面肌痉挛显微血管减压术的诱发肌电图监测和评估

目的:探讨面神经诱发肌电图在显微血管减压(MVD)术中、术后对面肌痉挛治疗效果的监测和评估。方法:对26例典型面肌痉挛病人、探讨在MVD术前、术中、术后,经皮刺激痉挛侧(手术侧)面神经下颌缘支,记录诱发同侧眼轮匝肌肌电位(MD-OC反应)变化,并以正常侧作对照检查。结果:26例术前均记录到痉挛侧MD-OC反应,在术中操作不同阶段,21例均见MD-OC反应消失。术后1周～3个月随访复查21例中,12例痉挛完全消失,MD-OC反应不复存在,9例症状明显或部分减轻,但有4例再记录到MD-OC反应。另5例术中,术后均记录到MD-OC反应,症状未有改善。结论:面神经诱发肌电图运用于MVD术中监测和预后判断,可改善和提高面肌痉挛的治愈率。     

正常国人肺静脉血流多普勒频谱分析

运用彩色多普勒超声观察了１０７例正常国人的肺静脉血流（ＰＶＦ）。结果：正负四相型（ＳＩＳ２ＤＡ），占３７％；正负三相型（ＳＤＡ）占４５％，正向两相型（ＳＤ）占１８％。呼吸，性别不显著影响其表现，但心率、心律及取样容积位置均影响之。９４％（１０１／１０７）正常者的ＳＦ＞５０％，表明正常国人前向性ＰＶＦ主要是收缩期占主型，增龄使这一特征更明显。９８％（１０５／１０７）正常者ＰＶＦ的Ａｐ＜４０ｃｍ／ｓ，且其不受年龄影响。结论：正常国人ＰＶＦ超声表现的多形性间有本质上的同一性，正确认识之有助于指导辨别病理性ＰＶＦ频谱     

云南省卫生资源配置标准的弹性系数研究

目的　在进行云南省区域分类基础上制定云南省区域卫生资源配置标准标志值后 ,根据云南省各个地区的特点增加不同弹性系数。方法　采用流行病学研究方法 ,收集和分析云南省不同地州市 1990～ 1999年有关人口、社会经济状况及卫生经费的投入、居民健康状况、居民文化、生活水平、少数民族状况、旅游地区、边境线长短及贫困状况等资料。结果　研究结果表明曲靖地区、玉溪市、保山地区增加弹性系数最少 ,分别为 0 67%、 1 5 8%和1 68% ,怒江州、迪庆州和西双版纳州增加弹性系数最多 ,分别为 11 15 %、 10 2 5 %和 9 84 %。其它地区的弹性系数分别为昆明市 5 88% ,昭通地区 2 3 1% ,楚雄州 2 3 0 % ,红河州 7 0 3 % ,文山州 5 5 3 % ,思茅地区 7 4 3 % ,大理州4 94 % ,德宏州 6 78% ,丽江地区 4 3 5 % ,临沧地区 6 13 %。结论　云南省区域卫生配置标准的弹性系数研究为云南省卫生资源区域分类配置标准提供了科学依据 ,不同弹性系数体现了云南省不同地区的卫生资源区域分类配置标准的公平性、合理性及实用性     

33例精神分裂症患者氯丙嗪治疗前后血小板聚集功能

本文对精神分裂症患者用氯丙嗪治疗前后PAg(T)功能进行观察及BPRS评定,发现精分症患者PAg(T)功能明显高于对照组,用氯丙嗪治疗1个月后,BPRS评定分值下降,患者临床症状消除,而PAg(T)第一时相无变化,第二时相明显升高,说明氯丙嗪聚药物可促发血小板释放内源性致聚物质,同时也说明患者PAg(T)异常不仅仅是情绪应激所致,更重要的是血小板生理功能异常。     

Effect of Sirpα1 on the expression of nuclear factor-kappa B in hepatocellular carcinoma

BACKGROUND:Signal regulatory protein alpha1(Sirpα1) is a member of Sirps families containing four immunoreceptor tyrosine-based inhibitory motifs(ITIMs) domains in the cytoplasm of and an activated substrate of receptor tyrosine kinase(RTK),that negatively regulates the RTK-dependent cell proliferating signal transduction pathway.Previously we found that Sirpα1 was closely associated with the occurrence and development of hepatocellular carcinoma(HCC)as well as liver regeneration.Since it is unclear about the regulatory mechanisms,we established the cell line transfected Sirpα1 gene and preliminarily clarified the mechanisms by which Sirpα1 negatively regulates the carcinogenesis and development of HCC. METHODS:Liver cancer Sk-Hep1 cell was respectively transfected with plasmids of pLXSN,pLXSN-Sirpα1 and pLXSN-Sirpα1Δ4Y 2 ,screened with the drug of G418(1200 μg/ml),and various transfected Sk-Hep1 cell lines were obtained.The protein expressions of P65,P50,IκBα,cyclin D1 and Fas in various Sk-Hep1 cell lines were determined by Western blotting,and P65 and P50 were localized by the immunofluorescence technique. RESULTS:Sirpα1 could significantly upregulate the protein expression of IκBα(vs.other cell lines,P<0.05) in the Sk-Hep1 cell,and downregulate the protein expressions of P65,P50 and cyclin D1(vs.other cell lines, P<0.05)in the Sk-Hep1 cell.P65 protein expression was mainly localized in the cytoplasm in the pLXSN Sk-Hep1 cell,and in the nucleus of the Sk-Hep1 cell with mutantSirpα1Δ4Y 2 ,but in nucleus of the Sk-Hep1 cell with wild Sirpα1.P50 protein expression was localized in the cytoplasm and nucleus of the pLXSN Sk-Hep1 cell,but in the nucleus of the Sk-Hep1 cell with wild Sirpα1 and mutant Sirpα1Δ4Y 2 plasmid. CONCLUSIONS:Sirpα1 might negatively regulate and control the abnormal proliferation of liver cancer cells by influencing the protein content and localization of nuclear factor-kappa B,then influence the expression of cyclins such as cyclin D1 in the signal transduction pathway.It may be one of the important mechanisms by which Sirpα1 negatively regulates the carcinogenesis and development of HCC.     

左旋精氨酸对兔肺缺血再灌注损伤的保护作用

目的 :观察左旋精氨酸对在体兔肺缺血再灌注损伤的影响。方法 :复制在体兔肺缺血再灌注损伤模型。 30只日本雄性大耳兔 ,随机分为三组 :假手术组 ,缺血再灌注组 (IR组 )和左旋精氨酸 +缺血再灌注组(Larg组 )。对比观察各组血浆SOD活力 ,NO、MDA含量 ,肺组织湿干重比 (W /D) ,肺损伤组织学定量评价指标 (IQA)及光镜和电镜下的组织形态学改变。结果 :缺血再灌注后Larg组血浆NO含量和SOD活力较S组、IR组明显升高 (P <0 .0 1) ,MDA、W/D、IQA较IR组明显降低 (P <0 .0 5 ,P <0 .0 5 ,P <0 .0 1) ;IR组镜下见有肺组织水肿 ,肺泡损伤严重 ,内皮细胞线粒体水肿或空泡化 ,毛细血管内炎性细胞浸润 ;而Larg组肺组织上述改变明显减轻。结论 :在体兔肺缺血前预先用L Arg处理 ,可减轻随后的缺血再灌注损伤 ;其机制之一可能与L Arg抗氧自由基作用有关     

Fine mapping of the spatial relationship between acute ischemia and dendritic structure indicates selective vulnerability of layer V neuron dendritic tufts within single neurons in vivo.

We have evaluated the spatial relationship between clotted vasculature and the structural integrity of layer V cortical neurons in YFP (yellow fluorescent protein)-H transgenic mice 2 to 10 h after photothrombotic stroke. Fortuitously, ischemic zones could be finely mapped about dysmorphic YFP labeled axons and dendrites using histology since Texas-red dextran used to assess blood flow in vivo was trapped within fixed clotted vessels. Ischemic damage to layer V neurons located at the border of ischemia was contained within apical tuft spiny dendritic structures and did not propagate to spines on the more proximal region of the apical dendrite. The lateral spread of dendritic damage decayed sharply with distance from the edge of ischemia (50% reduction in beaded dendrites within approximately 100 microm) and increased with time up to 6 h after stroke but not thereafter. Axonal damage also increased with time but extended further laterally than dendritic damage, up to 500 microm from the stroke core. Apoptotic and necrotic cell death cascades were activated 6 h after stroke; however, only within 300 microm of the ischemic core. These data suggest that the axonal and dendritic circuitry of neurons located 300 microm outside of an ischemic zone can be relatively free of damage or commitment to cell death suggesting that they may be in an ideal position to contribute to functional recovery. Given that ischemic damage may have a larger effect on circuitry involving superficial dendrites and projecting axons, it is conceivable that surviving peri-infarct neurons may have unique structural and functional properties.     

Recurrent lens binding and central island formations in a fast-responding orthokeratology lens wearer.

A 12-year-old girl with a history of fast myopia progression underwent advanced orthokeratology (ortho-k) treatment and suffered from recurrent lens binding and central corneal staining. The problem could not be fixed by lens fenestration and refitting with a less aggressive lens (three-zone ortho-k) design. After refitting with a lower target advanced ortho-k lens, these complications were no longer occurring, and the amount of power reduction was greater than expected considering the target designed for the refitted lenses. During the following 15 months of ortho-k lens wear, there was no clinically significant change to her refractive error. The patient and her parents were happy with the outcome, although the refractive error was not totally eliminated and she still needed to wear spectacles for clear vision. Possible etiologies of the complications are discussed.     

Efficacy of minor analgesics in primary dysmenorrhoea: a systematic review

Objective To quantify the efficacy and safety of naproxen, ibuprofen, mefenamic acid, aspirin and acetaminophen (paracetamol) in the treatment of primary dysmenorrhoea through a systemic overview of randomised controlled trials.
Methods MEDLINE, EMBASE and the Science Citation Index were searched for randomised controlled trials. Efficacy was assessed by measurement of pain relief, requirement for rescue analgesics, restriction of daily life and absence from work or school. The rate ratios of side effects were used to assess safety.
Results Fifty-six trials describing 55 comparisons of analgesics with placebo and 12 direct comparisons with other analgesics met our inclusion criteria. Women taking naproxen were over three times more likely to have at least moderate pain relief than those taking placebo. Ibuprofen, mefenamic acid and aspirin were also superior to placebo but acetaminophen was not. The requirement for rescue analgesics, restriction of daily life and absence from work or school were less frequent with naproxen and ibuprofen than placebo but not with aspirin or acetaminophen. Direct comparisons did not show any difference between naproxen and ibuprofen. Side effects occurred more frequently only with naproxen when compared with placebo.
Conclusion Naproxen, ibuprofen, mefenamic acid and aspirin are all effective in primary dysmenorrhoea. Ibuprofen appears to have the most favourable risk-benefit ratio. Acetaminophen appears to be less effective than nonsteroidal anti-inflammatory drugs, but there was only one trial meeting our inclusion criteria and further studies are required.