足背皮瓣与第二足趾复合及组合移植修复复杂手外伤

目的探讨手部严重毁损伤所致的多指缺失、皮肤缺损的复杂手外伤的修复方法。方法对13例多指缺失、手部皮肤缺损的复杂手外伤行游离足背皮瓣与第二足趾复合及组合移植进行修复与再造。结果13例足背皮瓣与再造手指全部成活，外形满意，功能良好。结论本术式由于足背皮瓣与第二足趾共用血管蒂，切取方便，皮瓣较薄，外形好，适合于修复复杂手外伤。     

复方联苯苄唑液治疗角化型手足癣的双盲对照研究

目的观察复方联苯苄唑治疗角化型手足癣的临床疗效。方法采用随机双盲对照法观察复方联苯苄唑液(试验组)与联苯苄唑液(对照组)外用治疗角化型手足癣的临床疗效。结果试验组瘙痒、红斑、丘疹和角化的平均消失时间比对照组短,消失率亦明显高于对照组,统计学处理均有显著性差异(P<0.05)。真菌学评价:试验组治疗4周后真菌转阴率为93.90%,对照组转阴率为74.39%,明显低于试验组(P<0.05)。停药后2周再次真菌检查试验组转阴率升至96.31%,对照组则降为70.67%。试验组痊愈率为75.61%,有效率为100%,对照组分别为58.54%和81.71%。试验组和对照组均未见明显不良反应。结论复方联苯苄唑液治疗角化型手足癣临床疗效高,无明显副作用。     

Firing properties of two types of nucleus raphe dorsalia neurons during the sleep-walking cycle and their responses to sensory stimuli

Spontaneous activity of the nucleus raphe dorsalis (NRD) neurons during the sleep-walking cycle and effects of sensory stimuli upon NRD neurons were studied in cats. Seventy-one neurons recorded within the NRD were classified into two groups with the use of the coefficient of variation of firing intervals during walking (W): 41 regularly firing (clock-like) and 30 irregularly firing (non-clock-like) neurons. The majority of clock-like and one-third of non-clock-like neurons showed a decrease in their firing rate during slow-wave sleep (SWS) compared with W. All neurons of both types displayed their lowest level of activity during paradoxical sleep. During the late phase of SWS, many clock-like neurons reduced their firing prior to the occurence of pontogeniculo-occipital waves, whereas non-clock-like neurons did not show such a specific property. Clock-like neurons were totally unresponsive to nociceptive and non-nociceptive somesthetic stimuli, while about half of the non-clock-like neurons were driven by these stimuli. Half of the clock-like and one-third of the non-clock-like neurons were driven by click stimulation, and the majority of them showed an excitatory response. Some of the clock-like and non-clock-like neurons exhibited inhibitory and excitatory response to flash stimulation, respectively. The results of this experiment show that two types of neurons do exist in the NRD and suggest that they play a functionally different role in the brain.     

Variation of tryptophan-5-hydroxylase concentration in the rat raphe dorsalis nucleus afterp-chlorophenylalanine administration. II. Anatomical distribution of the tryptophan-5-hydroxylase protein and regional variation of its turnover rate

Distribution of tryptophan-5-hydroxylase (TpOH)-containing cells and TpOH protein tissue concentrations were evaluated in the nucleus raphe dorsalis (NRD) of rat brain by immunocytochemistry and direct transfer onto nitrocellulose filters of unfixed adjacent brain sections. This work has demonstrated that: (1) the direct transfer onto nitrocellulose filters could be easily used for the quantitative analysis of TpOH protein distribution; (2) the origin of the TpOH in this brain nucleus was preferentially cellular; (3) classical subdivisions, qualtitatively defined from morphometric and topographic observations could be precisely described in terms of cellular density, tissue and cellular concentrations and turnover of TpOH protein. Such differences could imply a physiological control of TpOH gene expression in the serotoninergic neurons.     

Free composite dorsalis pedis flap for the reconstruction of the hand

Summary One-stage reconstruction of traumatic loss of metacarpal bones, extensor tendons and skin is a challenging problem for the reconstructive surgeon. The anatomical and functional similarity between the structures of the dorsum of the foot and of the hand, makes the dorsalis pedis composite flap a consideration in reconstruction of compound defects of the hand.     

大鼠延髓网状背侧亚核传入投射的荧光金逆行追踪法研究

将荧光金注入单侧大鼠延髓网状背侧亚核进行该部位的传入投射研究。结果发现；在脊髓后角Ⅰ层，Ⅲ－Ⅳ层，Ｘ层背侧有阳性标记细胞，中缝大核，线性核，中缝背核，中脑导水管周围灰质，丘脑室旁核等均有较多的标记细胞。     

谷氨酸受体在延髓网状背侧亚核内的分布

谷氨酸是哺乳类中枢神经系统的一种重要的神经递质。为了探讨谷氨酸是否作用于延髓网状背核的神经元,采用免疫组织化学方法,对代谢型谷氨酸受体的７种亚型以及离子型谷氨酸受体中的Ｎ－甲基－天门冬氨酸１型受体在延髓网状背侧亚核内分布的情况进行了研究。结果显示,几种谷氨酸受体的免疫阳性产物主要定位在神经元的胞体和树突上。在延髓网状背侧亚核可以观察到ｍＧｌｕＲ５,ｍＧｌｕＲ７和ＮＭＡＤＡＲ１这３种受体亚型的免疫阳     

A case of bilateral anomalous origin for dorsalis pedis arteries (anomalous dorsalis pedis arteries)

Summary A case of bilateral anomalous arterial supply of the lower limb is presented. In this case, both anterior tibial arteries were hypoplastic. These arteries came to the anterior (extensor) compartment by passing superiorly through the interosseous membrane. They ran between the tibialis anterior and the extensor hallucis longus muscles and terminated after giving numerous muscular and fascial branches. The dorsalis pedis arteries originated from the peroneal arteries. The peroneal arteries reached the anterior compartment by piercing the interosseous membrane at its lower part and ran as the dorsalis pedis arteries. Awareness of the anatomical variations in anatomy of the distal popliteal artery is important for angiographers, vascular surgeons and reconstructive surgeons who operate upon these regions.

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Un cas d'origine anormale bilatérale des artères dorsales du pied

Résumé Un cas de vascularisation artérielle anormale bilatérale du membre inférieur est présenté. Dans ce cas les deux aa. tibiales antérieures étaient hypoplasiques. Elles gagnaient la loge antérieure de la jambe en traversant la partie haute de la membrane interosseuse. Elles passaient entre les mm. tibial antérieur et long extenseur de l'hallux et se terminait en donnant de nombreuses branches musculaires et fasciales. Les aa. dorsales du pied naissaient des aa. fibulaires. Les aa. fibulaires gagnaient la loge antérieure de la jambe en traversant la partie basse de la membrane interosseuse et avaient ensuite le trajet normal des aa. dorsales du pied. La connaissance des variations anatomiques de la partie distale de l'a. poplitée est importante pour les radiologues pratiquant l'angiographie, les chirurgiens vasculaires et les chirurgiens reconstructifs opérant dans ces régions.

     

Trichophyton sensitivity in allergic and nonallergic asthma

BACKGROUND: Although the role of inhaled fungi in inducing asthma has been repeatedly confirmed, there are few reports about the association of asthma with dermatophyte sensitivity and the causal role of Trichophyton allergy in asthma. The objective was to investigate the presence of Trichophyton sensitivity among patients with allergic and nonallergic asthma in combination with tinea, and to compare the situation with several control groups in order to evaluate the factors determining Trichophyton sensitivity. METHODS: A total of 86 subjects (55 female, 31 male) with a mean age of 38.6 +/- 11.1 years were included in the study. The patients were divided into five groups: 1) nonallergic asthma plus tinea (n = 19) 2) allergic asthma plus tinea (n = 15) 3) asthma without tinea (n = 22) 4) tinea without asthma (n = 17) 5) healthy controls (n = 13). Skin tests with standardized extracts of T. rubrum and specific IgE measurements were performed in all subjects. All patients were also subjected to microscopic evaluation and fungal culture for dermatophyte infection. RESULTS: The skin test positivity rate to Trichophyton extract of groups 1 (63.1%), 2 (46.7%), and 4 (47.1%) was higher than that in groups 3 (4.4%) and 5 (7.7%) (P < 0.05). Although not significant, the rates of sensitivity to T. rubrum (63.1%) and of severe asthma (31.6%) were higher in the group with nonallergic asthma with tinea (group 1) than in other groups. Among 51 patients in whom direct microscopic evaluation revealed dermatophyte infection, 60.8% had positive fungal cultures for T. rubrum (58.1%), T. mentagrophytes (35.5%), and Candida (6.4%). CONCLUSION: According to our data, the presence of fungal infection seems to be an important determinant in hypersensitivity to Trichophyton whether or not the subject is asthmatic and/or allergic. Since a greater proportion of patients with nonallergic asthma--in whom the rate of severe asthma was also higher - showed positive skin tests to Trichophyton extracts in this study, we believe that patients with severe, intrinsic asthma should be examined for signs of fungal infection and tested to determine immediate hypersensitivity to dermatophyte antigens.     

颅眶截骨前移结合游离皮瓣整复放疗后眶畸形

目的探讨经颅眶截骨前移结合足背游离皮瓣串联胫前筋膜瓣整复放疗后眼眶凹陷及结膜囊狭窄畸形的临床疗效。方法自2004年以来,共收治5例视网膜母细胞瘤手术及放疗后眼眶及结膜囊严重凹陷畸形,应用冠状切口经颅眶前部截骨前移,钛钉钛板坚强固定后,复原头皮瓣,再在狭窄的结膜囊中部切开向四周分离,根据结膜囊缺损的大小及颞部的凹陷范围设计足背游离皮瓣串联胫前筋膜瓣,分别移植于结膜囊及颞部凹陷部位,血管蒂与颞浅动静脉或面动脉及颈外静脉吻合。结果皮瓣全部成活,经3-6个月随访,眶外形满意,颞部凹陷明显改善。结膜囊内义眼模固定3个月后3例配戴义眼外形良好;2例较差,其中1例眼窝凹陷仍较明显,二期行义眼座置入术,另1例结膜囊挛缩,术后下穹隆过浅,二期行自体硬腭黏膜移植。上述2例经二期修整后1个月安戴义眼,外形也达到满意效果。足部供区4例愈合良好,1例延期愈合。结论经颅眶截骨前移结合游离足背皮瓣串联胫前筋膜瓣转移整复放疗后眼眶及颞区凹陷及结膜囊狭窄畸形具有可行性,一期手术即可完成。