Normal values of MAPSE and TAPSE in the paediatric population established by cardiovascular magnetic resonance

The International Journal of Cardiovascular Imaging -     

Multidetector CT and histological features of benign mesenchymoma of the infratemporal space: a rare case report

Benign mesenchymoma is a soft tissue neoplasm composed of an admixture of two or more benign mesenchymal components in addition to fibrous tissue. A rare case of benign mesenchymoma of the infratemporal space in a 14-year-old boy is presented. In this case report we discuss the salient imaging and histopathological features of this rare entity.     

Toll样受体4在子痫前期中的表达和意义

目的探讨Toll样受体4(TLR4)在子痫前期发病机制中的作用。方法选取20例轻度子痫前期(MP)和20例重度子痫前期(SP),15例正常妊娠患者(NP)作为研究对象。用RT-PCR方法检测TLR4mRNA在外周血单核细胞(PBMC)中的表达。免疫组化法检测TLR4蛋白在子痫前期患者胎盘中的表达。用ELISA方法检测血清中肿瘤坏死因子-α(TNF-α)的浓度。结果 TLR4mRNA和蛋白在SP患者中表达水平高于MP组,MP组高于NP组,差异有统计学意义(P=0.000)。血清中TNF-α水平,SP组高于MP组,MP组高于NP组,差异有统计学意义(P=0.000)。在PE患者中,TNF-α的表达与TLR4mRNA和蛋白均呈正相关关系(P=0.000)。结论 TLR4的高表达可能是子痫前期发病机制的启动因素。两者可能通过介导TNF-α表达的上升而参与子痫前期的病理生理变化和促进疾病的进展。     

下胸段单钉T11~12镍钛合金弹性内固定系统有限元分析及临床意义

目的　建立T11~12前路病灶清除植骨+单钉单棒镍钛合金弹性固定系统三维有限元模型,分析弹性固定系统所受应力对其进行改进。 方法 对一名成年男性进行螺旋CT扫描,将所得数据导入计算机,通过Mimics13.0软件和Ansys11.0有限元软件建立T11~12前路病灶清除植骨+单钉单棒镍钛合金弹性固定系统三维有限元模型,并在椎体上表面施加500 N压力和10 Nm的力矩模拟腰椎前屈、后伸、侧屈和旋转4种生理载荷,观察不同载荷下固定器械的应力分布,并对其进行比较。 结果 单钉单棒弹性固定系统在用于侧前方固定时,其下位螺钉根部与“U”形棒中段承受应力始终较大,而螺钉的中部与“U”形棒的上部则较小。螺钉根部在4种运动状态下,旋转运动加载的应力最大,而侧弯运动时最小,“U”型棒中部在4种运动状态下应力均较大。但均小于镍钛合金的屈服强度。 结论 T11~12运动节段前路椎间植骨单钉单棒弹性固定患者在正常运动状态下不会由于定械某部位应力过高而导致断钉断棒。     

Is peri-articular multimodal drug infiltration in knee arthroplasty safe when used in conjunction with autologous retransfusion drains?

INTRODUCTION

Adequate peri-operative analgesia following total knee arthroplasty (TKA) promotes earlier rehabilitation but remains problematic because of the drug side-effects. Peri-articular multimodal drug infiltration (PMDI) has been developed as an alternative strategy to avoid such complications. Autologous retransfusion drains reduce the need for peri-operative allogenic blood transfusions and the consequent risk. There is a theoretical risk of local anaesthesia toxicity when these systems are used concurrently. We performed a review of current practice to quantify this risk.

PATIENTS AND METHODS

A series of 10 patients undergoing TKA by the senior author (CAB) had drain fluid analysed for the concentration of ropivacaine. At the same time, the patients completed a questionnaire to establish the presence of ropiva-caine-induced side-effects.

RESULTS

The ropivacaine level in the retransfusion blood was less than 10 mg in all patients. This concentration was a factor of 6 below the published safe level. Three patients had minor neurological disturbances which recovered spontaneously and quickly. There were no cases of significant cardiovascular compromise.

CONCLUSIONS

The theoretical risk of local anaesthesia toxicity when these systems are used together is negligible and we conclude that peri-articular multimodal drug infiltration is safe in conjunction with the use of autotransfusion drains.     

神经精神病学试卷质量分析

目的分析和评价神经精神病学期末考试试卷的质量。方法选择2003级临床专业学生的神经精神病学期末考试试卷进行统计分析。结果考试成绩呈正态分布,平均成绩为（77.03±8.25）分,平均难度为0.778,区分度为0.426。结论该试卷试题难度适中,区分度适中,试题质量良好,能较全面地评价学生对课程的掌握程度。