从中医理论探索方药的作用机理

主要以所承担过的科研课题的研究思路及研究结果为依据,论述从传统中医理论探索方药作用机理的重要性。文中从养阴生津方药治疗热瘀证的作用、血分证中运用活血化瘀法的作用、辛开苦降法的作用及解表法的作用等方面论述从中医的特有理论出发,可以在探索方药作用机理时提供思路、开拓新的研究领域。同时,中医传统证治理论也要不断发展、提高,在运用传统证治理论研究方药作用机理时,不能完全被其所束缚,随着对证治理论认识的发展,对方药作用机理的认识也必然会出现一个飞跃。     

Potential preventive strategies and therapies in urinary tract infection

There are perhaps five strategies either presently advocated or under investigation for prevention of recurrent urinary tract infection (UTI): antibiotics, including natural peptides; functional foods; vaccines; probiotics; and miscellaneous, including avoidance of spermicides and maintenance of good hygiene. It is not possible to state the proportion of patients using antibiotics versus foods such as cranberry or using alternative approaches such as avoidance of spermicides. The majority of women who are referred to specialists will be prescribed long-term, low-dose antibiotics. However, given the magnitude of the problem, it is safe to state that large numbers of women are at least experimenting with alternative remedies such as drinking of cranberry juice or ingestion of herbal remedies with a view to enhancing their immune response. Vaccine development remains a long way from human use and has yet to be developed for organisms other than Escherichia coli. The use of probiotics to restore the normal vaginal flora and provide a competitive bacterial barrier to pathogens is close to becoming available as an alternative preventive approach. The next decade should see the introduction of new methods for reduction of the high incidence of UTI and better management of recurring urogenital infections.     

重庆市1997年中小学生身体形态与机能发育研究

目的：了解重庆市中小学生生长发育现状和变化特点。方法：对1997年重庆市7－17岁中小学生的生长发育调查资料进行分析,并与本市1990年和全国1995年资料进行对比分析。结果：男生11－15岁,女生9－14岁为生长发育快速增长期;城市学生的生长发育好于乡村学生;男女生的形态发育出现两次交叉,机能发育无交叉。7年间,形态指标的发育在大多数年龄纷呈上升趋势,但均低于全国水平（P＜0．01）。机能发育指标,无论城乡男女,绝大多数年龄组均低于1990年本市水平和1995年全国水平（P＜0．01）。结论：重庆市中小学生形态发育存在长期增长趋势,而机能发育较差。     

High resolution evoked potentials of cognition

Summary The precision of four methods of quantifying neuroelectric signals has been improved by increasing EEG spatial sampling, using up to 124 electrodes, and by accurate anatomical registration of the EEG with Magnetic Resonance Images (MRIs). One such method, equivalent dipole modeling, is a well-known form of source localization which is useful when the generator of the scalp recorded signal approximates a simple dipolar source, as is usually the case with early and mid-latency Evoked Potentials (EPs). Two methods of enhancing spatial detail which benefit from increased spatial sampling include the Laplacian Derivation and the Finite Element Deblurring method. The latter is a new technique which estimates the EP distribution at the superficial cortical surface. The fourth method, Evoked Potential Covariance, characterizes the spatiotemporal relationships among EP segments at different recording sites. This is useful when studying functional neural networks underlying higher cognitive functions. These methods are reviewed and examples of results of their application in recent experiments are presented.Supported by competitive grants from The National Institute of Mental Health, The National Institute of Neurological Diseases and Stroke, The Air Force Office of Scientific Research, The Office of Naval Research, The National Science Foundation NASA and The National Institute on Alcohol Abuse and Alcoholism of the United States Federal Government. Thanks to all members of the EEG Systems Laboratory and SAM Technology, past and present, for their vital contributions to the work presented here.This paper is based on an invited lecture given at the Tenth Anniversary Meeting of The Japanese Society for Brain Electromagnetic Topography held in Fukuoka, Japan in September, 1992.     

Face lifting with suspensory restoration of the fibromuscular tissues of the face and neck

A series of before and after slides are shown of patients who have had the author's wall type restoration of the fibro-fatty musculo-fascial restoration of the face and neck in conjunction with face lifting. Several sutures (2–0 white Dacron usually 8 to 10 in all) are placed together so as to tighten the fibro-fatty musclo-fascial layer of the neck and face to as nearly as possible that which it had in youth. These are not the typical plication sutures but are sturdy suture material and are tied tightly. Furthermore, the tension on the tissues is distributed evenly by a whole series of sutures which additionally gives a smoother wall type reconstruction.The technique decreases the dead space in the cervico-facial dissection by at least 50 per cent and avoids suture ridging. Since using this technique and subsequent to the submission of this paper, there have been no hematomata in over 150 consecutive face lifts.     

The functional restoration approach for chronic spinal disability

The functional restoration approach to treating chronic spinal disability consists of a medically directed, interdisciplinary team approach to physical reconditioning and a cognitive-behavioral crisis intervention procedure for dealing with related psychosocial problems. One- and two-year follow-up studies have demonstrated the clinical efficacy of this approach. The present article describes this approach and summarizes the research documenting its success in treating patients with chronic spinal disability. This article also highlights the pitfalls in misunderstanding and misrepresenting the components of the functional restoration approach when evaluating treatment efficacy.     

Functional imaging and localization of electromagnetic brain activity

Functional imaging of electric brain activity requires specific models to transform the signals recorded at the surface of the human head into an image. Two categories of model are available: single-time-point and spatio-temporal methods. The instantaneous methods rely only on the few voltage differences measured at one sampling point. To create a spatial image from this limited information, they require strict assumptions that rarely conform with the underlying physiology. Spatio-temporal models create two kinds of images: first, a spatial image of discrete equivalent multiple dipoles or regional sources, and second, an image of source current waveforms that reflect the temporal dynamics of the brain activity in circumscribed areas. The accuracy of the spatial image is model dependent and limited, but it can be validated from the spatio-temporal data by the "regional source imaging" technique, introduced here. The source waveforms are linear combinations of the scalp waveforms, and thus, specific derivations which image local brain activities at a macroscopic level. Brain source imaging of somatosensory evoked potentials revealed temporally overlapping activities from the brainstem, thalamus and from multiple sources in the region of the contralateral somatosensory projection areas.     

Elektromyographische und funktionsanalytische Befunde bei obstruktiven Defäkationsstorungen

Zusammenfassung Zur Beurteilung der funktionellen Ergebnisse bei Patienten mit obstruktiven Defäkationsstö-rungen warden bei 27 Patienten (im Alter von 42–74 Jahren) elektromyographische, manometrische und radiologische Untersuchungen durchgeführt. Die Elektromyographie stellt eine dynamische Untersuchungstechnik dar und erlaubt eine Differenzierung zwischen neuro- und myogenen Störungen der willkürlichen Bekkenbodenmuskulatur. Patienten mit einer obstruktiven Defäkation lassen sich elektromyographisch in eine Gruppe mit neurogenen, eine Gruppe mit myogenen und eine weitere Gruppe mit neuromyogenen Veränderungen einteilen. Die Gruppen mit neurogenen bzw. myogenen Veränderungen zeigten statistisch signifikante Unterschiede gegenüber der Kontrollgruppe bei der mittleren Amplitude, der Entladungsfrequenz und dem Integral. Die neurogene Patientengruppe zeigte weiterhin Unterschiede hinsichtlich der Aktionspotentialdauer und die myogene hinsichtlich der Aktionspotentialhöhe. 77 % der untersuchten Patienten waren nicht in der Lage, während der Defakation den Beckenboden zu relaxieren.

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Einctromyographic and functional analytic findings in obstructed defecation. A contribution to discriminate between neurogenic and myogenous sphincter injuries

Summary The aim of this study was to get further information about functional results in patients with outlet obstruction. We investigated 27 patients (age between 42 and 74 years) by electromyography (EMG), manometry and radiology with contrast-solution. The electromyography, a dynamic investigation method, allows the differentiation between neuronal and muscular malfunctions of the voluntary controlled pelvis muscles. Patients with outlet obstruction should be divided into three groups by EMG diagnosis: One group with neuronal alterations, another group with muscular alterations and one group with neuro-muscular alterations. We obtained marked statistical differenceds between patients with neuronal or muscular malfunctions in the mean amplitude, the turns per second and the integration of the mean amplitude compared to the control group (14 patients). Patients with only neuronal alterations showed furthermore statistically significant distinctions of the action potential duration from control, whereas the data of patients with muscular malfunctions were significantly different from control in the peak amplitude of the action potentials. 77 % of all investigated patients were not able to relax the pelvis muscles during defecation.

     

Die Bedeutung des Musculus canalis ani für die Kontinenz und anorectale Erkrankungen

Zusammenfassung Es wird die funktionelle Morphologie des bisher wenig bekannten M. canalis ani beschrieben. Dieser Muskel liegt dem Sphincter ani internus auf und zieht längs durch die submuköse und subcutane Schicht des Analkanals. Es wird gezeigt, daß er ein Bestandteil des Kontinenzorgans ist und für den Verlauf anorectaler Erkrankungen bedeutsam ist.

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The importance of the musculus canalis ani for continence and anorectal diseases

Summary The functional morphology of the M. canalis ani is described. Hitherto this muscle has not been studied in detail. The M. canalis ani is located inside of the M. sphincter ani internus and reaches through the spatium submucosum et subcutaneum of the analcanal. This muscle is part of a described organ of continence. Its importance in the course of anorectal disease is shown.

     

134例头颈部肿瘤手术后缺损修复

目的：分析4种皮瓣修复头颈部缺损的效果、功能、并发症和供区创伤的大小，以为不同的缺损选择不同的皮瓣。方法：134例头颈部肿瘤患者，均行联合根治术加胸大肌肌皮瓣、颈阔肌肌皮瓣、额瓣、前臂皮瓣修复。结果：胸大肌皮瓣全部存活96例，部分坏死21例，坏死≥1／25例，全部坏死2例，颈阔肌皮瓣全部存活2例，部分坏死1例，全部坏死1例，4例额瓣和2例前臂皮瓣全部存活。结论：口腔及颈部大面积缺损需要胸大肌肌皮瓣修复，对需要洞穿修复的，尤其是女性，应尽量避免用胸大肌折叠瓣，可用复合瓣。对一般的口腔缺损用前臂皮瓣修复最为合适。