Revascularized fibula for tibia replacement in adamantinoma

Adamantinoma of long bones is one of the rarest of malignant bone tumors; it is commonly located in the middle or lower third of the diaphysis of the tibia. A case with multiple occurrences affecting both the tibia and fibula is presented. En bloc resection with wide operative margins was performed, and a large tibial defect of 23 cm was effectively bridged by a revascularized free fibular flap. At 13 months follow-up, there was no sign of local recurrence or metastasis, and the patient was mobile.     

Lugol液染色对食管早期癌和癌前病变的诊断价值

目的 探讨Lugol液染色对食管早期癌和癌前病变的诊断价值。方法 对45例食管黏膜可疑病变经内镜以2％Lugol液喷洒染色，观察黏膜染色情况，并取活检送病理组织学检查。结果 45例食管病变染色后，39例呈浅染色或不染色，其中食管癌8例（食管早期癌5例，进展期癌3例），Barrett食管5例，轻至中度不典型增生1l例。本组Lugol液染色对食管早期癌和癌前病变的检出率达46．7％。结论 内镜下应用Lugol液染色结合活检有助于食管早期癌和癌前病变的诊断，且操作简便，具有重要的临床价值。     

A Five-Step Strategy in Treatment of Diabetes

Diabetes is a metabolic syndrome characterized by hyperglycemia. When it manifests itself mainly in hyperglycemia, hypertension, hyperlipemia, hyperurecemia, and obesity, it is also called Ⅹ syndrome, or insulin-resistance syndrome. Step 1. Identifying t…     

李振华教授治疗崩漏经验

著名中医学家李振华,现为河南中医学院教授、主任医师,中华中医药学会终身理事及河南分会名誉会长。曾任河南中医学院院长、第七届全国人大代表等职。是全国首批名老中医药专家,也是国务院批准享受政府特殊津贴者。老师治学严谨,博学多闻,精研医理,善于辨证,在长期的医疗实践中     

自体输血在出血性手术中的应用

外科手术,特别是出血量较大的急诊手术、术中出血较多的心内直视手术、以及颅脑外科手术等用血量大,一直是医疗中棘手的问题,而随着人们对输血所带来并发症的重视,以及近年来血源不足及合理输血、血液保护等,使得自体输血成为主流。本文就自体输血在临床应用,特别是大出血性手术中的应用价值作一综述。     

11C-乙酸盐PET显像在肾脏肿瘤诊断中的作用

目的探讨^11C-乙酸盐PET显像在肾脏肿瘤诊断中的作用及其与^18F-脱氧葡萄糖（FDG）肾肿瘤显像的关系。方法29例疑肾肿瘤患者行^11C-乙酸盐PET早期及延迟显像，其中22例1周内行^18F—FDG PET显像。所有患者均有手术病理检查或CT、随访结果。患者静脉注射^11C-乙酸盐后即刻采集肾脏部位早期图像，以反映肾皮质血流灌注；10min后采集延迟图像，以反映^11C-乙酸盐在肾皮质内的代谢。观察^11C-乙酸盐在人体内的分布，并比较^11C-乙酸盐与^18F—FDG肾肿瘤显像的阳性率及其与病理类型、分级的关系。结果^11C-乙酸盐在人体内以胰腺摄取最高，并可能经胰液分泌人肠道。肾皮质对^11C-乙酸盐摄取随时间而变化，延迟相大部分原发肾皮质肿瘤（13例中分级Ⅰ～Ⅱ为12例）对^11C-乙酸盐摄取高于正常肾皮质，阳性率为76．9％（10／13例）；而^18F—FDG显像仅为30．8％（4／13例）。6例肾盂输尿管移行细胞癌^11C-乙酸盐显像阳性仅2例；其中5例行^18F—FDG显像，均阳性。1例肾血管平滑肌脂肪瘤^11C-乙酸盐早期及延迟显像均清晰显示，2例输尿管炎症对^11C-乙酸盐无摄取。结论^11C-乙酸盐PET显像对恶性程度较低的肾皮质肿瘤显像阳性率较高，可弥补^18F—FDG显像的不足。     

天文潮汐对心脏病患者心力衰竭发生率影响的研究

目的　研究天文潮汐对心脏病患者发生心衰的影响。方法　分析 118例心脏病患者发生心衰在各潮汐期的分布。结果　在强天文潮汐期内心脏病患者发生心衰显著多于其余时期 ,而且在朔、望期发生的人数多于上、下弦期。结论　护理人员要了解天文潮汐的变化规律 ,教育心脏病患者在强天文潮汐期内要保持情绪稳定 ,必要时在强天文潮汐期内可给予心脏病患者适量的镇静剂和安眠药。     

Cortical plasticity: effect of high and low intensity conditioning electrical stimulations (100 Hz) on SEPs to painful finger stimulation.

OBJECTIVE: To study the effect of high-frequency (100 Hz) repetitive conditioning electrical stimulation (CES, 10 min) on human somatosensory evoked potentials (SEPs) to evaluate if short-term cortical plasticity could be induced. METHODS: Painful electrical stimulations were applied to thumb (D1) and little finger (D5) fingertips, respectively. The 124-channel EEG was recorded from 10 healthy male volunteers. Peak stages around 34, 45, 212, 331 ms were analyzed with focal maximum amplitude (FA) and area magnitude (AM) of scalp field potential, topography, and equivalent current dipole source localisation, comparing before and after two-level CES (high- vs. low-level) applied to the He-Gu acupoint. RESULTS: After a high-level CES, the positive FA and AM of the current efflux showed a significant increase at the early phase 34 ms, and significantly decreased at 45 ms in D1 SEPs. The negative FA and AM of the current influx were significantly increased at late phase 350 ms of the D5 SEPs. Only 36 ms, the z-axis position of dipole was significantly changed from (x: -15.9 mm, y: 29.6 mm, z: 43.9 mm) to (x: -12.9 mm, y: 29.4mm, z: 51.5mm) for the D5 SEPs. CONCLUSIONS: The high-level CES significantly attenuated the subsequent cortical activation (45 ms peak for D1 stimulation). Both low- and high-level CES significantly enhanced the late activities (226, 350 ms) in D5 stimulation. This may be explained by pain sensation change at the level of subcortical cingulate cortex induced by the site-dependent post-effect of CES. SIGNIFICANCE: This study showed cortical plasticity induced by conditioning somatosensory stimulation.     

土壤环境基因组技术及其在新药发现中的应用

土壤是微生物最重要的生境，土壤微生物具有极大的多样性。然而传统培养技术只能得到约1％的微生物纯培养，其余都是未被纯培养微生物。利用土壤环境基因组技术，可以把未被纯培养微生物的基因克隆到载体中并在宿主中进行表达，获得比已培养微生物丰富的代谢产物多样性，这为我们发现新颖结构先导化合物以及新药开辟了新的道路。本文介绍应用环境基因组技术构建土壤DNA文库的思路和方法。