晶体玻璃体视网膜联合手术治疗复杂性视网膜脱离

目的探讨玻璃体视网膜手术（ｖｉｔｒｅｒｅｔｉｎａｌｓｕｒｇｅｒｙ，ＶＲ术）联合晶体切除／超声粉碎的效果。方法对８１例（８１只眼）应用晶体玻璃体视网膜联合手术（ｌｅｎｔｉｃｕｌａｒ－ｖｉｔｒｅｏｒｅｔｉｎａｌｓｕｒｇｅｒｙ，ＬＶＲ术）治疗的复杂性视网膜脱离进行回顾性分析。结果解剖性成功者６４只眼（７９．０１％），功能性成功者４５只眼（５５．５６％）；手术成功率显著降低的原因是前部增殖性玻璃体视网膜病变（ｐｒｏｌｉｆｅｒａｔｉｖｅｖｉｔｒｅｏ－ｒｅｔｉｎｏｐａｔｈｙ，ＰＶＲ）（成功率４２．８６％，Ｐ＜０．０１）和术中／术后眼内出血（成功率５８．８２％，Ｐ＜０．０２５）。结论ＬＶＲ术是治疗复杂性视网膜脱离的主要方法；显著影响手术预后的因素是前部ＰＶＲ和术中／术后眼内出血。     

脑前循环系统动脉瘤的外科治疗

本文报告113例脑前循环系统动脉管其中包括颈内动脉后交通动脉瘤75例.前交通动脉瘤17例,大脑中动脉瘤10例,人脑前动脉-胼周动脉瘤3例,颈内动脉-眼动脉瘤2例,颈内动脉海绵窦段动脉瘤1例.多发动脉瘤5例.共118个动脉瘤在显微镜下直视手术,动脉瘤直接夹闭术108例.孤立或包裹术5例:5例多发动脉瘤行同期手术3例,分期手术2例.术中发生动脉瘤破裂18次.Hunt和HessⅠ～Ⅱ级病人中有例行早期手术.全组术后死亡率为7.9%.着重讨论手术时机.术中动脉瘤破裂处理及多发动脉瘤的治疗.     

外阴汗腺癌七例临床分析

目的：总结外阴汗腺癌的临床特点及治疗方法。方法：对７例外阴汗腺癌病例进行回顾性分析。结果：外阴汗腺癌的发病年龄为４０～５８岁。７例患者的治疗为局部扩大切除或根治性外阴广泛切除，２例辅以术后放疗。７例中５例存活５年以上，其中１例曾在首次治疗后第７年、１１年２次复发并于第１７年死于肿瘤。２例存活＜５年，１例在术后２年半死于脑出血，１例因脊椎广泛转移在术后１年零９个月死亡。结论：外阴汗腺癌的预后较好，局部扩大切除或根治性外阴切除，是首选治疗方法。     

人体蠕形螨的生物学研究

用透明胶带法观察蠕形螨在人体面部的寄生、逸出及其在体外的存活能力。结果表明：毛囊蠕形螨（Ｄｅｍｏｄ－ｅｘｆｏｌｉｃｕｌｏｒｕｍ，Ｄ．ｆ．）主要以颚体朝向毛囊底部寄生，且常常有多条群居现象，而皮脂蠕形螨，（Ｄｅｍｏｄｅｘｂｒｅｖｉｓ，Ｄ．ｂ．）一般为单条独居生活。两种人体蠕形螨昼夜均可主动爬出毛囊口出现在皮肤表面，Ｄ．ｆ．以白天１０００～１８００为逸出高峰；Ｄ．ｂ．则以夜间２２００～２００逸出最多。此外，蠕形螨在体外有较强的活动力和存活力。透明胶带法在人体蠕形螨的流行病学调查和生物学研究方面具有较高的应用价值     

缺氧缺血性脑病新生鼠补钙前后脑细胞,红细胞内外钙的变化

为了观察一般剂量补钙对缺氧缺血性脑病（ＨＩＥ）脑细胞和红细胞内外钙变化的影响，以探讨ＨＩＥ时补钙是否增加脑细胞钙超载，用ＨＩＥ新生动物模型进行了实验研究，结果表明：（１）缺氧缺血时红细胞、脑细胞及脑组织出现钙积聚；（２）补钙后，血浆总钙浓度明显升高，而脑细胞、脑组织及红细胞钙积聚并未加重；（３）血浆总钙浓度与脑细胞或红细胞胞浆游离钙离子浓度无相关关系。提示：（１）ＨＩＥ时钙内流可能是全身性的；（２）对ＨＩＥ并低钙血症患儿吸氧后一般剂量补钙可能是安全的。     

Practical value of a new serum digitoxin assay

The purpose of this study was to evaluate a new fluorescence polarization immunoassay, TDx, for digitoxin by comparing the results of this assay with those of a radioimmunoassay (RIA). Thirty-three serum samples were obtained from 15 patients during, and for 4 weeks after, a 4-week course of digitoxin therapy. Each sample was separated by centrifugation, coded, and frozen until analysis. At the time of analysis, each sample was divided and analyzed simultaneously by TDx and RIA. Nine samples yielded results less than 2 ng/ml (limit of assay sensitivity) by one or both methods and were excluded from further data analysis. Linear regression analysis of the results of the remaining 24 paired samples (x = TDx, y = RIA) revealed a strong correlation coefficient of r2 = 0.95, slope = 0.95, and a y intercept of -0.99 (y = -0.99 + 0.95x). Additionally, the TDx results were lower than the RIA values in only five of 33 paired samples; and these occurred in four patients who had a significantly lower mean estimated creatinine clearance than that of the other 11 patients (39.0 +/- 9.1 ml/min/1.73 m2 vs. 63.3 +/- 11.8 ml/min/1.73 m2, p less than 0.01). The TDx system is a comparable alternative to the RIA method, but differences in specificity and sensitivity may exist and should be evaluated more thoroughly.     

Comparison of PET, MRI, and CT with pathology in a proven case of Alzheimer's disease

Positron emission tomography (PET) with fluorodeoxyglucose (FDG), magnetic resonance imaging (MRI), and CT were carried out in a patient with Alzheimer's disease 16 months before he died. At autopsy, the gross appearance of the brain correlated with MRI and CT, which showed some regional atrophy. These were much less revealing than PET, which correlated with microscopic findings of neuronal loss and proliferation of glia. In areas of moderately impaired local cerebral metabolic rate of glucose, as revealed by reduced FDG uptake, there was some gliosis, primarily around the numerous senile plaques. In areas of severe metabolic impairment, there was a profound loss of neurons, extensive gliosis, and a diminished appearance of plaques. PET-FDG is a better measure of the severity of Alzheimer's disease than MRI or CT, because it reflects the degree of neuronal pathology.     

Changes in serum amino acids in total parenteral nutrition supported patients with intra abdominal infection

Serum aminogram changes were prospectively studied in 95 patients with enteric fistula and intraabdominal infection who was under total parenteral nutrition (TPN) therapy with Anfuming 14s. In patients with sepsis and starvation, the aminogram showed remarkably low total free amino acids before TPN therapy. In 81 survivors, free amino acids increased gradually to normal in 2 weeks after use of TPN and in 14 dead cases increased rapidly to a significantly higher peak at terminal stage. Both in survivors and nonsurvivors, phenylalanine level remained high during the study. In response to infection, proline was also elevated but to a lesser degree; the ratio of branched chain amino acid (BCAA) to aromatic amino acid (AAA) was lower than normal and the decrease of arginine was parallel to the severity of infection. We conclude that the ideal amino acids preparation for the starvated and septic patients should be high in BCAA and arginine but low in phenylalanine, administration of inappropriate exogenous amino acids in decompensated metabolic septic patients may bring about more harm than benefit, and in septic patients that the levels of serum phenylalanine and proline are elevated persistently along with the decrease of arginine level is a useful prognostic indication.