Primary angiitis of the central nervous system: MRI features and clinical presentation

We report the MRI features in a series of four patients with primary angiitis of the central nervous system (PACNS). Based on MRI features, clinical presentation, paraclinical investigations and laboratory tests, including cerebrospinal fluid (CSF) analysis, various differentials were considered. In two patients with MRI findings of cortical, subcortical and deep white matter lesions, lack of mass effect, focal areas of bleed and heterogeneous parenchymal, leptomeningeal or pial enhancement and a normal magnetic resonance angiography, a differential diagnosis of primary angiitis of the CNS was also considered. In all patients, an open brain biopsy was advised to establish a definitive diagnosis of PACNS. Here, we briefly discuss the MRI features, correlation with clinical presentation and paraclinical parameters for the diagnosis of this entity. We also briefly review the literature.     

P27kipl 在胃癌与癌旁粘膜中的表达及意义

目的：探讨P27kipl在胃癌及癌旁粘膜中的表达情况及其意义。方法：应用免疫组化技术（S－P法）检测了P27kipl在75例胃癌及癌旁粘膜中的表达，结果：P27kipl在胃癌中的阳性表达率为45．3％，在癌旁粘膜中随着不典型增生级数增高其表达强度明显减弱。P27kipl的表达与胃癌的浸润深度（P＜0．05），淋巴结转移（P＜0．05）、分化程度（P＜0．05）及临床病理分期（P＜0．05）显相关，而与肿瘤大小、部位无关。结论P27kipl有癌中的低表达反映了其恶性进展，是一个有价值的预后因子。     

小型移动数字成像系统下行经皮冠状动脉腔内成形术

目的 :探讨移动数字成像系统GE OECSeries 980 0进行经皮冠状动脉腔内成形术 (PTCA)的可行性和安全性。方法 :回顾分析 32例应用GE OECSeries 980 0X线机进行PTCA治疗冠心病的临床资料。结果 :①本组病例成功率为 90 6 % (2 9/ 32 ) ,血管成功率为 88 1% (37/ 4 2 ) ,病变成功率 83% (39/ 4 7)。成功病例狭窄由术前目测平均直径狭窄(92 8± 3 5 ) %减少到术后的 (6 5± 4 2 ) %。②AMI溶栓后补救性PTCA成功率高。结论 :应用GE OECSeries 980 0X线机能够满足心血管病区心脏介入治疗的需要 ,是安全可行的和具有良好的成本 效益比     

Freezing of gait in postmortem-confirmed atypical parkinsonism.

The frequency and pathophysiology of freezing of gait (FoG) in atypical parkinsonism is unknown. We analysed the frequency of FoG in postmortem-confirmed atypical parkinsonian disorders (APD) comprising corticobasal degeneration (CBD), dementia with Lewy bodies (DLB), multiple system atrophy (MSA), and progressive supranuclear palsy (PSP). Sixty-six patients with pathologically confirmed APD (CBD, n = 13; DLB, n = 14; MSA, n = 15; PSP, n = 24) formed the basis for a multicenter clinicopathological study. Clinical features at first and last clinical visit were abstracted from patient records on standardized forms following strict instructions. At the first visit (median 36 months after symptom onset), 24% of APD had FoG (CBD, 8%; DLB, 21%; PSP, 25%; MSA, 40%). Logistic regression analysis showed a significant association of FoG and urinary incontinence (P = 0.04) at first visit. At last visit, 47% of APD had FoG (CBD, 25%; PSP, 53%; DLB, 54%; MSA, 54%). Clinicopathological correlation based on routine postmortem examination failed to identify a consistent neuropathological substrate of FoG. This study demonstrates that (1) FoG is common in APD, and (2) urinary incontinence is significantly associated with FoG in these disorders. Whether FoG and urinary incontinence share similar neuropathological substrates remains to be determined by future studies.     

百年乐与人参黄芪合剂对心血管系统的药理作用比较

百年乐和人参黄芪合剂对心血管系统的作用研究表明:百年乐能加速小鼠肠系膜微循环障碍的恢复,增加离体兔耳血管的流量,使主动脉平滑肌松弛,对抗心肌缺氧,抑制血栓形成,其作用强于人参黄芪合剂。     

Successful choledochojejunostomy for choledochal stricture with preservation of the collateral parabiliary venous system following iatrogenic portal occlusion

We surgically treated a patient with biliary stricture and portal vein occlusion, after operation for gastric cancer with lymphadenectomy along the hepatoduodenal ligament, that had led to choledochal stone formation and a dilatated parabiliary venous system. A 57-year-old man without hepatic dysfunction exhibited hepatic duct dilatation with choledochal stone on ultrasonography and percutaneous transhepatic cholangiography, respectively. Pharmacoportography revealed occlusion of the portal vein and dilatation of the parabiliary venous system. Of various preoperative imaging studies used, enhanced computed tomography was most useful for delineating the surgical anatomy of the hepatoduodenal ligament. Complete preservation of the dilatated vessels, which functioned as the main portal collateral pathway, resulted in a successful choledocho-jejunostomy, with an uneventful postoperative course.     

Discrete time optimal control of linear time-delay systems

A discrete time optimal control for linear time-delay systems is developed to ensure that all closed-loop eigenvalues will lie inside a circular region centred at (β;, 0) with radius α. It is shown that by suitable manipulations the problem can be reduced to a standard discrete time quadratic regulator problem. An illustrative example is included to demonstrate the applicability of the proposed method.     

关于高等医学教育管理体制与学制改革的思考

高等医学教育管理体制与学制改革是二十一世纪社会发展的需要。文章阐述了医学教育小规模、长学制、高投入的基本特征,强调了遵循医学教育规律的重要性,分析了医学院在综合性大学的重要地位,医学院与附属医院以及相关院系的关系。文章还依据社会发展的需要和医学教育国际化的趋势,分析了医学教育学制调整的必要性以及学制调整思路。     

Nursing in the health care system of the postmodern world: crossroads, paradoxes and complexity

Entering the postmodern world in which society is confronting crossroads, paradoxes, and complexity, the health care system is encountering a transformation more comprehensive and revolutionary than has ever been seen before. Analysis of the state of nursing vis a vis these transformations indicates that the current paradigm does not ensure the existence of the profession in the postmodern health care system. That is because of increased difficulties in consolidating the economic and quality issues into the core of nursing, and in understanding the complexity inherent in health related situations.