急性心肌梗死与肺炎衣原体关系的多因素分析

急性心肌梗死(AMI)属动脉粥样硬化性冠心病最严重的临床类型,而动脉粥样硬化(As)的感染机制日益受到人们的重视。本次研究旨在通过对AMI患者进行血清流行病学调查,探讨AMI与肺炎衣原体(Cp)感染的关系。     

解析南非医疗『公私合营』机制

南非在建立和发展公平、高效、高质量的医疗保障体系的过程中,为公立医疗机构和私立医疗机构之间开展建设性的合作提供了相当大的空间。当决定是否应该在医疗体系中追求新的公私互动或公私合营机制之前,有必要对现有这种机制的功过是非、全民医疗体系的目标和已经取得的成绩进行认真评估。     

Food-dependent exercise-induced anaphylaxis in childhood

The clinical syndrome of food-dependent exercise-induced anaphylaxis (FDEIA) is typified by the onset of anaphylaxis during (or soon after) exercise which was preceded by the ingestion of the causal food allergen/s. In FDEIA, both the food allergen/s and exercise are independently tolerated. FDEIA is an uncommon allergic condition in childhood, but nonetheless is an important differential diagnosis to be considered when faced by a child who has experienced exercise-associated anaphylaxis. The diagnosis of FDEIA is heavily dependent on the clinical history. Allergy tests may need to be performed to a broad panel of food and food additives. Modified exercise challenges (performed with and without prior ingestion of food) are frequently required as allergy test results frequently return low-positive results. A diagnosis of FDEIA facilitates the safe independent return to exercise and reintroduction of foods for patients who otherwise may unnecessarily avoid exercise and/or restrict their diet. The natural history of FDEIA is unknown; however, a safe return is usually achieved when the ingestion of the causal food allergen/s and exercise are separated.     

脐血铅水平与妊娠结局及影响因素的关系

目的 :了解本地区脐血铅水平现状及其妊娠结局与妊娠并发症 ,新生儿体格发育及神经行为发育的关系 ,并探讨脐血铅与环境因素的关系。方法 :采用 HB2 10 0原子吸收光谱仪用原子吸收法测定 178例经剖宫分娩的新生儿脐带血水平 ,同时观察孕妇妊娠与分娩期有无合并症与并发症 ,并于新生儿出生后即刻测量体重、身长 ,2 4 h内测量头围、胸围和腹围 ,采用神经行为发育量表 ,对出生后 4 2 d的 5 0例婴儿进行神经行为发育评分。同时对产妇家庭环境等相关因素进行问卷调查。结果 :178例脐血铅最高值 12 2 μg/ L,最低值 1μg/ L,中位数 36 μg/ L,脐血铅≥ 10 0 μg/ L 者 6例 ,占3.33%。脐血铅水平与妊娠并发症无明显相关性 ,与新生儿体格发育及神经行为发育评分无明显相关性。新生儿血铅水平与环境因素 (家庭住址、居室新旧、家庭经济情况、职业等 )差异有显著性 ,P<0 .0 5。结论 :本组脐血铅水平与孕期并发症及新生儿体格发育及神经行为发育评分无明显关系。脐血铅水平与环境因素有关。     

单蒂横行腹直肌肌皮瓣乳房再造中Ⅳ区皮瓣的取舍

目的探讨单蒂横行腹直肌肌皮瓣乳房再造术中Ⅳ区皮瓣的取舍。方法通过16例实施单蒂横行腹直肌肌皮瓣乳房再造术，术中观察皮瓣的皮色、断面出血颜色，并利用近红外血氧监测仪测定皮瓣各区的组织血氧饱和度，决定Ⅳ区皮瓣的取舍。术后观察指标包括术后并发症及美学效果。结果16例中5例Ⅳ皮瓣的肤色正常、断面出血呈鲜红色而非暗红色、组织血氧饱和度不低于Ⅲ区组织血氧饱和度的95％。在接受了保留Ⅳ区皮瓣的单蒂横行腹直肌肌皮瓣乳房再造术后，再造乳房全部成活，无严重术后并发症，患者对再造乳房均很满意。结论近红外血氧无创检测有助于决定Ⅳ区皮瓣的取舍。有选择地实施保留Ⅳ区皮瓣的单蒂横行腹直肌肌皮瓣乳房再造术，可用于大面积胸壁缺损或乳腺尾叶的修复重建。     

Compromised late-stage motion processing in schizophrenia.

BACKGROUND: Visual motion processing is compromised in schizophrenia, as shown in deficient velocity discrimination. Processing of motion signals comprises progressive stages along the geniculate-striate-extrastriate-cortex pathway. Based on neurophysiologic and brain lesion studies, a velocity discrimination deficit can implicate early-stage motion processing if it is contrast-dependent or late-stage motion processing if it is contrast-independent. METHODS: To determine which stage underlies the deficient velocity discrimination in schizophrenia, we examined the effects of visual contrast on velocity discrimination. We measured velocity discrimination thresholds in schizophrenia patients (n = 34) and normal control subjects (n = 17) at both low and high contrasts, using each subject's contrast detection threshold to equate contrast levels. RESULTS: Schizophrenia patients showed poor velocity discrimination that improved little with high contrast, whereas normal control subjects showed enhanced velocity discrimination with increased contrast. CONCLUSIONS: The finding that the velocity discrimination deficit in schizophrenia is independent of contrast modulation implicates the later, rather than the earlier, stages of motion processing, which is mediated in the extrastriate cortex.     

应用RNA干扰技术抑制神经元E3B1基因表达及对轴突生长的影响

目的:探讨应用RNA干扰(RNAi)技术抑制神经元E3B1基因表达及其对轴突生长的影响.方法:选择针对E381(NCBI:NM-024397)RNAi的3个靶位点Abil1、Abil2、Abil3和1个不针对任何mRNA的RNAi靶位点(阴性对照)以及甘油醛-3-磷酸脱氢酶(GAPDH,阳性对照),用带有neoR选择标志和GFP绿色荧光标志的真核表达载体pGenesil-1构建E381 RNAi质粒,分别转染培养的神经元,在荧光显微镜下观测转染率,经G418筛选得到单一的转染细胞,并用Western blot法检测各转染组神经元E3B1蛋白的表达情况,选出具有最佳抑制效应的siRNA转染神经元,加人轴突生长抑制物,观测轴突生长情况.结果:成功构建了RNAi质粒,各组细胞的转染率相近,均为34%左右.与阴性对照组相比,Abil1、Abil2和Abil3转染组细胞内E3B1 mRNA的表达都受到了不同程度的抑制,其中Abil3转染组细胞的E381 mRNA和蛋白的表达抑制最为显著,加入轴突抑制剂后Abil3转染组神经元轴突仍能继续生长.结论:应用RNA干扰技术能高效特异地抑制神经元E3B1基因的表达,E3B1基因的表达下调可促进神经元轴突的生长.     

髋臼骨折合并同侧下肢骨折临床治疗分析

目的：探讨髋臼骨折合并同侧下肢骨折的创伤机制和治疗方法。方法：髋臼骨折并同侧下肢骨折14例,男9例,女5例;年龄18～65岁,平均35岁。髋臼骨折按Letournel分型,后壁伴后柱骨折11例,单纯后柱骨折3例,均行钢板内固定。伴同侧股骨转子间骨折3例,1例行起重机架外固定,2例行DHS固定;伴同侧股骨颈骨折3例,均行空心钉加压固定;伴同侧股骨干骨折6例,1例行钢板固定,余5例行带锁髓内钉固定;伴同侧胫骨平台骨折2例,行钢板内固定。结果：1例半年后死亡,余13例获得随访,随访时间18个月～5年,平均30个月。按照美国矫形外科研究院髋关节疗效评定标准,优9例,良3例,差1例。结论：髋臼骨折合并同侧下肢骨折受伤暴力大、机制复杂、合并创伤多、易漏诊,应早期明确诊断,合理内固定。