Exercise training for claudication.

Exercise advice is a well established component of the conservative management of intermittent claudication. Supervised programmes of exercise remain relatively uncommon and are provided mainly in secondary care. This review outlines the evidence for the effectiveness of different exercise regimens and the relative benefits of exercise therapy, where comparisons have been made with medical therapy, angioplasty and surgery.     

关节镜下胭绳肌腱部分重建、单束重建和双束重建前交叉韧带的疗效比较

目的 研究使用腘绳肌腱进行关节镜下前交叉韧带（ACL）损伤后部分重建、单束重建和双束重建的疗效差异。方法 本研究共包括56例ACL重建病例，其中部分重建11例，单束重建25例，双束重建20例。所有患者术前及随访时均进行IKDC2000、Tegner和Lysholm评分以及常规KT-2000和后推KT-2000测量，并对结果进行统计学分析。结果 平均随访19．84±5．03个月（13～22个月）。对三组的IKDC、Lysholm和Tegner评分的配对t检验显示，术后的IKDC、Lysholm和Tegner评分比术前均有显著改善。后推法KT-2000测量显示，ACL双束重建可以比单束重建获得更好的膝关节稳定性，ACL部分重建组膝关节的稳定性优于单束重建和双束重建组。但常规KT-2000测量无法辨别三种术式之间膝关节稳定性的差异。结论 ACL双束重建可以比单束重建更好地重建膝关节的稳定性，ACL部分重建的临床效果优于单束重建和双束重建；后推KT-2000测量在ACL双束重建和部分重建的术后稳定性评估上可能具有重要的应用价值。     

磁共振尿路成像诊断肾移植输尿管坏死

目的:探讨磁共振尿路成像(MRU)诊断肾移植输尿管坏死的价值。材料和方法:12例肾移植术后怀疑输尿管坏死患者,临床表现为移植肾区肿痛、少尿或无尿,B超提示移植肾盂积水,输尿管扩张,移植肾周积液,用重T2WI快速自旋回波序列和脂肪抑制技术行MRU检查。结果:MRU均显示移植肾盂及肾盏扩张,输尿管上段扩张,重T2WI表现为高信号。输尿管连续性消失,其下方为局限性包裹液性区。在渗出的包裹性尿液邻近或下方可见高信号的膀胱影。12例患者均接受手术探查,术中均发现输尿管有坏死,坏死部位与MRU显示输尿管连续性消失部位一致,输尿管坏死下方可见渗出的尿液,与MRU所见局限性包裹液性区相吻合。结论:MRU诊断肾移植后输尿管坏死具有极高诊断价值。     

医学遗传学教学中计算机辅助教学的应用

目的:探讨计算机辅助教学在医学遗传学教学中的作用.方法:将180名护理中专生按学年分为对照组和观察组,分别采用传统的教学方法和计算机辅助教学进行医学遗传学教学,并在学期末对两组学生进行理论与综合考试,并调查两组学生对各组教学方法的作用及满意度.结果:两组学生考试成绩比较,观察组明显好于对照组(P＜0.05);两组学生对各自所在组教学方法的作用及满意度比较,观察组好于对照组(P＜0.05),差异有显著性意义.结论:计算机辅助教学有利于增强学生的学习兴趣,提高学生的学习效果,是一种较好的医学遗传学教学方法.     

Tailoring Management Strategies for the Patient With Menstrual Migraine: Focus on Prevention and Treatment

Many women report an increased frequency of headaches around the time of menses. For some women, these headaches are more severe, of longer duration, and lead to greater disability than those occurring at other times in the menstrual cycle. A headache diary is critical to properly diagnose menstrual migraine (MM) by prospectively documenting headache days, severity of headache, and the headaches' relationship to menses. In women with diagnosed MM, acute treatment has been proven to be effective in randomized clinical trials. For those women who have predictable periods and may require preventive therapy, short-term prevention is a reasonable approach due to the predictability of MM. Although several agents (eg, naproxen sodium, magnesium, triptans) have been evaluated for prevention of MM, all but triptans have been assessed in small trials of between 20 and 35 women. Naratriptan, frovatriptan, and, most recently, zolmitriptan have been proven effective in preventing MM. Triptans are generally well tolerated, and the long-term safety of these agents is currently being evaluated. The flexibility of using acute and preventive therapy allows physicians to tailor treatment of MM and meet the needs of individual patients.     

Toxocariasis: a serological survey of blood donors in the Australian Capital Territory together with observations on the risks of infection

The sera from 660 healthy blood donors from Canberra were tested for antibodies to Toxocara canis by the ELISA test. The results were compared with those from patients with suspected or confirmed visceral larva migrans or ocular toxocariasis. Over 7% of Canberra sera showed elevated levels of antibody reacting with T. canis antigen. Sera from patients resident in Australia with other helminth parasites did not cross-react with T. canis antigen in our tests. However, studies of sera collected in several tropical countries with other parasitic infection, show that cross-reactions with other parasites are possible. The use of purified glycoprotein antigen does not alter the possibility of cross-reaction. Observations and experiments show that people in Canberra may be exposed to the infective eggs of T. canis.     

Phospho-akt expression is associated with a favorable outcome in non-small cell lung cancer.

Akt, a Serine/Threonine protein kinase, mediates growth factor-associated cell survival. Constitutive activation of Akt (phosphorylated Akt, P-Akt) has been observed in several human cancers, including lung cancer and may be associated with poor prognosis and chemotherapy and radiotherapy resistance. The clinical relevance of P-Akt in non-small cell lung cancer (NSCLC) is not well described. In the present study, we examined 82 surgically resected snap-frozen and paraffin-embedded stage I to IIIA NSCLC samples for P-Akt and Akt by Western blotting and for P-Akt by immunohistochemistry. P-Akt protein levels above the median, measured using reproducible semiquantitative band densitometry, correlated with a favorable outcome (P = 0.007). Multivariate analysis identified P-Akt as a significant independent favorable prognostic factor (P = 0.004). Although associated with a favorable prognosis, high P-Akt levels correlated with high tumor grade (P = 0.02). Adenocarcinomas were associated with low P-Akt levels (P = 0.039). Akt was not associated with either outcome or clinicopathologic variables.Cytoplasmic (CP-Akt) and nuclear (NP-Akt) P-Akt tumor cell staining was detected in 96% and 42% of cases, respectively. Both CP-Akt and NP-Akt correlated with well-differentiated tumors (P = 0.008 and 0.017, respectively). NP-Akt also correlated with nodal metastases (P = 0.022) and squamous histology (P = 0.037).These results suggest P-Akt expression is a favorable prognostic factor in NSCLC. Immunolocalization of P-Akt, however, may be relevant as NP-Akt was associated with nodal metastases, a known poor prognostic feature in this disease. P-Akt may be a potential novel therapeutic target for the management of NSCLC.