Infracture Technique for the zygomatic body and arch reduction

In the Orient, prominent malar regions are considered unaesthetic and the majority of women with a prominent malar want to reduce the zygoma. Various operative procedures such as shaving or chiseling the zygomatic body or the zygomatic arch have been used for reducing malar eminence, but the zygomatic arch cannot be reduced sufficiently by these methods. By combining intraoral shaving of the zygomatic body and a new effect arch infracture technique through a temporopreauricular incision, we have obtained very satisfactory results in 19 cases and notable minimal complications over the last three years.     

Raman and UV–vis spectroscopic study of polyaniline membranes containing a bulky cationic additive

Electrically conducting soluble polyaniline (PANI), containing different amounts of a bulky lipophilic cationic additive, tridodecylmethylammonium chloride (TDMACl), was studied by Raman (λ_exc=780 nm) and UV–vis spectroscopy. PANI was made simultaneously electrically conducting and soluble with bis[4-(1,1,3,3-tetramethylbutyl)phenyl]phosphoric acid in dichloromethane. The PANI membranes were prepared by drop casting on glassy carbon or ITO substrates. Raman and UV–vis measurements were carried out in a 0.1 M CaCl₂ solution at potentials between 400 and ?600 mV (vs. SCE) at pH 6, or alternatively at the open circuit potential at pH 10. The results of Raman, UV–vis and cyclic voltammetric measurements confirm that the incorporation of TDMACl into the PANI membrane facilitates the oxidation and reduction of PANI.     

颈椎侧块钢板在脊髓型颈椎病治疗中应用

目的 对15例脊髓型颈椎病患者行后入路椎管减压、椎板成型术的同时使用颈椎侧块钢板固定，探讨和分析该手术方法的优点和手术治疗效果。方法 从自2000年3月—2002年12月，对15例脊髓型颈椎病患者(术前颈椎MR显示有三个节段颈椎椎间盘水平病变并有黄韧带增厚突入椎管)，行颈椎后入路双开门椎板成型术加双侧颈椎侧块钢板固定。按JOA评分法评定患者手术前后恢复情况。结果 本组患者男10例，女5例，随访5个月—1年2个月，平均9个月，术后2—7天(平均3．5天)可戴颈围坐起，颈围外固定时间12周，融合时间3—5个月，(平均为3．5个月)，术后JOA评分明显提高，所有病人无术中血管、神经根损伤，无植骨不愈合，无内固定断裂。结论 行颈椎后入路双开门椎板成型术联合应用颈椎侧块钢板固定，从后方扩大椎管容积，对脊髓进行减压，辅助以侧块钢板对减压后的颈椎行即时的稳定的固定，增加后方所植髂骨的融合成功率，大大地减少颈椎术后后突畸形发生和术后卧床并发症的发生率。     

Effects of surgical treatment in thymoma with myasthenia gravis: our experience in 103 patients.

A retrospective study of 103 thymectomies examines the effects of the integration of surgical and medical therapy in patients affected by myasthenia gravis accompanied by thymoma. An extended thymectomy via a median longitudinal sternotomy was used in 102 patients. The operative mortality was 4.85% (5/103 patients), the 10-year survival rate was 78% with a recurrence rate of 3.06% (3/98). Neoplastic infiltration and postoperative radiotherapy did not influence the survival rate. There was no correlation between a preoperative Osserman's class better than III and postoperative outcome. The improvement of medical treatment, and anaesthesiological and intensive care techniques resulted in a decrease of the operative mortality and long-term death rate during the last 10 years of our 20-year series. Extended thymectomy via sternotomy is the best intervention in patients with myasthenia gravis associated with thymoma judged by the low operative mortality and the favorable 10-year survival rates.     

Measurement of free and total hydroxyproline by automated flow injection of serum or urine samples from maintenance hemodialysis patients with renal osteodystrophy

An automated measurement of total and free hydroxyproline in serum or urine is presented that uses flow injection analysis. After exclusion of nonspecific substances, hydroxyproline was oxidized by chloramine- T and L-cysteine with Ehrlich's reagent. The linearity obtained was from 3.8μmole/ L to 1.22 mmole/L with good precision (CV <3%). Comparison of the proposed method with HPLC yielded r = 0.939 as the correlation coefficient. Reference intervals of free and total hydroxyproline are 1.4–9.7 μmole/L, 3.8–27.2 μmole/L for serum, and 10.0–72.5 μmole/L, 25.2–303.6 μmole/L for urine, respectively. Serum free and total hydroxyproline levels in renal osteodystrophy patients on maintenance hemodialysis (N = 71) were significantly higher than in controls (P<0.0001). This method is superior to the use of HPLC with regard to stability of the color reaction. The measurement of serum free and total hydroxyproline is a useful marker for therapeutic observation of renal osteodystrophy patients. © 1994 Wiley-Liss, Inc.     

Antigen-specific cytolysis of infected cells in murine candidiasis

Immune L3T4+ and Lyt-2+ lymphocytes play an important role in the acquired resistance of mice to challenge with virulent Candida albicans, and release macrophage-activating cytokines in response to yeast cells in vitro. To determine whether antigen (Ag)-specific cytotoxic T lymphocytes are generated during fungal infection, purified L3T4+ and Lyt-2+ lymphocytes from immunized mice were cultured in the presence of syngeneic accessory cells, Candida Ag, and IL-2. Yeast-infected bone marrow macrophages and peritoneal exudate neutrophils were used as target cells in a standard ⁵¹Cr release assay. Ag-specific, MHC-unrestricted lysis of infected macrophages was evident with immune Lyt-2+ cells after 5–10 days in culture. Under the same experimental conditions, the cytotoxic activity of L3T4+ cells was negligible, but its expression could be induced by the addition of anti-CD3 antibody.Culturing immune Lyt-2+ cells for shorter periods of time (1–2 days) resulted in preferential lysis of infected neutrophils. In addition, at limiting effector cell numbers, Ag-specific MHC-restricted lymphocytes with cytotoxic activity to infected macrophages could be identified. We suggest that C. albicans infection stimulates multiple cytotoxic T-cell precursors with varying recognition stringency, wich may have an important role in antifungal resistance in vivo.     

李辅仁治疗老年脑部疾患的经验

治疗脑出血,急症抢救期先以安宫牛黄丸之类芳香开窍醒脑,并予以止血,待神志清醒,血压稳定后,再施以补气活血、化瘀通络、平肝潜阳之法,脑血栓亦先开窍醒脑,后用自拟安脑化瘀汤以安脑通络、活血化瘀治之;老年性痴呆则以滋补肝肾、填精健脑为主,佐平肝活血、醒脑开窍为辅,药用自拟醒脑复聪汤;蛛网膜下腔出血以清脑醒神、镇痉熄风为治,药用自拟清脑熄风汤。     

Effect of Omeprazole on Diazepam Disposition in the Rat: in Vitro and in Vivo Studies

Purpose. The inhibitory effects of omeprazole on diazepam metabolism in vitro and in vivo are compared in the rat. Methods. 3-hydroxylation and N-demethylation of diazepam was investigated in the presence of a range of omeprazole concentrations (2-500µM) in hepatic microsomes and hepatocytes. Zero order infusions together with matched bolus doses of omeprazole were used to achieve a range of steady state plasma concentrations (10-50mg/ L) and to study the diazepam-omeprazole interaction in vivo. Results. The 3-hydroxlation pathway was more prone to inhibition (K_Is 108 ± 30 and 28 ± 11 µM in microsomes and hepatocytes, respectively) than the demethylation pathway (K_Is of 226 ± 76 and 59 ± 27 µM in microsomes and hepatocytes, respectively). In both in vitro systems, the mechanism of inhibition was competitive with Km/K_I ratios larger than 1 for the 3HDZ pathway and smaller than 1 for the NDZ pathway. There was an omeprazole concentration dependent decrease in diazepam clearance in vivo which could be modelled using a simple inhibition equation with a K_I of 57µM (19.8mg/L). In contrast there was no statistically significant change in the steady state volume of distribution for diazepam in the presence of omeprazole. Conclusions. The in vivo K_I for the omeprazole: diazepam inhibition interaction shows closer agreement with the K_I values obtained in hepatocytes than with those observed in microsomes.     

加强保健措施 降低孕产妇死亡率的试点研究

经调查河南省七县1988～04～1989～03孕产妇死亡率为136.1/10万,高于全国平均水平(94.7/10万)。从七县中选择了死亡率偏高的三个县(147.9/10万)为样本.进行厂降低农村孕产妇死亡率保健措施的研究。自1990年4月1日～1992年3月31日。在三县采取了以下保健措施:①加强基层妇幼卫生建设,特别是中心乡卫生院的建设,②整顿和完善三级保健网;③建全孕产妇系统管理制度,高危妊娠筛查,转化和转诊制度,④配备必要设备,建立联合小产院,实行定点接生。两年内孕产妇死亡率,由1989年的147.9/10万下降到67.7/10万,下降幅度为54.44%,最高达72.1%。此工作为实现2000年孕产妇死亡率下降一半的规划目标提供了依据。     

介入治疗并发症的发生与防治

介入治疗是融合了内科药物治疗、外科手术治疗及医学影像学的一种特殊的治疗体系 ,其疗效受到世人瞩目并成为目前发展最为迅速的学科之一。但是 ,再好的方法也会存在不足之处 ,介入治疗也不例外。随着介入治疗在各家医院的普遍应用 ,并发症的发生也会越来越多 ,迫使人们关注这个问题。所谓介入治疗并发症 ,是指因血管造影及 (或 )血管内治疗所引起、需要一定治疗、使病人的治疗复杂化或延长病人住院时间的不良反应 ,就其全身多系统而言 ,介入治疗引发并发症的原因大致可归纳为两个主要因素即介入器材操作和引入人体内的物质(包括介入治疗所…