经食道心房调搏测定窦房结功能

对27例病窦综合征患者和42例正常对照组,经食道心房调搏,测定窦房结功能。发现病窦患者,窦房结恢复时间>1450ms;校正窦房结恢复时间≥550ms;窦房结传异时间>191ms;固有心率均明显低于正常对照组(R<0.01)。用阿托品,心得安进行功能性植物阻滞前、后观察,发现阻滞后各次参数在正常对照组中有明显降低,而病窦组则无明显差异。实验证明,经食道心房调搏方法是无创性窦房结功能检查的有效方法。     

Myoblast fusion in Drosophila melanogaster is mediated through a fusion-restricted myogenic-adhesive structure (FuRMAS).

During myogenesis in Drosophila embryos, a prominent adhesive structure is formed between precursor cells and fusion-competent myoblasts (fcms). Here, we show that Duf/Kirre and its interaction partners Rols7 (found in founder myoblasts and growing myotubes) and Sns (found in fcms) are organized in a ring-structure at the contact points of fcms with precursor cells, while cytoskeletal components like F-actin and Titin are centered in this ring in both cell types. The cytoplasmic protein Blow colocalizes with the actin plugs in fcms after cell adhesion. Furthermore, the requirement of additional as yet unidentified components was demonstrated by using mammalian C2C12 myoblasts. In this study, we propose that the fusion-restricted myogenic-adhesive structure (FuRMAS) is pivotal in linking cell adhesion as well as local F-actin assembly and dynamics to downstream events that ultimately lead to plasma membrane fusion. Moreover, we suggest that the FuRMAS may restrict the area of membrane breakdown.     

Appropriateness of hysterectomy in Taiwan.

BACKGROUND AND PURPOSE: Hysterectomy is among the most frequently performed surgical procedures in developed countries, but few studies from the Asia-Pacific region have assessed the appropriateness of hysterectomy. The purpose of this study was to examine the rate of inappropriate hysterectomy in Taiwan and its association with patient characteristics and indications for the procedure. METHODS: A random sample of hysterectomies for which claims were submitted to the Taiwan Bureau of National Health Insurance from July 1, 1997 to June 30, 1998 was selected. A total of 658 charts were reviewed by an expert panel composed of 5 senior gynecologists. RESULTS: Overall, 74.2% of patients underwent hysterectomy for appropriate reasons, 5.6% for uncertain reasons, and 20.2% for inappropriate reasons. Inappropriate procedures were positively associated with younger age and premenopausal status. Primary indications that accounted for over 25% of inappropriate procedures were chronic pelvic pain (42.9%), abnormal uterine bleeding (37.5%), and endometriosis (27.7%). CONCLUSIONS: This study found a high rate of inappropriate hysterectomy in Taiwan. Gynecologists and physician organizations should take action to improve physician agreement on the use of hysterectomy, especially for indications associated with high rates of inappropriate procedures.     

Search for coloured objects in natural surroundings by people with abnormal colour vision

Background: People with abnormal colour vision often report difficulty seeing coloured berries and flowers in foliage, which suggests they will have a diminished capacity for visual search when target objects are marked out by colour. There is very little experimental evidence of the effect of abnormal colour vision on visual search and none relating to search for objects in natural foliage. Method: We showed 79 subjects with abnormal colour vision (seven protanopes, 10 deuteranopes, 16 protanomals and 46 deuteranomals) and 20 subjects with normal colour vision photographs of natural scenes and asked them to locate clumps of red berries, to trace the length of a red string on grass and to name the season depicted in a photograph taken in the Autumn and the same scene photographed in the Summer. Colour vision was assessed using the Ishihara, the Medmont C100, the Farnsworth D15, the Richmond HRR and the Nagel anomaloscope. Results: All the subjects with abnormal colour vision located fewer clumps of red berries than those with normal colour vision. The subjects who failed the Farnsworth D15 performed significantly worse than those who passed but the distribution of scores in the two groups overlaps. The majority of subjects with abnormal colour vision could not trace the full length of the string: only 38 per cent of anomalous trichromats who passed the Farnsworth D15 test and three per cent of those who failed it were able to trace the full length of the string. Fifty‐five per cent of those classed as having a mild deficiency by the HRR test could trace the whole string. Most dichromats were unable to identify the Autumn season and those who did may have been assisted by guessing. Most (94 per cent) of those who passed the Farnsworth D15 test and all those classified as having a ‘mild’ deficiency by the HRR test could identify the season. Conclusions: All people with abnormal colour vision, even those with a very mild deficiency, have some degree of impairment of their ability to see coloured objects in natural surroundings. A pass at the Farnsworth D15 test or a ‘mild’ classification with the Richmond HRR test identifies those likely to have the least problems with visual search and identification tasks. The results have practical implications for the selection of personnel in occupations that involve visual search in natural terrain.     

扶正化瘀胶囊干预慢性乙型肝炎肝纤维化作用的多中心临床研究

目的　研究扶正化瘀胶囊治疗慢性乙型肝炎肝纤维化的临床疗效及其安全性。方法　多中心、随机、双盲、平行对照的方法 ,入选年龄 18～ 65岁的慢性乙型肝炎肝纤维化患者。试验药 (扶正化瘀胶囊 )和对照药 (和络舒肝胶囊 ) ,均为每次 5粒 ,3次 /d口服 ;疗程 2 4周。疗程结束后进行 12周的随访。观测指标 :(1)于治疗第 0、2 4周观察肝组织病理学、HBV标志物 ,第 0、12、2 4周检测肝纤维化血清指标 (HA、LN、P Ⅲ P、Ⅳ C)、B超肝脾检查 ,第 0、6、12、18、2 4周观察肝功能 (随访期评价肝功能、血清肝纤维化指标 )。 (2 )安全性指标 :治疗前、后检测血、尿常规 ,肾功能 ,心电图。结果　 (1)受试者入组情况及人口学资料 :试验组 110例 ,对照组 10 6例 ,两组病例人口学特征、生命体征、病程、药物过敏史、既往治疗史、肝功能、纤维化血清学指标、肝组织病理学 (试验组 99例 ,对照组 96例 )、HBV标志物、肾功能等各项指标比较 ,无显著差异。 (2 )肝组织病理学 :治疗前后作活检肝组织学观察 93例 ,试验组 50例和对照组 43例治疗前纤维化分期 (S)均值分别为 2 .3 3和 2 .11。试验组治疗后S均值为 1.80 ,较治疗前显著下降。对照组治疗后S均值为 2 .14 ,与治疗前比较无显著改善。试验组活检肝组织纤维化分期判断     

TrKA和p75神经营养因子受体在嗅神经母细胞瘤的表达

目的 :探讨TrKA和p75神经营养因子受体在嗅神经母细胞瘤的表达及其临床意义。方法 :应用免疫组化和双荧光标记法对 10例鼻腔嗅神经母细胞瘤及 5例正常鼻腔嗅黏膜及 5例鼻咽癌组织进行TrKA和p75神经营养因子受体检测。结果 :免疫组化检测发现 10例鼻腔嗅神经母细胞瘤TrKA和p75蛋白均呈阳性表达 ,5例正常鼻腔嗅黏膜及 5例鼻咽癌组织均为阴性表达 ;双荧光标记显示所有肿瘤组织中TrKA和p75蛋白均在同一细胞表达。结论 :TrKA和p75神经营养因子受体的过度表达可能与嗅神经母细胞瘤的发生和发展有关 ;TrKA和p75神经营养因子受体检测可作为嗅神经母细胞瘤的一种辅助诊断方法     

动力型手内在肌功能重建术18例临床分析

目的 分析动力型手内在肌功能重建手术的临床疗效和影响因素.方法 回顾分析18例动力型手内在肌功能重建手术的临床结果(其中改良Bunnell法14例,Brand法4例).术后按疗效功能评定标准和Brand手功能评定标准,得出术后疗效的优良率.结果 术后随访时间为2～30个月,18例术后疗效总优良率为33%.结论 动力型手内在肌功能重建术的适应证为单纯尺神经损伤者,其他复合性损伤术后疗效较差.同时应注重移位动力肌的选择、止点缝合张力等问题.     

MMP-9和TIMP-1在实验性肺气肿大鼠肺组织中的表达及其意义

目的研究基质金属蛋白酶(MMP-9)及其组织抑制因子(TIMP-1)在弹性蛋白酶所致肺气肿大鼠肺组织中的表达.方法雄性Wistar大鼠20只,随机分为两组:正常对照组和肺气肿模型组,每组10只.模型组大鼠气管内滴入弹性蛋白酶复制肺气肿模型.25d后,观察各组大鼠肺组织的病理改变,免疫组化方法观察肺组织MMP-9和TIMP-1中的蛋白表达情况.结果肺气肿模型组MMP-9和TIMP-1的表达与正常对照组相比明显增强(P＜0.01),且MMP-9/TIMP-1比值失衡.结论MMP-9/TIMP-1失衡在肺气肿形成中起重要作用.