术中电生理动态监护下显微手术切除椎管神经鞘瘤（附65例报告）

目的 探讨术中电生理监护对椎管神经鞘瘤显微手术中的作用及意义，提高对椎管内神经鞘瘤的治疗水平。方法 回顾性分析65例术中电生理动态监护下，显微手术切除椎管内神经鞘瘤。结果 治愈60例（占92．3％），好转5例（占7．7％），无死亡；肿瘤全切62例，次全切除3例，全切率95．4％。结论 常规动态电生理监测下显微手术切除椎管神经鞘瘤，能保全脊髓神经的功能，减少副损伤，提高手术安全性；显微手术有助于提高肿瘤全切率，可有效减少术后复发。对影响脊柱稳定性的行脊柱融合内固定。     

北欧清洗消毒现状——消毒过程如何减少医院感染

1“消毒”定义的发展250多年前,在瑞典的医疗工作中已经开始使用“消毒”(Disinfection)作为术语,主要指控制或减少医院内的怪味。当时微生物致病的重要性依然不为民众所知。消毒的现代定义是指去除或杀灭致病微生物,以达到清洁要求。消毒的理想方式是完全去除表面的微生物,当然如果真能做到这一点,物品的表面就不止达到了消毒要求,而应为无菌状态了。2现代消毒技术水作为溶剂和优良的载体,对清洁过程起着至关重要的作用。但是,单纯用水或水溶液清洗的方法达不到去除所有微生物的要求。这样,消毒过程要分两步,第1步是通过清洗或机械手段尽…     

中日大学生“ぁぃさつ”语言行为比较研究

以“家庭”“家庭访问”中的“ぁぃさつ”语言行为为中心，通过实证调查和具体事例进行综合性的描述和分析，探究中日两国ぁぃさつ语言行为的体系结构、共性和特性，可以加深对日本文化的理解，同时帮助日语学习者提高跨文化交际语言行为的能力。     

磁共振成像在肝移植术后并发症诊断中的应用

目的探讨磁共振成像在肝移植并发症诊断中的价值。方法回顾分析11例肝移植术后发生并发症者的磁共振检查影像资料。结果11例患者术后出现皮肤和巩膜黄染、发热以及尿黄等症状，丙氨酸转氨酶、天冬氨酸转氨酶、γ-谷氨酰转移酶和胆红素升高．经B型超声波检查不能明确原因，采用磁共振（MRI、MRA和MRCP）检查，明确肝动脉吻合口狭窄1例；肝动脉闭塞2例；下腔静脉吻合口狭窄及血栓形成各1例；胆管吻合口狭窄4例，其中1例伴胆汁瘤形成；肝门水平非吻合口狭窄6例；肝坏死2例；肝包膜下血肿及右肾上腺出血各1例；均显示不等量的右侧胸腔积液、腹腔积液及肝门部水肿。结论磁共振一次检查可显示肝内外的多种结构，能为肝移植术后并发症的诊断提供丰富的肝脏、血管、胆道以及肝外结构的图像信息。     

X线及MRI对聚丙烯酰胺凝胶隆胸后乳腺病变诊断价值的评价与比较

目的对聚丙烯酰胺凝胶(PAG)注射式隆胸术后,出现并发症或合并乳腺其他病变的X线与MRI的诊断价值进行评估。方法回顾性分析26例PAG隆胸术后钼靶X线与MRI的影像表现。结果钼靶X线及MRI能显示充填物位置、形态,合并乳腺病变4例,X线全部漏诊,MRI能检出病灶。结论钼靶X线是PAG隆胸术后普查、随访的首选方法,但出现并发症或者合并乳腺病变时,MRI具有无法比拟的优越性,在临床诊断与治疗中发挥了重要作用。     

Mozart effect in preschool children?

In 1993, Rauscher et al. reported a temporary increase in spatial-temporal ability after listening to Mozart's music. This led to numerous replication and extension studies with mixed findings in the past decade. This study investigated the 'Mozart effect' in preschool children. Forty-one boys and girls, aged three to five, attempted a series of pencil-and-paper maze tests after each of three listening conditions: Mozart's Piano Concerto in A Major (K488), age-appropriate popular music and silence. Overall, there were no statistically significant differences among the three interventions. The results are discussed in relation to the findings of other investigations of the Mozart effect, and the need for further investigation of possible trends.     

重组腺相关病毒-阳离子脂质体载体的构建及评价

目的探讨重组腺病毒相关病毒（rAAV）-阳离子脂质体（LyoVec）复合载体的构建方法及其转染率评价。方法构建rAAv～GFP，rAAv—LyoVec复合载体及rAAV—GFP—LyoVec。倒置荧光显微镜观察，测定rAAV—GFP，LyoVec—GFP及rAAV—GFP-LyroVec对定量C6细胞的转染率，筛选出高转染率载体。结果rAAV—GFP组24、48、72和96h转染率分别为16％、23％、21％和9％；LyoVec-GFP组为28．5％、33％、32％和11％；rAAV—GFP—Lyovec组为49％、59％、64％和20％。rAAV-GFP—LyoVec纽分别在24、48、72和96h的转染率显著高于rAAV—GFP组（P〈0．01）及LyoVec—GFP组（P〈0．01）。结论新构建rAAV—LyoVec复合载体基因的转染效率远远高于rAAV或LyoVec独立转染。     

牙冠延长术在残根残冠修复中的临床疗效

目的评价牙冠延长术在牙体缺损达龈下的残根残冠修复中的临床疗效。方法自2004年5月至2005年6月,对32例患者的36颗牙体缺损达龈下的患牙,术前按断端位于龈下最深距离分为A组(20颗患牙,距离<3.0mm)和B组(16颗患牙,3.0mm≤距离≤4.0mm),均采用牙冠延长术暴露龈下牙体断面,术后6周行桩冠修复。分别记录和比较手术前、后牙周探诊深度(PD)、菌斑指数(PLI)、龈沟出血指数(SBI)和牙齿松动度,以观察临床疗效。结果术后随访患者6个月,两组病例术后6周牙体断端均暴露较好、龈缘颜色正常,术后修复效果有效率为100%,满意率为77.78%。A组术后无松动,修复效果满意;B组术后50.00%出现Ⅰ度松动,修复效果欠佳,两组修复效果比较差异有显著意义(P<0.05)。术后各阶段两组的PD、PLI、SBI均明显优于术前(P<0.05),但两组术后牙周指数比较差异无显著意义(P>0.05)。结论牙冠延长术有利于残根残冠的保存和修复,但要注意适应证的选择。     

Evaluation of corticospinal tract injury with three-dimensional diffusion tensor tract in patients with acute cerebral infarction

Three-dimensional diffusion tensor tract (DTT) is the newest imaging to describe the structure of white matter fiber in three-dimensions, it has great significance in dividing the concrete anatomic site of gray and white matter lesions, displaying the correlation with fibrous band and judging clinical prognosis, which is incomparable by other imagings.OBJECTTVE: To observe the conditions of corticospinal tract (CST) in acute cerebral ischemic stroke patients,and analyze the relationship between motor function and the severity of CST injury.DESIGN: A case-control observation.SETTTNG: Department of Medical Imaging, Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA.PARTTCTPANTS: Fifteen patients with acute cerebral infarction were selected from Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA from February to December in 2005. They all suffered from acute attack and motor disorder of hemiplegic limbs to different extent, and were conformed by CT or MRI.There were 9 males and 6 females, aging 16-87 years old, the median age was 51.7 years, and all were right handed. Fifteen right-handed normal subjects, who were matched by age and sex with the patients in the cerebral infarction group, were selected from the relatives of patients and physicians of the Imaging Department as the control group. All the subjects were informed and agreed with the study.METHODS: The patients with acute cerebral infarction and subjects in the control group received MR diffusion tensor imaging (DTI) with GE 1.5 T nuclear magnetic resonance system, fiber tracking with the software of dTV- Ⅱ. Fractional anisotropy (FA) maps and three-dimensional tractography of bilateral CST of all patients were created. Displacement, continuity and destroy of fibrous bands were observed. At the same time, muscle strength of ipsilateral hand of patients with cerebral infarction was measured with Brunnstrom standard. The correlation between the severity of CST injury and the muscle strength of ipsilateral hand was analyzed with spearman correlation analysis.MAIN OUTCOME MEASURES: ① FA values in the infarcted sites and those in the contralateral corresponding sites of patients with cerebral infarction; ② CST manifestations in the patients with cerebral infarction and the control group.RESULTS: All the 30 testees were involved in the analysis of results. ① The FA values in infarcted sites of white matter were significantly lower than those in the contralateral ones (t =4.570, P ＜ 0.001 ). ② In the control group, bilateral CST were reconstructed, they originated from precentral gyrus, went downwards to internal capsule, and extended to pontine and medulla oblongata, each fiber had good uniformity in continuous form. In the patients with cerebral infarction, the forms of contralateral CST were consistent with those in the control group with good continuity. Due to the involvement by the infarcted site to different extents, the ipsilateral CST manifested as continuous interruption and loss of uniformity in anatomic structure and form. The CST involvements were divided into three grades: integrated CST for grade I (n =2); integrated CST but compressed or displaced for grade 2 (n =5); interrupted CST for grade 3 (n =8). ③ The severity of CST injury was obviously correlated with the muscle strength of the ipsilateral hand (r=0.888, P＜ 0.05＝.CONCLUSION: ① CST is injured to different extents in patients with acute cerebral infarction, and the severity of injury is associated with muscle strength. It is indicated that it can be used to judge the prognosis of rehabilitative treatment. ②DTT can directly display the status of pyramidal tract more three-dimensionally.     

醋酸精氨酸对创烧伤患者预后的影响及安全性分析——86例多中心、随机、双盲、安慰剂对照试验

目的观察服用醋酸精氨酸对创烧伤患者预后的影响及可能出现的不良反应。方法采用多中心、随机、双盲、安慰剂平行对照的研究方法,将96例创烧伤患者(实际完成86例)随机分为治疗组和对照组,治疗组41例,服用醋酸精氨酸0．4 g·kg-1·d-1;对照组45例,服用安慰剂酪氨酸,剂量同前,均连用7 d。两组患者采用等氮、等热量的营养支持疗法。比较患者创面(切口)愈合时间、住院时间及不良反应发生情况。结果创伤患者治疗组(29例)创面(切口)愈合时间和住院时间分别为(11．1±2．8)、(19±6)d,明显短于对照组(13．2±5．5)、(22±6)d(33例,P< 0．05);烧伤患者治疗组(12例)创面愈合时间和住院时间各为(20±5)、(28±6)d,与对照组(22±8)、(29±8)d(12例)比较,差异无统计学意义(P>0．05)。在整个试验过程中,患者出现的不良反应为恶心、腹泻,其中治疗组1例占2．44％,对照组1例占2．22％,两组比较差异无统计学意义(P= 1．000)。以上不良反应停药后消失。结论服用醋酸精氨酸能显著促进创伤患者创面(切口)愈合,缩短住院时间,且无明显不良反应,但对烧伤患者的预后无明显改善,这可能与病例数较少有关,其确切疗效有待于通过大样本的临床试验予以确定。