三种颈前路钢板重建对维持颈椎曲度和高度的比较

目的对3种不同颈椎前路钢板系统重建并维持颈椎融合节段曲度和高度的作用进行比较.方法 2002年1月～2004年6月,行颈前路减压,自体髂骨植骨,钢板内固定术122例;男85例,女37例,年龄14～70岁.根据采用Orion、Zephir、Codman 3种颈椎前路钢板系统分为A组37例、B组39例及C组46例.于术前、术后1周和随访时摄颈椎侧位X线片,测量融合节段的曲度和高度,并比较其变化及3组间差异.结果术后患者均获随访6～35个月,平均17.3个月.术后6个月3组患者术段颈椎均获骨性融合.且术后1周时颈椎融合节段曲度和高度较术前明显改善(P＜0.05),但最后1次随访时和术后1周比较,差异无统计学意义(P＞0.05),3组间比较差异无统计学意义(P＞0.05).结论 3种钢板系统均能有效重建并维持颈椎融合节段曲度和高度,近期效果优良.     

动脉韧带与左喉返神经的解剖研究

本文用30例成人尸体观察了动脉韧带和左喉返神经,动脉韧带长1.2.97±4.53mm,圆索状动脉韧带23例(77％),直径为3.92±1.12mm。动脉韧带的主动脉端附着于主动脉弓(80％)或降主动脉(20％),肺动脉端附着于左肺动脉,6例肺动脉端位于心包内。19例(63％)左喉返神经绕主动脉弓,11例(37％)绕动脉韧带的主动脉端。     

胸腰椎前路手术的新入路

目的：介绍一种胸腰椎前路手术的新入路。方法：通过横突前，沿横突、椎弓根和椎体腰部，严格的从骨膜下向前剥离，直达前纵韧带下方。结果：经155例临床应用，这种新入路，不需要结扎节段血管，切口短、出血少、缩短了手术时间。结论：手术方法简单、操作技术方便，比原来的腹膜后入路损伤小，也同样达到理想暴露的目的。     

牵张力作用下培养的人牙周膜成纤维细胞生成NO的实验研究

目的：观察在机械牵张力作用下牙周膜成纤维细胞NO的生成情况以及iNOS的表达情况。方法：用自行研制的细胞加载系统，对培养至第4代的人牙周膜成纤维细胞施以频率为每分钟6个周期（5s拉伸，5s松弛）、拉伸率为12％的牵张力，分别于加载后3，10，20，40，60min取上清液进行NO含量检测；以及于加载24，48，96h后固定细胞，进行iNOS免疫组化反应。结果：NO含量在所研究时间范围内逐渐增加；iNOS免疫组化结果显示iNOS的染色强度随着作用时间延长而增强。结论：牙周膜成纤维细胞在机械牵张力作用下合成NO增多，它可能通过合成和释放NO这一途径，在应力作用下的牙周组织改建过程中起作用。     

Haemorrhagic fever with renal syndrome: Clinical aspects

Based on clinical and pathological features a typical case of haemorrhagic fever with renal syndrome passes through five phases: (1) febrile phase, (2) hypotensive phase, (3) oliguric phase, (4) diuretic phase and (5) convalescent phase. The major manifestations are fever, pain in the back and abdomen, flushed face, prostration, proteinuria, purpura and haemorrhage and acute renal failure. Selective right auricular haemorrhage, marked congestion and haemorrhage in the renal medulla and necrosis of the anterior lobe of the pituitary gland are the three prominent pathological findings. The clinical severity depends upon the causative agents, namely Hantaan virus, Seoul virus and the European form in that order. Specific serological diagnosis of haemorrhagic fever with renal syndrome is made by demonstrating a rise in titre of specific immunofluorescent antibody against Hantaan and related viruses. The management is supportive, based on an understanding of the pathophysiology of the disease.     

Preexpanded distant "super-thin" intercostal perforator flaps for facial reconstruction without the need for microsurgery.

BACKGROUND: Concept of the 'super-thin perforator flap' was introduced in 1994 by authors. Since then, various types of 'super-thin perforator flaps' were applied successfully especially for contour sensitive reconstruction such as face and neck. METHODS: Eleven patients requiring large flaps who presented with extensive disfiguring facial scar (male: seven cases, female: four cases). On the consideration of flaps' colour, texture and thickness requirements, the authors selected 'super-thin' anterior intercostal perforator flaps (AICP, range from 4 x 14 cm to 25 cm x 9 cm) for reconstruction purpose. First, tissue expanders (volume range from 800 cc to 1200 cc) were carefully inserted under the AICP. After the flaps were expanded for 2 months, distant scars were removed and the covering super-thinned flaps were transferred into recipient site. Two weeks later, pedicles in the anterior chest were cut down and flaps were transferred to replace all the left scars. RESULTS: Flap were survived without any complications. The colour, texture and thickness of the transferred flap were satisfactory, shrink of flaps were not observed after long term follow-up. The authors present a method of facial reconstruction that has the advantages of creating a large amount of thin tissue of both good colour and texture, without the need of microsurgery and few disadvantages of donor-site morbidity. The disadvantages are three-staged procedures, complications of tissue expansion and uncomfortable compulsory posture for patients. In our opinion, this is an alternative method of choice for reconstructing all large defects in the lower two-thirds of the face.     

短伸肌腱修复供足第1跖骨深横韧带(附55例报告)

目的在第2足趾移植再造拇指术中,应用     

A new view of anterior choroidal artery territory infarction

Summary Infarction in the territory of the anterior choroidal artery (AchA) has been the subject of several recent reports. To the classical clinical syndrome of hemimotor, hemisensory, and visual field deficit has been added hemiataxia acute pseudobulbar mutism, pure motor and pure sensory syndromes and disorders of higher cortical function. The definition of anatomic and clinical correlates to AchA stroke is aided by CT-MRI findings and reveals an unexpected superior extension of infarct to include the periventricular caudate nucleus and inferior corona radiata. Prognosis depends upon unilaterality, bilateral strokes having often a fatal outcome. Etiology and treatment may be intimately related to hypertension.     

Ultrasonography in the detection of cervical incompetency

In 80 pregnancies with clinical and ultrasonic signs of cervical incompetency, the length of the cervix and the thickness of the anterior wall of a lower uterine segment have been evaluated ultrasonically. We have also measured the width of the endocervical canal and studied the prolapse of fetal membranes (with fetal parts) into the endocervical canal. We evaluated these same parameters in 80 healthy pregnancies. The length of the cervix, the thickness of the anterior wall of a lower uterine segment, and the width of the endocervical canal were followed longitudinally in the patients from the 10th to the 36th gestation week. No statistically significant differences between age groups were found. In four age groups at risk for cervical incompetency, cervical lengths and wall thickness were significantly different (p less than 0.001) from those in comparable controls. Forty-five percent of the patients in the at-risk group, with cervical cerclage, delivered at 37.3 (range: 32 to 41) weeks and 6.25% of pregnancies ended in abortion when the amniotic membrane herniated into the cervical canal, with or without some part of the fetus.     

Anatomy and pathophysiology of the popliteal tendon area in the lateral meniscus: 1. Arthroscopic and anatomical investigation

An arthroscopic and anatomical investigation was performed to define the abnormal conditions of the popliteal tendon area in a lateral meniscus. Arthroscopic findings for 100 patients and anatomical observations of 10 amputated knees were analyzed. Five of the 10 dissected menisci were also examined histologically. Menisco-tibial coronary ligaments were classified into two types, as follows: type I--a coronary ligament covering an entire popliteal tendon beneath the meniscus; type II--a popliteal tendon visible beneath the meniscus through defects of the coronary ligament. Twenty-one of 100 cases were classified as type I, and 79 were classified as type II. Three of the 10 anatomical dissections were type I, and the remaining 7 were type II. Menisci in which the type I coronary ligaments were thought to be torn and menisci with type II coronary ligaments showed a rather marked mobility, but no conclusion could be reached.