CT图像和重组技术在骶椎临床影像解剖学研究中的应用

目的 观察骶椎的解剖形态及其与耻骨联合的位置关系,为骶椎正位X线摄影体位的优化设计提供解剖学依据。 方法 回顾性随机收集1000例患者骨盆腔CT影像,借助CT图像重组技术观测骶椎的解剖形态及其与耻骨联合的相对位置关系。 结果 骶椎均为前面凹陷、底朝上、尖向下后方走行,骶椎上下端中点连线M与人躯体长轴之间的夹角A均为锐角,耻骨联合位于骶椎的前正中偏下位置,其与骶椎下缘的连线N和躯体长轴垂线间夹角B>0 °（即耻骨联合上缘低于骶椎下缘的位置）占89.7%（897/1000);青少年组（14~45岁）角A为（35.86±6.88）°,明显低于中年组（46~69岁）（37.82±6.34）°和老年组（>69岁）（37.60±6.65）°（P<0.05）,青少年组角B为（10.27±7.02）°,明显高于中年组（8.88±7.23）°和老年组（7.83±6.93）°（P<0.05）,而中年组和老年组间差异均无统计学意义;男性角A（36.12±0.27）°和角B（6.27±0.25）°,均明显低于女性（38.03±0.33）°和（12.79±0.33）°（P<0.05）。 结论 CT图像重组技术可用于观察和分析骶椎的解剖形态及其与耻骨联合的位置关系,不同年龄段和不同性别者骶椎与耻骨联合的相对位置情况差异显著,可为骶椎正位X线摄影检查体位的优化设计提供可靠的解剖学依据。     

年龄相关性的L4椎板腰部与下关节突尖端距离比值变化的研究

目的　研究腰椎椎板、小关节形态随着年龄变化的规律。 方法　选取300例无腰椎疾患的正常人为研究对象,行腰椎正侧位X线检查。将研究对象根据年龄分为6个组：（组 I:＜30岁, 组 II: 31~40岁, 组 III:41~50 岁, 组 IV: 51~60 岁, 组 V: 61~70岁, 组 VI:＞70岁）。测量L4椎板腰部（a）与腰4下关节突尖端之间的距离（b）的比值。 结果　a/b的比值在6个年龄组分别为0.825±0.101、0.836±0.088、0.840±0.098、0.858±0.084、0.878±0.091、0.890±0.119。伴随着年龄的增长其呈现逐渐增大的趋势。大于70岁组比值最大,与组I到组IV存在统计学差异。 结论　伴随着年龄的增长,椎板腰部的距离与下关节突尖端之间的距离比值逐渐增大,这意味着椎管横径逐渐狭窄、小关节更偏向于矢状位,发生退行性滑脱的可能性较大。     

经颅多普勒超声对男女性脑血管弹性比较分析

目的探讨正常人群中相同年龄阶段的男性与女性脑血管弹性的差异。方法对1 588例体检者进行经颅多普勒超声（TCD）检查,将所有受检者按年龄分为31~40岁、41~50岁、51~60岁三个组,检测颅内主要血管搏动指数、血流速度、频谱形态、血流声频及血流方向等指标的变化,根据各指标评价受检者脑血管弹性情况。结果三个年龄段脑血管弹性减退例数女性组均较男性组有不同程度的增多,各年龄段间脑血管弹性减退发生率比较有显著性差异（P〈0.05）。结论通过经颅多普勒超声检查检测证实相同年龄阶段脑血管弹性减退发生率女性较男性显著增高,在相同年龄段中女性脑血管弹性比男性差。     

颈椎钩突相关夹角增龄变化的特征与意义

背景:钩椎关节作为颈椎所特有的结构,其发生、发展和发育直接影响着颈椎的稳定性和活动度,也与颈椎病的发病密切相关,深入了解钩椎关节的发育特点对颈椎病的发病类型、诊断与治疗有着重要意义。目的:利用影像学和三维重建技术对不同年龄段的颈椎钩突相关夹角进行大样本测量和观察,旨在揭示其随年龄和椎骨增长变化的特点,以及与颈椎稳定性之间的关系。方法:采用回顾性设计,将收集到的符合研究要求的1447例完整颈椎节段CT影像学资料的原始数据以DICOM格式导入Mimics 21.0软件进行后处理,并进行钩突夹角、钩突矢状位角测量,按照性别、年龄、侧别分组。结果与结论:①钩突夹角随椎序的增加呈V字形增长,其最低峰值位于C5处;总体随年龄的增长呈尖峰状,其峰值多介于30-39岁年龄范围内;②钩突矢状位角随椎序的增加呈鱼钩样增长、总体随年龄的递增也呈尖峰状,其峰值多介于20-29岁年龄范围内;钩突夹角与钩突矢状位角在侧别和性别间仅部分存在显著性差异(P<0.05);③提示钩突夹角随椎序递增呈V字形增长;钩突矢状位角随椎序递增鱼钩样增长,而2个夹角随年龄的增长总体呈尖峰状,钩突夹角在131°左右,可能与颈椎的稳定性密切相关;而钩突矢状位角在14°左右,可能对限制颈椎过度旋转有一定作用。     

创伤性膝关节挛缩应用物理因子联合运动疗法治疗的临床效果

目的探讨物理因子联合运动疗法治疗创伤性膝关节挛缩的临床疗效。方法选择2015年1月至2016年11月在安徽医科大学第二附属医院康复医学科就诊的以创伤性膝关节挛缩为第一诊断的患者45例,其中男性22例,女性23例;年龄11~61岁。随机分为治疗组和对照组。治疗组22例,其中男性10例,女性12例;年龄20~59岁,平均年龄38.90岁。对照组23例,其中男性12例,女性11例;年龄11~61岁,平均年龄32.74岁。均按照膝关节挛缩的治疗方案正规治疗,对照组行常规康复治疗(主要包括微波治疗、石蜡疗法、关节松动术、冷疗等),治疗组在此基础上同时行主被动运动疗法。比较两组患者治疗前后膝关节活动度和膝关节疗效评分有无差异,其中膝关节活动度以膝关节屈曲角度(°)表示,膝关节疗效评分以百分制(分)计。结果两组患者治疗前关节活动度(治疗组32.254 60°±11.401 41°,对照组33.386 70°±9.848 50°)差异无统计学意义(P0.05);两组治疗后膝关节活动度(治疗组127.850 00°±13.554 78°,对照组97.562 50°±26.131 45°)与治疗前膝关节活动度比较,差异均有统计学意义(P0.05);治疗组和对照组治疗后膝关节活动度差异有统计学意义(P0.05)。两组患者治疗前膝关节疗效评分(治疗组34.545 50分±7.288 13分,对照组34.391 30分±7.709 14分)差异无统计学意义(P0.05);两组患者治疗后膝关节疗效评分(治疗组87.636 40分±6.945 68分,对照组77.695 70分±5.611 96分)与治疗前膝关节疗效评分比较,差异均有统计学意义(P0.05)。治疗组和对照组治疗后膝关节疗效评分差异有统计学意义(P0.05)。结论物理因子联合运动疗法治疗可有效提高膝关节挛缩患者的膝关节活动度,提高膝关节疗效评分,改善膝关节功能。     

100例肺癌纤维支气管镜检查结果分析

1.1 性别、年龄 100例中,年龄最小29岁,最大78岁、男性82例,女性18例,患病年龄多在41～70岁之间,其中51～60岁较多。男性明显高于女性,与文献中肺癌发病率年龄相符。 1.2 临床表现 本病的一般临床表现有不同程度的症状,其中以刺激性咳嗽、胸痛、气促、咯血痰者居多,其次发热、消瘦、声音嘶哑、关节痛、     

零切迹颈椎椎间融合器解剖学参数测量

目的　通过测量正常国人的颈椎椎间隙解剖学参数，为设计符合国人的颈椎前路零切迹椎间融合器提供理论依据。 方法　纳入200例健康志愿者，在标准颈椎正侧位X线片上测量颈C2~3、C3~4、C4~5、C5~6、C6~7椎间隙的前缘、中点、后缘高度，椎间隙横径，椎间隙矢状径，螺钉进钉的最佳角度和深度，椎间盘角。分别计算各解剖参数的均值和标准差。 结果　纳入男性志愿者100人，平均年龄31.21岁，女性志愿者100人，平均年龄31.05岁。男性组椎间隙横径为（19.88±1.06）mm，矢状径（19.42±1.59）mm，前缘高度（5.57±0.74）mm，中点高度（7.24±0.98）mm，后缘高度（4.11±0.27）mm；上位螺钉进钉的最佳深度为（33.54±1.14）mm，下位螺钉进钉的最佳深度（24.35±1.53）mm；上位螺钉进钉的最佳角度为（41.10±2.86）°，下位螺钉进钉的最佳角度为（47.13±3.17）°；椎间盘角为（4.94±1.36）°。女性组椎间隙横径为（18.29±0.89）mm，矢状径（13.76±1.41）mm，前缘高度（5.12±0.64）mm，中点高度（6.68±0.67）mm，后缘高度（3.20±0.25）mm；上位螺钉进钉的最佳深度为（25.18±1.75）mm，下位螺钉进钉的最佳深度为（21.83±1.66）mm；上位螺钉进钉的最佳角度为（41.66±2.70）°，下位螺钉进钉的最佳角度为（47.03±2.43）°；椎间盘角为（4.80±1.38）°。男性组与女性组各参数对比，差异无统计学意义（P>0.05）。同节段椎间隙前、中、后缘高度均存在统计学差异，表现为后缘高度<前缘高度<中点高度（P<0.05）。 结论　通过正常人群颈椎X线解剖学测量，可获得设计零切迹颈椎椎间融合器的国人数据。     

胰腺钩突的横断面解剖与CT研究

目的：为临床影像诊断胰腺钩突病变提供实用的形态学依据。方法：采用30例成人腹部连续横断层标本和30例健康成人腹部CT图像，观测胰腺钩突所在平面与脊柱的对应关系。选取钩突所在的4个连续横断面，观测各层面中钩突的断面形态、毗邻及有关径值。结果：在脊柱L2层面内胰腺钩突可100％显示；肠系膜上动、静脉和下腔静脉分别居胰腺钩突的左、前、后方，可作为各层面识别钩突的标志结构；钩突依据断面形态可分为钩形、角形、圆形3型，在断面标本及CT图像各层面中均以钩形多见（分别为61.67％；58．33％）。结论：通过对胰腺钩突横断面标本及其CT测值的对照研究，显示两者间无显著差异；在肾门下份及胰头下份层面，钩突前后径与同层面胰头前后径之间有相关关系（P〈0．05）。     

不同性别和年龄健康成年人足趾皮肤温度和血流灌注量的测定分析

目的:测定不同性别和年龄健康成年人足趾皮肤温度和加热前后微血管血流灌注量的变化。方法:选择51例健康成年人(31～83岁)。分别按性别不同分为:男性组(n=25),女性组(n=26),以及按年龄不同分为:31～40岁组(n=11)、41～50岁组(n=9)、51～60岁组(n=6)、61～70岁组(n=10)、≥71岁组(n=15)后,用激光多普勒血流仪(LDF)检测各组左足趾皮肤温度、基础血流灌注量(PU0)、加热至44℃时的血流灌注量(PU)以及加热后血流灌注量与基础血流灌注量的比值(加热后比值),比较不同性别组和年龄组上述指标测定值的差异,分析年龄与加热前后血流灌注量的相关性。结果:(1)不同性别的足趾皮肤温度、PU0、PU、加热后比值均无显著性差异(P>0.05),但PU明显高于PU0(P<0.01)。(2)不同年龄组足趾皮肤温度、PU0及PU的比较均无显著性差异(P>0.05);不同年龄组之间加热后比值随年龄增长呈下降趋势。统计学分析结果显示:61～70岁组以及≥71岁组加热后比值明显低于31～40岁组(P<0.01);≥71岁组加热后比值明显低于41～50岁组(P<0.05)。(3)年龄与足趾皮肤温度、PU0及PU之间均无显著相关性(P>0.05);年龄与加热后比值呈负相关(r=-0.419,P<0.05)。结论:不同性别健康成年人足趾皮肤温度和血流灌注量无明显差异,随着年龄增加,足趾皮肤微血管反应性明显降低,血流储备能力下降。     

四川遂宁地区8892例就诊者高危型HPV-DNA检测结果分析

目的分析了解人乳头瘤病毒(Human papilloma virus,HPV),尤其是高危型HPV的感染情况及临床意义。方法采用PCR-荧光法进行高危型HPV检测,2014年1月1日~2015年7月23日遂宁市中心医院对8892例就诊者(其中男性121例,女性8771例)进行了高危型HPV DNA检测。结果高危型HPV阳性1470例,阳性率为16.53%,其中男性60例,阳性率为49.59%(60/121),女性1410例,阳性率为16.08%(1410/8771)。高危型HPV检测感染年龄分布情况:10~20岁占2.11%;21~30岁占16.94%;31~40岁占31.02%;41~50岁占33.54%;51~60岁占7.90%;61~70岁占2.59%;71~80岁占0.68%;年龄不详者78例,占5.31%。结论定期HPV DNA检测,尤其是检测高危型HPV感染非常重要,可以预测发生宫颈癌的风险。     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.     

The universal muscular chamber. A basic unit of the genitourinary, cardiovascular, gastro-intestinal, skeletal, cutaneous, respiratory and other systems, endocameral hypertension; and spasm, the key to their idiopathic diseases and arthropathies

Starting with the integument, we see many organs are contractile sacs or multiples thereof, which tubes or bags constitute the major part of the entire body. Recognition of this basic unit and its characteristics sheds new light, individually and collectively, on many disorders previously considered unrelated. Muscular tears and perforations develop in the walls of these chambers, being no way peculiar to those organs, wherein, hydrochloric acid occurs. So, it is not necessary to explain the absence of excessive acid from patients who exhibit holes in the gastric, uterine, aortic, duodenal, rectal, pulmonary, retina, and other walls. Muscle, not acid is the great common factor relating idiopathic disorders in the gastrointestinal tract to each other and to similar diseases in other systems. When the units are linked together, the lesions tend to appear as arthropathies, i.e. at the joints. Rephrasing common-place observations, frees us from conventional, conceptual cul-de-sacs. An observation is only as good as its interpretation, so all possibilities must be considered, otherwise, we will remain blinded by our misconceptions.     

Der Einfluß von Nahrungsmitteln und Rauchen auf die klinisch-chemische Diagnostik von Phäochromozytom,Neuroblastom und Karzinoid-Syndrom

Zusammenfassung Der Einfluß von verschiedenen Nahrungsmitteln auf Methoden zur Bestimmung von Adrenalin (AD), Noradrenalin (NA), Vanillinmandelsäure (VMS), Metanephrinen (MN), Homovanillinsäure (HVS) und 5-Hydroxyindolessigsäure (5-HIE) im 24 h-Harn zur Diagnose des Phäochromozytoms bzw. Karzinoid-Syndroms wurde untersucht. Die in die Untersuchung einbezogenen Nahrungsmittel waren: Tee, Kaffee, Mandeln, Ananas, Käse, Walnüsse, Vanillepudding, Bananen, Tomaten und Milchschokolade. Außerdem wurde der Einfluß des Zigarettenrauchens auf die Bestimmung von AD, NA, VMS und MN untersucht.Walnüsse führten zu einer starken Erhöhung der 5-HIE-Ausscheidung. Bananen erhöhten die Ausscheidung von AD, NA, VMS, MN und 5-HIE. Kaffee und Ananas bewirkten eine geringe Zunahme der MN-Werte. Rauchen von 20–30 Zigaretten/Tag beeinflußte keine der vier Variablen.Wenn die beschriebenen Methoden benutzt werden, sollte lediglich auf den Verzehr von Bananen und Walnüssen vor und während der Harnsammelperioden verzichtet werden, da die oberen Normgrenzen im Harn überschritten werden könnten. Ein Verzicht auf Kaffee und Ananas in normalen Mengen ist nicht erforderlich. Es besteht kein Anlaß, weiterhin die bisherigen umfangreichen Restriktionen der übrigen Nahrungsmittel beizubehalten.