大隐静脉传统剥脱术与激光治疗大隐静脉曲张的临床对比分析

目的：比较大隐静脉曲张的传统剥脱术和激光治疗术的治疗效果。方法大隐静脉曲张患者(双侧)36例随机分为两组,每组18例,一组行大隐静脉传统剥脱手术,另一组行大隐静脉高位结扎联合激光腔内闭合术。比较两组术中术后出血量、切口长度、术后住院时间和术后并发症发生率。结果激光治疗组的术中术后出血量、切口长度、术后住院时间较传统静脉剥脱组显著减少(P<0.05)。但两组患者的术后并发症的发生率差异无显著意义(P>0.05)。结论大隐静脉高位结扎联合激光腔内闭合术治疗大隐静脉曲张是一种安全有效的微创手术方法。     

自制弧形槽针在治疗单纯性大隐静脉曲张中的应用（附30例报告）

目的探讨采用弧形槽针做皮内缝合结扎曲张静脉的手术方式治疗单纯性大隐静脉曲张的治疗效果。方法选择30例单纯性大隐静脉曲张患者35条下肢,通过使用自制的弧形槽针在皮内环绕曲张静脉缝合结扎,将线结置于皮下;在常规大隐静脉结扎切口下方做切口,显露出大隐静脉主干,在分支下方用粗丝线双重结扎,不切断抽除大隐静脉主干与传统手术方式进行比较。结果随访6个月至2年半静脉曲张无一例复发,皮内缝合处针孔疤痕全部消失。结论采用弧形槽针治疗大隐静脉曲张的治疗方法安全可靠、简便省时、费用低、创伤小、小腿无疤痕,值得临床推广。     

大隐静脉射频消融术与大隐静脉高位结扎剥脱术治疗静脉曲张的疗效对比

目的比较大隐静脉射频消融术和大隐静脉高位结扎剥脱术治疗静脉曲张的临床疗效。方法回顾性分析2018年9月至2019年5月江苏省中医院收治的70例(93条患肢)下肢大隐静脉曲张患者的临床资料,将行大隐静脉射频消融术和高位结扎剥脱术治疗的患者分别设为观察组和对照组,每组35例(对照组43条患肢,观察组50条患肢)。对比分析2组患者手术时间、恢复时间、切口数量、术后VAS疼痛评分等手术相关情况,比较2组患者手术前后CEAP分级、临床疗效、术后并发症、术后生活质量和满意度评分。结果与对照组相比,观察组所需手术时间、术后首次下床时间、住院时间及恢复时间较短,术中出血量、切口数量较少,术后VAS疼痛评分较低;2组患者CEAP分级构成在术后均比术前显著降低;观察组患者术后并发症总发生率显著低于对照组;观察组患者术后生活质量总评分及各项评分均显著高于对照组;观察组患者对治疗方法的整体评价高于对照组,以上差异均具有统计学意义(P<0.05)。结论大隐静脉射频消融术与大隐静脉高位结扎剥脱术疗效相当,但射频消融术有操作简单、创伤小、恢复快、并发症少且美观等优势,同时可减轻患者痛苦,显著改善术后生活质量,提高患者满意度。     

68例大隐静脉激光治疗围手术期并发症分析

目的探讨应用大隐静脉高位结扎联合腔内激光治疗大隐静脉曲张,围手术期常见并发症及其处理。方法自2012年1月~2013年1月,68例患者的97条大隐静脉病变血管,应用大隐静脉高位结扎联合腔内激光治疗。结果本组68例行大隐静脉高位结扎联合腔内激光治疗手术,均治愈出院,无1例死亡或有严重并发症,住院时间3~15d,平均(5.5±2.6)d,无伤口感染,术后57条患肢(58.76%)存在不同程度的下肢肿胀,2~4d后消失。78条患肢(80.41%)有局部感觉异常,82条患肢(84.53%)沿大隐静脉或分支走向可触及硬结感,经随诊复查,2~8w症状逐渐消退。1条患肢(1.03%)出现皮肤损伤。结论大隐静脉高位结扎联合腔内激光治疗手术是一种安全有效的方法,操作成功率和近中期效果确切,可作为大隐静脉曲张的首选治疗方法,治疗同时注意预防局部并发症。     

大隐静脉高位结扎联合点式剥脱术治疗大隐静脉曲张的应用效果观察

目的:探讨对大隐静脉曲张患者采取高位结扎与点式剥脱术联合治疗的效果.方法:选取我院 2021 年5 月至 2022 年 10 月期间收治的 94 例大隐静脉曲张患者作为研究对象,根据住院号将患者分为对照组和观察组(n=47),对照组采用大隐静脉高位结扎联合传统剥脱术治疗,观察组实施大隐静脉高位结扎联合点式剥脱术治疗.经治疗 3 d后,对比两组患者的临床疗效,采用视觉模拟评分法(Visual analogus scale,VAS)评估患者疼痛程度,应用静脉曲张临床严重程度评分表(Venous clinical severity score,VCSS)评估患者病情,应用酶联免疫吸附法检测白细胞介素-6(Interleukin-6,IL-6)、肿瘤坏死因子-α(Tumor Necrosis Factor-α,TNF-α)水平,应用全自动凝血分析仪检测凝血酶原时间(Prothrombin Time,PT)、凝血酶时间(Thrombin Time,TT)、活化部分凝血酶时间(Activated Partial Thromboplastin Time,APTT).结果:观察组治疗有效率显著高于对照组(P＜0.05);观察组VAS评分与VCSS评分均明显低于对照组(P＜0.05);观察组IL-6、TNF-α水平均显著低于对照组(P＜0.05);观察组APTT、PT、TT均长于对照组.结论:在大隐静脉高位结扎的基础上联合点式剥脱术治疗大隐静脉曲张,减轻应激反应与术后疼痛,对患者凝血功能的影响较小     

大隐静脉曲张血管内光凝治疗后LPO,SOD,GSH-Px的变化

目的 :比较血管内激光光凝治疗大隐静脉曲张后和传统静脉高位结扎 ,分段剥脱手术治疗大隐静脉曲张后血液中过氧化脂质 (LPO)、超氧化物歧化酶 (SOD)和谷胱甘肽过氧化物酶 (GSH -Px)的表达。方法 :70例大隐静脉曲张患者 ,37例行血管内激光光凝治疗 ,33例行传统大隐静脉高位结扎 ,分段剥脱手术。分别在术前、术后第 1,3,5 ,7,10 ,15天取静脉血 ,测定LPO、SOD和GSH -Px的水平 ,测定方法分别为硫代巴比妥酸法(TBA)荧光法 ,放射免疫分析法和二硫双硝基苯甲酸 (DTNB)直接法。另外取 30例健康成人作为对照。结果 :大隐静脉曲张患者LPO水平较正常水平高 ,SOD、GSH -Px水平较正常水平低。两种术式治疗后LPO水平均升高 ,随着病情的恢复逐渐下降 ,接近正常水平 ;SOD和GSH -Px先下降后升高 ,升高的时间落后于LPO。血管内光凝组患者LPO的增高水平低于静脉结扎、剥脱治疗组 ,而且恢复至正常水平的时间先于静脉结扎、剥脱组。结论 :LPO、SOD和GSH -Px的表达水平与手术创伤和术后病情恢复情况密切相关。     

高位加分段结扎治疗大隐静脉曲张

高位加分段结扎治疗大隐静脉曲张高位加分段结扎大隐静脉曲张术，是将大隐静脉及汇集支分别结扎切断，阻断了股静脉内的血液倒流；分段结扎将静脉腔分隔成数段，使血流阻隔，令其静脉血通过交通支汇入深静脉，使大隐静脉废用萎缩。山东临沂矿务局中心医院用该法治疗１６例...     

腔内激光与传统高位结扎术治疗大隐静脉曲张的临床疗效对比

目的：观察对比腔内激光与传统高位结扎术治疗大隐静脉曲张的各自临床效果。方法将245例大隐静脉曲张患者随机分为治疗组129例和对照组116例。对照组给予传统高位结扎术治疗,治疗组给予腔内激光治疗,观察两组临床疗效。结果治疗组患者的手术时间、出血量及住院时间均优于对照组,差异有统计学意义(P<0.05);治疗组不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论腔内激光术较传统高位结扎抽剥术治疗大隐静脉曲张有明显的优势,激光术对患者身体损害小,且操作安全简单、术后恢复快、复发率低等优点,值得临床推广应用。     

腔内激光联合高位结扎及点式剥脱术治疗大隐静脉曲张23例临床分析

目的:评价腔内激光联合高位结扎及点式剥脱术治疗单纯性大隐静脉曲张的临床疗效.方法:采用腔内激光联合高位结扎或点式剥脱术治疗大隐静脉曲张23例,28条患肢.结果:所有患者术后均恢复良好,无下肢深静脉血栓形成.随访2～10个月,无一例复发.结论:腔内激光联合高位结扎及点式剥脱术治疗大隐静脉曲张,具有安全、有效、微创的优点,值得临床推广应用.     

大隐静脉高位结扎联合腔内半导体激光治疗下肢静脉曲张的临床疗效

目的 探讨大隐静脉高位结扎联合腔内半导体激光治疗下肢静脉曲张的临床疗效。方法 选取2016年9月~2018年3月我院收治的下肢静脉曲张患者100例,采用随机数字表法分成对照组与观察组,每组50例。对照组给予大隐静脉高位结扎术治疗,观察组在对照组基础上联合腔内半导体激光治疗,比较两组临床疗效、下肢症状体征改善情况及手术相关指标。结果 观察组总有效率为96.00%,高于对照组的82.00%,差异有统计学意义（P＜0.05）。治疗后观察组酸胀、疼痛、水肿、色素沉着、皮炎、溃疡改善情况优于对照组,差异有统计学意义（P＜0.05）。观察组手术时间长于对照组[（85.14±8.32）min vs（62.62±8.37）min],差异有统计学意义（P＜0.05）;两组术中出血量及疼痛评分比较,差异无统计学意义（P＞0.05）。结论 大隐静脉高位结扎联合腔内半导体激光治疗下肢静脉曲张可有效改善患者下肢症状体征,不增加术后疼痛程度,具有良好的治疗效果。     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.     

The universal muscular chamber. A basic unit of the genitourinary, cardiovascular, gastro-intestinal, skeletal, cutaneous, respiratory and other systems, endocameral hypertension; and spasm, the key to their idiopathic diseases and arthropathies

Starting with the integument, we see many organs are contractile sacs or multiples thereof, which tubes or bags constitute the major part of the entire body. Recognition of this basic unit and its characteristics sheds new light, individually and collectively, on many disorders previously considered unrelated. Muscular tears and perforations develop in the walls of these chambers, being no way peculiar to those organs, wherein, hydrochloric acid occurs. So, it is not necessary to explain the absence of excessive acid from patients who exhibit holes in the gastric, uterine, aortic, duodenal, rectal, pulmonary, retina, and other walls. Muscle, not acid is the great common factor relating idiopathic disorders in the gastrointestinal tract to each other and to similar diseases in other systems. When the units are linked together, the lesions tend to appear as arthropathies, i.e. at the joints. Rephrasing common-place observations, frees us from conventional, conceptual cul-de-sacs. An observation is only as good as its interpretation, so all possibilities must be considered, otherwise, we will remain blinded by our misconceptions.     

Der Einfluß von Nahrungsmitteln und Rauchen auf die klinisch-chemische Diagnostik von Phäochromozytom,Neuroblastom und Karzinoid-Syndrom

Zusammenfassung Der Einfluß von verschiedenen Nahrungsmitteln auf Methoden zur Bestimmung von Adrenalin (AD), Noradrenalin (NA), Vanillinmandelsäure (VMS), Metanephrinen (MN), Homovanillinsäure (HVS) und 5-Hydroxyindolessigsäure (5-HIE) im 24 h-Harn zur Diagnose des Phäochromozytoms bzw. Karzinoid-Syndroms wurde untersucht. Die in die Untersuchung einbezogenen Nahrungsmittel waren: Tee, Kaffee, Mandeln, Ananas, Käse, Walnüsse, Vanillepudding, Bananen, Tomaten und Milchschokolade. Außerdem wurde der Einfluß des Zigarettenrauchens auf die Bestimmung von AD, NA, VMS und MN untersucht.Walnüsse führten zu einer starken Erhöhung der 5-HIE-Ausscheidung. Bananen erhöhten die Ausscheidung von AD, NA, VMS, MN und 5-HIE. Kaffee und Ananas bewirkten eine geringe Zunahme der MN-Werte. Rauchen von 20–30 Zigaretten/Tag beeinflußte keine der vier Variablen.Wenn die beschriebenen Methoden benutzt werden, sollte lediglich auf den Verzehr von Bananen und Walnüssen vor und während der Harnsammelperioden verzichtet werden, da die oberen Normgrenzen im Harn überschritten werden könnten. Ein Verzicht auf Kaffee und Ananas in normalen Mengen ist nicht erforderlich. Es besteht kein Anlaß, weiterhin die bisherigen umfangreichen Restriktionen der übrigen Nahrungsmittel beizubehalten.