MRI容量重建技术在颞上沟-侧脑室颞角手术入路选择中的应用

目的:通过测量经颞上沟-侧脑室颞角手术入路的相关数据,初步定位大脑背外侧面颞上沟进入侧脑室最短距离的点,寻找经颞上沟进入侧脑室颞角的最佳手术入路点。方法：选取120例成年人脑部MRI扫描标本,利用容量重建技术构建大脑三维立体模型,测得颞上沟的长度S1。沿垂直于颞叶长轴的方向以1.0 mm间距切割得到多个冠状切面,依次测量颞上沟到侧脑室颞角的距离并确定最短距离S2,同时测量颞上沟的深度S3,测量大脑颞上沟表面相对应的最短距离点到颞上沟前端起始部的距离S4,计算S4与S1的比值M,同时测量最短距离与正中矢状位方向之间的夹角α。所有样本进行双侧测量,对比两侧的测量结果。 结果：120例国人的S1左侧为（159.56±17.55）mm,右侧为（164.35±15.07）mm,左右两侧比较差异无统计学意义（P>0.05）;S2左侧为（8.18±0.96）mm,右侧为（7.81±0.90）mm,左右两侧比较差异无统计学意义（P>0.05）;S3左侧为（12.19±1.43）mm,右侧为（11.57±1.33）mm,左右两侧比较差异无统计学意义（P>0.05）;S4左侧为（100.88±16.09）mm,右侧为（104.15±14.49）mm,左右两侧比较差异无统计学意义（P>0.05）;M左侧为（0.63±0.07）,右侧为（0.63±0.06）,左右两侧比较差异无统计学意义（P>0.05）;α左侧为（55.80±3.64）°,右侧为（56.46±4.17）°,左右两侧比较差异无统计学意义（P>0.05）。结论：颞上沟前端3/5处可能为理想的手术入路点,由该点进入侧脑室颞角距离最短,提示实施颞上沟-侧脑室颞角手术时该入路可减少对脑组织损伤。     

Who is the 40-Year-Old Virgin and Where Did He/She Come From? Data from the National Survey of Family Growth

IntroductionLittle is known about young and middle aged adults who have never engaged in sexual intercourse. Individuals who have not engaged in sexual activity may theoretically have diminished overall quality of life, as recent evidence suggests that sexual activity may be related to overall health status in adults.AimWe sought to identify factors related to sexual abstinence in young and middle-aged adults.MethodsWe analyzed data from the male and female sample of the 2002 National Survey of Family Growth to examine sexual abstinence among unmarried participants aged 25–45 (men: N = 2,469; women: N = 5,120).Main Outcome MeasuresMultivariable logistic regression modeling was used to test for independent associations between demographic, medical, and anthropometric variables and abstinence while adjusting for confounding and mediating variables.ResultsA total of 122 (13.9%) men aged 25–45 reported never having had sex, representing approximately 1.1 million American men in this age cohort. Among female participants, a total of 104 (8.9%) women aged 25–45 reported never having sex, representing approximately 800,000 American women in this age cohort. Both men and women who reported that they attend religious services one or more times per week were more likely to be sexually abstinent, independent of their specific religious beliefs. Virgin status was also significantly associated with drinking alcohol within the past year. While a college degree in women predicted virginity, education was not associated with virginity in men. Men showed lower rates of sexual abstinence if they reported having spent time in prison or serving in the military.ConclusionsAmongst young adults, sexual abstinence does not appear to be mediated by health status, anthropometric measures, or age. Attending religious services and avoidance of alcohol consumption are associated with virginity in adults. Other factors associated with abstinence differ between genders and merit further study. Eisenberg ML, Shindel AW, Smith JF, Lue TF, and Walsh TJ. Who is the 40 year old virgin and where did he/she come from? Data from the National Survey of Family Growth. J Sex Med 2009;6:2154–2161.     

军事航空医学专业数字图书馆建设

介绍军事航空医学专业数字图书馆现状,详细阐述军事航空医学专业数字图书馆建设对策,包括回溯建库资源数字化、软硬件设施建设保障化、专业数据库重点化等。     

Psychological,endocrine and neural responses to social evaluation in subclinical depression

This study aimed to identify vulnerability patterns in psychological, physiological and neural responses to mild psychosocial challenge in a population that is at a direct risk of developing depression, but who has not as yet succumbed to the full clinical syndrome. A group of healthy and a group of subclinically depressed participants underwent a modified Montreal Imaging Stress task (MIST), a mild neuroimaging psychosocial task and completed state self-esteem and mood measures. Cortisol levels were assessed throughout the session. All participants showed a decrease in performance self-esteem levels following the MIST. Yet, the decline in performance self-esteem levels was associated with increased levels of anxiety and confusion in the healthy group, but increased levels of depression in the subclinical group, following the MIST. The subclinical group showed overall lower cortisol levels compared with the healthy group. The degree of change in activity in the subgenual anterior cingulate cortex in response to negative evaluation was associated with increased levels of depression in the whole sample. Findings suggest that even in response to a mild psychosocial challenge, those individuals vulnerable to depression already show important maladaptive response patterns at psychological and neural levels. The findings point to important targets for future interventions.     

Parkinson's disease,cortical dysfunction,and alpha‐synuclein

The ability to understand how Parkinson's disease neurodegeneration leads to cortical dysfunction will be critical for developing therapeutic advances in Parkinson's disease dementia. The overall purpose of this project was to study the small‐amplitude cortical myoclonus in Parkinson's disease as an in vivo model of focal cortical dysfunction secondary to Parkinson's disease neurodegeneration. The objectives were to test the hypothesis that cortical myoclonus in Parkinson's disease is linked to abnormal levels of α‐synuclein in the primary motor cortex and to define its relationship to various biochemical, clinical, and pathological measures. The primary motor cortex was evaluated for 11 Parkinson's disease subjects with and 8 without electrophysiologically confirmed cortical myoclonus (the Parkinson's disease + myoclonus group and the Parkinson's disease group, respectively) who had premortem movement and cognitive testing. Similarly assessed 9 controls were used for comparison. Measurements for α‐synuclein, Aβ‐42 peptide, and other biochemical measures were made in the primary motor cortex. A 36% increase in α‐synuclein was found in the motor cortex of Parkinson's disease + myoclonus cases when compared with Parkinson's disease without myoclonus. This occurred without significant differences in insoluble α‐synuclein, phosphorylated to total α‐synuclein ratio, or Aβ‐42 peptide levels. Higher total motor cortex α‐synuclein levels significantly correlated with the presence of cortical myoclonus but did not correlate with multiple clinical or pathological findings. These results suggest an association between elevated α‐synuclein and the dysfunctional physiology arising from the motor cortex in Parkinson's disease + myoclonus cases. Alzheimer's disease pathology was not associated with cortical myoclonus in Parkinson's disease. Cortical myoclonus arising from the motor cortex is a model to study cortical dysfunction in Parkinson's disease. © 2011 Movement Disorder Society     

川芎嗪对慢性肺源性心脏病患者趋化因子Fractalkine及肿瘤坏死因子-α表达的影响

目的探讨趋化因子Fractalkine(FKN)、肿瘤坏死因子-α(TNF-α)与慢性肺源性心脏病(简称肺心病)的关系,揭示川芎嗪抑制肺动脉高压的作用机制。方法将35例确诊为慢性肺心病患者随机分为川芎嗪组(19例)及常规治疗组(16例),并选取18名健康体检者为健康组。常规治疗组给予常规治疗(哌拉西林/他唑巴坦针3.375 g静脉滴注,每天2次;左氧氟沙星针0.6 g静脉滴注,每天1次;氨溴索针60 mg静脉滴注,每天1次;多索茶碱针0.2 g静脉滴注,每天1次,均连用10～14天,并纠正酸碱失衡及电解质紊乱),川芎嗪组在常规治疗基础上加用盐酸川芎嗪(商品名:川青,每支120 mg,240 mg加入生理盐水注射液250 mL中静脉滴注,每天1次,连用10～14天),分别于治疗前后采用酶联免疫法检测血清FKN、TNF-α水平,应用多普勒超声仪检测治疗前后肺动脉压(mPAP)的变化。结果(1)治疗前常规治疗组、川芎嗪组血清FKN及TNF-α水平差异无统计学意义(P0.05),但均高于健康组(均P0.01);(2)川芎嗪组治疗后FKN、TNF-α及mPAP水平显著低于治疗前,且低于常规治疗组治疗后(P0.05,P0.01)。(3)FKN与TNF-α水平呈显著正相关(r=0.662,P0.01)。结论(1)慢性肺心病患者存在FKN及TNF-α的高表达状态;(2)川芎嗪能抑制慢性肺心病患者FKN与TNF-α的表达,这可能是其降低肺动脉压的重要作用机制之一。     

Reliability and validity of using a Brief Psychiatric Symptom Rating Scale in clinical practice

To develop a reliable and valid psychiatric self-rating scale for use in medical practice, the authors modified Derogatis' Symptom Check List-90-R (SCL-90-R) and designed a shorter form, named Brief Symptom Rating Scale (BSRS). The BSRS comprises 50 items, which best reflect the original ten symptom dimensions and three indices of psychopathology from the SCL-90-R. The BSRS has been proven in different populations to have an excellent split-half reliability as well as good internal structure according to factor analysis. In addition, BSRS scores are highly correlated with the parental form SCL-90-R among medical populations for each symptom dimension and the three indices. The rate of accurate classification for BSRS between psychiatric and nonpsychiatric cases was 75.8%, with a sensitivity of 66.7% and a specificity of 86.7% by discriminant analysis based on 10 dimensional scores obtained from 1,638 subjects, randomly selected from the Psychiatric Outpatient Clinic, the Family Medicine Clinic and nonpsychiatric medical inpatients. Therefore, the BSRS is a satisfactory global measure and case-finding screening instrument for psychopathology in both psychiatric and nonpsychiatric medical settings.     

输精管结扎术后附睾瘀积—发生机制及其防治方法的研究

木文对输精管结扎后的“附睾瘀积”进行了系统研究。选用金黄地鼠为实验动物，结扎组８４只，对照组７６只。采用微穿刺、微量分析方法证实扎管后附睾功能受损。组织学检查示附睾管扩张，间质充血，有大量慢性炎细胞浸润。临床收集４９例病人，３９例微波治疗，１０例手术，效果优良。采用Ｂ超、Ｃ超、ＭＲＩ观察瘀积附睾，发现附睾瘀积多位于附睾尾部。人类标本的光镜及电镜检查证实，附睾瘀积的病理实质是附睾对外渗精子的一种无菌性炎症反应。本文根据研究资料，阐明了附睾瘀积的发生机制，提出了防治方法，并定名为“附睾瘀积综合征”。     

Correction of penile curvature using the 16-dot plication technique: a review of 132 patients

PURPOSE: We review the results of 132 cases of congenital and acquired penile curvature corrected with our 16 or 24-dot, minimal tension technique using multiple parallel plications performed under papaverine induced erection. MATERIALS AND METHODS: Chart and telephone interviews were conducted on 132 consecutive patients 16 to 79 years old who underwent penile plication between December 1995 and November 2000. Patient data as well as outcomes were analyzed. RESULTS: We were unable to contact 8 patients. Of the patients 16 had congenital penile curvature, including 4 in whom the Nesbit procedure performed elsewhere had failed, and 116 had Peyronie's disease, including 8 in whom a previous Nesbit procedure had failed. Preoperative complaints included persistent penile pain with erection for more than 1 year in 15 of 132 cases, difficult intercourse or partner discomfort in 106 and poor self-image in 11. Curvature ranged from 30 to 120 degrees. Erections were evaluated preoperatively with duplex ultrasound after intracavernous injection and self-stimulation. Of the patients 63% had good erections, 25% moderate erections requiring sildenafil and 12% poor erections requiring injection therapy. Foreskin edema necessitating subsequent circumcision and an organized hematoma requiring evacuation occurred in 1 case each. At 6 months 93% of patients reported straight erections and 7% reported almost straight but acceptable erections. Recurrence of curvature was reported by 15% of patients at a mean of 2.6 years of followup. Four patients reported worsening of erectile function after the procedure. CONCLUSIONS: Penile plication is a simple, safe method to correct congenital and acquired penile curvature. Using a minimal tension parallel plication technique, excellent durable results can be attained. This simplified repair avoids the neurovascular bundles and has a minimal to no detrimental affect on erectile function. Preoperative counseling must be given regarding penile shortening and the palpable small bumps from the nonabsorbable sutures.