单侧经皮穿刺脊柱后凸椎体成形术的入路探讨

目的探讨单侧穿刺法行脊柱后凸成形术的手术方法，以减少行手术及射线时相关的损害。方法复习椎骨的解剖形态，确定经椎弓根穿刺进针的路径；对患者45个压缩椎体进行单侧穿刺球囊扩张治疗，观察椎体高度及Cobb角的改变。结果与椎骨矢状面成30°～45°的角度穿刺，均能顺利进针并使针尖到达椎体中部的前份；临床手术按前述方法均可安全完成，椎体前缘、中部高度及Cobb角分别由术前的（1．8土0．3）cm、（1．4±0．4）cm及（28．4±10．2）°改变为术后的（2．2±0．4）cm、（2．3±0．3）cm及（19．2±4．5）°；椎体两侧前缘高度都有所恢复，两侧高度净差值为0．1cm。结论单侧穿刺法行脊柱后凸成形术，能够很好地恢复脊柱的形态，减少术者及患者的射线接触。     

Experience of cervical plexus reinnervation for patients with unilateral recurrent laryngeal nerve invasion or injury

OBJECTIVE To explore the clinical and therapeutic effects of cervical plexus reinnervation for infiltrated or injured unilateral recurrent laryngeal nerve （URLN）. METHODS Functional neck dissection for removal of differentiated thyroid carcinoma （DTC） in patients was performed, in which cervical plexus reinnervation was adopted for patients with stage I disease and URLN with injury or with tumor invasion. Outcomes of surgery were evaluated by examination under fibrolaryngoscope, and the patients＇ voices were evaluated before and after surgery. RESULTS All cases were followed up for 3 mon-2 years （average 8 mon）. Abductory motion of the vocal cords of 15 patients was completely or partly restored, but 3 patients＇ vocal cords were immovable. The recovery rate of abductory motion of the paralyzed vocal cords was 83.33% （15/18）. The function of phonation in the 16 patients was restored to normal or near normal limits, and their hoarseness was improved significantly. CONCLUSION Cervical plexus-URLN reinnervation should be considered when treating patients with unilateral vocal cord paralysis. Removing the tumor simultaneously with cervical plexus reinnervation during surgery for repair of unilateral recurrent laryngeal nerve injury was convenient and easy to perform with less functional damage compared with other methods of reinnervation. The abductory motion of vocal cord could be satisfactorily restored by this reinnervation. Surgical performance skills and application of neurotrophic drugs were important for the success of the surgery.     

大鼠骨髓内皮祖细胞移植对单侧输尿管梗阻大鼠肾脏损伤的修复

目的 探讨大鼠骨髓内皮祖细胞移植对单侧输尿管梗阻大鼠肾脏的修复作用.方法 应用密度梯度离心法分离骨髓单个核细胞,内皮祖细胞选择性培养液培养后移植到单侧输尿管梗阻大鼠.应用PAS、HE、Masson染色方法判断梗阻大鼠损伤和修复情况,应用免疫组织化学检测α-SMA和HIF-1α表达,应用Western blot检测HIF表达.结果各组间肝功能、肾功能无显著性差异;与假手术组比,UUO组肾脏病理积分显著增加,移植组肾脏病理积分显著低于UUO组(P<0.05);UUO组α-SMA在14、21d显著高于假手术组(P<0.05),移植组α-SMA在14、21d显著低于UUO组(P<0.05);假手术组仅有少量HIF表达,且主要表达在胞质,UUO组HIF表达随病程进展逐渐增加(P<0.05),移植组HIF表达显著低于UUO组(P<0.05).结论 EPCs移植改善了UUO大鼠梗阻肾脏的损伤、纤维化和低氧状况.     

咬肌电最大Lyapunov指数功能分析

目的：将混沌特征量应用于偏侧咀嚼预测。方法：采用混沌分析方法中的小数据量法计算了男性和女性的咬肌电的最大Lyapunov指数,对最大Lyapunov指数应用可重复双因素方差分析处理。结果：咬肌电具有混沌特性;男性咬肌电最大Lyapunov指数明显高于女性咬肌电最大Lyapunov指数;左右2侧的咬肌电混沌程度相当。结论：可以将最大Lyapunov指数用于表征咬肌电,在预测和诊断偏侧咀嚼时,左右2侧咬肌电最大Lyapunov指数对比分析可以用于参考。     

Electroconvulsive therapy in the Nordic countries, 1977-1987.

In 1977 a questionnaire was sent to all psychiatric departments in the Nordic countries: Sweden, Norway, Denmark, Finland and Iceland, concerning indications for electroconvulsive therapy (ECT) and the use of unilateral and bilateral treatment, respectively. The inquiry was repeated in 1987 and the answers compared with those obtained in 1977. In addition, the answers from Denmark were compared with previously performed inquiries. The use of exclusively unilateral treatment (U) and of both unilateral and bilateral treatment (UB) has increased in most of the countries and exclusively bilateral treatment (B) has decreased drastically. In Denmark the situation has not changed for ECT in endogenous depression and acute delirium, and the use in reactive psychosis, mania and schizophrenia decreased somewhat during the 1970s and then again stabilized or increased during the 1980s. Nearly all departments in the Nordic countries used ECT in endogenous depression in 1977 and were still doing it in 1987. In mania, about 50% of all departments have found ECT indicated occasionally or exceptionally both in 1977 and 1987. Manic-depressive mixed states have been regarded as an indication in somewhat more than two thirds of departments, increasing during the period. The use of ECT in schizophrenia has been rare and somewhat decreasing, but still about half of the departments apply it once in a while. In reactive psychosis the use of ECT decreased slightly, but in 1987 it was still in use for this indication in about 50% of all departments. In acute delirium there has been an overall increase in the use of ECT.(ABSTRACT TRUNCATED AT 250 WORDS)     

单侧唇裂继发畸形的美学修复

目的 探讨单侧唇裂继发畸形与I期手术方式选择的关系,以及进行唇裂继发畸形美学修复的策略.方法 选择单侧继发唇裂120例,根据I期采用的不同术式进行分组,对唇裂畸形进行观察和分析,采用个体化设计,进行美学修复.对采用Millard、Tennison、矩形瓣及上三角瓣法的单侧唇裂继发畸形修复后,观察上唇人中窝形念、瘢痕、唇峰形态的恢复.结果 显示原采用Millard方法、上三角瓣方法优于Tennison方法和矩形瓣方法.Ⅱ期修复术后效果满意.结论 单侧唇裂I期采用的手术方式对继发畸形的程度和修复有显著影响.     

SUNCT Syndrome. Statuslike Pattern

Four SUNCT patients with a clinical "SUNCT status" witnessed by the investigators are reported. Such an extreme aggregation of typical attacks lasting for the better part of the day, 1 to 3 days in a row has not previously been observed. Appropriate supplementary examinations ruled out an intracranial lesion in all four patients. Indeed an observation period of more than 5 years speaks against a symptomatic etiology of SUNCT in these cases. Although rarely seen, clinical status may be a feature of the SUNCT syndrome.     

改进Millard法修复单侧唇裂的临床应用及体会

目的介绍改进Millard法修复单侧唇裂的方法和体会。方法以Millard法为基础，定点设计、旋转C瓣对位缝合，在A、B瓣皮下潜行分离并将位于鼻小柱、鼻翼处的口轮匝肌离断，旋转褥式缝合形成嵴，以利于唇外形的形成及功能的恢复。结果本组48例患者，术后随访3个月～3年，双侧唇高相等、唇弓形态自然并恢复了上唇的功能，促进了牙槽嵴裂隙的逐渐靠拢和上颌骨的发育，效果满意。结论采用改进Millard法修复单侧唇裂有利于减轻术后常见的畸形，更好地恢复了唇部的形态及鼻部的对称性。     

护理干预对脑损伤致单侧视觉空间忽略的影响

目的观察护理干预对脑损伤致单侧视觉空间忽略临床疗效的影响。方法将确诊的脑损伤致单侧视觉空间忽略患者随机分成护理干预组和常规组，护理干预组在常规组的基础上配合康复护理。治疗前后分别采用二等分线段、数字划销、画钟试验等方法观察两组患者认知功能恢复情况。结果护理干预组治疗后显著优于常规组（P〈0.001）。结论康复护理干预对改善单侧视觉空间忽略具有重要作用。     

Early unilateral cochlear implantation promotes mature cortical asymmetries in adolescents who are deaf

Unilateral cochlear implant (CI) stimulation establishes hearing to children who are deaf but compromises bilateral auditory development if a second implant is not provided within ～1.5 years. In this study we asked: 1) What are the cortical consequences of missing this early sensitive period once children reach adolescence? 2) What are the effects of unilateral deprivation on the pathways from the opposite ear? Cortical responses were recorded from 64‐cephalic electrodes within the first week of bilateral CI activation in 34 adolescents who had over 10 years of unilateral right CI experience and in 16 normal hearing peers. Cortical activation underlying the evoked peaks was localized to areas of the brain using beamformer imaging. The first CI evoked activity which was more strongly lateralized to the contralateral left hemisphere than normal, with abnormal recruitment of the left prefrontal cortex (involved in cognition/attention), left temporo‐parietal‐occipital junction (multi‐modal integration), and right precuneus (visual processing) region. CI stimulation in the opposite deprived ear evoked atypical cortical responses with abnormally large and widespread dipole activity across the cortex. Thus, using a unilateral CI to hear beyond the period of cortical maturation causes lasting asymmetries in the auditory system, requires recruitment of additional cortical areas to support hearing, and does little to protect the unstimulated pathways from effects of auditory deprivation. The persistence of this reorganization into maturity could signal a closing of a sensitive period for promoting auditory development on the deprived side. Hum Brain Mapp 37:135–152, 2016. © 2015 Wiley Periodicals, Inc.