改良部分拇趾甲切除术治疗顽固性甲沟炎的疗效观察

目的观察改良部分拇趾甲及甲床切除方法治疗顽固性甲沟炎的疗效。方法1978-01—2009-05对326例拇趾甲沟炎病人采用单趾一侧或双侧、双趾一侧或双侧病灶部分趾甲及甲床切除术。结果治愈319例（97．9％）,复发7例（2．1％）;44例（13．5％）患拇趾头变形者中,39例恢复正常形态（88．6％）,5例（11。4％）变形有不同程度改善;11例（3．4％）合并骨髓炎者经治疗后痊愈。结论改良部分拇趾甲切除及病变甲床清除,使破坏后病变甲床不再生长趾甲,彻底清除甲沟炎的致病因素,疗效可靠。     

Glycine transporter (GlyT1) inhibitors with reduced residence time increase prepulse inhibition without inducing hyperlocomotion in DBA/2 mice

Inhibition of the glycine transporter type 1 (GlyT1) leading to potentiation of the glycine site (GlyB) on the N-methyl-d-aspartate (NMDA) receptor has been proposed as a novel therapeutic approach for schizophrenia. However, sarcosine-based GlyT1 inhibitors produce undesirable side effects including compulsive walking and respiratory distress. The influence of specific biochemical properties of GlyT1 inhibitors, such as mode of inhibition and residence time, on adverse effects is unknown. Two GlyT1 inhibitors that contain a sarcosine moiety, sarcosine and ALX-5407, and two compounds that do not contain a sarcosine moiety, Roche-7 and Merck (S)-13h, were evaluated for their potency, mode of inhibition, and target residence times in vitro, and modulation of prepulse inhibition (PPI) and locomotor activity in vivo. (S)-13h and sarcosine were competitive inhibitors while ALX-5407 and Roche-7 demonstrated mixed noncompetitive inhibition. Potency of GlyT1 inhibition (ALX-5407 > (S)-13h > Roche-7 ? sarcosine) did not correlate with residence time on GlyT1 (sarcosine = Roche-7 ? (S)-13h < ALX-5407). ALX-5407 and (S)-13h induced compulsive walking, termed obstinate progression (OP), at doses that increased PPI in DBA/2 mice, demonstrating that OP was not a function of mode of inhibition or inhibitor chemotype. Sarcosine and Roche-7 increased PPI without inducing OP, suggesting that compounds with decreased GlyT1 residence time were efficacious without adverse effects. Direct activation of the GlyB site by d-serine did not produce OP. However, OP induced by (S)-13h was blocked by strychnine, a glycine receptor (GlyA) antagonist, suggesting that OP induced by GlyT1 inhibition was mediated by GlyA. Thus, GlyT1 inhibitors with short residence times demonstrated efficacy without mechanism-based adverse effects.     

关于裂脑人神经心理学实验结果的分析

本文对顽固性癫痫病人裂脑手术治疗前后心理功能变化进行研究。通过对10例裂脑人的wechsler的成人记忆测验(WMS),wechsler成人智力测验(WAIS)及Halstead-Reitan神经心理成套测验(HR)等三项心理学检查,认为胼胝体切断术(裂脑)治疗癫痫效果肯定;对病人的智力、记忆力等神经心理功能无不良影响。从裂脑人出现的左右功能的转移与倒置,发现了人类大脑左、右半球的言语和操作等各自功能的优劣及其胼胝体的整合作用。进一步验证了“每一个半球分别具有高级智慧机能”的新观点。     

颈总动脉注射莨菪类药物治疗153例顽固性癫痫疗效分析

颈总动脉注射莨菪类药物治疗153例顽固性癫痫,完全控制74例,显效43例,有效13例,总有效率达84.9％。毒、副作用小。     

MEK inhibitor-induced paronychia in a paediatric population: A tertiary centre experience

The cutaneous toxicity of MEK inhibitors may limit treatment adherence. The authors present a retrospective study of 41 paediatric patients with NF-1 undergoing therapy with selumetinib and propose a treatment algorithm.     

以甲沟炎及甲损害为主要表现的副肿瘤性皮肤病一例

患者女,38岁,因甲沟红肿伴疼痛、体重减轻2年,甲剥离6个月就诊。患者2年前无明显诱因出现双足趾甲沟红肿伴疼痛,经抗感染治疗无明显缓解,6个月前部分趾甲松解变形,2年内体重逐渐减轻15 ~ 20 kg。既往身体健康,否认内科疾患史及先天性遗传性疾病史,家族内无相似症状者。皮肤科检查：部分指、趾甲变形、松解伴甲沟红肿（图1）……     

清肺利水活血法治疗肺心病顽固性心衰38例

采用清肺利水活血法治疗肺心病顽固性心衰。结果显示 3 8例患者临床总有效率 89 47%。     

星状神经节和局部神经阻滞治疗顽固性头痛疗效观察

目的探讨顽固性头痛治疗的新方法。方法总结2004年12月至2009年12月采用同时注射药物阻滞痛侧星状神经节和痛区局部神经治疗447例顽固性头痛的临床疗效。结果经1~3次治疗头痛消失且1年内无复发者161例（36.02%）;经4~5次治疗头痛消失且1年内无复发者183例（40.94%）;经6~7次治疗头痛消失且1年内无复发者98例（21.92%）;经7次治疗头痛次数明显减少或头痛程度明显减轻者5例（1.12%）。结论同时阻滞患侧星状神经节和痛区局部神经是顽固性头痛的一种有效治疗方法 。     

周仲瑛运用动物类药物治疗疑难杂症的经验

通过总结动物类药物的临床应用方法和使用要点,结合验案分析,介绍周仲瑛教授运用动物类药物治疗疑难杂症的临床经验。     

葛根黑苏汤联合通元针法对顽固性薄型子宫内膜患者黄体中期子宫内膜容受性与子宫血流动力学的影响

目的:探讨葛根黑苏汤联合通元针法对顽固性薄型子宫内膜患者黄体中期子宫内膜容受性(ER)与子宫血流动力学的影响。方法:选择顽固性薄型子宫内膜患者84例为研究对象,随机分为两组。对照组接受阿司匹林治疗,观察组在对照组基础上给予葛根黑苏汤联合通元针法治疗,两组疗程均为3个月经周期。记录两组治疗前后中医症侯积分的变化,在阴道超声下观察黄体中期的子宫内膜厚度、容积与血流情况,并比较两组治疗前后子宫内膜分型与子宫内膜血流分型、子宫动脉血流参数。比较两组临床疗效,治疗后的经期行经时间、妊娠成功率和妊娠患者受孕时间。结果:与治疗前比较,两组治疗后各个单项中医证候积分与总积分均明显降低(P<0.05),且观察组治疗后的上述积分均低于对照组(P<0.05)。两组治疗后子宫内膜厚度、容积均增大,子宫内膜血流收缩期峰值流速/舒张末期流速(S/D)降低,且观察组治疗后的上述指标均优于对照组(P<0.05)。两组治疗后子宫内膜分型与血流分型均有明显改善,且观察者改善情况优于对照组(P<0.05)。两组治疗后平均子宫动脉血流搏动指数(mPI)、阻力指数(mRI)和平均血流收缩期峰值流速/舒张末期流速(mS/D)均明显降低,且观察组上述指标均低于对照组(P<0.05)。观察组治疗总有效率为81.0%,明显高于对照组的61.9%(P<0.05)。观察组治疗后的经期行经时间、受孕时间短于对照组,而妊娠率高于对照组(P<0.05)。结论:葛根黑苏汤联合通元针法能够显著减轻顽固性薄型子宫内膜患者临床症状,改善子宫内膜厚度、容积与形态,并提高子宫血流灌注,从而有利于改善ER及子宫血流动力学,提高妊娠率。