健康和病变人声带振动特性声门图

本文用多功能声门图仪测定了健康受试者(男46名,女34名)和不同喉病患者(男134名,女87名)声门图的波形及其特征参数。根据测出的正常声门图及其参数分布研究了恶性喉病变、声带麻痹、喉内关节病变、功能性声门发声障碍、声带息肉、声带小结、喉炎和早期喉病的临床声门图表现及其与声带振动模式变异之间的关系,并探讨了上述病变声门图的鉴别诊断指标和用声门图对喉病手术治疗、药物治疗和功能治疗的疗效进行定性和定量评价。研究结果证实:声门图方法能准确、定量、灵敏地反映声带振动模式及其变异;在喉病诊治中具有重要的应用价值。     

Shape of the myopic eye as seen with high-resolution magnetic resonance imaging.

We have obtained multislice magnetic resonance (MR) images of the eye and calculated ocular dimensions along the three cardinal axes: antero-posterior (A-P), equatorial, and vertical. We found no difference in the shape of hyperopic (average refractive error: +3.72 D) and emmetropic eyes, both of which had an equatorial diameter longer than the A-P and vertical diameters. Myopic eyes (average refractive error: -6.54 D) were larger than hyperopic eyes, and most had the same spheroelliptical shape as that of the emmetropic and hyperopic eyes. The results suggest that during myopic progression an overall enlargement or a radial volume expansion has occurred.     

内镜治疗老年总胆管结石30例体会

目的：探讨内窥镜治疗老年总胆管结石的安全性和有效性。方法：对我院普外科收治的30例70岁以上的老年总胆管结石患者进行回顾性分析，所有患者均经B超或螺旋CT明确诊断并接受内镜治疗，治疗方法包括逆行胰胆管造影（endoscopic retrograde cholangiopancreatography,ERCP)，鼻胆管引流（endoscopic nasobiliary drainage,ENBD)，乳头括肌切开（endoscopic shincterotomy,est)和取石术，碎石术，测定患者内镜治疗前后的生化指标变化。结果：30例老年总胆管结石患者行ERCP检查，成功率100％，28例行EST，总胆管结石直径＜1.0cm者成功率100％，结石直径1.0-1.5cm者成功率86％，结石直径≥1.5cm者需进行机械碎石取石，成功率75％；另有2例患者植入塑料支架作长期引流。1例患者发生与内镜有关的并发症，死亡例，30例患者治疗后各项生化指标较治疗前均有明显改善（P＜0．001）。结论：内镜治疗老年总胆管结石成功率增高，避免了手术创新，安全性好，缩短住院时间，是当前治疗老年总胆管结石的首选方法。     

Prognostic role of alveolar-arterial oxygen pressure difference in acute pulmonary embolism.

BACKGROUND: This study investigated the utility of the alveolar - arterial oxygen pressure difference (AaDO (2)) in predicting the short-term prognosis of acute pulmonary embolism (PE). METHODS AND RESULTS: This study retrospectively enrolled 114 consecutive patients with acute PE, diagnosed by either spiral computed tomography or high probability ventilation - perfusion lung scans. During the first 24 h of admission, all patients had initial artery blood gas collected under room air. Patient exclusion criteria were chronic lung disease, septic emboli, and moderate and low probability lung scans. Patients were assigned to 2 groups based on either 30-day death or a 30-day composite event. Receiver operating characteristic analyses was used to determine the AaDO(2) cut-off value for predicting primary and composite endpoints. Statistical analysis demonstrated significant differences in AaDO(2) between the 30-day composite endpoint group and the 30-day composite event-free survival group (p=0.012). The AaDO(2) had a strong trend between the 30-day death group and the survival group (p=0.062). The best cut-off value for AaDO(2) was 53 mmHg and using this, the positive predictive value for 30-day death was 25% and the negative predictive value was 92%. For the 30-day composite endpoint, the positive predictive value for AaDO(2) was 35%, and the negative predictive value was 84%. In this study, thrombocytopenia was also an indicator of poor prognosis for patients with acute PE. CONCLUSION: The AaDO(2) measurement is a highly useful and simple measurement for predicting short-term prognosis in patients with acute PE. It has high negative predictive value and moderate positive predictive value for 30-day death and 30-day composite event. Aggressive thrombolytic treatment strategies should be considered for patients with an initial poor prognostic parameter (ie, AaDO(2) >or=53 mmHg).     

Effect of estradiol on accelerated atherosclerosis in rabbit heterotopic aortic allografts.

Migration and proliferation of vascular smooth muscle cells are early and major events in the formation of atherosclerotic lesions. We report on an aorta transplant model in rabbits wherein myointimal proliferation is inhibited by 17-beta-estradiol. The abdominal aortas of outbred white New Zealand rabbits were harvested and allografted to the carotid artery of the recipient. The animals, which were fed either a normal or a high-cholesterol (0.5%) diet, were killed 3 weeks later. The degree of myointimal proliferation was measured with a digitized system attached to a light microscope. The myointimal hyperplasia was expressed as the cross section area of the intima/the area of the intima + the area of the media x 100. Transmission electron micrographs were obtained for all vessels. Intimal thickening was shown mainly to consist of proliferating smooth muscle cells. The cholesterol diet resulted in significantly higher serum total cholesterol levels compared to animals on a normal diet (p < 0.0001) but did not affect serum high-density lipoprotein-cholesterol or serum triglyceride levels. The cholesterol diet was also associated with a greater but not significant amount of intimal thickening. Treatment with 17-beta-estradiol significantly decreased both serum triglyceride concentration (p < 0.05) and myointimal thickening (p < 0.01) in cholesterol-fed animals. Transmission electron microscopy showed that the endothelial cells appeared structurally normal in the estradiol-treated animals. Further, estradiol prevented the appearance of vacuolized macrophages. Thus estradiol may decrease myointimal thickening by preserving the endothelium and preventing macrophage appearance in the intima.(ABSTRACT TRUNCATED AT 250 WORDS)