缺铁性贫血患者脑血流动力学的变化

目的 应用经颅多普勒超声(TCD)分析缺铁性贫血(IDA)的脑血流动力学特点并探讨TCD的诊断价值.方法 对46例IDA患者(中重度贫血组28例,轻度贫血组18例)行TCD检测,观察其脑血流动力学改变,并与40例健康者(对照组)比较.结果 除3例TCD结果正常外,其余贫血患者脑血流广泛增高.中重度贫血组血流速度显著高于轻度贫血组(P<.05),两组均显著高于对照组(P<0.01).中重度贫血组搏动指数显著低于对照组(P<0.01).IDA患者中有2例TCD诊断血管狭窄,5例有晕厥发作.结论 脑血流速度的增高程度可初步反映贫血的严重程度,TCD检测IDA患者有助于评估其血流代偿能力,提高脑血管狭窄的发现率.     

血清半胱氨酸蛋白酶抑制剂C、β2微球蛋白及肾血流动力学对过敏性紫癜早期肾损害的诊断价值

目的探讨过敏性紫癜（HSP）患儿血清半胱氨酸蛋白酶抑制剂C（cystatin．C）、β2微球蛋白（β2-MG）及肾血流动力学变化对早期肾损害的临床意义。方法选取46例HSP患）L（HSP组）和40例健康儿童（对照组）。运用ELISA法测定血清cystatin-C,放射免疫法测定血清β2-MG,彩色多普勒超声检测肾血流动力学变化。结果HSP组患儿血清eystatin．C[（3．96±1．52）msm]及β2-MG[（2．74±0．82）ms／L]均显著高于对照组[（1．67±0．61）mg／L和（1．89±0．47）mg／L],P值均〈0．01。HSP组患儿肾血流频谱为高速高阻型,肾主动脉收缩期最大峰值流速[（1．068±0．348）m／s]和阻力指数（0．894±0．125）均高于对照组[（0．859±0．357）m／s和0．726±0．078],P值均〈0．05。结论联合检测血清cystatin-C及肾血流动力学变化能大大提高早期发现肾损害的敏感性。     

Corticotomy facilitated orthodontics: Review of a technique

Corticotomy found to be effective in accelerating orthodontic treatment. The most important factors in the success of this technique is proper case selection and careful surgical and orthodontic treatment.Corticotomy facilitated orthodontics advocated for comprehensive fixed orthodontic appliances in conjunction with full thickness flaps and labial and lingual corticotomies around teeth to be moved. Bone graft should be applied directly over the bone cuts and the flap sutured in place. Tooth movement should be initiated two weeks after the surgery, and every two weeks thereafter by activation of the orthodontic appliance.Orthodontic treatment time with this technique will be reduced to one-third the time of conventional orthodontics. Alveolar augmentation of labial and lingual cortical plates were used in an effort to enhance and strengthen the periodontium, reasoning that the addition of bone to alveolar housing of the teeth, using modern bone grafting techniques, ensures root coverage as the dental arch expanded.Corticotomy facilitated orthodontics is promising procedure but only few cases were reported in the literature. Controlled clinical and histological studies are needed to understand the biology of tooth movement with this procedure, the effect on teeth and bone, post-retention stability, measuring the volume of mature bone formation, and determining the status of the periodontium and roots after treatment.     

Crystallographic Orientation Influence on the Serrated Yielding Behavior of a Single-Crystal Superalloy

Since Ni-based single-crystal superalloys are anisotropic materials, their behavior in different crystal orientations is of great interest. In this study, the yielding behavior in both tension and compression for ?001?, ?011? and ?111? oriented materials at 500 °C has been investigated. The ?011? direction showed a serrated yielding behavior, a great tension/compression asymmetry in yield strength and visible deformation bands. However, the ?001? and ?111? directions showed a more homogeneous yielding, less tension/compression asymmetry in yield strength and no deformation bands. Microstructure investigations showed that the serrated yielding behavior of the ?011? direction can be attributed to the appearance of dynamic strain aging (DSA) and that only one slip system is active in this direction during plastic deformation.     

Experiences in Computer Audiometry (ECoG and ERA)

By the ear-drum arrangement of electrode action potentials of the 8th nerve may be recorded down to the threshold intensities of click stimuli. A decrease in the amplitude of these potentials was observed with ipsilateral presentation of a masking noise. Contralateral conditioning sound stimulation caused either an increase or a decrease of click-evoked action potentials. The increase was observed with intensities of conditioning stimuli exceeding 50-60 dB SL, whereas the decrease was stated at higher stimulation levels. The former effect was ascribed to the activity of the olivo-cochlear fibres and the latter effect to reflex contraction of the middle ear muscles

Scalp-derived slow auditory evoked responses were studied in different conditions of sound stimulation. The peak latencies of these responses were longer, and the peak amplitude was lower for tone bursts as compared to effects of intensity-modulated tonal stimuli. With equal intensities of tonal increments, the peak latencies of derived responses were shorter and the amplitude was greater at higher steady-tone levels. In most cases, there was a close correspondence of the objective and subjective thresholds for both tone bursts and intensity-modulated stimuli. On the grounds of data obtained, the problems related to cross-examination and control test procedures during computer audiometry are discussed     

Can the Up-to-date Research in Neurophysiology of the Outer Ear Explain the Therapeutic Effects of Auricular Stimulation?

Clinical reproducible phenomena have to be explained not only by hypothesis but by a real scientific validation. This is the case for auriculotherapy discovered by Paul Nogier [1]. In fact, it could seem strange for a non-specialist medical colleague to accept the idea that it is possible to observe some clinical improvement after a puncture with a needle on the skin of the ear pavilion. The goal of this paper is to try to demonstrate that, at present, we already have enough valid scientific data accessible to justify the clinical use of auriculotherapy for diagnostic as well as therapeutic purposes.     

不停跳搭桥中有预测缺血性改变和血流动力学不稳定的心脏表面传感器的多吸式心脏定位器TENTACLES

Background： During OPCAB, it is usually difficult to predict the ischemic change of the distal site of the anastomosis especially in rotating the heart, resulting in hemodynamic instability. To resolve this problem, we have produced multi-suction heart positioner TENTACLES in which sensors （thermometer, ECG and tissueblood flow） are mounted inside of the TENTACLES＇ suction cup. This devise can position the heart and monitor simultaneously. In this study, the utility of TENTACLES equipped with sensors was examined.     

右旋美托咪定对静吸复合全身麻醉行全髋置换术老年患者血流动力学及苏醒质量的影响

目的 评价右旋美托咪定对全麻下行全髋置换手术的老年患者血流动力学及苏醒质量的影响。方法 选择2007 年7 月~2013 年7 月在本院接受全髋置换术的60 例老年患者作为研究对象,分为观察组和对照组。患者上肢静脉通路后,观察组将0.4 μg/kg 负荷量右旋美托咪定采用微量泵从静脉10min 内泵入,维持量为0.3 μg/(kg· h);对照组将50 ml 0.9%NaCl 溶液从静脉泵入,方法同观察组。分别记录患者入室（T0）、开始泵药（T1）、泵药10 min（T2）、切皮（T3）、切皮30 min（T4）、拔管（T5）、拔管后30min（T6）的收缩压（SBP）、舒张压（DBP）、心率（HR）、脑功能状态指数(CSI)等参数,并记录患者苏醒时间、拔管时间及术后30 min 警觉镇静（OAA/S）评分。结果 观察组SBP、DBP、HR 在T5、T6 时点与对照组比较显著下降,差异有统计学意义（P < 0.05）;观察组CSI 在T2~T6 各时点与对照组比较差异均有统计学意义（P < 0.05）;观察组拔管时间、苏醒时间均显著短于对照组（P < 0.05）,但OAA/S 评分显著高于对照组（P < 0.05）。结论 对全麻下行全髋置换术的老年患者术前给予右旋美托咪定可有效维持患者围手术期血流动力学稳定,缩短拔管时间和苏醒时间,维持OAA/S。     

多层螺旋CT灌注成像在儿童肝脏肿瘤中的应用分析

目的:探讨多层螺旋CT灌注成像对儿童肝脏肿瘤的诊断价值。方法:回顾性分析32例经病理证实的儿童肝脏肿瘤的多层螺旋CT灌注表现,其中男18例,女14例,年龄15天～12岁,分析肝脏肿瘤病变的灌注参数及血运改变情况。结果:肝恶性肿瘤组病灶中心HAI均明显高于病灶边缘,高于正常肝组织,肝良性肿瘤组病灶中心HAI与正常肝组织一致。在良、恶性肿瘤的鉴别诊断方面肝动脉灌注指数(HAI)具有重要的价值。结论:多层螺旋CT灌注成像是可以提供一种准确且相对简洁的评价儿童肝脏肿瘤的范围及性质的方法。     

易形成前交通动脉瘤的血管模式再探讨

目的探讨易形成前交通动脉瘤的血管模式。资料与方法将1081份正常磁共振血管成像(MRA)图像定义为一般国人脑血管形态类型,与49例前交通动脉瘤患者脑血管形态类型进行对照。结果49例前交通动脉瘤中一侧A1优势型45例(占87.76%),与正常国人一侧A1优势型和其他类型构成差异有统计学意义(P<0.0001)。其中左侧A1优势型(33例)约为右侧A1优势型(12例)的3倍,与一般人群左侧A1优势型与右侧A1优势型比(11.19%/3.98%)差异无统计学意义(P=0.952)。一侧A1优势型前交通动脉双侧大脑前动脉A2段起始部夹角测量有瘤患者夹角平均值为174.5°,无瘤患者平均值为113.45°,两夹角差异有统计学意义(t=14.198,P=0.002)。结论一侧A1优势供血与前交通动脉瘤的形成相关,造成前交通动脉瘤左右侧差异的原因是一侧A1优势型发育左右侧存在差异,双侧大脑前动脉A2段夹角增大更易形成动脉瘤。对发现的此种血管模式应随访。