丙硫咪唑治疗包虫病的实验研究与临床观察

细粒棘球绦虫原头蚴在体外培养中与3种不同浓度的丙硫咪唑(10μg/ml,20μg/ml,40μg/ml)作用96小时后,原头蚴死亡率分别为48.5±3.2％、55.6±3.8％、66.4±4.2％。扫描电镜观察可见原头蚴多呈外翻型,顶突界面缺损,部分头钩脱落,吸盘变形,体表出现边缘不整齐的凹陷及皮层细胞脱落。丙硫咪唑治疗继发性小鼠包虫病(0.1g·kg·d×10,灌胃)的囊肿减轻率为72.2％,与对照组相比有显著性差异(P<0.05)。丙硫咪唑用于治疗10例细粒棘球蚴病患者(15mg·kg·d,连服14天为一疗程,每例4～12疗程),提示有较好的近期疗效,可能是一种有希望的抗包虫药物。     

乳房假体隆乳术后并发症12例分析

目的 减少隆乳术并发症的发生，提高隆乳术的远期效果。方法 对１２例乳房假体隆乳术后１～１３年间出现并发症患者的临床表现及包膜病理变化进行分析讨论。结果 １２例１５侧乳房中，单侧９例并发１种并发症者４例，并发２种者４例，并发３种者１例；双侧３例，并发同一种并发症者２例，并发３种并发症者１例。各种并发症有其特有的包膜病理及临床特点。结论 严格执行无菌操作、熟练掌握该术技能、造反优质假体、首选胸大肌下置     

Microscopic examination of hippocampal slices after short-term lead exposure in vitro

By using light microscopic, electron microscopic and morphometric methods 450 μm thick slices of guinea pig hippocampus were studied after 5-hr incubation as controls in normal media and after incubation in media containing 40 μM lead acetate. Pyramidal neurons of the CA1 region and the granule cells of the fascia dentata were well preserved in the center of the slice, whereas neuronal structures in outer parts of the slice were either vacuolated or hyperchromatic and shrunken. Most of the CA4 neurons were lytic except for a few in the center of the slice. Morphometric analysis of the pyramidal layer of CA1 yielded approximately 55% well-preserved pyramidal neurons both in lead-exposed slices and in slices incubated in normal media. Electron microscopic examination of the CA1 region demonstrated no ultrastructural changes of lead-exposed slices compared to control. In conclusion, the reduction of evoked neuronal activities in the CA1 region of hippocampal slices during short-term lead exposure in vitro appears not to be linked to a specific neuropathological lesion.     

Surgical treatment of mammary hyperplasia during pregnancy

Reduction mammaplasty is an effective procedure and the treatment of choice for symptomatic breast hypertrophy. Two unusual cases of reduction mammaplasty are reported. After uneventful immediate postoperative courses, two unusual wound complications occurred requiring further treatment. It was discovered retrospectively that the two women (21 and 24 years old) were pregnant. There was no other cause to explain the skin problems which were encountered. It is suggested that a pregnancy test may be needed before undertaking reduction mammaplasty. Received: 25 May 1999 / Accepted: 10 August 1999     

X线与CT评估椎管内骨折块间接复位的对比研究

目的 对比研究X线透视椎体标准侧位像上椎体后壁"一线影"与CT扫描对判断椎管内骨折块复位的价值,为术中X线透视即刻判断骨折块间接复位的程度提供依据. 方法 回顾性分析25例胸腰椎爆裂骨折患者的临床资料.术前CT证实均为爆裂骨折,骨块占椎管中矢径比例平均35.2%.所有患者采用短节段椎弓根螺钉系统间接复位,未行椎板切除减压.术中X线透视标准侧位像上骨折椎体后壁呈现连续、平滑的"一线影"时,即认为骨块已复位.术后均行CT扫描观察骨块复位情况. 结果 术后CT示骨折块占椎管中矢径比例由术前35.2%减少至8.6%,术前、术后相比差异有统计学意义(t=9.122,P<0.01),达到椎管有效减压的要求.随访时25例患者的神经功能均正常. 结论 标准侧位像上椎体后壁连续、平滑的.一线影"可作为判断椎管内骨折块复位的一种简单有效的方法,能为术中决定是否行椎板切除减压和骨块推顶提供有效的依据.     

聚丙烯酰胺注射隆胸的清除及同期假体置入疗效观察

目的探讨聚丙烯酰胺注射隆胸患者的聚丙烯酰胺清除及同期置入假体的可行性。方法12例患者，分2组。第一组：2例，局麻下行注入盐水负压抽吸术。第二组：10例，全麻下乳晕切口清除聚丙烯酰胺，并同期置入硅胶假体。结果术后3个月随访，经抽吸或切开取出聚丙烯酰胺，同期置入硅胶乳房假体后，术前症状消失，疗效满意。结论聚丙烯酰胺水凝胶大部分可经乳晕切口取出，同期置入硅胶乳房假体是切实可行的方法。     

微创复位椎体后凸成形治疗重度骨质疏松性脊柱骨折

目的探讨微创复位椎体后凸成形(MIRKP)治疗重度骨质疏松性脊柱骨折的临床疗效。方法11例12个椎体骨质疏松、楔形压缩或爆裂性骨折,经CT、MRI检查后判断椎体后缘骨块突入椎管内的程度及脊髓有无受压后,单侧微创复位恢复椎体高度,另一侧行经皮穿刺,并C型臂X线机定位后注入骨水泥。结果8例Frankel神经分类D级均恢复至E级;Cobb角平均恢复15°;椎管骨块侵占率平均减少21%;平均灌注骨水泥5.2ml。随访平均7.6个月,未发现手术并发症及椎体高度的丢失。结论MIRKP治疗骨质疏松性脊柱骨折安全、有效,对严重骨质疏松性脊柱骨折有很好的疗效。     

经乳头根部小切口盐水假体隆乳术-30例临床回顾

目的：选择合适的皮肤切口入路，操作方便，组织损伤小，术后瘢痕不明显是未来隆乳术的发展方向。基于这一原则，笔者选择经乳头根部小切口行盐水假体隆乳术，旨在观察术后的效果。方法：全麻或局麻下，于乳头下侧缘距基底部2mm处设计半环形切口。对于乳头过小者，可向两侧乳晕水平方向延长5mm，总长度小于2．5cm。沿此切口切开皮肤全层，沿乳腺导管走行方向分离，在乳腺下或胸大肌下制造腔穴，将充注式盐水袋假体置入腔穴。再将200ml～300ml盐水通过阀门注入。观察双侧乳房大小、形状、对称性均满意后分层缝合和包扎。结果：从2000年1月～2007年12月，我们用此种方法行隆乳术30例。术后早期5例患者出现乳头感觉暂时减退，1～3月后均恢复正常。10例乳房表面出现局部轻微褶皱塌瘪，2例假体破裂，取出后再次置入新假体。无乳头畸形、包膜挛缩、双侧不对称，所有患者对切口瘢痕感到满意。结论：经乳头根部小切口置入盐水充注式假体手术，操作简便，安全性高，损伤乳腺组织少，愈后切口瘢痕隐蔽。该术式是可行的，值得在临床上推广应用。     

188例小儿肠套叠空气灌肠整复治疗体会

目的探讨小儿肠套叠空气灌肠整复的临床应用,进一步提高其临床应用的整复率。方法对确诊的188例小儿肠套叠进行动态可监测下不同气压空气灌肠整复的临床观察进行回顾性分析。结果 188例中有174例(92.56%)成功整复,14例(7.44%)失败。结论空气灌肠是诊断与治疗小儿肠套叠的最好方法,结合间歇注气、手法按摩,明显提高整复成功率,对于部分患者发现套头固定、时间大于3d或有肠穿孔者应尽早手术治疗。     

Mind-Body-Medizin: Neue (alte) Wege in der Medizin

The term ,Mind/Body Medicine' (MBM), which was coined in Northern America, encompasses a holistic therapeutic approach aiming at the integration of physical and psychological as well as social and spiritual aspects of human existence. By applying various techniques which have become well-established in medical research and practice as part of the behaviourist tradition, the interaction between mind, body and behaviour is utilized to strengthen the self-healing properties of the individual. The most fundamental approach incorporates and cultivates the patients' individual abilities and resources. In this system, the role of the therapist is to encourage and to empower, rather than to ”treat”.