术前TAGM联合弹簧圈门静脉栓塞根治肝门胆管癌1例报告

正右侧侵犯为主的肝门胆管癌根治术多需要联合右半肝切除,可能会导致术后肝衰竭。近年来,计划性肝切除的策略备受关注,采用门静脉栓塞(portal vein embolization,PVE)的介入技术能诱导未来残余肝(future liver remnant,FLR)术前增生、降低肝衰风险~([1-3])。使用三丙烯酸酯明胶微球(tris-acryl gelatin microspheres,TAGM)作为末梢栓塞剂,联合近侧弹簧圈的PVE在国内鲜有报道。笔者单位1例尝试采用此技术治疗1例。报告如下。     

罹患重度牙周病变磨牙采取微创拔牙和微翻瓣位点保存术后种植修复效果观察（附1例3年随访报告）

种植治疗因其临床长期效果稳定,逐渐成为牙列缺损或缺失后的常规修复方法,而充足的骨量和良好的软组织条件对种植治疗方案的实施至关重要。罹患重度牙周病变的磨牙不但在拔牙之前已经存在牙槽骨吸收,而且在拔牙窝愈合过程中所发生的不同程度牙槽骨吸收均会增加种植治疗的难度。文章完整展示了1例磨牙牙周-牙髓联合病变病例从病情分析、采取微创拔牙和微翻瓣技术在拔牙窝实施位点保存创造良好硬组织条件、按照标准化流程完成种植修复到追踪观察3年的具体实施过程,为评价此类病例微创拔牙和微翻瓣位点保存术后种植修复的长期效果提供了依据。     

人格障碍的遗传度及父母之间的交互作用

目的:从群体的角度研究人格障碍(personality disorder,PD)的遗传度及父母在子女人格障碍发生过程中的交互作用。方法:本研究采用分层整群抽样方法抽取北京市的25所中学,对抽取学校的所有高三学生(N=9892)及他们的父母进行调查(其中人格障碍病例组共181人,对照组共2605人)。以国际人格障碍检查表(International Personality Disorder Examination,IPDE)、人格诊断问卷(PersonalityDiag-nositic Questionnaire-4,PDQ-4)、父母养育方式问卷(Egma Minnenav Bardndosnaupp for-stran,EMBU)和自编一般情况调查表为工具,利用现况研究资料和病例对照研究资料,计算人格障碍的遗传度并分析父母在子女人格障碍发生过程中的交互作用。结果:总体PD的遗传度0.7,各组PD的遗传度均0.3。单独父亲人格障碍与子女人格障碍的关联强度比值比为12.9;单独母亲人格障碍与子女人格障碍的关联强度比值比为3.3;父母同为人格障碍与子女人格障碍的关联强度比值比为123.2。结论:遗传因素在人格障碍的发生过程中具有重要的影响。父亲和母亲对子女人格障碍的发生具有交互作用。     

1978-2009年间中国精神病学科研发展系统评价

目的:通过系统评价,了解我国1978-2009年间精神病学领域科研的研究发展概况。方法:英文文献采用计算机检索PubMed,中文文献检索中国期刊全文专题数据库(China National Know ledge Infra-structure,CNK I,1979-2009),并辅以文献追溯等方法,全面收集近32年的精神病学专业研究文献。并以精神分裂症为例定性地总结近32年来研究发展情况。结果:共检索到中国精神病学及相关专业英文文献2197篇,中文文献62761篇。随着年代的推移,发表的文献总数以及关于各类精神障碍的文献数均呈成倍递增趋势。各类精神疾病文献中,关于心境障碍和精神分裂症方面的文献最多。关于创伤后应激障碍和双相情感障碍的文献数量增长速度最快。对精神分裂症的定性研究发现,随着年代的推移,精神分裂症方面的研究涉及越来越多的领域并运用了越来越多的方法。结论:从1978年到2009年间,中国在精神病和精神卫生领域的研究取得了长足的发展。     

B cell apoptosis accelerates the onset of murine lupus

To investigate whether the increased rate of lymphocyte apoptosis in systemic lupus erythematosus is involved in the onset of the disease, apoptotic or necrotic T or B lymphocytes from various cell lines were injected intraperitoneally into pre-autoimmune (NZBxNZW)F1 mice (BW) and non-autoimmune BALB/c mice. The intraperitoneal production of cytokines and chemokines, the specific T cell response in the spleen, and the production of anti-histone and anti-dsDNA Ab were investigated. The onset of the disease was characterized by creatinine levels and evaluation of glomerular IgG deposits. In BW, but not in BALB/c mice, injection of apoptotic and not necrotic cells up-regulated IL-6 and IL-10 in resident macrophages. Administration of apoptotic cells augmented the number of Th2 and B lymphocytes recruited in the peritoneal cavity. Only the treatment with apoptotic B cells promoted a systemic Th2 autoimmune response to H2 histones, associated with earlier occurrence of high levels of anti-dsDNA autoantibodies, higher creatinine levels and more numerous glomerular IgG deposits than in BW controls not injected with apoptotic B cells. In genetically susceptible mice exposure to apoptotic of B, but not T, lymphocytes can elicit a Th2 response to H2 histones that helps B cell production of anti-dsDNA Ab and finally triggers the onset of lupus.     

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??Value of preoperative lymphoscintigraphy in sentinel lymph node biopsy of breast cancer SUN Xiao*, LIU Juan-juan, WANG Yong-sheng, et al. *Breast Cancer Center, Shandong Cancer Hospital, Jinan 250117, China
Correcponding author: WANG Yong-sheng, E-mail: wangysh2008@yahoo.com.cn
Abstract Objectives Background Although preoperative lymphoscintigraphy for sentinel lymph nodes biopsy (SLNB) in breast cancer patients is undergone commonly, its clinical significance remains controversial. Methods Firstly, a database containing 716 consecutive breast cancer patients who received preoperative lymphoscintigraphy before SLNB was retrospectively analyzed. Secondly, 565 consecutive breast cancer patients were prospectively randomized into groups with or without preoperative lymphoscintigraphy before SLNB. Results In the retrospective study, sentinel lymph nodes (SLNs) were well imaged by lymphoscintigraphy in 86.6% patients, and negative lymphoscintigraphy results were associated with axillary node metastases. Failure of identification of SLNs by isotope alone was associated with whether axillary hot spot was imaged by lymphoscintigram (P<0.001). There were no significant differences in the false negative rate (P=0.731) of SLNB by isotope alone, in the identification rate (P=0.174) and the false negative rate (P=0.947) of SLNB by combination of dye and isotope between patients who had axillary hot spot in lymphoscintigram and those who had not. In the prospective study, 290 patients were randomized into the group with preoperative lymphoscintigraphy (82.1% patients were well imaged by lymphoscintigraphy) and 275 patients without. There were no significant differences between two groups in the identification rate (P=0.757) and the false negative rate (P=1.00) of SLNB by isotope alone, also in the identification rate (P=1.00) and the false negative rate (P=1.00) of SLNB by combination of dye and isotope. Conclusion Preoperative lymphoscintigraphy could not improve the identification rate and reduce the false negative rate of SLNB in breast cancer patients, and it is not a prerequisite for SLNB.