2-DE、CDFI、CDPI和PW对移植肾的动态观察

目的 探讨4种方法对移植肾动态观察的价值。方法 对移植肾应用4种方法联合观察，对其所获资料，综合分析，明确诊断。结果 （1）18例19次肾移植术后发生BARl例，AR4例，HAR和AR手术切除移植肾各1例，病理诊断分别符合HAR和AR。移植肾无功能3例；（2）目前存活15～56个月17例（94．4％），死亡1例（5．6％）；（3）并发症主要有移植肾自发性破裂，消化道出血，肾周积液，肾静脉血栓，输尿管扩张、肾盂积水。结论 （1）移植肾术后早期超声检查多呈弥漫性病变样改变，此后正常者逐渐代偿性增大，失功者逐渐缩小，血供明显减少；（2）AR主要显示为移植肾体积增大，实质增厚，锥体增大，肾窦变小，肾内血管变细，血流灌注减少，高流速高阻力，RI〉0．8；（3）超声检查安全无创，简便快捷，可重复，获取信息量多，进行动态观察，综合分析，为诊治、评估疗效及预后提供客观依据。     

Evaluation of the impact of the exposure route on the human kinetic adjustment factor

The objective of this study was to assess the impact of the exposure route on the human kinetic adjustment factor (HKAF), for which a default value of 3.16 is used in non-cancer risk assessment. A multi-route PBPK model was modified from the literature and used for computing the internal dose metrics in adults, neonates, children, elderly and pregnant women following three route-specific scenarios to chloroform, bromoform, tri- or per-chloroethylene (TCE or PERC). These include 24-h inhalation exposure, body-weight adjusted oral exposure and 30 min dermal exposure to contaminated drinking water. Distributions for body weight (BW), height (BH) and hepatic cytochrome P450 2E1 (CYP2E1) content were obtained from the literature, whereas model parameters (flows, volumes) were calculated from BW and BH. Monte Carlo simulations were performed and the HKAF was calculated as the ratio of the 95th percentile value of internal dose metrics in subpopulation to the 50th percentile value in adults. On the basis of the area under the parent compound's arterial blood concentration vs time curve (AUC(pc)), highest HKAFs were obtained in neonates for every scenario considered, and were the highest for bromoform (range: 3.6-7.4). Exceedance of the default value based on AUC(PC) was also observed for an oral exposure to chloroform in neonates (4.9). In all other cases, HKAFs remained below the default value. Overall, this study has pointed out the dependency of the HKAF on the exposure route, dose metrics and subpopulation considered, as well as characteristics of the chemicals investigated.     

Prenatal diclofenac sodium administration increases the number of Purkinje cells in female rats: a stereological study

Diclofenac sodium (DS) may affect the number of Purkinje cells in the developing cerebellum since DS can easily be transported from the maternal to the fetal physiological system during the pregnancy. In the present study, the effects of prenatal exposure to DS on the number of Purkinje cells in the cerebellum of 4-week-old (4W-old) and 20-week-old (20W-old) female rats were investigated. There were two main groups: the drug-treated group (DTG) and the control group (CG). Beginning from the 5th day after mating for a period of 15 days, a daily dose of 1 mg/kg of DS (Voltaren, 75 mg/3 ml ampul, Novartis, Mefar Ilaç Sanayi A.S., Kartal, ?stanbul, Turkey) was intraperitoneally injected in the DTG of pregnant rats. In contrast, a daily dose of 1 ml/kg of isotonic saline was intraperitoneally administered to the CG of pregnant rats during the same period. After spontaneous delivery, female offspring were obtained, and the main groups’ offspring were divided into two subgroups as a 4W-old group and a 20W-old group. Therefore, there were four groups at the end of the experiment: the 4W-old DTG and the CG, and the 20W-old DTG and the CG. At the end of 4W and 20W, offspring were perfused, their brains were dissected, and the number of cells estimated via the optical fractionator technique. Our results showed that while the total number of Purkinje cells in the cerebellum of offspring of DT 20W-old female rats was significantly higher than that of the CG, there was no significant difference between the 4W-old DTG and the control groups. Therefore, it could be suggested that DS administration during the prenatal period increases the number of Purkinje cells in the cerebellum of a developing female rat throughout postnatal 20W.     

基于心电和脉搏波数据融合的呼吸率估计

本研究提出了一种通过心电和脉搏波提取呼吸信号并基于卡尔曼滤波的多路数据融合估计呼吸率的算法。算法分别从心电的RR间期、R波的绝对高度和脉搏波搏动周期中提取呼吸信号,利用AR模型估计呼吸率,根据信号波形、节律和频谱特征获得反映信号质量高低的质量指数,然后基于信号质量指数和卡尔曼滤波残差进行数据融合,获得融合呼吸率。14名志愿者参加了实验。结果表明,融合呼吸率比单独从心电或脉搏信号提取的呼吸率更好地反映了呼吸率的变化。与压阻式呼吸传感器提供的参考呼吸率相比,融合呼吸率误差为(-0.03±2.78)次/min,而从心电RR间期、R波的绝对高度和脉搏法提取的呼吸率的误差分别为(0.62±3.30)、(0.42±3.47)和(-0.17±2.69)次/min。总体认为,基于多路数据融合的方法可以有效避免干扰的影响,较准确地估计呼吸率。     

Supracondylar fractures of the humerus in children with a note on the surgical correction of late cubitus varus

A new classification of supracondylar fractures is proposed in the light of experience gained in treating a large series of these fractures in children. This classification has proved useful as a guide to the clinical management of these injuries and helpful in predicting the likelihood of complications both early and late.     

Diagnosis of the Prader-Willi syndrome by proving the absence of the unmethylated PW71 DNA fragment

The Prader-Willi syndrome (PWS) is a genetic disorder which is difficult to diagnose from clinical symptoms in newborns and young children. However, it is known that in PWS a fragment within the q11-13 region of the paternally derived chromosome 15 is deleted. Recently it has been observed that the D15S63 (PW71) locus in chromosome 15q11-13 is methylated on the maternally derived chromosome, but unmethylated on the paternally derived chromosome. Based on this observation a rapid diagnostic test (the PW71 methylation test) using methylation-sensitive restriction enzymes has been developed for patients presumed to have PWS. We have studied 56 patients; 30 patients with classical features of PWS and 26 patients with only psychomotor retardation and obesity, referred to us from different parts of Sweden. Twenty-nine of the 30 classical PWS patients were found to have an absence of the unmethylated paternally derived PW71(D15S63) locus in chromosome 15q11-13. None of the patients with only obesity and psychomotor retardation had this "absence" pattern on chromosome 15q11-13. Using the PW71 methylation test on patients with PWS, a concordance of 96% was found. The PW71 methylation test is presently the method of choice for rapid diagnostic testing of patients suspected of having PWS.     

Ethanol dependence in the rat: role of extrapyramidal motor systems in the withdrawal reaction

Rats were implanted with chronic recording electrodes in the caudate nucleus, substantia nigra, red nucleus, and pontine reticular formation and thereafter maintained on ethanol-containing liquid diets for 18 to 22 days. The removal of ethanol resulted in the time-dependent appearance of epileptiform abnormalities in each of the explored brain regions. The abnormalities characteristically began with increases in EEG synchrony and amplitude coupled with the appearance of epileptiform spike activity, which increased in amplitude and frequency during the latter stages of withdrawal. Quantification of preconvulsive epileptiform spike activity revealed major differences in the temporal sequence of development of spiking in the caudate nucleus and substantia nigra compared to the red nucleus and pontine reticular formation. However, a significant equipotentiality existed among these regions as initiation sites for seizure discharge during spontaneous behavioral convulsion. It was concluded that these brain sites, which have previously been considered to serve significant motor functions, play an active, but as yet unspecifiable, role in the genesis of the ethanol withdrawal reaction. It was further hypothesized that an important aspect of the development of epileptiform activity during the ethanol withdrawal reaction may involve interaction of the caudate nucleus, substantia nigra, and red nucleus with existing thalamocortical synchronizing systems in the midline and nonspecific thalamic nuclei.     

The radiological and urodynamic significance of large bladder diverticula

Large acquired bladder diverticula in adults may cause severe urodynamic disturbance and exacerbate difficulty in micturition. They may accommodate a large proportion of the contents of the bladder during attempted voiding, thus decreasing the effect of the detrusor muscle contraction. The post-micturition radiographs on intravenous urography, after the diverticula have emptied again, may only show a large intravesical post-micturition residue and give little information as to the size of the diverticula during the act of micturition.