锰接触对新生大鼠脑发育的时空影响因素研究

目的　探讨锰接触对大鼠生后脑发育过程中时程因素和区域因素 (即时、空因素 )的影响作用。方法　将新生雄性SD大鼠随机分为染锰 1月龄组、2月龄组、3月龄组和各自对照组。染锰组自出生之日起供给 10g L氯化锰的溶液自由饮食 ,对照组供以自来水。 2 1日断奶后 ,取出母鼠 ,仔鼠继续供以上述溶液至处死之日止。各组动物于染锰结束后 ,采用胶质细胞纤维酸蛋白 (GFAP)免疫细胞化学染色与微机图象分析相结合技术 ,检测锰接触大鼠脑部不同时程和不同区域的胶质细胞纤维酸蛋白免疫反应情况及其反应阳性产物的平均相对密度。结果　 (1)染锰 1月龄组仔鼠 ,脑部的躯体感觉皮质和躯体运动皮质的GFAP阳性产物平均相对密度与对照组相比差异无显著性 ;而内侧隔核、斜角带、杏仁复合体、苍白球和无名质等锥体外系结构的GFAP阳性产物平均相对密度与对照组相比均显著升高 (P <0 . 0 0 1)。 (2 )染锰 2月龄组仔鼠 ,脑部的躯体感觉皮质和躯体运动皮质的GFAP阳性产物平均相对密度与对照组和 1月龄组相比 ,差异均无显著性 ;而锥体外系诸结构的GFAP阳性产物平均相对密度除显著高于对照组外 (P <0 .0 0 1) ,亦明显高于 1月龄组 (P<0 .0 1)。 (3)染锰 3月龄组仔鼠 ,脑部躯体感觉皮质、躯体运动皮质和锥体外系诸结构的GFAP阳性?     

Intraductal biliary and pancreatic endoscopy： An expanding scope of possibility

Intraductal endoscopy describes the use of an endoscope to directly visualize the biliary and pancreatic ducts. For many years, technological challenges have made performing these procedures difficult. The “mother-baby” system and other various miniscopes have been developed, but routine use has been hampered due to complex setup, scope fragility and the time consuming, technically demanding nature of the procedure. Recently, the SpyGlass peroral cholangiopancreatoscopy system has shown early success at providing diagnostic information and therapeutic options. The clinical utility of intraductal endoscopy is broad. It allows better differentiation between benign and malignant processes by allowing direct visualization and targeted sampling of tissue. Therapeutic interventions, such as electrohydraulic lithotripsy （EHL）, laser lithotripsy, photodynamic therapy, and argon plasma coagulation （APC）, may also be performed as part of intraductal endoscopy. Intraductal endoscopy significantly increases the diagnostic and therapeutic yield of standard endoscopic retrograde cholangiography （ERCP）, and as technology progresses, it is likely that its utilization will only increase. In this review of intraductal endoscopy, we describe in detail the various endoscopic platforms and their diagnostic and clinical applications.     

Dorsal medulla oblongata stroke after a wasp sting

INTRODUCTION: Although wasp stings can cause local reactions such as pain, flare, edema, swelling and severe reactions, including anaphylaxis; neurological vascular complications are rare. CASE REPORT: We report a case of a 36-year-old male who developed focal neurological symptoms after a wasp sting. The brain MRI showed an infarct in the left dorsal medulla. The blood test has showed an elevated level of venom-specific IgE antibodies and the skin test with wasp venom was highly positive. Improvement occurred rapidly after treatment with methylprednisone. The postulated mechanisms include vasoconstriction and platelet aggregation secondary to an injection of distinct allergens contained in wasp venom. CONCLUSION: It would thus be important to ask patients about any recent wasp sting, in order to provide appropriate treatment.     

临床医护人员健康促进生活形态及其相关因素分析

目的了解临床医护人员的健康促进生活形态,分析其健康概念、健康行为自我效能及自觉健康状态等变数与健康促进生活形态的相关性。方法以某市级医院282位医护人员为调查对象,采用自填式结构性问卷进行资料收集、分析。结果临床医生和护士在健康促进生活形态中得分最低的皆为运动保健方面,医生组得分较高的项目大多为自我实现方面,护理组则在职场安全方面得分较高。两组人员在健康概念、健康行为自我效能及自觉健康状况与健康促进生活形态有显著相关,其中以健康行为自我效能的相关最强。结论临床医护人员的健康促进生活的意愿有待加强,以期提高生活与工作的质量。     

带蒂骨膜瓣移植修复负重区关节软骨缺损的实验研究

为探讨带蒂骨膜瓣再生软骨的机理及修复负重区关节软骨缺损的可行性,在兔右股骨内髁造成全层软骨缺损,实验组用逆运脉血流方向切取的带蒂骨膜瓣,对照组用游离骨膜移植修补。分别于术后2、4、8、12周处死实验动物,作肉眼及组织学观察。结果显示,带蒂骨膜瓣的再生软骨能力优于游离骨膜,更适宜于修复负重区关节软骨缺损。     

Retropharyngeal Ganglioneuroma: A Case Report

Ganglioneuromas are uncommon, benign, and highly differentiated tumors arising from sympathetic ganglia. Common sites for these tumors include the paraspinal region of the retroperitoneum and posterior mediastinum. We report a case of a retropharyngeal ganglioneuroma, a rare occurrence, emphasizing its key imaging characteristics.     

Nd:YAG激光消毒用于慢性根尖周炎一次性根管治疗

目的 :探讨一定剂量的脉冲Nd :YAG激光根管消毒一次性治疗慢性根尖周炎的临床可靠性和优越性。方法 :收集无症状的慢性根尖周炎患者 12 4例 13 7牙 ,常规根管预备后按根管消毒方式随机分为 3组 :激光组以 2W或 1.5W 2 0Hz 5s× 4剂量根管内照射 ;碘伏组以 5g/L的碘伏液冲洗 ;FC组封FC药。然后前 2组即刻根充 ,一次性完成治疗 ;后 1组封药复诊 ,无症状后同法完成。 3组根充后 2 4h、1、12、2 4周分期随访 ,记录自发痛、叩痛 ,2 4周拍X线牙片行根尖周指数 (PAI)评分。综合评价 3组临床疗效。结果 :根充后 2 4h内 3组自发痛发生率及其程度无显著差异 ,但有窦道者发生率明显低且程度轻 ;叩痛发生率 3组在 1、12周无显著性差异 ,而 2 4周时激光组显著低于FC组。结论 :激光用于根管消毒一次性治疗慢性根尖周炎 ,疗效优于FC组 ,且可缩短疗程 ,具有较好的临床应用前景     

Thermodynamic Origin of the Vitreous Transition

The vitreous transition is characterized by a freezing of atomic degrees of freedom at a temperature T_g depending on the heating and cooling rates. A kinetic origin is generally attributed to this phenomenon instead of a thermodynamic one which we develop here. Completed homogeneous nucleation laws reflecting the energy saving due to Fermi energy equalization of nascent crystals and their melt are used. They are applied to bulk metallic glasses and extended to inorganic glasses and polymers. A transition T*_g among various T_g corresponds to a crystal homogeneous nucleation temperature, leading to a preliminary formation of a cluster distribution during the relaxation time preceding the long steady-state nucleation time of crystals in small samples. The thermally-activated energy barrier ΔG*_2ls/k_BT at T*_g for homogeneous nucleation is nearly the same in all glass-forming melts and determined by similar values of viscosity and a thermally-activated diffusion barrier from melt to cluster. The glass transition T*_g is a material constant and a linear function of the energy saving associated with charge transfers from nascent clusters to the melt. The vitreous transition and the melting temperatures alone are used to predict the free-volume disappearance temperature equal to the Vogel-Fulcher-Tammann temperature of fragile glass-forming melts, in agreement with many viscosity measurements. The reversible thermodynamic vitreous transition is determined by the disappearance temperature T*_g of the fully-relaxed enthalpy H_r that is not time dependent; the observed specific heat jump at T*_g is equal to the proportionality coefficient of H_r with (T*_g − T_a) for T ≤ T*_g as expected from the enthalpy excess stored by a quenched undercooled melt at the annealing temperature T_a and relaxed towards an equilibrium vitreous state. However, the heat flux measurements found in literature over the last 50 years only gave an out-of-equilibrium T_g since the enthalpy is continuous at T*_g without visible heat jump.     

急性心肌梗死后延迟冠状动脉介入术的临床分析

目的　探讨急性心肌梗死(AMI)后延迟经皮冠状动脉腔内成形术及支架术治疗的临床疗效。方法　将88例患者分为经皮冠状动脉介入治疗(PCI)和非PCI组,PCI组于发病后平均13d行PCI术。随访两组患者的心脏事件发生率。结果　与非PCI组相比,PCI组患者在不稳定型心绞痛发作,左室射血分数的提高及复合终点事件方面差异有显著性。结论　AMI后延迟PCI可减少患者的心脏事件发生。