成年男性舌下神经在舌根部的定位研究

目的:探讨成年男性舌根部舌下神经解剖走行特点,指导临床舌根部射频温控减容术治疗阻塞性睡眠呼吸暂停低通气综合征(OSAHS)时针形电极刺入舌根部的部位及深度,以避免损伤舌下神经。方法:选择10具成年男性的舌标本,定型后在冰冻状态下作冠状切面,通过计算机图像处理与测量系统行舌下神经定位测量,并进行相关的统计学分析。结果:(1)两侧舌下神经呈对称性分布。(2)成年男性舌下神经舌内部分的主干(本实验为舌盲孔前后15mm范围内)其垂直向解剖走行基本恒定,距舌表面(22.21±2.22)mm;水平向走行中,舌盲孔后一般位于舌中内(近中线侧)(28.61±2.66)％处,舌肓孔前为(21.89±1.93)％处。结论:本实验为舌根部射频温控减容术治疗OSAHS提供了一个相对安全的范围:在不超过(22.21±2.22)mm深度且舌盲孔后避开中内(近中线侧)(28.61±2.66)％区域、舌盲孔前避开中(内近中线侧)(21.89±1.93)％区域,基本不会损伤舌下神经。     

眶颧骨折的治疗研究

目的 探讨眶颧骨折的修复时机和方法.方法 本组43例患者,其中41例在受伤早期行切开复位和内固定,根据不同伤情选择不同的手术入路和相应的固定点.结果 伤口均Ⅰ期愈合,术后6个月～ 1年随访,骨折愈合良好,外观及功能恢复满意.结论 眶颧骨折应在伤后早期复位和坚强固定.     

切开复位内固定治疗髋臼骨折

目的:探讨切开复位内固定在治疗髋臼骨折中的临床应用价值。方法 :采用切开复位内固定治疗有移位的髋臼骨折共 15例。手术入路采用 Kocher- L angenbeck(K- L)入路 7例 ,髂腹股沟入路 3例 ,髂股加 K- L 入路 3例 ,三射线入路 2例。结果 :解剖复位 10例 ,满意 3例 ,差 2例。随访功能评分优 7例 ,良 3例 ,可 2例 ,差 3例。结论 :切开复位内固定已成为多数有移位髋臼骨折的治疗标准 ,L etournel分类对手术入路有很好的临床应用价值     

Cholesterol screening: observed cholesterol reduction in a prospective study in Norway

The general public of the City of Bergen, Norway was Invitedto participate in a cholesterol screening programme in October1988. Participants received the results of the cholesterol screeningand nutritional information from trained health personnel. Ashort questionnaire was mailed to all 354 participants 1–2weeks after the initial cholesterol screening. In March 1990,all participants were invited to have their cholesterol levelsre-examined. Psychosocial factors believed to be predictiveof future serum cholesterol changes were assessed at baselinealong with demographic variables. The majority of participants(61%) reduced their cholesterol level from October 1988 to March1990, and the average reduction in cholesterol level for thetotal population was 4.0%. Baseline cholesterol levels, beingconfident of one's own ability to change one's diet (self-efficacy),seeing heart disease risk reduction as very important, and maritalstatus were factors that significantly predicted successfulcholesterol reduction 18 months later.     

Nipple sensitivity and lactation in two methods of breast reduction

Two methods of breast reduction were performed between 1981 and 1986. One was wedge resection of the breast in which nipple and gland were disconnected. The other was the tangential and circumferential breast reduction, in which the nipple remained in continuity with the gland. For each method, there were 21 patients. The mean follow-up was 5 years and 9 months. In both groups, 8 patients had 11 children, but only the tangential reduction patients lactated. They also had better subjective nipple sensitivity whereas objectively the differences were rather small.     

Impedance study of the electrochemical reduction of adrenochrome on glassy carbon

The electrochemical reduction of adrenochrome on a glassy carbon electrode was investigated by ac impedance in a constant ionic strength McIlvaine buffer solution. When the frequency was lower than 60 kHz, —Z″ against Z′ showed straight lines whose inclined angles with the real axis were within the range 71–76° in the diagrams of the complex impedance plane obtained at different do potentials. In the corresponding admittance diagrams, distorted semicircles appeared. The electrode reaction involves adsorption of electroactive species and the effect of concentration polarization cannot be neglected. Based upon the admittance model of the equivalent circuit, the optimal estimated values of some model parameters were obtained by using a Gauss-Newton algorithm and non-linear curve fitting. The characteristics of the electrode process are also discussed.     

92例跟骨骨折后足部畸形功能障碍治疗探讨

本文对92例106足波及距下关节的跟骨骨折治疗后1～6年遗留足畸形、功能障碍的病例(PALey:舌型17足,中央压陷型53足,严重粉碎型36足)进行了分析和总结。作者强调解剖复位、牢靠固定、一期植骨、早期关节持续被动运动及不过早负重是预防跟骨骨折众多并发症的重要措施。     

Comparison of acid reduction in antiulcer operations

Background: Three acid-reducing operations have recently been described for the laparoscopic treatment of peptic ulcer disease. These consist of a posterior truncal vagotomy combined with either (1) an anterior seromyotomy (SERO), (2) an anterior highly selective vagotomy (AHSV), or (3) a linear stapled lesser curvature excision (STAP). The purpose of this study was to investigate the physiologic effects of these procedures in terms of basal and maximal acid outputs. Methods: Fifty New Zealand rabbits were prospectively randomized into five open laparotomy groups (n= 10): a control group without vagal manipulation (CON), a bilateral truncal vagotomy with pyloromyotomy group (VP), a SERO group, an AHSV group, and a STAP group. All animals underwent placement of a gastrostomy tube for subsequent gastric secretory analysis. On postoperative day 6, basal acid outputs (BAO) and maximal acid outputs (MAO) following IV pentagastrin stimulation (30 μg/kg/h) were measured. Results were compared statistically using the ANOVA method. Results: Pentagastrin stimulation was associated with a significant increase in MAO in the CON group (p < 0.05 vs BAO); however, this response was effectively blunted in all the experimental groups. There were no differences in BAO or MAO between any of the vagotomized groups (SERO, HSV, STAP, VP). Conclusions: We conclude that the three acid-reducing procedures modified for laparoscopy are equally efficacious in reducing gastric acid secretion and that they compare favorably with VP. To our knowledge, this is the first report comparing basal and stimulated gastric acid secretion between these new acid-reducing techniques. Received: 27 March 1996/Accepted: 17 July 1996