XD—1型微电脑程序刺激器在心血管病中的临床应用

本文应用XD—Ⅰ型微电脑程序刺激器检查26例患者,在窦房结功能检查中测定了窦房结恢复时间、窦房传导时间及固有心率;在房室传导功能的估计中测定了文氏点,2∶1阻滞点及房室结的有效不应期;在室上性心动过速中测定了旁路不应期,房室结双通道,折返区及折返性心动过速区;还进行了心脏负荷试验及右束支不应期等方面的测定。并就其方法,判断标准及临床意义等分别作了讨论。     

The use of the facial translocation technique in the management of tumors of the paranasal sinuses and skull base.

OBJECTIVE: We sought to assess the efficacy of facial translocation in the management of tumors of the skull base and paranasal sinuses. STUDY DESIGN AND SETTING: From July 1993 to December 1999, 75 patients, aged 3 to 102 years old, underwent facial translocation. Thirty-three (44%) patients also underwent a combined neurosurgical procedure. Nineteen (25%) had previous surgery. These patients were followed up to 6 years. RESULTS: There were 21 benign and 54 malignant tumors. There were no perioperative deaths. The morbidity rate was 31%. Of the 54 patients with malignant tumors, the actuarial 3-year survival rate was 59%, whereas the local control rate was 54%. CONCLUSION: The facial translocation technique offers favorable exposure of the critical zones of the anterior and middle cranial base, thus facilitating extensive resection and reconstruction. SIGNIFICANCE: This study demonstrates that facial translocation is one of the best surgical approaches to the skull base.     

Coronary permeability and left ventricular function following thrombolytic therapy

We study 40 patients, 55 +/- 7 years old with acute myocardial infarction treated early by thrombolytic therapy (20 STK and 20 rt-PA). All patients were angiographically studied in the following conditions: 1) baseline, before initiating therapy. 2) Three hours after treatment. 3) Twenty four hours later. 4) Before discharge. The infarct related artery was patent 24 hours after treatment in 31 patients (78%); five of them were patent before treatment, and we observed an early reperfusion in 20 patients (57%) and late reperfusion in 6 patients (17%). The number of patients with angiographic evidence of intraluminal thrombus decreased progressively through conditions while the grade TIMI of coronary perfusion increased in the absence of reocclusion. Final regional wall motion of infarct related myocardial zones and their degree of recovery were significantly higher in recanalized patients, as compared with non-reperfused patients. Similarly, left ventricular functional recovery was higher in patients with antegrade of collateral flow to the infarct area, as compared with totally occluded patients.     

Spectroscopic imaging of the pilocarpine model of human epilepsy suggests that early NAA reduction predicts epilepsy.

Reduced hippocampal N-acetyl aspartate (NAA) is commonly observed in patients with advanced, chronic temporal lobe epilepsy (TLE). It is unclear, however, whether an NAA deficit is also present during the clinically quiescent latent period that characterizes early TLE. This question has important implications for the use of MR spectroscopic imaging (MRSI) in the early identification of patients at risk for TLE. To determine whether NAA is diminished during the latent period, we obtained high-resolution (1)H spectroscopic imaging during the latent period of the rat pilocarpine model of human TLE. We used actively detuneable surface reception and volume transmission coils to enhance sensitivity and a semiautomated voxel shifting method to accurately position voxels within the hippocampi. During the latent period, 2 and 7 d following pilocarpine treatment, hippocampal NAA was significantly reduced by 27.5 +/- 6.9% (P < 0.001) and 17.3 +/- 6.9% (P < 0.001) at 2 and 7 d, respectively. Quantitative estimates of neuronal loss at 7 d (2.3 +/- 7.7% reduction; P = 0.58, not significant) demonstrate that the NAA deficit is not due to neuron loss and therefore likely represents metabolic impairment of hippocampal neurons during the latent phase. Therefore, spectroscopic imaging provides an early marker for metabolic dysfunction in this model of TLE.     

前臂逆行骨间背侧皮瓣的临床应用

目的总结前臂逆行骨间背侧皮瓣的临床疗效。方法回顾性分析42例前臂逆行骨间背侧皮瓣，并结合文献阐明其变异程度及变异的处理。结果骨间背侧血管在前臂中1／3缺如1例．皮瓣边缘坏死；皮瓣向近端延伸超过4cm者4例，远端坏死，延迟愈合；其余均一期愈合：结论虽然前臂骨间背侧血管有变异，但前臂逆行骨间背侧皮瓣仍是修复手背中等大小创面较为理想的方法，以近点皮肤穿支向近端延伸皮瓣不要超过4cm。     

Hand hygiene and glove use behavior in an Italian hospital.

In an Italian hospital, we observed that hand hygiene was performed in 638 (19.6%) of 3,253 opportunities, whereas gloves were worn in 538 (44.2%) 1,218 of opportunities. We observed an inverse correlation between the intensity of care and the rate of hand hygiene compliance (R2=0.057; P<.001), but no such association was observed for the rate of glove use compliance (R2=0.014; P=.078). Rates of compliance with hand hygiene and glove use recommendations follow different behavioral patterns.     

人胎儿前庭器超微结构的观察

对人胎儿前庭器超微结构的研究,国内外报道甚少。本文对18至36周人胎儿颞骨10具进行了扫描电镜和透射电镜的观察,并对应用Surface preparation法制做人胎儿前庭器标本的方法进行了探讨。本文观察所见:豚鼠平衡斑的生理状态与人胎儿很近似,体面积比人胎儿平衡斑小,感觉毛长,细胞排列更整齐。28周以后的胎儿因前庭周围骨质变硬,制做标本时可以分别取出两囊斑和壶腹嵴。     

重症肌无力患者泼尼松治疗前后免疫学指标的变化

探讨泼尼松治疗重症肌无力（MG）免疫学机制。对382例MG患者在漏尼松中剂量冲击，小剂量维持疗法治疗前后，检测酰胆碱受体抗炎（AchRab)，突触前膜抗体（PsMab)，单个核细胞亚群（PBMC），肿瘤坏死因子（TNF），可溶性白介素－2受体（SIL－2R），β2－微球蛋白（β2－m)，以及红细胞免疫功能的变化。结果表明：MG患者在泼尼松治疗前后多项免疫指标有显著性的变化。为泼尼松治疗MG提供了评定疗效的免疫学指标，进一步阐明了MG发病的免疫学机制。     

A novel DRB1*09 allelic sequence in the Jing ethnic minority of China.

A new DRB1 allele, DRB1*0902, has been identified in an individual of the Jing ethnic minority. Its sequence was confirmed by sequencing of PCR products and clones. This allele differed by three nucleotides from DRB1*09012 at positions 157, 161 and 166, and resulted in amino acid motif substitution from VAES to DAEY.