对截石位手术床腿架装置的改进与制作

目的针对目前手术室使用的截石位手术床腿架存在调节费力、螺丝松脱会造成病人大腿受伤的问题,笔者设计了一种可以通过前后移动来调整高度的截石位手术床腿架。方法手术床腿架主干采用不锈钢材质制作,由主撑、滑套、斜撑、撑杆和腿托5个部分组成,主撑和斜撑分别固定于手术床床尾同一侧的上下选定部位,滑套套装在主撑上,与斜撑相连;斜撑为气弹簧组件,其长度可调,用来调节腿架的高度,腿托通过可以左右两个自由度活动的撑杆固定在滑套上。结果它操作方便,升降平缓安全,解决了操作费力及存在安全隐患的问题。结论较之原先未改进的手术床腿架,缩短了手术摆位时间,更易于调整双腿分开角度,提高了腿位放置的舒适度,医生、护士使用操作更加灵活、方便、可靠。     

Intravenous infusion of propofol for induction and maintenance of anaesthesia during endoscopic carbon dioxide laser ENT procedures with high frequency jet ventilation

Fourteen patients of ASA grades 1 3 were anaesthetised with continuous infusions of propofol and alfentanil for endoscopic carbon dioxide laser ENT microsurgery. Their lungs were ventilated with an oxygen-air mixture using a high frequency jet ventilator. Propofol was given at an initial rate of 120 μg/kg/minute for 10 minutes after a bolus dose of 2.6 mg/kg, and then at 80 fig μg/kg/minute. Alfentanil was given at a rate of 0.5 μg/kg/minute. Arterial pressure decreased significantly after the bolus dose. It increased significantly for a few minutes after laryngoscopy and returned to baseline values during maintenance of anaesthesia. Heart rate increased significantly during induction and until laryngoscopy was performed but it decreased below its initial value after 5 minutes of maintenance. Platelet count and the degree of aggregation did not change during infusion of propofol.     

Autologous melanocyte–keratinocyte suspension in the treatment of vitiligo

Background In stable vitiligo, several techniques of autologous transplantation of melanocytes are used. Autologous melanocyte transplantation of non‐cultured melanocytes is one of those techniques with variable reported outcomes. Objective The objective of this study was to evaluate the response to autologous melanocyte–keratinocytes suspension transplantation in cases of stable vitiligo. Methods A total of 25 cases of vitiligo were treated by autologous melanocyte–keratinocytes suspension transplantation. After 6–17 months, patients’ response was evaluated according to the extent of pigmentation (excellent 90–100%, good 50–89%, fair 20–49% and poor response <20%). Results Of the 25 patients treated, 22 continued the follow‐up period. Five (23%) patients showed excellent response, 7 (32%) good, 6 (27%) fair and 4(18%) showed poor response. Conclusion Unlike transplantation of cultured melanocytes, which requires experience in culture technique, autologous melanocyte–keratinocytes suspension transplantation is an easy economic technique, which may be used in resistant areas of stable vitiligo.     

Broadening the spectrum of controls for skin biopsy in painful neuropathies

Epidermal nerve fiber density (ENFD) is useful in the evaluation of small‐fiber neuropathies (SFSNs). A recent evidence‐based review highlighted the need to broaden the spectrum of ENFD controls to include lower limb pain states other than polyneuropathy. We studied epidermal innervation in multiple sclerosis (MS) and distal lower limb burning pain (DLLBP). Distal‐leg ENFD/morphology in MS DLLBP patients did not differ significantly from that of healthy controls. This study extends the range of ENFD controls and further supports use of ENFD assessment in SFSN. Muscle Nerve, 2010