Lymphoepithelioma-Like Carcinoma of the Skin: An Exceedingly Rare Primary Skin Tumor

Primary lymphoepithelioma-like carcinoma of the skin (LE-lCS) is a very rare cutaneous malignancy of uncertain origin. The neoplasm reveals typical morphological similarity to undifferentiated nasopharyngeal carcinoma (lymphoepithelioma). This case report presents a 47-year-old man with a 5 mm erythematous papule on dorsal nose of six months duration. The patient underwent complete surgical excision and is disease free 7 months later.     

老年人平衡能力特点及评估

学术背景:平衡能力是人体的一项重要生理机能,在人类生活中有非常重要的意义.特别是老年人平衡能力下降,直接影响老年人独立生活能力,严重的会引起老年人跌倒,诱发其他疾病.目的:总结老年人平衡能力的国内外研究现状,并展望未来老年人平衡能力研究的发展方向.检索策略:应用计算机检索PubMed数据库1990-12/2007-06有关老年人平衡能力方面的文章,检索词“elderly,balance“,限定文章语言种类为English,共检索到208篇文章.同时应用计算机检索中国期刊全文数据库、万方数据库1997-12/2007-06的相关文章,检索词“老年人、平衡能力“,限定文章语言种类为中文,共检索到85篇文章.对资料进行初审,选取符合研究要求的有关文章找全文.纳入标准:①平衡能力的研究.②老年人平衡特征.③平衡能力评价.④运动干预对平衡能力的研究.排除理由:①较陈旧的文献.②重复研究.文献评价:共19个研究满足全部纳入标准,予以纳入.其中6篇为老年人平衡特征的文献、8篇平衡评价的文献、5篇运动干预老年人平衡影响的文献.资料综合:①平衡能力是人体相关系统功能的集中表现,研究影响平衡能力的前庭系统、视觉系统、躯体感觉、神经系统及肌肉-骨骼等系统功能增龄性的变化趋势,探究导致平衡能力增龄性变化的主要因素是待解决的问题.②平衡测试是定量评定平衡能力的前提,针对老年群体的特殊性,逐步寻求安全、简捷能全面反映其平衡能力的测试方法.③国内专业人员日益提高了对平衡的关注,发表的论文也较多,但由于平衡评定方法不统一,对中国人民平衡能力增龄性变化的研究没有继承性,研究国民的平衡能力增龄性变化是必要的.④众多研究表明,体育锻炼可以延缓平衡能力的衰退.但研究比较分散,运动项目比较单一,探究利于干预的运动项目以及最佳时机是待解决的热点课题.结论:建立一整套适合中国国民平衡能力评价体系,研究国民的平衡能力增龄性变化是十分有必要的,为全民健身活动中的老年人科学地进行健身提供依据.     

GAP-43 heterozygous mice show delayed barrel patterning, differentiation of radial glia, and downregulation of GAP-43

GAP-43 heterozygous (HZ) mice exhibit abnormal thalamocortical pathfinding, fasciculation, and terminal arborization at postnatal day 7 (P7). Here we tested whether these defects are correlated with delayed development of HZ cortical patterns. We assessed the rate of barrel segregation and radial glia differentiation in wild-type (WT) and HZ cortices. Since GAP-43 is involved in some forms of neural plasticity, we also compared the duration of the critical period for lesion-induced plasticity in both genotypes. Cytochrome oxidase histochemistry revealed a delay of approximately 1 day in barrel pattern formation in GAP-43 HZ mice. GAP-43 WT barrels showed complete segregation between P2-P3, while HZ barrels did not reach the same level of segregation until P3-P4. We found a similar delay in the transformation of radial glia from monopolar to multipolar phenotypes, from P5 in WT to P7 in HZ cortex. Radial glial cells represent many of the neuronal progenitors in developing cortex and aid in cell migration. Thus, the delay in radial glial differentiation may contribute to the delay in HZ barrel segregation. Interestingly, we found no change in the extent of the critical period for HZ cortical responsiveness to early peripheral damage or in the time course of the cortical response. As expected, GAP-43 expression in HZ cortex is significantly reduced early in development. However, HZ GAP-43 expression remains at maximum levels after P9, when it is normally downregulated. As a result, HZ GAP-43 expression is near-normal by P26, by which time near-normal barrel dimensions have been restored. Our findings indicate that GAP-43 deficiency leads to early delays in barrel development and suggest that these failures are followed by homeostatic responses, including prolonged GAP-43 expression. These compensatory mechanisms may rescue normal cortical reorganization in neonates and near-normal barrel morphology and GAP-43 expression in adulthood.     

Target setting in intensive insulin management is associated with metabolic control: the Hvidoere Childhood Diabetes Study Group Centre Differences Study 2005

Swift PGF, Skinner TC, de Beaufort CE, Cameron FJ, Åman J, Aanstoot H‐J, Castaño L, Chiarelli F, Daneman D, Danne T, Dorchy H, Hoey H, Kaprio EA, Kaufman F, Kocova M, Mortensen HB, Njølstad PR, Phillip M, Robertson KJ, Schoenle EJ, Urakami T, Vanelli M, Ackermann RW, Skovlund SE for the Hvidoere Study Group on Childhood Diabetes. Target setting in intensive insulin management is associated with metabolic control: the Hvidoere Childhood Diabetes Study Group Centre Differences Study 2005. Objective: To evaluate glycaemic targets set by diabetes teams, their perception by adolescents and parents, and their influence on metabolic control. Methods: Clinical data and questionnaires were completed by adolescents, parents/carers and diabetes teams in 21 international centres. HbA1c was measured centrally. Results: A total of 2062 adolescents completed questionnaires (age 14.4 ± 2.3 yr; diabetes duration 6.1 ± 3.5 yr). Mean HbA 1c = 8.2 ± 1.4% with significant differences between centres (F = 12.3; p < 0.001) range from 7.4 to 9.1%. There was a significant correlation between parent (r = 0.20) and adolescent (r = 0.21) reports of their perceived ideal HbA1c and their actual HbA1c result (p < 0.001), and a stronger association between parents' (r = 0.39) and adolescents' (r = 0.4) reports of the HbA1c they would be happy with and their actual HbA1c result. There were significant differences between centres on parent and adolescent reports of ideal and happy with HbA1c (8.1 < F > 17.4;p < 0.001). A lower target HbA1c and greater consistency between members of teams within centres were associated with lower centre HbA1c (F = 16.0; df = 15; p < 0.001). Conclusions: Clear and consistent setting of glycaemic targets by diabetes teams is strongly associated with HbA1c outcome in adolescents. Target setting appears to play a significant role in explaining the differences in metabolic outcomes between centres.     

高龄多器官功能衰竭患者甲状腺功能的变化

1临床资料2003-10/2004-12住院老年多器官功能衰竭患者46例,全部为男性,年龄(79±5)岁.2个器官功能衰竭为A组15例,年龄(77±6)岁;3个以上器官功能衰竭为B组20例,年龄(79±7)岁;死亡为C组11例,年龄(78±4)岁;无重要脏器功能衰竭的老年患者20例为对照组,年龄(78±6)岁,全部为男性.以上受试对象均无甲状腺疾病病史,未用影响甲状腺功能的药物.清晨空腹安静状态下抽取静脉血2mL用放免法测定TT3,TT4,FT3,FT4及TSH,药盒由天津DPC公司提供.ABC3组TT3(nmol/L)和FT3(pmol/L)水平均减低,C组减低最明显,分别为1.7±0.4和3.9±0.9,1.3±0.4和…     

肾实质癌59例临床组织病理学分析

0引言肾实质癌通常来源于肾小管上皮细胞的腺癌,透明细胞癌占85%,其余为颗粒细胞癌及混合细胞癌,常伴有出血、坏死、囊变和钙化[1-3].我们分析手术根治的肾实质癌组织病理情况并讨论临床意义.     

Assessing quality. As pressure mounts for clinics to deliver quality, medical practice blueprints and genograms serve as useful tools

Increasingly, medical practices feel pressure to provide and communicate high quality patient care. Offering their insight on how a medical practice can improve quality, the authors describe the process of delivering medical care during patient encounters. Specifically, they present two methods that can be used to understand, evaluate, and improve interactions between patients and providers: medical practice blue prints and medical practice genograms.