Differential risks of subsequent vascular events for transient ischaemic attack and minor ischaemic stroke.

Using a prospective hospital-based registry, 146 patients with transient ischaemic attack (TIA) were compared with 376 patients with minor first-ever ischaemic stroke with respect to the 3-month risk of subsequent vascular events, in order to clarify the distinctions between the disease entities. All patients were enrolled within 48 h of onset. The risk factor distribution for the two groups was comparable, except that the TIA patients had more previous TIAs. Large artery atherosclerosis (34%) and small vessel occlusion (32%) were the main aetiologies in the TIA group, whereas small vessel occlusion (49%) was the major cause in the stroke group. The 3-month risk of combined endpoints of stroke, myocardial infarction, and vascular death for TIA patients was higher than that for the minor stroke group (15.1% vs. 3.2%; hazard ratio 4.6, 95% confidence interval 2.3-9.3 in multivariate analysis). Large artery atherosclerosis and male sex were the other significant predictors. TIA may demand more urgent management than minor stroke. The fact that aetiology is a predictor, highlights the need for rapid diagnostic tests to establish pathogenesis.     

颈椎骨折类型与脊髓损伤关系之临床观察

通过对９２例颈椎骨折病例的分析，发现屈曲型损伤最多见（５３％），其次为过伸型（２６％），压缩型（２１％）。屈曲型和压缩型多见于年轻人，而屈曲损伤导致的脱位及过伸型则多见于年龄较大者。爆裂骨折引起的神经损害最重，其次为屈曲型、过伸型及压缩（非爆裂）骨折。神经功能改善率以爆裂型骨折最差，死亡率亦最高，以压缩（非爆裂型）骨折最好，其次为过伸型及屈曲型。文内对各型的特点进行了详细讨论。     

A method for calculating the mean absorption time of drugs undergoing reversible and first-pass metabolism

A method has been derived for calculating the mean absorption time of an oral drug and its interconversion metabolite which is generated from the drug systemically and presystemically. The method evolves from the convolution integral and requires plasma AUC and AUMC values after separate intravenous administration of the drug and its interconversion metabolite and oral administration of the drug. It can also be used to calculate the mean input time of a drug undergoing reversible metabolism and administered by any other extravascular route. Results of a simulation study using both errorless and errant data indicate that, when the absorption rate constant of a drug or its interconversion metabolite is not much larger than the apparent elimination rate constant, the proposed method performs satisfactorily. However, when the absorption rate constant of a drug or its interconversion metabolite is much larger than the apparent elimination rate constant, the proposed method appears to be inaccurate.     

便携式野战—Ⅰ型多功能骨科手术器械

一种便携式野战多功能骨科手术器械。重量仅１．１ｋｇ，体积为２１５ｍｍ×１０５ｍｍ×１５ｍｍ，如铅笔盒，而功能多达３３种，具有结构紧凑、操作简便、一械多用、轻巧便携。价廉实用、效价比高的特点。是基层巡诊、抢险救灾救治中适用的骨科器械。     

BUERGER'S DISEASE IN HONG KONG: A REVIEW OF 89 CASES

Background : A retrospective analysis of 103 case records from 1978 to 1996 with a provisional diagnosis of Buerger's disease was undertaken at the Department of Surgery, University of Hong Kong, Queen Mary Hospital. The aim of the study was to elucidate the clinical course and evaluate the results of surgical intervention of Buerger's disease in Hong Kong Chinese people. Methods : Fourteen patients were subsequently excluded from the study because of inability to fulfil our diagnostic criteria. Data on clinical presentation, investigations, indications and results of surgical intervention were reviewed. Sympathectomies and arterial reconstructions were performed on 42 and four patients, respectively, for critical ischaemia or rest pain. Outcome was analysed with respect to the rate of ulcer healing, pattern of recurrence and limb loss. Results : The patients were all young male heavy smokers with a mean age of 36.5 years. The majority of patients (80%) presented with ischaemic ulceration or gangrene. Vascular reconstruction was undertaken in four patients and satisfactory long-term results were obtained in three patients. Sympathectomy was able to relieve symptoms in 87% of operated patients and ischaemic ulceration healed in 2.6 (mean) ± 1.7 (SD) months after the operation. If the patient continued to smoke, surgical intervention did not exempt the patient from a relapse or amputation. Conclusion : Sympathectomy provides short-term pain relief and promotes ulcer healing in patients with Buerger's disease but carries no long-term benefit. Complete abstinence from smoking is the only means of arresting the progression of the disease.     

Duchenne型肌营养不良症

作者综述了１０年来对Ｄｕｃｈｅｎｎｅ型肌营养不良症（ＤＭＤ）的研究概况。主要包括①ＤＭＤ的临床研究。②血清生化研究表明ＣＫ、ＬＤＨ、Ｍｂ是诊断ＤＭＤ病人和携带者的敏感指标。③心脏无创性检测和肌肉超微结构研究。④部分抗肌萎缩蛋白基因ＹＡＣ物理图谱，精细限制酶图谱和缺失热区的核苷酸顺序分析，首次发现内含子中ＡＴ富集区的同源顺序与ＤＭＤ断裂有关。⑤抗肌萎缩蛋白的缺失热区疏水肽段存在与否与ＤＭＤ发病密切相关。     

中草药红背丝绸不同成分对内皮素-1效应拮抗作用的研究

本文用中草药红背丝绸醇提物、乙酸乙脂提取物和单体ＣＡ－１２０１ 三种不同成分对ＥＴ－１ 在动物整体及离体水平生物学效应的拮抗作用进行了研究。结果发现：这三种成分对ＥＴ－１ 致小鼠进行死亡有保护作用，使得小鼠的死亡率及死亡数下降；并可拮抗ＥＴ－１ 致胸主动脉的缩血管效应，醇提物和乙酸乙脂提取物（１０－ ７母液）拮抗ＥＴ 缩血管效应分别为５７．２７％ 和５８．６１％ ；ＣＡ－１２０１ １０－ ８和１０－ ９ Ｍ 亦能拮抗ＥＴ－１ 的缩血管效应；醇提物和乙酸乙脂提取物口服及ＣＡ－１２０１ 静脉注射后能拮抗ＥＴ－１ 的升压作用，拮抗ＥＴ－１ 作用均呈现明显的剂量依赖性。提示中草药红背丝绸不同成分可拮抗ＥＴ－１ 的生物学效应。     

单侧鼻前庭切口经蝶切除垂体腺瘤

对１６例垂体腺瘤采用单侧鼻前庭切口经蝶切除，效果满意，既可减少手术创伤，又缩短了手术距离，且避免了美容缺陷，是一种设计巧妙，较为实用的手术方法，尤其适用于生长激素腺瘤。     

Demonstration of synergistic effects of hyperthermia and photodynamic therapy using the chick chorioallantoic membrane model.

The chick chorioallantoic membrane (CAM) model was used to study vascular effects of photodynamic therapy (PDT) and hyperthermia (HPT) and the synergism of these modalities. The CAM is a convenient medium for monitoring the modifications of the vasculature. It is possible to view the CAM and to examine structural changes of individual blood vessels in real time. Moreover, the CAM is a closed system which lends itself to mathematical modeling of the temporal and spatial temperature profile and in which HPT can be performed quantitatively and to a selected depth, using different lasers. A porphyrin-type photosensitizer solution was applied to areas of the CAM, defined by teflon O-rings placed on the surface. Uptake dynamics of the sensitizer into the CAM was determined by analyzing its fluorescence in vivo. The CAM area was irradiated with a dual-wavelength laser system composed of a dye laser at 644 nm (to induce PDT) and a CO2 laser at 10.6 microns (to bring about HPT). Damage to the CAM vasculature, due to combined PDT+HPT, was compared to the outcome of the separate modalities, and a synergistic effect of about 40% was observed.