宫颈环形电切术对阴道镜活检诊断为宫颈上皮内瘤变的再评估

目的通过宫颈环形电切术(LEEP)对阴道镜活检诊断为宫颈上皮内瘤变(C IN)的准确性和全面性进行评估。方法对118例阴道镜活检诊断为C IN的患者行LEEP,对比术前术后的病理结果。结果32例阴道镜活检病理为C INⅠ级病例中有11例与LEEP术病理相符,6例LEEP术后病理级别上升,15例LEEP术后病理级别下降;26例阴道镜活检病理C INⅡ级病例中有17例LEEP术后病理示相符,5例LEEP术后病理级别上升,4例LEEP术后病理级别下降;60例阴道镜活检病理为C INⅢ级病例中有44例LEEP术后病理示相符,11例LEEP术后病理级别上升,5例术后病理级别下降。结论LEEP术是明确诊断和治疗C IN的有效而理想的方法,阴道镜活检有一定局限性。     

核桃仁泥外敷治疗肌肉注射后皮下硬结的疗效观察

采用核桃仁泥外敷治疗１３８例（实验组）肌肉注射后皮下硬结，并与４０例（对照组）采用新鲜土豆片外敷硬结法比较。结果表明：实验组患者治疗１５天后Ⅰ度和Ⅱ度硬结治愈率分别为８１．１３％和４２．２５％，总有效率达９２．０３％，明显优于对照组（Ｐ＜０．００１）。     

The “Biplanar” forehead lift

A new technique of forehead rhytidectomy is presented that combines the best features of the coronal incision with those of the anterior hairline incision. The plane of dissection is formed by an anterior subcutaneous plane dissecting a lateral subgaleal plane. This approach is particularly valuable in patients with high foreheads, severe static wrinkling, and asymmetrical eyebrows.Presented in part at the Annual Meeting of the American Society of Aesthetic Plastic Surgeons, Boston, MA, 1984     

狗喉上神经袢神经束性质的鉴别

用成年杂种狗１２只，在全麻状态下放血，取其颈交感干与喉上神经外支间的交通支及其与喉上神经外支汇合后的神经干，甲醛固定，明胶包埋，恒冷切片后用Ｋａｒｎｏｖｓｋｙ乙酰胆碱酯酶组化方法，对上述材料进行观察。我们发现交通支多为无髓纤维，酶反应呈强阳；混合后的神经含有髓酶反应阳性和阴性纤维及无髓酶反应强阳性纤维，证实喉上神经袢含有体躯运动、内脏运动（交感神经）纤维及感觉纤维。因此，喉上神经拌为混合神经。     

止血带致皮下出血并休克的不良反应1例报告

患者,男,64岁,以“左手掌皮下条索状硬结10年,加重伴小指屈曲畸形1年”于2005年12月6日入院。查:左手掌第五掌指关节处皮肤皱褶,皮下一纵行挛缩带如弓弦样感,使第五掌指关节呈屈曲90°位畸形,严重影响功能和外观。诊断为左手掌腱膜挛缩症。无高血压、冠心病及糖尿病史,心电图正常,肝肾功能、血常规和血凝化验均在正常范围,于12月8日在臂丛麻醉下行掌腱膜松解切除植皮手术。常规应用电子气囊止血带,压力40kPa,定时60min,手术切开皮肤后即发现止血带失用,出血明显,约在止血带使用6min时,患者述疲乏不适,继而突然出现心率减慢(48次/min),血压下降(60/48mmHg)。麻醉师考虑与使用     

Altered chromatin landscape in circulating T follicular helper and regulatory cells following grass pollen subcutaneous and sublingual immunotherapy

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Hand and joint paths during reaching movements with and without vision

 This study examines whether the kinematics of pointing movements are altered by the sensory systems used to select spatial targets and to guide movement. Hand and joint paths of visually guided reaching movements of human subjects were compared with two non-visual conditions where only proprioception was available: (1) movements of the same subjects with blindfolds, and (2) movements by congenitally blind subjects. While hand-path curvatures were overall quite small, sighted subjects wearing a blindfold showed a statistical increase in hand-path curvature compared with their visually guided movements. Blindfolded subjects also showed greater hand-path curvature than blind subjects. These increases in hand-path curvature for blindfolded subjects did not always lead to a decrease in joint-path curvature. While there were differences between blind subjects and sighted subjects using vision for some movement directions, there was no systematic difference between these two groups. The magnitude of joint-path curvature showed much greater variation than hand-path curvature across the movement directions. We found variation in joint-path curvature to be correlated to two factors, one spatial and one geometrical. For all subject groups, joint-path curvature tended to be smaller for sagittal-plane movements than for transverse or diagonal movements. As well, we found that the magnitude of joint-path curvature was also related to the relative motion at each joint. Joint-path curvature tended to increase when movements predominantly involved changes in shoulder angle and was minimal when movements predominantly involved elbow motion. The consistently small curvatures of hand trajectory across blind and sighted subjects emphasize the powerful tendency of the motor system to generate goal-directed reaching movements with relatively straight hand trajectories, even when deprived of visual feedback from very early in life. Received: 16 July 1997 / Accepted: 20 May 1998     

The early phase of experimental acute renal failure

Experiments were conducted to establish whether diminished solute reabsorption in the loop of Henle during acute renal failure could explain the loss of urinary concentration and participate in generating a tubuloglomerular feedback-mediated reduction in filtration rate. The electrolyte content of the fluid in the ascending limb of the loop of Henle was determined in situ by monitoring its electrical conductivity after propulsion into the distal tubule with a sudden burst perfusion. The value of the minimum electrolyte concentration decreased exponentially with increasing equilibration time, reaching a steady-state value equivalent to 27±9 mM NaCl in normal kidneys, 34±15 mM in mercuric chloride kidneys and 53±22 mM following ischaemia. A mathematical model was derived to describe the process of sodium chloride dilution from which it was possible to calculate both the permeability and transport velocity of the cortical thick ascending limb. In the normal kidney, the transport velocity was calculated to be 4.65±0.92 ·10^–5 cm/s, a value not significantly different from that of the mercuric chloride or ischaemic kidneys, and the estimated permeability was 1.13±0.52·10^–5 cm/s, not different from that of the mercuric chloride kidneys but significantly lower than that calculated for the ischaemic kidneys. It is concluded that for the more severely damaged ischaemic model, the loss of urinary concentrating ability was accompanied by a reduction in diluting ability of the ascending limb of the short loop of Henle, which appears to be due, at least in part, to an elevation of the passive permeability to sodium chloride in this segment.