显微锁孔手术治疗脑干及其周围病变

目的 将显微锁孔手术应用于脑干及其周围病变的外科治疗，探求以最小的创伤来取得最佳的手术疗效。方法 采用颞下锁孔人路、乳突后锁孔人路、枕下正中锁孔人路，以20mm左右直径的骨窗进行脑干及其周围病变的显微手术治疗。结果 本组16例例病人术后3d内均行MRI或DSA检查，肿瘤或动静脉畸形全切除11例，次全切除3例，部分切除1例，1例小脑后下动脉瘤成功夹闭。术中输血3例。并发脑脊液耳漏1例，硬膜下积液1例，1例术后持续昏迷40d苏醒，无死亡及感染病例。结论 锁孔人路微创技术处理脑干及其周围病变，因其手术创伤小，疗效佳，费用节省，值得临床推广应用。     

脑干区占位病变的手术入路

本文报告了1990年5月以来脑干区大型、复杂占位病变15例.其中,位于脑干内3例,脚间窝2例,岩尖部4例,全岩骨区1例,全斜坡区2例,第四脑室内3例.本组采用以扩大了的岩骨入路为主的联合入路,行肿瘤全切除8例,次全切除5例.2例仅作了活检加减压术.除1例死亡外,均恢复良好.本文结合文献,对脑干区手术入路进行了讨论.     

Penetration of Schistosoma japonicum cercaria into host skin.

The anterior part of Schistosoma japonicum cercaria is a specialized head organ which can slightly stretch out and retract. There are three different types of large unicellular glands in cercarial body, consisting of one head gland, 2 pairs of pre- and 3 pairs of postacetabular glands. These glands differ in position, gross feature, histochemistry and functions. Both polysaccharase and protease activities are demonstrated in the secretions from these glands. Mode of cercarial penetration is described in detail and the penetration is effected by a combination of lytic secretions and mechanical movements. The schematic representation of the process of cercarial penetration is presented. The dynamic distributions of schistosomula in skin at different time intervals after skin penetration in various mammalian hosts are shown. Some newly transformed schistosomula die while penetrating into the skin of 7 mammalian species and the mortality rate varies with the host species, and that can also be affected by the age of cercariae following emergence from the snail. Some physiological aspects between cercariae and newly transformed schistosomula are compared. In contrast to cercariae, schistosomula are saline-adapted and water-intolerant. They were modified histochemically and antigenically.

     

143例孔源性视网膜脱离临床分析

本文分析了１４３例（１４７眼）孔源性视网膜脱离的一般临床资料、眼部情况、手术类型及治疗结果。本组出院时１３６眼痊愈（９２．５％）；随访２月至６年的４３眼中３４眼痊愈（７９．０％）。讨论了视网膜脱离的易发因素、术式选择、手术注意事项和预后。     

乌贼墨诱生小鼠细胞毒因子活性的检测

用乌贼墨处理小鼠后，采集血清。经体外细胞毒实验证明：乌贼墨诱生的血清对人和鼠的肿瘤细胞株均有不同程度的杀伤作用。这一结果提示：乌贼墨可能具有诱生内源性细胞毒因子产生的活性。     

大剂量卡铂化疗的药物毒性观察

6例肺癌患者接受了大剂量卡铂并自体骨髓移植治疗 ,卡铂剂量从 5 60～ 1375 mg/ m2 ,5例加用 VP～ 1630 0 mg,1例并用 MMC6mg和 VCR2 mg;主要毒性反应为白细胞、中性粒细胞、血小板减少和脱发 ( WHO毒性反应 ～ 级 )其次是贫血、皮肤粘膜出血、呕吐和可逆性肝功能损害 ,口腔粘膜溃疡及轻度发烧各 2例 ,一过性蛋白尿、室上性心动过速和便秘各 1例 ,尿素氮和肌酐未见升高 ;全部患者骨髓均获解救 ,从自体骨髓回输到骨髓造血功能重建成功平均 2 6.67( 17～ 32 )天     

Neuromuscular block with vecuronium reduces the rapidly extracted auditory evoked potentials index during steady state anesthesia

PURPOSE: During clinical monitoring, vecuronium appeared to reduce the rapidly extracted auditory evoked potentials index (A-line ARX index or AAI) to some extent. A prospective and randomized study was designed to analyze this phenomenon. METHODS: Forty adult patients undergoing elective surgery were studied. After tracheal intubation, anesthesia was maintained with an end-tidal isoflurane concentration (F(ET)ISO) of 1.0% for 20 min, then a 10-mL dose of either vecuronium 0.05 mg*kg(-1), 0.1 mg*kg(-1), 0.2 mg*kg(-1) or saline was administered in a randomized, double-blind design. The AAI and bispectral index (BI(hx)) were monitored throughout the study and analyzed off-line. RESULTS: BI(hx) was unaltered after the administration of saline or vecuronium. The mean of the averaged (per patient) AAI values recorded from two minutes to ten minutes after the administration of saline or vecuronium 0.05 mg*kg(-1) did not differ significantly from the corresponding mean recorded from 15 min to 20 min after F(ET)ISO maintained 1.0% (P = 0.678, 0.169), however after the administration of vecuronium 0.1 mg*kg(-1) or 0.2 mg*kg(-1), AAI was reduced from 18.3, 18.0 to 14.8, 13.4 (P = 0.016, 0.017). CONCLUSIONS: Neuromuscular block with vecuronium reduces AAI in patients during steady state anesthesia without surgical stimuli, while BI(hx) is unaltered. The cut-off values of AAI for events should be determined according to the level of neuromuscular blockade when monitoring the depth of anesthesia/sedation.     

Some sufficient conditions for global exponential stability of delayed Hopfield neural networks.

In this paper, we have derived some sufficient conditions for existence and uniqueness of equilibrium and global exponential stability in delayed Hopfield neural networks by using a different approach from the usually used one where the existence, uniqueness of equilibrium and stability are proved in two separate steps, rather we first prove global exponential convergence to 0 of the difference between any two solutions of the original neural networks, the existence and uniqueness of equilibrium is the direct results of this procedure. We obtain the conditions by suitable construction of Lyapunov functionals and estimation of derivates of the Lyapunov functionals by the well-known Young's inequality and Holder's inequality. The proposed conditions are related to p-norms of vector or matrix, p in [1, infinity] and thus unify and generalize some results in the literature.     

Innervation of the trapezius muscle: is cervical contribution important to its function?

OBJECTIVE: To study the effect of the cervical plexus and the accessory nerve to the function of the trapezius muscle. STUDY DESIGN AND SETTING: Eighteen adult male Sprague-Dawley rats were randomly divided into three groups. The neurotomies were performed in the left sides and the right sides served as within-subject controls. In group A, the accessory nerve was transected. The C2-5 were transected in group B, and both of the accessory nerve and C2-5 were cut in group C. The electrophysiologic, myophysiologic, and histologic changes of the muscles were measured. RESULTS: There were significant differences (P < 0.05) between the three groups in the recovery rates of the transverse area of the muscles. The CMAP recorded from the experimental sides in group B were similar to the control sides. The values of the maximum tension of the tetanus contraction between the two sides showed no differences either (P > 0.05). CONCLUSION: The accessory nerve supplies the most important motor input to the trapezius. Motor innervations of the cervical plexus are not very significant.     

Intracranial Extramedullary Hematopoiesis in β-thalassemia Major

A case of β-thalassemia major with a huge mass of hernatopoictic tissuc firmly attached tothe dura mater was reported This is the first case reported in China.