脑梗死后再发缺血性卒中与脑出血患者微血管病变及预后的比较

【目的】探讨脑梗死后再发缺血性卒中与脑出血患者的临床特点、影像学上微血管病变及预后的异同。【方法】连续收集急性复发性卒中的住院病例（初发事件为脑梗死，复发事件包括脑梗死或脑出血），详细记录临床资料。观察脑内微出血及自质病变的严重程度，随访有无严重血管事件及死亡的发生。【结果】175例再发脑梗死患者。19例复发事件为脑出血的患者进入本研究。155例（88．6％）再发脑梗死患者，以及18例（94．7％）脑出血患者存在自质病变。77例（44％）再发脑梗死患者和16例（84．2％）脑出血患者存在脑内微出血。脑出血组自质病变的严重程度及微出血的数目均明显高于再发脑梗死组（P=0．033，0．016），脑出血组的死亡率及再发脑出血的危险性明显增高（P=0．034，0．036）。【结论】严重的脑自质病变及微出血的出现与脑梗死后再发脑出血有关。多发微出血提示出血风险增高。如复发事件为脑出血，则其死亡率及再次复发脑出血的风险均明显增加。     

Locomotor strategies before independent walking: prospective study of 50 mentally retarded children.

To investigate the association between pre-walking locomotor strategies and psychomotor developments in children with mental retardation (MR), 50 children with non-specific MR were included in this study. There were 29 boys and 21 girls, 96% of whom had moderate to severe MR. They were followed from 4-53 months to 25-99 months of age, and their follow-up periods ranged from 10 to 48 months (mean 30 months). According to the pre-walking locomotor strategies, these children were categorized into three groups: the crawling group (n = 34) who used crawling or creeping as their main locomotion pattern before independent walking; the shuffling group (n = 9) who used shuffling prior to independent walking; and the direct-walking group (n = 7) who did not have any other locomotor strategies except rolling. In almost all motor developmental milestones, children in the direct-walking group developed earlier than those in the crawling and shuffling groups. Children in the crawling group had more advanced developments than those in the shuffling group. The difference in the mean ratio developmental quotients of the Bayley Mental Scale among the three groups was not significant. The present study showed that crawling may not be a necessary prerequisite for early ambulation or better cognitive function in MR children.     

骨盆骨折合并阴道损伤（附5例报告）

报告5例女性骨盆骨折合并阴道损伤，占骨盆骨折41例中的12.2%,均为交通事故伤，都合并有失血性休克，开放伤3例，闭合伤2例，治疗作阴道修补术2例，用碘仿纱条填塞阴道2例。未作处理1例，均治愈，阴道损伤表现为四型；横行撕裂伤，纵行撕裂伤，斜行撕裂伤和刺伤，强调早期诊断，及时治疗以防止合并症。     

江西麦饭石对某些实验动物生理功能影响

用江西麦饭石水浸液喂养小鼠116只,自来水喂养39只,食物条件完全相同,一个月后,发现饮用江西麦饭石水浸液的小鼠体重增长和抗疲劳及耐缺氧能力均优于对照组。用麦饭石任氏液灌注离体蛙心后,心肌收缩力有明显增强。     

Rules for differentiating symptoms and signs of the heart-qi deficiency syndrome

344 cases of Heart-Qi Deficiency Syndrome (HQDS) including 19 Kinds of disease were observed to explore the rule of differentiation of symptoms and signs for HQDS. The results showed that the common symptoms of HQDS were weakness, shortness of breath, and palpitation, etc. According to with or without complicated cardiovascular diseases, the patients were divided into two groups: group A with cardiovascular diseases, group B without that. In group A, the symptoms and signs of HQDS were the most frequent and early clinical manifestations, the associated symptoms and signs were blood stasis and attack of water-evil, etc. In group B, in whom often associated with nervous and emotional symptoms such as insomnia, dreamfulness, and amnesia, etc., which was due to the disturbance of emotional activities of heart. In order to avoid diagnostic confusion, the authors suggest that the HQDS patients with cardiovascular diseases would be diagnosed as HQDS; on the other hand, the HQDS patients without cardiovascular diseases would be diagnosed as disturbance of emotional activities of heart.     

Segmental fixation with U-shaped rod in the treatment of spondylolisthesis

Summary From 1987 to 1990 the authors treated 20 cases of spondylolisthesis by an improved operative procedure including excision of the medial part of the superior articular processes of the slipped vertebra, excision of the soft tissue between the ununited isthmi, and excision of the ligamentum flavum between the intervertebral space above the slipped segment. In some instances the lower portion of the lamina over the slipped vertebra should be resected. A U-shaped rod was used to hold sublaminar fixation of two segments above and below the slipped vertebra, with the slipped vertebra spared. Utilizing the U-shaped rod as support, bone strips were placed along the lateral and anterior sides of the rod to bridge the gap between the laminae of the displaced vertebra. Other bone grafts were focused on the facet joints. The patients were allowed ambulation early postoperatively. 19 cases could be evaluated at preliminary follow-up. All showed satisfactory results.     

Reduced 293T cell susceptibility to acrolein due to aldose reductase-like-1 protein expression.

Acrolein is a highly reactive alpha,beta-unsaturated aldehyde produced endogenously during lipid peroxidation and naturally distributed pervasively in living environments, posing serious threats to human health if not properly metabolized. In this study, we report aldose reductase-like-1 (ARL-1) as a novel enzyme that catalyzes the reduction of acrolein and protects cells from their toxicity. Using purified ARL-1 protein, we determined its enzymatic activity in response to acrolein and defined its steady-state kinetics with K(m) and V(max) at 0.110 +/- 0.012 mM and 3122.0 +/- 64.7 nmol/mg protein/min, respectively. By introducing a functional Enhanced Green Fluorescent Protein (EGFP)/ARL-1 fusion protein into 293T cells, we demonstrated that plating efficiency in liquid culture and focus formation in soft agar increased by more than 60% (p < 0.05), compared to the vector control cells. More significantly, at a low dose of 5 microM acrolein, EGFP/ARL-1 expression enhanced both plating efficiency and focus formation by more than threefold, and the foci (in soft agar) of 293T cells expressing EGFP/ARL-1 were significantly larger than those of the vector control cells. At high concentrations of acrolein (25 and 50 microM), EGFP/ARL-1 protein prevented oncotic death of 293T cells induced by acrolein. In summary, our data demonstrated for the first time that the ARL-1 protein protects 293T cells from acrolein toxicity. Due to the high toxicity and wide distribution of acrolein, this finding is important to the understanding of its detoxification mechanisms.     

胃癌双对比造影表现与血5‘—核苷酸酶相关性的研究

目的　初步探讨胃癌影像学表现与 5′-核苷酸酶 (5′- NT)活性的变化关系。方法　经病理证实的 4 1例胃癌 ,均行 X线双对比造影摄片 ,并采用分光光度法测其治疗前血清 5′- NT活性。以 4 0例健康人作对照组。结果　胃癌组 5′- NT活性 (1.14± 0 .16 u/ ml)较正常健康人明显减低 (2 .6 0± 0 .10 u/ m l) (P<0 .0 5 )。解剖部位上 ,从贲门、胃体到胃窦部胃癌 ,其 5′- NT活性分别为 0 .98、1.2 0、1.2 8u/ m l,呈逐渐升高的趋势。溃疡型胃癌 5′- NT活性(0 .96 u/ ml)低于肿块型 (1.12 u/ m l)和浸润型 (1.4 0 u/ ml)。 期胃癌 5′- NT(1.5 3u/ ml)高于 期 (0 .83u/ m l)、 期 (0 .98u/ ml)和 期 (1.0 3u/ m l) (P<0 .0 5 )。结论　胃癌患者血清 5′- NT活性明显较正常人降低 ,其酶活性的变化与胃癌的形态、生长部位及进展程度有一定的相关     

重症急性胰腺炎并发上下消化道出血的病因和处理

重症急性胰腺炎（SAP）是临床常见的病死率很高的急腹症。病人主要死于早期的休克、多脏器功能衰竭和全身感染，以及残余感染期的出血和感染相关的并发症。SAP并发致死出血的发生率在1．2％～14．5％，主要表现为消化道、腹腔以及腹膜后出血。SAP病人消化道出血可表现为突发腹痛、腹胀、心动过速和低血压，但有时也表现为慢性间断性出血。SAP并发消化道出血的常见病因包括：应激性溃疡出血、胰源性门静脉高压症出血、胰腺脓肿或假性囊肿穿破消化道引发的出血。     

行为干预对糖尿病患者健康相关行为的研究

目的观察行为干预对糖尿病(diabetesmellitus,DM)患者健康行为的影响。方法将本科收治172例DM患者作为目标人群进行健康教育,建立目标人群管理档案,进行目标人群健康行为干预,比较教育前后相关行为的改变。结果DM患者10项健康行为和10项危险健康行为有明显改观,统计学检验干预前后差异显著P<0.01。结论通过行为干预,有效的使DM患者完全遵从医嘱合理用药,完全依从健康行为,从而减少危险行为的发生。