脑血管病诊断技术进展

近年来脑血管病诊断技术发展很快，有些高科技的先进技术如：PET（Positron Emission Tomography）（派特）正电子发射计算机断层扫描、64层多螺旋CT（siemens sensation）是当今影像诊断电子技术突破性高科技的发展水平代表，为便于推广普及应用临床；提高医疗技术水平和医疗质量，特此为大家作一些简介供参考。     

定制式人工全髋假体设计制造及临床应用

延长人工关节的有效使用寿命是人工关节研究的关键,而骨吸收和无菌性松动是影响其使用寿命的主要因素。由于人体的绝对个性化特点,标准人工假体与病人骨骼之间的误差使二者难以很好匹配,不能确保人工关节的长期稳定。同时,一些病人骨骼呈先天性畸形或由于骨骼病变造成骨与关节大面积损坏,其骨骼关节与正常情况明显不同,亦不可能选用标准人工假体。计算机辅助设计和制造(Com puter aided design/ Com puter aidedmanufacture,CAD/ CAM)通过对病人骨骼的三维重建,为每一位病人进行特殊设计和制造,提高了假体与病变骨骼的匹配度,提高了人工关节的长期稳定性,有效防止了关节松动。本文对CAD/ CAM定制式人工髋假体的优点、设计制造、临床应用及有待解决的问题进行了介绍     

加国学者研发出“骨骼打印机”人造骨粉转变成精密的骨骼组织

加拿大学者最近研发出“骨骼打印机”，利用类似喷墨打印机的技术，将人造骨粉转变成精密的骨骼组织。一般认为，此新科技会为骨骼移植手术带来重大革新。     

非影像医学专业开设断层解剖教学体会

上世纪70年代以来，随着医学科学技术的发展，超声成像、X线计算机断层扫描（CT）、磁共振MRI成像、发射型计算机断层扫描（ECT）、单光子发射体层成像（SPECT）和正电子发射体层成像（PET）等现代影像技术相继崛起并迅速应用于临床。虽然这些影像技术各有不同，但其形态学基础都是断层解剖学。因此，随着这些影像技术的快速发展和以临床应用为导向的基础医学改革，     

多层螺旋CT扫描三维重建后逐层显示解剖结构及临床意义

目的：探讨多层螺旋CT（MSCT）扫描后三维重建在临床手术中的应用价值。方法：回顾性对8例下肢、1例颈部扫描病人进行三维重建，CT机为GE公司Light Speed16螺旋CT，重建采用GE公司三维重建软件。重建后调整CT值域值逐层显示病人解剖结构。结果：9例病人在去除皮肤及皮下组织后均能清晰显示肌肉组织，增强扫描还能清晰显示肌肉与知名大血管的毗邻关系，在去除肌肉后能清晰显示骨骼结构，并能多方位观察，增强扫描能清晰观察血管与骨骼的解剖关系。结论：采用本技术可逐层显示人体各层解剖结构，如增强扫描还能显示血管与周围组织关系；可正确指导手术设计，防止术中大出血，减少对术区健康组织的损伤，还可进行手术模拟训练。     

血清CA15-3和超声、CT、MRI检查对乳腺癌诊断价值的比较

目的：探讨了三种非创伤性影像检查方法,超声（US）、X线计算机断层摄影技术（CT）和磁共振成像（MRI）及血清CA15-3水平在乳腺癌诊断中的敏感性和准确性,以提高对乳腺癌早期诊断的方法。方法：回顾分析,比较38例乳腺癌患者的US、CT和MRI及CA15-3的优缺点。结果：乳腺癌的确诊率US为76.3%,CT为84.2%,MRI为93.8%,CA15-3为68.4%。US对乳腺癌的早期检出率较高,但确诊率较低。CT和MRI对乳腺癌的确诊率较高,血清CA15-3的确诊率较低。结论：US、CT、MRI和血清CA15-3各有其优点,合理的综合应用可提高对乳腺癌的早期诊断。     

基于CT三维重建个体化股骨假体的计算机辅助设计(英文)

背景:由于人体的绝对个性化特点,标准人工假体与患者骨骼之间的误差使二者难以很好匹配。计算机辅助设计和制造个体化假体克服了其他假体的缺点,可有效地延长人工关节的使用寿命和使用质量,并可能解决人工关节的翻修问题。国内的研究尚处于起步阶段。目的:基于CT图像的三维重建,探求个体化股骨假体计算机辅助设计在提高假体与病变骨骼匹配度中的作用。方法:CT扫描对象为1例健康男性志愿者,排除髋关节疾患。采用GESpeedLight16排螺旋CT对股骨中上段进行层厚3mm扫描,得到CT数据的二维图像,利用自主开发的数据格式转换软件将CT图像转换为bmp格式。对位图编辑预处理,用Mimics8.1软件进行矢量化处理,提取股骨内外轮廓。然后输入Mimics8.1和Rapidform2004三维反求工程软件中,生成股骨内外轮廓的特征曲线,重建股骨三维模型。将股骨髓腔的特征轮廓曲线dxf文件输入计算机辅助设计建模软件Solidworks2004中,以此股骨髓腔轮廓为基础,完成个体化股骨假体的设计。结果与结论:利用自主开发的数据格式转换软件,实现了CT图像信息的矢量转换。以CT二维图像为依据,进行三维反求,可获得精确的股骨内外轮廓三维实体模型。采用反求工程与正向计算机辅助设计相结合,可设计出匹配良好的个体化股骨假体。提示反求工程和计算机辅助设计技术为个体化假体的研制提供了一个有效可行的途径,解决假体与病变骨骼的良好匹配,可防止假体松动,提高其长期稳定性。     

多媒体技术在内分泌临床教学中的应用

计算机辅助教学（Computer Assisted Instruction，CAI）是教师利用计算机对信息进行贮存、处理和多形态呈现的功能来支持自己教学的一种方式，其基于对根据一定教学目的、表现特定教学内容、反映一定教学策略的多媒体软件的应用。本文就多媒体技术在内分泌临床教学中的应用进行初步探讨。     

脑电地形图与显著性概率地形图在功能性疾病中的应用及其进展

脑电地形图（Brain Atlas，BA）是80年代问世的一项具有国际先进水平的临床医学，电子工程学和计算机学相结合的新兴科学。是继CT和MRI技术之后，又一成像技术的重大发展，是基于电子计算机分析生物电的一种新的诊断技术。它既可进行功能诊断，又可协助进行病理诊断，     

基于贝叶斯决策的髋关节自动分割方法

背景:基于CT图像的髋关节分割技术已广泛应用于计算机辅助手术规划、假体设计和有限元分析。目的:探讨基于贝叶斯决策的髋关节自动分割方法在计算机辅助髋关节手术中的应用效果。方法:针对髋关节序列CT图像中骨骼近端分割精度低,计算复杂度高,自动化程度低等问题,提出了一种自动分割算法,通过对比度增强、阈值分割和区域增长等算法提取股骨的初步轮廓,再根据贝叶斯决策论对股骨边缘进行再次分割。结果与结论:基于贝叶斯决策的髋关节自动分割方法计算速度快,鲁棒性高,分割准确,在计算机辅助髋关节手术及假体设计等方面具有一定的实用价值。     

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.     

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.     

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.     

What will studies of Fulani individuals naturally exposed to malaria teach us about protective immunity to malaria?

There are an estimated over 200 million yearly cases of malaria worldwide. Despite concerted international effort to combat the disease, it still causes approximately half a million deaths every year, the majority of which are young children with Plasmodium falciparum infection in sub-Saharan Africa. Successes are largely attributed to malaria prevention strategies, such as insecticide-treated mosquito nets and indoor spraying, as well as improved access to existing treatments. One important hurdle to new approaches for the treatment and prevention of malaria is our limited understanding of the biology of Plasmodium infection and its complex interaction with the immune system of its human host. Therefore, the elimination of malaria in Africa not only relies on existing tools to reduce malaria burden, but also requires fundamental research to develop innovative approaches. Here, we summarize our discoveries from investigations of ethnic groups of West Africa who have different susceptibility to malaria.     

'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.