神经移植端侧缝合颈5/7神经根与上干桥接治疗产瘫

目的：探讨一种不影响残存神经自行恢复的产瘫臂丛神经修复新方法。方法：将上干损伤部位行松解,不切除神经瘤,将其近端的颈5或颈7神经根和神经瘤远端的臂丛上干的神经束膜切开窗口,取颈丛皮支或前臂外侧皮神经前成多段（一般每段长约2．0－2．5cm）,两端分别与颈5神经根和上干的神经束膜行端侧缝合,结果：8例患儿经术后1－11年（平均3年）的随访,4例的三角肌和肱二头肌骨力达4级和4^-级,4例达3例。3例后期进行了肩关节松解和旋前圆肌肌腱切断,结论：该方法既提供了可使损伤近端颈5神经根的新生纤维生长至上干的神经通道,又未阻断神经瘤内残存神经纤维的自行恢复,是治疗产瘫特别是Tassin2型的新术式。     

朝鲜族人群鼻部肿瘤

[目的 ]了解朝鲜族的各种鼻部肿瘤的发病率并确定针对高发鼻部肿瘤的研究课题 .[方法 ]调查 1990年 1月到 1999年 10月之间在延边大学医学院附属医院病理科经活检确诊为鼻部肿瘤的全部患者的原始记录 .[结果 ]发现了 82例朝鲜族鼻部肿瘤患者 .其中 ,发病率最高的为乳头状瘤 ( 3 6/ 82 ) ,其次为鳞状上皮癌 ( 13 / 82 ) .[结论 ]朝鲜族鼻部乳头状瘤的发病率明显高于国内其它地区 .必须提高对鼻部乳头状瘤的诊断和治疗水平 ,并加快有关鼻部乳头状瘤和人类乳头状瘤病毒之间的关系的研究 .     

黄白口服液对吸入全麻所致兔肺组织磷脂酶A2活性影响的研究

目的：研究黄白口服液预防大白兔肺组织在吸入全麻中受损的临床疗效。方法：将３６只大白兔随机分为空白对照组、阳性对照组和黄白口服液组,并检测大白兔肺组织磷酯酶Ａ２（ＰＬＡ２）活性。结果：黄白口服液组大白兔组织的ＰＬＡ２活性明显低于阳性对照组（Ｐ〈０．００１）。结论：黄白口服液可大大减轻大白兔肺组织在进入全麻时所受到的伤害。     

尿道压力分布图对α受体阻滞剂治疗良性前列腺增长效果 …

目的：研究尿道压力分布图（ＵＰＰ）对良性前列腺增长（ＢＰＨ）患者α肾上腺素能受体阻滞剂治疗效果的预测。方法：用改良苄胺唑啉ＵＰＰ试验将ＢＰＨ患者分为阳性及阴性组,比较ＵＰＰ图诸参数之差异。结果：１４３例ＢＰＨ患者行改良苄胺唑啉ＵＰＰ试验,阳性６４例,占全部病例（４５７例）的１４．０％。资料完整者阳性组（３８例）及阴性组（２８例）试验前最在尿流率（Ｑｍａｘ,ｍｌ／ｓ）及ＵＰＰ诸参数无显著性差异（ｐ〈     

P_(16)蛋白在卵巢上皮性肿瘤的表达及临床意义

目的 :探讨P16蛋白在卵巢上皮性肿瘤中的表达及临床意义。方法 :采用SP免疫组化法检测P16蛋白在 82例卵巢上皮性肿瘤组织 (良性 2 0例 ,恶性癌 6 2例 )及 1 5例正常卵巢组织常规石蜡标本的表达。结果 :P16蛋白在卵巢上皮性癌中检出率为 5 3 2 % ,低于良性卵巢瘤 90 0 %及正常组织 93 3% (P <0 0 1 )。不同分化程度卵巢癌之间P16蛋白的阳性率无显著差别 (P >0 0 5 ) ,P16蛋白表达与临床分期及预后有关 (P <0 0 5 ,P <0 0 1 )。结论 :P16蛋白在卵巢上皮性恶性肿瘤的发生、发展中起作用 ,P16的缺失表达与卵巢癌的进展和预后不良有关。     

大肠腺癌DNA和RNA测定与转移及预后的关系

探讨大肠腺癌DNA和RNA含量的变化意义及预后的关系。方法 :对我院 1985年～ 1992年收治的术后随访 74例病人的大肠腺癌石腊标本重新切片 ,用流式细胞技术进行DNA和RNA含量测定 ,探讨其变化意义与转移预后的关系。结果 :大肠腺癌DNA异倍体与组织学类型无关 ,RNA含量与组织学类型关系密切。DNA异倍体和RNA含量大肠腺癌的Dukes’分期、淋巴结转移、其它脏器转移和根治术后复发均有关。术后生存 5年以上病人的DNA异倍体出现率和RNA含量较术后 1年内死亡病人为低 ,两者有显著性差异 (P <0 .0 1)。结论 :DNA和RNA含量测定可作为判断大肠腺癌的恶性程度、估价预后的客观可靠指标。     

Risk factors for hepatocellular carcinoma at baseline and 1 year after initiation of nucleos(t)ide analog therapy for chronic hepatitis B

Nucleos(t)ide analogs (NAs) cannot completely suppress the risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB). This study aimed to identify the risk factors for HCC development in naïve CHB patients treated with current NA. Patients receiving NA (n = 905) were recruited retrospectively from the 17 hospitals of the Japanese Red Cross Liver Study Group. All treatment-naïve patients had been receiving current NA continuously for more than 1 year until the end of the follow-up. We analyzed the accuracy of predictive risk score using the area under receiver operating characteristic curve. The albumin–bilirubin (ALBI) score was significantly improved by NA therapy (−0.171 ± 0.396; p < 0.001 at Week 48). A total of 72 (8.0%) patients developed HCC over a median follow-up of 6.2 (1.03–15.7) years. An independent predictive factor of HCC development was older age, cirrhosis, lower platelet counts at baseline and ALBI score, and alpha-fetoprotein (AFP) at 1 year after NA therapy according to multivariate analysis. The accuracy was assessed using the PAGE-B, mPAGE-B, aMAP, APA-B, and REAL-B scores that included these factors. Discrimination was generally acceptable for these models. aMAP and REAL-B demonstrated high discrimination with 0.866/0.862 and 0.833/0.859 for 3- and 5-year prediction from the status of 1 year after NA therapy, respectively. Baseline age and platelet count, as well as ALBI and AFP one year after NA, were useful for stratifying carcinogenesis risk. The aMAP and REAL-B scores were validated with high accuracy in Japanese CHB patients.     

天津市汉沽区媒介生物调查初报

本文报道了天津市汉沽区域媒介生物的调查结果:本地区有蚊类6种;鼠类5种;蝇类31种;蜚蠊类3种;蚤类2种;螨类1种。     

一种关于RPM放疗呼吸门控系统束流时间延迟性能的参考质控方法

目的：提出一种关于RPM放疗呼吸门控系统束流时间延迟性能的参考质控方法,给出参考条件下VB与EDGE加速器的时间延迟测量结果。方法：首先设计梯形质控呼吸曲线并加载运动模体,利用定位CT扫描由运动模体驱动的W-L模体,然后设计用于束流出束和截止延迟测量的两类质控计划,最后在加速器上执行质控计划,使用EPID采集模体的静态参考图像与运动测量图像,通过分析致密金属球在运动图像和参考图像中的位置差,反推束流的时间延迟,分别在VB与EDGE两台加速器上做方法验证。结果：VB与EDGE加速器的束流出束时间延迟均小于100 ms,截止时间延迟基本一致,VB加速器约为14 ms,EDGE约为22 ms。10FFF各剂量率的出束时间延迟基本一致,而6FFF、6 MV和10 MV则随剂量率的变化略有增加。4个能量各剂量率的束流截止时间延迟均较小且相对一致,部分能量有随剂量率变大而延迟缩小的趋势。结论：本研究提出的RPM束流时间延迟参考质控方法和条件具有较高的测量可信度和较强的临床实操性,测量结果表明RPM呼吸门控系统响应灵敏,研究结果为呼吸门控系统的时间延迟质控提供了重要的方法学指导与数据参考。     

Effects of local muscle fatigue on three-dimensional scapulohumeral rhythm

The relationship of scapulothoracic motion to glenohumeral motion, commonly referred to as the scapulohumeral rhythm, has been the subject of numerous investigations. The purpose of this study was to assess the effects of localized muscular fatigue on three-dimensional scapulothoracic motion and the resulting scapulohumeral rhythm during elevation of the humerus in the plane of the scapula. A six-degree-of-freedom digitizing system (Metrecom(TM)) was used to define scapular and trunk reference frames, and three-dimensional Eulerian angles were determined for scapular motion for 0-135 degrees of humeral elevation before and after fatigue of the upper and lower trapezius muscles. Local muscle fatigue was determined using spectral analysis of electromyographic signals for the upper and lower trapezius muscles. The results demonstrated an average of 22% decrease in the median frequencies of the muscles sampled following resistive exercise, suggesting a state of local muscle fatigue. Concomitant with the fatigue was a selective decrease in scapulothoracic motion about two of the three scapular axes. RELEVANCE: Occupational and recreational conditions often require repetitive overhead elevations of the arms, resulting in muscular fatigue and various pathologies. During repetitive arm elevations the scapulohumeral rhythm or synchronization between the humerus and the scapula is balanced to allow the most efficient elevation of the arm. A better understanding of this much-discussed scapulohumeral rhythm and the changes induced by muscular fatigue may provide insight into the pathomechanics associated with shoulder dysfunction.