Subscapularis Transthoracic Versus Posterolateral Approaches in the Surgical Management of Upper Thoracic Tuberculosis: A Prospective,Randomized Controlled Study

The objective of the present study was to evaluate the clinical, radiological, and functional outcomes of a subscapularis transthoracic surgical approach and a posterolateral surgical approach with debridement, bone graft fusion, and internal fixation for the treatment of upper thoracic tuberculosis.There is currently debate over the best surgical approach for the treatment of upper thoracic tuberculosis. Traditionally, the subscapularis transthoracic approach has been preferred; however, the posterolateral approach has gained popularity in the past few years.A prospective, consecutive cohort of 43 upper thoracic tuberculosis patients with a mean age of 39 years (range: 20–52 years) was followed up for a minimum of 12 months (range: 12–60 months). Patients were randomly divided into 2 groups. Group A (n = 21) was treated by the subscapularis transthoracic approach and group B (n = 22) was treated by the posterolateral approach. All cases were evaluated for clinical, radiological, and functional outcomes. Intraoperative blood loss, operative duration, intraoperative and postoperative complications, hospital stay, the cure rate, fusion time, and the Frankel scale were used for clinical and functional evaluation, whereas the kyphosis angle was used for radiological evaluation.Grafted bones were fused by 10 months in all cases. There was no statistically significant difference between groups before surgery in terms of gender, age, segmental tuberculosis, erythrocyte sedimentation rate (ESR), Frankel scale, or Cobb''s angle (P > 0.05). The average operative duration for Group B was lower than that of Group A. There were no significant differences in intraoperative blood loss, intraoperative and postoperative complications, hospital stay, grafted bone fusion time, or cure rate between groups (P > 0.05). The Cobb''s angle correction rate for group B (68.5%) was significantly better than that of group A (30.9%). The neurological score showed significant postoperative improvement in both groups, with no significant difference between the groups.The subscapularis transthoracic approach and the posterolateral approach with debridement, bone graft fusion, and internal fixation are both sufficient and satisfactory for the surgical treatment of upper thoracic tuberculosis. However, the posterolateral approach is superior to the subscapularis transthoracic approach in terms of surgical trauma, operative time, and kyphosis correction.     

肾小球微血管构型的扫描电子显微镜观察

应用微血管铸型扫描电镜技术研究8例成人肾脏的肾小球微血管构筑,结果发现:1.输入小动脉在肾小球血管极处分为2～5支小球内小叶微动脉。输入小动脉血管铸型的直径为126.35±20.5μm。2.肾小球是由小球内小叶微动脉、毛细血管、毛细血管网小叶间交通支和毛细血管输出根所构成的近似于球状体,小球内每个毛细血管网小叶均是一个独立的机能解剖学单位;3.299个肾小球均有一支输出小动脉,只有一个肾小球有两支输出小动脉。输出小动脉的血管铸型直径为91.35±11.7μm。4.输出小动脉起始处具有毛细血管前括约肌装置,此结构在调控肾小球内的微循环血流有着重要意义。     

中风毒邪论与神经保护治疗的研究

中风毒邪论是一种与传统中医中风病理有所不同的理论 ,在中风毒邪论指导下形成解毒通络方是较为理想的神经保护剂 ,可解决目前神经保护治疗的主要障碍 ,有望成为提高中医治疗中风急性期疗效的关键     

“津血同源”“肾为唾”的研究

以23例肾功能不全与20例肾功正常患者的唾液尿素氮、钠、钾、舌面pH值和血液的相应生化检查作对照。结果唾液尿素氮、钾与血尿素氮、钾成正相关性。证实了中医“津血同源”“肾为唾”的理论。     

吸入一氧化氮对心瓣膜置换术后肺动脉高压患者血流动力学的影响

目的：观察吸入一氧化氮（ＮＯ）对心瓣膜置换术后肺动脉高压患者血流动力学的影响。方法：选择９例心瓣膜置换术后伴肺动脉高压的病人，吸入ＮＯ０．００３％，观察三个时象点：吸入ＮＯ前；开始吸入ＮＯ后１５分钟；停止吸入ＮＯ后１５分钟。结果：吸入ＮＯ能显著降低肺动脉压和肺循环阻力指数（Ｐ＜０．０１），停止吸入ＮＯ１５分钟后，肺动脉压和肺循环阻力指数恢复到原有水平。在整个观察过程中，心率、平均动脉压、中心静脉压、肺动脉楔压、体循环阻力指数和心脏指数均无显著变化（Ｐ＞０．０５）。结论：吸入ＮＯ具有选择性肺血管扩张作用，是治疗心瓣膜置换术后肺动脉高压的较理想药物。     

轻食广义，爱上无负担身体

你发现了吗？现在，许多餐厅开始设计具有健康概念的“轻食套餐”，面包店也推出以蔬菜、杂粮为材料的面包。 “轻食主义”正大肆流行开来![编者按]     

腹腔内疝的CT表现

腹腔内脏器穿过腹膜或膜突入另一腹腔内间隙称为腹腔内疝（internal abdominal hernias）。最常表现为一段小肠嵌入正常或异常的腹腔内孔道，引起急性小肠梗阻。作为疝口的结构可以是腹腔内的正常解剖结构，如裂孔、隐窝、陷窝等，     

国人心壁内血管系统的研究——左心室壁心外膜区微血管形态计量学研究

为探察人左心室壁心外膜区微血管的三维空间构型和形态计量学指标。本研究应用微血管腐蚀铸型/扫描电子显微镜技术和酶组化(碱性磷酸酶反应)染色方法,观察10例心脏标本,得出心外膜区的毛细血管直径为7.2±1.9μm(±S.D),微血管密度是3484.44/mm~2。获得左心室壁心外膜区从微动脉-动脉端毛细血管-毛细血管网-静脉端毛细血管-“萝卜根样”微静脉这个微循环单位的三维空间构型资料。