介入技术在下肢动脉硬化闭塞症合并血栓形成中的应用

目的:探讨导管接触性溶栓(catheter-directed thrombolysis,CDT)联合球囊及支架成形术治疗下肢动脉硬化闭塞症合并血栓形成的临床疗效及安全性。方法:选择2011年1月~2014年12月收治的36例下肢动脉硬化闭塞症合并血栓形成性病变患者,先行置管溶栓治疗,再联合球囊及支架成形术治疗,观察其溶栓效果及血管再通情况。结果:本组溶栓总有效率为86.1%,尿激酶用量(75.5±34.6)万单位,溶栓后31例下肢缺血症状改善,下肢疼痛症状有不同程度减轻,下肢跛行距离明显延长,无垃圾脚发生。球囊及支架成形术后踝肱指数(ABI)由术前的0.39±0.11升高至术后的0.79±0.19,差异有统计学意义(P0.01)。随访1~48月,无死亡病例,9例出现支架内膜增生血管再狭窄,5例出现糖尿病膝下动脉狭窄闭塞,给予球囊扩张及支架成形术后下肢缺血症状减轻,其中1例患者于术后3年行下肢截肢治疗。结论:CDT联合球囊及支架成形术治疗下肢动脉硬化闭塞症合并血栓形成具有较高的临床价值,可以为PTA血管成形或支架置入赢得时机,改善下肢缺血,该方式创伤小,并发症少。     

Menez-Dregan 1 (Plouhinec,Finistère,France) : un site d’habitat du Paléolithique inférieur en grotte marine. Stratigraphie,structures de combustion,industries riches en galets aménagés

The Lower Palaeolithic site of Menez-Dregan I is currently the subject of an important excavation and has been part of a multidisciplinary project since 1991. It is an ancient marine cave whose roof has gradually collapsed and thus partly protected the site from erosion. In Menez-Dregan 1, the sedimentological evidence has been significantly reduced due to multiple episodes of marine erosion in the cave (low sedimentary preservation in terms of sedimentation and erosion process). However, the proximity of a section with a longer sedimentary record (Gwendrez cliff) has allowed for an attempt at correlation between the different deposits by way of a sedimentologic study applied to sandy marker beds (dunes). The resulting new data permitted a more precise chronostratigraphy of this site to be drawn up and contributed to further validation of dating. Three main stratigraphic units show distinct levels of human occupation at the site, separated by coastal deposits. The ESR dates tend to place the first human occupation in MIS 12 or at the end of MIS 13 (around 465,000 years). The ESR dating obtained at the base of layer 5 gave an age of 380,000 years. The geological analysis (sedimentology, stratigraphical correlations at short distance) tends to confirm these dates. The fauna has not preserved due to the acidic environment, leaving only the lithic industry to show how the human groups who settled at the site lived and, it is worth noting, mastered fire lighting, and or control, at a very early date (late MIS 13 or early MIS 12). The lithic industry from the upper levels (layer 5) is likely Colombanian and is composed of numerous flakes and cores alongside a great quantity of cobble tools (mostly choppers), fractured cobbles, and cobbles with isolated removals on various types of rocks, some cleavers and very rare bifaces. Additionally denticulates and notches form the main part of the light duty tools, together with scrapers. These retouched light duty tools are mainly made on flint, but quartz and glossy sandstone were also used. The last level of occupation (layer 4) probably shows the transition between Lower and Middle Palaeolithic. This may represent a regional cobble tool industry of the south armorican shoreline, however, it is still difficult to separate it totally from the classic European Acheulean from Northern France. These armorican lithic industries could indeed correspond with areas of specialised activities, as demonstrated for some Middle Palaeolithic groups with a cobble tools lithic industry. The notion of culture that could be chosen to explain this variability must be treated with caution, because it would only be based on the presence or absence of only one type of tool (the handaxe).     

Observations on Syracosphaera rhombica sp. nov.

A spherical coccosphere and two collapsed coccospheres composed of monomorphic rhombic coccoliths were encountered in 2005 in the Java upwelling system of the SE Indian Ocean, while a further two specimens with elongate coccospheres were recently found in the Gulf of Mexico. All of the specimens were collected from the lower photic zone (75–160 m). The coccoliths possess a proximal flange, a slightly flared wall with a serrated distal margin, and a relatively plain central area structure comprised only of overlapping laths. The taxon appears to be an undescribed species of the Syracosphaera nodosa group, so we describe it herein as Syracosphaera rhombica sp. nov.     

A new sauropodomorph ichnogenus from the Lower Jurassic of Sichuan,China fills a gap in the track record

A dinosaur tracksite in the Lower Jurassic Ziliujing Formation of Sichuan Province, China consists of a spectacular sub-vertical exposure, with multiple track-bearing levels and trackways showing parallel and bimodal orientations. Based on well-preserved material, the new ichnogenus and ichnospecies, Liujianpus shunan ichnogen. nov. ichnosp. nov. is erected to accommodate distinctive sauropodomorph trackways occurring in this assemblage. Liujianpus has a unique combination of features, some relating to the early Jurassic basal sauropodomorph (prosauropod in traditional usage) ichnogenus Otozoum, others to the sauropod ichnogenus Brontopodus. Despite such a mix of basal sauropodomorph- and sauropod-like features, the trackmaker of Liujianpus is likely a basal sauropodomorph. This identification is consistent with the occurrence of basal sauropodomorph skeletons from geographically and chronologically close localities. The other distinct morphotype from the tracksite is linked to a sauropod trackmaker. As such, the ichnofauna consisting of two distinct foot morphotypes reflects the diversity of sauropodomorph dinosaurs in the Early Jurassic of Asia.     

Cortical motor representation of the rectus femoris does not differ between the left and right hemisphere

Transcranial magnetic stimulation (TMS) involves non-invasive magnetic stimulation of the brain, and can be used to explore the corticomotor excitability and motor representations of skeletal muscles. However there is a lack of motor mapping studies in the lower limb and few conducted in healthy cohorts. The cortical motor representations of muscles can vary between individuals in terms of center position and area despite having a general localized region within the motor cortex. It is important to characterize the normal range for these variables in healthy cohorts to be able to evaluate changes in clinical populations. TMS was used in this cross-sectional study to assess the active motor threshold (AMT) and cortical representation area for rectus femoris in 15 healthy individuals (11 M/4F 27.3 ± 5.9 years). No differences were found between hemispheres (Left vs. Right P = 0.130) for AMT. In terms of y-axis center position no differences were found between hemispheres (Left vs. Right P = 0.539), or for the x-axis center position (Left vs. Right P = 0.076). Similarly, no differences in calculated area of the motor representation were found (Left vs. Right P = 0.699) indicating symmetry between hemispheres.     

The relative contributions of sagittal,frontal, and transverse joint works to self-paced incline and decline slope walking

Positive and negative work are generated at the lower limb joints in order to locomote over various terrains. Joint work quantifies the changes in energy that are necessary to adapt gait to environmental demands. The aim of this study was to quantify 3D joint work at the hip, knee, and ankle during slope walking. Work was calculated for ten males (23.9 ± 1.1 years) walking at a self-selected speed on inclines and declines (−20, −12, −6, 0, 6, 12, 20 degrees). Sagittal positive work significantly increased at the hip, knee, and ankle for incline walking (for example, hip positive work increased 153%, 280%, and 453% for 6, 12, and 20 degrees, respectively; knee and ankle positive work also increased) (p ≤ 0.05), in order to raise and propel the body forward. Sagittal negative work increased significantly at the hip, knee and ankle for decline walking (for example, knee negative work increased 193%, 355%, and 496% for −6, −12, and −20 degrees, respectively; hip and ankle negative work also increased) (p ≤ 0.05), in order to control body descent. These substantial changes in work will be especially challenging for people with compromised strength due to age and disease. Furthermore, changes in work were not limited to the sagittal plane: 46% of the total hip joint work occurred in the frontal and transverse planes for six degree decline walking. Thus, decline walking placed greater demands on the hip ab/adductors and rotators, and this may be related to the greater risk of falls observed for descent versus ascent.     

川西汉源-荥经地区下奥陶统大乘寺组的笔石

对川西汉源-荥经地区CYD2井下奥陶统弗洛阶大乘寺组的笔石进行研究,结果表明Baltograptus deflexus笔石带在这一覆盖区发育良好。CYD2井的该带笔石动物群共含2属5种。根据下垂对笔石类的始端发育型式,修正前人对波罗的笔石属(Baltograptus)和巅峰笔石属(Corymbograptus)内一些种的归属,并对CYD2井的5种笔石进行描述。可能受制于钻心标本的限制,该地区的Baltograptus deflexus带笔石动物群分异度较低。川西汉源-荥经-峨眉山地区的大乘寺组与上覆二叠系梁山组呈假整合接触,表明该地区长期遭受沉积间断和剥蚀作用,B.deflexus带的确定,指示了这一长期剥蚀作用的最大深度。     

Evidence for a single median fin-fold and tail in the Lower Cambrian vertebrate, Haikouichthys ercaicunensis

In this study, we illustrate an exceptionally well-preserved Haikouichthys ercaicunensis from the Lower Cambrian Chengjiang fauna that displays complete single dorsal, ventral and caudal fins. This 530-million-year old vertebrate is fish-shaped and characterized by a single median fin-fold, which is an essential trait of the initial vertebrate chordates. The radially orientated ray-like structures in its dorsal fin somewhat resemble but are probably not real radials seen in basal vertebrates, such as hagfishes and lampreys. The unique design of primitive fins and fin structures provides additional insights into the early evolution of vertebrates.     

Vascular endothelial cells express a functional fas-receptor due to lack of hemodynamic forces

The fas system is present in atherosclerotic lesions. However, its role in the initiation and progression is still unclear. Here we show that in endothelial cells (EC) the expression of the fas receptor is regulated by flow conditions. The EC of the vascular system are regularly exposed to a range of hemodynamic forces with great impact on cellular structures and functions. Recently it was reported that in endothelial cells the lack of hemodynamic forces as well as irregular flow conditions trigger apoptosis by induction of a mechanosensitive autocrine loop of thrombospondin-1 and the _V3 integrin/integrin-associated protein complex. Here we show that EC cultivated under regular laminar flow conditions are devoid of the fas-receptor whereas cultivation under static conditions as well as under turbulence leads to its expression. Stimulation of the fas-receptor by its ligand increases the amount of apoptotic cells by twofold; the increase can be prevented by blocking the fas-receptor. The availability of the expressed fas receptor for stimulation by its ligand hints at a role as a tool for progression of atherosclerosis.