痉挛性斜颈病人行斜颈三联术后监护

痉挛性斜颈（spasmodic torticollis．ST）是一种累及颈部肌肉的肌张力障碍性疾病，是指颈肌受到中枢神经异常冲动造成不可控制的痉挛或阵挛，从而使头颈部向一侧痉挛性倾斜扭转，致使出现多动症状和姿势异常。斜颈三联术治疗痉挛性斜颈是由陈信康教授1994年提出并施行的手术，其组成包括：颈脊神经1-6后支切断，颈部副神经切断及肌切断。由于斜颈三联术的特殊要求，术后监护护理上有一定的特殊性，现对我院近2年行斜颈三联术的50例病人监护总结如下：     

痉挛性斜颈的外科治疗

痉挛性斜颈(spasmodic torticollis)是一种累及颈部肌肉的肌张力障碍性疾病,好发于成年人.1792年Wepter最先报道了此病.据流行病学调查,其患病率约为9/10万[1],每年新发病人数约为10.9/100万[2],是成年人中最常见的肌张力障碍.有10%～20%的患者可以出现症状自然缓解,但是几乎所有患者都在5年内复发.由于其病因至今没有研究清楚,相应的治疗方案也是众说不一.下面根据目前国内外文献的报道,将痉挛性斜颈的外科治疗做一综述.     

痉挛性斜颈的外科治疗

痉挛性斜颈（spasmodic tortieollis）是一种累及颈部肌肉的肌张力障碍性疾病，好发于成年人。1792年Wepter最先报道了此病。据流行病学调查，其患病率约为9／10万，每年新发病人数约为10．9/100万，是成年人中最常见的肌张力障碍。有10％-20％的患者可以出现症状自然缓解，但是几乎所有患者都在5年内复发。由于其病因至今没有研究清楚，相应的治疗方案也是众说不一。下面根据目前国内外文献的报道，将痉挛性斜颈的外科治疗做一综述。     

个体化手术“拧”正“歪脖子”

病因不明：情绪激动时易加重痉挛性斜颈是一种累及颈部区域的局限性肌张力障碍,表现为颈肌阵发性不自主收缩,引起头向一侧扭转或倾斜。据流行病学统计。其发病率约为9,100000,发病年龄以30～40岁较多,男女比例大致相当。患者表现为晨起轻,运动或情绪激动后加重。     

痉挛性斜颈病因及其诊断和治疗

痉挛性斜颈(spasmodic torticollis,ST)亦称为颈肌张力障碍(cervical dystonia),是常见的局限性肌张力障碍.根据Stacy[1]报道,ST的患病率大约是9/10万,其发病率与性别和年龄相关,女性的发病率通常是男性的1.5～1.9倍,发病的高峰年龄为50岁,70%～90%的患者在40～60岁发病.美国明尼苏达州罗斯切特市在1960-1979年的ST整体发病率为1.2/10万(95%可信区间为0.5～1.9),女性的发病率为男性的3.6倍,提示ST的病因和发病率存在地区差异性.     

先天性肌性斜颈手术 1～5岁最适宜

肌性斜颈,俗称歪脖儿,是指由于一侧胸锁乳突肌挛缩导致的颈部偏斜,头和颈不对称的畸形。先天性肌性斜颈80％发生于右侧,20％合并先天性髋关节脱位,是小儿矫行外科疾病中最常见的先天性畸形之一。     

假肥大型肌营养不良的临床诊断与防治

假肥大型肌营养不良的临床诊断与防治中国医科大学第二临床学院基础儿科潘晓丽假肥大型肌营养不良（Ｄｕｃｈｅｎｎｅｍｕｓｃｕｌａｒｄｙｓｔｒｏ－ｐｈｙ，ＤＭＤ）是儿科临床较常见的性连锁隐性遗传的致死性肌病，是进行性肌营养不良中最严重、最常见的一型。多为男性...     

斜颈的由来及矫正

斜颈是指头向一侧偏斜。根据发病原因不同可分为肌性、骨性、麻痹性及习惯性斜颈等。其中,肌性斜颈最为常见。 头的摇动和转向除与骨骼和关节有关外,尚与颈部的肌肉有关,在颈的两侧各有一条较粗的肌肉,一端附着在耳后的乳突上,另一端附着在颈前下方的胸锁骨连接处,取名为胸锁乳突肌。在正常情况下,     

发作性运动诱发性运动障碍12例视频脑电图及临床分析

发作性运动障碍（pamxyslmaldyskinesias，PD）是表现为发作性肌张力障碍、舞蹈样动作或舞动样动作、或在正常活动背景上发生的任何这些肌张力障碍性疾患。发作性运动诱发性运动障碍（paroxysmal kinesigenic movementdisorder，PKMD）是PD中最常见的类型，通常可分为发作性运动诱发性舞蹈手足徐动症（paroxysmal kinesigenicchoreoat hetosis，PKC）及发作性运动诱发性肌张力障碍（paroxysmal kinesigenic dystonia，PKD）两种类型。     

肌性斜頸的诊治

斜颈是指以头向患侧斜、前倾、旋向健侧和面部变形为特点的一种畸形。一般分为以下四类。①骨性斜颈由颈椎骨发育缺陷所致,如半椎体畸形;②代偿姿势性斜颈由斜视、听力障碍所致;③神经性斜颈颈部肌麻痹所致;④肌性斜颈一侧胸锁乳突肌纤维化和挛缩,失去了它原来的功能所致。临床上我们常见的是肌性斜颈。病因尚未完全清楚,一般认为有原发性(先天性)和继发性(后天性)两方面因     

医疗服务操作分类与编码的设计与应用简

医疗服务操作分类与编码是医学信息标准化的重要组成部分,是临床数据提取、分析和应用的基础。世界卫生组织及世界多国一直致力于开发、更新和维护此分类与编码。我国此前一直沿袭美国准备在2014年停止使用的ICD-9-CM-3（卷3）,中国需要结合国际主流设计思路,根据国情开发出适宜的多轴、一体化的医疗服务操作分类与编码体系。     

Adenocarcinoma of the stomach and esophagus and drinking water and dietary sources of nitrate and nitrite

We conducted a population-based case-control study of adenocarcinoma of the stomach and esophagus in Nebraska, U.S.A. Nitrate concentrations in public drinking water supplies were linked to residential water source histories. Among those using private wells at the time of the interview, we measured nitrate levels in water samples from wells. Dietary nitrate and nitrite were estimated from a food-frequency questionnaire. Among those who primarily used public water supplies (79 distal stomach, 84 esophagus, 321 controls), average nitrate levels were not associated with risk (highest versus lowest quartile: stomach OR=1.2, 95% CI [0.5-2.7]; esophagus OR=1.3, 95% CI [0.6-3.1]). We observed the highest ORs for distal stomach cancer among those with higher water nitrate ingestion and higher intake of processed meat compared with low intakes of both; however, the test for positive interaction was not significant (p=0.213). We did not observe this pattern for esophagus cancer. Increasing intake of nitrate and nitrite from animal sources was associated with elevated ORs for stomach cancer and with a significant positive trend in risk of esophagus cancer (P-trend=0.325 and 0.015, respectively). Larger studies with higher exposures to drinking water sources of nitrate are warranted to further evaluate N-nitroso compound precursors as risk factors for these cancers.     

Drinking water and dietary sources of nitrate and nitrite and risk of glioma

OBJECTIVE: Dietary nitrite has been associated with increased glioma risk; however, drinking water nitrate has not been extensively evaluated. METHODS: We conducted a population-based case-control study of adult glioma in Nebraska. Water utility nitrate measurements were linked to residential water source histories. We computed average nitrate exposure over a 20-year period. A food frequency questionnaire was used to assess dietary nitrate and nitrite. RESULTS: Increasing quartiles of the average nitrate level in drinking water were not significantly associated with risk (adjusted odd ratios: 1.4, 1.2, 1.3). Risk was similar among those with both higher and lower intakes of vitamin C, an inhibitor of N-nitroso compound formation. Dietary nitrite intake was not associated with risk. CONCLUSIONS: Our study does not support a role for drinking water and dietary sources of nitrate and nitrite in risk of adult glioma.     

黄体功能不健的调控机理

主要就引起卵巢黄体功能不健的因素 ,分别从激素调节、细胞因子 (VEGF、TNF α、BFGF、IFN γ、IGF)、C myc、Fas、SGP 2基因调控以及细胞连接、细胞粘附分子、NO等对卵巢功能的调节及对黄体细胞的凋亡影响进行阐述 ,认为卵泡发育不良、颗粒细胞、黄体细胞的凋亡与黄体功能不足有密切的关系。且多种细胞因子、基因表达产物参与此过程的调控。深入的研究这一调控机制 ,对于进一步了解卵巢卵泡生长发育、卵泡闭锁及黄体细胞凋亡的内在机制有重要意义     

浸润性和转移性膀胱癌的诊断和评价

一、膀胱癌的分级与分期 1.膀胱癌的组织学类型:尿路被覆的上皮统称为尿路上皮(urothelium).传统上将尿路上皮称为移行上皮(transitional epithelium).目前在文献和习惯上这两个名词常常被交替使用.膀胱癌的组织学类型包括尿路上皮癌、鳞状细胞癌和腺癌,其次还有较少见的转移性癌、小细胞癌和癌肉瘤等.     

Absorption and excretion of cholecalciferol and of 25-hydroxycholecalciferol and metabolites in birds

The absorption and excretion in vivo of cholecalciferol or 25-hydroxycholecalciferol (25-HCC) were determined in chicks (Gallus domesticus) and turkeys (Meleagris gallopavo). The overall net cholecalciferol or 25-HCC absorption in chicks and cholecalciferol in turkey poults was 66.5 +/- 3.3, 74.9 +/- 3.7 and 83.6 +/- 7.1% of the intake, respectively. The absorption of cholecalciferol or 25-HCC in chicks and turkeys occurred at the upper part of the intestine. 25-HCC, esters and non-polar metabolites of cholecalciferol or 25-HCC, and their polar metabolites, were secreted in the duodenum of chicks and turkeys but were partially reabsorbed at the upper part of the jejunum.     

环境中双酚A的污染及降解去除的研究进展

近10年来随着科学与社会的发展,环境雌激素污染日益引起人们的关注。双酚A是环境雌激素的一种,用途广泛,但具有多方面的毒性。对其毒理、污染及降解去除的研究已经成为国际上的研究热点。该文拟对上述几方面的研究进展情况作一简要介绍。