促血小板生成素对预测脑瘫高危儿的意义

目的探讨缺氧缺血性脑病(hypoxia-ischem ia encephalopathy,H IE)胎儿和H IE新生儿血清中促血小板生成素(Thrombopoietin,TPO)水平与脑损伤的关系,为脑瘫(cerebral palsy,CP)高危儿人群进行早期干预提供监测手段。方法收集23例H IE胎儿和34例H IE新生儿血清以及25例正常胎儿和30例正常新生儿血清,34例H IE新生儿包括11例轻度H IE,8例中度H IE和15例重度H IE。采用双抗体夹心ABC-ELISA法检测H IE胎儿组和轻、中、重H IE新生儿组血清中TPO的水平,并与正常胎儿组和正常新生儿组比较。结果H IE胎儿组和H IE新生儿组TPO分别高于正常胎儿组和正常新生儿组(分别P<0.01,P<0.01),重度H IE组TPO低于轻度H IE组(P<0.05)。结论血清TPO水平与H IE所致脑损伤严重程度有关。脐血TPO检测可为脑瘫高危儿人群进行早期干预提供监测手段。     

Pulmonary Lophomonas blattarum infection in patients with kidney allograft transplantation

The aim of the study was to analyse the clinical manifestation and management of pulmonary Lophomonas blattarum infection in four allograft transplantation recipients retrospectively. Four patients with pulmonary L. blattarum infection were diagnosed by using Fiberoptic bronchoscopy (FOB) and bronchoalveolar lavage (BAL) examination. Their clinical manifestation and management are summarized. Four cases of pulmonary L. blattarum were found during the period from the second month to the third month after transplantation. Concurring infection by other pathogens was found in three of them. Common initial symptoms included fever (>38 degrees C) without cough and breathlessness. Lower lobe shadowing could be found on chest X-ray. Body temperature decreased to the normal range in three patients and to 37.5 degrees C in the other one, after intravenous injection of metronidazole and tapering immunosuppressant. Radiological examination confirmed improved health condition of the patients afterwards. Two patients received repeated FOB and only dead L. blattarum was found. Pulmonary L. blattarum infection in allograft transplant recipients carry relatively obscure initial symptoms. Possible L. blattarum infection needs to be screened in post-transplantation pulmonary infection patients with similar symptoms, especially in those who respond poorly to anti-infection treatment. Microscopic examination of BAL fluid can help to identify pulmonary L. blattarum infection and metronidazole is an ideal treatment choice.     

氦氖激光血管内照射配合吗啡控制癌痛的对照观察

目的探讨氦氖激光血液照射辅助治疗控制癌痛的疗效。方法对52例中晚期癌症重度痛患者在使用口服吗啡治疗基础上加用低能量氦氖激光血液照射治疗1周后,对疼痛缓解程度及平均缓解时间进行对照观察。结果加用激光照射组的镇痛疗效优于单用吗啡组,P<0.05,有效率分别为92%和84%,P>0.05,显效率分别为67%和46%,u=2.07,P<0.05,均数缓解时间分别为(8±3)h和(8±4)h,t=0.78,P>0.05,差异无显著性意义。结论氦氖激光血液照射治疗有一定协同镇痛作用。     

56例踝关节骨折的内固定治疗分析

目的总结踝关节骨折手术治疗方法及临床疗效。方法对自2004年1月～2004年12月踝关节骨折56例手术进行性回顾分析。结果56例获6～18个月随访，骨折愈合时间12～18周，疗效评定依据Baird-Jackson评分标准：本组优37例，良13例，可5例，差1例，优良率89.3％。结论合理的手术时机和内固定治疗踝关节骨折可取得满意的疗效。     

不同病理类型原发性甲状旁腺功能亢进症临床表现的比较分析

目的 分析不同病理类型甲状旁腺功能亢进（PHPT）的临床表现特点。方法 回顾性分析1958-2005年北京协和医院收治经手术病理证实的280例PHPT患者的临床资料。按病理类型分为甲状旁腺腺瘤组208例，甲状旁腺增生组52例及甲状旁腺腺癌组20例。结果 腺癌组中男性高于另外2组（P〈0．05）。增生及腺癌组中骨畸形、骨软化比例较低，增生组骨吸收、病理性骨折比例低于腺瘤组；胃肠道症状、多饮多尿及泌尿系统病变在腺癌组中高于另外2组（P均〈0．05）。血总钙（TCa）、血游离钙离子（ICa）及24h尿Ca在腺癌组显著高于腺瘤组及增生组（P均〈0．01），在腺瘤组与增生组间差异无统计学意义（P〉0．05）。出现高钙危象的比例在腺癌组显著高于另外2组（P〈0．01）。腺癌组病灶重量高于增生组，腺瘤组病灶直径小于增生组（P均〈0．05）。结论 在本组病例中，腺癌组男性比例较高，泌尿系统病变更为多见，出现高钙危象的比例显著增高，术后复发的比例较高。增生组骨骼系统病变相对较轻，其病变甲状旁腺重量低于腺癌与腺瘤组。     

社区卫生服务:行走在点线面之间

2006开年,一个似曾相识的专有名词重返人们的视野——社区卫生服务,作为一种由政府强力推动的解困手法,被迅速纳入到有效缓解“看病难看病贵”的社会预期之中。由上而下的理论先导,只能经由行之有效的实践打磨才能得以还原。如果将整个社区卫生服务网络比作一个完整的神经系统,那么只有这个新     

大树倒了?

2004年8月26日,哈医大二院建院50周年庆典,位于哈市近郊的这所庞大的医院一扫往日的紧张忙碌,被欢快的乐、缤纷的鲜花、五色的气球和飞扬的条幅紧紧包裹。在庆典活动的中心——该院科技会馆,前去采访的本刊记者穿过络绎不绝的祝贺来宾和整齐划一的迎宾方阵,流连在会场外整齐摆放的各类奖杯、奖牌和科研成果宣传展板之间。这些被物化了的荣誉,几乎挤满了偌大的会堂一层走廊的每一寸角落,静静地宣示着这家医院半个世纪的所有自尊和自豪。在随后进行的庆祝仪式上,在医院各科室职工代表声情并茂的发言之后,哈医大二院院长张岂凡走上讲台。面对眼前如云的嘉宾和着装整齐统一的医护人员方阵,看得出这位著名的技术型院长难掩激情。他在题为“弘扬二院精神,再创世纪辉煌“的演讲词中这样形容：“50年的砥砺前行,50年的春华秋实,令天的哈医大二院已经成为我国医院之林中的一棵生机盎然的大树,根深叶茂,硕果累累。”命运总是在不动声色间逆转,谁能料到,一年后爆出的“天价医药费”事件,使曾经激情飞扬的哈医大二院再一次名动天下,所不同的是,再度亮相的哈医大二院,这一次坐在了被告席上。这棵生长了50年的医疗常青树,难道就此在瞬间轰然倒地?     

Analyzing and shaping human attentional networks.

In this paper we outline a conception of attentional networks arising from imaging studies as connections between activated brain areas carrying out localized mental operations. We consider both the areas of functional activation (nodes) and the structural (DTI) and functional connections (DCM) between them in real time (EEG, frequency analysis) as important tools in analyzing the network. The efficiency of network function involves the time course of activation of nodes and their connectivity to other areas of the network. We outline landmarks in the development of brain networks underlying executive attention from infancy and childhood. We use individual differences in network efficiency to examine genetic alleles that are related to performance. We consider how animal studies might be used to determine the genes that influence network development. Finally we indicate how training may aid in enhancing attentional networks. Our goal is to show the wide range of methods that can be used to suggest and analyze models of network function in the study of attention.     

IIEF-5与NEVA检测在阴茎勃起功能障碍诊断中的意义

目的探讨应用国际勃起功能评分5(IIEF-5)问卷表结合夜间阴茎勃起测定系统(NEVA)筛选勃起功能障碍(ED)的可行性及意义。方法148例门诊ED病人,应用IIEF-5问卷表评分,再通过NEVA测定仪监测夜间阴茎勃起情况,次日数据输入主机回放并分析。结果93例为心理性ED;在19~69岁的5个年龄组中,重度ED的比例由11.8%到55.0%,NEVA中度异常者IIEF积分(12.98±2.58)分,NEVA重度异常者IIEF积分(7.32±1.04)分。结论NEVA能有效地鉴别心理性与器质性ED,IIEF-5评分值与NEVA检测阴茎勃起时血容量变化值有相关性。IIEF-5与NEVA检测结合,能提高诊断和评估ED的可靠性。