冷冻(断裂)复型电镜技术的应用

本文简单介绍冷冻断裂复型电镜技术在国内、外的概况,並阐明了该项新技术的独特作用和具体的操作步骤;在制作生物样品时所需的仪器设备和试剂的配制等内容。     

Factors influencing survival of reconstructions. Consensus report of Working Group 2

Abstract: In order to evaluate the level of evidence of factors influencing the survival of reconstructions, systematic reviews of the relevant literature were prepared by a group of rapporteurs. The review papers were circulated to the members of the group before the conference and formed the basis for group and panel discussions. Subsequently, modifications were added to the review papers, and suggestions for consensus statements concerning the following topics were prepared and again critically reviewed in the group and in the plenum: Impact of (i) periodontal disease on the survival of tooth-supported reconstructions, (ii) post-surgical factors as supportive therapy on the survival of implant supported reconstructions, (iii) technical and/or biological complications on the survival of different types of reconstructions, (iiii) material choice for reconstructions on the survival of single crowns and fixed dental prostheses.     

Growth, bone maturation and pubertal development in children with the EMG-syndrome

In 7 patients (5 girls, 2 boys) with the EMG or Wiedemann-Beckwith syndrome, statural growth, bone age (BA), weight and pubertal development were studied longitudinally. Height was above the 90th percentile (%) for chronological age (CA) after age 2 years, reaching an average of 2.5 SD above the mean at or after puberty. Adult or attained height also exceeded significantly (P<0.015) parental (genetic) target height by 13.2 cm on the average. In one girl, adult height prognosis (190 cm) could be reduced to an adult height of 183 cm by high-dose estrogen treatment. In most children, growth velocity remained above the 90th % up to 4–6 years of age and normalized thereafter. In all patients studied, bone age was markedly advanced and particularly so during the first 4 years after birth. Weight was above the 90th–97th % during infancy and early childhood and remained there, appropriate or slightly subnormal for height, until adulthood, except for 3 girls who reached and maintained the 50th % during or after puberty. Spontaneous pubertal development occurred within normal limits for CA and around the 50th % for BA. Except for the marked bone age acceleration, the reason for the increased statural growth and adult height in patients with the EMG syndrome is still unknown.     

‘Translation is not enough’: using the Global Person Generated Index (GPGI) to assess individual quality of life in Bangladesh,Thailand, and Ethiopia

Currently few subjective measures of Quality of Life (QoL) are available for use in developing countries, which limits their theoretical, methodological, and practical contribution (for example, exploring the relationship between economic development and QoL, and ensuring effective and equitable service provision). One reason for this is the difficulty of ensuring that translated measures preserve conceptual, item, semantic, operational, measurement; and functional equivalence (Herdman, M., Fox-Rushby, J., & Badia, X. (1998). Quality of Life Research, 7, 331), which is illustrated by an account of the translation, pre-piloting, and administration of a new individualised QoL measure, the Global Person Generated Index or 'GPGI'. The GPGI is based on the widely used Patient Generated Index (Ruta, Camfield, & Martin, (2004) Quality of Life Research, 13, 1545.) and offers many of the advantages of the participatory approaches commonly used in developing countries, with added methodological rigour, and quantitative outcomes. It was successfully validated in Bangladesh, Thailand, and Ethiopia, using quantitative and qualitative methods--open-ended, semi-structured interviews (SSIs), conducted immediately post-administration. Both the measure and method of 'qualitative validation' described later in the paper offer an exciting alternative for future researchers and practitioners in this field. The quantitative results suggest the GPGI shows cultural sensitivity, and is able to capture both the areas that are important to respondents, and aspects of life one would expect to impact on QoL in developing countries. There were strong correlation between scores from the GPGI and SSIs for the area of health, and moderate correlations for 'material wellbeing' (MWB)('Material wellbeing' refers to respondents' perceptions of their achievement in the areas of farming, debt reduction, assets, crops, livestock, job, land, property, and agriculture) and children. Weak to moderate correlations were observed between the Satisfaction with Life Scale and the GPGI; however, the highest coefficient was between the GPGI and the most conceptually similar item. Statistically significant differences were seen in GPGI scores between rich and poor, urban and rural respondents, and different countries. Health and material wellbeing scores, derived from the SSIs, also showed a linear relationship with GPGI scores, with a suggestion of curvilinearity at the higher levels, as predicted by a general QoL causal model. In conclusion, the GPGI has great potential for use in this area, especially when supported by extensive interviewer training, and supplemented with a cognitive appraisal schedule.     

Assessment of functional vision and its rehabilitation

This article, based on a report prepared for the International Council of Ophthalmology (ICO) and the International Society for Low Vision Research and Rehabilitation (ISLRR), explores the assessment of various aspects of visual functioning as needed to document the outcomes of vision rehabilitation. Documenting patient abilities and functional vision (how the person functions) is distinct from the measurement of visual functions (how the eye functions) and also from the assessment of quality of life. All three areas are important, but their assessment should not be mixed. Observation of task performance offers the most objective measure of functional vision, but it is time‐consuming and not feasible for many tasks. Where possible, timing and error rates provide an easy score. Patient response questionnaires provide an alternative. They may save time and can cover a wider area, but the responses are subjective and proper scoring presents problems. Simple Likert scoring still predominates but Rasch analysis, needed to provide better result scales, is gaining ground. Selection of questions is another problem. If the range of difficulties does not match the range of patient abilities, and if the difficulties are not distributed evenly, the results are not optimal. This may be an argument to use different outcome questions for different conditions. Generic questionnaires are appropriate for the assessment of generic quality of life, but not for specific rehabilitation outcomes. Different questionnaires are also needed for screening, intake and outcomes. Intake questions must be relevant to actual needs to allow prioritization of rehabilitation goals; the activity inventory presents a prototype. Outcome questions should be targeted at predefined rehabilitation goals. The Appendix cites some promising examples. The Low Vision Intervention Trial (LOVIT) is an example of a properly designed randomized control study, and has demonstrated the remarkable effectiveness of vision rehabilitation. It is hoped that further similar studies will follow.     

对儿童X线体检中减少照射剂量的探讨

目的:探讨儿童在X线体检中减少照射剂量的方法。方法:应用东芝500mA遥控X线机、FJ-427型热释光剂量仪等设备,对100名3~5岁儿童体检时,随机分成两个对照组、每组50名,分别接受胸透或平片检查,对检查测得数据均进行统计学处理。结果:胸透时胸部接受的照射剂量是平片的22倍多,其它部位接受的X线散射剂量平均值之比亦在20~30倍之间。结论:在儿童X线体检中应采用常规胸片替代胸透,可以有效地降低其辐射危害。     

后入路手术治疗胸腰段爆裂性骨折

目的分析后入路手术治疗胸腰段爆裂性骨折的疗效及适应证。方法应用后入路手术治疗胸腰段爆裂性骨折38例。从影像学、手术操作过程及神经功能恢复等方面分析疗效。结果伤椎高度由47·3%恢复到94·4%;水平移位完全恢复;Cobb角由术前22·6°恢复到术后3·6°。椎管受压程度:删除椎管开放减压的7例,余受压面积由术前42%恢复到术后16%,受压的矢状径从术前54·9%恢复到81·8%。脊髓神经功能恢复依照Frankel分级标准均有1级以上改善。结论合理选择后入路手术对胸腰段爆裂性骨折治疗效果良好,手术中进行椎管造影有助于提高复位效果。     

C型骨盆骨折合并髋关节中心性脱位的手术治疗

目的:研究C型骨盆骨折合并髋关节中心性脱位的临床疗效。方法:13例患者中男8例,女5例;年龄23～65岁,平均36.5岁。骨盆骨折分型:C1型8例,C2型3例,C3型2例。髋臼“T”形骨折2例,粉碎性骨折9例,双柱骨折2例。均采用手术治疗,术前术后均采用股骨髁上牵引,术中采用髂腹股沟入路,必要时附加患髋后外侧切口,术中采用重建钢板固定。结果:本组随访时间6～28个月,平均13.4个月。髋臼骨折复位后残存移位:0～1mm9例,2～3mm2例,4～5mm2例,无>5mm者。髂骨骨折复位后各向残存移位:0～1mm9例,2～5mm3例,>5mm1例。3例原发性坐骨神经损伤的患者,术后3个月内其感觉、运动功能全部获得恢复。1例继发性坐骨神经损伤,术后6个月恢复。异位骨化2例,股骨头坏死、髋臼及股骨头软骨坏死、髋关节创伤性关节炎5例,患者关节疼痛、活动受限,影响功能。疗效综合评定:优8例,良1例,可2例,差2例。结论:C型骨盆骨折合并髋关节中心性脱位通过手术治疗,能够最大程度恢复其解剖结构,术后关节功能恢复较好。     

Indoor radon measurement with The Lucas cell technique

Rn-222 is the most important source of natural radiation and is responsible for approximately half of the received dose from all sources. Most of this dose is from inhalation of the Rn-222 progeny, especially in closed atmospheres. A Lucas cell technique, using a portable device, “PRASSI” (SILENA mod. 5S), for Rn-222 measurements inside the Centre for Radiation Protection and Radioecology (ZSR), Hannover University was used. The portable radon monitor PRASSI is suitable for radon gas continuous or grab sampling measurements with the scintillation cell technique. In recognition of the wide periodic variations in concentration, measurements were made daily for extended periods. At the same time, meteorological variables, such as temperature and humidity were observed so that their influence on radon levels could be evaluated. The radon average concentration during the year was about 55.9 Bq/m³ which gives rise to an annual effective dose 2.2 mSv y⁻¹. The radon concentration is within the limits prescribed by the International Commission for Radiation Protection. A detailed analysis of radon distribution with seasonal variation is presented.