切开复位内固定治疗髋臼骨折

目的:探讨切开复位内固定在治疗髋臼骨折中的临床应用价值。方法 :采用切开复位内固定治疗有移位的髋臼骨折共 15例。手术入路采用 Kocher- L angenbeck(K- L)入路 7例 ,髂腹股沟入路 3例 ,髂股加 K- L 入路 3例 ,三射线入路 2例。结果 :解剖复位 10例 ,满意 3例 ,差 2例。随访功能评分优 7例 ,良 3例 ,可 2例 ,差 3例。结论 :切开复位内固定已成为多数有移位髋臼骨折的治疗标准 ,L etournel分类对手术入路有很好的临床应用价值     

国人跟骨距关节面的形态研究

观察329块(男193,女136)国人成年跟骨的距关节面形态。其中A型出现率,男为45.08±3.58％,女为41.18±4.22％;B型出现率男为53.89±3.59％,女为58.82±4.22％;C型仅男性出现2例,占1.04±0.73％。成套标本中,距关节面左右对称的,男性90例中有81例,占90.00±3.16％;女性67例中有59例,占88.06±3.96％。经统计学处理,侧别间及性别间均无明显差异。文内结合观察结果提出自己的分型标准及类型,并与以往资料进行了比较。     

山羊急性心肌缺血时恶性心律不齐的发生和...

The coronary collateral circulation of goat is very spare, so myocardiac ischemia model of goat can simulate the patient previously with normal coronary circulation and suddenly developing complete occlusion of coronary arteries. In this study 80 Chengdu goats were used, and the branches of their left coronary artery were ligated. Ventricular tachycardia (VT) developed in 23 goats and ventricular fibrillation (VF) in 39 goats. VT and VF both occurred in the early phase of acute myocardial ischemia, and both had 6 min as the median time of onset. In 71 cases data on the weight of myocardiac ischemic area were collected, in which the weight percentage of ischemic area relating to the ventricles of 34 goats with VF was significantly higher than that of 37 goats without VF (35.4 +/- 2.4% vs 19.5 +/- 1.9%). After coronary ligation, 9 cases directly precipitated into VF which could not be defibrillated. In the remaining 62 cases, the weight percentage of ischemic area of 21 cases with VT was higher than that of 41 cases without VT (32.9 +/- 2.8% vs 20.9 +/- 2.1%). The relationships between the incidence of VT or VF and the weight percentage of ischemic area were fitted with logistic curve. The likelihood of occurrence of VT or VF is increased as the weight percentage of ischemia area goes up.     

牙源性脓肿标本中的产黑色素类杆菌群菌株分离鉴定

本文对４４例牙源性脓肿（尖周脓肿２４例，牙周脓肿１２例，冠周脓肿８例）脓液标本中的产黑色素类杆菌群菌株进行分离、培养、鉴定。其中３８例存在产黑菌群，以中间型类杆菌阳性率最高。牙龈类杆菌在牙周脓肿中检出率最高。２４例尖周脓肿可分离出６株牙髓类杆菌而其它两种牙源性脓肿则无牙髓类杆菌，推测该菌与牙髓尖周感染的病理过程有关。     

母体钙代谢与补钙对妊娠的影响

妊娠期缺钙严重影响母婴的安全健康 ,其原因是由于妊娠期母体钙代谢发生变化 ,使母体血清游离钙离子浓度降低 ,血清铅浓度增高。有关研究表明 ,母体缺钙导致血铅竞争性过高 ,使胎儿身长、体重均小于胎龄儿 ,胎儿宫内发育迟缓的发生率增高 ,甚至发生早产、死胎等。同时发现血清钙离子可能对内源性一氧化氮合成释放起调节作用 ,而内皮素是最强的缩血管物质之一 ,母体补钙可调节一氧化氮与内皮素的平衡 ,从而降低妊高征的发生率。因此孕期补充钙剂是非常重要的。     

Development of specificity in corticospinal connections by axon collaterals branching selectively into appropriate spinal targets

Corticospinal projections in adult rodents arise exlusively from layer V neurons in the sensorimotor cortex. These neurons are topographically organized in their connections to spinal cord targets. Previous studies in rodents have shown that the mature distribution pattern of corticospinal neurons develops during the first 2 weeks postnatal from an initial widespread pattern that includes the visual cortex to a distribution restricted to the sensorimotor cortex. To determine whether specificity in corticospinal connections also emerges from an intially diffuse set of projections, we have studied the outgrowth of corticospinal axons and the formation of terminal arbors in developing hamsters. The sensitive fluorescent tracer 1, 1′, dioctadecyl-3, 3, 3′, 3′-tetramethylindocarbocyanine perchlorat (DiI) was used to label corticospinal axons from the visual cortex or from small regions of the forelimb or hindlimb sensorimotor cortex in living animals at 4–17 days postnatal. Initially axon outgrowth was imprecise. Some visual cortical axons extended transiently beyond their permanent targets in the pontine nuclei, by growing through the pyramidal decussation and in some cases extending as far caudally as the lumbar enlargement. Forelimb sensorimotor axons also extended past their targets in the cervical enlargement, in many cases growing in the corticospinal tract to lumbar levels of the cord. By about 17 days postnatal these misdirected axons or axon segments were withdrawn from the tract. Despite these errors in axon trajectories within the corticospinal tract, terminal arbors branching into targets in the spinal gray matter were topographically appropriate from the earliest stages of innervation. Thus visula cortical axons never formed connections in the spinal cord, forelimb sensorimotor axons arborized only in the cervical enlargement, and hindlimb cortical axons terminated only in the lumbar cord at all stages of development examined. Corticospinal arbors formed from collaterals that extended at right angles from the shafts of primary axons, most likely by the process of interstitial branching after the primary growth cone had extended past the target. Once collaterals extended into the spinal gray matter, highly branched terminal arbors formed within 2–4 days, beginning at about 4 and 8 days postnatal for the cervical and lumbar enlargements, respectively. These results show that specificity in connectivity is achieved by selectivty growth of axon collaterals in to appropriate spinal targets from the beginning and not by the later remodeling of intially diffuse connections. In contrast, errors occur in the initial outgrowth of axons in the corticospinal tract, which are subsequently corrected. Copyright © 1994 Wiley-Liss, Inc.     

二维彩色多普勒超声心动图诊断扩张型心肌病（附100例分析）

应用ＡＴＬ－ｕｌｔｒａｍａｒｋ超６型彩色多普勒超声诊断仪诊断扩张型心肌病１００例，并与性别、年龄相应的正常人对比分析。结果：除扩张型心肌病各组室间隔及左室后壁舒张期厚度与相应正常对照组相比无显著性差异（Ｐ＞０．０５）外，其左室舒张内径及收缩内径、左房内径明显大于正常对照组（Ｐ＜０．０１），左室射血分数及左室内径缩短分数较正常对照组明显降低（Ｐ＜０．０１），并见心腔内血流速度缓慢，颜色变淡。另在７７例病人中探及４０例瓣膜返流。提示该诊断方法对扩张型心肌病具有直观、简便、准确、迅速的优点，为本病的诊断及鉴别诊断提供了良好的手段。     

天麻素对缺血再灌注神经细胞膜的保护作用

用新生Wistar大鼠大脑皮层进行神经细胞培养 ,将培养 8d的神经细胞置于模拟“缺血”状态下 ,5h后神经细胞发生肿胀 ,胞内乳酸脱氢酶 (LDH)漏出增加 ,膜流动性下降、脂质过氧化(LPO)含量增加 ;将经过“缺血”损伤神经细胞置 1 8h模拟“再灌注” ,“再灌注”后细胞数目明显减少 ,LDH的漏出、膜流动性下降和LPO增加继续加重 ,说明细胞损伤进一步加重。经过天麻素孵育后的神经细胞“缺血”或“再灌注”后LDH的漏出及LPO含量明显低于损伤组 ,而膜流动性则明显高于损伤组。表明 :天麻素对体外培养神经细胞的缺血再灌注损伤有保护作用     

潘库溴铵在婴幼儿、儿童和成年人的药代动力学

研究观察年龄对潘库溴铵药代动力学的影响，选择24例施择期整形外科手术的患者，根据年龄分成三组：1组为5例婴幼儿，年龄0．75－2．95岁；2组为13例儿童，年龄4－14岁；3组为6例病人，年龄16－27岁，静注潘库溴铵100ug/kg后用改良蒌光法测定其血浓度，潘库溴铵的体内过程能用二室开放模型完整描述，年龄愈小，分布容积愈大，血浆清除率愈高，潘库溴铵的血药浓度愈低，V1（中央室分布容积），V2（周边室分布容积），Vdss(稳态分布容积），C1（血浆清除率）和AUC（曲线下面积）在三相间有明显差别，1组的T1／2β和MRT明显比2，3组长，但T1／2α和K21在三组间无明显差别。