前臂逆行骨间背侧皮瓣的临床应用

目的总结前臂逆行骨间背侧皮瓣的临床疗效。方法回顾性分析42例前臂逆行骨间背侧皮瓣，并结合文献阐明其变异程度及变异的处理。结果骨间背侧血管在前臂中1／3缺如1例．皮瓣边缘坏死；皮瓣向近端延伸超过4cm者4例，远端坏死，延迟愈合；其余均一期愈合：结论虽然前臂骨间背侧血管有变异，但前臂逆行骨间背侧皮瓣仍是修复手背中等大小创面较为理想的方法，以近点皮肤穿支向近端延伸皮瓣不要超过4cm。     

亚低温配合自由基清除剂治疗脑梗死的临床研究

目的探讨亚低温与自由基清除剂治疗脑梗死的方法和疗效。方法139例脑梗死患者随机分为3组,对照组47例常规治疗;治疗组1:46例采用亚低温治疗;治疗组2:46例给予亚低温配合自由基清除剂治疗。分别评定治疗前后的神经功能缺损评分(NDS)、重要脏器功能指标及预后。结果与对照组相比:亚低温治疗能提高患者治疗有效率(P<0.01),降低NDS(P<0.05)和血乳酸水平(P<0.01),亚低温配合自由基清除剂治疗能显著提高患者治疗有效率(P<0.01),降低NDS(P<0.01)和血乳酸水平(P<0.01),并能显著降低患者肝、肾功能不全和心律失常的发生率(P<0.01 VS对照组);结论亚低温配合自由基清除剂辅助脑梗死的综合治疗可明显改善患者预后、提高患者治疗有效率,降低并发症,值得临床推广。     

芳香烃羟化酶活性与苯并[a]芘中间代谢产物生成关系的研究

100mg香烟烟油,多氯联苯诱导大鼠肝S_9组分中芳香烃羟化酶代谢B[a]P为3-OH-B[a]P的活性分别升高约40,20倍,而代谢B[a] P生成6-OXY-B [a]P自由基产物却仅由多氯联苯诱导的S_9组分作用中才被观察到。     

Variability in hand surface representations in areas 3b and 1 in adult owl and squirrel monkeys

Detailed microelectrode maps of the hand representation were derived in cortical areas 3b and 1 from a series of normal adult owl and squirrel monkeys. While overlap relationships were maintained, and all maps were internally topographic, many map features varied significantly when examined in detail. Variable features of the hand representations among different monkeys included a) the overall shapes and sizes of hand surface representations; b) the actual and proportional areas of representations of different skin surfaces and the cortical magnifications of representations of specific skin surfaces, which commonly varied severalfold in area 3b and manyfold in area 1; c) the topographic relationships among skin surface representations, with skin surfaces that were represented adjacently in some monkeys represented in locations many hundreds of microns apart in others; d) the internal orderliness of representations; e) the completeness of representations of the dorsal hand surfaces; and f) the skin surfaces represented along the borders of the hand representation. Owl monkey maps were, in general, internally more strictly topographic than squirrel monkey maps. In both species, area 3b was more strictly topographic and less variable than was area 1. The degree of individual variability revealed in these experiments is difficult to reconcile with the hypothesis that details of cortical maps are ontogenetically specified during a period in early life. Instead, we propose that differences in the details of cortical map structure are the consequence of individual differences in lifelong use of the hands. This conclusion is consistent with earlier studies of the consequences of peripheral nerve transection and digital amputation, which revealed that cortical maps are dynamically maintained and are alterable as a function of use or nerve injury in these monkeys (Merzenich et al., '83a,b, '84a; Merzenich, '86; Jenkins et al., '84; Jenkins and Merzenich, '87).     

德国小蠊成虫血淋巴游离氨基酸的测定

采用离心法收集羽化后不同天数的雌雄虫血淋巴，用意大利ＣＡＢＬＯＥＲＢＡ３Ａ３ｏ型氨基酸自动分析仪测定，共检出１０种氨基酸和１个氨残基，其氨基酸总量及每种氨基酸的含量与成虫性别、不同发育期有密切的关系。     

Microvascular transfers of serratus anterior muscles in rats

Summary The serratus anterior muscle in the rat is supplied by the serratus division of thoracodorsal vessels, in a pattern similar to man [2]. The serratus anterior muscles were transferred to the groin area as a free muscle flap in 17 rats and as a free muscle graft in 13 rats. In the free muscle flap group, the serratus anterior muscles of 8 of 10 rats survived; histological examination showed them to be viable and the vascular anastomoses were patent at the 30th day. In the free muscle graft group, all of the muscle grafts became necrotic. As a result, it is concluded that the microvascular transfer of serratus anterior muscles in rats is a useful small animal model for microsurgical laboratory training of clinical free flap transfers and also for performing pharmacological and biochemical studies in transplanted muscle.     

多囊卵巢综合征患者血清游离脂肪酸浓度测定及相关因素分析

目的:观察多囊卵巢综合征(PCOS)患者血清游离脂肪酸(FFAs)水平变化及相关因素分析.方法:PCOS患者(39例)分为肥胖组(11例)和非肥胖组(28例),对照组为年龄匹配的健康妇女(21例).测定血清FFAs、游离睾酮、雄烯二酮、睾酮、性激素结合球蛋白、TC、TG、HDL-c、LDL-c、空腹血糖(FPG)、餐后2h血糖(PPG)、空腹胰岛素及胰岛素敏感性(M值,两步法高胰岛素-正葡萄糖钳夹技术评价).结果:血清FFAs水平在肥胖PCOS组和非肥胖PCOS组之间无明显差别,但均高于对照组(P＜0.05).对所有研究对象的血清FFAs进行相关分析表明FFAs分别与游离睾酮(r=0.464,P=0.001),睾酮(r=0.368,P=0.01),雄烯二酮(r=0.418,P=0.003)和PPG(r=0.334,P=0.014)呈正相关,与M值(r=-0.392,P=0.003)呈负相关.进一步做回归分析表明,FFAs与游离睾酮显著相关(β=0.219,P＜0.05).结论:与年龄相当的健康妇女比较,PCOS妇女血清FFAs水平显著增高,并且FFAs升高与游离睾酮水平升高有关.     

An effective pharyngoesophageal reconstruction with free radial forearm flaps

Summary Treatment of cancer of the cervical aerodigestive tract is challenging due in part to the difficulty in reestablishment of pharyngoesophageal continuity after resection of the involved tract. From May 1989 to August 1990, six patients underwent immediate reconstruction utilizing microvascular transfer of free radial forearm flaps following resection of pharyngoesophageal neoplasms. A small island flap connected to the radial vascular pedicle by fasciocutaneous branch was used to monitor the vascular condition of the hidden fabricated free forearm flap. Stricture is the most troublesome complication of esophageal reconstruction using a conventional free forearm flap. Two small triangular flaps were designed and inserted bilaterally in the distal anastomosis of both lateral esophageal walls to prevent circular contracture. The outer layer sutures were anchored to surrounding rigid structures to withstand shrinkage and circular contraction. The problem of stricture was solved by these procedures. This one-stage, easily monitored operation for pharyngoesophageal reconstruction is considered to be as useful as a free jejunal transfer.     

补肾化瘀法延缓衰老机理研究─—六味丹坤方对老年小鼠自由基代谢的影响

选用自由基代谢为指标，对比观察了补肾六味地黄汤、化瘀丹坤方及补肾化瘀六味丹坤方的延缓衰老作用。实验结果表明：（１）六味地黄汤及丹坤方均能明显增加老年小鼠红细胞ＣＡＴ的活性，增加ＮＰＳＨ的含量，减少肝脑ＭＤＡ含量，即明显改善老年小鼠的自由基代谢紊乱；丹坤方尚能明显增强老年小鼠ＳＯＤ及ＧＳＨ－Ｐｘ的活性；（２）补肾化瘀六味丹坤方的作用明显优于单纯补肾的六味地黄汤或单纯化瘀的丹坤方；（３）补肾化瘀是更为有效的延缓衰老手段，并为衰老的“正虚挟瘀”观点提供了实验证据。     

Free flap reconstruction of the lower extremity in the elderly

Summary Over a four year period, thirteen patients over the age of 60 (mean 69 years) underwent reconstruction of lower extremity defects with free tissue transfers. Ten latissimus dorsi, one tensor facia lata, and two rectus abdominus free flaps were used. Despite significant risk factors which included previous tobacco use, hypertension, diabetes mellitus, and angiographic vessel abnormalities, ten of thirteen cases had successful outcomes. There was one acute flap failure secondary to arterial thrombosis. Four flaps had delayed healing, with one patient eventually requiring amputation secondary to persistent pain and wound drainage. This experience demonstrates that free flap reconstruction of lower extremity defects in the elderly patient is a reasonable alternative to amputation when other options are limited.From the Section of Plastic and Reconstructive Surgery at the Mayo Clinic and Mayo Foundation, Rochester, Minnesota, USA Requests for reprints: J. Fisher, M.D.