甲状腺动脉栓塞治疗难治性甲状腺机能亢进

目的 探讨经导管甲状腺动脉栓塞治疗难治性甲状腺机能亢进的方法及疗效。方法 使用高压消毒后明胶海绵、聚乙烯醇(PVA)微球栓塞甲状腺上动脉及下动脉。结果 13例病人甲状腺动脉栓塞成功，颈围缩小，11例T3、T4降至正常，2例轻废增高。结论 经导管甲状腺动脉栓塞治疗难治性甲状腺机能亢进可作为内外科治疗及^131I治疗替代疗法，只要正确掌握操作方法，是安全有效的。     

子宫动脉栓塞术治疗子宫肌瘤21例临床分析

目的 探讨子宫动脉栓塞术(UAE)治疗子宫肌瘤的疗效。方法 选择21例子宫肌瘤病人，采用Seldinger技术行双侧子宫动脉插管，造影确认后注入PVA栓塞颗粒。结果 UAE治疗3个月后，子宫肌瘤病人的临床症状明显缓解，月经恢复正常，肌瘤体积缩小(P＜0．01)。保留了子宫完整的生理功能。结论 UAE治疗子宫肌瘤有其特殊的优越性，为子宫肌瘤病人提供了另一种可选择的治疗方法。     

Use of tactile stiffness to detect fatigue in the latissimus dorsi muscle

In clinical settings, no method has been established to examine the fatigue of a latissimus dorsi muscle (LDM) preconditioned for cardiomyoplasty. We examined the feasibility of measuring muscle stiffness (tactile stiffness) to evaluate muscle fatigue in situ using our tactile sensor. We stimulated canine LDM with burst pacing and monitored both stiffness and tension to determine their relationship. In both dissected LDM and LDM in situ, the decrements of these parameters during burst pacing were compared between preconditioned and unconditioned LDM. In measurement in situ, the sensor probe was placed on the LDM through a small incision. Strong statistical correlation was shown between stiffness and tension (r = 0.935). In decrements of stiffness in situ, there were statistically significant differences between preconditioned and unconditioned LDM. Our tactile sensor system can provide an efficient method for evaluating fatigue of muscles in situ without measuring muscle tension.     

Analysis of the arterial blood pressure waveform using Fast Fourier Transform technique during left ventricular nonpulsatile assistance: in vitro study

The arterial blood pressure waveform is variable during left ventricular assistance. The aim of this study is to examine the correlation between the left ventricular assist device (LVAD) condition and the arterial blood pressure waveform in a fixed cardiac output condition using a mock circuit. This mock circulation loop was composed of an aortic compliance chamber, a left atrial compliance chamber, a pneumatic pulsatile pump as a native heart, and a rotary blood pump representing the LVAD with left atrial drainage. The Fast Fourier Transform technique was utilized to analyze the arterial blood pressure waveform and calculate the pulsatility index (PI) and the pulse power index (PPI). The PI and PPI decreased with the increase of the LVAD rotational speed, exponentially. There was a significant negative correlation between the PI, PPI, and the LVAD rotational speed, flow rate, and assist ratio. The best correlation was observed between the PPI and the assist ratio (r = 0.986). From this viewpoint, an ideal LVAD condition may be estimated from the pulsatility change of the arterial blood pressure waveform.     

动脉化疗在中晚期膀胱癌治疗中应用的初步报告

自1996年1月至今，我科为12例晚期膀胱癌患者施行了髂内动脉灌注化疗。结果：1例T4期降至T2期后给予膀胱部分切除；7例经手术＋动脉化疗，2年复查未发现复发现象；4例带瘤生存，病灶无进展。动脉化疗毒性反应较轻，疗效是肯定的，为中晚期膀胱癌开辟了一条新的治疗途径。     

Adaptative effects of loss of vision on upright undisturbed stance

In order to evaluate the long term effect of blindness on an undisturbed postural task, seven blind individuals (BLI) were compared to twelve healthy individuals (REF) who were required to close their eyes. To this aim, centre of pressure (CP) trajectories were recorded through a force platform on which the subjects remained upright. Through a low-pass filter, the vertical projection of the centre of gravity (CG(v)) and consequently the difference CP-CG(v) were estimated. The former represents the controlled variable whilst the latter is assumed to express the resultant joint stiffness. A first analysis consisted in studying the frequency distribution of these motions. Increased mean amplitudes in both elementary motions and no difference between frequency distributions were observed for the BLI when compared to the REF group. These trajectories were then modelled as a fractional Brownian motion process in order to gain insight about the nature of the control mechanisms called into play and their spatio-temporal organisation. Moreover, the main characteristic observed in the BLI group is a decreased in CP-CG(v) motions, which, according to Winter's model, may be related to joint stiffness. In addition, reduced spatial transition point co-ordinates and more deterministic control mechanisms aimed at returning the estimated CG to an equilibrium point during the longest Deltat were observed. This phenomenon is more pronounced in the antero-posterior direction and also allows the blind subject to significantly diminish their CG sways. Finally, these features are discussed in relation to other similarly analysed investigations.     

子宫腺肌病UAE治疗后妊娠及分娩的研究

目的:了解子宫腺肌病子宫动脉栓塞治疗(UAE)后患者的妊娠情况及结局,探讨该治疗方法对生育功能的影响。方法:对我院所完成的252例因子宫腺肌病行UAE的病例进行追踪观察,了解治疗后妊娠情况及结局。结果:①252例患者中有13例共16次妊娠,均为自然受孕。受孕时间为术后3~43个月,平均为13个月。②没有生育要求的208例患者中,有4例(4次)意外受孕:2例(2次)药物流产,2例(2次)行人工流产术。其中1例行人工流产术的患者取其绒毛组织作染色体检查正常。③有生育要求的44例患者中有9例12次妊娠(妊娠2次者1例,妊娠3次者1例),受孕率为27.3%(12/44)。其中足月顺产分娩3例,足月要求剖宫产和术中切除子宫1例,因胎膜早破早产要求行剖宫产1例,此5例均未发生产后出血,新生儿常规体格检查均未发现异常。自然流产4例(4次),均为孕4个月内胚胎停止发育。目前正在妊娠中患者1例,该患者行血液唐氏综合征筛查风险值为1/780,B超符合孕周,发育良好。结论:子宫腺肌病UAE治疗后可以正常受孕和分娩,但可能存在流产和早产的高危因素。     

肢体动脉阻塞性疾病的介入溶栓治疗

目的探讨栓子内溶栓治疗肢体动脉急、慢性阻塞性疾病的方法和效果。方法12例血管造影证实为肢体动脉阻塞者,将导管和溶栓导丝插入血栓内,以4000U/min尿激酶(UK)灌注直至血栓溶解。结果病程<3d者6例,血管全部再通,UK平均用量67万U;病程>2个月者6例,血管再通5例,UK平均用量106万U,1例无效者病程4.2年。术中术后无严重并发症。结论栓子内溶栓安全有效,是治疗肢体动脉急、慢性阻塞性疾病的优先选择的方法。