一次性根治术治疗多发性肛瘘临床观察

为观察Parks分类对多发性肛瘘一次性根治手术的指导意义,对32例多发性肛瘘根据Parks分类采用不同手术方式。32例患者全部治愈,术后随访3～6个月,未发现明显并发症。对于多发性肛瘘其手术成功的关键是做好瘘管的解剖定位,即了解肛瘘穿经外括约肌不同平面是正确处理肛瘘的前提,它可以有效减轻手术过程中对括约肌的损害。同时正确的处理中央间隙和内口是降低复发率的关键。     

HIV唾液快速检测在公园场所MSM人群中的应用

目的探索在公园场所男男性行为人群（MSM）中开展艾滋病病毒（HIV）唾液快速检测的可行性,为进一步推广使用提供基础依据。方法由经过培训的9名MSM同伴教育志愿者,在北京市各个MSM活动的公园开展HIV唾液快速检测,收集受检者的姓名、年龄、身份证号、联系方式、文化程度、婚姻状况以及户籍所在地等一般人口学特征。结果 2个月共为1 076名MSM提供了HIV唾液快速检测服务,发现阳性53例,快检阳性率为4.9%。其中44人采集血液进行复测和确认,42人确认HIV阳性,确认阳性率为3.9%。HIV唾液快检与确认检测的一致性为95.5%。结论 HIV唾液快速检测方法在公园场所MSM人群中有很强的实用性,接受性好,值得推广使用。     

Potentiating effects of clofibrate on prostaglandin-dependent and -independent pathways of human platelet activation: evidence for involvement of cyclic AMP

Although clofibrate has been shown to inhibit platelet aggregation that is caused by thrombin, ADP and epinephrine, by blocking the release of arachidonic acid from platelet phospholipids [8], here we have demonstrated that clofibrate enhanced platelet aggregation by arachidonic acid and PLC and reversed the effects of PGE1 on platelet cAMP concentration and on PLC-induced secretion of [14C]-5HT in similar, concentration-dependent manners. Taken together, these findings strongly suggest that the proaggregatory effect of clofibrate is mediated by a lowering of cAMP in platelets.     

81. Die plastischen Korrekturoperationen im Ano-Rectalbereich

Zusammenfassung Die Indikation zu unseren 483 plastischen Korrektur-Operationen im Anorectalbereich bildete der isolierte Mucosaprolaps, Hamorrhoiden III. Grades mit Mucosaprolaps, das Ectropium, die Analstenose, größere perianale Tumoren, hohe transsphinctere Analfisteln sowie kleinere rectovaginale Fisteln. Die angewandten plastischen Verfahren waren anal reconstruction nach Parks, die V-Y-Plastik, bei großen perianalen Tumoren die Lappenplastik bzw. S-Plastik nach Ferguson sowie der gestielte Rectumschleimhautlappen bei den hohen transsphincteren Anal- bzw. Rectovaginal-Fisteln.     

低位直肠癌9例改良式Parks术临床分析

本文介绍9例低位直肠癌施行改良式Parks手术治疗,随访时间14个月至3年3个月,平均1年9个月,无局部复发。8例在术后3周至7周内控便达正常功能,平均4.4周。文中对保肛的生理解剖、临床手术适应证和术前、后辅助性综合治疗方面进行了讨论。     

Medical and surgical importance of the arterial blood supply of the thumb

The arterial supply of the thumb was studied in 50 cadaver hands. In 80% the princeps pollicis artery was the first palmar metacarpal artery, a major branch of the deep radial arch. In 50% of the specimens the princeps pollicis artery also supplied the proper radial digital artery to the index finger. Variations of the thumb arterial patterns were present in 25%. In 75% there was a single end-arterial blood supply to the thumb. The anatomic findings are correlated with problems of radial artery injections, thrombosis, and surgical injury to illustrate the clinical importance of the princeps pollicis artery.     

结膜Parks切口联合表面麻醉在斜视手术中的应用

目的观察结膜Parks切口联合表面麻醉下进行斜视手术的效果。方法斜视患者136例,表面麻醉剂0．4％盐酸奥布卡因滴眼液术前3次点术眼,常规行结膜Parks切口。观察麻醉效果、术中、术后并发症及手术效果。结果麻醉效果I级者98例（72．05％）,Ⅱ级者38例（27．95％）,Ⅲ级者0例;术后睑裂区外观正常,美容效果显著,未出现持续不退的结膜充血、结膜囊肿、结膜瘢痕等并发症。结论结膜Parks切口联合表面麻醉剂的斜视手术安全可行、操作简便、手术快捷、并发症少、美容效果好。     

Neighborhood poverty,park use,and park-based physical activity in a Southern California city

A rich literature indicates that individuals of lower socio-economic status engage in less leisure time physical activity than individuals of higher socio-economic status. However, the source of the difference is believed to be, in part, due to differential access to resources that support physical activity. However, it has not been shown as to whether equal access to parks can mitigate differences in leisure time physical activity. Using systematic direct observation, we quantified physical activity in neighborhood parks in a large Southern California city located in areas with high, medium, and a low percentage of households in poverty. We documented how neighborhood parks are managed and programmed and also interviewed both a sample of park users and a random sample of households within a mile radius of the parks. We found that parks are used less in high-poverty areas compared to medium- and low-poverty area parks, even after accounting for differences in size, staffing, and programming. The strongest correlates of park use were the number of part time staff, the number of supervised and organized programs, and knowing the park staff. Perceptions of safety were not relevant to park use among those interviewed in the park, however it had a small relationship with reported frequency of park use among local residents. Among park users, time spent watching electronic media was negatively correlated with the frequency of visiting the park. Future research should test whether increasing park staffing and programming will lead to increased park use in high-poverty neighborhoods.     

An integrated approach to create a spatial database of parks for urban health research

The role of urban parks has gained interest in urban health research. However, there are currently no clear definitions of these urban assets as exposure variable across the literature, which do have implications for the analysis. In this study, we exhibit an approach to design a comprehensive spatial database of urban parks in cities, using the example of Madrid. This approach consisted of the combination of different spatial databases containing information about parks and green spaces in the city of Madrid, and then a spatial processing to keep only those that met the selected criteria for urban park definition: accessible for pedestrians (to have at least one path around or through the area) and with the minimum size suitable (bigger than 0.50 ha) for physical activity. This approach can be helpful to design spatial databases that enable conducting epidemiological studies on the relationship between urban parks and population health.