神经梅毒的临床特征与诊断分析

目的：分析神经梅毒的分型和临床特征及提供早期诊断依据。方法：回顾性分析经临床和实验室检查确诊的18例神经梅毒病人的有关临床资料。结果：神经梅毒的临床特征包括：(1)急性、亚急性起病为主；(2)临床以间质型，尤其是以脑卒中起病常见，症状元特异性；(3)血清学检查以梅毒螺旋体血凝试验(TPHA)及快速血浆反应素试验(RPR)特异性较高；(4)脑脊液检查表现为压力增高(42．9％)、蛋白增高(81．2％)及细胞数增高(56．3％)；(5)头颅CT、MRI表现与高血压、动脉硬化所致脑梗死不同，为多发、散在病灶。结论：神经梅毒早期误诊率高，临床表现与分型密切相关，实验室及影像学检查是诊断的重要依据。     

RESEARCH ON A REAL-TIME CONTROL SYSTEM OF LOW POWER DISSIPATION FOR CONTINUOUS CYCLIC PERITONEAL DIALYSIS(CCPD) CYCLER

FOREWORDPeritonealdialysisrepresentssoluteandfluidexchangemainlybetweenperitonealcapillarybloodanddialysissolutionintheperitonealcavity'CombinedwithhemodialySisandrenaltransplantation,peritonealdialysisisusedmainlyforthetreatmentofrenalfailure,particularlyforchronicfailure'In1976,Prof'Popovichdevelopedcontinuousambulatoryperitonealdialysis(CAPD)basingontheconceptofcontinuousequilibrationdialysis('1'Fromthenon,peritonealdialysisfounditsclinicaluse'Continuouscyclicperitonealdialysis(CCPD…     

Quantitative evaluation of recall and precision of CAT Crawler,a search engine specialized on retrieval of Critically Appraised Topics

Background

Critically Appraised Topics (CATs) are a useful tool that helps physicians to make clinical decisions as the healthcare moves towards the practice of Evidence-Based Medicine (EBM). The fast growing World Wide Web has provided a place for physicians to share their appraised topics online, but an increasing amount of time is needed to find a particular topic within such a rich repository.

Methods

A web-based application, namely the CAT Crawler, was developed by Singapore's Bioinformatics Institute to allow physicians to adequately access available appraised topics on the Internet. A meta-search engine, as the core component of the application, finds relevant topics following keyword input. The primary objective of the work presented here is to evaluate the quantity and quality of search results obtained from the meta-search engine of the CAT Crawler by comparing them with those obtained from two individual CAT search engines. From the CAT libraries at these two sites, all possible keywords were extracted using a keyword extractor. Of those common to both libraries, ten were randomly chosen for evaluation. All ten were submitted to the two search engines individually, and through the meta-search engine of the CAT Crawler. Search results were evaluated for relevance both by medical amateurs and professionals, and the respective recall and precision were calculated.

Results

While achieving an identical recall, the meta-search engine showed a precision of 77.26% (±14.45) compared to the individual search engines' 52.65% (±12.0) (p < 0.001).

Conclusion

The results demonstrate the validity of the CAT Crawler meta-search engine approach. The improved precision due to inherent filters underlines the practical usefulness of this tool for clinicians.

     

人和大鼠腰椎关节突关节的SP能神经纤维的分布

目的：证实支配腰椎关节突关节的神经支配和化学性质，方法：用逆行荧光素标记结合免疫组化法，研究７只大鼠腰部脊神经节细胞的周围突分支投射到腰椎关节突关节及其递质性质以及３例人腰椎关节突关节囊上神经末梢的化学性质，结果：发现大鼠一侧Ｌ５和Ｌ６之间的关节突关节受同侧Ｌ２－５节段的脊神经节的部分细胞周围突分支支配，其中有３３．３９９％的中型和小型细胞为中ＳＰ能免疫反应阳性，人的关节突关节囊含有ＳＰ阳性的神经     

腰骶部SPR术中脊神经前后根定位的应用解剖

目的：为ＳＰＲ提供可靠的术中脊神经前、后根鉴别的解剖学依据。方法：在２０例成人脊柱标本上,去除后部结构,暴露整个马尾神经,对Ｌ１～Ｓ２节段的前后根进行形态学观察和测量。结果：脊神经后根位于马尾的后半部,前根则位于前半部。脊神经后根较相应的前根粗大,后根从Ｌ１～Ｓ１逐渐增大,以Ｓ１为最粗大;前根则以Ｌ３最粗大。相应前后根出硬脊膜前,有一段相互贴附并紧贴硬脊膜侧壁。结论：在多椎板切除ＳＰＲ术中前、后根的定位及鉴别,暴露时可根据前、后根出硬脊膜前的相互贴附;在限制性椎板切除时则可通过脊髓外侧索和Ｌ１前、后根之间的最下端的齿状韧带加以鉴别     

Assessment of HBV persistent infection in an adult population in Taiwan

In order to study the prevalence of hepatitis B virus (HBV) in the adult population of Taiwan, we screened for the presence of HBV DNA in 205 blood samples from adult (20-59-year-old) volunteers. According to the serological markers of HBV, samples were divided into three groups: group I (173 subjects) was negative for both HBsAg and HBeAg; group II (14 subjects) was positive for both HBsAg and HBeAg; and group III consisted of 18 subjects who were HBsAg-positive but HBeAg-negative. Plasma HBV DNA was not detected in group I, but it was found in 85.7% and 11.8% of samples in group II and group III, respectively. A free-form HBV DNA was found in 14.3% of the leukocyte samples in group II. Furthermore, an integrated form of HBV DNA was detected in the leukocytes of two cases of group I who remained healthy based on clinical data. HBV DNA was also detected in the spermatozoa and liver cells of one of the cases.     

Involvement of protein kinase c in responses of rat dorsal horn neurons to mechanical stimuli and periaqueductal gray descending inhibition

 The effects of a protein kinase C (PKC) activator, 12-O-tetradecanoylphorbol-13-acetate (TPA), on the activity and periaqueductal gray (PAG)-induced inhibition of rat dorsal horn neurons of the lumbar spinal cord were tested. A microdialysis fiber was placed through the dorsal horn for the purpose of local application of pharmacological agents. Extracellular single-unit recordings from dorsal horn neurons were made near the microdialysis fiber. TPA was tested on nociceptive dorsal horn cells. There was a significant increase in the background activity and responses to ”brush”, with no changes in responses to pressure and pinch stimuli. TPA also significantly blocked the PAG-induced inhibition of responses to brush, press, and pinch. These effects were eliminated by coadministration of the PKC inhibitor NPC-15437. The solvent, which contained dimethyl sulfoxide, was also tested for its effect on the responses to peripheral mechanical stimuli and PAG-induced inhibition of the dorsal horn neurons. There were no significant changes. This experiment suggests that activation of the PKC second messenger system might increase the activity of dorsal horn neurons and their responses to peripheral stimuli; in addition, the phorbol ester attenuated the PAG-induced descending inhibition of the dorsal horn neuron activity. Received: 15 May 1996 / Accepted: 14 November 1996     

Limited diversity of the protein D gene (hpd) among encapsulated and nonencapsulated Haemophilus influenzae strains.

Protein D is a surface-exposed lipoprotein of the gram-negative bacterium Haemophilus influenzae with affinity for human immunoglobulin D myeloma protein. The gene encoding protein D (hpd) in a serotype b strain of H. influenzae was cloned. Escherichia coli carrying the hpd gene bound human myeloma immunoglobulin D. Nucleotide sequence analysis identified an 1,092-bp open reading frame that was more than 99% identical to the hpd gene from a nontypeable H. influenzae strain. In the deduced amino acid sequences for protein D, only 2 of 364 amino acid residues differed. The restriction fragment length polymorphism of the hpd region in different strains was analyzed by Southern blot analyses of PstI- or EcoRI-digested genomic DNA from 100 H. influenzae strains. The analysis was performed by using isolated fragments of the cloned hpd gene, originating from the nontypeable H. influenzae 772, as probes. All strains tested had DNA sequences with a high degree of homology to the hpd probes. The analysis also showed that restriction endonuclease sites within the gene were more conserved than sites adjacent to the hpd gene. An interesting difference between type b strains and unencapsulated strains was observed. The majority of type b strains seem to have a 1.4-kbp DNA fragment upstream of the hpd gene that is absent in nontypeable strains. On the basis of the high degree of conservation of the hpd gene among H. influenzae strains, we conclude that protein D is a possible vaccine candidate.