Successful Use of Surgically Placed Impella 5.0 and Central Extracorporeal Membrane Oxygenation Circuit in a Patient with Postcardiotomy Shock

The Impella 5.0, a percutaneously inserted left ventricular assist device, has been used to support patients who have severe heart failure or who are undergoing high-risk percutaneous coronary intervention. We report our surgical placement of the Impella 5.0, through a graft sewn to the aorta, to unload the left ventricle of a 59-year-old man who was undergoing venoarterial extracorporeal membrane oxygenation for postcardiotomy shock. The patient underwent successful placement of a long-term left ventricular assist device before his discharge from the hospital. The versatility of the Impella 5.0 is exemplified in this patient who was successfully bridged to long-term support.     

前路器械内固定手术矫治脊椎侧凸

作者从１９７９年开始使用戴瓦氏手术，１９８３年开始使用斯伍基氏手术，至１９９４年共做５７例（男性２８例，女性２９例），年龄为９～２８岁。手术无死亡。术后并发症戴瓦氏手术：１例截瘫，２例椎体骨折伴螺丝钉拔出，２例螺丝钉折断，２例金属缆折断；斯伍基氏手术，１例杆折断，２例切口感染。     

贫血病人SF STfR和FEP间关系研究

目的 :研究贫血病人 SF、STf R和 FEP间的关系。方法 :测定 116例贫血病人血清中 SF、STf R和 FEP。结果 :如果以 SF<15μg/ L为界值 ,STf R和 FEP诊断 IDA的敏感度分别是 79%和 81% ,如果以 SF>2 0 0μg/ L为界值 ,STf R和 FEP诊断 IDA的特异性分别为 76 %和 5 9% ;SF<15μg/ L时 ,FEP和 STf R之间有良好的相关性 (r=0 .89,P<0 .0 0 1) ,FEP和 MCV及 STf R和 MCV之间均呈负相关 (r=- 0 .75 ,P<0 .0 0 1及 r=- 0 .72 ,P<0 .0 0 1)。结论 :对单纯 IDA病人 ,如果 SF<15 μg/ L,FEP和 STf R诊断 IDA是相当的     

Magnetic fields elicited by tones and vowel formants reveal tonotopy and nonlinear summation of cortical activation

A long-latency response component (N1m) and the sustained field (SF) of the auditory evoked magnetic field elicited by two composite stimuli (a two-tone combination and a two-formant vowel) and their individually presented components (a 600-Hz and a 2100-Hz pure tone and two single-vowel formants with formant frequencies matched to the tone frequencies) were recorded using a 37-channel magnetometer. The response to the composite stimuli differed from the linear sum of the responses to the respective components in latency, equivalent dipole moment, and equivalent dipole location, suggesting an interaction among the processes elicited by the constituents of composite stimuli. Nlm and SF source locations were more medial for the response to the high tone than to the low tone and more medial for the response to the high vowel formant than to the low vowel formant. The Nlm formant sources were more lateral than the Nlm tone sources. These findings suggest that, at the level of the auditory cortex, vowels are represented in terms of both the spectral pitches determined by their most prominent harmonics and, within the latency range of the Nlm, the virtual pitch determined by the spacing of the harmonics.     

特发性脊柱侧凸King型和型远端融合椎的选择

目的回顾采用椎弓根钩和螺钉CD技术治疗特发性脊柱侧凸King型和型患者,分析选择性缩短融合节段的治疗效果。方法2000年3月~2003年1月,治疗58例特发性脊柱侧凸单胸弯患者,男17例,女41例,年龄12~18岁,平均14岁。其中King型40例,King型18例。胸弯Cobb角平均64°(50~83°),柔韧性62%;腰弯Cobb角平均37°(16~48°),柔韧性105%。腰弯腰骶角平均为17°(10~22°)。所有患者C7重力垂线均不同程度地偏离骶骨中线。采用椎弓根钩和螺钉CD技术矫形治疗,以中立椎为基础选择远端融合椎,所有远端融合节段均未超过中立椎。术后随访摄站立前后位和侧位X线片,观察各项指标的变化。结果患者均获随访1年8个月~3年2个月,平均2.4年,均未出现明显的躯干侧方移位和双肩不平衡。术后Cobb角平均丢失3.1°(-1~5°);最后随访时,胸弯矫正率68%;除2例C7重力垂线偏离骶骨中线1~2cm外,其余均通过骶骨中线;腰弯腰骶角减少至平均8°(2~13°),矫正率为53%;48例远端融合椎为非稳定椎者术后成为稳定椎。与Harrington远端融合椎选择原则相比,患者远端融合椎平均节省1.4个节段(1~2个节段)。结论采用三维节段性器械内固定系统治疗特发性单胸弯时,以中立椎为基础选择远端融合椎,可获得较好的临床效果。     

不同起搏模式对病人生存质量影响的调查研究

[目的]探讨不同起搏模式对病人生存质量（QOL）的影响。[方法]以健康调查问卷（SF一36量表）对112例不同起搏模式病人进行问卷调查，比较3种起搏模式下病人的QOL水平。[结果]除机体疼痛、角色情绪2个维度外其余6个维度（生理功能、角色限制、活力、社会功能、精神健康、总体健康）3种起搏模式间比较差异有统计学意义（P〈0．05）。[结论]应用AAI型、DDD型起搏器的病人生存质量优于VVI型起搏。     

A newly designed attachment device of multipurpose frame for neuronavigator

Summary A newly designed attachment device of the multipurpose head frame (Sugita) for Neuronavigator (Watanabe) is presented with an illustrative case of glioblastoma in an eloquent area. This has extended the usefulness of the neuronavigator for those who prefer and use the multipurpose head frame, while the requirements for keeping a stereotactic combination and the original concept of the multipurpose head frame, as well as that of the neuronavigator have been kept undisturbed.     

16株假单胞菌DNA的G＋C百分含量测定

采用改良的热变性温度法，将DNA升温及恒温处理与紫外吸收值的测定分两步进行，检测3株标准菌株和16株假单胞菌DNA的G Cmol% 含量。结果表明，14株假单胞菌与其相应标准菌种的DNAG＋Cmol%含量基本一致，与其生物学性状亦相符；另2株DNA的G＋Cmol%含量与其生物学性状不符，其分类学位置尚待探讨。     

颈椎侧块钢板在脊髓型颈椎病治疗中应用

目的 对15例脊髓型颈椎病患者行后入路椎管减压、椎板成型术的同时使用颈椎侧块钢板固定，探讨和分析该手术方法的优点和手术治疗效果。方法 从自2000年3月—2002年12月，对15例脊髓型颈椎病患者(术前颈椎MR显示有三个节段颈椎椎间盘水平病变并有黄韧带增厚突入椎管)，行颈椎后入路双开门椎板成型术加双侧颈椎侧块钢板固定。按JOA评分法评定患者手术前后恢复情况。结果 本组患者男10例，女5例，随访5个月—1年2个月，平均9个月，术后2—7天(平均3．5天)可戴颈围坐起，颈围外固定时间12周，融合时间3—5个月，(平均为3．5个月)，术后JOA评分明显提高，所有病人无术中血管、神经根损伤，无植骨不愈合，无内固定断裂。结论 行颈椎后入路双开门椎板成型术联合应用颈椎侧块钢板固定，从后方扩大椎管容积，对脊髓进行减压，辅助以侧块钢板对减压后的颈椎行即时的稳定的固定，增加后方所植髂骨的融合成功率，大大地减少颈椎术后后突畸形发生和术后卧床并发症的发生率。