The extended use of the transverse abdominal skin (tras) flap,anatomical and clinical considerations

Summary The transverse thoraco-abdominal skin flap, originally described by Baroudi et al. [1], was used for closure of postmastectomy chest defects after radical mastectomy. Some modifications to the original flap have been made which add to its reliability. These mainly consist of the preservation of musculo-cutaneous perforators on both the ipsi- and contralateral sides of the pedicle, and leaving the umbilicus intact. This flap may also be used for reconstruction of groin defects. The blood supply to the TRAS flap was investigated in six fresh cadavers. Following the raising of six TRAS flaps the contralateral superior and inferior deep epigastric arteries (epigastric arcade) were cannulated and injected with microfil. The flap specimens including their pedicles were then detached and x-rayed by mammography. Complete filling of the medial half of the flaps was observed in most of the specimens indicating anastomosis of blood vessels across the midline. Since the contralateral penetration of the microfil was not observed in larger blood vessels, it is assumed that the musculo-cutaneous perforators are the main conduit for this blood supply. Beyond the reach of the contrast material the flap borrows its vasculature from the pre-existent subcutaneous network on the random flap principle. Three case reports are presented, in which one supra-and two infra-umbilical TRAS flaps were employed.     

KMG03粉针剂对大鼠实验性急性心肌缺血的保护作用

采用结扎大鼠冠脉造成急性心肌缺血模型。观察KMG03粉针剂的抗心肌缺血作用。结果：KMG03粉针剂50mg/kg和100mg/kg对大鼠实验性急性心肌缺血均有一定程度的保护作用。在改善心电图S——T段的上移、降低血清CPK,LDH方法两个剂量组均有显著作用。在缩小心肌塞范围方面,以100mg/kg组为明显,KMG03粉针剂和丹参均能保护超氧化物岐化酶活性,显著降低丙二醛含量,还能显著增加缺血心肌前列环素合成。结果表明：KMG03粉针剂对心肌缺血的保护作用与抗脂质过氧化作用有关,其促进前列环素合成作用可能与其抗心肌缺血有关。     

雷尼替丁与复方丹参联合治疗急性胰腺炎35例疗效分析

目的：观察雷尼替丁与复方丹参联合治疗急性胰腺炎的疗效。方法：对确诊急性胰腺炎65例随机分成治疗组35例,对照组30例,分别用常规治疗,常规治疗加雷尼替丁与复方丹参静滴,连用4－7天,评价其疗效。结果：治疗组与对照组显效率分别为85.71%、43.3%,两组差异显著,P＜0.05。结论：两药联合应用不仅可减轻本病的炎症病变,且可改善心肌细胞营养状况。     

四妙勇安汤加味合血塞通治疗小儿钩端螺旋体脑动脉炎疗效分析

目的：探讨四妙勇安汤加味合血塞通注射液对钩端螺旋体脑动脉炎的临床疗效。方法：从入院先后随机分组对照,治疗组口服四妙勇安汤加味,静滴血塞通;对照组肌注青霉素,静滴维脑路通加脑细胞激活剂。结果：治疗组治愈率65.22％,总有效率95.65％;对照组治愈率37.5%,总有效率84.37％。两组治愈率、总有效率比较有显著性差异（P＜0.05）,治疗组治疗后血液流变学各项指标明显下降,而对照组仅有部分改善。结论：四妙勇安汤加味联用血塞通注射液治疗钩端螺旋体脑动脉炎临床效果显著,优于常规西医治疗。     

板兰根冲剂致药疹1例

1　病例介绍患者冯某,男,18岁,入院前4天因自觉咽喉疼痛,遂自服“板兰根冲剂(北京同仁堂制药二厂生产)2包。因药后症状未缓解,也未再服用。入院前1日在腹部出现红色细小斑丘疹,微痒,未予重视。夜间皮疹逐渐增多,泛发全身,尤以面部、胸腹部为多,自觉瘙痒,伴见口苦咽痛,便干尿黄,纳差,眠差,舌质红苔黄,脉弦数。于1998年9月26日入院。查体:神差懒言,咽部充血(),心肺无异常。T:37.7℃,R:17次/分。皮肤科检查:全身泛发鲜红色斑丘疹,针尖至米粒大小,密集成片,皮疹尤以面部、胸腹部为多,皮温高。血常规检查示:白细胞15.4×109/L,中性36%,淋巴64%…     

视神经萎缩的治疗临床研究

目的 探讨视神经萎缩的有效治疗方法。方法 对324例526例眼视神经萎缩患,用胞二磷胆碱、肌苷做球后注射。结果 临床治愈88例,显效261例,进步106眼,有效率86．9％,收到了较满意的效果。结论 胞二磷胆碱、肌苷可通过卵磷脂的合成改善视神经周围的血液循环,刺激和促进视神经纤维的生物修补,从而导致视神经功能的改善和恢复。     

鞘内注射孤啡肽对吗啡耐受形成及吗啡耐受大鼠抗伤害感受作用的影响

目的:观察孤啡肽(OFQ)对大鼠吗啡耐受的形成是否具有延缓作用,以及OFQ与吗啡间是否存在交叉耐受性.方法:本实验运用热辐射甩尾测痛模型,采用鞘内同时注射不同剂量的OFQ与吗啡,观察其对急、慢性吗啡耐受形成的影响;并观察OFQ对吗啡耐受大鼠及吗啡对OFQ耐受大鼠的抗伤害性感受作用.结果:鞘内注射OFQ可延缓慢性吗啡耐受的形成,而对急性吗啡耐受的形成几乎无影响;OFQ与吗啡间无交叉耐受性.结论:OFQ延缓慢性吗啡耐受形成的作用可能与其通过受体后信号转导途径影响G蛋白-AC-cAMP系统有关,也可能与其抑制伏隔核多巴胺的释放有关;OFQ与吗啡耐受形成的机制可能不同,OFQ可能通过其特异性受体发挥脊髓抗伤害性感受作用.     

紫外光谱法测定利巴韦利葡萄糖注射液中利巴韦林的含量

目的建立利巴韦林葡萄糖注射液中利巴韦林的快速测定方法.方法用紫外分光光度法直接测定利巴韦林葡萄糖注射液中利巴韦林的含量.结果在207 nm处,以水为溶媒,利巴韦林葡萄糖注射液中利巴韦林浓度在3～15μg/ml,与其相应的吸收度呈良好的线性关系(n=5;r=0.999 9),样品平均回收率为101.4%±0.53%.结论该法简便快速、准确可靠,适合药房快速分析.     

单精子胞质内注射治疗严重男性不育和受精障碍102个周期的回顾性分析

回顾性分析从 1 998年 1月至 2 0 0 0年 1 2月在我室接受单精子显微授精治疗的共 1 0 2个周期。以 2 0 0 0年2月为界 ,随着显微操作技术 ,的改进和操作环境的改善 ,后阶段单精子显微注射的存活率 (90 6 % )、受精率 (73 3 % )、胚胎发育率 (97 3 % )较前阶段 (分别为 68 8% ,39 0 % ,78 7% )有显著提高。两阶段临床妊娠率分别为 41 3 %和2 1 4% ,目前本室建立的单精子胞质内注射技术能有效地治疗临床严重男性不育和受精障碍     

Utility and Prognostic Ability of a Diagnostic Injection Before Revision Total Knee Arthroplasty

BackgroundDiagnostic injections are commonly utilized in the workup of painful total knee arthroplasties (TKA), particularly when the diagnosis remains unclear. However, current literature provides limited evidence regarding the utility and prognostic capability of anesthetic injections in this scenario. This study sought to establish the role of diagnostic injections in predicting successful revision TKA.MethodsA retrospective review was conducted on 144 consecutive aseptic revision TKAs receiving diagnostic anesthetic injections. Instability (57.6%) and aseptic loosening (33.3%) comprised most revision etiologies. Patient-reported percentage pain relief after the injection was statistically correlated with KOOS JR, Knee Society Score, UCLA Activity Level, and satisfaction scores.ResultsAbout 74.3% (107/144) of revision TKAs reported >50% pain relief after injection. There were no differences in pain relief based on revision indication (P = .841). Improvement from preoperative activity level was greater in the >50% pain relief group (P = .024). Four-month patient satisfaction did not differ between patients who reported >50% and ≤50% pain relief (67% vs. 66%, P = .130). About 64% of patients who reported >50% pain relief were satisfied at minimum 1-year follow-up, compared with only 47% of those who reported ≤50% pain relief after diagnostic injection (P < .001).ConclusionStudy results show that patients reporting >50% pain relief after diagnostic injection have improvements in activity level and maintain greater satisfaction at minimum 1-year than those reporting ≤50% pain relief. Expectations for improvement after revision TKA should be tempered if diagnostic anesthetic injection yields minimal subjective pain relief.