神经移植端侧缝合颈5/7神经根与上干桥接治疗产瘫

目的：探讨一种不影响残存神经自行恢复的产瘫臂丛神经修复新方法。方法：将上干损伤部位行松解,不切除神经瘤,将其近端的颈5或颈7神经根和神经瘤远端的臂丛上干的神经束膜切开窗口,取颈丛皮支或前臂外侧皮神经前成多段（一般每段长约2．0－2．5cm）,两端分别与颈5神经根和上干的神经束膜行端侧缝合,结果：8例患儿经术后1－11年（平均3年）的随访,4例的三角肌和肱二头肌骨力达4级和4^-级,4例达3例。3例后期进行了肩关节松解和旋前圆肌肌腱切断,结论：该方法既提供了可使损伤近端颈5神经根的新生纤维生长至上干的神经通道,又未阻断神经瘤内残存神经纤维的自行恢复,是治疗产瘫特别是Tassin2型的新术式。     

渤海鱼类和头足类异尖科线虫幼虫感染情况调查

[目的 ]调查渤海鱼类和头足类异尖科线虫幼虫感染情况 .[方法 ]对渤海 2 5种鱼 2 90尾和 3种头足类 10 8尾进行剖检 .[结果 ]发现 19种鱼 15 6尾和 1种头足类 8尾感染异尖科线虫幼虫 6种 ,计73 2 7条 .从 15种鱼 (N =191)中的 12 1尾 ( 63 4 % )和一种头足类 (N =5 4 )中的 8尾 ( 14 8% )体内检出简单异尖线虫幼虫 5 992条 ,占总数的 81 8% ,4种鱼是本幼虫的新发现宿主 .其余 13 3 5条幼虫中 ,15 4( 2 1% )条为鲔蛔线虫B型幼虫 ,采自 4种鱼 2 3尾 ;10 13 ( 13 8% )条为鲔蛔线虫C型幼虫 ,采自 13种鱼79尾 ;164( 2 2 % )条为宫脂线虫中国V型幼虫 ,采自 4种 2 0尾鱼 ;2种鱼感染针蛔虫幼虫 3条 ;仅发现 1条伪新地蛔虫幼虫 .     

抗角蛋白自身抗体对银屑病裸鼠皮损移植模型的影响

目的：建立银屑病裸鼠皮损移植模型,观察抗角蛋白自身抗体（AK auto Ab)对银屑病动物模型的影响。方法：将人体银屑病皮损组织块移植于裸鼠背部,移植后一组裸鼠腹腔注射纯化的人体AK auto Ab,另一组裸鼠腹腔注射生理盐水作为对照,从组织病理变化评价银屑病裸鼠皮损移植模型的可行性以及AK auto Ab对移植的银屑病皮片组织学改变的影响。结果：对照组皮损植片相当一段时间内能稳定地维持银屑病的部分重要组织学改变,而AK auto Ab注射组则可使银屑病的组织学特征的维持时间明显缩短。结论：银屑病裸鼠皮损移植模型是银屑病短期内理想的动物模型,AK auto Ab具有促进银屑皮炎恢复的作用。     

丙肝宁对动物实验性肝损伤的保护作用

目的 研究中药复方丙肝宁的保肝作用。方法 采用Ｄ－Ｇａｌ造成大鼠的急性肝损伤模型和ＣＣＩ４所致慢性肝损伤模型。结果 丙肝宁２个剂量组对Ｄ－Ｇａｌ造成大鼠的急性肝损僵模型和ＣＣＩ４所致慢性肝损伤模型的血清酶活性均具有明显的抑制作用（Ｐ〈０．０５,Ｐ〈０．０１）,病理检查结果表明,丙肝宁２个剂量组对Ｄ－Ｇａｌ造成大鼠的急性肝损伤模型和ＣＣＩ４所致慢笥肝损伤模型的肝脏病理形态的改变具有明显的改善作用。结     

Dynamic assessment of the electrocardiographic QT interval during citrate infusion in healthy volunteers.

OBJECTIVE--To investigate changes in the electrocardiographic QT interval during rapidly induced, sustained hypocalcaemia in healthy volunteers. DESIGN--Serial rate corrected QT measurements were made during and after a variable rate trisodium citrate infusion designed to "clamp" the whole blood ionised calcium concentration 0.20 mmol/l below baseline for 120 min. SUBJECTS--12 healthy teetotallers aged 19- 36 years who were not receiving medication known to influence calcium homoeostasis. MAIN OUTCOME MEASURES--Whole blood ionised calcium concentration and QaTc intervals (onset of the Q wave to T wave apex divided by the square root of the RR interval). RESULTS--Mean (SD) ionised calcium concentration decreased from 1.18 (0.03) mmol/l preinfusion to values close to target (0.98 mmol/l) between 10 and 120 min. The QaTc interval lengthened from a baseline of 0.309 (0.021) to a maximum 0.343 (0.024) s0.5 at 10 min before returning to a stable level from 15 to 120 min (0.334 (0.023) and 0.330 (0.023) s0.5 respectively). The change from baseline of both variables expressed as a ratio (delta QaTc/ delta [Ca2+]) was greater during rapid induction of hypocalcaemia (at 5 and 10 min) than at other times during and after the infusion (P < 0.02). CONCLUSIONS--The disproportionate prolongation of QaTc interval during prompt induction of hypocalcaemia suggests rate dependency which can be represented by a hysteresis relation between (ionised calcium, QaTc) coordinates. This finding may have clinical implications.     

不同方法制作犬腹主动脉瘤模型的比较

目的：探讨用于检验带膜记忆合金支架血管腔内搭桥治疗动脉瘤的模型。方法：分别以实验动物腹直肌后鞘、Ｄａｃｒｏｎ补片、不同口径的Ｄａｃｒｏｎ人血管及球囊导管材料,采用四种不同手术方法制作腹主动脉瘤模型。结果：１１例动物１０例模型制作成功,１例死亡,１月后造影检查发现９例的动脉瘤模型形态满意,１例动脉脉瘤扩张程度较差。结论;以腹阗甩垢鞘为材料制作动脉瘤模型具有取材方便,操作简便、不易漏血、无异物反应的优     

Burden of caregiving in mild to moderate dementia: an Asian experience

This survey sought to determine (a) the prevalence of carer stress in patients with mild to moderate dementia, (b) whether caregiver burden was already associated with plans to institutionalize patients, and (c) which patient-related and caregiver-related variables best predicted caregiver burden. The principal caregivers of 93 Asian patients with mild to moderate dementia attending an outpatient cognitive assessment clinic were interviewed via a structured questionnaire that focused upon (a) patient-related variables such as their behavioral and functional abnormalities; and (b) caregiver-related variables such as whether they were having problems looking after the patients, the duration of their caregiving, their associated feelings of anger and/or depression, and their financial status as well as intentions to institutionalize patients. Forty-nine percent of caregivers reported problems in looking after the patients, and their perception of difficulties was significantly associated with institutionalization plans for the patients. Logistic regression analysis using a forward variable selection procedure showed two of the patients' behavioral abnormalities (repetition, agitation) and one of their functional impairments (urinary incontinence) as well as the carers' depressed feelings to be predictive of the carers' problematic status, explaining 40% of the variance. It is important that even in the early stages of dementia, the medical assessment also evaluate behavioral, functional, and social dimensions of the illness, so that appropriate interventions can be implemented to reduce caregiving burden and delay institutionalization.     

Treatment of femoral neck nonunions with a sliding compression screw: comparison with and without subtrochanteric valgus osteotomy

BACKGROUND: The aim of this prospective study was to investigate and compare the results of treatment of femoral neck nonunions using a sliding compression screw (SCS) with and without subtrochanteric valgus osteotomy (SVO). METHODS: Thirty-two consecutive patients with femoral neck nonunions, which sustained no osteonecrosis of the femoral head based on bone scan study, were prospectively treated with SCS with (21 patients) or without (11 patients) SVO. The indication for SCS with SVO was a femoral neck nonunion with leg shortening of more than 1.5 cm. SCS without SVO was for leg shortening of less than 1.5 cm. RESULTS: Seventeen patients with osteotomy and nine patients without osteotomy were followed for at least 2 years (range, 2-8 years). All femoral neck fractures healed, with a union period of 4.6+/-1.0 months (95% confidence interval, 4.1-5.1 months) for osteotomy cases and 4.6+/-1.1 months (95% confidence interval, 3.8-5.4 months) for nonosteotomy cases (p = 0.83). However, in the osteotomy group, two patients sustained osteonecrosis of the femoral head, and nonunion remained in 1 patient at the osteotomy site (complication rate, 18%; 3 of 17 patients). There were no complications in the nonosteotomy group (p = 0.26). The average lengthening achieved from osteotomy was 1.0 to 1.5 cm (p < 0.001). CONCLUSION: Using SCS without SVO to treat femoral neck nonunions can result in a very satisfactory outcome. It is thus preferred for indicated patients. SCS without SVO, however, cannot concomitantly correct a femoral neck shortening; furthermore, shortening may deteriorate because of a telescoping effect. For patients with evident shortening, therefore, combined SVO with SCS is more suitable.     

Total Esophagectomy versus Proximal Esophagectomy for Esophageal Cancer at the Cervicothoracic Junction

To investigate the adequate extent of esophagectomy and lymphadenectomy for an esophageal cancer localized at the cervicothoracic junction, the mortality and morbidity rates, survival rates, and patterns of recurrence were retrospectively analyzed in two groups—14 patients who underwent total esophagectomy with or without laryngectomy and 15 patients who underwent proximal esophagectomy with or without laryngectomy—at Kurume University Hospital from 1981 to 1996. Proximal esophagectomy with or without laryngectomy resulted in a lower hospital mortality rate and better overall survival for patients who underwent curative esophagectomy compared with total esophagectomy with or without laryngectomy. Multivariate analysis indicated that the extent of esophagectomy (total esophagectomy versus proximal esophagectomy) was not a prognostic factor. The incidence of recurrence was not different between the two groups. Lymph node metastasis or recurrence from such esophageal cancers was localized to the neck and upper mediastinum. For an esophageal cancer localized at the cervicothoracic junction, therefore, proximal esophagectomy with or without laryngectomy and with cervical and upper mediastinal lymphadenectomy could be better indicated for preselected patients.