不同年龄段心电图异常患者临床特点对比

目的比较不同年龄段心电图异常患者的临床特点。方法选择我院体检者887例作为研究对象,按年龄层次分为青中年组、老年组和高龄组。均接受心电图检查,并对结果进行归纳总结。结果青中年组心电图检查异常率为27.75%,老年组为44.91%,高龄组为81.36%,差异具有统计学意义(P0.05)。结论随着年龄的增长,心电图异常率增加,临床应加强排查。     

Duchenne型肌营养不良症肌细胞膜异常的研究

本文应用凝集素免疫电镜和冷冻断裂电镜技术，通过对6例DMD患者组和4例健康对照组骨骼肌细胞膜的观察，发现RCA-I和WGA凝集素受体主要分布在肌质膜上，DMD患者有40％左右的肌质膜存在局限性的受体分布缺损区，并且DMD肌质膜的PF面和EF面上的膜蛋白颗粒还明显减少，从分子病理学水平证实了DMD存在肌细胞膜的异常。     

Classical and Follicular Variant Papillary Thyroid Carcinoma: Comparison of Clinical,Ultrasonographical, Cytological,and Histopathological Features in 444 Patients

Follicular variant papillary thyroid carcinoma (FVPTC) is the most common variant of papillary thyroid carcinoma (PTC) after classical PTC (CPTC). In this study, we aimed to compare functional status, ultrasonographical features, cytological results, and histopathological characteristics of patients with CPTC and FVPTC. Preoperative thyroid functions, thyroid autoantibodies, ultrasonographical features, cytology, and histopathology results of 354 (79.9%) CPTC and 90 (20.3%) FVPTC patients were reviewed retrospectively. Sex distribution, mean age, thyroid autoantibody positivity, and thyroid dysfunctions were similar in two groups. Among 320 patients with preoperative ultrasonography (US) findings, a hypoechoic halo was observed more frequently (p = 0.003), and marginal irregularity was observed less commonly (p = 0.024) in FVPTC lesions. In CPTC, rate of malignant cytology (p = 0.001), and in FVPTC, rate of suspicious cytology (p < 0.001) were significantly higher. Histopathologically, mean tumor diameter was markedly higher in FVPTC compared to CPTC (16.89 ± 13.86 vs 10.64 ± 9.70 mm, p < 0.001), while capsular invasion and extrathyroidal spread were significantly lower in patients with FVPTC (p = 0.018 and p = 0.039, respectively). FVPTC tend to have more benign features in US and less malignant results in cytology. Higher tumor size in FVPTC might be explained by the recognition of clinical importance of these lesions after reaching particular sizes due to benign US features.     

血液系统恶性疾病中MLL基因异常的生物学和临床研究进展

MLL基因定位于染色体11q23，是人类急性白血病染色体易位中常见的一种。MLL基因大约能和30多种不同的伙伴基因融合，形成的融合基因编码产生新的融合蛋白。MLL基因异常多见于淋巴系白血病、髓系白血病以及双表型白血病的患者，同时在婴幼儿患者和拓扑异构酶Ⅱ抑制剂引起的继发急性髓系白血病患者中也常常见到，这些患者预后多数不良。     

Clinical and Laboratory Features of the Catastrophic Antiphospholipid Syndrome

Catastrophic antiphospholipid syndrome (CAPS, Asherson’s syndrome) is an unusual form of antiphospholipid syndrome (APS) characterized by multi-organ failure and high mortality. Fortunately, CAPS accounts for less than 1% of APS cases. Due to the rarity of the condition, an international registry of CAPS patients was created in 2000 supported by the European Forum on Antiphospholipid Antibodies held in Taormina, Italy at the Tenth International Congress on Antiphospholipid Antibodies. Clinical and laboratory features are the most important in the criteria for the diagnosis of this syndrome and can affect many organ systems. The majority of patients presented with multiple organ involvement at the time of CAPS. The combination of pulmonary, cardiac, and renal involvement was most commonly seen. The organ systems most commonly involved at the onset include the cardiopulmonary system, primarily characterized by dyspnea and respiratory failure, the central nervous system, and the renal system. Laboratory criteria for the classification of CAPS include the presence of antiphospholipid antibodies—LA and/or aCL and/or β₂-GPI antibodies.     

酒依赖的临床特点与治疗

目的探讨酒依赖的临床特点与国内外治疗现状,以便更好进行防治。方法采用文献检索方法,在近10年内检出相关论文40余篇,进行阅读和整理。结果酒依赖者的特点包括精神依赖性、躯体依赖性、戒断综合征及耐受性 心理治疗和药物治疗酒依赖有效。结论心理和药物联合治疗能取得较好效果。     

环甲膜前部的测量及其临床意义

本文观测了40例成人尸体环甲膜前部的高度、上下宽度和血管分布：（1）环甲膜前部的高度和上、下宽度，男性分别为11．4±1.8mm、11．2±1．2mm和4．8±1．6mm；女性分别为9．6±1．7mm、9.9±1.9mm和3．7±1．1mm。男性各值均大于女性（P＜0．05）。（2）环甲动脉起自甲状腺上动脉前支，行至环甲膜前部上1／3者占94％。建议：（1）环甲膜切开术选用气管套管外径男性不应大于10mm，女性不应大于9mm；（2）横行切开环甲膜应在此膜的下份靠近环状软骨进行，以免损伤环甲动脉。     

单双相抑郁障碍住院患者临床特点比较

目的探讨双相抑郁和复发性抑郁住院患者的临床特征及相关因素。方法回顾性分析1999年到2001年我院诊断情感障碍住院病人506例,比较双相抑郁107例和复发性抑郁399例人口学资料、病程、诊断及疗效等变量。结果复发性抑郁组女性比例高于双相抑郁组(268/399比54/107,χ2=10.17,P<0.01);复发性抑郁组以往多次抑郁发作史低于双相抑郁组(41.4%/57%,χ2=8.4,P<0.01),病程短于双相抑郁组(58.8±4.5/96.3±9.6,t=-3.77,P<0.01),首次抑郁年龄大于双相抑郁组(41.7±0.8/29.4±1.4,t=6.95,P<0.01),首次抗抑郁治疗有效率大于双相抑郁组(81.3%/57%,χ2=95.2,P<0.01),复发抑郁组同一次病程首次诊断符合率高于双相抑郁组(97%/31.8%,χ2=324.4,P<0.01),双相抑郁组中61.7%(66/107)首次诊断为抑郁起病年龄20岁左右者发生双相抑郁概率明显大于60岁以后起病者(OR=2.45)。病程5年以上发生双相抑郁概率大于病程短于1年者(OR=2.75),首次抗抑郁疗效差出现双相抑郁概率大于首次抗抑郁疗效好者(OR=3.18)。双相抑郁组同一次病程61.7%首次诊断抑郁障碍。结论首发抑郁的年龄、病程、首次抗抑郁效果与出现双相抑郁的概率有关。首发抑郁年龄越早,病程越长,首次抗抑郁疗效越差,发生双相抑郁概率越大。2/3双相抑郁首次诊断复发性抑郁。     

鼻腔解剖结构异常致非炎症鼻源性头痛临床疗效观察

目的：探讨鼻腔解剖结构异常所致非炎症鼻源性头痛的病因及合理的治疗措施。方法：对56例非炎症鼻源性头痛患者,采用高分辨率CT检查,结合鼻内镜技术,对鼻腔解剖结构异常进行分析,明确病因后应用鼻内镜微创技术,对鼻腔解剖结构异常部位进行手术矫正。结果：56例中,治愈39例、有效11例、无效6例。结论：CT结合鼻内镜技术可提高非炎症鼻源性头痛患者的诊断率,通过鼻内镜微创手术,针对不同鼻腔解剖结构异常进行相应的处理,可使非炎症鼻源性头痛患者获得良好的治疗效果。     

Ultrastructural Features of Retinal Capillary Basement Membrane Thickening in Diabetic Swine

Purpose: To assess retinal capillary basement membrane thickening (BMT) in a swine model of type 1 diabetes. Materials and methods: Yorkshire pigs were rendered diabetic with streptozotocin and dyslipidemic with a high fat and cholesterol diet. At 18, 26, and 32 weeks of diabetes, the retina sections within 3 disc diameters from the optic disc were examined under transmission electron microscopy to evaluate the ultrastructural features of the capillary BM. Digital morphometric analysis was performed to measure BMT. Results: Diabetic swine had significantly thicker retinal capillary BMs compared to controls. Pigs that sustained diabetes for longer periods or experienced severe diabetes tended to have more BMT. Those pigs that did not sustain glucose levels above 200?mg/dL did not demonstrate thicker retinal capillary BMs. Characteristic ultrastructural features of diabetic vasculopathy observed included rarefaction as an early stage of Swiss cheese cavitation, lamellation with multiplication of electron dense layers, and fibrillar materials within capillary BM. Conclusions: Diabetic Yorkshire pigs develop characteristic features of an early retinal microvasculopathy fairly rapidly and may serve as a higher-order animal model for studies of type 1 diabetes.     

鼓膜穿孔与鼓膜修补材料的有限元分析及临床研究进展

鼓膜穿孔是耳鼻咽喉科常见的疾病之一,造成鼓膜穿孔的原因主要有中耳炎及外伤等。 随着有限元分析方 法的快速发展,该方法被应用于鼓膜穿孔及修补材料的临床研究中。 通过建立中耳有限元模型,从生物力学角度 分析鼓膜穿孔及常用鼓膜修补材料的特点,并与临床应用结果相结合。 对近年来鼓膜穿孔及其修补材料的有限元 分析及临床研究进展进行总结。     

Clinical and Prognostic Features of Erionite-Induced Malignant Mesothelioma

This review analytically examines the published data for erionite-related malignant pleural mesothelioma (E-MPM) and any data to support a genetically predisposed mechanism to erionite fiber carcinogenesis. Adult patients of age ≥18 years with erionite-related pleural diseases and genetically predisposed mechanisms to erionite carcinogenesis were included, while exclusion criteria included asbestos- or tremolite-related pleural diseases. The search was limited to human studies though not limited to a specific timeframe. A total of 33 studies (31042 patients) including 22 retrospective studies, 6 prospective studies, and 5 case reports were reviewed. E-MPM developed in some subjects with high exposures to erionite, though not all. Chest CT was more reliable in detecting various pleural changes in E-MPM than chest X-ray, and pleural effusion was the most common finding in E-MPM cases, by both tests. Bronchoalveolar lavage remains a reliable and relatively less invasive technique. Chemotherapy with cisplatin and mitomycin can be administered either alone or following surgery. Erionite has been the culprit of numerous malignant mesothelioma cases in Europe and even in North America. Erionite has a higher degree of carcinogenicity with possible genetic transmission of erionite susceptibility in an autosomal dominant fashion. Therapeutic management for E-MPM remains very limited, and cure of the disease is extremely rare.     

自杀未遂者社会心理因素和临床特点对照研究

目的：了解自杀未遂者的社会心理因素及临床特点。方法：本研究对７６名自杀未遂者进行了调查,对其中部分自杀未遂者进行了心理量表评定,并作出了精神病学诊断,以３１名正常人为对照。结果：１自杀未遂者中年轻女性多见;自杀方式绝大多数为服药或服毒;自杀未遂者中一半患精神障碍。２自杀未遂者早年与父母分离比例较高,自杀未遂者早年得到父母情感温暖与理解明显少于正常对照。３自杀未遂者具有焦虑、病态人格和疑心等性格特点。４自杀未遂者的个体素质因素是自杀未遂发生的主要原因。