局麻下深龋充填对成人牙科畏惧症的影响

目的　探讨局麻下深龋充填对成人牙科畏惧症的影响。方法　采用Corah’s牙科畏惧症评分法 ,筛选出 10 0例需深龋充填的DF成人患者 ,分为实验组与对照组。实验组在局麻下行深龋充填术 ,对照组则为常规的牙科治疗。结果　实验组DF程度明显降低 ,与治疗前以及对照组比较都有显著性差异 (P <0 .0 1)。牙科治疗过程中两组脉搏的变化有显著性差异 (P <0 .0 1)。结论　局麻下行深龋充填术 ,对成人牙科畏惧症有治疗作用     

改良上颌平面导板矫正青少年深覆颌的临床观察

目的观察改良上颌平面导致矫正青少年深覆颌的效果。方法制作上颌平面导板,下颌双侧尖牙与其接触,后牙抬高3.0 mm。分为昼夜戴用导板及仅夜间戴用导板两组,观察疗效。结果深覆颌总矫正率72.2%,昼夜戴用该改良上颌平面导板组的深覆颌矫正率100%。结论改良上颌平面导板制作简单,戴用方便,效果明显。     

下腔静脉滤器在治疗下肢深静脉血栓中的应用

目的：探讨下腔静脉滤器在治疗下肢深静脉血栓(DVT)中的应用价值。方法：选择10例DVT患，使用进口铁质滤器，经股静脉或颈静脉途径置人下腔静脉，随访8—20个月。结果：10例患中无一例发生肺动脉栓塞和其他严重并发症。结论：下腔静脉滤器置人方法简单，安全；可有效防止肺动脉栓塞的发生。     

Deep brain stimulation for Parkinson''s disease: electropermeabilization and activation

Deep brain stimulation, DBS, is an accepted technique for the treatment of Parkinson's disease. DBS affects the electrical functions of neurons, but exactly how it alters those functions is not clearly explained. An electrical model is determined to simulate treatment with DBS of the sub thalamic nucleus. This model shows the difference in electrical fields between the inside and the outside the neurons. The generated electrical field near the electrodes is high enough to perform an electropermeabilization of the cell membranes, which most likely blockade normal nerve pulses or reduce the nerve impulse speed. Further away from the electrodes activation of large axons is performed.     

Changes in Glucose Metabolism in Cerebral Cortex and Cerebellum Correlate With Tremor and Rigidity Control by Subthalamic Nucleus Stimulation in Parkinson's Disease: A Positron Emission Tomography Study

Objective. Employing [¹⁸F]fluorodeoxyglucose (FDG) positron emission tomography (PET) to assess the correlation between the effect of deep brain stimulation (DBS) on the subthalamic nucleus (STN) and the regional cerebral metabolic rate of glucose (rCMRGlc) in advanced Parkinson's disease patients (N = 8). Materials and Methods. On the basis of patients’ diary records, we performed FDG‐PET during the off‐period of motor activity with on‐ or off‐stimulation by STN‐DBS on separate days and analyzed the correlation between changes in motor symptoms and alterations in the rCMRGlc. Result. When FDG‐PET was performed, the motor score on the unified Parkinson's disease rating scale (UPDRS) was 64% lower with on‐stimulation than with off‐stimulation (p < 0.001, Wilcoxon single‐rank test). STN‐DBS increased the rCMRGlc in the posterior part of the right middle frontal gyrus, which corresponded to the premotor area, and the right anterior lobe of the cerebellum (p < 0.005, paired t‐test). No region exhibited a decrease in rCMRGlc. Among the items of the UPDRS motor score, the changes in resting tremor and rigidity of the left extremities showed a significant correlation with the changes in rCMRGlc observed in the right premotor area (p < 0.02 and p < 0.05, respectively, Spearman's rank correlation). Conclusions. STN‐DBS either activates the premotor area or normalizes the deactivation of the premotor area. These FDG‐PET findings obtained are consistent with the idea that STN‐DBS modifies the activities of neural circuits involved in motor control.     

Measurement of contact impedance of electrodes used for deep brain stimulation

High frequency electrical stimulation by means of electrodes implanted into the brain has become an accepted technique for treatment of Parkinson's disease. The electrical field distribution normally inserted into the sub thalamic nucleus minimise abnormal brain activity. Square wave pulses of 1–3.6 V with duration of 60–90 μs at a frequency range of 130–185 pps are generally used. Every electrode unit consists of four cylindrical electrodes positioned in a row and can be switched on independently. This paper determines the contact impedance of the electrodes for different frequencies and proposes improvement to reduce the contact impedance between the electrodes and the brain. Measurements were performed by placing the electrodes in a tank filled with saline. Different frequencies were applied on two electrodes via a resistor. The current was measured through the resistor and the voltage was registered between one of the electrodes and a third non current carrying electrode. The obtained values were used to calculate the contact impedance. The result shows large contact impedance for the used frequency compared to the impedance of the treated tissue, which means that variation in contact impedance can result in variation in the electrical field applied to the tissue.     

The use of deep inspiration preceding the valsalva maneuver and rapid expiration in color doppler imaging of the lower extremity veins

Deep inspiration preceding Valsalva maneuver and rapid expiration immediately following it (DIVE) enhance venous blood flow on color Doppler flow imaging (CDI). The effect of DIVE was assessed in 115 consecutive lower extremity examinations. Of these, 95 or 115 (83%) had negative CDI sonograms, and 20 of 115 (17%) had partially (six of 115) or completely (14 of 115) occluding deep vein thrombosis. DIVE enhanced venous blood flow in 68% of the negative cases, resulting in transient venous distention, and/or more complete color filling, and/or greater spectral flow velocities. The 14 cases with completely occluding thrombi showed no response to DIVE. Six cases with partially occluding thrombi showed moderate to mild response to DIVE, with improved color delineation of the residual patent lumen around the thrombus. The authors conclude that DIVE facilitates deep venous CDI, especially when compression cannot be used to augment venous flow.     

The middle collateral artery: anatomic basis for the “extreme” lateral arm flap

The vascularization of the posterolateral area of the arm is supplied by the terminal branches of the deep brachial artery [middle collateral artery (MCA) and posterior radial collateral artery]. Their anatomy has been a field of confusion for a long time. An extended lateral arm flap, named the extreme lateral arm flap, supplied by these branches and dissected as a retrograde island flap has been proposed as an alternative for large compound defects of the distal forearm. We carried out an extensive anatomic study of the extreme lateral arm flap on 69 upper limbs: 54 fresh injected with colored latex, 10 embalmed and 5 radiographed after Micropaque injection. Two origin levels of the MCA were found: a proximal one (37%) above the radial groove, and a distal one (63%) at the level of the groove. The deep brachial artery always bifurcated after the origin of the MCA into a posterior radial collateral artery (PRCA) and anterior radial collateral artery (ARCA). Indeed in our dissections, after the origin of the MCA from the deep brachial artery, there was always a common trunk named the radial collateral artery (RCA) which bifurcated into the ARCA and PRCA. In all dissected arms we always found the MCA anastomosed in a transverse pattern with the inferior ulnar collateral artery (IUCA), contributing to the anastomotic circle of the elbow. This circle represents the unique vascularization source of the reverse extreme lateral arm flap.     

实验高压电烧伤深筋膜微循环动态变化及意义

目的研究肢体高压电烧伤后深筋膜微循环变化规律。方法将28只家兔随机分成实验组与对照组。实验组家兔的右下肢采用1万伏额定电压 ,77mA电流及通电5s的方法制作单侧后肢电烧伤模型 ,对照组采用假电的方法制作单侧后肢假电烧伤模型 ,两组均采用“滴水开窗法”制作左侧下肢远端深筋膜微循环观测窗 ,并采用WX -9B型多部位微循环显微仪及其图像处理系统在通电前、通电后即刻、通电后30min、2、4、6h观测微动脉、毛细血管、后微静脉、微静脉的形态、流态、管周状态。结果肢体高压电烧伤后 ,微血管形态在30min内可观测到显著性变化 (P<0.05) ,表现为血管密度减小 ,微动脉、毛细血管、微静脉收缩 ,后微静脉扩张 ,微动脉、毛细血管均在6min以后变得不清以致模糊(P<0.05)、后微静脉、微静脉分别在2h、30min以后变得不清(P<0.05)。微血管内的流态以白微栓的变化可见规律性 ,即白微栓在电后2h开始出现 ,4h迅速达高峰 ,6h又有快速下降的趋势。微静脉和后微静脉在通电30min后有渗出(P<0.05) ,只有后微静脉在通电后2h有出血(P<0.05)。结论电烧伤后存在全身性反应 ,其在肢端深筋膜微循环的表现是一个阶段性加重的过程 :第一阶段电烧伤后30min内为缺血型微循环障碍 ,第二阶段微循环障碍包含两个方面 :其一是微血管的出血     

CD8+T-bet+ cells as a predominant biomarker for inclusion body myositis

Background

Myositis is a heterogeneous group of muscular auto-immune diseases with clinical and pathological criteria that allow the classification of patients into different sub-groups. Inclusion body myositis is the most frequent myositis above fifty years of age. Diagnosing inclusion body myositis requires expertise and is challenging. Little is known concerning the pathogenic mechanisms of this disease in which conventional suppressive-immune therapies are inefficacious.