleus mesencephalicus nervi trigemini - Vmo nucleus motorius nervi trigemini - Vts nucleus tractus spinalis nervi trigemini - XII nucleus nervi hypoglossi     

单钉——沟槽柱翼钢板的生物力学实验研究

作者自行研究设计的单钉－沟槽柱翼钢板复位固定治疗腰椎滑脱症。预先采用６具成人尸体的Ｌ３－Ｓ３骨骼做成椎弓崩裂并滑脱模型，采用临床Ｉ型手术方法进行了复位固定，在每片钢板上粘贴６片电阻应变片，进行中心和偏心加载试验，同时进行了弯矩和扭矩试验，在５８６微机上进行了线性回归分析，求出了线性方程及线性相关系数ｒ，中心和偏心加载达到９００Ｎ未出现钢板松动，扭矩和弯矩在８３３Ｎ；ｃｍ和６６６．４Ｎ．ｃｍ以内左右     

Role of the mesenteric arteries in the arterial blood supply to the lower limbs

Summary The arteries of the gut, and in particular in the inferior mesenteric artery (a. mesenterica inferior), normally play a minimal role in supplying blood to the lower limbs. However, this is far from being the case in aorto-iliac obstruction. The anatomical anastomoses between the intestinal arterial system and the arteries of the lower limb hypertrophy and in one case out of ten become predominant.In the present study the path taken and the relations of the collaterals of the intestinal arteries and of their anastomoses have been traced, and several collateral pathways are described.

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Rôle des artères mésentériques dans la revascularisation artérielle des membres inférieurs

Résumé Les artères digestives, et en particulier l'artère mésentérique inférieure (a. mesenterica inferior), jouent à l'état normal un rôle minime dans la vascularisation des membres inférieurs. Il n'en est pas de même en cas d'oblitération aorto-iliaque. Les anastomoses anatomiques entre le système artériel digestif et les artères du membre inférieur s'hypertrophient et, dans un cas sur 10, deviennent prédominantes.Dans cette étude, le trajet et les relations des collatérales des artères digestives et leurs anastomoses sont étudiés. Plusieurs voies collatérales sont possibles.