脑内主要神经核团三维空间的定位及其临床意义

目的：对脑内主要神经核团进行定位研究，为脑立体定向手术提供解剖学基础。方法：对１０２个整脑作三维切面的２ｍｍ厚连续切片，分别对８２个红核、黑质、丘脑底核，１１０个杏仁核、１２２个豆状核（壳核、苍白球）、丘脑和１１４个尾状核头等脑内主要神经核团进行定位研究。结果：各神经核团三轴“靶心”坐标值以及与大脑原点的位置关系。上述核团全部位于原点外，红核１００％位原点下、７６．８％位原点后，黑质１００％位原点下、６４．６％位原点前，丘脑底核１００％位原点下、４３．５％位原点前，杏仁核全部位原点前、下，壳核７６．６％位原点前、６９．２％位原位点，苍白球７６．１％位原点前、５８．９％位原点上，丘脑６１％位原点后、８９．５％位原点上，尾状核头１００％位原点前，８０％位原点上。结论：脑内主要神经核团的空间位置结果对脑的立体定向手术有参考价值     

下颈椎棘突及棘突间隙影像解剖及其临床意义

目的　测量下颈椎棘突及棘突间的解剖参数,为试制颈椎棘突间非融合固定装置提供解剖学依据。 方法　收集46名（男性22人,女性24人）进行颈椎CT扫描的志愿者,将扫描信息传至GE AW4.4工作站测量棘突长度、宽度、高度、倾斜角度以及相邻棘突间距。并做统计学分析。 结果　男女存在显著差异,男性下颈椎棘突：C7最长,C3最短;C7最宽,C5最薄;C7最高,C5最矮;C6倾斜角度最大,C3最小;C3/C4棘突间距最大,C6/C7最小。女性下颈椎棘突：C7最长,C3最短;C7最宽,C4最薄;C7最高,C3最矮;C7倾斜角度最大,C3最小;C3/C4棘突间距最大,C6/C7最小。 结论　本研究较全面地测量了下颈椎棘突的相关指标,包括棘突长度、宽度、高度、倾斜角度以及相邻棘突间距,为试制颈椎棘突间非融合固定装置提供了一定的数据支持和指导意义。     

高血压病人中医辨证分型与甲襞微循环变化的关系

对用中医辨证分型理论分为４型的１３４例高血压患者行甲襞微循环检查，结果表明微循环的障碍程度从肝火亢盛到阴虚阳亢型、痰浊壅盛型、气血瘀滞型逐渐加重，肝火亢盛型为轻度微循环障碍，阴虚阳亢型特点是微血管内流速较快，数目增多，管径最细，长度最长，颜色最浅；痰浊壅盛型特点是微血管模糊不清，畸形最多最重，排列不整，流速较慢，颜色较暗，乳头较浅；气血瘀滞型特点是流速最慢，颜色最暗，乳头最浅，袢顶最宽，红细胞聚集最严重。提示：微循环检查可为中医辨证施治提供科学依据。     

Involvement of oxidative stress in the pathogenesis of diabetes

Pancreatic beta-cell failure is the common characteristic of type 1 and type 2 diabetes. Type 1 diabetes is induced by pancreatic beta-cell destruction, which is mediated by an autoimmune mechanism and consequent inflammatory process. Various inflammatory cytokines and oxidative stress produced by islet-infiltrating immune cells have been proposed to play an important role in mediating the destruction of beta cells. The JNK pathway is also activated by such cytokines and oxidative stress and is involved in beta-cell destruction. Type 2 diabetes is the most prevalent and serious metabolic disease affecting people all over the world. Pancreatic beta-cell dysfunction and insulin resistance are the hallmark of type 2 diabetes. Once hyperglycemia becomes apparent, beta-cell function gradually deteriorates, and insulin resistance is aggravated. This process is called "glucose toxicity." Under such conditions, oxidative stress is provoked, and the JNK pathway is activated, which is likely involved in pancreatic beta-cell dysfunction and insulin resistance. In addition, oxidative stress and activation of the JNK pathway are involved in the progression of atherosclerosis, which is often observed under diabetic conditions. Taken together, it is likely that oxidative stress and subsequent activation of the JNK pathway are involved in the pathogenesis of type 1 and type 2 diabetes.     

The science of searching--how to find the evidence quickly and efficiently

One of the most common findings from health research is the failure to routinely translate research evidence into daily practice. Studies simply can't guarantee the use of their findings. There is just too much research to keep track of and so a large gap develops between what is known and what is done. Evidence that should change practice is often ignored for years. The literature is constantly changing and when an answer to a clinical question is sought, it often comes from an out-of-date textbook. Remaining knowledgeable of current, relevant research is difficult. Consequently, the development of skills in searching electronic databases is vital for the up-to-date clinician.     

Systemic lupus erythematosus and nucleosome]

The property of nucleosome in systemic lupus erythematosus (SLE) is reviewed. Nucleosome, complex of histone and DNA, is thought to have a pivotal role in pathogenesis of SLE. It is formed during apoptosis that is increased in peripheral lymphocytes of SLE. The concentration of nucleosome is elevated in SLE, probably related with disease activity. Nucleosome is speculated that the clearance from peripheral blood is decreased and that is modified by viral infection to become more immunogenic. Anti-nucleosome antibody is highly positive in majority of SLE, and is very specific for SLE except scleroderma and mixed connective tissue disease. This antibody is thought as a diagnostic marker and probably an activity marker for SLE. Anti-nucleosome antibody forms immune complex with nucleosome. As histone has strong positive charge, it is demonstrated that this nucleosome/anti-nucleosome complex is bound to negatively charged heparan sulfate of glomerular basement membrane in kidney. Then, complements bind to this antibody to generate lupus glomerulonephritis. Although main site of apoptosis in SLE is considered as lymphocytes, we experienced a case with SLE who had liver dysfunction with elevated soluble Fas ligand (sFasL) and apoptosis in her hepatocytes in the active stage of SLE. We measured serum sFasL, and found the relation of sFasL and liver involvement in active SLE. As major source of nucleosome should be apoptosis of lymphocytes in SLE, hepatocytes could be another candidate of apoptosis in some SLE.     

Quantitation of metabolites in NMR spectra from isolated tissues, using 14N spectroscopy and nitrate to determine tissue volume.

Quantification of metabolites is a goal of many biomedical NMR studies. To obtain absolute measurements of metabolite concentrations is often both difficult and time-consuming. In this paper a method for determining metabolite concentrations directly is described and validated. It is applicable to studies of amphibian muscles, and with suitable precautions, to other isolated organs and tissues. The method is based upon using 14N NMR and nitrate-containing solutions to determine what fraction (F) of the sensitive volume of the RF coil is occupied by tissue. As the concentration of nitrate is known it can be used to calibrate other 14N metabolites in the tissue. Moreover, once F is determined, it can be used to calibrate metabolites in spectra from other nuclei e.g., 31P or 31C. All that is required is that a spectrum from a standard for that nucleus is obtained. Thus this method does not require any 'internal' (intrinsic to the tissue) standard, and is extremely quick and simple to use.     

Iteratively Reweighted Least Squares Mapping of Quantitative Trait Loci

Mapping quantitative trait loci (QTL) is a typical problem of regression with uncertain independent variables because the genotype of a putative QTL is not observed. Rather, the genotype is inferred from marker information. The method of maximum likelihood (ML) methods is considered to be the optimal solution for this problem because the distribution of the unobserved QTL genotype is fully taken into account. The simple linear regression method (REG) is a first-order approximation to ML and usually performs very well. In this study, an iteratively reweighted least squares method (IRWLS) is proposed. The new method is a second-order approximation to ML because both the expectation and the variance of the unobserved QTL genotype are taken into consideration. The IRWLS is developed in the context of a single large outbred family. The properties of IRWLS are demonstrated and compared with REG and ML via replicated Monte Carlo simulations. The conclusions are: (1) when marker information content is high, the three methods perform equally well, but ML and IRWLS outperform REG when marker information content is low and the variance explained by the QTL is high; (2) when the residual distribution is not normal, ML can fail or have low power to detect small QTLs, but REG and IRWLS are robust to non-normality; and (3) when the residual distribution is normal, the performance of IRWLS is almost identical to ML, but the computational speed of IRWLS is many times faster than that of ML.     

带绦虫体壁的超微结构研究

用ＴＥＭ观察了Ｔａｅｎｉａｓｏｌｉｕｍ，Ｔ．Ｓａｇｉｎａｔａ，Ｔ．Ｄｉｓｉｆｏｒｍｉｓ成虫体壁的超微结构。体壁由皮层及实质两部分组成。皮层为合胞层，从位置上分成两个区：远端胞质区（ｄｉｓｔａｌｃｙｔｏｐｌａｓｍｉｃｚｏｎｅ），和深层的核周胞质区（ｐｅｒｉｎｕｃｌｅａｒｃｙｔｏｐｌａｓｍｉｃｚｏｎｅ）。远端胞质的外表面密布微毛。微毛外被质膜，由基部和端部组成，端部较基部致密，呈电子致密的棘状。基部与端部之间有电子致密环（ｅｌｅｃｔｒｏｎｄｅｎｓｅｒｉｎｇ）２条。微毛的长度，随节片的发育而增长，主要是棘的增长。远端胞质内充满大量的，形状各异的空泡、囊泡、杆状器（ｒｈａｂｄｉｔｉｆｏｒｍｏｒｇａｎｅｌｌｅ），线粒体及内质网。其中豆状带绦虫远端胞质内主要是杆状器；猪带绦虫则以圆形囊泡为主；牛带绦虫为充满内含物的椭圆形囊泡。远端胞质的内面为基膜。基膜下为实质区，实质以网状细纤维样的间质为基质，肌束，核周胞质、支持细胞、实质细胞分布其间。在实质深层，实质细胞逐渐退化成空泡样，构成实质的海绵状结构。     

Enterocolic lymphocytic phlebitis: clinicopathologic features and review of the literature

Enterocolic lymphocytic phlebitis (ELP) is a recently described entity and is of unknown etiology and pathogenesis. It is characterized by phlebitis of the bowel wall and mesentery, without arterial involvement or evidence of systemic vasculitis. The clinical presentation of ELP is varied, but it most commonly manifests with signs of an acute abdomen. Clinical, radiologic, and endoscopic findings are often conflicting and misdiagnosis is common as venous thrombosis is not suspected. The diagnosis of ELP is obtained histologically. There is a spectrum of histologic features associated with ELP, which includes lymphocytic phlebitis, necrotizing phlebitis, granulomatous phlebitis, and myointimal hyperplasia. Other features include venous thrombi and acute ischemic changes of the intestine. Surgical resection of the affected bowel is usually curative and recurrences are rare. The clinical and histopathologic features of ELP are reviewed.     

麻醉深度监测的实验研究

目前,麻醉深度定量监测的主要途径是EEC和AEP,它们的主要指标分别是双谱指数(BIS)和AEP指数,这两个指数各有所长.EEG的BIS是由多个子参数融合而成的,这暗示其稳定性欠佳;AEP指数比较可靠,但是长时间实时测量AEP会使病人因过多的单调声刺激而烦躁不安.因此,研究BIS子参数和AEP指数的一致性和互补性,就显得非常必要.本文的目的正在于此.我们研发了实验用信号采集系统,系统由两部分组成:单片机模块和PC机,单片机模块是硬件的核心,负责刺激和采集信号,以及与PC机通信.PC机控制软件用Labview编写,负责信号的简单处理和记录.信号的后处理用Matlah实现.动物实验:10只大耳白兔,麻醉剂使用3%戊巴比妥钠,按每公斤体重0.5 ml,0.25 ml,0.25 ml,0.25 ml的剂量于耳缘静脉注射,间隔为20分钟,注射麻剂5分钟后记录EEG和AEP.之后,每隔10分钟记录一次,共三次.结果:经过数据处理,我们初步发现BIS子参数和AEP指数具有较好的一致性.     

'BREAKS' Protocol for Breaking Bad News

Information that drastically alters the life world of the patient is termed as bad news. Conveying bad news is a skilled communication, and not at all easy. The amount of truth to be disclosed is subjective. A properly structured and well-orchestrated communication has a positive therapeutic effect. This is a process of negotiation between patient and physician, but physicians often find it difficult due to many reasons. They feel incompetent and are afraid of unleashing a negative reaction from the patient or their relatives. The physician is reminded of his or her own vulnerability to terminal illness, and find themselves powerless over emotional distress. Lack of sufficient training in breaking bad news is a handicap to most physicians and health care workers. Adherence to the principles of client-centered counseling is helpful in attaining this skill. Fundamental insight of the patient is exploited and the bad news is delivered in a structured manner, because the patient is the one who knows what is hurting him most and he is the one who knows how to move forward. Six-step SPIKES protocol is widely used for breaking bad news. In this paper, we put forward another six-step protocol, the BREAKS protocol as a systematic and easy communication strategy for breaking bad news. Development of competence in dealing with difficult situations has positive therapeutic outcome and is a professionally satisfying one.     

Defective release of Hepcidin not defective synthesis is the primary pathogenic mechanism in HFE-Haemochromatosis

Recent findings indicate a principal role for Hepcidin in iron homeostasis. Hepcidin is also thought to play a vital role in the pathogenic mechanism of anaemia in patients with inflammation or chronic disease. Under normal conditions influx and efflux of iron from duodenal enterocytes is regulated by Ferroportin. Ferroportin is a Hepcidin binding protein expressed in duodenal enterocytes. Hepcidin is a peptide synthesised in the liver and is the main regulator of iron homeostasis. It is a defensin like protein and exhibits anti-microbial and anti-fungal activity. The Hepcidin gene is principally expressed in hepatocytes but to a lesser extent in neutrophils and macrophages. Hereditary Haemochromatosis is caused by disruption of iron homeostasis due to mutations in the HFE gene (C282Y or H63D). Unrestricted uptake of iron by duodenal enterocytes causes iron overload which is the hallmark of the disease. Current thinking is that defective Hepcidin synthesis or defective iron-sensing mechanisms leading to Hepcidin deficiency is the cause of iron overload in HFE-Haemochromatosis. Thus HFE-Haemochromatosis has been described as an endocrine disease. Basal levels of Hepcidin appear to be normal in HFE-Haemochromatosis patients. This contradicts current theories of defective Hepcidin synthesis as the cause of Hereditary HFE-Haemochromatosis. We propose that the defect in HFE-Haemochromatosis is the loss of Hepcidin surge in response to intake of dietary iron and is not as a result of reduced synthesis.     

新疆伊犁地区维吾尔族,哈萨克族,蒙古族活体测量比较

对新疆伊犁地区维吾尔族404人(男232人、女172人)、哈萨克族 359人(男197人、女162人)、蒙古族209人(男117人、女92人)×32项活体测量项目及22项体质指标指数的性别和民族间比较.结果表明,三民族共同特征:身材超中等,头短而宽,头长高指数属高头型,头宽高指数属阔头型,面高而宽,中等鼻高,窄型鼻宽,鼻指数属狭鼻型,口裂宽中等,女性头较男性圆、高、阔.主要不同之处:哈萨克族身材较高、面宽、唇厚、头型阔而圆;蒙古族额部、面部较宽、骨盆值最大;维吾尔族面较窄、唇薄等.     

Plunging ranula: a case report and a literature review.

The plunging ranula is a mucous extravasation cyst of the sublingual gland. It is slightly more common in females, shows no side preference, and is more prevalent in the second and third decades of life. It typically manifests as a painless, nonmobile swelling in the neck and in four of five cases is associated with an intraoral ranula or swelling. If there is no history of an oral ranula the clinical diagnosis is difficult, and it may be left to the reporting pathologist to give the correct diagnosis. The histologic appearance is characteristically of a cyst, devoid of epithelium or endothelium, with a vascular fibro-connective tissue wall containing some chronic inflammatory cells and macrophages stuffed with mucin. The correct diagnosis is essential for the most effective treatment, which is excision of the sublingual gland.     

Light scattering associated with tension changes in the short-range elastic component of resting frog's muscle.

1. A study has been made of some optical and associated mechanical properties of resting frog's sartorius muscles in isotonic and hypertonic solutions. Tension and transparency changes accompanying small alterations of muscle length (smaller than 1-5%) were recorded simultaneously. 2. The form of the transparency change is complex. It has three phases, two of which occur during the length change and the third (delayed phase) after it is complete. Directional recording of the response reveals both scattering and diffraction components. 3. The change of light scattering is associated with tension changes in the short-range elastic component (SREC) of the muscle. Its magnitude is related to the stiffness of the SREC; both increase when the osmotic strength of the external solution is raised and when muscle length is increased. 4. The change of light scattering is not much affected by the velocity of the applied length change. This is true also of the mechanical stiffness of the SREC. 5. The origin of the diffraction change is not known. 6. It is concluded that the scattering effect is caused by conformational changes in the SREC.     

Cemento-ossifying fibroma and benign cementoblastoma

Cementum is a calcified dental tissue that covers the roots of teeth and is part of the periodontium. Its function is to help anchor the teeth in their sockets within the alveolar bone of the jaws. Two benign mesenchymal odontogenic tumors are uniquely distinguished by elaboration of cementum or cementum-like material: cemento-ossifying fibroma and benign cementoblastoma (true cementoma). Cemento-ossifying fibroma, which is also termed periodontoma, is characterized by production of cementum and bone in a fibrous stroma. It is a painless, slow-growing tumor usually detected in the third and fourth decade of life and is more common in women. The mandible is its site of predilection. Benign cementoblastoma is intimately associated with the roots of teeth, most commonly mandibular molars. It affects young patients, usually under the age of 20 years. Pain is a common symptom in addition to bone expansion. Benign cementoblastoma bears considerable histologic resemblance to osteoblastoma.     

The Language of Psychotherapy: Metaphor, Ambiguity, Wholeness

Psychoanalysis is approached from the perspective of linguistics. It is argued .hat analysis is concerned with a type of communication different in nature and logic from that of the natural sciences. The characteristics of analytic language are illustrated by comparing poetry and psychoanalysis. Transference is discussed as a special type of metaphor; ambiguity is seen as an intrinsic aspect of aesthetic language; wholeness is held to be a goal of both therapy and the arts. The relevance of this view to recent findings in neurophysiology and ethology is discussed.     

Revenge through a Looking Glass

The author discusses the concept of revenge from a number of different angles. She suggests that it is useful to separate revenge from the broader terms of aggression and hostility. Her two clinical examples are illustrations of revenge that is overt, obvious and acted upon, or that is repressed and covert. Working in settings where revenge is acted out can prepare the analytical therapist for the rawness and violence of such feelings and phantasies in the consulting room. The desire for revenge is a common feeling which is not always pathological and is a more frequent occurrence in therapy than is widely recognized.     

女子举重下蹲式上挺的运动生物力学分析

目的从运动学和动力学特征方面对举重下蹲式上挺进行研究,为教练员和运动员认识和寻找适合自己的上挺方式提供理论依据。方法采用三维录像和三维测力台同步测试的方法。结果发现下蹲挺下蹲撑铃点低,人体重心下蹲撑铃比较迅速,杠铃上升距离短,所需杠铃上升速度小。但是下蹲挺撑铃的前后稳定角及平衡角小,稳定性低,稍有不慎就可导致动作失败。下蹲挺撑铃和起立时间较长,起立距离也较长,消耗的能量多。结论下蹲挺上挺发力所需力小,但是撑铃和起立的稳定性差。