健康和病变人声带振动特性声门图

本文用多功能声门图仪测定了健康受试者(男46名,女34名)和不同喉病患者(男134名,女87名)声门图的波形及其特征参数。根据测出的正常声门图及其参数分布研究了恶性喉病变、声带麻痹、喉内关节病变、功能性声门发声障碍、声带息肉、声带小结、喉炎和早期喉病的临床声门图表现及其与声带振动模式变异之间的关系,并探讨了上述病变声门图的鉴别诊断指标和用声门图对喉病手术治疗、药物治疗和功能治疗的疗效进行定性和定量评价。研究结果证实:声门图方法能准确、定量、灵敏地反映声带振动模式及其变异;在喉病诊治中具有重要的应用价值。     

Adenosine''s role in the genesis of bradyarrhythmias induced by acute myocardial hypoxia.

A close or even causal relation between myocardial adenosine and bradyarrhythmias during acute myocardial hypoxia was testified in guinea pig, rabbit and dog mainly by using specific competitive antagonist and synchronous quantitative analysis of 3 variables: intensity of myocardial hypoxia, degree of endogenous adenosine increment and severity of bradyarrhythmias. Results disclosed: A) striking resemblance of the bradyarrhythmias with hypoxic origin to those caused by exogenous adenosine, B) same locality of A-V conduction block induced by both myocardial hypoxia and exogenous adenosine, C) precise parallelism among the above-listed 3 variables with very high correlativity (r = 0.99, P < 0.01), D) frequent accompaniment of reversal of hypoxic bradyarrhythmias through resupply of 21% O2 with normalization of preexisted increase in myocardial adenosine, E) satisfactory blockade of hypoxic bradyarrhythmias by adenosine's specific antagonist--aminophylline and their augmentation by adenosine's uptake inhibitor--dipyridamole, F) close similarity of the characteristic curve representing relation among the above 3 variables to that among intensity of myocardial hypoxia, degree of endogenous adenosine increment and amount of coronary blood flow in which adenosine's role as a mediator has been well documented and G) reproducible persistence of bradyarrhythmias during myocardial hypoxia irrespective of preliminary vagotomy and atropinization, denoting independence of the occurrence of such dysarrhythmias upon vagal drive, suggestive of a mechanism other than vagotonia. We advocated that hypoxia-induced bradyarrhythmias was caused by increment in endogenous adenosine.

     

伴严重增殖性玻璃体视网膜病变视网膜脱离的玻璃体手术及失败原因探讨

本文报导采用现代玻璃体手术结合巩膜扣带、空气或硅油填塞治疗81例伴严重增殖性玻璃体视网膜病变(PVR)视网膜脱离的手术效果.经过6～28个月(平均14个月)的随访,视网膜完全平伏者54例,成功率66.7%,对极严重的PVR D(?)(闭斗状脱离)也取得50%的成功率.硅油填塞初步应用于极严重病例尤其是巨大裂孔的治疗,取得明显的效果.本文病例术后视力提高者50例,不变19例,下降12例,术后视力在0.05以上者共34例.认为玻璃体手术结合其它技术是伴严重PVR手术治疗的有效方法,提出进一步提高PVR治疗成功率的方法:彻底清除增殖膜及寻找一种有效抑制膜增殖而对眼内其它组织无毒性的药物。指出旧的PVR分级法存在的不足,推荐用于硅油研究的PVR新的分级法.     

Preexpanded distant "super-thin" intercostal perforator flaps for facial reconstruction without the need for microsurgery.

BACKGROUND: Concept of the 'super-thin perforator flap' was introduced in 1994 by authors. Since then, various types of 'super-thin perforator flaps' were applied successfully especially for contour sensitive reconstruction such as face and neck. METHODS: Eleven patients requiring large flaps who presented with extensive disfiguring facial scar (male: seven cases, female: four cases). On the consideration of flaps' colour, texture and thickness requirements, the authors selected 'super-thin' anterior intercostal perforator flaps (AICP, range from 4 x 14 cm to 25 cm x 9 cm) for reconstruction purpose. First, tissue expanders (volume range from 800 cc to 1200 cc) were carefully inserted under the AICP. After the flaps were expanded for 2 months, distant scars were removed and the covering super-thinned flaps were transferred into recipient site. Two weeks later, pedicles in the anterior chest were cut down and flaps were transferred to replace all the left scars. RESULTS: Flap were survived without any complications. The colour, texture and thickness of the transferred flap were satisfactory, shrink of flaps were not observed after long term follow-up. The authors present a method of facial reconstruction that has the advantages of creating a large amount of thin tissue of both good colour and texture, without the need of microsurgery and few disadvantages of donor-site morbidity. The disadvantages are three-staged procedures, complications of tissue expansion and uncomfortable compulsory posture for patients. In our opinion, this is an alternative method of choice for reconstructing all large defects in the lower two-thirds of the face.     

多巴酚丁胺负荷对缺血性扩张型心肌病患者左心室充盈的影响：病理生理学及预后意义

目的：本研究旨在探讨多巴酚丁胺对缺血性心肌病（ICM）患者左心室（LV）充盈功能的影响，并确定峰值负荷时限制性充盈型（RFP）是否具有预后预测价值。背景：ICM患者峰值负荷时RFP的预后价值尚属未知。方法：在静息和负荷情况下，采用多普勒超声心动检查研究了69例ICM患者；RFP定义为跨二尖瓣E／A比≥1．0、等容舒张时间（IVRT）〈80ms及E波减速时间（EDT）〈120ms。结果：69例患者中有42例静息时出现RFP，其中有24例患者负荷情况下转变为非RFP（EA），18例患者RFP持续存在（EE）；69例患者中27例静息和峰值负荷时均无RFP（AA）。     

类风湿关节炎掌指关节尺侧偏斜的预防与矫治器的临床应用研究

[目的]预防和矫治类风湿关节炎掌指关节尺侧偏斜,提高病人的生活自理能力。[方法]选取戴矫治器的病人305只手作为观察组,另选不戴矫治器的病人295只手作为对照组,观察至少3个月以上。[结果]戴矫治器病人的手发生掌指关节尺侧偏斜的明显低于不戴矫治器的病人的手。[结论]戴矫治器后明显降低了病人掌指关节尺侧偏斜的发生率,同时也使已发生掌指关节尺侧偏斜病人的手能及时矫正,恢复部分生活自理能力。