糖尿病患者第3腰椎骨密度测量的意义

糖尿病（ＤＭ）患者继发骨质疏松较多见，为探讨早期诊断，对３０例非胰岛素依赖型糖尿病（ＮＩＤＤＭ）患者和４０例正常对照者，进行血清钙（Ｃａ）、磷（Ｐ）、碱性磷酸酶（ＡＫＰ）的测定，拍照胸部、腰椎和骨盆Ｘ线片，并分别经ＣＴ进行第３腰椎骨密度（ＢＭＤ）测量。结果，ＤＭ组ＢＭＤ均值为１２７．１±２５．７７ｍｇ／ｃｍ３，对照组ＢＭＤ均值为１８９．１１±７１．６８ｍｇ／ｃｍ３，两组比较有非常显著差异（Ｐ＜０．０１），提示第３腰椎骨密度测量对ＤＭ患者骨质疏松的早期诊断有一定价值。     

髌骨关节面的应用解剖学研究

本文利用150例髌骨(干燥髌骨100例,福尔马林固定膝关节内的髌骨50例)观测了髌骨关节面和关节软骨的形态及其与股骨内外侧髁关节面在屈膝0～135度范围的对应关系。结果发现中间纵嵴向后突起并由下向上逐渐变凸占100％;内侧纵嵴明显突起者占62％,此时其髌骨内侧部关节面与股骨关节面之间的间隙较大;在膝关节屈曲过程申两关节面接触的顺序为髌骨关节面自下而上、股骨内外侧关节面从前向后相对滑动,伸膝时则相反;髌骨关节面的表面积为1019±20(650～1540)mm~2。并讨论了髌骨关节面的解剖学特点及其临床意义。     

异体胸腺的解剖、组织学及吻合血管移植治疗晚期恶性骨肿瘤的研究

本文对20例20～36周引产死胎胸腺进行了解剖学,组织学观察,并应用吻合血管胎儿胸腺移植治疗晚期恶性原发及继发骨肿瘤12例。结果表明,胎儿胸腺的血供主要来自胸廓内动脉,其次为甲状腺下动脉和心包膈动脉胸腺支,7～8个月胎儿胸腺静脉血管壁较厚,适合作血管吻合,胸腺细胞发育成熟,组织结构正常,已有分泌胸腺素及转化免疫细胞的功能,在解剖学,组织学,免疫学方面均具备了良好的移植条件。12例接受吻合血管胎儿胸腺移植的晚期恶性骨肿瘤患者,其临床症状、体征、X线、免疫指数均有明显改善,患者生存6个月至37个月以上。     

一种直接高效克隆PCR产物的载体制备

Ｂｌｕｅｓｃｒｉｐｔ经ＥｃｏＲ Ｖ酶切后，在Ｔａｑ酶作用下加入ｄＴＴＰ使其３’端加上碱基“Ｔ”而成为３’端突出的粘性末端载体。用此载体直接与ＰＣＲ产物连接进行克隆。克隆效率比采用平端载体克隆的效率提高约５０倍。     

综合医院精神科会诊患者失眠的临床研究

目的：探讨综合医院精神科会诊患者失眠的临床特征及与其它精神障碍的关系。方法：对168例精神科会诊患者进行分析。结果：128例(76、2％)会诊患者有失眠．其中61．7％(79／128)为慢性失眠。原发性失眠仅占5．5％(7／128)，85．1％(109／128)是与其它精神障碍有关的失眠。常见的精神障碍诊断为焦虑障碍、心境障碍和谵妄。60．9％的失眠患者在会诊前得到了处理。结论：应对临床医师进行精神卫生教育，提高他们对失眠等常见精神障碍的识别和处理能力。     

Effect of wrist and ulna head position on gliding resistance of the extensor digitorum minimi and extensor digitorum communis III tendons: a cadaver study.

While attrition from sharp bony surfaces is the most common cause of extensor digiti minimi (EDM) tendon rupture, the etiology of other cases of spontaneous EDM tendon rupture is still unknown. Friction within the compartment may play a role, especially with ulna dislocation. The purpose of this study was to compare gliding resistance of the EDM tendon with that of a tendon which rarely ruptures spontaneously, the extensor digitorum communis of the middle finger (EDC III) tendon, under various wrist and ulna head positions. Eight fresh frozen cadavers were used. Gliding resistance between the tendon and its sheath in each compartment was measured in five different wrist positions and three different ulna head positions. Gliding resistance of the EDM tendon (0.13 +/- 0.03 N) was significantly greater than the EDC III tendon (0.09 +/- 0.03 N) (p < 0.05). For the EDM tendon, the gliding resistance in ulnar deviation or pronation was higher than the gliding resistance in neutral, radial deviation, or supination (p < 0.05), and the gliding resistance with ulnar lengthening (over 6 mm) or dorsal ulnar dislocation (over 9 mm) was higher than in neutral ulnar head positioning. For the EDC III tendon, the gliding resistance in ulnar deviation was significantly higher than the gliding resistance in neutral, radial deviation, or supination, or dorsal dislocation with ulnar lengthening (p < 0.05). Wrist ulnar deviation, ulnar dorsal dislocation (over 9 mm), and ulnar lengthening (over 6 mm) increased the gliding resistance of the EDM tendon. In patients at risk for EDM rupture, such as those with rheumatoid arthritis or distal radioulnar joint osteoarthritis, avoiding such positions may be advantageous.     

联合雾化吸入对老年支气管哮喘急性发作的疗效观察及护理

支气管哮喘是一种由多种细胞及细胞因子参与的慢性炎症性疾病。气道慢性炎症导致气道高反应,从而产生反复发作的喘息、胸闷、呼吸困难、咳嗽等相关症状,尤其多发于夜间及凌晨。我科自2005年6月开始采用特布他林、异丙托溴胺、布地奈德联合雾化吸入治疗老年哮喘急性发作取得满意疗效。现报告如下。1一般资料1.1对象我科2005年6月—2007年5月共收治老年支气管哮喘急性发作病人78例,年龄65岁~95岁(73.0岁±6.0岁),均符合诊断标准[1]。随机分为两组,对照组38例:男30例,女8例;治疗组40例:男35例,女5例。两组年龄、性别比较,差异无统计学意义(P>0…     

胸腺瘤与重症肌无力的外科处理

10例胸腺瘤中3例合并重症肌无力症,经手术治疗配合抗胆碱酯酶药物治疗,9例治愈。     

Serum modulates cyclic AMP-dependent morphological changes in cultured neurohypophysial astrocytes

The effects of serum on the morphological plasticity exhibited by pituicytes in explant cultures of the neurohypophysis of adult rats have been examined. Cultured pituicytes are normally nonstellate, protoplasmic, amorphous cells (< 25% are stellate with a distinct cell body and phase bright processes). After incubation (90 min) of pituicyte cultures in a HEPES buffered salt solution (HBSS) supplemented with isoproterenol or forskolin, the fraction of stellate pituicytes significantly increased. The increase in the fraction of stellate cells induced by isoproterenol was not reversed by subsequent incubation in isoproterenol-free HBSS for 90 min. In contrast, after stellation was induced in cultures by exposure to forskolin (90 min), the fraction of stellate cells was significantly reduced if these cultures were incubated in forskolin-free, serum (0.5%) supplemented HBSS for the same duration. Serum also blocked the increase in the fraction of stellate pituicytes induced by forskolin. These experiments suggest that serum components may have a significant role in controlling the plasticity of neuroglial relations in the neurohypophysis priviously demonstrated in vivo.