介入联合手术治疗急性下肢深静脉血栓形成1

目的：探讨下肢深静脉血栓形成的手术治疗方法。方法：急性下肢深静脉血栓形成14例，先经健侧股静脉置入下腔静脉滤器，再切开患侧股静脉，远端血栓以挤压法驱出，近端髂股静脉内血栓以Fogarty球囊取出；球囊扩张左髂静脉狭窄11例，其中5例放置支架；最后做临时性股动静脉瘘。结果：14例手术成功。13例随访2。30个月，其中12例患肢肿胀消退，1例复发：结论：本方法创伤小，恢复快，疗效好，多数患者能耐受。下腔静脉滤器应以临时性为首选。     

手术取栓、挤压驱栓联合介入治疗急性下肢深静脉血栓65例临床分析

目的 探讨急性下肢深静脉血栓合理的治疗方式.方法 自2006年3月至2009年9月我院共收治下肢深静脉血栓患者65例,病变累及左侧者48例,右侧者15例,双侧者2例,首先植入下腔静脉滤器,再取患侧股部切口,髂静脉血栓以Fogarty管取出,远侧静脉内血栓以挤压的方法驱出,球囊扩张联合支架置入治疗髂静脉狭窄.结果 30例存在左侧髂静脉狭窄,扩张后26例髂静脉狭窄回缩达50%以上,置入支架.病人无死亡和肺动脉栓塞.出院时,患者治疗效果良好,46例肢体肿胀消失,19例轻度肿胀.随访60例,时间3-30个月,无肺栓塞的发生,55例肿胀消失,5例轻度肿胀.结论 本方法是安全有效的治疗下肢深静脉血栓的手术方式.     

介入联合手术治疗下肢深静脉血栓后综合征

目的：探讨下肢深静脉血栓后综合征的外科治疗方法.方法：下肢深静脉血栓后综合征20例,采用球囊扩张左股总及髂静脉狭窄段、置入支架并做临时性股动静脉瘘方法治疗,其中10例同时行大隐静脉结扎抽剥术.结果：所有病例介入及手术取得成功.出院时14例肢体肿胀明显缓解,4例轻度肿胀,2例缓解不明显.随访15例（3～24个月）,13例肿胀消退,5例足靴区溃疡愈合,2例未愈.结论：多数下肢深静脉血栓后综合征患者的髂静脉病变是以狭窄为主,可以通过介入的方法治疗.本方法创伤小、近期疗效较好.     

Cockett综合征并发急性下肢深静脉血栓的外科治疗

目的：总结Cockett综合征并发下肢深静脉血栓的外科治疗经验，探讨有效治疗下肢深静脉血栓的外科方法。方法：采用外科手术方法共治疗Cockett综合征并发下肢深静脉血栓患者42例，其中取栓 左髂总静脉闭塞段切除、人工血管原位移植15例，取栓 左髂外静脉→下腔静脉搭桥6例，取栓 左股总静脉→下腔静脉搭桥7例，取栓 Palma手术14例；除原位移植外，所有患者加作临时性股静脉瘘。结果：全组无手术死亡及肺动脉栓塞发生，42例患者除3例患肢消肿不明显外，其余患者均取得了良好疗效。随访2月-6a，4例人工血管内血栓形成，6例吻合口狭窄，血栓后综合征发生率为16，67％。结论：Cokett综合征极易并发急性下肢深静脉血栓，外科治疗下肢深静脉血栓时要高度警惕左髂总静脉病变并彻底矫正，选择合理有效的术式是提高远期通畅率、降低血栓后综合征发生率的关键。     

腔静脉滤器置入联合胫后静脉置管溶栓治疗急性下肢深静脉血栓形成

目的：探讨腔静脉滤器置入联合胫后静脉途径置管直接溶栓治疗急性下肢深静脉血栓形成的临床应用价值。方法：18例急性下肢深静脉血栓形成患者,先行患肢血管造影明确诊断后,在下腔静脉滤器置入的基础上采用胫后静脉置管微泵持续推注尿激酶直接溶栓治疗,对其中髂静脉狭窄5例和闭塞1例患者在拔除溶栓导管后实施髂静脉球囊扩张成形术。结果：18例患者置管溶栓治疗后症状均得到明显改善,1例术前合并肺动脉栓塞者症状消失。溶栓后的健、患侧大腿周径差及小腿周径差比治疗前明显减小,差异均有统计学意义（P〈0．001）。治疗期间,无一例围手术期死亡,无肺动脉栓塞发生,无置管处渗血或血肿形成、神经损伤等置管相关并发症发生。术后17例获随访,随访时间1～12个月,平均5个月。15例肢体肿胀基本消退、肌张力减低、恢复正常劳动力;2例活动后肢体出现轻微肿胀伴沉重感,能进行正常家务劳动;17例均未出现患肢浅静脉曲张及静脉营养性障碍。结论：腔静脉滤器置入联合胫后静脉置管直接溶栓治疗急性下肢深静脉血栓形成具有疗效好、创伤小、安全性高、适应证宽,便于护理等优点,是一种安全、有效的治疗方法。     

下腔静脉滤器保护下导管溶栓治疗下肢深静脉血栓患者的围手术期护理

目的：总结下腔静脉滤器置入保护下导管溶栓治疗下肢深静脉血栓形成(DVT)的护理方法。方法回顾性分析19例患者通过下腔静脉滤器置入联合导管溶栓治疗下肢DVT的围手术期护理措施,包括心理护理、基础护理及并发症观察。结果19例患者均得到有效治疗,患肢肿胀消退或减轻,未发生明显出血、肺栓塞等并发症。结论围手术期积极、细致、有效的护理,可以促进下腔静脉滤器置入保护下导管溶栓治疗下肢深静脉血栓患者的康复。     

下腔静脉滤器置入预防肺动脉栓塞的生物相容性和安全性

背景：下腔静脉滤器应用于临床可预防肺动脉栓塞。 目的：探讨下腔静脉滤器置入预防肺栓塞的生物相容性、安全性和手术适应证,以及相关并发症出现的原因与预防措施。 方法：回顾性分析桂林市人民医院2001/2011经颈内静脉或股总静脉置入下腔静脉滤器治疗的下肢深静脉血栓96例患者临床资料。 结果与结论：96例中55例置入永久性滤器,23例置入可回收滤器,18例置入临时性滤器。置入后随访8个月~7年,有症状的肺栓塞发生者1例,滤器倾斜2例,轻微宿主反应2例,均未对治疗有太大影响。表明下腔静脉滤器置入可以有效预防致命性肺栓塞,具有良好的生物相容性和安全性。     

下腔静脉滤器置入在下肢深静脉溶栓中的应用体会12例

目的 探讨下腔静脉滤器置入在下肢深静脉血栓治疗中预防肺栓塞(PE)的发生及使用问题.方法 对12例下肢深静脉血栓(DVT)形成病人实施经皮股或颈静脉穿刺腔静脉滤器置入术,观察滤器的位置、形态及扩张情况,然后进行溶栓治疗.结果 12例均在下腔静脉距右肾静脉开口以下0.5～2cm处成功置入,然后进行溶栓治疗,随访时间3～23个月,所有病例在溶栓过程中均未出现肺动脉栓塞.结论 下腔静脉滤器置入术操作简便安全,在下肢深静脉血栓形成治疗中能有效预防肺栓塞的发生,值得临床推广应用.     

深静脉血栓形成的介入治疗

目的 探讨对深静脉血栓形成（DVT）的患者进行介入溶栓治疗的选择原则和并发症的预防。方法 38例DVT患者放置下腔静脉滤器后进行血管腔内治疗，包括静脉腔内插管溶栓术38例、球囊扩张术14例和支架放置术2例。48h照腹平片观察滤器的位置．1周后行彩色多普勒检查了解下腔静脉和病变深静脉的通畅度。出院后定期复查滤器位置和患肢情况。结果 髂静脉、锁骨下静脉和肱静脉DVT的完全缓解率为100％，股静脉DVT完全缓解率为93．3％，小腿静脉DVT为68．4％；其余为部分缓解。滤器放置成功率为100％，溶栓过程中及追踪复查均未发生肺动脉栓塞。结论 深静脉血栓形成的患者进行介入溶栓治疗结合下腔静脉滤器放置术有效而安全，有较高的临床应用价值。     

Aegisy可回收滤器在下肢深静脉血栓形成治疗中的应用

目的探讨在下肢深静脉血栓治疗中应用Aegisy式可回收滤器的临床效果。方法选取我院创伤骨科收治的急性或亚急性单侧下肢深静脉血栓形成(DVT)患者92例,Aegisy滤器经股静脉植入下腔静脉,第2天开始进行溶栓治疗,治疗后10~15 d观察患者患肢愈合情况,采用超声以及血管造影证实下肢静脉内无新鲜或游离血栓,采用抓捕器将Aegisy可回收滤器取出,下肢静脉造影术复查,并同时抗凝治疗。结果全部患者置入成功,Aegisy滤器释放均无明显前跳和回缩现象,介入治疗及造影复查过程中,滤器无移位。置入滤器时间平均(16.8±1.3)d,89例患者回收滤器成功。下肢深静脉血栓患者经治疗效果明显,疼痛减轻,无肺动脉栓塞症状。结论 Aegisy可回收滤器能够明显改善下肢深静脉血栓临床症状,具有置入定位准确、捕获血栓能力高、回收成功率高等优点,对临床具有指导意义。     

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.