多层螺旋CT多平面重组重建功能对中央气道腔内占位诊断与治疗的意义

目的探讨多层螺旋CT多平面重组（MPR）重建对中央气道占住的CT诊断价值和对治疗的指导意义。方法对9例中央气道占位的病例进行多层螺旋CT扫描,在工作站上进行MPR重建处理,分别对轴位图像和重建图像进行分析对比。结果MSCT对于6例中央气道肿瘤及3例异物的病例进行横断薄层扫描及MPR重建后分析得出,MPR重建能明确显示中央气道,气道占位部位、大小、管腔狭窄程度、截断,管壁增厚及管周改变。结论多层螺旋CTMPR重建功能能够有效地评价中央气道病变的解剖与病理关系,有助于气管占位的诊断与鉴别诊断,并指导治疗。     

Asthma increase among farmers: a 12-year follow-up

Respiratory disease is a well known health hazard for farmers, but the long-term prognosis is less well known. This is a 12-year follow-up of an investigation of Swedish farmers, most of them dairy farmers. A questionnaire was mailed to all 418 farmers who were alive of the farmers originally participating in 1982. They were invited to an interview, spirometry, and blood sampling. Ninety-one per cent (380) of the farmers, 321 men and 59 women, responded to the questionnaire. The mean age was 56 years for the men and 55 years for the women. Of the group, 10% were smokers, 25% ex-smokers, and 65% had never smoked. The population estimate for asthma in the farmers was 8.9% in 1994 compared to 2% in 1982, and to 5.4%–6.6% in the general population in the region in 1982. Of the asthmatic subjects, one-third had positive RAST tests (radioallergosorbent tests). Almost 90% of the new onset asthma cases since 1982 had non-IgE-mediated asthma. Most of the IgE-mediated asthmatics had had symptoms for many years, while 70% of the non-IgE-mediated asthmatic farmers had no or only wheezing with colds 1982. Two new cases of hypersensitivity pneumonitis were identified, and 7.3% had experienced inhalation fever during the last 12 years. In general, individuals with asthma and chronic bronchitis who had left farming were in better health in 1994 as compared to 1982. In conclusion, farmers have an enhanced risk to develop asthma increasing with age. Asthma in farmers is often non-IgE-mediated.     

Sheehan's syndrome presenting as psychosis: a rare clinical presentation

Sheehan''s syndrome (SS) refers to the occurrence of varying degree of hypopituitarism after parturition (1). It is a rare cause of hypopituitarism in developed countries owing to advances in obstetric care and its frequency is decreasing worldwide. However, it is still frequent in underdeveloped and developing countries. Sheehan''s syndrome is often diagnosed late as it evolves slowly (2,3). Reports of psychoses in patients with Sheehan''s syndrome are rare. Herein, a case report of psychosis in a 31 year old woman who developed Sheehan''s syndrome preceded by postpartum haemorrhage is presented. Treatment with thyroxine and glucocorticoids resulted in complete remission after attaining euthyroid and eucortisolemic state.     

双侧开胸治疗左主支气管病变侵及隆突病例分析

目的 总结双侧开胸治疗左主支气管病变侵及隆突的治疗体会.方法 回顾分析中国医学科学院肿瘤医院1999年至2008年间4例双侧开胸治疗左主支气管病变侵及隆突的资料.结果 4例病人中男2例、女2例,中位年龄37.5岁(27～55岁).4例均采用双侧后外侧开胸切口,均行隆突切除成形术,其中3例行左侧全肺隆突切除,1例行气管隆突肿物切除.术后病理检查显示1例为结核,1例为鳞状细胞癌,另外2例为腺样囊性癌.3例术后呼吸机辅助通气,通气时间3～21d.手术死亡1例,死亡原因为吻合口裂开.结论 对于相对年轻、心肺功能较好的左主支气管病变侵及隆突的患者,双侧后外侧开胸也是一种可以选择的方法.术中根据组织病理学类型和左主支气管侵犯的长度决定手术方式.     

原发性气管平滑肌瘤的误诊分析

原发性气管平滑肌瘤临床少见,极易误诊、漏诊。本文回顾1例气管平滑肌瘤患者的诊治经过,分析误诊原因。患者女,59岁,反复咳嗽、气促2年,长期诊断支气管炎、哮喘,但疗效不佳。后因病情加重,经胸部CT、支气管镜检查确诊气管平滑肌瘤,手术治愈。因此,对于疗效不佳的＂支气管炎＂、＂哮喘＂,需警惕气管平滑肌瘤等少见大气道肿瘤,及时进行胸部CT、支气管镜等检查,以免误诊、漏诊。     

乙酸盐预处理对MPTP诱导亚急性帕金森病小鼠的神经保护作用

目的 初步探索乙酸盐(Ace)对1-甲基-4-苯基-1,2,3,6-四氢吡啶(MPTP)诱导亚急性帕金森病小鼠的神经保护作用及可能机制.方法 将24只小鼠随机分为对照组、MPTP组、MPTP+Ace组,每组8只,对照组和MPTP组饮用正常饮用水,MPTP+Ace组饮用水中添加1 mol/L Ace,连续7 d后,MPT...     

新生儿气管主支气管的应用解剖

研究新生儿气管、主支气管的长度、管径、气管叉夹角及毗邻关系。方法：在手术显微镜下对气管、主支气管及毗邻关系进行观测。结果：气管长（３７．０５±３．８７）ｍｍ,左主支气管长（１６．９６±２．５２）ｍｍ,右主支气管长（９．３８±１．６１）ｍｍ,气管内周径、内横径、内前后径分别是（１５．３２±１．１６）ｍｍ、（４．６９±０．４１）ｍｍ、（３．６２±０．４６）ｍｍ,左主支气管内周径、内横径、内前后径分别是（１０．３７±１．５５）ｍｍ、（３．２２±０．４１）ｍｍ、（２．４２±０．４２）ｍｍ．右主支气管内周径、内横径、内前后径分别是（１１．７７±１．３２）ｍｍ、（３．７４±０．３９）ｍｍ、（２．８７±０．４７）ｍｍ,气管叉夹角为（７４．９３±４．８４）°。颈段气管前方颈前静脉弓出现率为１００％．胸腺均伸入到颈静脉切迹上方,头臂干、甲状腺下动脉、左头臂静脉、甲状腺下静脉的出现率分别是（２６．６６±８．０７）％、（２６．６６±８．０７）％、（１３．３３±６．２１）％、１００％。结论：气管的长度随身高增加而加长,左、右主支气管与气管长轴的夹角不等并非生后发育所致,甲状腺下动脉、头臂千出现率较高。     

气管内插管延长置管时间治疗呼吸衰竭

本文报导了26例呼吸衰竭病人经鼻气管内硅胶插管维持呼吸，最长达50天，拔管后无严重的呼吸道并发症。作者认为，在新型高分子医用材料应用于临床后，可以延长气管内置管时间。     

气管后腔的应用解剖学研究

本文对35例成人气管后腔和气管后隐窝进行了观测.气管后腔为气管后壁至1～5胸椎体前缘之间的腔隙.气管后腔的深度从上至下逐渐加深,平均深度为18.68±4.03mm.气管后隐窝位于气管后壁与食管右侧之间,由肋胸膜和纵隔胸膜凹陷转折而成.是上浅下深的凹槽形,其内由右肺上叶后缘充填.     

小儿气管、支气管异物的诊治体会

目的：提高小儿气管、支气管异物的诊断及治疗水平，以进一步减少或避免并发症的发生．方法：对我院１９９７年１月～２００１年２月收治的气管、支气管异物３１０例进行回顾性分析．结果：除２例自行咳出外，其余均在全麻下行支气管镜检顺利取出，异物位于气管内 ８３例，支气管 ２２７例（其中右例 １２２例，左侧 ９９例，双侧６例）．术前及术中气管切开８例．入院时并发气胸、纵隔及皮下气肿５例，术中窒息６例，术后喉头水肿５例，无死亡．结论：气管、支气管异物多发生于３岁以下的小儿，临床症状常较重，易误诊．诊断主要依靠病史及Ｘ线检查．早期诊断、恰当的手术时机、良好的麻醉技术是顺利取出异物、减少并发症的关键．     

冷哮丸对动物祛痰作用的影响

目的：探讨冷哮丸对动物的祛痰作用及其作用机制。方法：采用酚红法和毛细玻管法测定排痰量，用家鸽活体气管法及兔离体气管法测其纤毛运动。结果：冷哮丸能显增加小鼠气管酚红排泌量，增加大鼠排痰作用，增强在体鸽及离体兔气管纤毛运动。结论：冷哮丸有显的祛痰作用，其机理可能是增加气管内浆液成分，痰液变稀，同时加快气管纤毛运动而达到祛痰目的。     

帕金森病小鼠模型行为学检测方法的比较研究

目的比较目前常用的5种帕金森病(PD)小鼠模型行为学检测方法在PD研究中的作用。方法用MPTP建立C57BL小鼠PD模型,通过行为学检测(自主活动计数、滚轴实验、游泳实验、爬杆实验、悬挂实验)、免疫组织化学和荧光分光光度法,对比5种行为学检测方法的平均数与变异系数,观察MPTP对PD小鼠模型的行为学、黑质多巴胺(DA)神经元和纹状体酪氨酸羟化酶免疫反应阳性(TH-ir)神经纤维以及纹状体DA水平的影响。结果给与MPTP后,小鼠行为学计数降低,爬杆实验未能得到检测结果,悬挂实验变异系数很高,结果有明显的偶然性,滚轴实验结果变异系数中等,平均数呈现一定的上升趋势,自主活动计数中移动与站立和游泳实验的平均数则呈现明显的下降趋势,变异系数很低,而黑质DA神经元数目减少约58%,纹状体TH-ir神经纤维密度减低,纹状体DA水平明显降低约88%,两组相比差异有显著性(P<0.01)。结论MPTP所致的C57BL小鼠的神经病理、生化改变与PD患者近似,自主活动计数和游泳实验优于其他行为学检测方法。     

Frequency-specific Alterations of Large-scale Functional Brain Networks in Patients with Alzheimer's Disease

Background:

Previous studies have indicated that the cognitive deficits in patients with Alzheimer''s disease (AD) may be due to topological deteriorations of the brain network. However, whether the selection of a specific frequency band could impact the topological properties is still not clear. Our hypothesis is that the topological properties of AD patients are also frequency-specific.

Methods:

Resting state functional magnetic resonance imaging data from 10 right-handed moderate AD patients (mean age: 64.3 years; mean mini mental state examination [MMSE]: 18.0) and 10 age and gender-matched healthy controls (mean age: 63.6 years; mean MMSE: 28.2) were enrolled in this study. The global efficiency, the clustering coefficient (CC), the characteristic path length (CpL), and “small-world” property were calculated in a wide range of thresholds and averaged within each group, at three different frequency bands (0.01–0.06 Hz, 0.06–0.11 Hz, and 0.11–0.25 Hz).

Results:

At lower-frequency bands (0.01–0.06 Hz, 0.06–0.11 Hz), the global efficiency, the CC and the “small-world” properties of AD patients decreased compared to controls. While at higher-frequency bands (0.11–0.25 Hz), the CpL was much longer, and the “small-world” property was disrupted in AD, particularly at a higher threshold. The topological properties changed with different frequency bands, suggesting the existence of disrupted global and local functional organization associated with AD.

Conclusions:

This study demonstrates that the topological alterations of large-scale functional brain networks in AD patients are frequency dependent, thus providing fundamental support for optimal frequency selection in future related research.     

Mechanisms of Electroacupuncture on Alzheimer's Disease: A Review of Animal Studies

Alzheimer's disease(AD) is the main type of dementia affecting elderly people. The medicines used for treating AD have limits in their ability to alleviate cognitive and functional decline. Electroacupuncture(EA), an economical alternative and complementary therapeutic measure used in Chinese medicine, has strong clinical applicability, and its treatment effects are more reliable as its stimulation factors can be standardized. EA has been effectively used for ameliorating spatial learning and memory impairment in AD patients and rodent AD models. Here, we summarized the mechanisms of EA on rodent AD models, aiming to provide a theoretical basis for identifying new targets and research directions, and exploring appropriate EA stimulation parameters, then provide a detailed methodology to optimize the effects of EA, ultimately reducing the heavy burden of treating AD patients on families and countries. Our review showed that 8 acupoints were used when treating AD animals; Baihui(GV 20) was the most frequently used. Four mechanisms of EA were studied:(1) protection of cerebral neurons from oxidative stress, apoptosis, neuroinflammation, synaptic plasticity and hormone levels;(2) regulation of metabolism, including glucose metabolism and plasma metabolism;(3) regulation of brainderived neurotrophic factor; and(4) regulation of β-amyloid peptide protein deposition.     

A patient with Graves' disease who survived despite developing thyroid storm and lactic acidosis

A 56-year-old woman with Graves'' disease presented with the complaints of diarrhea and palpitations. Physical examination and laboratory data revealed hypothermia and signs of mild hyperthyroidism, heart failure, hepatic dysfunction with jaundice, hypoglycemia, and lactic acidosis. The patient was diagnosed as having developed the complication of thyroid storm in the absence of marked elevation of the thyroid hormone levels, because of the potential hepatic and cardiac dysfunctions caused by heavy alcohol drinking. A year later, after successful treatment, the patient remains well without any clinical evidence of heart failure or hepatic dysfunction. Thyroid storm associated with lactic acidosis and hypothermia is a serious condition and has rarely been reported. Prompt treatment is essential even if the serum thyroid hormone levels are not markedly elevated. We present a report about this patient, as her life could eventually be saved.     

Parkinson's disease and primate research: past, present, and future

Scientific research involving non-human primates has contributed towards many advances in medicine and surgery. This review discusses its role in the progress made towards our understanding of Parkinson's disease and its treatment. Established medical treatments like dopamine agonists continue to need primate models to assess their efficacy, safety, and mechanism of action. The recently developed treatment of deep brain stimulation of the subthalamic nucleus required validation in primates before entering the clinic. Controversies surrounding future treatments such as gene therapy show the need for properly evaluated preclinical research using appropriate animal models before progression to clinical trials. Research on primates has played--and continues to play--a crucial part in deepening our understanding of Parkinson's disease, improving current therapies, and developing new treatments that are both safe and effective. In animal research, the "three Rs" of humane technique--reduction, refinement, and replacement--should be adhered to.