肺先天性囊性腺瘤样畸形

肺先天性囊性腺瘤样畸形昌红，严庆汉（铁道部北京铁路总医院病理科１０００３８）肺先天性囊性腺瘤样畸形（ｃｏｎｇｅｎｉｔａｌｃｙｓｔｌｃａｄｅｎｏｍａｔｏｉｄｍａｌｆｏｒｍａｔｉｏｎ，ＣＣＡＭ）是一种先天畸形。据文献统计，ＣＣＡＭ主要见于出生１月内的婴儿...     

先天性膈肌缺如伴多脏器畸形及腹腔脏器胸腔异位1例

1　病例报告女 ,孕 41 5周 ,因胎动频繁 ,胎儿心率快 ,B超检查羊水过少 ,行剖腹产。产后无自主呼吸 ,进行气管插管抢救时出现前胸、颈部皮下气肿 ,产后 40 min死亡。尸体解剖 :体表皮肤、口唇及甲床青紫 ,前胸、颈部肿胀 ,触之有弹性 ,切开有气体溢出。打开胸腔 ,双侧均有气体溢出 ,心脏及胸腔大血管位置正常 ,左侧肺明显萎缩 ,两叶完全分离 ,左侧胸腔完全相通 ,胸腔见胃、肠、阑尾、脾脏及部分肝左叶。右侧肺叶完全分离 ,可见一叶横于心脏后 ,气管分叉下 ,其余肺叶下部和肝右叶顶部、右肾上腺紧密粘连。心脏 :4.5 cm× 3.5 cm× 2 .0 cm,…     

MRI诊断先天性环枕畸形

ＭＲＩ诊断先天性环枕畸形余永强，王仁贵，李松年本文观察了２５例先天性环枕畸性的ＭＲＩ，旨在评价其诊断价值。１资料与方法本文２５例病人中，男１６例，女９例，年龄８～４１岁（平均年龄３３．５岁）；病程２月～１０年。全部病例经Ｘ线确诊颅底凹陷，其中１３例行...     

B 超诊断胎儿复杂畸形1例

Ｂ超诊断胎儿复杂畸形１例王茜王福明杨志杰（南昌市中西医结合医院，南昌３３０００３）１病例报告孕妇，３０岁，Ｇ１Ｐ０。因足月妊娠入院待产，妊娠前一年有铅、苯等化学品接触史，无近亲结婚史及畸形胎儿生产史。Ｂ超所见：胎头形态如常，双顶径８．５ｃｍ，颈椎、胸...     

先天性短食管胸胃1例

1病例报告 女,36岁.主诉右上胸部不适月余,有时伴有胸骨后酸痛,无呕吐,于2004-03-18来我科就诊.查体:心肺未见明显异常.实验室检查:血、尿、粪常规检查均正常.既往体健,无手术史.     

十二指肠乳头高位畸形3例

1 临床资料 1985～1995年间,本院内镜检18768人次中,发现并确诊十二指肠乳头高位畸形3例。发病率为0.016％。皆为女性,年龄20～25岁,病程14～20年。临床表现为反复发作上腹疼痛,胸骨后疼痛,嗳气、呕吐黄色苦味水。有时伴畏寒发热等。胃镜下3例乳头位置距幽门口分别为0.5cm、1.0cm,1.0cm。合并症有:①复合性溃疡;②胆汁返流性胃炎;③返流性食管炎。家族史中,其父亲均有程度不同的类似发作病史,而兄弟均无类似发作。现就其中1例报告于下。 女,25岁。因反复上腹疼痛、嗳气、呕黄苦味水17年,畏寒发热,右上腹阵发性绞痛10天入院。初诊为慢性胃炎急性发作。经制酸、解痉、抗炎等治疗效差。每天仍呕黄苦水数次,每次量约150～700ml不等。无呕血及黑便。患者1970年因胃窦部穿孔,曾在本院做过胃修补     

先天性内耳畸形的临床表现及处理：——附Mondini畸形1例并文？…

目的 熟悉先天性内耳畸形的临床表现及处理原则。方法 对Ｍｏｎｄｉｎｉ畸形１例进行分析，并结合文献进行讨论。结果 ＣＴ检查有利于该病的诊断。结论 不明原因感音性聋伴或不伴脑脊液耳鼻漏，均应考虑本病可能。瘘口周围粘膜充分搔刮是自发性脑脊液耳鼻漏修补成功的关键。     

两性畸形的B超诊断分析

两性畸形的Ｂ超诊断分析济南军区总医院刘兰芬，李心民，苗风君，牟楠楠，管一帆我院自１９８２年以来共收治两性畸形１９例，年龄９～２７岁，平均２０．５岁。女性假两性崎形１０例，男性假两性畸形４例，先天性卵巢发育不全３例，真两性畸形２例。患者分别作手术校正及...     

先天性肾动静脉畸形一例报告并文献复习

[目的]提高对先天性肾动静脉畸形的认识.[方法]收治先天性肾动静脉畸形女性患者1例,结合文献复习讨论先天性肾动静脉畸形诊治要点.[结果]患者临床表现为肉眼血尿.增强CT示右肾前部靠近集合系统的高密度血管影,CT血管成像(CTA)示右肾中下部簇状血管团.磁共振血管成像(MRA)示右肾下部异常血管团.数字减影血管造影(DSA)证实右肾中下部动静脉畸形,肾静脉早期显影.予以介入栓塞治疗.随访12个月,患者临床症状消失无复发.[结论]肾动静脉畸形临床少见,肉眼血尿为主要临床表现之一,DSA是诊断金标准,介入栓塞为当前主要的治疗方法.     

Guns and Knives in New Mexico: Patterns of Penetrating Trauma, 1978–1993

Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

Interprofessional approaches to creating safe,high quality health care

Three supplementary perspectives are presented arguing that interprofessional collaboration is both necessary and desirable. Nonetheless, there are often too many serious intra-professional barriers and obstacles to interprofessional collaboration to make it successful. Some of these barriers, it is argued and illustrated, are found in the multiple ways in which professional identity is tacitly acquired and embodied in the practitioners' habitual, everyday practice. The paper then explores ways in which reflection, especially Second order reflection, can help to elucidate and overcome these obstacles, as well as increasing professional adaptability and competence.     

Systematic Reviews Published in the January 2011 Issue of The Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly as a DVD and monthly online. The January 2011 issue (first quarterly DVD for 2011) contains 4515 complete reviews, 1985 protocols for reviews in production, and 13,521 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 641,000 randomized controlled trials, and 14,018 cited papers in the Cochrane methodology register. The health technology assessment database contains over 9300 citations. One hundred and seven new reviews have been published in the last 3 months, of which five have potential relevance for practitioners in pain and palliative medicine.     

Modified micro-superior percutaneously-assisted total hip: early experiences & case reports

Because of the extensile nature and familiarity of the standard posterior-lateral approach to the hip, a family of "micro-posterior" approaches has been developed. This family includes the Percutaneously-Assisted Total Hip (PATH) approach, the Supercapsular (SuperCap) approach and a newer hybrid approach, the Supercapsular Percutaneously-Assisted Total Hip (SuperPATH) approach. Such approaches should ideally provide a continuum for the surgeon: from a "micro" (external rotator sparing) posterior approach, to a "mini" (external rotator sacrificing) posterior approach, to a standard posterior approach. This could keep a surgeon within his comfort zone during the learning curve of the procedure, while leaving options for complicated reconstructions for the more practiced micro-posterior surgeons. This paper details one author's experiences utilizing this combined approach, as well as permutations of this entire micro-posterior family of approaches as applied to more complex hip reconstructions.     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

Structure and function of "metalloantibiotics"

Although most antibiotics do not need metal ions for their biological activities, there are a number of antibiotics that require metal ions to function properly, such as bleomycin (BLM), streptonigrin (SN), and bacitracin. The coordinated metal ions in these antibiotics play an important role in maintaining proper structure and/or function of these antibiotics. Removal of the metal ions from these antibiotics can cause changes in structure and/or function of these antibiotics. Similar to the case of "metalloproteins," these antibiotics are dubbed "metalloantibiotics" which are the title subjects of this review. Metalloantibiotics can interact with several different kinds of biomolecules, including DNA, RNA, proteins, receptors, and lipids, rendering their unique and specific bioactivities. In addition to the microbial-originated metalloantibiotics, many metalloantibiotic derivatives and metal complexes of synthetic ligands also show antibacterial, antiviral, and anti-neoplastic activities which are also briefly discussed to provide a broad sense of the term "metalloantibiotics."