影像学检查在儿童过敏性紫癜的临床价值

目的探讨儿童过敏性紫癜的影像学特点及其临床价值。方法回顾性分析32例过敏性紫癜并发肠套叠患儿的临床及影像学资料。结果出现并发症之前过敏性紫癜的腹部X线主要表现为局限性小肠充气扩张，粘膜增粗，肠间隙增宽，可伴有液平；B超显示为不同程度的多发节段性肠壁水肿增厚，肠管狭窄等表现；出现并发症后，其X线表现加重，部分病例伴有肠穿孔；B超及X线监视下空气灌肠可以明确是否并发肠套叠，部分病例可通过空气灌肠达到复位治疗的目的。结论影像学检查的重要临床价值在于能与需要手术治疗的其他急腹症相鉴别，同时可以了解其是否并发常见的并发症，为临床确定治疗方案提供可靠的信息。     

信息管理与信息系统(医学)专业课程体系设置

针对当前国内医学信息学专业的发展现状和社会对医学信息学领域的人才需求,探讨信息管理与信息系统(医学)专业的培养目标和培养方向,并在此基础上对该专业的课程设置和教学方法提出一些构想,以便促进我国目前医学信息学专业教学的发展。     

食管癌放疗中二次模拟定位临床探讨

目的：探讨食管癌放疗中间再次定位的必要性和重要性。方法：我院放疗科自1998年10月－2001年3月对356例食管癌患者行单纯放疗或放疗加化疗，356例患者照射全过程都进行二次模拟定位（第一次模拟定位后照射30－40GY／15－20次后进行第2次模拟定位）。比较分析前后二次模拟定位靶中心移位的情况。结果；靶中心移位＜0．5cm为157例，移位0．5－1．0cm为130例，移位＞1．0cm为69例。全部靶中心移位达55．90％。食管肿瘤长度＜5cm靶中心移位27例，5－8cm移位117例，病变长度＞8cm移位55例，P＜0．05；食管肿瘤发生于颈段，上胸段靶中心移位25例，而中、下段食管移位174例，P＜0．01。结论：食管肿瘤外照射达到一定剂量时，靶中心会出现不同程度的移位，肿瘤长度越长靶中心移位会更明显， 肿瘤位置越小，移位亦显著。因此，我们对食管癌患者放疗全过程必需进行2到3次定位，这样才能保证靶中心的精确度，以达到预期治疗目的。     

Klinische Erfahrungen mit der Knorpel-Knochen-Transplantation

The treatment of deep cartilage defects in load-bearing joints is a problem that still has no satisfactory solution. Full-thickness defects of the articular cartilage rarely heal spontaneously, usually leaving damage that can lead to early arthrosis. Techniques currently available for the treatment of chondral defects include abrasion, drilling, micro-fracturing, transplantation of tissue autografts and allografts, and cell transplantation. Osteochondral autograft transplantation is currently the only surgical cartilage repair technique known to lead to the formation of genuine hyaline articular cartilage and its retention at least in the medium term. The Draenert method, in which a water-cooled diamond bone-cutting system is used, is an effective procedure for resurfacing the joints affected by localised cartilaginous defects, even when there is also severe bone loss. Donor-side morbidity can be kept to a minimum by filling the defect caused by harvesting with a press-fit cylinder of cancellous bone covered with periosteum for protection.     

De-novo expression of vascular ecto-5′-nucleotidase and down-regulation of glomerular ecto-ATPase in experimental chronic renal transplant failure

Ischemic injury plays an important role in chronic renal transplant failure (CRTF). Down-regulation of ecto-adenosine triphosphatase (ATPase) in combination with up-regulation of ecto-5'-nucleotidase is a hallmark of ischemic injury. We studied the expression of renal ecto-5'-nucleotidase and ecto-ATPase in experimental renal transplantation. Fisher 344-to-Lewis allografted rats were either treated with an angiotensin-converting enzyme inhibitor (ACEi) or left untreated. Lewis-to-Lewis syngrafted rats served as controls. Untreated allografted rats developed proteinuria, glomerulosclerosis, and mild intimal hyperplasia. ACEi completely prevented focal and segmental glomerulosclerosis (FGS) and proteinuria, but significantly enhanced intimal hyperplasia. Untreated allografted rats revealed marked vascular ecto-5'-nucleotidase activity, which increased with ACEi. Vascular ecto-5'-nucleotidase activity was absent in syngrafted animals. Ecto-5'-nucleotidase activity correlated well with intimal hyperplasia. Glomerular ecto-ATPase expression was significantly reduced in untreated allografted rats compared to syngrafted rats and correlated well with the extent of FGS. ACEi prevented reduction in glomerular ecto-ATPase. We found de-novo expression of ecto-5'-nucleotidase at sites of renal intimal hyperplasia. Glomerular ecto-ATPase expression was markedly reduced in allografted rats and was prevented by ACEi. These enzyme expression patterns suggest local ischemic damage in experimental CRTF.     

The concept of culture: A core issue in health disparities

Contemporary discourse contains numerous examples of use of the concept of culture by social and behavioral scientists. Simple reification, where the speaker makes culture into a thing capable of action exemplifies one usage in public discourse. Some quantitative social scientists attempt to characterize people’s cultural identities by means of a single categorical variable, which often “lumps” people into categories such as “Hispanic” or “Black” that in fact have numerous culturally bounded subcategories. Approaches that emphasize cultural process are preferable to those who attempt to categorize; more complex measures of acculturation help investigators to make convincing analyses of circumstances in which health disparities occur. Examples in which investigators make appropriate use of cultural characterizations demonstrate their utility in investigating health disparities in Haitian American women, injecting and noninjecting drug users, Hispanic youth, and adult Hispanics at risk of HIV infection. Focus on culture in the study of health disparities can identify entanglements between structural factors such as poverty and lack of education and cultural factors such as beliefs about health. Qualitative methods coupled with quantitative methods have great potential to improve investigators’ grasp of cultural nuance while capturing the distribution of qualitatively derived behaviors.