Isolated oculomotor nerve paralysis in Lyme disease: MRI

Lyme disease is a cause of illness involving multiple organ systems, including, in 10–15 % of cases, the nervous system. Peripheral radiculoneuritis, cranial neuritis, encephalitis and myelitis are among the neurological manifestations found in the second and third stages. We present the MRI findings in isolated oculomotor nerve involvement by Lyme disease and discuss the differential diagnosis. Received: 14 June 1995 Accepted: 16 January 1996     

甘肃省1995年急性弛缓性麻痹病例病毒学监测

甘肃省１９９５年共报告１５岁以下儿童急性弛缓性麻痹（ＡＦＰ）病例９０例，发病率为１．３２／１０万。省脊髓灰质炎（脊灰）实验室收到ＡＦＰ病例的粪便标本共７９例，占８８％；双份合格粪便标本采集率为６８％（６１／９０）；粪便标本７天内送省脊灰实验室的占６５％（５２／７９）收到粪便标本后７天内分离培养的占８９％（７０／７９）；分离培养结果及时报告率为８７％（６９／７９）。病毒分离阳性率１３．９２％（１１／７９），其中脊灰病毒（ＰＶ）Ⅱ型５株，Ⅲ型１株，非脊灰肠道病毒（ＮＰＥＶ）５株。收到ＡＦＰ病例密切接触者粪便标本３ｌ８份，病毒分离阳性率５．６６％（１８／３１８），其中ＰＶⅡ型８株，ＮＰＥＶ１０株。全部送检粪便标本ＮＰＥＶ分离率３．７８％（１５／３９７）。所分离的ＰＶ均为疫苗株，且Ⅱ型居多。     

Severe hypokalemia in thyrotoxic periodic paralysis

Thyrotoxic hypokalemic periodic paralysis is an uncommon but sometimes fatal disease in which early recognition and therapy may prevent untoward complications. The case of a 26-year-old Chinese man who presented to the emergency department with rapidly progressive profound weakness and severe hypokalemia (serum potassium, 1.2 mEq/L) is presented. The patient required endotracheal intubation, ventilatory assistance, and intravenous potassium administration. Emergency medical evaluation and management of this entity are discussed.     

Meeting health care needs of women experiencing complications of miscarriage and unsafe abortion: USAID's postabortion care program

Each year, an estimated 210 million women become pregnant. Worldwide, more than one fourth of these pregnancies will end in abortion or an unplanned birth. While many abortions may result from the desire to delay or avoid pregnancy, 15% to 20% of pregnancies will end in miscarriage or stillbirth with some causative agents being malaria, HIV/AIDS, and physical violence. Postabortion care (PAC) is needed to provide treatment for complications caused by incomplete or spontaneous abortion and critical family planning counseling and services to prevent future unplanned pregnancies that may result in repeat abortions. In 2003, the United States Agency for International Development (USAID) initiated a 5-year strategy wherein seven countries were provided financial funding and technical assistance. Since 2003, more than 3000 women have been seen in health centers and health posts for PAC services; more than 14,000 community members have received messages on unsafe abortion; family planning, and complications of unsafe abortion and miscarriage; and more than 600 documents were reviewed for inclusion in a global PAC resource package. This package has been used for developing Cambodia's national PAC policy and for developing patient education materials and provider job aids in Cambodia and Tanzania. These promising methodologies will be replicated in other countries.     

低钾型周期性麻痹的临床及病理研究

目的 总结低血钾型周期性麻痹(hypoPP)的临床表现及其肌肉组织病理学改变的特点。方法 回顾分析42例hypoPP患者的主要临床表现及辅助检查，并对其中的3例行肌肉组织病理学检查。结果 总体来看，血钾越低患者临床症状及其他辅助检查变化也就越重、治疗效果越差，但患者的肌无力和腱反射的变化与血钾的变化并不完全平行，肌力下降也可不对称，2例患者出现呼吸肌麻痹，其中1例还同时伴有脑神经支配肌肉的受损，11例患者出现主观感觉障碍，54．5％(18／33例)的患者肌酸磷酸激酶(CPK)增高。患者骨骼肌病理学检查中可见空泡样肌纤维及管状集合物。结论 血清钾水平与肌无力症状不完全平行；主观感觉异常、CPK增高、恢复时间较长与肌肉组织的病理改变有关；不典型低钾型周期性麻痹应与吉兰—巴雷综合征、多发性肌炎等进行鉴别，必要时应进行骨骼肌病理学检查。     

自发性食管破裂的诊断和外科治疗

目的:探讨自发性食管破裂的诊断和外科治疗。方法 :对 14例自发性食管破裂患者的诊断、治疗方法及治疗结果进行回顾性分析。结果:本组确诊时间 2 4 h以内者仅 2例 ,确诊时间大于 2 4 h者 12例 ;一期食管修补、带蒂胸膜覆盖术 3例 ,治愈 1例 ,治疗失败 2例 (其中 1例死亡 ,1例延期行结肠代食管术后治愈 ) ;行破裂段食管切除、胃 -食管吻合术的 5例全部治愈 ;保守治疗 6例 ,治愈及死亡各 3例。结论:早期诊断自发性食管破裂是提高疗效、降低病死率的关键。发病 2 4 h以上者 ,如全身情况允许 ,破裂段食管切除、胃 -食管吻合术的疗效较好。     

96例急性迟缓性麻痹病例监测分析

目的：观察急性迟缓性麻痹病例（AFP）在我市的发病状况。方法：对96例急性迟缓性麻痹病人采集48h内粪便进行病毒分离，并进行个案调查与随访。结果：96例中，7例分布于城镇，89例分布于农村；格林-巴利综合征55例（57.3%）-横断性脊髓炎16例（16.6%）、神经炎11例（11.5%）、重症肌无力12例（12.5%）、与疫苗相关的脊髓灰质炎AFP病例（VAPP）2例（2.08%）。结论：防疫部门与各级医院加强合作和直接管理能及时了解发病状况。市髓灰质炎减毒疫苗（OPV）免疫工作尚存不足，宣讲教育应进一步加强。     

Behavioral models in mice. implication of the alpha noradrenergic system

1. The mechanism of action of drugs might change according to the test used. Several noradrenergic drugs were tested in order to understand their implication in the mobility tests.

2. It was found that clonidine, an Alpha 2 agonist, acted differently according to the tast used. It provoked sedation in spontaneous activity test, and anti-immobility effects in the other tests.

3. Tall suspension test is able to show the double acting of clonidine.

4. Idazoxan might act either as an alpha 2 antagonist or as partial alpha 2 agonist. TST shown the unexpected partial alpha agonist effect of the molecule.

5. Forced swimming test is more specific for predicting antidepressant activity than tail suspension test which is close to a spontaneous activity model.     

Treatment Outcomes in Spontaneous Intracranial Hypotension: Do Epidural Blood Patches Stop the Leaks?

Abstract:   Spontaneous intracranial hypotension (SIH) is a postural headache syndrome unrelated to dural puncture. Because of the increasing failure of epidural blood patch (EBP) to relieve headache in SIH, we retrospectively investigated the epidemiological features and treatment outcomes in 55 cases of SIH. The study population was stratified by age and sex; continuous variables were compared for differences by t -tests; categorical variables were compared by Chi-squared analysis or Fisher exact tests. Significant differences were identified by P values of 0.05 or less. The mean age of the study population was 44 ± 12 years with a female to male ratio of 1.3:1.0. Men presented with subdural hematomas ( P  = 0.001) more often than women. Meningeal enhancement on contrast magnetic resonance imaging (MRI) was the most consistent radiographic finding. Radionuclide cisternography (RC) demonstrated thoracolumbar dural leaks in 16 of 22 patients. EBP failures were more common in patients aged 40 and younger than in older patients ( P  = 0.003). Postural headache from SIH was not uniformly responsive to EBP, and had significant comorbidities, especially in men. The management of postural headache in SIH by other techniques to restore brain position and cerebrospinal fluid dynamics should be investigated.     

久强脑立清对自发性高血压大鼠重要器官的保护作用

目的探讨久强脑立清 (JNQ )对自发性高血压大鼠 (SHR)重要器官心、脑、肾组织形态学的影响。方法动物分为 4组 ,Wistar大鼠对照组、SHR组、SHR服用JNQ高剂量组 (0 5 3 0g/kg)和低剂量组 (0 2 65 g/kg) ,给药 5周。采用尾脉搏测压法测定动物血压 ;动物经组织灌流后 ,低温下快速取出心、脑、肾 ,固定于 10 %福尔马林中 ,4℃保存 ,常规组织切片 ,HE染色。结果给药前各组SHR的血压明显高于对照组 (P <0 0 1) ,给药 3周和 5周后血压未见明显下降。组织病理结果显示 ,未治疗组SHR心肌细胞肥大 ,肌束间小动脉壁增厚 ,官腔变窄 ;大脑皮层血管管腔狭窄 ,管壁增厚 ,血管周围间隙增大 ;肾小球萎缩 ,有玻璃样变。上述病理性改变在经JNQ治疗 5周后得到不同程度的改善 ,以高剂量组明显。结论SHR经JNQ治疗 5周后血压未见明显降低 ,但对重要器官心、脑、肾的病变有较明显改善作用