Lower Lid Blepharoplasty—The Transconjunctival Approach: Extended Indications

The transconjunctival blepharoplasty is an elegant and secure technique especially in young people and helps to avoid the hazard of a scar. In older patients, it saves them the possible sequelae such as rounding sclero show or possible ectropion after a classical operation. Because there is no visible scar, the transconjunctival approach respects the integrity of the functional structure of the orbital septum and the orbicular muscle, the active support of the lower eyelid.     

下体负压晕厥前症状下事件相关电位变化特征

目的探讨下体负压晕厥前症状（ＰＳＳ）下事件相关电位（ＥＲＰｓ）的Ｐ３潜时（Ｐ３Ｌ）变化特征，为飞行员加速度性晕厥的医学鉴定提供实验方法和依据。方法用下体负压方法（ＬＢＮＰ）诱发ＰＳＳ，观察ＥＲＰｓ的Ｐ３Ｌ变化特征。结果出现ＰＳＳ时，ＥＲＰｓ的Ｐ３Ｌ由３４３．３５±１４．７２ｍｓ延长至５０６．８７±３７．４４ｍｓ（Ｆ（６，４８）＝１４．９６，Ｐ＜０．０５，ＯＺ电极），相关任务反应时（ＲＴ）由５０８．６５±１１．１３ｍｓ延长至６３１．２５±２９．１６ｍｓ（ｔ＝２．９７，Ｐ＜０．０５），靶刺激反应错误率由（４．００±１．６７）％增加至（４３．３８±３．５４）％（ｔ＝３．０６，Ｐ＜０．０５）。ＰＳＳ后第５ｍｉｎ，Ｐ３Ｌ仍明显高于基线值（Ｐ＜０．０５）。而ＲＴ、错误率与基线值已无显著差异（Ｐ＞０．０５）。结论ＥＲＰｓ的Ｐ３Ｌ结合ＲＴ、错误率等指标对飞行员加速度性晕厥的研究有潜在应用价值。     

Effects of trapidil-derivatives on calcium channel currents in isolated ventricular cells from mice

Summary A single glass micropipette voltage clamp technique with intracellular dialysis was used to study the effects of the trapidil derivatives AR 12–456 and AR 12–463 on Ca channel currents carried by Bat+ in isolated ventricular cells from mice hearts. Inspite of a more potent inhibition of the cAMP phosphodiesterase from heart (Bartel et al. 1985) a reversible Ca channel blocking action of both compounds could be observed. The concentration of half maximal block was calculated to about 50 mol/l for both derivatives tested. Neither a shift in the current-voltage relationships nor a significant change in the potential for half maximal activation was found. The maximal Ba²⁺ -conductance was reduced. The steady state inactivation was shifted towards more negative potentials by application of 100 mol/l AR 12–463. The decay of the Ba currents was accelerated in the range of the applied test potentials between –20 and +20 mV. It is concluded that the new trapidil derivatives with more potent inhibitory action on cardiac phosphodiesterase than trapidil can block myocardial Ca channels. Send offprint requests to B. Nilius     

前锯肌平面阻滞和胸椎旁神经阻滞在胸腔镜手术中的麻醉效果及对疼痛因子的影响

目的 研究前锯肌平面阻滞与胸椎旁神经阻滞对胸腔镜手术患者的麻醉效果及对疼痛因子的影响。方法 选取2020年11月—2021年9月安徽省池州市人民医院60例接受胸腔镜手术治疗的患者作为研究对象,按照随机数字表法分为A组和B组,每组30例。两组患者术中均接受气管插管全身麻醉,麻醉诱导前,A组选择前锯肌平面阻滞,B组选择胸椎旁神经阻滞。比较两组患者的麻醉效果、阻滞操作时间、阻滞起效时间、阻滞持续时间、生命体征、术后镇痛泵按压次数、术后舒芬太尼使用量、疼痛因子、术后疼痛评分及术后不良反应发生率。结果 A组的麻醉优良率为96.67%,B组的麻醉优良率为93.33%,两组比较,差异无统计学意义（P>0.05）。两组患者的麻醉平面、阻滞起效时间比较,差异无统计学意义（P>0.05）;A组较B组阻滞操作时间缩短,阻滞持续时间延长。两组患者切皮前后收缩压、舒张压、心率差值比较,差异无统计学意义（P>0.05）。A组的术后48 h内镇痛泵按压次数、术后舒芬太尼使用量较B组减少（P <0.05）。两组患者手术前后血清PGE2、IL-6差值比较,差异有统计学意义（P <0.05）...     

Influence of sinus impulses on the parasystolic cycle length

Recently, it has been shown that in most clinical cases of parasystole, the parasystolic rhythm is not completely independent of the sinus rhythm. In this study, to disclose the mechanism of such "irregular" parasystole, parasystolic cycles with an intervening sinus QRS complex (XSX) were compared with their immediately adjacent pure parasystolic cycles without any intervening nonparasystolic QRS complexes (XX) in 10 cases of ventricular parasystole. In eight cases, the XSX interval was equal to or nearly equal to the adjacent pure XX interval; in one, the XSX interval was shorter than the XX interval; and in only one, the XSX interval was longer than the XX interval. In six cases in which the XSX interval was almost equal to the XX interval, calculated XSX intervals with a later intervening sinus QRS complex were obtained from the differences between the XSSX interval (ie, interectopic interval with two intervening sinus QRS complexes) and its adjacent XX interval. In five of the six cases, the calculated XSX interval was shorter than the XX interval. These observations suggest that in most cases of parasystole, early intervening sinus impulses do not change the parasystolic cycle, whereas late intervening sinus impulses shorten the parasystolic cycle. This suggests the presence of type I second-degree entrance block as the mechanism of "irregular" parasystole.     

Computerized axial tomo-epidurographic and radiographic documentation of unilateral epidural analgesia

A 23-year-old primigravid patient who received epidural analgesia for pain of labour presented with persistent, apparently irremediable, unilateral analgesia. Computerized axial tomo-epidurography demonstrated absence of circumferential spread due to lateral placement of the catheter. Transforaminal escape of contrast medium into the paravertebral area had occurred and anterior and posterior midline partitioning of the epidural space was obvious. All the usual measures to promote contralateral analgesia, except re-insertion of the catheter, had been tried without success.     

Afferent fiber connections from lower brain stem to hypothalamus studied by the horseradish peroxidase method with special reference to noradrenaline innervation

Summary Attempts were made to determine the afferent projections to the anterior hypothalamus including the preoptic area from the lower brain stem by means of the horseradish peroxidase method combined with monoamine oxidase staining to identify noradrenaline (NA) neurons. In addition to this technique, a histofluorescence analysis was performed. NA fibers in the medial part of the anterior hypothalamus were mainly supplied by A1 and A2 NA neuron groups, while the lateral part and periventricular zone received NA terminals from both pontine and medulla oblongata NA neuron groups. Furthermore, the present study indicated that there were direct projections to the anterior hypothalamus from non-noradrenergic neurons in the lower brain stem: nuclei raphe dorsalis, centralis superior, cells in the mesencephalic and pontine central gray matter, nuclei parabrachialis lateralis and medialis, cells around fasciculus longitudinalis medialis.Abbreviations CA Commissura anterior - CO Chiasma opticum - DP Decussatio pyramidum - DPCS Decussatio pedunculorum cerebellarium superiorum - F Columna fornicis - FLM Fasciculus longitudinalis medialis - FMT Fasciculus mamillothalamicus - GCM Griseum centrale mesencephali - GCP Griseum centrale pontis - LL Lemniscus lateralis - LM Lemniscus medialis - PCM Pedunculus cerebellaris medius - PCS Pedunculus cerebellaris superior - TO Tractus opticus - TS Tractus solitarius - TVme Tractus mesencephalicus nervi trigemini - V Ventriculus tertius - VTS Tractus spinalis nervi trigemini - am nucleus ambiguus - B Barrington nucleus - com nucleus commissuralis - cp nucleus caudatus putamen - cs nucleus centralis superior - ct nucleus corporis trapezoidei - cu nucleus cuneatus - dX nucleus dorsalis nervi vagi - Gd nucleus tegmentalis dorsalis (von Gudden) - gr nucleus gracilis - Gv nucleus tegmentalis ventralis (von Gudden) - ha nucleus hypothalamicus anterior - hl nucleus hypothalamicus lateralis - hpe nucleus periventricularis (hypothalami) - hvm nucleus ventromedialis hypothalami - lc nucleus locus coeruleus - oi nucleus olivaris inferior - p nucleus pontis - pa nucleus paraventricularis - pbl nucleus parabrachialis lateralis - pbm nucleus parabrachialis medialis - ph nucleus praepositus hypoglossi - pol nucleus preopticus lateralis - pom nucleus preopticus medialis - pop nucleus preopticus periventricularis - rd nucleus raphe dorsalis - re nucleus reuniens - rl nucleus reticularis lateralis - rm nucleus raphe magnus - ro nucleus raphe obscrus - sc nucleus suprachiasmaticus - so nucleus supraopticus - st nucleus interstitialis striae terminalis - td nucleus tractus diagonalis (Broca) - ts nucleus tractus solitarii - Vme nucleus mesencephalicus nervi trigemini - Vmo nucleus motorius nervi trigemini - Vts nucleus tractus spinalis nervi trigemini - XII nucleus nervi hypoglossi     

CPP-SOM整合cDNA基因芯片平台的建立

目的　在转录组水平全面迅速地了解疾病发生和药物作用的分子机理 ,以及寻找潜在的治疗靶标。方法　通过建立基因芯片平台 ,用全反式维甲酸诱导急性早幼粒细胞白血病来源的 NB4细胞分化作为模型 ,并应用自主开发的自组织图结合成分平面展示 (componentplane presentation integrated self-organizing map,CPP- SOM)的方法对数据进行初步分析。结果　建立的 c DNA芯片共有 12 6 30条克隆 ,其中已知基因 94 36条。应用该芯片进行实验 ,结果重复性好、准确性高。CPP- SOM不仅可以将功能相关的基因进行聚类 ,而且可以动态性地从全基因组水平观察药物作用过程中基因的表达变化。结论　我们建立的芯片平台是稳定、可靠的技术平台 ,CPP- SOM是一种新型有效的芯片数据的处理方法。     

星状神经节阻滞对急性心肌梗死患者应激激素水平的影响

目的 观察星状神经节阻滞对急性心肌梗死患者体内去甲肾上腺素（NE）、肾上腺素（adrenalin，ADR）、促肾上腺皮质激素（ACTH）、皮质醇（cortisol，ODR）等应激激素水平的影响。方法 选择已被确诊为急性心肌梗死患者68例，随机分为治疗组（34例）和对照组（34例）．治疗组患者采用星状神经节阻滞治疗，两周为一疗程；对照组常规内科治疗。于阻滞前及阻滞后24、48、72、144h抽取静脉血标本。测定各时段的NE、肾上腺素、ACTH、皮质醇应激激素的含量。结果 阻滞后治疗组患者的NE、ADR、ACTH、ODR应激激素的含量与阻滞前及同时段的对照组比较有明显的降低，P〈0．05。结论 星状神经节阻滞可快速有效地缓解由于冠状动脉供血不足引起的缺血性疼痛，抑制应激反应，降低患者体内NE、ADR、ACTH、00R应激激素的水平。