甘丙素在急性心肌梗塞发病学中的意义

本文测定了３１例急性心肌梗塞（ＡＭＩ）患者血浆甘丙素（ＧＡＬ）的放免活性，结果显示ＡＭＩ患者急性期各次血浆ＧＡＬ水平明显高于对照组，伴高血压、糖尿病和心功能不全者升高更显著，ＧＡＬ与内皮素（ＥＴ）、血糖水平均呈正相关。实验性心肌梗塞大鼠血浆ＧＡＬ、血清肌酸激酶（ＣＫ）、ＣＫ同功酶（ＣＫ－ＭＢ）、丙二醛（ＭＤＡ）含量亦明显高于对照大鼠。用ＧＡＬ抗血清治疗心肌梗塞大鼠，减少坏死面积４５．４％和缩小了梗塞范围４７．１％，亦明显降低了血浆ＧＡＬ水平，抑制血清ＣＫ、ＣＫ－ＭＢ、ＭＤＡ活性，提示早期阻断ＧＡＬ的生物学效应，对防治ＡＭＩ有重要意义。     

Anatomy of the arterial vascularization of the lips

Summary The findings from 12 dissections of previously injected facial masks, 8 dissections of the face following intrarterial injection of a red solution of Latex Neoprene, and a corrosion cast specimen allowed us to study the arterial supply of the lips. The arterial supply of the upper lip arises mainly from the superior labial arteries, but also from the subseptal arteries and from the subalar arteries. There is a figure of 8 shaped anastomotic system between these arteries lying on the upper lip. The arterial supply of the lower lip arises from the inferior labial arteries and from branches of the mental artery. A constant inferior labial arterial network was shown at the level of the lower lip arising in a fifth of cases from a T-shaped inferior labial artery. All these recent anatomic findings help us to improve our understanding of plastic surgery of the lips.

---

Vascularisation artérielle des lèvres

Résumé Douze dissections de masques faciaux préalablement injectés à la gélatine minium, huit dissections de face après injection artérielle par une solution de latex néoprène rouge, et une injectioncorrosion a permis l'étude de la vascularisation artérielle labiale. La lèvre supérieure reçoit sa vascularisation artérielle des artères labiales supérieures principalement, mais aussi des artères sous-narinaires branches des artères faciales, et des artères de la sous-cloison. Il existe un système d'anastomose fréquent entre les trois artères décrivant un aspect de 8 de chiffre couché au niveau de la lèvre supérieure. La lèvre inférieure est vascularisée par les artères labiales inférieures et par des branches de l'artère mentonnière ; il existe de manière constante au niveau de la lèvre inférieure une arche artérielle labiale inférieure provenant une fois sur cinq d'une artère labiales inférieure en T unique. Toute ces données anatomiques récentes permettent d'envisager dans de meilleures conditions la chirurgie réparatrice des lèvres.

     

Abnormal extrapelvic course of the inferior gluteal artery

At its extrapelvic course the inferior gluteal a. is found to be strictly related to the sciatic n. This relationship has been described in a general way, emphasizing its medial localization in respect to the nerve. Clinicosurgical reports describe cases of aneurysms of the inferior gluteal a. on its extrapelvic course and subsequent compression at the nerve. In order to get further details on the relationship between these two structures, 80 gluteal regions from 40 cadavers of adult Brazilian individuals, 29 males and 11 females, were dissected. The inferior gluteal a. was found medial to the sciatic n. in 62 cases (77.5%); in the 18 remaining (22.5%) the trunk of the artery or one of its branches perforated the nerve. Of these, 14 (77.8%) were males and 4 (22.2%) females. This disposition was found 8 times (44.4%) on the right and 10 (55.6%) on the left side; was unilateral in 4 individuals (1 on the right and 3 on the left side) and bilateral in 7. The course of the inferior gluteal a. through the sciatic n. and/or the presence of aneurysms of this artery should be considered as a possible cause of nerve compression.     

结扎双侧椎动脉对家兔BAEPs的影响

本实验通过对１０只家兔双侧推动脉结扎，观察手术前后脑干听觉诱发电位（ＢＡＥＰｓ）的变化［１］。结果发现：动物在推动脉结扎后，随时间延长ＢＡＥＰｓ各波的波幅逐渐减压，潜伏期逐渐延长；上述变化持续进行４０分钟，以后无大变化。提示：ＢＡＥＰｓ可以客观地反映椎基底动脉的供血情况。本项研究为临床用ＢＡＥＰｓ诊断椎基底动脉供血不足，提供了一项理论依据。     

常规与微创冠脉搭桥术围手术期血浆S100-B蛋白水平的相关研究

目的: 通过测定体外循环和非体外循环条件下冠脉搭桥术患者血浆S100-B蛋白水平的变化，比较2种手术方式对脑损伤程度有无不同，探讨术中影响血浆S100-B蛋白水平变化的相关因素。方法: 30例择期行冠脉搭桥术的患者，分为体外循环组（CPB group，A组）和微创非体外循环组（non-CPB group，B组）,每组均为15例。于术前、麻醉后、主动脉侧壁钳开放时、术毕时、术后2 h、6 h、12 h和24 h采血测血浆S100-B蛋白浓度。结果： （1） 两组患者血浆S100-B蛋白浓度均在升主动脉侧壁钳开放时显著高于术前，且A组患者血浆S100-B蛋白浓度峰值是B组的3倍多（2.32±0.26 μg/L和0.71±0.14 μg/L）,之后逐渐降低，到术后24 h基本接近正常。（2） 术中患者血浆S100-B蛋白升高水平与体外循环转机时间或心表手术操作时间呈正相关（A组：r＝0.659，P＜0.05;B组：r＝0.584, P＜0.05）。结论： 血浆S100-B蛋白水平可以用来评价2种冠脉搭桥术对脑的损伤程度，术后连续检测对于诊断脑损伤并及时采取相应预防措施具有重要价值;非体外循环微创冠脉搭桥术较常规体外循环下手术更能够有效降低对脑损伤的程度和术后出现神经功能障碍的风险。     

A dominant ovarian follicle induces unilateral changes in the origin of the blood supply to the tubal corner of the uterus

BACKGROUND: The blood supply to the tubal corner of the uterus may originate from the uterine and ovarian arteries. The border of supply from the arteries has been found to move in young women; the change seemed dependent on ovarian steroid production. The present work investigated whether the border of supply could differ between the two sides of the uterus in the same woman having one dominant follicle (>10 mm). METHODS: Vagina was flushed with saline of room temperature in 15 women with a dominant follicle >10 mm. The temperature was measured in the mid-uterine lumen and in the tubal corner of the uterus at 2, 5 and 7 min after starting cooling. The investigation was repeated 30 min later measuring the temperature in the other tubal corner. RESULTS: The temperature decrease was, as found in previous investigations, more pronounced in the uterine cavity than in the tubal corners. However, a difference was found between the two tubal corners. At all measurement times the decrease was significantly smaller in the tubal corner corresponding to the dominant follicle than in the contralateral side. CONCLUSIONS: In our model, 'cold' is transferred from the vaginal venous blood to the uterine artery and the cooling defines the supply area of the uterine artery. Therefore, the results indicate that the area of supply from the ovarian artery in the tubal corner ipsilateral to the dominant follicle is greater than that in the contralateral side. It is possible to speculate that this difference is related to the hormonal production of the dominant follicle.     

Radial artery running beneath the biceps tendon and its interrelation between the radial recurrent arteries

A radial artery running beneath the biceps tendon was found in the cadaver of a Japanese woman during a student dissection course at Kumamoto University School of Medicine in 2006. The brachial artery bifurcated into the radial artery and the ulnar artery in the cubital fossa, and the radial artery twisted laterally running beneath the biceps tendon, and when it was situated laterally to the tendon, twisted distally at the level of the radial tuberosity, and then twisted medially again. After the radial artery passed over the biceps tendon, it turned distally and continued as a normal radial artery. The superficial brachial artery, which coexisted with the brachial artery, was given off from the axillary artery and it continued to the final twist of the radial artery. The course of this radial artery is similar to the arterial rings surrounding the biceps tendon, found during the same dissection course. The arterial rings were formed between the brachial artery and the radial artery, and their proximal origins ran beneath the biceps tendon, while the distal origins were superficial. The present arterial variation is thought to have occurred when the normal part of the radial artery in the cubital fossa was substituted by the arterial ring, coexisting with the superficial brachial artery, which usually disappears during normal development. Furthermore, it is suggested that a part of the arterial ring always remains as a radial recurrent artery.     

颈内动脉岩内段形态位置与毗邻结构的相关分析

目的:探讨颈内动脉岩内段形态位置变化的规律及其与毗邻结构的关系.方法:对66侧正常成人颅底高分辨率CT连续图像进行分析,测量颞骨气房体积,建立定位颈内动脉岩内段及其毗邻结构的参照系,对其位置和形态进行测量,运用偏相关分析方法求出它们形态位置的变化规律及其影响因素.结果:在男性,颈内动脉垂直段更偏外侧,其水平段长度也大于女性.颞骨气化好,则颈内动脉垂直段更偏后移.颈内动脉垂直段与颈静脉球的位置变化表现为同步.垂直段的内外移位相应地使水平段与中线的夹角发生变化.颈内动脉水平段的方位与蜗轴方向相关,蜗轴偏离中线的角度越小,则颈内动脉水平段偏离中线的角度越大,反之亦然.结论:影响颈内动脉岩内段形态位置变化的因素是复杂和多重的,包括性别因素、颅底发育状态、颞骨气化程度以及毗邻结构发育状态均可能是影响因素.     

急进高原人群脑血流量测定对急性高原病易感人群预测的临床与实验观察

本文对三级急进高原人群资料回顾分析了急进高海拔区（＞4500M）人群脑皿流量测定的临床意义。结果表明急进高原人群脑血流量较在低海拔区明显增高，有显著性差异；而急进高原人群中的急性高原反应和急性高原病患者脑血流量又显著高于高原适应人群。采用药物和吸氧治疗急进高原人群中急性高原反应人群，脑血流量明显降低，急进高原人群的高原反应程度和急性高原病的发病率亦相应降低。因此监测急进高原人群的脑血流量，不仅可以早期发现急性高原反应及急性高原病患者，更可以预测急性高原易感者，可为急性高原病的早期治疗和预防，扩大高原适应人群提供重要的理论依据。