Repigmentation after autologous miniature punch grafting in segmental vitiligo in North Indian patients.

Segmental vitiligo is rather refractory to medical treatment. The paucity of literature on the results of autologous miniature punch grafting in segmental vitiligo in dark-skinned patients led us to conduct such a study in 15 dark-skinned patients of North Indian origin to observe the repigmentation response to this technique at different sites. The age range was 16-42 years (mean 23.08 years). There were four males and eleven females (M:F ratio being 1:2.75) who had the disease for 3-15 years. After autologous miniature punch grafting, a remarkable repigmentation was obtained in 12 (80%) cases with 90% to 100% improvement. About 40-60% repigmentation was observed within 3-6 months in the majority (66.6%) of cases and near total to total repigmentation was observed within 2 years. The maximum pigment spread was observed over the face (cheeks) and neck, and the minimum pigment spread was observed over the left arm and right upper eyelid. Complications were minimal. The present study demonstrates that autologous miniature punch grafting is a safe and easy technique, that produces good cosmetic results in the unsightly depigmenting lesions of segmental vitiligo, especially on the face and exposed areas, even in dark-skinned races if patients are selected carefully. This can be of great benefit to patients who are psychologically disturbed by their disease.     

猪原位肝移植的麻醉及管理

目的：采用杂种猪模拟原位肝移植的麻醉及管理。方法：对实验猪行经口气管内插管静吸复合全身麻醉。结果：猪的气管插管术与人体相比有其自身特点。实验猪对氯胺酮基础麻醉有较大的耐受量。转流开始时和新肝期开始时血流动力学有较大的改变。结论：对实验猪进行肌松或非肌松气管内插管是可行的。对血流动力学改变的处理应以预防为主。精确计算失血量并及时进行输血输液和维持适当的麻醉深度，对预防和纠正失血性休克有根重要作用。若麻醉处理得当，术中严重的心律失常是完全可能避免的。     

微超声探头诊断食道隆起性病变的价值

目的 探讨经内镜微超声探头(TEMP)对食道隆起性病变的诊断价值。方法 对67例电子胃镜疑有食道隆起性病变者行经内镜微超声探头检查。结果 67例中平滑肌瘤8例，平滑肌肉瘤1例，早期和进展期癌各5例，囊肿24例，壁外压迫9例，食道静脉瘤6例，静脉曲张3例，炎症2例，异位胰腺1例，息肉2例。结论 经内镜微超声探头对食道隆起性病变有较大的诊断价值。     

冠状动脉内多普勒超声评价猪急性冠状动脉闭塞侧支循环状态及影响因素

目的评价猪急性闭塞冠状动脉侧支循环状态及硝酸甘油和酚妥拉明对其的影响。方法使用冠状动脉内多普勒超声测定14头小型家猪正常状态及急性闭塞后左回旋支的血流频谱,并观察冠状动脉内应用硝酸甘油和酚妥拉明对其的影响。结果急性闭塞10min时回旋支远端的平均峰值流速(APV)明显低于正常(0.97±1.05cm/s比25.78±4.36cm/s,P<0.01),应用硝酸甘油和酚妥拉明后梗死相关血管变为反向或双向血流,APV绝对值(8.32±1.53cm/s和8.54±2.15cm/s)较用药前明显增加(P<0.01);闭塞后90min时及重复应用上述两药后APV分别为0.99±1.14cm/s、9.02±1.47cm/s和8.95±2.36cm/s,闭塞90min较闭塞即刻差异无统计学意义,用两药后APV值差异无统计学意义(P均>0.05)。结论猪急性冠状动脉闭塞时侧支循环自身建立不足,硝酸甘油和酚妥拉明均可明显增加冠状动脉侧支循环血流。     

可植入微型轴流血泵溶血实验研究

目的通过自制轴流血泵进行体外、体内溶血实验,探讨血泵的溶血特性。方法轴流血泵置于充满新鲜羊血的模拟循环通路中,在输出流量为5L／min,后负荷压力为100mmHg的条件下,检测血泵体外溶血水平。在3只健康绵羊体内植入血泵进行在体辅助实验,并稳定运转24h,测定其在体溶血水平。结果可植入微型轴流血泵的体外溶血指数（normal index of haematolysis,NIH）为（0．01644&#177;0．00018）g／100L。在体实验中,血泵运行无机械故障,循环辅助后血浆游离血红蛋白（plasma free hemoglobin,FHb）及乳酸脱氢酶（lactate dehydrogenase,LDH）呈现上升趋势,平均最大值分别达（7．93&#177;0．71）g／L、（622．3&#177;22．5）U／L。结论血泵溶血性能在可接受范围内,接近于部分国外三代血泵溶血水平,初步具备进入动物辅助实验研究水平。     

野百合碱诱导的肺动脉高压小型猪的肺病理改变

目的观察野百合碱诱导小型猪肺动脉高压模型不同时期心肺组织的病理变化。方法 12头雄性西藏小型猪,4.0~4.5月龄,体质量15.0~18.0 kg。测定12头小型猪平均肺动脉压作为基础值;然后选择10头小型猪腹腔注射野百合碱(MCT)10.0 mg/kg;给药4周和8周后再分别测定小型猪平均肺动脉压。分别于4、8周处死两头小型猪,采样观察小型猪心肺组织病理改变情况。结果给药4周和8周后,西藏小型猪的肺动脉压力与人体相近,正常平均肺动脉压约为(15.19±0.70)mmHg(1 mmHg=0.133 kPa);给药4周后平均肺动脉压升至(19.69±2.47)mmHg;给药8周后升至(25.62±4.88)mmHg,与基础压相比均有显著差异(P<0.01)。组织病理学分析显示,给药4周后即可形成有意义的病理改变,右心室肥厚;8周后有明显的病理学改变,如右心室纤维化和肺动脉中层增厚。结论 MCT给药8周后,造成肺动脉压力升高和肺血管重构,可以诱导西藏小型猪形成慢性肺动脉高压模型。     

The thalamic nucleus submedius and ventrolateral orbital cortex are involved in nociceptive modulation: A novel pain modulation pathway

Recently, a series of studies have given rise to and provided evidence for the hypothesis that the nucleus submedius (Sm) in the medial thalamus is involved in modulation of nociception. The Sm, ventrolateral orbital cortex (VLO) and the periaqueductal gray (PAG) constitute a pain modulatory pathway, activation of which leads to activation of the PAG–brainstem descending inhibitory system and depression of the nociceptive inputs in the spinal cord and trigeminal nucleus. Other studies have indicated that the Sm–VLO–PAG pathway plays an important role in the analgesia induced by electroacupuncture stimulation of the acupuncture point (acupoint) for exciting small diameter fiber (A-δ and C group) afferents. Opioid peptides, serotonin, dopamine, glutamate and their related receptors are involved in Sm- and/or VLO-mediated descending antinociception, and a GABAergic disinhibitory mechanism participates in mediating the antinociception induced by activation of μ-opioid receptors, serotonin 1_A receptors, and dopamine D₂-like receptors. This review describes these findings, which provide important new insights into the roles of the thalamus and cerebral cortex in descending pain modulation.     

广西巴马小型猪无气管插管全身麻醉模型建立的初探

目的建立广西巴马小型猪无气管插管的全身麻醉动物模型。方法选用8头健康广西巴马小型猪,先耳后肌肉注射地西泮10mg和氯胺酮0．1g行基础麻醉,建立静脉通道后使用氯胺酮和地西泮间断静脉注射全身麻醉。行泌尿系统手术时根据心率、睫毛反射和疼痛反应调整麻醉深度。结果该方法麻醉效果理想,试验动物无一头死亡且恢复良好。结论使用氯胺酮和地西泮对腹部手术的广西巴马小型猪进行问断静脉麻醉的方法效果理想,且安全、简易,值得借鉴。     

微型外固定架结合有限内固定治疗38例46处开放性粉碎性掌指骨骨折分析

目的 探讨应用微型外固定架结合有限内固定治疗开放性粉碎性掌指骨骨折方法及疗效.方法 自2002年以来对38例46处手开放性粉碎性掌指骨骨折应用微型外固定架治疗.结果 术后随访6个月至2年,无骨不连及骨髓炎并发症,临床愈合时间平均6周,手功能恢复按TAM标准评价优良率达78.9%.结论 微型外固定架结合有限内固定治疗手部开放性粉碎性掌指骨骨折创伤小,固定可靠,愈合率高,利于早期功能锻炼,有良好的治疗效果.