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。     

原发性下肢静脉曲张腔内激光治疗体会

目的评价静脉腔内激光治疗原发性、单纯性下肢静脉曲张的效果。方法回顾分析我们对87例原发性、单纯性下肢静脉曲张病人进行腔内治疗的临床资料。所有病人均排除原发性下肢深静脉功能不全、下肢深静脉血栓形成、动静脉瘘，病人随访时间为1—3年。结果全部病人下肢静脉曲张症状均消失，无严重并发症发生。结论激光腔内治疗下肢静脉曲张安全、创伤小、并发症少，效果满意。     

激光腔内治疗单纯性下肢静脉曲张

目的评价激光腔内治疗单纯性下肢静脉曲张的临床效果。方法对35例患者（45条患肢）行大隐静脉及浅表曲张静脉腔内激光治疗,随访3－6个月,观察手术效果及术后并发症。结果所有患者彩超显示大隐静脉均闭合,未探及明显血流;未见严重并发症及静脉曲张复发。结论激光腔内治疗单纯性下肢静脉曲张安全性高,创伤小,恢复快,短期效果理想。     

腔内激光治疗大隐静脉曲张的护理配合

目的探讨腔内激光治疗大隐静脉曲张的护理要点。方法对42例采用腔内激光治疗大隐静脉曲张的患者均采用术前心理护理；患肢的准备；充分的物品准备；术中仪器的正确连接与使用；手术间的科学管理；激光光纤的妥善保管等多种有效的护理措施。结果42例手术均顺利完成，达到了微创的目的，且疗效满意。结论完善的术前准备及术中严密的护理是保证手术成功的重要环节。     

静脉腔内激光治疗术治疗大隐静脉曲张125例临床分析

目的：探讨静脉腔内激光治疗术(EVLT)对大隐静脉曲张的治疗效果。方法对于我院2012年6月~2013年6月行静脉腔内激光治疗术治疗大隐静脉曲张125例(141条肢体)患者的临床资料进行回顾性的分析和总结。结果全部病例手术均顺利完成,症状缓解率100%。术后皮下淤血或血肿18肢(12.8%),皮肤条状烧伤1肢(0.7%),隐神经损伤6肢(4.3%)。随访6~18个月无复发。结论该方法治疗下肢静脉曲张疗效确切、创伤小、易于操作,适合基层医院应用。     

超声引导下肿胀麻醉液辅助腔内激光治疗下肢静脉曲张

目的:探讨超声引导下肿胀麻醉液辅助腔内激光治疗下肢静脉曲张的临床效果。方法:回顾性分析23例采用超声引导下肿胀麻醉液辅助腔内激光治疗下肢静脉曲张患者的临床资料,观察患者术中、术后疼痛情况,出院后随访下肢浅静脉曲张临床症状、体征变化,色素沉着、湿疹、溃疡等皮肤改变情况。结果和结论:23例患者术中VAS评分2~5分,平均2.8分,术后6 h VAS评分1~4分,平均1.3分。23例患者均在术后2 h内下床活动,术后1~2 d出院,术后3~6月内有19例患者得到随访,被随访患者下肢浅静脉曲张临床症状、体征均消失,色素沉着、湿疹、溃疡等皮肤改变者均不同程度减轻,其中9例患者彩超检查均未见静脉再通及复发。     

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。     

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。     

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。     

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.     

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.     

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.     

The case for allele‐specific recognition by the TCR

There is a sharp difference in how one views TCR structure–function–behaviour dependent on whether its recognition of major histocompatibility complex‐encoded restriction elements (R) is germline selected or somatically generated. The generally accepted or Standard model is built on the assumption that recognition of R is by the V regions of the αβ TCR, which is not driven by allele specificity, whereas the competing model posits that recognition of R is allele‐specific. The establishing of allele‐specific recognition of R by the TCR would rule out the Standard model and clear the road to a consideration of a competing construct, the Tritope model. Here, the case for allele‐specific recognition (germline selected) is detailed making it obvious that the Standard model is untenable.     

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.