Retardation of pain development: a case of recovery from congenital insensitivity to pain

Congenital analgesia is a rare genetic disorder. We report here that a 12-year-old boy was able to recover from congenital insensitivity to pain. Neurological examinations revealed that there was a 'stocking' distribution of pain decrement on the lower extremities under the patient's knee joints. Magnetic Resonance Imaging (MRI) of his brain showed gyrus thinning with sulcus widening at both sides of the parietal lobe. Southern blot hybridization probed with cDNAs of various opioid receptors did not detect any significant abnormality. Our results suggest that this rare case may not be genetically determined.     

Urban and Rural Differences in Health Insurance and Access to Care

This study considers differences in access to health care and insurance characteristics between residents of urban and rural areas. Data were collected from a telephone survey of 10,310 randomly selected households in Minnesota. Sub-samples of 400 group-insured, individually insured, intermittently insured, and uninsured people, were asked about access to health care. Those with group or individual insurance were also asked about the costs and characteristics of their insurance policies.
Rural areas had a higher proportion of uninsured and individually insured respondents than urban areas. Among those who purchased insurance through an employer, rural residents had fewer covered benefits than urban residents (5.1 vs 5.7, P < 0.01) and were more likely to have a deductible (80% versus 40%, P < 0.01). In spite of this, rural uninsured residents were more likely to have a regular source of care than urban residents (69% versus 51%, P < 0.01), and were less likely to have delayed care when they thought it was necessary (21% versus 32%, P<0.01). These differences were confirmed by multivariate analysis.
Rural residents with group insurance have higher out-of-pocket costs and fewer benefits. Uninsured rural residents may have better access to health care than their urban counterparts. Attempts to expand access to health care need to consider how the current structure of employment-based insurance creates inequities for individuals in rural areas as well as the burdens this structure may place on rural providers.     

Family system test (FAST): Are parents' and children's family constructs either different or similar,or both?

Perceptions of family cohesion and hierarchy structures were assessed by theFamily System Test (FAST), a clinically-derived figure placement technique. Parents (N=140) and their preadolescent offspring (N=70) completed typical and conflict representations in individual as well as group settings. Typical representations were characterized by balanced family structures (i.e. cohesive and moderately hierarchical) and those displaying conflict situations showed predominantly unbalanced patterns. FAST portrayals were related to respondent (mother vs. father vs. child). Fathers represented typical family relations as balanced more often than mothers. Regarding conflict representations, children were more likely than fathers to portray the family as unbalanced. However, analyses of representations of the same family (i.e. intra-family comparisons) indicated that all respondents differed in their perceptions and, that fathers' typical portrayals showed most often the same structure as those done by the family members as a group.     

优良资源植物——三颗针的质量考查研究之二

对四种同季不同产地采集的“三颗针”不同部位的四种生物碱进行了含量测定和分析,为该类药材的质量研究、生药采收、药厂选投料及开发应用等提供了科学依据。同时对该类资源的可持续利用也具有积极意义。     

神经系统功能磁共振联合应用研究进展

随着磁共振功能成像技术的发展,尤其是弥散张量成像(d iffusion tensor,DTI)及血氧依赖水平磁共振成像(b lood ox-ygenation level dependent,BOLD)技术的日臻完善,在活体状态下显示活动的皮质区并无创跟踪脑内白质纤维,反映解剖连通性已成为可能。本文就功能磁共振BOLD、DTI联     

对青海省海西州绒山羊业发展的思考和建议

绒山羊是青海海西州经济社会发展的基础性产业,本文从海西州资源、社会、经济等方面出发,结合绒山羊生物学特点,对当地绒山羊业发展提出一些问题和建议。     

多发性颅骨内血管瘤一例报告并文献复习

目的探讨多发性颅骨内血管瘤的临床特征和预后。方法报告1例多发性颅骨内血管瘤病例,结合相关文献分析该疾病的X线、CT、MRI和DSA等临床特征,探讨治疗效果和预后。结果多发性颅骨内血管瘤临床上极为罕见,大约占所有骨肿瘤的0.2%。X线平片检查见整个颅骨内蜂窝状改变,CT、MRI显示颅骨溶骨性病变或糜烂并向颅内外发展,DSA造影病变无染色,病理显示大小不等的异常血管,骨结构异常以及出血征象。外科治疗效果不佳。结论多发性颅骨血管瘤为颅骨内破坏性病变,涉及整个颅骨的多发性颅骨血管瘤,外科治疗效果不佳。     

非常见胆道梗阻性或黄疸性疾病的诊治

黄疸作为一个最具警觉的体征，容易诊断。然而发生黄疸的病因繁多，可由肝前性、肝细胞性和梗阻性（包括肝内胆汁淤积和肝外胆道狭窄梗阻）三类疾病引起。对于临床上的黄疸，首先是同步进行诊断和鉴别诊断。如确诊为梗阻性黄疸，因常需采用外科治疗（包括手术及介入方法）而得到根治或缓解，故临床上通常称为外科性黄疸。但并非所有的梗阻性黄疸均需用外科手术解决，有些肝内胆小管弥漫性疾病也可出现梗阻性黄疸，称为肝内胆汁淤积性黄疸，如毛细胆管型肝炎（又称胆汁淤积性病毒性肝炎）、原发性胆汁性肝硬化、药物性肝炎和妊娠期特发性黄疸等。此时仅需内科治疗，手术非但无益，反而会加重病情。     

膀胱癌组织P-gp,GST-π和TOPO-Ⅱ表达评估灌注化疗

目的：探讨膀胱癌的多药耐药性(MDR)，指导灌注化疗用药。方法：采用免疫组化法检测44例膀胱癌病理标本中P-糖蛋白(P-gp)、谷胱肽S转移酶(GST-π)和拓扑异构酶(TOPO—Ⅱ)的表达，评估肿瘤耐药谱。结果：①P-gp检测显示，54．5％的病例对阿毒索、丝裂毒索、长春新碱等抗生索类和生物碱类抗癌药高耐药。②GST-π检测显示仅34．1％的病例对顺铂、环磷酰胺等高耐药，而反有56．8％的病例对该类药无耐药或低度耐药。③TOPO-Ⅱ检测显示对阿霉索、柔红毒索、VP16等TOPO-Ⅱ抑制剂类抗癌药，仅13．6％的病例高度耐药，29．5％中度耐药。56．8％低度耐药。结论：检测膀胱癌MDR，了解多药耐药谱，可指导灌注化疗用药。     

外科围手术期糖尿病的治疗

目的:探讨外科手术病人伴发糖尿病的治疗及围手术期处理。方法:对1998年至2000年收治的125例外科手术伴发糖尿病病例进行回顾总结。结果:93例给予补液、降糖等处理无1例死亡。其他32例未进行有效的降糖处理,死亡5例。结论:外科手术病人伴发糖尿病时,围手术期要控制血糖,可以降低手术并发症及死亡率。