The spinoglenoid ligament: an anatomic study

The spinoglenoid ligament and its anatomic variations are described in 27 shoulders from 15 cadavers. In each shoulder one or two distinct spinoglenoid ligaments originated from the base of the spine of the scapula; they inserted on the neck of the scapula or the shoulder joint capsule. In the 19 shoulders in which only one spinoglenoid ligament was present, it inserted into the neck of the scapula in 14 cases and into the shoulder joint capsule in five instances. In the eight shoulders in which there were two ligaments, one inserted into the neck of the scapula and the other into the shoulder joint capsule. We did not observe any hypertrophic spinoglenoid ligaments that may have compressed the suprascapular nerve.     

Nutcracker phenomenon demonstrated by three-dimensional computed tomography

We report a 15-year-old girl with nutcracker syndrome (NCP) in whom three-dimensional helical computed tomography (3D helical CT) was useful for diagnosis; angiographic imaging using 3D helical CT provided fine outlines of the vascular structures in NCP, i.e., a compression of the left renal vein between the aorta and the superior mesenteric artery and the abnormal acute angle between them. Thus, a 3D helical CT enables precise depiction of the anatomical characteristics of renal vasculature and, therefore, may be a useful alternative imaging technique instead of conventional examinations, such as invasive venography or digital subtraction angiography. Further study in a large number of children with vascular abnormalities would be worthwhile. Received: 8 February 2001 / Revised: 10 May 2001 / Accepted: 10 May 2001     

左肾静脉压迫综合征的诊断和治疗--附1例报告

目的：探讨左肾静脉受压综合征的发病机制、临床诊断及最佳外科治疗方案。方法：1例左肾静脉受压综合征病例，采用多普勒彩色超声及计算机体层成像检查确诊，创新采用外支撑架治疗方法，结合近年来的文献进行分析和探讨。结果：病人症状获得完全缓解，尿检正常，无手术并发症。结论：可采用多普勒彩色超声结合临床表现诊断左肾静脉压迫综合征；对年龄小、症状轻的病人，可采用保守治疗；外支撑架的手术治疗方法是一种简单、安全、有效的治疗方式，值得进一步推广。     

Laser extraction of entrapped leads

Removing entrapped pacing and defibrillator leads has been greatly simplified by making use of the excimer laser extractor. Sixty-two leads were successfully removed, although where appropriate, portions of the lead remained in place in 10 cases. There were two serious complications, one tear of the superior vena cava during an ICD extraction and one tear of the atrium during an atrial lead extraction. Both were controlled successfully through emergency sternotomy. Although extracting entrapped leads has been much simplified by making use of the laser extractor, the process is not free of serious complications. Those involved in explanting leads should be aware of the outcomes and be prepared for emergent management.     

Intraoperative measurement of pressure gradient in median arcuate ligament syndrome as a rationale for radical surgical approach

Background: Median arcuate ligament syndrome (MALS) describes clinical symptoms in patients with stenosis of the celiac artery due to external compression by the ligament. There is an ongoing debate, whether sole release of the median arcuate ligament warrants long-term relief of the symptoms.

Materials and methods: Eight patients diagnosed with MALS underwent open surgical treatment beginning with the release of the ligament. Systemic pressure and pressure in the left gastric artery were measured before and after division of the median arcuate ligament and release of the celiac artery. In patients with persistent gradient above 15?mm?Hg after the release a PTFE bypass was performed.

Results: After the release, the pressure gradient decreased from 66?±?19 to 48?±?14?mm?Hg (p?=?.001) and therefore in all patients either an aorto-celiac bypass (n?=?6) or aorto-hepatic bypass (n?=?2) was created. Consequently, the gradient decreased to 7?±?2?mm?Hg (p?=?.0001). One month postoperatively, three patients were free of symptoms and the rest reported relief of symptoms.

Conclusions: Release of the celiac artery resulted in insufficient decrease of pressure gradient, which was achieved by bypassing the segment with favorable mid-term outcome. We believe that the effect of the release should always be assessed to decide on subsequent treatment.     

响应面设计优化三磷酸胞苷二钠脂质体的制备工艺

目的采用逆相蒸发法制备三磷酸胞苷二钠脂质体。方法以包封率、外观形态、体外释放为指标,采用响应面分析法设计实验,优化脂质体制备工艺。结果优化工艺为卵磷脂∶胆固醇为0.675g∶0.125g,PBS用量为8mL,超声时间为6min。结论在此条件下制得的脂质体包封率为94.30%,粒径范围在20～50μm,体外释放具有突释和缓释的特点。     

改良针刀疗法治疗手指屈肌狭窄性腱鞘炎的效果

目的评价改良针刀微创腱鞘切开治疗屈指肌腱狭窄性腱鞘炎的疗效及安全性。方法采用改良针刀切开掌骨头部指屈肌腱环形纤维性腱鞘,治疗指屈肌腱狭窄性腱鞘炎196例,219个手指,术后进行疗效评定,同时观察并发症。结果术后1个月时治愈率97．3％（213／219例）,3个月与6个月时治愈率均为100％。结论改良针刀微创腱鞘切开可有效治疗手指屈肌腱狭窄性腱鞘炎。     

阿霉素纳米脂质体制备工艺研究

目的 本实验尝试制备阿霉素纳米脂质体并测定其包封率,探求其最佳制备工艺.方法 采用薄膜分散高压均质法制备阿霉素纳米脂质体,高效液相色谱法检测阿霉素包封率.结果 制得的阿霉素纳米脂质体大小均匀、分散性好、粒径在180nm左右、包封率为71.46%,4℃保存3个月稳定.阿霉素在0.54μg/mL～21.60μg/mL范围内线性良好(r=0.9997),回归方程为Y=46632x+19140.结论 该法制备的阿霉素纳米脂质体,工艺简单易行,质量可控.     

多层螺旋CT血管成像技术诊断左肾静脉压迫综合征8例分析

目的：探讨多层螺旋CT血管成像在左肾静脉压迫综合征中的诊断价值。方法：应用16层螺旋CT对8例左肾静脉压迫综合征病例进行泌尿系增强多期扫描,并获得后处理图像。结果：8例左肾静脉压迫综合征病例均可见肠系膜上动脉（SMA）压迫左肾静脉的征象。CT多平面重建直观地显示了腹主动脉（AO）与SMA之间的关系。结论：MSCT在左肾静脉压迫综合征诊断中具有明显的优势。     

盐酸青藤碱纳米柔性脂质体的制备及其性质研究

目的制备盐酸青藤碱纳米柔性脂质体,探索其体外透皮给药的规律与机制。方法采用薄膜分散法制备以丙二醇为柔软剂的盐酸青藤碱纳米柔性脂质体,考察卵磷脂、胆固醇与丙二醇对脂质体包封率的影响;高效液相色谱(HPLC)法测定青藤碱的量,原子力显微镜(AFM)、透射电镜(TEM)和光子相关光谱仪(PCS)描述其物理性质。采用双室扩散池法研究其体外透皮给药规律,透皮给药结束后用扫描电镜(SEM)观察皮肤表面结构的变化。结果卵磷脂、胆固醇和丙二醇的质量分数分别为3%、0.02%、25%时,制备的柔性脂质体对盐酸青藤碱的包封率为(66±2.3)%;其外观为圆形或椭圆形,内部为多层囊泡结构,粒径为(170±26)nm,表面电位为-(43±3.4)mV。柔性脂质体能够使角质层结构变得紊乱无序,角质细胞间隙增大而提高皮肤对药物的渗透性。结论纳米柔性脂质体能够显著提高盐酸青藤碱透皮给药效果,可作为盐酸青藤碱透皮给药的新型纳米载体。