A Ro/SS-A auto-antibody positive mother's infant revealed congenital complete atrioventricular block,followed by insulin dependent diabetes mellitus and multiple organ failure

We experienced a congenital complete atrioventricular block infant who was born from a Ro/SS-A antibody positive mother. Ro/SS-A antibody was also found in this baby which was presumed to be mediated by the maternal placenta. Temporary cardiac pacing was required at birth and pacemaker implantation was performed at 9 months. At 11 months of age, the baby fell into shock and experienced multiple organ failure because of diabetes mellitus-induced coma. The association between congenital complete heart block and the Ro/SS-A antibody is well known. However, the accompaniment of insulin-dependent diabetes mellitus has not been reported previously. As the Ro/SS-A antigen appears in the cytoplasm of many tissues, the possibility of an association between Ro/SS-A antibody and diabetes mellitus is difficult to deny. We report this rare case to draw attention to the possibility that babies who are born from an Ro/SS-A antibody positive mother may develop diabetes mellitus as well as congenital complete heart block.     

生物素标记HBV DNA探针在肝石蜡切片上作原位杂交技术的研究——各型肝病时HBV DNA的定位及形态

报告用生物素标记HBV DNA探针原位杂交技术,现察75例慢性肝病者肝石蜡切片上HBV DNA定位及形态。共检出HBV DNA阳性者25/75例(33.33％)。其中:CPH2/7例、CAH10/21例、肝硬化0/3例、SS4/11例、无症状HBsAg携带者4/21例和HCC5/12例。HBVDNA在肝切片上呈棕黄色粗颗粒状,主要分布于肝细胞浆内,个别核内亦可见少数浅染棕黄色颗粒。阳性肝细胞分布有三种形式:Ⅰ型(弥漫型):25例中有4例(16％),Ⅱ型(局灶型):20例(80％),Ⅲ型(散在型):仅1例(4％)。颗粒在胞浆内亦有a型(密集)和b型(稀疏)之分。各型乙型肝炎HBV DNA在肝切片上定位与分布不完全相同,可能表示不同的病毒感染状态和复制的活跃程度。HCC只在癌旁肝组织内查见HBV DNA。     

小儿中枢神经系统肿瘤71例病理分析

本文分析了1962年至1986年间的71例小儿中枢神经系统肿瘤的病理资料,该病占同期中枢神经系统肿瘤的16.6％。71例中,颅内肿瘤67例,椎管内肿瘤4例。颅内肿瘤中幕上38例,以星形细胞瘤多见,其次为先天性肿瘤。幕下29例以髓母细胞瘤多见,其次为星形细胞瘤。小儿中枢神经系统肿瘤以恶性居多,预后不佳。脑中线是肿瘤的好发区。     

胸腰椎骨折脱位157例临床分析

本文报告157例胸腰椎骨折脱位病人,非手术治疗36例,手术治疗116例。作者对临床治疗中的有关问题进行了讨论。     

Assessment in undergraduate psychiatric education

An assessment of medical students' psychiatric performance demonstrated no association between the ability to rate psychopathology or to observe interview behaviour and traditional written methods of academic achievement. This is in accordance with those few studies which have addressed this issue and indicates that there may well be at least three independent skills involved in clinical decision-making: the ability to engage in interpersonal interaction and elicit information; and the ability to acquire and use academic knowledge. This is consistent with work suggesting that maturational and learning processes influence clinical reasoning, and demonstrates that each component should be addressed in assessing students in psychiatry.     

大学生预防性治疗的结核菌素反应强度标准研究

目的 探讨结核菌素反应强度与结核病发病的相关性;提出预防性治疗对象的结核菌素反应标准.方法 对不同结核菌素反应强度的新入学大学生进行4年的结核病发病观察,分析结核菌素反应强度与发病危险性、发病时间的关系,比较不同反应强度预防性治疗对象发病率的变化.结果 26 543名健康学生进行了结核菌素试验和4年的发病观察,反应强度为0～4、5～9、10～14、15～19和≥20 mm或水泡丘疹者的年均结核病发病率分别为12.97/10万、13.34/10万、50.32/10万、167.56/10万和250.21/10万;0～4和5～9 mm反应者头2年发病率很低,第3、4年有所增高,而15～19和≥20 mm或水泡丘疹者头2年发病率很高,随着时间推移有下降趋势.当逐个计算反应强度每增加1 mm及以上反应者的发病率时,15 mm以上的各反应强度者中结核病发病率相似,一直维持在较高水平.PPD反应标准15 mm及以上可以覆盖80.8%的病人,而且病人的发现效率也维持在一个高水平.结论 结核菌素反应强度与结核病发病存在明显正相关,特别在头2年危险比更大;PPD反应≥15 mm或有水泡丘疹阳性者的发病机会明显升高,PPD反应≥15 mm或有水泡丘疹阳性标准能够覆盖80%以上的病人,病人的发现效率也最高.因此以PPD反应≥15 mm或有水泡丘疹作为预防性治疗对象的结核菌素反应标准更为合理.     

The influence of muscle-conditioned media on chick embryo brainstem neurons in culture

Brainstem pieces from the trigeminal region of the metencephalic basal plate of 10-day chick embryos were dissociated and cultured in control conditions or in the presence of muscle-conditioned medium (MCM). The MCM was derived from age-matched target tissue relevant to this neuronal region (jaw musculature), from relevant target tissue of an age at which innervation would initially be taking place (4 days), and from nonrelevant target tissue also of an early stage (4-day limb bud). Neuronal survival and differentiation was assessed daily, for 7 days. Survival and differentiation were significantly enhanced by the 4-day jaw MCM compared to both the controls and the cultures grown with 10-day jaw MCM and 4-day limb MCM. These measures in the presence of 10-day jaw MCM and 4-day limb MCM did not differ, but surpassed that seen in control cultures. The results are compared to the more specific responsiveness seen in earlier (2-day) neural tube cultures, and their relationship to in vivo regenerative nerve fiber outgrowth is considered.     

31例活动性肺结核治疗前及治愈后的CT征象分析

目的 探讨抗结核疗前及治愈后活动性肺结核CT征象的变化特点.方法 选取临床治愈的活动性肺结核31例,对比观察活动性肺结核的CT征象转归表现.结果 肺结核活动性CT征象治愈前检出率为100.0%,治疗后检出率为35.5%.活动性CT征象中毛玻璃阴影、节段分布小叶中心结节影、小叶样实变影、树芽征、支气管壁增厚、厚壁空洞和肺实变治疗前检出率分别为87.1%、80.6%、80.1%、61.3%、58.1%、48.4%和32.3%、,治愈后检出率分别为0、19.4%、0、0、12.9%、0和3.2%.治疗前活动性肺结核CT检查可检出多种活动性影像,而疗程结束后上述征象减少并多以单发为主,两者有显著差异（P＜0.01）.结论 CT检查有助于活动性肺结核治疗疗效的判定,并具有较高的敏感度,但特异度较低.