吡硫翁锌气雾剂联合复方氨肽素片治疗头皮银屑病疗效观察

目的观察吡硫翁锌气雾剂联合复方氨肽素片治疗头皮银屑病的疗效。方法将70例银屑病患者随机分为两组：治疗组35例患者口服复方氨肽素片,外用吡硫翁锌气雾剂;对照组35例患者口服复方氨肽素片,外用2％酮康唑洗剂外洗头皮。观察并评价两组患者治疗后第4周的临床疗效。结果治疗组痊愈21例,显效11例,总有效率为91．42％;对照组痊愈13例,显效12例,总有效率为71．42％,两组总有效率比较差异有统计学意义（P〈0．05）。结论口服复方氨肽素片联合外用吡硫翁锌气雾剂治疗寻常型银屑病,疗效好,不良反应小。     

上肢机器人虚拟情景训练联合头针对脑卒中患者认知功能障碍的影响

目的 探讨上肢机器人虚拟情景训练联合头针对脑卒中后认知功能障碍的影响。 方法 选取脑卒中后认知功能障碍（PSCI）患者90例,按照随机数字表法分为对照组、头针组、综合组,每组30例。对照组给予常规认知和康复训练,头针组给予常规认知和康复训练联合头针治疗,综合组给予常规认知和康复训练、头针治疗和上肢机器人虚拟情景训练。治疗前和治疗4周后（治疗后）,采用简易精神量表（MMSE）和蒙特利尔认知评估量表（MoCA）评估3组患者认知功能,同时采用改良的Barthel指数（MBI）评估3组患者日常生活活动能力。 结果 治疗后,3组患者的MMSE评分、MoCA评分和MBI评分较组内治疗前均明显改善（P<0.05）。头针组治疗后,仅MMSE评分和MBI评分显著优于对照组治疗后（P<0.05）。综合组治疗后的MMSE评分为（22.03±0.96）分,MoCA评分为（15.07±1.48）分,MBI评分为（73.10±8.45）分,均显著优于头针组和对照组治疗后（P<0.05）。 结论 上肢机器人虚拟情景训练联合头针可显著改善PSCI患者的认知功能,并提高其日常生活活动能力。     

两种体位在婴幼儿头皮静脉输液时的效果比较

目的探讨婴幼儿头皮静脉输液时的最佳体位。方法将160例门诊输液患儿随机分为观察组和对照组各80例,观察组采用背兜式静脉输液体位,对照组采用家长怀抱式输液体位,比较两组患儿输液时的一次性穿刺成功率及输液量达50ml以上重新穿刺率。结果观察组一次性穿刺成功率为90．00％,与对照组的87．50％比较差异无统计学意义（P〉0,05）;观察组重新穿刺率为11．25％,明显低于对照组的27．50％,差异有统计学意义（x2=0．652,P〈0．01）;观察组患儿家长对护理技术的满意度达95．00％,明显高于对照组的86．25％,差异具有统计学意义（x2=8．721,P〈0．01）。结论背兜式静脉输液体位优于家长怀抱式输液体位．值得在临床椎广．     

Facial layers of the scalp. A study of 48 cadaveric dissections

Summary The arrangement and structure of the fascial layers of the scalp were studied in 48 red neoprene latex-injected cadavers with the aid of an operating microscope. The galea aponeurotica was continuous with a superficia temporal fascia. Deep to the galea, the subaponeurotic connective tissue was bilaminar. There was an outer, vascular, areolar layer, and an inner, avascular, membranous layer. Underlying the temporalis muscle, the pericranium was thinner and more adherent than elsewhere with no subpericranial tissue.

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Les couches aponévrotiques du scalp. Etude de 48 dissections cadavériques

Résumé La disposition et la structure des couches aponévrotiques du scalp ont été étudiées sur 48 cadavres injectés au latex néoprène rouge à l'aide d'un microscope opératoire. La galéa aponévrotique était en continuité avec un fascia temporal superficiel. Profondément à la galéa, le tissu conjonctif sous-aponévrotique était bilaminaire. Il y avait une couche externe aréolaire, vasculaire et une couche interne, avasculaire, membraneuse. Au dessous du muscle temporal, le périoste était plus fin et plus adhérent qu'ailleurs, sans tissu sous-périosté.

     

Two cases of scalp reimplantation based on one artery and one vein with interposed vein grafts

The authors report their experience in successful reimplantation of avulsed scalp in two patients with one arterial and one venous anastomosis to the superficial temporal vessels. In both cases a double vein graft, harvested from the dorsum of the hand, was interposed between the pedicle of the scalp and the recipient temporal vessels to avoid tension after trimming of the damaged segments. Scalp replantation based on two or more vessels has previously been reported in the literature. In the present cases, the complete survival of the scalp on only a single vascular pedicle suggests that replantation should be considered also when the available vessels for the anastomosis are few. Moreover, even if these reconstructions are lengthy, a prolonged ischemic interval does not appear to be a significantly limiting factor for the success of the revascularization. The cosmetic and psychological success of these cases lend support to the idea that one should always attempt a microvascular replantation of avulsed scalps.     

Aesthetic Reconstruction of Burn Alopecia by Using Expanded Hair-Bearing Scalp Flaps

Tissue expansion is one of the most important armamentaria for aesthetic scalp reconstruction after burn; however, the proper way to employ this technique for the scalp reconstruction usually presents a challenge to the plastic surgeon, especially in the case of a ``sideburn' scenario or a large lesion, as with, for example, hemiscalp alopecia. In this article, 11 patients, with different degrees of hair-bearing scalp loss as a result of burn, and including four patients with hemiscalp alopecia were successfully treated by using tissue expansion. The results show that tissue expansion is a simple, safe, and efficient technique for aesthetic scalp reconstruction. Versatile design of the expanded scalp flap can distribute the expanded hair-bearing scalp properly in the reconstructed recipient site.     

The measurement of ofloxacin in hair as an index of exposure

Summary Several strands of hair were collected from each of patients who had been taking ofloxacin against bacterial infections some time in the past. In 10 out of total 14 subjects studied the drug was detected only in the hair portions corresponding to the administration period with the assumption of the hair growth rate of about 1 cm/month. Even in a subject who had received 300 mg/day of ofloxacin only for two days the drug could be detected in the corresponding portion. In 3 subjects the drug was detected in some other portion(s) than the corresponding ones. This might be due to the uncertainty of having used the drug on the other occasion. Only in one subject the dosage history could not be deduced from the drug distribution along hair length.In 3 subjects, who had taken the drug within 1 month, hair samples were collected every month for 3 or 4 consecutive months. The front of drug appearance in hair was clearly shown to move outwards along hair shaft every month at a pace of 1–1.5 cm/month.These results suggest that ofloxacin is excreted into human scalp hair, captured there and moves outwards along the hair shaft at its own growth rate. This leads to the concept that the distribution of ofloxacin along hair length can be used for knowing the individual exposure or non-exposure to the drug, and even for knowing hair growth rate when the innoculation(s) of the drug is strictly supervised and recorded.     

A case of giant cell arteritis and polymyalgia rheumatica misdiagnosed as temporomandibular dysfunction

We report the case of a 83-year-old man who presented with bilateral scalp ulcerations, temporomandibular joint pain, anorexia, and generalized discomfort. The aspecific presentation and timing of the symptoms led to a referral delay of 117 days. A temporal artery biopsy confirmed the diagnosis of giant cell arteritis (GCA). FDG-PET showed increased uptake at the large vessels, shoulders, and hips, suggesting concomitant polymyalgia rheumatica. Initiation of methylprednisolone resulted in resolution of the muscle-related complaints and healing of the ulcerations. This report highlights the importance of prompt diagnosis and the rarity of bilateral scalp necrosis in GCA, with an incidence of <5%.     

头针为主治疗急性脑梗塞近期疗效对比观察

方法：治疗组66例采用穴位皮内注射结合头皮电针治疗急性脑梗塞,对照组62例采用西医常规治疗。结果：差异具有显著意义（P＜0.05）,说明前者疗效优于后者。