骨间后神经阻滞麻醉的应用解剖

目的:为骨间后神经阻滞麻醉提供解剖学资料.方法:选用福尔马林固定的成人上肢标本46例,显露骨间后神经后分别测量骨间后神经起始处(即桡神经深支穿出旋后肌的部位)与皮肤表面的垂直距离(深度)、与桡骨头的距离、与髁间线的距离、与肱骨外上髁和Lister结节连线的水平距离以及桡骨茎突与髁间线之间的距离.结果:骨间后神经的起始处即桡神经深支穿出旋后肌的部位均位于肱骨外上髁与桡骨Lister结节连线的尺侧,且与该连线的水平距离平均为(6.0±2.1)mm、与皮肤表面的垂直距离平均为(18.4±3.5)mm、与桡骨头的距离平均为(52.8±4.9)mm、与髁间线的距离平均为(60.3±15.8)mm,髁间线与桡骨茎突尖端的距离平均为(229.2±18.7)mm.结论:髁间线下方约60mm、肱骨外上髁与桡骨Lister结节连线尺侧约6mm处可作为桡神经深支远端即骨间后神经起始处的定位标志,本实验可为骨间后神经阻滞麻醉提供可靠的解剖学资料.     

舌咽神经阻滞入路的解剖基础

目的:为舌咽神经阻滞入路和预防并发症的发生提供解剖学资料.方法:应用35具成人头、颈部标本,逐层解剖,显露舌咽神经并追溯到颈静脉孔外口,仔细观察舌咽神经与周围诸结构的位置及毗邻关系并测量相关数据.结果:舌咽神经与迷走神经、副神经、岩下窦及颈内静脉一起自颈静脉孔出颅,出颅后与颈内动脉、颈内静脉、舌下神经、副神经、迷走神经等结构关系密切.舌咽神经阻滞进针的深度即下颌角与外耳门连线的中点至颈静脉孔的距离,左侧为22.33±1.98 mm,右侧为22.45±2.03 mm,进针方向为斜向内上方稍偏前,与正中矢状面呈45～60°.结论:本研究可为舌咽神经阻滞入路和预防并发症的发生提供可靠的解剖学资料.     

Do doctors’ attachment styles and emotional intelligence influence patients’ emotional expressions in primary care consultations? An exploratory study using multilevel analysis

Objective

To investigate whether and how doctors’ attachment styles and emotional intelligence (EI) might influence patients’ emotional expressions in general practice consultations.

Effects of core-to-dentin thickness ratio on the biaxial flexural strength,reliability, and fracture mode of bilayered materials of zirconia core (Y-TZP) and veneer indirect composite resins

Statement of problem

Indirect composite resins (ICR) are promising alternatives as veneering materials for zirconia frameworks. The effects of core-to-dentin thickness ratio (C/Dtr) on the mechanical property of bilayered veneer ICR/yttria-tetragonal zirconia polycrystalline (Y-TZP) core disks have not been previously studied.

Dipyridamole stress myocardial perfusion by computed tomography in patients with left bundle branch block

Background

Functional tests have limited accuracy for identifying myocardial ischemia in patients with left bundle branch block (LBBB).

Objective

To assess the diagnostic accuracy of dipyridamole-stress myocardial computed tomography perfusion (CTP) by 320-detector CT in patients with LBBB using invasive quantitative coronary angiography (QCA) (stenosis ≥ 70%) as reference; to investigate the advantage of adding CTP to coronary computed tomography angiography (CTA) and compare the results with those of single photon emission computed tomography (SPECT) myocardial perfusion scintigraphy.

Methods

Thirty patients with LBBB who had undergone SPECT for the investigation of coronary artery disease were referred for stress tomography. Independent examiners performed per-patient and per-coronary territory assessments. All patients gave written informed consent to participate in the study that was approved by the institution’s ethics committee.

Results

The patients’ mean age was 62 ± 10 years. The mean dose of radiation for the tomography protocol was 9.3 ± 4.6 mSv. With regard to CTP, the per-patient values for sensitivity, specificity, positive and negative predictive values, and accuracy were 86%, 81%, 80%, 87%, and 83%, respectively (p = 0.001). The per-territory values were 63%, 86%, 65%, 84%, and 79%, respectively (p < 0.001). In both analyses, the addition of CTP to CTA achieved higher diagnostic accuracy for detecting myocardial ischemia than SPECT (p < 0.001).

Conclusion

The use of the stress tomography protocol is feasible and has good diagnostic accuracy for assessing myocardial ischemia in patients with LBBB.     

BOP1与肿瘤关系的研究进展

增殖阻断蛋白1(BOP1)是一种核蛋白。它参与核糖体的生物合成,进而影响蛋白质的合成。近来研究表明,BOP1在某些肿瘤中表达增高,并在上皮间质转化(EMT)、肿瘤发生发展、侵袭转移方面发挥关键作用。BOP1在肿瘤中的具体作用机制尚不十分明了。笔者就其生物学特性及与肿瘤的关系的研究进展作一综述。     

防城港市婚前医学检查人群感染HIV、梅毒情况分析

目的:了解防城港市免费婚前医学检查人群的HIV、梅毒感染情况,为制订HIV、梅毒传播防治策略提供参考依据。方法:对防城港市2010年度婚检人群进行HIV、梅毒抗体检查。结果:2010年婚检人数18 837例,其中HIV抗体检测人数为18 106例,HIV确诊阳性28例,HIV感染率为0.15%;梅毒筛查人数为18 614例,检出梅毒191例,检出率为1.03%。性传播是感染HIV和梅毒的主要途径,感染人群以低文化程度和农民为主,男性比女性感染率高。感染趋势由高危人群向一般人群发展。结论:防城港市婚检人群中HIV、梅毒感染情况严重,预防和控制HIV、梅毒等性传播疾病的工作严峻;婚前医学检查是早发现、早治疗、及时控制HIV、梅毒感染及传播的关键。     

Growth inhibition of experimental glioma grafts by monoclonal antibody treatment

Summary The effects of 14AC1 monoclonal antibody (McAb) on 79FR-G-41 rat glioma cells in vitro, on the formation of metastases in lung by antibody coated glioma cells, and on the growth of glioma grafts in BALB/c-nu/nu mice were investigated.The 14AC1 antibodies — isotyped as IgG2a — were obtained from a hybridoma clone established after fusion of X63-Ag8.653 myeloma cells and spleen cells of BALB/c mice hyperimmunized with 79FR-G-41 glioma cells. Antibody treatment of glioma cells in vitro caused evident cell surface alterations and pronounced growth depression of most cells. However, a few tumor cells remained unchanged in morphology and continued to proliferate. Moreover, 14AC1 antibodies drastically reduced lung metastasis by pretreated and i.v. delivered glioma cells. Additionally, 14AC1 antibodies suppressed the growth of transplanted rat gliomas in nude mice as evidenced by a longer latency period and a smaller volume of glioma grafts in treated than in control tumor bearers. Nevertheless, glioma grafts showed accelerated growth after termination of antibody treatment.Further experimental investigation is required in order to identify the precise mechanisms of the effects of McAbs on tumor cells in vitro and in vivo.     

Evaluation of a Kalman-based block matching method to assess the bi-dimensional motion of the carotid artery wall in B-mode ultrasound sequences

We aim at investigating arterial diseases at early stage, by assessing the longitudinal (i.e. in the same direction as the blood flow) motion of the intima-media complex. This recently evidenced phenomenon has been shown to provide relevant and complementary information about vascular health.Our method assesses the longitudinal and radial motion from clinical in vivo B-mode ultrasound sequences. To estimate the trajectory of a selected point during the cardiac cycle, we introduce a block matching method that involves a temporal update of the reference block using a pixel-wise Kalman filter. The filter uses the initial gray-level of the pixel as control signal to avoid divergence due to cumulating errors. The block and search-window sizes are adapted to the tissue of interest.The method was evaluated on image sequences of the common carotid artery, acquired in 57 healthy volunteers and in 25 patients at high cardiovascular risk. Reference trajectories were generated for each sequence by averaging the tracings performed by three observers. Six different computerized techniques were also compared to our method.With a pixel size of 30 μm, the average absolute motion estimation errors were 84 ± 107 μm and 20 ± 19 μm for the longitudinal and radial directions, respectively. This accuracy was of the same order of magnitude as the inter- and intra-observers variability, and smaller than for the other methods. The estimated longitudinal motion amplitude was significantly reduced in at-risk patients compared with healthy volunteers (408 ± 281 μm vs. 643 ± 274 μm, p < 0.0001).Our method can constitute a reliable and time-saving technique to investigate the arterial stiffness in clinical studies, in the objective to detect early-stage atherosclerosis.     

局部封闭在阻生齿拔牙中的应用体会

目的：探讨局部封闭的同时拔除阻生齿，可减少术后炎症反应的临床疗效。方法：拔除阻生齿前10′用庆大霉素8万μ,DXm5mg，利多卡因1ml行远中盲袋封闭，常规局麻拔除患牙，观察24－48h后的炎症反应。结果：24h后无明显出血，张口受限，48h后无干槽症的为98％，轻度张口受限的为2％。结论：局部封闭的同时拔除阻生齿，可有效的减少术后炎症反应。