乳腺病变X线立体定位钢丝置入移位的分析

目的分析乳腺立体定位下钢丝置入移位的表现、原因、处理方法，提高术前定位的准确性。方法行立体定位置入钢丝患者79例，96个病变，发生钢丝移位13例。结果立体定位中发生钢丝移位5例，原因分别来自于患者和操作医师；立体定位完成后钢丝移位5例，原因是局麻注射药物过多，导致乳腺Z轴的深度与计算机提示的实际深度不符合、放置定位针的方法不正确、拔出钢丝外套针套时疏忽钢丝是否已锚定病变。处理方法：可按照钢丝提示位置向病变方向移位2cm以内进行手术，重新放置第2根钢丝，将双J型钢丝收入针套并取出体外，重新定位。手术中钢丝脱出2例，因术后过分提拉钢丝所致，放射科医师放置钢丝后应向外科医师准确描述深度、方向，并从距离钢丝头端距离皮肤最近处取切口手术。术后标本未见钙化1例，与钙化位于手术电刀破坏的腺体内有关，可扩大范围切除并短期复查，证实钙化是否完整切除。结论正确认识乳腺X线立体定位下钢丝移位的表现，熟练掌握其处理方法，可提高对不可触及的乳腺病变的定位准确性，正确引导外科手术。     

注射自体成纤维细胞除皱的临床应用

目的观察体外培养的自体成纤维细胞注射的面部除皱临床效果,探讨其在面部年轻化治疗中的意义。方法取10例睑袋及上睑松弛手术切除的皮肤行体外培养,细胞数量扩增至108后注射入面部不同治疗部位皮肤的真皮深层,共注射3次,每次间隔2周。结果10例随访6~12月,各例皱纹均得到明显改善,未出现免疫排斥、肉芽肿等并发症。结论应用培养的自体成纤维细胞注射去除面部浅表皱纹,治疗过程简便、创伤微小、安全、效果确实,是一种较好地填充除皱方法。由于尚缺乏更长期的随访结果,远期疗效还有待进一步观察。     

Short-term interventions for morbid jealousy

This paper discusses short-term treatment for morbid jealousy. A brief account of the clinical presentation of morbid jealousy is given. Theoretical approaches to this phenomenon are summarized and commented on. Specific behavioural and cognitive techniques are described, and their rationale explained. Case examples are cited to illustrate the use of these techniques. Some general comments on the application of these techniques are also made.     

-2-Hydroxyglutaric acid inhibits mitochondrial creatine kinase activity from cerebellum of developing rats

L-2-Hydroxyglutaric acid (LGA) is the biochemical hallmark of patients affected by the neurometabolic disorder known as L-2-hydroxyglutaric aciduria (LHGA). Although this disorder is predominantly characterized by severe neurological findings and pronounced cerebellum atrophy, the neurotoxic mechanisms of brain injury are virtually unknown. In the present study, we investigated the effect of LGA, at 0.25-5mM concentrations, on total creatine kinase (tCK) activity from cerebellum, cerebral cortex, cardiac muscle and skeletal muscle homogenates of 30-day-old Wistar rats. CK activity was measured also in the cytosolic (Cy-CK) and mitochondrial (Mi-CK) fractions from cerebellum. We verified that tCK activity was significantly inhibited by LGA in the cerebellum, but not in cerebral cortex, cardiac muscle and skeletal muscle. Furthermore, CK activity from the mitochondrial fraction was inhibited by LGA, whereas that from the cytosolic fraction of cerebellum was not affected by the acid. Kinetic studies revealed that the inhibitory effect of LGA on Mi-CK was non-competitive in relation to phosphocreatine. Finally, we verified that the inhibitory effect of LGA on tCK was fully prevented by pre-incubation of the homogenates with reduced glutathione (GSH), suggesting that this inhibition is possibly mediated by oxidation of essential thiol groups of the enzyme. Considering the importance of creatine kinase activity for energy homeostasis, our results suggest that the selective inhibition of this enzyme activity by increased levels of LGA could be possibly related to the cerebellar degeneration characteristically found in patients affected by L-2-hydroxyglutaric aciduria.     

盐酸普罗帕酮注射液细菌内毒素检查方法的确立

目的：验证盐酸普罗帕酮注射液细菌内毒素检查法的可行性。方法：通过抑制／增强试验确定盐酸普罗帕酮注射液的有效稀释浓度和细菌内毒素限值。结果：0．35mg/ml的盐酸普罗帕酮溶液无干扰作用，其内毒素限值符合规定。结论：盐酸普罗帕酮注射液可用细菌内毒素检查法来控制其细菌内毒素含量。     

肺栓塞1例

[背景 ]对肺栓塞的认识普遍较低 ,容易漏诊、误诊 .[病例报告 ]患者年龄为 5 7岁 ,女性 ,以原因不明的呼吸困难为主要症状 ,超声心动图检查示右心房右心室扩大及肺动脉高压 .进一步做CT肺血管造影检查确诊为肺栓塞 .[讨论 ]可根据临床表现及非特异性检查 (胸部X线片、超声波及心电图等检查 )确诊肺栓塞 ,当疑似为肺栓塞时可做有确诊意义的CT肺血管造影检查 .