桡动脉与冠状动脉几何性状和显微结构成份的比较

目的：通过对桡动脉与冠状动脉几何性状和显微结构成份的比较研究，为桡动脉应用于冠状动脉搭桥术提供依据。方法：非心脏病死亡的尸体，在其桡动脉的上端、中点、下端及冠状动脉主干根部，横断取材制作切片，光镜下观察并用图像分析仪对其显微结构成份进行定量研究。结果：桡动脉的内、外径与冠状动脉的前室间支、旋支、右冠状动脉接近，但它的内膜面积和管腔狭窄率均明显低于冠状动脉。桡动脉与冠状动脉的显微结构成份相似；管壁平滑肌的含量二者无显著差异。结论：桡动脉是冠脉搭桥术可供选择的较理想的移植血管。     

Radial artery running beneath the biceps tendon and its interrelation between the radial recurrent arteries

A radial artery running beneath the biceps tendon was found in the cadaver of a Japanese woman during a student dissection course at Kumamoto University School of Medicine in 2006. The brachial artery bifurcated into the radial artery and the ulnar artery in the cubital fossa, and the radial artery twisted laterally running beneath the biceps tendon, and when it was situated laterally to the tendon, twisted distally at the level of the radial tuberosity, and then twisted medially again. After the radial artery passed over the biceps tendon, it turned distally and continued as a normal radial artery. The superficial brachial artery, which coexisted with the brachial artery, was given off from the axillary artery and it continued to the final twist of the radial artery. The course of this radial artery is similar to the arterial rings surrounding the biceps tendon, found during the same dissection course. The arterial rings were formed between the brachial artery and the radial artery, and their proximal origins ran beneath the biceps tendon, while the distal origins were superficial. The present arterial variation is thought to have occurred when the normal part of the radial artery in the cubital fossa was substituted by the arterial ring, coexisting with the superficial brachial artery, which usually disappears during normal development. Furthermore, it is suggested that a part of the arterial ring always remains as a radial recurrent artery.     

人血清免疫球蛋白工作标准的制备与标定

本文报导混合浓缩人血清工作标准(89-1)的制备和用WHO相应参考标准血清标定出其中五类免疫球蛋白(Igs)及IgG4亚类含量。该制剂主要用于体外测定IgG、IgA、IgM的工作标准,也可供作体外测定IgD、IgE、IgG4的工作标准。混合前每份血清均无乙型肝炎表面抗原、转氨酶正常。定量分装为每安瓿0.5ml,经冷冻干燥后,4℃保存。参照国际参考标准血清67/97及67/37,分别以免疫单扩散法标定89-1中IgG、IgA、ISM含量;以酶联免疫吸附试验(ELISA)标定IgD、IgG4和IgE含量。其中IgG、IgG4、IgA、IgM含量,应用本室制备的相应单克隆抗体(McAb)标定,而IgD和IgE应用多克隆抗体(PcAb)进行标定。并用五剂量法及四剂量法分别计算Igs含量。     

Methodologic problems in establishing normal values for IgG subclass concentrations in a pediatric population; comparison of radial immunodiffusion and ELISA methods

The aim of this study was to establish an enzyme-linked immunosorbent assay (ELISA) to measure IgG subclasses by means of monoclonal antibodies. The distribution of IgG subclass protein concentrations in sera from 227 healthy Danish children and 90 adults was measured. Furthermore, this newly established ELISA was compared with different assay systems for determination of IgG subclasses: two radial immunodiffusion methods (RID), one using polyclonal and one using monoclonal antibodies, as well as a commercially available ELISA kit. There was good agreement of results obtained by the different methods of measuring IgG3 and IgG4 concentrations. There was good correlation between results obtained by both RID methods. Despite good correlation between the assays, the ELISA kit showed higher levels of IgG1 in all investigated sera, and the ELISA kit showed no correlation with the other methods, when IgG2 was measured. Analysis of the normal ranges measured by ELISA developed in our laboratory and by RID with polyclonal antibodies showed that the levels obtained by RID were higher than those obtained by our ELISA in sera with low levels of both IgG1 and IgG2, and lower in sera with high concentrations of these two immunoglobulins. Our results emphasize the importance of establishing age-related normal limits for any novel assay measuring IgG subclass concentrations.     

Modulation of human cutaneous reflexes during rhythmic cyclical arm movement

The organization and pattern of cutaneous reflex modulation is unknown during rhythmic cyclical movements of the human upper limbs. On the assumption that these cyclic arm movements are central pattern generator (CPG) driven as has been suggested for leg movements such as walking, we hypothesized that cutaneous reflex amplitude would be independent of electromyographic (EMG) muscle activation level during rhythmic arm movement (phase-dependent modulation, as is often the case in the lower limb during locomotion). EMG was recorded from eight muscles crossing the human shoulder, elbow, and wrist joints while whole arm rhythmic cyclical movements were performed. Cutaneous reflexes were evoked with trains of electrical stimulation delivered at non-noxious intensities (approximately 2 x threshold for radiating paresthesia) to the superficial radial nerve innervating the lateral portion of the back of the hand. Phasic bursts of rhythmic muscle activity occurred throughout the movement cycle. Rhythmic EMG and kinematic patterns were similar to what has been seen in the human lower limb during locomotor activities such as cycling or walking: there were extensive periods of reciprocal activation of antagonist muscles. For most muscles, cutaneous reflexes were modulated with the movement cycle and were strongly correlated with the movement-related background EMG amplitude. It is concluded that cutaneous reflexes are primarily modulated by the background muscle activity during rhythmic human upper limb movements, with only some muscles showing phase-dependent modulation.     

桡动脉解剖及获取技术在冠状动脉搭桥手术中的应用

目的：探讨冠状动脉搭桥术中桡动脉的获取技术方法及应用效果。方法：回顾性总结72例冠状动脉搭桥手术中取桡动脉的经验，介绍获取桡动脉的技术方法和体会。结果：在使用桡动脉获取技术的患者中，3例出现手术切口及手背皮肤术后短时间内麻木，其他患者无前臂感觉及活动障碍，无前臂缺血并发症。结论：当术前评价证实手部桡动脉供血区域有足够的侧枝循环时，桡动脉是最好的搭桥血管之一.     

Steinfeld syndrome: Report of a second family and further delineation of a rare autosomal dominant disorder

We report on a fetus with alobar holoprosencephaly, microphthalmia, midline cleft lip and palate, absent nose, dysplastic ears, radial defects, pentalogy of Fallot, unilateral renal aplasia, absent gallbladder, vertebral anomalies, and absence of ribs. The father had a cleft palate, bilateral colobomas of the iris and retina, a bifid uvula, vertebral anomalies, and unilateral congential hearing loss. His sister had a cleft lip. On the basis of this family and the family reported by Steinfeld [1982], this malformation syndrome can be defined as a rare autosomal dominant syndrome whose main component manifestations are holoprosencephaly, predominantly radial limb deficiency, heart defects, kidney malformations, absence of gallbladder, and vertebral anomalies. © 1993 Wiley-Liss, Inc.     

桡神经深支卡压综合征的解剖学研究

根据５４侧成人尸体肘部桡管，旋后肌管及桡神经深支在肘部行程的解剖学研究，特别观察到桡侧腕短伸肌纤维桥有９０．６％为全腱性，其中有８８．９％与旋后肌弓外侧半重叠直接紧邻桡神经深支，认为该纤维桥是桡神经深支在肘部卡压的主要因素。并注意到桡神经深支与桡骨头部位的关节囊等关系密切，提示临床医生注意。     

灌洗法一期叻除吻合术在左侧梗阻性结肠癌中的应用

目的：探讨左半结肠癌并梗阻一期切除吻合的可行性。方法：术中灌洗肠内容物,术后吻合口减压。结果：1995年至1999年所遇左侧梗阻性大肠癌中选择5例用此方法吻合成功。结论：左侧梗阻性大肠癌,只要掌握好手术指针。术中充分灌洗肠内容物,术后扩肛可一期切除吻合。     

介入联合手术治疗膀胱癌32例疗效分析

目的观察髂内动脉灌注化疗联合手术治疗膀胱癌的疗效。方法对32例中晚期膀胱癌先行介入治疗,再手术切除。结果32例膀胱癌完全缓解(CR)率为71．9％。结论介入治疗中晚期膀胱的手术提供了良好基础,对一部分原本行扩大切除术甚至全切的患实行单纯部分切除术,从而保留了膀胱生理功能,有助于提高患生活质量,延长生命。