DSA引导下腰交感神经阻滞治疗妇科肿瘤术后下肢淋巴水肿

目的观察DSA引导下腰交感神经阻滞治疗妇科肿瘤术后下肢淋巴水肿的有效性及安全性。方法回顾性分析20例妇科肿瘤术后下肢淋巴水肿患者,均接受DSA引导下腰交感神经阻滞治疗(均治疗2次)。分别于阻滞前、首次阻滞后第1天及第2次阻滞后第1、7天测量患侧腿围,记录患侧腿围缩小值。采用Inbody720多频生物电阻人体成分分析仪检测阻滞前及第2次阻滞后1周时的组织水肿程度;观察症状改善及功能恢复情况。结果 20例均顺利完成阻滞。1例术后出现短暂下肢无力,余无不良反应。首次阻滞后第1天及第2次阻滞后第1、7天患侧下肢各测量点腿围均不同程度缩小,且各测量点第2次阻滞术后第1、7天腿围缩小值均高于第1次术后第1天(P均0.01)。第2次阻滞后1周组织水肿程度较术前降低(P0.01),髋关节活动度较术前增加(P0.01),患侧下肢肿胀感、紧绷感、疼痛感、麻木感均消失。结论 DSA引导下腰交感神经阻滞治疗妇科肿瘤术后下肢淋巴水肿有效且安全。     

Progress of laser and light treatments for lower eyelid rejuvenation

Laser and light treatments have recently become popular owing to its efficacy in treating laxity, rhytids, hyperpigmentation of the lower eyelids, and drooping of septum fat. For several decades, our department has explored the application of laser and light treatment for eye rejuvenation. This paper summarizes common treatment methods and analyzes the published literature on the indications and outcomes of multiple laser and light treatments for lower eyelid rejuvenation. An extensive survey of peer-reviewed literature was performed using PubMed, with the search terms “noninvasive treatment”, “infraorbital”, “palpebral bags”, “lower eyelid”, “radiofrequency (RF)”, “laser”, “nonsurgical skin tightening”, and “noninvasive fat reduction”. The results showed that the use of lasers, intense pulsed light (IPL), monopolar RF, bipolar RF, AdipoLASER rejuvenation (ALJ), and fractional RF microneedling are safe and effective treatments for palpebral bags. We conclude that using Q-switched lasers, IPL, RF, ALJ, and fractional RF microneedling is safe and effective for lower eyelid rejuvenation, with minimal complications and quick recovery. Further research and development of optoelectronic therapy may encourage breakthroughs in lower eyelid treatment, such as simplified complex surgery and noninvasive methods.     

补气活血止痛汤配合硫辛酸注射液对糖尿病周围神经病变 患者炎症反应和下肢神经功能的影响

目的:探讨补气活血止痛汤配合硫辛酸注射液对糖尿病周围神经病变(DPN)患者的炎症反应和下肢神经功能的影响。方法:选取2018年1月—2019年12月在上海市静安区江宁路街道社区卫生服务中心收治的DPN患者148例,按照随机对照的方法,随机分为对照组(n=74)和观察组(n=74),对照组给予硫辛酸注射液治疗,观察组在对照组的基础上给予补气活血止痛汤治疗,4周为1个疗程,连续用药2个疗程后比较临床疗效。结果:观察组治疗后患者IL-6、IL-1β、TNF-α及CRP水平较对照组显著下降(P<0.05);观察组治疗后左胫神经、右胫神经、左腓总神经和右腓总神经传导速度较对照组显著提高(P<0.05);观察组治疗后TCSS、TSS和NRS评分较对照组临床症状评分下降更明显(P<0.05)。结论:补气活血止痛汤配合硫辛酸注射液可显著降低炎症反应、促进神经传导功能,从而改善DPN患者的临床症状。     

下肢肌肉功能模型应用软件的开发与应用

目的建立人体下肢肌肉功能的数学模型并编写相应的计算机软件,为人体运动过程中的下肢各肌肉力学描述及评估提供快速可靠的数据支持。方法利用现有的国人下肢肌肉附着点的三维坐标数据及其与体表骨性形态学参数的回归方程等相关研究成果,利用VisualC++6.0平台,编写下肢肌肉功能评定软件。结果软件系统可输出任意模拟姿态或实际运动过程中的下肢肌肉功能参数。结论本研究成果可从肌肉动力学层面来指导运动员的专项力量训练,提高运动成绩,也可应用于相关医学领域。     

血栓闭塞性脉管炎患者血栓素、前列环素及血液流变学指标的检测分析

目的 :探讨血栓闭塞性脉管炎患者血栓素B2 、前列环素与血液流变学指标的变化及其与发病机制的关系。方法 :用放射免疫法测定TXA2 和PGI2 的代谢产物血栓素B2 (TXB2 )、6 酮 前列腺素F1α( 6 K PGF1α) ,LBY N6A自清洗旋转式粘度计测定血液流变学指标 ,并与对照组对比分析。结果 :血栓闭塞性脉管炎患者TXB2 ( 53.59± 83.2 1ng/L)、6 K PGF1α( 14 .50± 3.4 5ng/L) ,与对照组相比差异显著 ;全血高切粘度、低切粘度、血浆粘度及纤维蛋白原疾病组均高于对照组 ,差异具有统计学意义。结论 :血栓闭塞性脉管炎患者存在TXA2 /PGI2失衡 ,并与血液流变学的改变有密切关系     

老年人低位硬膜外麻醉围术期自主神经功能的变化

目的：应用心率变异性（HRV）分析仪监测评估低位硬膜外麻醉围术期自主神经的改变。方法：选择低位硬膜外麻醉下择期手术患者20例,ASAⅠ-Ⅱ级,按年龄分为老年组和年轻组,每组10例,观察术前1d、麻醉完善后切皮前、切皮后30min、术后2h,1d,3d,7d处时相点的心率（HR）、平均动脉压（MAP）以及HRV分析各成分变化。结果：围术期老年组HRV显示RMSSD（相邻RR间期差值均方根）、总频（TP）、低频（LF）、代频标化（LFnorm)均呈显著性下降,同时伴有心率减慢、平均动脉下降。年轻组TP和LF在麻醉完善后切皮前、术后2h,1d下降显著,于术后3d恢复,而R和MAP在围术期无显著改变。两组两比较,老年组TP和LF在麻醉后各时相占 明显低于年轻组（P＜0．01）。老年组高频（HF）及高频标化（HFnorm)在麻醉给药后切皮瓣均无明显变化,但在术中和术后各时相点的下降,而年轻组仅切皮后30min,出现一过性下降。结论HRV可较好地评估围术期机体自神经变化;术期麻醉和手术创伤均可使机体自主神系统调节受损,尤其老年人受损程度大,恢复慢,恢复慢,术后1周仍不能完全恢复。     

pH电极位置对反流性食管炎酸监测的影响

为探讨ｐＨ电极位置对反流性食管炎酸监测的影响,将６０例反流性食管炎随机分为对照（Ｃ）组和试验（Ｔ）组。 Ｃ组 ３０例用测压法将 ｐＨ电极置于下食管括约肌（ＬＥＳ）上缘 ５ ｃｍ处;Ｔ组 ３０例用 ｐＨ梯度法将电极放于胃食管连接处（ＧＥＪ）上方 ５ ｃｍ处。连续 ２４ ｈ ｐＨ监测。结果显示,Ｃ与Ｔ组前鼻孔至ＧＥＪ平均距离分别为（４６． ２±４．１） ｃｍ与（４６． ５±４． ５） ｃｍ,两者无明显差异（Ｐ＝０． ８）。两组前鼻孔至ＧＥＪ平均距离（４６． ３±４． ３） ｃｍ比 Ｃ组前鼻孔至ＬＥＳ上缘平均距离（４３． ３±３． １） ｃｍ低 ３． ０ ｃｍ（Ｐ＝０． ０００３）。食管酸监测的 ｐＨ＜４,总百分时间和总计分在Ｔ组（８．５和 ４５． ５）和Ｔ组中ＧＥＪ＞ＬＥＳ上缘＋３ ｃｍ和＜－３ｃｍ范围者（１０． ０和 ９９． ３）较Ｃ组（４． ８和 ２６． ３）均有明显增高, Ｐ均＜０． ０１）,而Ｔ组中ＧＥＪ≤ＬＥＳ上缘＋３ ｃｍ和≥－３ ｃｍ范围者（７． １和 ３９． ４）则无明显差异（ Ｐ均＞０． ０５）。研究结果表明,因 ＧＥＪ常比 ＬＥＳ上缘偏低,故以 ＧＥＪ安放电极（尤其是ＧＥＪ＞ＬＥＳ上缘 ＋ ３ｃｍ或＜－ ３ｃｍ范围者）对反流性食管炎行 ｐＨ监测时     

A comparative trial of anti-glycoconjugate antibody assays: IgM antibodies to GM1

IgM class antibodies against the ganglioside GM1 have been found in a subgroup of patients with lower motor neuron syndromes and multifocal motor neuropathies (MMN). The pathogenic relevance of these antibodies is still unclear, but some MMN patients with IgM antibodies against GM1 seem to profit from immunosuppressive therapy. A reliable test for IgM antibodies against GMl may be useful for identifying these patients. We have assessed the comparability of the ELISA tests used for the determination of IgM against GM1 by sending coded serum samples to nine laboratories. In three samples high-titre IgM antibodies against GM1 were detected by all laboratories. This result was confirmed by dot blot immunodetection and thin-layer chromatography immuno-overlay. Seven samples were read as negative by nearly all laboratories. Major discrepancies between laboratories were noted in the analysis of one sample with results ranging from negative to high titre. Participating laboratories: N. Baumann and A. Ben Younes-Chennoufi, Neurobiologie cellulaire moleculaire et clinique, INSERM U134, Hôpital de la Sâpetrière, Paris, France; P. Fredman and L. Svennerholm, Department of Psychiatry and Neurochemistry, Goteborg University, Sweden; N. Gregson and R. A. C. Hughes, Department of Neurology, Guy's and St. Thomas's Medical and Dental School, London, UK; A. A. Ilyas, Department of Neurosciences, University of Medicine & Dentistry of New Jersey, New Jersey Medical School, Newark, N. J., USA; A. Pestronk, Division of Neuromuscular Diseases, Washington University School of Medicine, St. Louis, Mo., USA; A. J. Steck, Service de Neurologie, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland (current address: Department of Neurology, University of Basle); H. Willison, Department of Neurology, University of Glasgow, Glasgow, UK     

Effects of angiopeptin on transplant arteriosclerosis in the rat

The influence of the somatostatin analogue angiopeptin on transplant arteriosclerosis was investigated using two aortic transplantation rat models. One was characterized by ischemia/reperfusion-induced changes in syngeneic transplants while immunologically induced changes dominated in the other allogeneic model. Angiopeptin, 100 g/kg per day, was administered continuously until the sacrifice of the rats after 8 weeks. No additional immunosuppression was used in either model. An image analysis system was used to quantify the intimal and medial thicknesses of the grafts. In the syngeneic grafts, the intimal thickness was less than 50% of that of control grafts (P<0.05), but no difference was seen in the allogeneic model. The expression of selected cells, TGF-s and PDGF and PDGF -receptors was detected immunohistochemically and displayed a similar picture in control and angiopeptin-treated grafts in both models. We conclude that angiopeptin has no clear immunosuppressive properties but may counteract ischemia-induced transplant arteriosclerosis.Part of this paper has previously been published in Transplant Proceedings (1993; 21: 2098–2099).     

高血压、冠心病患者血浆组织因子及组织因子途径抑制物活性变化

目的：观测高血压及冠心病患者血浆ＴＦ活性与ＴＦＰＩ活性的变化。方法：采用二步法测定血浆ＴＦ活性;以Ｓａｎｄｓｅｔ发色底物法测定ＴＦＰＩ活性。结果：高血压与冠心病患者血浆ＴＦ与ＴＦＰＩ活性均高于正常对照组（Ｐ＜０．０５）。结论：凝血功能亢进可能参与了高血压、冠心病形成,提示血浆ＴＦ和ＴＦＰＩ活性测定值可作为高血压、冠心病辅助性诊断指标。