上颌窦窦口的形态观察及其临床意义

目的：为了指导鼻内窥镜下功能性上颌窦手术。方法：对６０个头部标本（男３４，女２６）１２０侧进行了上颌窦口及其毗邻结构的观察测量。结果：上颌窦鼻通道的鼻开口口径为平均３．８ｍｍ，上颌窦通道长度为５．６ｍｍ，鼻内开口到前鼻棘连线与鼻底平面夹角为４５．２°，前鼻棘至鼻内开口的距离为３７．０ｍｍ，下鼻甲前端至鼻内开口距离为１９．５ｍｍ，中鼻甲前端至鼻内开口距离为１４．６ｍｍ。结论：上颌窦窦口为管状通道，该处的病变可以导致窦腔炎症，可以进行内窥镜下窦口扩大术，术中应避免损伤眼眶及鼻泪管。     

Baroreflex control of jejunal blood flow and fluid transport in cats; effects of yohimbine,an α.-adrenergic antagonist

The aim of the study was to test the hypothesis that baroreceptor unloading increases jejunal fluid absorption rate via an α₂-adrenergic effect on electrogenic active transport. In 13 chloralose-anaesthetized cats, the carotid sinus baroreceptors were isolated and perfused with arterial blood, and we studied the effects of a graded decrease in carotid sinus pressure on intestinal vascular resistance, net fluid absorption rate and the potential difference between the intestinal lumen and the peritoneal cavity (PD). Experiments were performed in seven control animals and in six animals pretreated with yohimbine, an α₂-adrenergic antagonist, at a dose of 0.1 mg kg^-I i.v. Yohimbine per se had no significant effects on systemic arterial pressure, intestinal vascular resistance, net fluid absorption rate or PD. In the control animals, baroreceptor unloading induced an increase in systemic arterial pressure, intestinal vascular resistance and net fluid absorption rate, and a decrease in the PD. Yohimbine pretreatment did not significantly affect the systemic blood pressure response to baroreceptor unloading, but abolished the effect on intestinal vascular resistance and PD. After yohimbine treatment, decreases in carotid sinus pressure still enhanced net fluid absorption rate, but this response was observed in a higher range of carotid sinus pressures than in control animals. We conclude that (1) a major component of the increase in jejunal absorption rate during baroreceptor unloading is due to a non-electrogenic mechanism, which may be either active or passive; (2) this component of the response is not blocked by yohimbine at a dose sufficient for an effect on presynaptic α₂-receptors; (3) the absorptive response to baroreceptor unloading is not a phenomenon secondary to the concomitant jejunal vasoconstriction.     

Cardiovascular indices of physiological arousal in boys with fragile X syndrome

In this study, the relationship between physiological arousal, as indexed by heart rate variability, was examined in boys with fragile X syndrome (FXS) and typically developing boys matched on chronological age. In addition, the relationship of heart activity to clinical and molecular factors in the group of boys with FXS was examined. Results suggest that boys with FXS have higher levels of heart activity during the passive phases, as reflected in shorter heart periods. This high level of heart activity appears to be due to increased sympathetic activity and reduced parasympathetic activity. Boys with FXS did not display the expected patterns of heart activity in response to phases of increasing challenge, and sympathetic and parasympathetic systems did not appear coordinated in these boys with FXS. Clinical factors may be related to neural regulation of heart activity while molecular factors do not appear to be.     

急性上颌窦炎实验动物模型的建立

目的:拟建立急性上颌窦炎的实验动物模型,并探讨窦口的阻塞和致病菌的毒力在急性上颌窦炎的发病机制中的地位。方法:第一天,阻塞单侧窦口,对侧做假手术。次日,注入0.5ml108CFU/ml肺炎链球菌悬浮液。第五天处死动物、观察、分离培养细胞、取材和制作切片。结果:阻塞上颌窦口和注入肺炎链球菌的联合组,鼻部症状明显;进食量减少;鼻窦粘膜水肿、微红,具有较多脓性分泌物,微血管扩张,白细胞浸润;肺炎链球菌的重新分离培养率为100％（与其余组比较具有显著意义P<0.01）。而仅阻塞上颌窦口或仅注入肺炎链球菌或假手术均无明显临床症状及组织病理学改变,细胞培养率也低。结论:窦口的阻塞和致病菌的毒力是上颌窦炎发生发展的重要的条件,其中,窦口的阻塞起着关键性作用;联合阻塞窦口并注入有荚膜的肺炎链球菌能较理想地建立急性上颌窦炎实验动物模型。     

Hostility and sex differences in the magnitude, duration, and determinants of heart rate response to forehead cold pressor: Parasympathetic aspects of risk

Recent models hypothesize that hostility confers increased risk of CHD through weaker parasympathetic dampening of cardiovascular reactivity (CVR). We tested this possibility using the forehead cold pressor task, a common maneuver which elicits the “dive reflex” characterized by a reflexive decrease in HR presumably through cardiac-parasympathetic stimulation. Participants were initially chosen from the outer quartiles of a sample of 670 undergraduates screened using the hostility subscale of the Aggression Questionnaire ([Buss, A.H., Perry, M., 1992. The Aggression Questionnaire. Journal of Personality and Social Psychology, 63, 452-459.]). The final sample of 80 participants was evenly divided between men and women and high and low hostility. Following a 10-min baseline, participants underwent a 3-min forehead cold pressor task. The task evoked a significant HR deceleration that was mediated by PNS activation, as assessed by respiratory sinus arrhythmia (RSA). Replicating prior research, men displayed greater decrease in HR. More important, low hostiles maintained larger HR deceleration over time compared to high hostiles although the autonomic basis for this effect was unclear. The findings broaden understanding of hostility and sex-related cardiovascular functioning and support the task as a method for evoking PNS-cardiac stimulation.     

小白鼠腘淋巴结淋巴窦的超微结构

我们观察了幼年小白鼠腘淋巴结淋巴窦的超微结构,窦壁由腔面向外一般出3层构成:(1)一层连续的内皮;(2)由一薄层细胞间质构成的基膜;(3)一层外膜网状细胞及其扁平的突起。内皮细胞核扁圆,异染色质细小,核仁不明显,胞质极薄,含粗面内质网极少,而有大量的吞饮小泡。细胞邻接处相互重叠或嵌合,有20nm宽的间隙相隔。有的地方可见不发达的细胞连接。当巨噬细胞或淋巴细胞穿越内皮时,可出现临时性间隙,内皮边缘与穿越细胞相贴。基膜由电子透明的无定形基质及细的胶原原纤维构成。外膜网状细胞的核异染色质较多,核仁明显,胞质丰富,含许多粗面内质网而很少吞饮小泡。外膜网状细胞之间常见0.5μm宽的间隙。在窦腔内有巨噬细胞、淋巴细胞及星状的网状细胞等。由于小白鼠腘淋巴结的淋巴窦小,故窦内星形的网状细胞很少,其超微结构特点,与外膜网状细胞及淋巴组织内的网状细胞相似,在突起的切面上,常见包有小束的胶原原纤维。巨噬细胞较多,形态不规则,常贴附于内皮细胞表面,核椭圆,常有凹陷,胞质丰富,含许多溶酶体。在取材前1h,于足垫注射中国墨汁的小鼠,巨噬细胞吞噬了大量粗的墨汁颗粒。本文认为,淋巴窦壁可能具有一定的屏障作用。     

有关冠状窦心导管术的应用解剖

对３０例成人心标本进行解剖，测得冠状窦口的纵径为１７．７９±４．６６ｍｍ，横径为８．７５±３．３９ｍｍ。发现冠状窦口朝向上或水平方向者占７０．００％；向下者占３０．００％，冠状窦瓣有新月状、半月状、网状、筛状和嵴状等五种形态。瓣高５．３１±４．１８ｍｍ，宽８．６２±２．４４ｍｍ。冠状窦的长度为３１．３３±１０．２２ｍｍ，最窄径为５．６０±１．０５ｍｍ；并有成角、缩窄和发育不良现象。其属支中有７３．３３％的心中静脉和１０．００％的心小静脉开口于冠状窦口处。本文并就冠状窦心导管术插管的成败因素进行了讨论。