踝关节融合术后后足关节生物力学分析

目的 探讨踝关节融合术后后足关节的生物力学特性。方法 利用健康成年男性志愿者右踝关节CT图像，构建踝关节融合前的三维有限元模型，在此基础上模拟踝关节融合术后骨性融合状态，采用中立、外旋、内旋、背伸和跖屈的5种载荷工况分别对融合前、后模型组进行有限元分析，评估踝关节融合前后的整体刚度变化、距下关节和距舟关节的接触力学特性变化。结果 踝关节发生骨性融合后，整体结构刚度较融合前模型显著增高；除中立位工况以外，融合后的距下关节的接触面积均有所减少，距舟关节接触面积则有所增加；而融合后的距下和距舟关节的接触应力在各工况下总体呈降低趋势。结论 踝关节骨性融合术后相邻关节的接触特性改变可能是足部整体结构刚度提高后承载模式发生变化的结果，其与相邻后足关节退行性改变之间的关联尚有待进一步研究证实。     

雨前雨后

六月流火。中考、高考、录取线……这些敏感的信息,从街头巷尾、视听及报刊媒体中,全方位、全天候地轰炸着人们的耳鼓和神经。紧迫、忧虑、焦躁,这些情绪在人群中蔓延。忙:电话拿起又放下,没完没了地迎来送往,难以突围的文山会海……步履匆匆,目光扫描,语速似急鼓,面皮紧绷,偶有小歇,张嘴喘息如鱼困沙滩,手抖领口频频扇风。人人都觉得热,气候     

车祸事件后创伤后应激障碍的研究

目的 :研究车祸事件后创伤后应激障碍的发生情况及特点。方法 :应用中国精神疾病分类方案与诊断标准第二版修订本中的急性应激障碍 (ASR)和创伤后应激障碍 (PTSD)诊断标准 ,对因车祸住我院治疗的 81例患者进行诊断 ,采用症状自评量表 (SCL -90 ) ,艾森克个性问卷 (EPQ)及症状记录表等进行测评。结果 :车祸后 3个月 ,81例中有 33例 ( 4 0 7%)曾经符合ASR诊断标准 ,31例 ( 38 3%)符合PTSD诊断标准。与非PTSD组比较 ,PTSD组SCL -90总分、总均分、阳性项目数、阴性项目数及躯体化、强迫症状、人际关系敏感、抑郁、焦虑、敌对、恐怖、其它因子分均显著高于非PTSD组 (P <0 0 5～ 0 0 1)。PTSD组情绪稳定度倾向不稳定型 ( 38 71%)的比率高于非PTSD组 (P <0 0 1)。与PTSD发病有关的影响因素为EPQ问卷中神经质、L量表及性别。结论 :车祸事件后PTSD并非罕见 ,与性别及个性心理特征有关。     

腹膜后淋巴引流预防宫颈癌术后盆腔淋巴囊肿

目的：探讨宫颈癌术后并发盆腔腹膜后淋巴囊肿的防治方法和疗效。方法：53例IB期宫颈癌患者随机分为A、B两组。在宫颈癌根治性切除后,A组20例阴道残端与盆腔腹膜缝合,盆腔腹膜后完全闭合,腹膜后淋巴不引流;B组33例采用阴道残端部分敞开腹膜后淋巴引流。结果：术后盆腔淋巴囊肿发生率A组为25％、B组为3．3％,两组比较差异有统计学意义（P〈0．05）。结论：宫颈癌根治术后腹膜后引流用于预防术后盆腔腹膜后淋巴囊肿,方法简单、效果可靠,值得临床推广应用。     

芦山地震后学生创伤后应激障碍与自我意识

目的:了解4.20芦山地震1年后,灾区儿童的心理健康水平与创伤后应激障碍(PTSD)的发生率。方法:采用PTSD问卷与儿童自我意识量表,对地震灾区芦山地区452名中小学生进行问卷及访谈调查。结果:在震后1年,芦山当地中小学生的自我意识水平低于平均常模;中学生与小学生的PTSD检出率较高分别为32.3%、14.0%,年级在主观评定因子(t=-2.03,P0.05),以及回避症状因子上存在显著差异(t=2.62,P0.01);而在自我意识因子上,性别和年级在各因子上不存在显著。小学生自我意识的大部分因子与PTSD因子存在显著相关。结论:灾后芦山中小学生的心理健康水平低于同龄儿童,他们的安全感降低,对自我意识不明确,这也是灾后创伤性应急障碍发生率重要影响因素之一。     

腹腔镜经后腹腔途径治疗下腔静脉后输尿管

目的探讨后腹腔镜治疗下腔静脉后输尿管的方法及临床效果。方法 8例患者均接受经后腹腔途径的腹腔镜输尿管端端吻合术。结果 8例手术均获成功。平均手术时间140 m in,术中出血量10~100 mL,无手术并发症发生,随访3个月至6年,肾积水均有改善,肾功能有恢复。结论后腹腔镜输尿管端端吻合术治疗下腔静脉后输尿管是一种理想的手术方式。     

流产后要注意创伤后压力症候群

正据美国WebMD医学新闻网2016-11-09报道,英国一篇新研究发现,妇女流产后可能会发生创伤后压力症候群(PTSD)。研究者认为,应让发生流产或异位妊娠的妇女进行PTSD例行性筛查,且接受心理健康支持。第一研究者、伦敦帝国学院肿瘤与外科的Jessica Farren认为,对于妇女流产后发生PTSD症状的比率如此之高,我们感到惊讶。Farren指出,目前,还没有对发生流产或异位妊娠的妇女进行常规追踪约诊;她在大学新闻稿中表示,我们有针对"产后"     

后巩膜加固术后巩膜生物力学性能的研究

研究后巩膜加固术后巩膜生物力学性能的变化,为该手术在临床的推广使用提供参考。在Instron5544材料性能试验机上,采用单向拉伸及球面致压两种方法对术后不同区域获取的兔眼巩膜进行预拉伸、松弛及蠕变实验。结果显示,加固条带区巩膜试件与其它各组试件相比,在线性阶段单位宽度上的刚度系数显著增大,在松弛阶段抗变形能力偏高,在蠕变阶段蠕变率明显偏低。说明后巩膜加固术能起到加强后巩膜薄弱部分抵抗变形的能力,同时降低巩膜蠕变率,从而控制进行性近视的发展。     

乳腺癌改良根治术后皮瓣坏死后的护理体会

目的 探讨乳腺癌患者改良根治术后发生皮瓣坏死的原因及护理方法.方法 从患者入院完善相关检查后确诊为乳腺癌开始,全面评估患者术前的全身情况,包括合并症如糖尿病、高血压、贫血、低蛋白血症等,注意有关因素并进行相应治疗护理.纠正营养不良,加强基础病的治疗,注意手术技巧,加强术后护理以及皮瓣坏死后的精心护理.结果 46例皮瓣坏死者经过精心护理成活45例,1例合并糖尿病以及皮瓣坏死范围大无法成活经过烧伤科植皮获得成功.结论 乳腺癌改良根治术后发生皮瓣坏死是多方面因素综合影响的,皮瓣供血不足是术后皮瓣坏死的根本原因,与患者基础疾病、手术方式、包扎技巧、术后双管引流、术后精心护理与观察等有很大关系,通过积极术前准备和术后精心护理,将有助于降低皮瓣坏死的发生率.对预防乳腺癌术后皮瓣坏死具有重要的临床意义.     

剖宫产术后阔韧带后腹膜血肿诊治体会

剖宫产术后阔韧带、后腹膜血肿是产科较为凶险的疾病，其出血的主要原因为子宫收缩乏力、胎盘因素、软产道损伤及凝血功能障碍。该病发展快、死亡率高，如不及时纠正，易出现失血性休克，造成多脏器功能衰竭甚至死亡。本文就我院产科2004年1月至2007年12月3例住院剖宫产术后阔韧带、后腹膜血肿病例临床分析如下。     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

What will studies of Fulani individuals naturally exposed to malaria teach us about protective immunity to malaria?

There are an estimated over 200 million yearly cases of malaria worldwide. Despite concerted international effort to combat the disease, it still causes approximately half a million deaths every year, the majority of which are young children with Plasmodium falciparum infection in sub-Saharan Africa. Successes are largely attributed to malaria prevention strategies, such as insecticide-treated mosquito nets and indoor spraying, as well as improved access to existing treatments. One important hurdle to new approaches for the treatment and prevention of malaria is our limited understanding of the biology of Plasmodium infection and its complex interaction with the immune system of its human host. Therefore, the elimination of malaria in Africa not only relies on existing tools to reduce malaria burden, but also requires fundamental research to develop innovative approaches. Here, we summarize our discoveries from investigations of ethnic groups of West Africa who have different susceptibility to malaria.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

The universal muscular chain reaction,muscle spasm,Torsions, ruptures and extravasations. Chameleons of pathology and some manifestations of simple muscular disorders

Most bodily functions require the coordinated actions of complementary and supplementary paired muscle groups. Where this essential muscular cooperation is lacking, hollow organs may burst and others become literally screwed up, giving rise to many similar spastic diseases such as Torticollis, Twisted ovarian cyst, Torsion of the Testis, Volvulus of the intestines, Varicose Veins, Megacolon, Aortamegaly, Scoliosis, Erb's Palsy, Peyronie's Disease, Main-en-Griffe, Undescended Foot (Pes Cavus), Talipes, Strabismus. Spasm is “panenepidemic” and unclassified examples of Torsion Dystonia and Dyskinesia really are as common as debt and taxes.     

Class II HLA in Georgia Caucasus Tbilisi Georgians and their Mediterranean ancestry: The Usko Mediterranean languages

Georgia (or Sakartvelo in its own language) is a South Caucasus Mts. country with its easternmost part is enigmatically named Iberia, like the Iberian Peninsula, which may refer to rivers “Kura” and “Ebro” or their valleys respectively. Most of their inhabitants speak Georgian which is included within Dene-Caucasian group and Usko-Mediterranean subgroup of languages. The latter includes Basque, Berber, ancient Iberian-Tartessian, Etruscan, Hittite, Minoan Lineal A and others. In the present paper, HLA class II -DRB1 and -DQB1 alleles has been studied and extended haplotypes calculated. Most frequent haplotypes are also of Mediterranean origin (i. e.: (A*02-B*51)-DRB1*11:01-DQB1*03:01, (A*02-B*51)-DRB1*13:01-DQB1*06:03, or (A*24-B*35)-DRB1*01:01-DQB1*05:01) and DA genetic distances show that closest world populations to Georgians are Mediterraneans. Georgians also show common extended haplotypes ((A*02-B*51)-DRB1*11:01-DQB1*03:01, (A*02-B*13)-DRB1*07:01-DQB1*02:01 and (A*03-B*35)-DRB1*11:01-DQB1*03:01) with Svan people, a secluded population in North Georgia mountains. We can conclude that Georgians belong to a very old Mediterranean substratum according to both linguistics (Usko Mediterranean languages) and HLA genetics.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.