肱骨干骨折--髓内钉与钢板固定的比较

总体而言，这些报道提示：采用髓内钉治疗肱骨干骨折较采用钢板带来更多的并发症，尤其是采用顺行人路。同时，这些报道没有提供确切的证据证明何种方法在骨折愈合、减少感染或上肢总体功能上优于另一种。     

SARS死亡病例的实验室检查特点

目的：了解严重急性呼吸综合征(SARS)死亡病例的临床特点，为SARS重症病例的诊断、治疗及预后判断提供帮助。方法：对我院2003年1月至4月底收治的102例确诊非典患者中的5例死亡病例的流行病学及实验室检查资料进行回顾性分析。结果：死亡病例均为男性，平均49岁，从发病到入院平均7．6d，从住院到确诊平均1．2d；从住院到死亡平均14．4d，从发病到死亡平均为22d。死亡病例粒细胞总数和百分比均明显升高，多数患者淋巴细胞计数和百分比降低(4／5)，血红蛋白均呈进行性下降。死亡患者除已见报道的ALT、AST、LDH、CK升高及低钙血症外，GLU均明显高于正常而ALB均明显降低；大多数患者TP、PA等多项生化指标均出现明显下降而脱氧血红蛋白百分率(HHb)明显上升，同时伴有低磷、低镁血症。结论：SARS死亡病例多项实验室指标均会出现明显异常，动态监测这些指标有助于SARS患者的诊断、治疗及预后判断。     

海水浸泡对腹部开放伤实验犬肝脏功能及形态学的影响

目的 探讨腹部开放伤后海水浸泡对实验犬肝功能及肝脏病理形态学的影响.方法 20只实验犬致伤后随机分为对照组(n=10)和浸泡组(n=10).对照组为单纯腹部外伤,浸泡组于致伤后置入人工配制的海水中.分别于致伤前(0h)及出水后4、8、12、16、20h取血测定总胆红素(TB)、ALT、AST、LDH、血氨(NH3)、凝血酶原时间(PT)、肿瘤坏死因子-α(TNF-α)、白介素6(IL-6)、内毒素(ETX)水平,于24h处死动物对肝组织进行病理检查.结果 与对照组比较,浸泡组TB、ALT、AST和PT增高,16h后升高明显.浸泡组伤后4h和12h LDH明显高于对照组,伤后4h血NH3明显高于对照组(P＜0.05).TNF-α、IL-6和ETX的变化与肝功能的损害程度呈正比.与对照组比较,浸泡组肝脏的病理形态学改变明显.结论 海水浸泡可导致实验犬的肝功能损伤和肝细胞病理形态学变化.     

质子磁共振波谱对创伤后应激障碍患者海马神经元异常的诊断价值

目的 探讨质子磁共振波谱（1HMRS）在诊断创伤后应激障碍（post traumatic stress disorder，PTSD）患者海马神经元异常中的价值。方法 对19例PTSD患者及19例健康对照组行常规MRI和1HMRS检查。结果 PTSD患者MRI检查未出现信号的异常。19例患者两侧海马均显示NAA／Cr明显减低，与健康对照组相比，差异有统计学意义（P〈0．01）；而患者两侧海马的Cho／Cr与健康对照组相比，差异无统计学意义（P〉0．05）。结论 1HMRS揭示了PTSD时海马存在着神经元的丢失或功能紊乱，而这些改变是构成PTSD的神经生物学基础之一。     

低压状态下猪鼾症模型的建立及其CT研究

目的探讨低压环境对动物上气道软组织形态学的影响。方法将试验猪置于一个低压环境饲养6个月建立猪的鼾症模型,当出现类似鼾症临床症状和鼾症相似的咽腔压力波形时,再进行CT扫描影像学检查。并与正常状态饲养的对照组进行对比。结果模型猪咽后壁及软腭明显增厚,分别为(0.94±0.16)cm和(1.06±0.23)cm;对照组分别为(0.60±0.11)cm和(0.59±0.13)cm。模型猪的气管截面积在在前、中、后部分别为(1.49±0.12)cm2、(1.37±0.32)cm2和(1.00±0.21)cm2,其中以悬雍垂水平(后部)最为狭窄;对照组前、中、后部分别为(1.30±0.14)cm2、(1.57±0.32)cm2和(2.48±0.42)cm2。结论低压状态是鼾症的重要的致病因素之一,低压状态可建立鼾症的动物模型。     

顺铂体外诱导的人肝癌耐药细胞株(QGY/DDP)的建立

目的 建立顺铂(DDP)诱导的人肝癌耐药细胞株(QGY/DDP),研究其生物学特性和耐药机制.方法 采用间歇诱导法,逐步递增DDP浓度,获得耐药细胞株QGY/DDP;MTT法测定药物敏感性;细胞计数法计算倍增时间,流式细胞术检测细胞周期;原子吸收光谱法测定细胞内铂离子蓄积量,流式细胞仪测定P-糖蛋白(P-gp)和谷胱甘肽S-转移酶-π(GST-π)的表达水平.结果 成功建立了顺铂诱导的人肝癌耐药细胞株QGY/DDP,耐药指数为10.81,与5-氟尿嘧啶、长春新碱等抗癌药有明显的交叉耐药;与QGY细胞相比,QGY/DDP细胞增殖减慢、倍增时间延长,G0/G1期细胞增多、S期与G2/M期细胞减少,细胞内Pt含量降低,GST-π的表达升高,而P-gp无明显变化.结论 QGY/DDP细胞具有耐药表型及耐药细胞的生物学特性;其耐药机制与细胞内Pt含量降低和GST-π过表达有关,而与P-gp无关.     

跖跗关节骨折脱位手术治疗21例报告

我院自 1993年 5月 - 2 0 0 1年 5月采用闭合复位或切开复位克氏针内固定治疗跖跗关节骨折脱位2 1例 ,取得满意疗效 ,现报告如下。1　临床资料　　本组 2 1例 ;男 14例 ,女 7例 ;左侧 12例 ,右侧 8例 ,双侧 1例 ;年龄 2 1～ 6 8岁 ,平均 4 0 5岁 ;闭合性骨折脱位 16例 ,开放性骨折脱位 5例 ;按照Kuss分类法 :同向性脱位 15例 ,分离性脱位 6例 ;伤因 :车祸伤 12例 ,高处坠落伤 5例 ,重物压伤 3例 ,扭伤 1例。同时伴肢体骨折 6例 ,胸腹伤 3例。2　治疗方法本组 16例闭合性损伤均采用闭合复位克氏针内固定。一般在硬麻下进行 ,取平卧位 ,膝关…     

64层螺旋CT诊断先天性冠状动脉起源异常的价值

目的：探讨64层螺旋CT冠状动脉造影诊断冠状动脉起源异常的临床价值。材料和方法：回顾性总结2005年12月至2006年12月间1800例64层螺旋CT冠脉造影的结果，统计冠状动脉起源异常的发生率。结果：1800例检查者中发现冠脉起源异常51例，发病率2．8％。包括右冠状动脉变异11例（21．6％）、左冠状动脉变异8例（15．7％）、左右冠均发生变异1例（2％）、单支冠状动脉1例（2％）、分支变异28例（54．9％）。结论：64层螺旋CT是诊断冠状动脉起源异常的安全有效方法，对临床治疗有重要的意义。     

Psychosis in epilepsy patients

Summary   Epileptic psychoses reflect a fundamental disruption in the fidelity of mind and occur during seizure freedom or during or after seizures. The psychotic symptoms in epilepsy share some qualities with schizophrenic psychosis, such as positive symptoms of paranoid delusions and hallucinations. Psychotic syndromes in epilepsy are most common but not exclusively associated with temporal lobe epilepsy. De Novo psychosis following epilepsy surgery is rare. Forced normalization—psychosis associated with dramatic reduction of epileptiform activity or seizures is described in small series only. Ictal and postictal psychosis can be prevented with seizure control, but postictal and chronic interictal psychoses require multidisciplinary and psychopharmacologic management.     

Implicit memory is independent from IQ and age but not from etiology: evidence from Down and Williams syndromes

Background In the last few years, experimental data have been reported on differences in implicit memory processes of genetically distinct groups of individuals with Intellectual Disability (ID). These evidences are relevant for the more general debate on supposed asynchrony of cognitive maturation in children with abnormal brain development. This study, comparing implicit memory processes in individuals with Williams syndrome (WS) and Down syndrome (DS), was planned to verify the ‘etiological specificity’ hypotheses pertaining to the skill learning abilities of individuals with ID. Method A modified version of Nissen and Bullemer's (1987) Serial Reaction Time (SRT) task was used. The performances of three group were evaluated. The first group consisted of thirty‐two people with WS (18 males and 14 females). The second group was comprised of twenty‐six individuals with DS (14 males and 12 females). The two groups of individuals with ID were selected so that the groups were comparable as for mental age and chronological age. The third group consisted of forty‐nine typically developed children with a mental age similar to that of the groups with WS and DS. Results The two groups of individuals with ID demonstrated different patterns of procedural learning. WS individuals revealed poor implicit learning of the temporal sequence of events characterizing the ordered blocks in the SRT task. Indeed, differently from normal controls, WS participants showed no reaction time (RT) speeding through ordered blocks. Most importantly, the rebound effect, which so dramatically affected normal children's RTs passing from the last ordered to the last block, had only a marginal influence on WS children's RTs. Differently from the WS group, the rate of procedural learning of the participants with DS was comparable to that of their controls. Indeed, DS and typically developed individuals showed parallel RT variations in the series of ordered blocks and, more importantly, passing from the last ordered to the last block. Therefore, a substantial preservation of skill learning abilities in this genetic syndrome is confirmed. Conclusions The results of the present study document that procedural learning in individuals with ID depends on the aetiology of the syndrome, thus supporting the etiological specificity account of their cognitive development. These results are relevant for our knowledge about the qualitative aspects and the underlying neurobiological substrate of the anomalous cognitive development in mentally retarded people.