慢性疼痛与情绪障碍及其干预治疗效应

目的:分析慢性疼痛与情绪障碍之间的关系,探讨心理及药物治疗对慢性疼痛的干预作用。资料来源:应用计算机检索Medline1989-01/2004-05和Embase1989-01/2004-05有关慢性疼痛与情绪障碍关系的文献,检索词“Chronicache,emotionaldisorder,treament”,并限定文章语言种类为English。观察对象为疼痛持续时间超过6个月以上的患者。资料选择:选取有关慢性疼痛与情绪障碍关系及其治疗干预的文献,进行初审,删除陈旧及重复的文献,然后查找余下的文献全文。质量评价主要考察资料的真实性,调查设计是否严密,实施过程是否严格,统计学处理是否合理。资料提炼:共检索到20篇关于慢性疼痛与情绪障碍关系及其治疗干预的文献,11篇文献符合纳入标准。排除的9篇试验中,7篇系重复的同一研究,2篇是Meta分析。资料综合:11篇文献均包括观察组和对照组,其中观察组应用镇痛药合并心理治疗及抗抑郁药,对照组应用镇痛药但未合并心理治疗及抗抑郁药,对两组患者的疗效进行比较分析。结论:慢性疼痛与情绪障碍同时存在,应用镇痛药合并心理治疗及抗抑郁药可以显著缓解患者的疼痛,干预效果优于单纯应用镇痛药者。     

MMP-2、TIMP-2与碱烧伤后角膜新生血管形成的实验研究

目的:探讨基质金属蛋白酶-2(MMP-2)、基质金属蛋白酶-2组织型抑制剂(TIMP-2)在碱烧伤大鼠角膜新生血管(CNV)形成中的表达和意义。方法:采用碱烧伤大鼠角膜建立CNV模型,摘除角膜作病理切片,多形核白细胞(PMN)记数;免疫组化法检测MMP-2、TIMP-2的表达。结果:烧伤后1d角膜缘PMN开始增多,到CNV7d组PMN增加最明显,此后逐渐减少;免疫组化显示:MMP-2在CNV中阳性表达逐渐增加,于7d表达最明显,此后随炎性细胞的减少而减弱,21d后几乎无表达;TIMP-2则于早期变化不明显,7d表达开始升高,14d达高峰。结论:烧伤后CNV形成早期,MMP-2活性增高,继而TIMP-2表达增加,使MMP-2活性受抑,基底膜降解受阻,新生血管延伸停滞;CNV形成中,MMP-2的表达增加,并与角膜的炎性反应程度一致,PMN浸润可能是CNV形成的关键因素。     

Characteristics of thyroidectomy in Taiwan.

BACKGROUND AND PURPOSE: Thyroidectomy is a common treatment for thyroid disorders in Taiwan, and constitutes a significant percentage of medical expenses. This study investigated the characteristics of thyroidectomy in Taiwan. METHODS: A total of 21 senior general surgeons from 16 medical centers and 5 regional hospitals participated. One surgeon from each hospital reviewed the hospital's medical records of thyroid operations performed in the year 2001. Medical records for 3846 thyroidectomies were retrospectively analyzed, including surgical indications and modalities, complications, pathology reports, and the use of antibiotics. RESULTS: Most of the patients were women (85%). Indications for surgery included proven malignancy (9%), suspicious malignancy (30%), evident compression symptoms (20%), hyperthyroidism (20%), and cosmetic reasons (12%). The majority of patients (78%) underwent a surgical procedure with lobectomy or bilateral thyroidectomy; 13% had unilateral partial thyroidectomy. Prophylactic antibiotics were administered in 46% of procedures, and continued postoperatively in 12%. Postoperative complications occurred in 12% of patients. Hypocalcemia was the most common complication (8%), and its incidence was significantly correlated with the frequency of total thyroidectomy (p < 0.01). Complete pathology reports for the thyroidectomized specimens were available in only 65% of the cases. The frequency of cosmetic reasons for surgery, unilateral subtotal resection, routine antibiotic administration, and incomplete pathology reports were significantly higher in regional hospitals than in medical centers. CONCLUSIONS: Reduction in the high rates of cosmetic reasons for surgery, unilateral partial thyroidectomy, incomplete pathology reports, and use of antibiotic prophylaxis are needed to improve the quality of thyroidectomy in Taiwan.     

Pneumocephalus after thoracoscopic excision of posterior mediastinal tumor.

Pneumocephalus is a very rare complication of video-assisted thoracoscopic surgery (VATS). A 66-year-old man developed pneumocephalus secondary to thoracoscopic excision of a neurogenic tumor in the posterior mediastinum. Pneumocephalus was diagnosed by brain computed tomography. Neurosurgical intervention was performed after conservative therapy had failed. The patient's condition had resolved without any neurologic sequelae 2 years later. When a patient has a relatively large amount of chest tube drainage and neurologic symptoms after VATS, the possibility of pneumocephalus due to cerebrospinal fluid leakage must be considered.     

Parkinson''s disease in China. Coordinational Group of Neuroepidemiology, PLA.

An epidemiological study on the incidence and prevalence of Parkinson's disease (PD) was carried out in 29 provinces, cities and autonomous regions in this country in 1986. The survey was conducted in 117 areas, and 566 patients with PD were found among 3,869,162 persons examined, giving a point prevalence for men and women of 16.9/10(5) and 12.4/10(5), with the highest prevalence after the fifth decade of age. The disease was most prevalent in the southern part of China, especially in Hunan and Guangxi provinces. The incidence was 1.5/10(5)/yr in 1986. Both the prevalence and incidence of PD in China are lower than those in the white race and Japanese.

     

Studies on Toxicity of Nitroquine-Dapsone Compound and Therapeutic Effects of Folic or Folinic Acid on Toxicated Animals

The toxic effects of nitroquine-dapsone compound(NQD)in mice and dogs were studied.The therapeutic index of NQDin mice is 1911,the greatest among the 6 antimalarials tested.Thetoxic effects of NQD(50 mg/kg/day for 3 days per os)and nitro-quine in dogs were manifested by injuries on the adrenal cortexand intestinal epithelium.When folic acid(4 mg/kg/day for 4 days)or calcium leucovorinum(0.3 mg/kg/day for 4 days)were usedconcomitantly with NQD,the death rate and the incidence of dia-rrhea in the toxicated dogs were greatly reduced,the injury on theintestinal epithelium was much milder,and the goblet cells weremuch more numerous than those without treatment.The results suggestthat folic acid and calcium leucovorinum can protect the undifferen-tiated cells in the intestinal crypts from being injured by NQD.     

世界脊髓损伤研究的代表性方向

我们现在要尽量使这些治疗方法进入临床试验证明他们的可行性现在脊髓损伤的临床试验基金很有限，所以只有很少的这些治疗方法真正用于病人主要的制药厂开始对脊髓损伤治疗产生兴趣，我们现在还有很多工作要做，但是前景方向十分清楚，我们需要努力快速的工作。     

女性减肥者的体像问题与社会支持及性格的关系

目的研究女性减肥者的体像特征及相关因素。方法采用体像障碍自评量表、社会支持量表、艾森克个性问卷调查了100例减肥门诊女性就诊者，并与100例近5年无减肥经历女性对照。结果(1)女性减肥者，体像得分明显高于正常对照组。(2)女性减肥者的体像得分与收入、P分、N分明显正相关；与社会支持得分明显负相关，与BMI无相关性。结论女性减肥者，不管是否为单纯性肥胖，都存在较多的体像问题，且与特定得人格和社会支持有关。