老年下肢动脉硬化症肱动脉及股浅动脉舒张功能的对比研究

目的　了解老年下肢动脉硬化症(LEASD)患者肱动脉及股浅动脉内皮依赖性舒张功能 (血流介导的血管扩张功能 ,FMD)和硝酸甘油介导的非内皮依赖性舒张功能 (NMD) ,并评价二者的相关性及特点。方法　采用高分辨率超声诊断系统检测 33例老年LEASD患者 (Ⅰ组 )肱动脉及股浅动脉的FMD及NMD ,并分别与 4 0例健康老人 (Ⅱ组 )及 30例具有心血管危险因素的老年非LEASD患者(Ⅲ组 )进行对照研究。结果　老年LEASD患者肱动脉的FMD(3 5 6 %±1 92 % )及NMD(8 5 4 %± 4 72 % )与股浅动脉的FMD(2 16 %±1 2 2 % )和NMD(5 2 7%± 3 6 9% )均显著低于Ⅱ组和Ⅲ组 (P <0 0 5 )。老年LEASD患者股浅动脉的FMD显著低于肱动脉的FMD(P =0 0 0 0 8) ;股浅动脉的NMD亦显著低于肱动脉的NMD(P =0 0 0 2 6 ) ;而股浅动脉的FMD与肱动脉的FMD相关性好 (r=0 9314 ,P <0 0 1) ,两者的NMD亦有较好的相关性(r=0 9191,P<0 0 1)。结论　老年LEASD患者肱动脉及股浅动脉的FMD及NMD均受损 ;对于老年LEASD患者FMD及NMD的检测 ,股浅动脉与肱动脉相关性好 ,股浅动脉的FMD及NMD能更敏感、更直接地反映老年LEASD患者的血管反应性     

Superficial Spreading Melanoma Arising in a Longstanding Melanocytic Nevus on the Sole

In Asians, the plantar surface is the commonest site for cutaneous melanoma, and most melanomas arising in this region are the acral lentiginous type. Herein we describe a rare case of superficial spreading melanoma arising in a longstanding melanocytic nevus on the sole of a Korean.     

颞浅动脉岛状皮瓣修复下眼睑缺损

目的:探讨颞浅动脉岛状皮瓣在修复下眼睑软组织缺损中的应用效果。方法:采用颞浅动脉岛状皮瓣修复下眼睑软组织缺损26例,观察其修复效果。结果:皮瓣全部成活,颜色、质地与眼周皮肤相近,无明显的挛缩,皮瓣感觉功能良好,睑裂闭合良好,外观满意;皮瓣供区位于发际边缘,切口隐蔽,愈合良好,无瘢痕增生。结论:应用颞浅动脉岛状皮瓣修复下眼睑软组织缺损方法简便,创伤小,切口隐蔽,修复后不仅外观效果好且下眼睑功能恢复满意,是一种修复面部眼周软组织缺损的较理想的方法。     

SUPERFICIAL ESOPHAGEAL SQUAMOUS CELL CARCINOMA WITH BULKY GASTRIC HIATUS LYMPH NODE METASTASIS: A CASE REPORT

In patients with superficial esophageal cancer, especially in those with tumor invasion above the muscularis mucosae, lymph node metastasis is very rare. We report a case of superficial esophageal cancer who presented with lymph node metastasis. In another hospital a 49‐year‐old man was found to have a bulky tumor adjacent to the cardiac area of the stomach and a total gastrectomy was carried out. Postoperatively, the tumor was identified as a lymph node containing metastatic squamous cell carcinoma. The main lesion could not be identified on fluorodeoxyglucose positron emission tomography. On esophagogastric endoscopy, using the iodine spray technique, we found an unstained lesion about 32 cm from the incisor teeth. The tumor was removed using endoscopic mucosal resection. The entire resected specimen was examined histopathologically; the depth of the tumor was above the muscularis mucosae. Thirty‐four months after endoscopic mucosal resection, there is no sign of tumor recurrence or metastasis.     

Treatment of disseminated superficial actinic porokeratosis with topical diclofenac gel: a case series

Disseminated superficial actinic porokeratosis (DSAP) is the most common of the of five clinical variants of porokeratosis. These are disorders of keratinization and the distinctive pathological feature is the cornoid lamella at the margin. DSAP usually manifests in the third or fourth decades of life with a female preponderance and with multiple lesions over sun‐exposed areas. A diverse range of treatments is employed though evidence of efficacy remains largely anecdotal. We report a series of eight patients with DSAP treated with 3% diclofenac gel (Solaraze® gel).     

Superficial siderosis of the central nervous system secondary to a thalamic hamartoma

A patient with radiologically evident superficial siderosis of the central nervous system secondary to a thalamic hamartoma is reported. Cerebral hamartomas are rare, benign congenital lesions which when vascular can cause repeated subarachnoid haemorrhages, which results in deposition of iron (haemosiderin) in the leptomeninges and in the subpial layers of the brain and spinal cord. Progressive sensorineural deafness and cerebellar ataxia, which are typical clinical manifestations of superficial siderosis, may then appear. The importance of prompt diagnosis and treatment is highlighted.     

皮内植线疗法治疗经前期综合征肝气逆证的随机对照研究

目的:观察皮内植线疗法辨证取穴治疗经前期综合征肝气逆证(PMS)的临床疗效。方法:将108例PMS患者,随机分为治疗组和对照组各54例,治疗组采用皮内植线疗法辨证取穴治疗,对照组采用口服药物对症治疗,两组均连续治疗3个月经周期,治疗后随访3个月经周期统计疗效。结果:纳入108例患者,105例完成试验,脱落3例。治疗组和对照组总有效率(ITT/PP)分别为92.6%/94.3%、75.7%/78.8%;治疗组:临床痊愈35/35,显效9/9,好转6/6,无效4/3;对照组:临床痊愈5/5,显效17/17,好转19/19,无效13/11;ITT和PP分析结果一致:治疗组的综合疗效以及痊愈患者显著优于对照组(P<0.01);两组治疗前后症状评分、汉密尔顿焦虑量表比较差异有极显著意义(P<0.001),以治疗组更好(P<0.001);治疗组较对照组快捷持久(P<0.05)。结论:皮内植线疗法采用辨证取穴的方法治疗PMS具有高效快捷、安全无痛的特点,临床疗效优于口服药物对症治疗,值得临床推广应用。     

High‐resolution sonography of the superficial radial nerve with two case reports

The purpose of this study was to find out whether high‐resolution sonography can be used to examine the superficial radial nerve. The sonographic appearance of the superficial radial nerve was assessed in 20 control subjects and the cross‐sectional area could be measured in all subjects. The mean cross‐sectional area of the superficial radial nerve in the control subjects was 2 mm² (SD 0.5 mm², range 1–3 mm²). Moreover, two patients with a superficial radial neuropathy and abnormal high‐resolution sonography are reported. One patient had an enlarged nerve after trauma, which was probably a neuroma. The other patient had a histologically proven Schwannoma of the superficial radial nerve. The superficial radial nerve, although small in size, can be visualized by high‐resolution sonography using specific landmarks. High‐resolution sonography can be useful to assess the underlying cause of superficial radial nerve pathology. Muscle Nerve 39: 392–395, 2009     

伊曲康唑治疗浅表念珠菌感染临床经验回顾

目的：评价适宜国人的伊曲康唑治疗浅表念珠菌感染的治疗方案。方法：复习10年来在我国皮肤科中文核心期刊上发表的有关伊曲康唑治疗浅表念珠菌感染的文献。结果：伊曲康唑治疗皮肤念珠菌感染的有效剂量为200mg／d，连续应用3d；治疗念珠菌性包皮龟头炎的有效剂量为200mg／d，连续应用5d；治疗初发性念珠菌性阴道炎的有效剂量为400mg／d，连续应用2d；治疗复发性念珠菌性阴道炎的有效剂量为400mg／d，以后在每月月经期加用伊曲康唑200mg／d，应用3～5d，连续3～6个月。结论：伊曲康唑治疗国人浅表念珠菌感染安全有效，不良反应发生率较低。