眼袋整形术并发症的防治

眼袋整形术的并发症主要包括下睑外翻、下睑睫毛外翻、睑球分离、泪小点外翻、眼鼻沟畸形及眶下睑沟凹陷畸形等。皮肤眼轮匝肌及眶隔脂肪切除过多是造成上述并发症的主要原因，另外，手术中失误或操作粗糙也可造成诸如复视、泪小管撕裂甚至球后血肿等严重并发症。防止下睑外翻的发生，主要在于如何测定松弛皮肤的方法，这要把眼球活动、面部肌肉活动以及重力对面部的影响等诸因素进行综合考虑，正确估算出皮肤的切除量，才能有效防止睑外翻的发生。对于轻度外翻可采用热敷、按摩等保守治疗，对于重度睑外翻据不同情况分别采用，眼轮匝肌提紧术，睑板部分切除、结膜囊缩小术及下睑皮肤移植术加以矫正。对于眶下区凹陷及眼鼻沟畸形，术中就应注意避免，特别是要控制好眶脂的切除量，一旦发生可采用脂肪或筋膜脂肪充填，也可行眼轮匝肌提紧加以矫正。总之，在眼袋整形术中避免去除过多的组织，无论是皮肤，还是眶隔脂肪，都可有效防止并发症的发生。     

超声显像诊断下肢深静脉血栓的临床应用

目的：探讨超声诊断下肢深静脉血栓的临床价值。方法：应用ＨＰ８５００多功能彩超仪，７．５ＭＨｚ线阵探头，外周血管软件检查临床疑下肢深静脉血栓３２例，另取１２例正常人２４条下肢深静脉作对照。２ＤＵＳ显示形态学改变，ＣＶＩ及ＰＷ模式观察血流状态。结果：超声检出下肢深静脉血栓形成２５例，除外血栓形成７例。２ＤＵＳ显示血栓形成部位血管内径明显增大，与患者健侧同水平深静脉内径进行配对ｔ检验，ｔ＝１３．８２，Ｐ     

The lateral arm free flap in lower extremity reconstruction

Reconstruction of skin defects of the distal third of the leg and foot is often a difficult task. Shape, resistance to shearing stresses in the weight-bearing surface and sensibility are the main features that have to be restored. For coverage of this region, the authors have used, in selected patients, the lateral arm flap (LAF) since 1994. This flap is thin, easy to dissect and has the possibility to be innervated through the posterior cutaneous nerve of the arm. Fourteen cases are presented. The drawbacks of this flap are the loss of sensibility in the forearm (partially transient) and the scar on the arm, which can be rather unsightly in young ladies and when big flaps are harvested skin graft is needed.     

Detecting cumulative trauma disorders in workers performing repetitive tasks

On-site testing of 157 poultry processors disclosed that 50% had three or more abnormal upper extremity findings out of a total of 22 possibles. The average worker had five to six abnormal findings. Impaired pinch strength, decreased vibration sensitivity in the fingertips, and reports of current numbness were the most prevalent. Of workers with signs, 25% reported no symptoms, whereas only 8% of workers reported symptoms but had no signs. The investigators concluded that this measurement method has utility for assessments of worker populations to determine prevalence of CTDs and, potentially, for preclinical detection of these disorders to permit early intervention, reduce medical costs, and minimize disability. The need for accurate measurement to enhance early detection and prevention is discussed.     

下肢深静脉血栓形成83例的病因分析

目的：探索下肢深静脉血栓形成的发病原因。方法：回顾1994年1月至2003年1月10年来所收集病人资料83例。结果：48例(占58％)病人病因明确，35例(占42％)病因不明。结论：血液高凝状态、下肢静脉血流缓慢、静脉内膜损伤三个因素综合作用造成了下肢深静脉血栓形成的发生。术后早期下床活动、抗血小板聚集可预防下肢深静脉血栓形成的发生。     

人工全髋置换术中拉钩对下肢深静脉血栓影响的研究

目的：通过对髂外动静脉及股动静脉与髋臼解剖学与临床的研究，探讨在全髋臼置换术中拉钩在髋放置位置对下肢深静脉血栓的影响。方法：通过解剖学研究56具成年骨盆标本中髂外动静脉及股动静脉来源及走行、与髋臼的关系进行测量分析；并通过临床观察22例（股骨颈骨折12例、股骨头缺血性坏死6例、类风湿性关节炎4例）在人工全髋置换术（THR）中拉钩放置安全区，经下肢静脉超声多普勒检查观察下肢深静脉血栓发病率。结果：在左侧3-5点间、右侧7-9点、左侧9点、右侧3点使用拉钩用力要适度，牵拉时间过长，会造成臀下血管、股动脉的牵拉过度或时间过长，易引起下肢深静脉血栓；通过临床22例THR拉钩放置安全区的观察，无一例下肢深静脉血栓，仅有2例轻度深静脉血流缓慢、但无明显的症状体征，经过口服活血通络中药后消失。结论：通过解剖学与临床观察研究，确定在THR中拉钩放置位置、深度是避免下肢深静脉血栓的重要因素。     

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。     

The heparin-induced thrombocytopenia and thrombosis syndrome: Treatment with intraarterial urokinase and systemic platelet aggregation inhibitors

We report a case of the heparin-induced thrombocy-topenia and thrombosis syndrome presenting with acute ischemia of a lower limb. The patient was successfully treated by withdrawal of heparin products, intraarterial urokinase, and platelet anti-aggregation therapy consisting of Dextran and aspirin.     

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