颈椎病前方入路术后恢复不良的原因分析

１９８０年１２月至１９９３年１２月，我科经前方入路治疗颈椎病并获随访１８３例，其中３７例（２０．２％）术后恢复不满意，ＪＯＡ恢复率小于６０％。根据主诉与症状，我们把这些病人分成４组。（１）术后症状立即加重，１年内仍无改善者４例。（２）术后症状无明显改善，１年后仍无进步者１１例。（３）术后症状减轻，但经过一段时间后，原症状又复出现者８例。（４）双下肢症状好转，但又出现新的上肢症状或上肢原症状加重者１４例。结合术后Ｘ线、ＣＴ、ＭＲＩ和椎管造影等检查所见，我们将发现的主要问题归纳为手术操作、病情发展演变、原有胸腰椎病和脊髓受压变性等情况。本文对以上发生的问题进行了分析，提出在以后的手术中应特别注意的事项。     

品酒之趣

点点酒意 带来神来之笔 酒赐予吾灵气。常酒后行文，数部拙著于案，盖盖于此！或得缪赞，以得酒资而侃之。     

几种中草药复配杀虫剂的急性毒性实验研究

为有效开发植物杀虫剂资源及今后的推广应用提供科学依据。用两种粉剂和两种醇剂的杀虫应用浓度给小白鼠灌,而家兔则行皮肤刺激试验。结果显示,除醒剂Y-13经口有中毒情况发生外,其它3种制剂均无中毒现象,醇剂Y-13的家兔皮肤也无刺激反应发生。作者认为:4种制剂在有杀虫效果的前提下,杀虫应用浓度对人和动物都较安全。有开发和推广应用价值。     

大,巨型垂体腺瘤的手术入路选择

自１９９０年以来收治直径在２－５．６ｃｍ的大、巨型垂体腺瘤３３例。依肿瘤生长形态与扩展范围将其简略分为三种类型。Ａ型：瘤体位于鞍内或侵入蝶窦；Ｂ型；瘤体呈椭圆形或哑铃向鞍上扩展，三脑室明显移位抬高；Ｃ型：瘤体巨大侵入三脑室阻塞室间孔或明显的鞍周扩展。     

青果微量元素的测定及其含量与功效的关系

用电感耦合等离子体发射光谱法(ICP—AES),同时测定了广州与潮州产青果中13种微量元素和宏量元素的含量,结果发现其含有多种人体必需和与乙型肝炎的发生发展有关的微量元素;初步讨论了它们与青果功效的关系。     

大鼠下丘脑及邻近区域催产素免疫阳性神经元与垂体后叶的关系

本文运用免疫细胞化学PAP及ABC法,显示大白鼠下丘脑内OXT免疫阳性神经元,并于垂体后叶注射WGA-HRP,显示下丘脑中逆行标记细胞,结合免疫细胞化学方法,观察下丘脑及其邻近区域内HRP与OXT双标记细胞,证实下丘脑视上核、室旁核、穹窿前核和后核、血管周细胞群、下丘脑视前区、下丘脑前区及外侧区、背侧副细胞群内、室周部、第三脑室侧壁室管膜细胞下及室间孔部室管膜细胞下,均有OXT免疫阳性神经元,其中至少部分神经元可发出向垂体后叶的投射纤维。位于第三脑室侧壁室管膜下及室间孔部室管膜下的神经元,可能监测脑脊液中各种因素的变化,调节垂体后叶OXT的分泌,也可能直接通过共树突向脑脊液内释放OXT。     

Polyarteritis Nodosa with Atrophy of the Left Hepatic Lobe

A 73-year-old Japanese man with a history of partial gastrectomy due to gastric cancer 4 years previously was admitted because of intermittent fever. The patient developed abdominal pain, erythema, and myalgia in addition to the fever during the final clinical course, and died of acute heart failure. Autopsy disclosed atrophy of the left lobe of the liver and acute myocardial infarction. Neither metastasis nor recurrence of the cancer was observed. Small and medium-sized arteries of the visceral organs showed various stages of necrotizing vasculitis with narrowing of the lumina. The vasculitis was most prominent in the left lobe of the liver and in the heart. Narrowing of the portal vein due to portal tract inflammation in addition to vasculitis of the hepatic arteries may have induced ischemia and infarction, which had resulted in atrophy of the left hepatic lobe. Acta Pathol Jpn 42: 662–666, 1992.     

Custom step wedge blocking using dynamic multileaf collimation for parametrial pelvic boost irradiation following brachytherapy for carcinoma of the cervix

Carcinoma of the cervix is typically treated with a combination of intracavitary brachytherapy and external beam radiation. The external beam dose is delivered with whole pelvis fields followed by split fields that protect midline organs at risk (bladder and rectum) while treating the parametria. Three approaches have been developed to shield midline structures: a simple rectangular block, a block customized to a single brachytherapy isodose line, and a step wedge filter constructed to conform to multiple brachytherapy isodose lines. A customized step wedge filter has the potential to produce a more homogeneous dose distribution but has not achieved widespread use due to labor intensive construction. We have developed a simple, novel method to produce a custom midline step wedge using dynamic multileaf collimation (dMLC). A comparison of film measurements in a phantom with the dose calculated by a commercial treatment planning system demonstrated agreement within 3% or 3 mm. The technique requires delivery times comparable to conventional techniques.