三种内固定治疗上肢长骨干骨折的临床比较研究

目的观察天鹅记忆接骨器(swan-likememoryconnector,SMC)治疗上肢长骨干骨折的疗效,并与加压接骨板(dynamiccompressiveplate,DCP)和带锁髓内针(lockedintramedullarynail,LIN)进行临床对比研究。方法随机选择1997年8月～2001年8月入院的新鲜上肢长骨干骨折148例,分别采用SMC(49例)与DCP(50例)、LIN(49例)进行内固定治疗,术后常规抗炎治疗1周,定期拍片并随访患肢功能恢复情况。结果SMC组的手术时间明显低于LIN组与DCP组(P<0.05),三组伤口感染率无差异。SMC组骨愈合时间和骨不连发生率显著短于DCP组和LIN组(P<0.05),而术后功能优良率高于DCP组和LIN组。在SMC固定下,骨折愈合直接由解剖型或类解剖型的骨样骨板状直接替代连接,固定段无应力遮挡和骨质疏松。结论SMC是治疗上肢长骨干骨折的有效方法,优于DCP和LIN。SMC的几何构形和力学特性有利于骨折愈合。在本器固定下,可能存在一种新的尚未被认知的骨折愈合方式。     

记忆合金环抱器治疗掌骨干骨折

2002年3月-2005年2月，我院采用切开复位镍钛形状记忆合金环抱器治疗掌骨干骨折49例，取得了较好疗效。     

Functional Anatomy of Visuomotor Skill Learning in Human Subjects Examined with Positron Emission Tomography

The present study was designed to examine patterns of regional cerebral blood flow (CBF) associated with the learning of a repeated visuomotor sequence both in the early and late phases of the acquisition process. In addition, changes in blood flow related to the implicit versus explicit aspects of learning such a skill were investigated. Fourteen normal control subjects were scanned while performing the task (i) in both early and advanced learning stages of the visuomotor sequence; (ii) after having acquired explicit knowledge of the sequences; and (iii) in two control conditions (perceptual and random sequence). Subtraction of the random condition from the highly learned condition revealed specific areas of activity in the right ventral striatum and dentate nucleus of the cerebellum. Blood flow changes in the right hemisphere were also seen in the medial posterior parietal and prestriate regions, as well as in the anterior cingulate cortex. Finally, once the subjects had acquired explicit knowledge of the embedded sequence that was presented in the highly learned condition, increased CBF activity was observed only in the mid-ventrolateral frontal area in the right hemisphere. These findings confirm that both the striatum and the cerebellum are involved in the implicit acquisition of a visuomotor skill, especially in the advanced stages of the learning process, and furthermore that the ventrolateral prefrontal cortex contributes preferentially to the declarative aspect of this task.     

A retrospective mortality study of workers exposed to arsenic in a gold mine and refinery in France

A historical mortality study of a cohort of employees of a gold mining and refining company was carried out in Salsigne, France. A major goal of the study was to investigate the relationship between lung cancer mortality and exposure to arsenic, radon, silica, and other contaminants of the working environment. A twofold excess of lung cancer was found both among miners and smelters, mainly concentrated among workers who had experienced exposure to past levels of arsenic, radon, and silica. The consistency of the results in the mine and the refinery are suggestive of a carcinogenic risk from both soluble and insoluble arsenic, although the potential role of other factors cannot be dismissed. © 1994 Wiley-Liss, Inc.     

Sequential Role of Hippocampus and Amygdala, Entorhinal Cortex and Parietal Cortex in Formation and Retrieval of Memory for Inhibitory Avoidance in Rats

The hippocampus and amygdala, the entorhinal cortex and the parietal cortex participate, in that sequence, both in the formation and in the expression of memory for a step-down inhibitory avoidance task in rats. Bilateral infusion of AP5 or muscimol caused retrograde amnesia when given O min after training into both hippocampus and amygdala, when given or 180 min after training into the entorhinal cortex, or when given 180 min after training into the parietal cortex. Therefore, memory formation requires the sequential and integrated activity of all these areas mediated by glutamate NMDA receptors in each case. Pre-test administration of CNQX 1 day after training into hippocampus and amygdala, 1 or 31 days after training in entorhinal cortex, or 1, 31 or 60 days after training in the parietal cortex temporarily blocked retention test performance. Therefore, 1 day after training, all these brain structures are necessary for retrieval; 1 month later, the hippocampus and amygdala are no longer necessary for retrieval but the entorhinal and parietal cortex still are; and 60 days after training only the parietal cortex is needed. In all cases the mechanisms of retrieval require intact glutamate AMPA receptors.     

Mood state and cerebral metabolism in persons with age-associated memory impairment

People undergoing medical procedures sometimes experience feelings that may influence the results. In this study, we explore the relationship between changes in mood state self-ratings and cerebral glucose metabolism during positron emission tomography (PET) in persons with age-associated memory impairment (mean age 59.4±9.8 years). Brain regions of interest involved in both mood and memory were examined. Mood ratings of increased boredom correlated significantly with mesial temporal and parietal asymmetry and decreased parietal metabolism. Mood ratings of increased fatigue correlated with basal ganglia asymmetry and the right basal ganglia and left mesial temporal metabolism. These findings suggest that subjective mood state changes during PET may influence metabolism in brain regions implicated in emotion and memory function in people with age-related memory complaints.     

Procedural memory stimulation in Alzheimer's disease: impact of a training programme

The study evaluates the efficacy of a procedural memory stimulation programme in mild and mild-moderate Alzheimer's disease (AD). Twenty basic and instrumental activities of daily living have been selected, and divided into two groups, comparable for difficulty. Ten normal elderly subjects (age 68.0±4.8 years; MMSE score: 28.7±0.9; education: 7.6±3.5 years) were asked to perform the two groups of daily activities and the time required to perform the tasks of each group was recorded and used as a reference. Ten mild and mild-moderate AD patients (age 77.2±5.3 years; MMSE score: 19.8±3.5; education: 7.3±4.7 years) without major behavioural disturbances constituted the experimental group. Patients were evaluated in all 20 daily activities and the time employed was recorded at baseline and after a 3-week training (1 h/d, 5 d/week) period. Five patients were trained during the 3 weeks on half of the 20 daily activities and the other five patients were trained on the remainder. This procedure was adopted in order to detect separately the improvement in "trained" and "not trained" activities, allowing to control better the effects of the intervention. The assessment of the functional impact of the training was directly measured, through the variation of time employed to perform tasks before and after training. After 3 weeks of training a significant improvement was observed for the trained activities, from 3.6 to 1.9 standard deviations below the performance of the normal elderly controls ( P <0.05). AD patients improved also in not-trained activities from 3.5 to 2.7 standard deviations below the controls'performance ( P <0.05). The rehabilitation of activities of daily living through developing procedural memory strategies may be effective in mild and mild-moderate AD patients.     

Alzheimer-type dementia and verbal memory performances: influence of selegiline therapy

In a double blind randomized crossover trial lasting 6 months selegiline, a selective MAO-B inhibitor, was tested against placebo for activity on verbal memory performances in Alzheimer-type dementia (DAT). Verbal memory was assessed with the Rey-Auditory-Verbal Learning Test at the start of treatment, at the time scheduled for crossover (90 days) and at the end of the trial (180 days). The results suggest that selegiline possesses significant activity on some memory parameters, which seems to depend on an improvement both in information processing abilities and in learning strategies at the moment of acquisition

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Sommario In uno studio doppio cieco cross-over, randomizzato verso placebo della durata di sei mesi, è stata analizzata l'influenza della selegilina, inibitore selettivo delle MAO-B, sulle prestazioni di memoria verbale di 22 pazienti con diagnosi clinica di demenza tipo Alzheimer (DAT). L'esame della memoria verbale è stato effettuato con il Rey-Auditory Verbal Learning test all'inizio del trattamento, dopo 90 giorni, momento previsto per il cross-over, e dopo 180 giorni, al termine della sperimentazione. I risultati suggeriscono una significativa efficacia della selegilina su alcuni parametri di memoria, che sembrano riconducibili ad un miglioramento sia delle capacità di elaborazione delle informazioni, sia delle strategie di apprendimento al momento dell'acquisizione.

     

奥明格健脑口服液改善小鼠记忆的作用

目的观察奥明格健脑口服液对改善小鼠记忆作用的影响。方法断乳小鼠，体重１２～１４ｇ，每组１４～１６只。把实验动物随机分为正常对照组、高剂量组、中剂量组和低剂量组，连续给样３０ｄ，进行跳台和水迷宫试验，以上试验按同样方法重复一次。结果两次小鼠实验表明，灌胃奥明格健脑口服液１ｍｏ后，跳台试验中受电击动物数和错误总数，各试验组均低于对照组，其中高剂量试验组显著低于对照组，而且潜伏期显著延长。水迷宫试验中，动物到达终点所需时间和错误总数，高中剂量组试验组均显著低于对照组。结论奥明格健脑口服液具有改善动物记忆的作用。