海南省陵水县黎族人群红细胞葡萄糖-6-磷酸脱氢酶缺乏症基因频率调查

目的：在疟疾流行区建立红细胞葡萄糖－６－磷酸脱氢酶缺乏者个人档案，以预防伯氨喹溶血反应的发生。方法：用四氮唑蓝（ＮＢＴ）法测定红细胞葡萄糖－６－磷酸脱氢酶活性。结果与结论：２４３９名黎族人群红细胞葡萄糖－６－磷酸脱氢酶缺乏症基因频率为０．１７５９，其女性杂合子发生率为２８．３３％，纯合子发生率为３．０９％。     

经颅眶入路治疗眶尖部肿瘤

目的总结经颅眶入路治疗眶尖部肿瘤时保存视神经、眼动脉、动眼神经等血管神经的方法。方法回顾性分析69例经颅眶入路治疗眶尖部肿瘤病人的临床资料。其中良性肿瘤62例,恶性肿瘤7例。采用经颅眶入路切除肿瘤,所有手术均由神经外科、眼科医师共同完成。结果肿瘤根治性切除60例,部分切除9例;术后4例动眼神经损伤,仅1例视神经、动眼神经、展神同时损伤。结论掌握眼科解剖学知识和神经外科显微操作是进行眶尖部肿瘤切除手术的基础。行经颅眶入路,在眶尖部骨性充分减压后先分离切除肿瘤前部,是保护视神经、眼动脉、动眼神经的有效方法。     

DTPA和喹胺酸对小鼠的致畸作用

DTPA-CaNa₃ (促排灵-235)、DTPA-ZnNa₃(新促排灵)和喹胺酸为放射性核素内污染的促排药物。三药对小鼠致畸作用试验中观察到,DTPA-ZnNa₃在人常用剂量100倍和200倍(人常用剂量以1 g/50kg计算)时耒生现对胎鼠的影响,而DTpA-CaNa₃、喹胺酸在20倍剂量时对胎鼠已见一些影响,引起活胎率下降、胚胎吸收数增加。所以核素中毒后进行促排治疗时对怀孕妇女应慎用DTPA-CaNa₃和喹胺酸,以采用低毒*每DTPA-ZnNa₃治疗较为安全稳妥。     

A few thoughts on brain ROIs

Quantitative mapping of structural and functional connectivities in the human brain via non-invasive neuroimaging offers an exciting and unique opportunity to understand brain architecture. Because connectivity alterations are widely reported in a variety of brain diseases, assessment of structural and functional connectivities has emerged as a fundamental research area in clinical neuroscience. A fundamental question arises when attempting to map structural and functional connectivities: how to define and localize the best possible Regions of Interests (ROIs) for brain connectivity mapping? Essentially, when mapping brain connectivities, ROIs provide the structural substrates for measuring connectivities within individual brains and for pooling data across populations. Thus, identification of reliable, reproducible and accurate ROIs is critically important for the success of brain connectivity mapping. This paper discusses several major challenges in defining optimal brain ROIs from our perspective and presents a few thoughts on how to deal with those challenges based on recent research work done in our group.     

The Cleveland Clinic experience with adult hypospadias patients undergoing repair: their presentation and a new classification system

Study Type – Therapy (case series)
Level of Evidence 4 What’s known on the subject? and What does the study add? Most previous studies, with few exceptions, have focused on short‐term outcomes of hypospadias repair in infancy or young adulthood. Little is known, however, about the long‐term outcomes both after hypospadias repair in childhood and for uncorrected hypospadias into adulthood. We report how these patients present to a urologist and their concurrent symptoms and add a classification system of how these patients present for urethral stricture/fistula/hypospadias repair.

OBJECTIVE

? To characterize and categorize adults with hypospadias who presented to our clinic with urethral stricture and fistula to better clarify the presentation, history and intraoperative findings in this heterogeneous group and to better describe the natural history of this anomaly in adulthood.

PATIENT AND METHODS

? A retrospective chart review was performed on adults with hypospadias who underwent urethroplasty for urethral stricture, urethrocutaneous fistula, and/or hypospadias repair at Cleveland Clinic between 1993 and 2009. All procedures were performed by a single staff surgeon (K.W.A.). ? The charts were reviewed for site of hypospadias, presenting complaint, overall symptoms, history of repair and type of surgery performed.

RESULTS

? Fifty‐five adult patients were identified. Median age was 37 years (range: 18–72). About half of the patients had distal (glanular/subcoronal or pendulous) hypospadias (56.4%) and the others had more proximal (bulbar) hypospadias (43.6%). ? Voiding symptoms (such as dysuria, weak stream, spraying, urgency, frequency) were the most common presenting complaint (50.9%) and overall symptom (81.8%). About half of patients underwent a two‐stage urethroplasty (52.7%). ? Based on their history of repair, patients were divided into three categories: I, patients who have undergone continuous multiple surgeries for repair with significant scarring and tissue loss; II, delayed complications after an initially successful childhood repair; and III, no previous repair. Most patients were category I (58.2%); however, seven patients (12.7%) were category III. Balanitis xerotica obliterans (BXO) was more common in this subgroup compared with other categories (42.9% vs 8.3%, respectively, P= 0.037). In two of the three patients in category III with BXO, the stricture length was longer than 7 cm.

CONCLUSIONS

? Adults with hypospadias represent a heterogeneous group. More than half of adults with complications related to hypospadias have had multiple operations (category I) representing one of the most difficult challenges to the reconstructive urologist. ? Roughly 30% of patients undergo an initially successful repair in childhood with recurrent problems in adulthood (category II), suggesting that the outcomes of repair may not be as durable as estimated by studies with shorter‐term follow‐up. ? Finally, BXO is over‐represented in men with hypospadias who have not previously undergone repair, which contradicts the previous suggestion that the risk of BXO is related to the use of skin grafts/flaps from previous repairs and suggests that there may be an increased risk of severe stricture disease in patients who have never undergone corrective surgery for this anomaly.     

早期胃癌93例临床与病理分析

目的探讨早期胃癌的临床与病理特点,提高早期胃癌的检出率,为进一步防治早期胃癌提供依据。方法收集93例早期胃癌患者的临床和病理资料,观察发病部位、组织学分型、浸润深度以及淋巴结转移程度等相关病理学指标。结果早期胃癌好发部位以胃窦居多,组织学分型多见于中分化和高分化,多为黏膜内层癌,早期胃癌淋巴结转移率为7.53%。结论浸润深度、伴随疾病、淋巴结转移等是早期胃癌组织病理学诊断的重要指标。     

猫脑射频热凝毁损灶体积的相关性分析

目的 利用MRI及病理检测方法 ,观察体内射频毁损灶体积的差异性.方法 利用猫脑建立体内不同毁损时间、温度下的毁损灶体积模型,通过病理检测及MRI确定毁损灶最大直径、高,经公式转换成体积.结果 射频毁损灶体积,均随时间温度变化出现规律性变化.结论 利用三维模型可对预定毁损体积选择合适的温度和时间,比以往单凭经验的做法更...     

Complex span tasks and hippocampal recruitment during working memory

The working memory (WM) system is vital to performing everyday functions that require attentive, non-automatic processing of information. However, its interaction with long term memory (LTM) is highly debated. Here, we used fMRI to examine whether a popular complex WM span task, thought to force the displacement of to-be-remembered items in the focus of attention to LTM, recruited medial temporal regions typically associated with LTM functioning to a greater extent and in a different manner than traditional neuroimaging WM tasks during WM encoding and maintenance. fMRI scans were acquired while participants performed the operation span (OSPAN) task and an arithmetic task. Results indicated that performance of both tasks resulted in significant activation in regions typically associated with WM function. More importantly, significant bilateral activation was observed in the hippocampus, suggesting it is recruited during WM encoding and maintenance. Right posterior hippocampus activation was greater during OSPAN than arithmetic. Persitimulus graphs indicate a possible specialization of function for bilateral posterior hippocampus and greater involvement of the left for WM performance. Recall time-course activity within this region hints at LTM involvement during complex span.     

小儿病毒性脑炎继发癫痫的EEG影像学及临床分析

目的探讨儿童病毒性脑炎继发癫痫(PEE)的脑电图(EEG)及影像学特点,进一步探讨其临床高危因素。方法以明确诊断的34例PEE患儿为观察组,选取同时期就诊的同年龄段病毒性脑炎未继发癫痫(no-PEE)患儿102例为对照组。收集患儿病毒性脑炎(VE)急性期临床资料,并进行随访。结果单因素分析得出2组病脑急性期痫性发作≥2次、癫痫持续状态(SE)、昏迷,EEG癫痫样放电、广泛或弥漫性慢波,影像学单纯皮层受损、皮层及皮层下受损、丘脑基底节受损差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,病毒性脑炎急性期痫性发作≥2次、SE、昏迷、EEG癫痫样放电、影像学皮层及皮层下同时受损差异有统计学意义(P<0.05),为PEE危险因素。2组患儿随访期间智力发育落后差异有统计学意义(P<0.001)。结论病毒性脑炎急性期EEG癫痫样放电、影像学皮层及皮层下同时受损、痫性发作≥2次、SE、昏迷为PEE危险因素。PEE患儿远期多有智力发育落后,应密切随访,及时干预治疗。