心绞痛的诊断与治疗进展

学习目标:在第一季度心血管科继续医学教育课程中应当掌握: 1.心绞痛的病理生理及分型; 2.稳定型心绞痛的诊断与治疗; 3.不稳定型心绞痛的诊断与治疗; 4.无症状心肌缺血诊断与治疗; 5.X综合征的病理生理及其诊断和处理。第三节稳定性心绞痛的临床治疗     

癫痫患者执行功能损害特点及影响因素研究

目的分析癫痫患者执行功能损害的特点及相关影响因素。方法1999年1月～2006年4月在我院癫痫专病门诊就诊或长期随访的109例成年癫痫患者和75例正常对照者进行神经认知心理测验，包括语义流畅性试验、数字广度测验、数字符号测验、色词干扰测验和连线试验检查。结果癫痫患者组语义流畅性显著差于正常对照组，数字广度、数字符号亦显著低于正常对照组．癫痫组连线时间、Stroop试验反应时显著延长，Stroop试验错误数显著增加（P〈0．01）。颞叶癫痫患者数字广度低于额叶癫痫患者。多元线性回归显示：文化程度高、非颞叶癫痫对语义流畅性有保护作用：文化程度高、单一抗癫痫药物治疗、病程短、年龄大对数字广度有保护作用；病程短、文化程度高和颅内无病灶对数字符号有保护作用。结论癫痫患者在多项执行功能方面均存在损害．文化程度高的患者执行功能相对较好；颞叶癫痫患者语义流畅性差；病程、药物、年龄对数字广度有影响：病程、有无病灶对数字符号有影响。     

强脉冲噪声对豚鼠耳蜗血管纹血管的影响

强脉冲噪声暴露后,用耳蜗电图记录CAP和-SP,光镜观察耳蜗毛细胞损伤情况,图象分析法定量测定耳蜗血管纹血管的管腔面积及红血球分布。结果提示,爆震后即刻,耳蜗各圈毛细胞血管明显扩张、充血,爆震后4天恢复至正常范围,CAP阈移以4kHz、8kHz最大,与外毛细胞损伤主要位于1T、2T基本吻合,但与血管纹血管变化并不协调对应,似说明耳蜗微循环的改变与毛细胞的损伤无直接关系。     

下胫腓联合韧带损伤诊治的进展

下胫腓联合韧带与内、外侧副韧带共同维持踝穴的稳定，踝关节骨折脱位常合并下胫腓联合韧带的损伤，是晚期常形成踝关节创伤性关节炎的原因之一。近年来，随着运动医学的发展和对踝部创伤研究的深入，对下胫腓联合韧带损伤的诊断和治疗有了进一步的认识，现综述如下。     

Differentiation of human epidermal stem cells into fibroblasts induced by TGF-β1 in vitro

Objective To investigate the correlation between human epidermal stem cell (hESCs) and hypertrophic scar or keloid. Methods Improved collagen Ⅳ-coated adhesion methods was used to isolate and culture the epidermal stem cells after neutral protease selectively digested the dermo-epidermal junctions. After the cells were cultured and expanded in vitro, and passage 3 hESCs were induced by different concentrations of TGF-β1 (0.1, 5.0, and 10.0 ng/ml). Morphological fea-tures and identification of these cells were meseasured by HE, Masson, immunohistochemical staining on the days 3 and 7, respectively. Results After induced by TGF-β1 for 3 and 7 days, the morpholo-gy of the epidermal stem cell (hESCs) was changed into fusiform shape, similar to fibroblasts. 70 % ofthe cell which was induced by TGF-β1 were blue stained in the cytoplasm by Masson stain, which is the distinctive method for collagen, suggesting collagen appeared or increased in the cells. The collagen concentrations in supernatants of hESCs were 0.4150±0.0014, 0.3380±0. 0020, and 0.3870±0.0020, much higher than that in control group (0.0780±0.0025) and normal skin fibro-blast group (0.15004±0.0051) (P<0.05). Immunohistochemical staining revealed that positive rates of these cells for anti-vimentin staining were more than (95.00±1.20)% in experiments and (5.70±0.20)% in control group. Conclusion The differentiantion of hESCs induced by TGF-β1 into fibro-blasts indicates that hESCs may play a role in the pathogenesis of hypetrophic scar and keloid.     

先天性颈耳翼1例

先天性颈耳翼１例赵绍军，王荣光先天性颈耳翼为第二鳃弓的软骨在胚胎发育阶段残留于颈部而致的畸形，临床上罕见。我科收治１例，报告如下。患者男，１５岁。自幼右侧颈部前下方有一皮肤突起物。家长述患者出生后即发现右颈部前下方一玉米粒大皮肤突起物，随年龄增长而增...     

脑血管病的临床研究迸展 第三节 脑出血的诊断和治疗

学习目标:在第三季度神经内科继续医学教育课程中应当掌握:1.急性脑血管病的急诊诊断与治疗;2.急性缺血性脑卒中的诊断和治疗;3.出血性脑血管病的诊断与治疗;4.缺血神经损坏的机制;5.神经保护治疗;6.组织化卒中医疗体系。     

静止性垂体促肾上腺皮质激素细胞腺瘤二例

例1 男性,47岁。因双眼视力进行性下降1年,于1989年3月18日入院。检查:双眼视力均为0.3,双颞侧偏盲,体毛稀疏,血促肾上腺皮质激素(ACTH)及催乳素(PRL)值正常。头颅 X 线摄片示蝶鞍轻度扩大,CT 扫描显示鞍区肿瘤3cm×4cm×4cm。4月2日在全     

表现为颅压增高的直窦血栓形成1例报告

自Ribes于1825年首先报道1例经尸检证实的上矢状窦、左横窦及顶部脑静脉血栓形成以来迄今国内尚未见直窦血栓形成(SST)的报道。现将我院最近经数字减影血管造影(DSA)证实的1例SST报道如下。病历摘要患者,女,35岁。无明显诱因之双侧持续性耳鸣2个月,伴左侧持续头痛呈跳痛,频繁呕吐及视物