胸椎错位并心律异常13例临床报告

目的 探讨脊柱源性心律紊乱的主要发病部位。方法 对13例脊柱病变引发的心律紊乱，主要以纠正上胸段错位为主，采用理筋、整脊和功能锻炼治疗。结果 经治疗均临床治愈，随访半年以上无复发。结论 脊源性心律紊乱主要部位在胸椎。     

中枢神经细胞瘤5例报告及文献复习

目的探讨提高中枢神经细胞瘤诊疗水平的策略和方法。方法回顾分析2004年8月至2006年4月我院收治的5例中枢神经细胞瘤，总结其临床表现、影像学表现、病理学特征及显微外科手术治疗效果。结果肿瘤位于侧脑室前部或室间孔附近，呈宽基底与侧脑室壁或透明隔相连。肿瘤边缘及内部可见多发囊泡，常见钙化，MRI检查T1WI、T2WI相均表现为等或略高信号，增强后呈轻至中度强化。免疫组织化学染色均显示神经突触素阳性。显微外科手术治疗5例，其中全切除4例，次全切除1例，1例死于术后并发症，4例随访至今未复发。结论中枢神经细胞瘤影像学表现具有一定特征，是术前诊断的重要参考。显微手术切除肿瘤是最佳的治疗手段，预后良好。     

开颅手术对脑脊液中药物浓度的影响

目的通过测定开颅术后周围静脉血、皮下引流液及脑脊液中药物浓度,来评价开颅手术对脑脊液药物浓度的影响.方法开颅手术前半小时静脉滴注硫酸庆大霉素8万单位,6小时后分别测定周围静脉血、皮下引流液及脑脊液中庆大霉素浓度,分别对无需切开硬脑膜及需要切开硬脑膜的病例各20例进行对照观察.结果硬脑膜完整组:周围静脉血为0.47±0.15,皮下引流液为1.41±0.46,脑脊液0.27±0.18,以皮下引流液中浓度最高,周围静脉血其次,脑脊液最低,三者比较均有显著差异(P＜0.01);硬脑膜开放组:周围静脉血为0.56±0.19,皮下引流液为1.28±0.75,脑脊液为0.52±0.15,亦是皮下引流液中浓度最高,但周围静脉血与脑脊液无显著差异(P＞0.05).两组之间周围静脉血以及皮下引流液无显著差异(P＞0.05),而脑脊液有显著差异(P＜0.01).结论开颅术后的皮下引流液中含有较高的药物浓度,与脑脊液间存在着明显的浓度差,药物能通过脑脊液与皮下渗出液的交换而进入颅内,使脑脊液中的药物浓度上升.     

华东地区汉族群体D10S2325基因座的遗传多态性研究

目的 研究D10S2325基因座等位基因和基因型频率在华东地区汉族群体的分布情况，评价该基因座在华东汉族人群的法医学应用价值。方法 用PCR扩增、非变性聚丙烯酰胺凝胶垂直电泳、银染显色方法检测D10S2325基因座的遗传多态性。结果 在华东地区汉族人群中共检出12个等位基因(6～17)，其CE值和DP值分别为0．628和0．948。结论 D10S2325等位基因频率分布好，提供的信息量大，对华东地区汉族人群具有较高的非父排除率和个人识别能力，是群体遗传学研究和法医学应用理想的STR位点。     

Changing health status and health expectancies among older adults in China: Gender differences from 1992 to 2002

Numerous studies document improvements in health status and health expectancies among older adults over time. However, most evidence is from developed nations and gender differences in health trends are often inconsistent. It remains unknown whether changes in health in developing countries resemble Western trends or whether patterns of health improvement are unique to the country's epidemiologic transition and gender norms. Using two nationally representative samples of non-institutionalized adults in China aged 65 years and older, this study investigates gender differences in the improvements in disability, chronic disease prevalence, and self-rated health from 1992 to 2002. Results from multivariate logistic regression models show that all three indicators of health improved over the 10-year period, with the largest improvement in self-rated health. With the exception of disability, the health of women improved more than men. Using Sullivan's decomposition methods, we also show that active life expectancy, disease-free life expectancy, and healthy life expectancy increased over this decade and were patterned differently according to gender. Overall, the findings demonstrate that China experienced broad health improvements during its early stages of the epidemiologic transition and that these changes were not uniform by gender. We discuss the public health implications of the findings in the context of China's rapidly aging population.     

Mao's heritage: Medicinal plant knowledge among the Bai in Shaxi,China, at a crossroads between distinct local and common widespread practice

Ethnopharmacological relevance

The study focuses on medicinal plant knowledge among the Bai in the Shaxi Valley, Northwest Yunnan, where no ethnobotanical study has been conducted so far. In an area of high biodiversity, distinct medicinal plant knowledge is documented and the influence of herbals on local knowledge is revealed.

Aim of the study

To analyse current medicinal plant knowledge among the Bai in the context of the influence of the Han culture and mainstream Chinese herbal medicine.

Materials and methods

During fieldwork in summer 2005, semistructured interviews were conducted with 68 stakeholders, and voucher specimens of all plants mentioned were prepared.

Results

A total of 176 medicinal plant species were documented and 1133 use-reports have been collected. Overall, 91.5% of the documented plants are already established as known drugs, and are mentioned in books on medicinal plants in Yunnan and China. Furthermore, the way in which they are used largely coincides. Fourteen plant species represent novel recordings, 9 of which were independently mentioned by three or more informants.

Conclusions

The medicinal plant knowledge of the Bai is strongly influenced by mainstream Chinese herbal medicine and especially by medicinal plant books from the 1970s, which were distributed under Mao Zedong's directive to improve rural health care. We conclude that these herbals have exerted, and continue to exert, a strong influence on the standardisation of plant knowledge among rural populations in China. However, distinct local use of plants also exists, indicating that plant knowledge specific to the Bai people is alive and practiced.     

Central serous chorioretinopathy and risk for obstructive sleep apnea

Patients with obstructive sleep apnea (OSA), in comparison to controls, have increased levels of circulating epinephrine and norepinephrine, both of which are risk factors for the development of central serous chorioretinopathy (CSCR). The aim of this pilot study was to investigate the frequency of symptoms that suggest OSA in CSCR patients and normal controls. The Berlin Questionnaire, a validated research tool to assess risk for OSA, was administered to 29 patients who met the criteria for active, acute, non-steroid-induced CSCR and 29 controls matched for age and sex. In this retrospective case-controlled study, the main outcome measure was increased risk for OSA. The mean age of the patients was 47.8 years (range 29–72) and the mean age of controls was 47.3 years (range 25–70). Seventy-six percent (22) of both groups were men. Survey scores showed 58.6% (17) of patients with CSCR to be at an increased risk for OSA compared to 31.0% (nine) of controls. A conditional logistic regression analysis showed that the CSCR group had a higher proportion with an increased risk for OSA compared to the control group (odds ratio=3.67; 95% CI: 1.02, 13.14; P = 0.046). Patients with CSCR may be more likely than other adults to have OSA, and screening for this sleep disorder should be considered in this population. Further research is warranted to determine whether sleep apnea may contribute to the development of CSCR, and to assess whether treatment of sleep apnea might offer a new therapeutic option for some patients with CSCR.     

Differential generation of class I H-2D- versus H-2K-restricted cytotoxicity against a demyelinating virus following central nervous system infection

Despite the fact that both H-2K and D molecules are up-regulated in the central nervous system (CNS) following Theiler's murine encephalomyelitis virus (TMEV) infection, resistance in this virus model of multiple sclerosis maps exclusively to D. To address this paradox, we examined the ability of the K and D molecules to present viral antigens to cytotoxic T lymphocytes (CTL). Whereas no virus-specific CTL were detected in the CNS of susceptible B10.Q and B10.S mice 7 days post-infection, D-restricted CTL were identified readily in the CNS of resistant B10 animals. There was no evidence of K-restricted CTL in the CNS of B10 mice at day 7 post-infection. The presence of both K- and D-restricted virus-specific CTL in the spleen of immunized B10 mice demonstrates that the exclusive use of D molecules by CTL in the CNS of mice 7 days post-infection is not due to the inability of the K molecules to present viral peptides to lymphocytes. We conclude that the prominent role of the D locus in determining resistance or susceptibility to TMEV-induced demyelination is determined by factors governing the regulation of the immune response, and not by the presence or absence of CTL precursors capable of recognizing viral peptides presented by the K and D antigen-presenting molecules, or by differences in the ability of the K and D molecules to present viral peptides.     

The dietary intake of homeless males sleeping rough in Central London

Data concerning the food and beverage intake (including alcohol) of 79 males, aged 19–50 years, sleeping rough in Central London, who did not appear to be under the influence of drink, drugs or suffering from mental illness were collected by prompted 24-h recall and food-frequency questionnaire (FFQ). The source of food was noted and the subjects were asked about food availability and food needs. The group had intakes significantly lower than Dietary Reference Values (DRV) for the UK for energy, carbohydrate, non-starch polysaccharides (NSP), folate, zinc and magnesium. Significantly higher values were seen for protein, fat, vitamin B₁₂, calcium and iron. Alcohol intake was higher than that assumed to approximate current intakes of the UK population. Mean macronutrient intakes for the group were similar to means for British adult men (OPCS, 1990), only protein and NSP were significantly lower. The FFQ showed very low consumption/week of fruit, vegetables, salad, fruit juice and wholewheat/brown products. Organized charities provided the major source of food energy for the group as a whole. Self-supplied sources provided the major source of total energy. It is suggested that the group may benefit from an increase in dietary fibre and energy, with an increase in the proportion of energy supplied by carbohydrate and a reduction in energy from fat and alcohol. A varied supply of food and hot meals during weekends as well as during the week may benefit the group both aesthetically and nutritionally. It may be advisable to increase the supply of wholemeal/brown bread, fruits, vegetables and salad foods without decreasing the energy content of the food available.