大鼠单侧后牙缺失后颞颌关节内P物质、降钙素基因相关肽的表达变化

目的 :观察单侧后牙缺失造成偏侧咀嚼的大鼠颞颌关节内P物质 (substanceP ,SP)和降钙素基因相关肽 (calcitoningene relatedpeptide ,CGRP)的表达情况 ,进一步探讨颞颌关节病的发病机制。方法 :Wistar雄性大鼠 12只 ,随机分为 4组 ,包括 2个实验组及相应的对照组 ,每组 3只。拔除实验组动物右侧上、下颌磨牙 ,人为造成偏侧咀嚼。同一部位的切片分 2组 ,分别行SP ,CGRP免疫组织化学反应 (SABC法 )。光镜观察 ,并用LUZEX F型显微图像分析仪分别进行测定。结果 :每一实验组咀嚼侧和非咀嚼侧颞颌关节内单位面积内SP ,CGRP阳性纤维面积与各自对照组比较显著增加 (P <0 .0 1) ,但 3个月组较 1个月组有较低的增长趋势。在每一实验组内 ,非咀嚼侧单位面积内SP ,CGRP阳性纤维面积明显高于咀嚼侧 (P <0 .0 1)。结论 :SP ,CGRP均参与了偏侧咀嚼引起的颞颌关节病的病理变化过程 ,且在偏侧咀嚼条件下 ,两侧颞颌关节病理变化程度不同     

偏侧咀嚼条件下SD大鼠翼外肌的组织学研究

目的观察偏侧咀嚼条件下SD大鼠的翼外肌组织学变化。方法30只SD大鼠随机分成实验组(24只)和对照组(6只),实验组分为拔牙组(12只)和分牙组(12只)。6周后将动物处死,对其双侧翼外肌、咬肌进行光镜和透射电镜观察。结果实验组双侧翼外肌和咬肌肌原纤维均有不同程度的细胞与组织损害及改建。翼外肌的损害程度重于咬肌。工作侧和非工作侧没有明显差异。结论偏侧咀嚼可以造成翼外肌的组织学损伤,这种损伤可能是颞下颌关节病的持续因素之一。     

医源性散瞳诱发青光眼急性发作的临床分析

目的：探讨医源性散瞳诱发青光眼急性发作的易感因素。方法：对26例(28眼)医源性散瞳诱发青光眼急性发作的患者进行回顾性分析。结果：散瞳检查眼底诱发青光眼急性发作16眼，翼状胬肉切除术后诱发青光眼急性发作4眼，胃肠手术后用阿托品诱发青光眼急性发作3眼。基础麻醉前用阿托品诱发青光眼急性发作5眼；全部发作眼前房轴深均小于1．8mm，房角呈关闭状况。结论：存在前房浅、房角窄解剖基础的眼睛是散瞳诱发青光眼急性发作的易感因素。     

Effects of unilateral pallidotomy on voluntary movement, and simple and choice reaction times in Parkinson's disease.

We studied the effects of unilateral pallidotomy on motor execution and reaction times in patients with moderately advanced Parkinson's disease (PD). Twelve consecutive patients (7 men, 5 women; all right-handed) underwent left-side microelectrode-guided pallidotomy. In addition to clinical rating, reaction time (RT) tests and repetitive movements of the contralesional hand/arm were carried out at baseline and 2 to 3 months after surgery while patients were on optimal medical regimens (on period). The initiation time in both simple reaction time (SRT) and choice reaction time (CRT) improved significantly after pallidotomy (P < 0.05), whereas no effect was observed on the choice processing time, which was calculated by subtracting the mean value of the onset of SRT from that of CRT. Pallidotomy resulted in significant improvement of repetitive movements such as hand pronation/supination and finger-tapping (P < 0.002, P < 0.005, respectively). Improvements in RT tests and repetitive movements suggest that pallidotomy may enhance attention and motor function. These effects are probably mediated through the pallido-thalamic-cortical neural circuitry.     

Unilateral subthalamic deep brain stimulation in advanced Parkinson's disease.

Eight patients with advanced PD received a unilateral STN DBS. The UPDRS III off drug-on DBS was improved by a mean 44%. Dyskinesias were ameliorated. Levodopa daily dose was reduced. Three patients required the implantation of the second electrode. Unilateral DBS may be efficacious in some patients with advanced PD.     

单双侧无抽搐电休克治疗精神分裂症在治疗指标及血清肌酸磷酸激酶（CPK）上的差异

目的 :比较单双侧无抽搐电休克治疗精神分裂症患者时在抽搐时间和抽搐后能量指数及血清肌酸磷酸激酶 (CPK)方面的差异。方法 :入组患者 6 0例 ,每例做 8次无抽搐电休克治疗 ,30例前 4次作双侧 ,后 4次做单侧治疗 ,另 30例行相反程序 ,治疗指标由电休克机自动测定 ;治疗前和治疗后分别测血清CPK一次。结果 :双侧组患者在抽搐时间上明显长于单侧组 (t=17 17,P <0 0 0 1)在抽搐后能量指数上亦明显高于单侧组 (t=11 5 3,P <0 0 0 1) ;治疗前后单双侧组比较血清CPK无显著性差异。结论 :表明双侧无抽搐电休克比单侧有更明显的神经生理影响 ,即双侧比单侧有更强烈、更广泛的脑内异常放电 ;但单双侧无抽搐电休克对血清CPK的影响并无显著性差异。     

Case report Man-in-the-barrel syndrome caused by cervical spinal cord infarction

Acute brachial diplegia with normal findings of the legs, "man-in-the barrel" (MIB) syndrome, is generally thought to be caused by bilateral supratentorial brain lesions of the prerolandic cortical and subcortical area. We report 1 patient with a sudden onset of MIB syndrome with no supratentorial lesion but a hemodynamically induced atypical anterior spinal cord infarction after unilateral vertebral artery dissection. Thus, in MIB syndrome an infratentorial lesion site, including the cervical spinal cord, should also be considered.     

交锁钉与外固定架治疗胫骨干多段骨折的疗效比较

目的　评价交锁髓内钉和单臂外固定架对胫骨干多段骨折的治疗效果。方法　回顾分析 1998年以来治疗胫骨干多段骨折应用交锁钉3 8例 ,应用外固定架 3 0例 ,比较术后 2年的恢复情况。结果　交锁钉治疗组骨折原位愈合率为 92 %( 3 5 /3 8) ,成角畸形愈合率 2 6%( 1/3 8) ,骨折延迟愈合 5 3 %( 2 /3 8) ,骨不连 0例 ,骨髓炎 2 6%( 1/3 8) ,皮瓣坏死 2 6%( 1/3 8) ,大隐静脉损伤 5 3 %( 2 /3 8) ,筋膜间隙综合征 0例。平均骨折愈合时间 6.5个月。而外固定架组分别为 5 0 %( 15 /3 0 )、16.7%( 5 /3 0 )、2 6.7%( 8/3 0 )、6 7%( 2 /3 0 )、10 %( 3 /3 0 )、10 %( 3 /3 0 )、10 %( 3 /3 0 )、6 7%( 2 /3 0 ) ,针眼感染 16 7%( 5 /3 0 ) ,平均愈合时间 8.5个月。结论　交锁髓内钉治疗胫骨干多段骨折生物力学好、操作方便、固定牢固、对骨折局部血供损伤小 ,下床负重早 ,其治疗效果好 ,并发症少。     

Comparing the 30-Day Risk of Venous Thromboembolism and Bleeding in Simultaneous Bilateral vs Unilateral Total Knee Arthroplasty

Background

Simultaneous bilateral total knee arthroplasty (SBTKA) may offer certain benefits; however, its overall safety is still disputed. This study aimed at comparing the risk of thromboembolism and bleeding in patients who underwent SBTKA vs unilateral total knee arthroplasty (TKA).