国内真菌性角膜溃疡治疗进展

真菌性角膜角膜溃疡发病率逐年上升,目前主要采用抗真菌药物治疗、手术治疗、抗真菌药物联合手术治疗以及中西结合治疗,尚无特效的治疗方法。本文就治疗该病的最新进展进行了综述。     

腹部及盆腔急性出血的介入治疗

目的探讨腹部急性出血选择性血管造影诊断及介入治疗价值。方法回顾性分析80例行选择性动脉血管造影及血管内介入治疗的腹部及盆腔急性出血患者的临床资料。结果80例均采用Seldinger技术,经股动脉插管后作选择性血管造影,用碘化油、明胶海绵或弹簧圈栓塞治疗,80例中完全止血68例、再出血9例、无效3例。结论介入方法不仅可确定出血部位,而且可达到止血目的,效果确切。     

牙列缺损的计算机三维建模

目的 建立牙列缺损的计算机三维模型。方法 采用表面绘制法,依据CT扫描头颅骨标本获得的二维断层图像数据在3D Studio Max中沿牙体长轴放样、微调并赋以材质,得到牙列缺损的计算机三维模型。结果 能在计算机中方便快速地模拟任意类型的牙列缺损,并可全方位地旋转、放大和缩小。结论 提供了一种牙列缺损三维建模的新方法,有利于三维义齿专家系统的开发和计算机辅助教学。     

腹腔镜外科和妇科联合手术的临床应用

目的：探讨腹腔镜技术在外科和妇科疾病治疗中联合应用的临床价值。　
方法：总结近7年来施行腹腔镜联合手术治疗妇、外科疾病229例的临床资料,其中腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)联合输卵管造口术5例,LC联合卵巢囊肿剥除术28例,LC联合子宫肌瘤剔除术25例,LC联合子宫次全切除术39例,LC联合子宫全切除术26例,LC联合子宫内膜异位症手术6例;腹腔镜阑尾切除术(laparoscopicappendectomy,LA)联合输卵管手术38例,LA联合卵巢囊肿切除术32例,LA联合子宫全切除术或子宫次全切除术24例,腹腔镜肝囊肿开窗引流术联合卵巢囊肿切除术6例。
结果：229例妇、外科联合腹腔镜手术均获成功,无中转开腹手术。手术时间40~220 min,平均120 min;住院1~6 d,平均3.4 d。仅1例术后10 d阴道残端出血非手术疗法治愈。175例随访3~24个(平均19.5)月,1例术后2个月发现阴道残端息肉,经手术切除治愈。　
结论：严格掌握联合手术指征,充分术前准备,多科室良好配合,腹腔镜联合手术能够有效地同时处理外科和妇科并存疾病,在基层医院具有良好的应用前景。     

The Role of Self-Beliefs in Predicting Postschool Outcomes for Deaf Young Adults

The aim of this study was to explore the role of self-beliefs in predicting postschool outcomes for deaf young adults in transition from secondary settings. Three self-level constructs were explored: self-concept, self-determination, and expectations about the future. This study utilized data from the National Longitudinal Transition Study-2 (NLTS2) that collected longitudinal data from youths with disabilities across the nation, 550 of which were deaf or hard of hearing and met the selection criteria in this study. This study examined the relationships between these deaf adolescents’ self-beliefs and actual future achievements that were reached as they transitioned to adult life, in three domains: life, employment, and education. Despite the generally positive self-beliefs of deaf individuals, which were, in some cases, related to postschool outcomes, the self-beliefs assessed in this study did not emerge as comprehensive predictors of postschool attainments. Findings suggest that for deaf individuals, successfully navigating transitions to adult life involves dimensions beyond individual agency. Positive self-beliefs are clearly a part of successfully attaining postschool outcomes, but deaf individuals may not have full access to equitable opportunities to capitalize on these beliefs.     

Late-onset epilepsy and occult cerebrovascular disease

The interface between cerebrovascular disease (CVD) and epilepsy is complex and multifaceted. Late-onset epilepsy (LOE) is increasingly common and is often attributed to CVD, and is indeed associated with an increased risk of stroke. This relationship is easily recognizable where there is a history of stroke, particularly involving the cerebral cortex. However, the relationship with otherwise occult, subcortical CVD is currently less well established yet causality is often invoked. In this review, we consider the diagnosis of LOE in clinical practice—including its behaviour as a potential mimic of acute ischemic stroke and transient ischemic attack; evidence for an association between occult CVD and LOE; and potential mechanisms of epileptogenesis in occult CVD, including potential interrelationships between disordered cerebral metabolism and perfusion, disrupted neurovascular unit integrity, blood–brain barrier dysfunction, and inflammation. We also discuss recently recognized issues concerning antiepileptic drug treatment and vascular risk and consider a variety of less common CVD entities associated with seizures.     

Biologic basis for interleukin-1 in disease

To understand the role of the proinflammatory cytokine interleukin-1 (IL-1) in disease, investigators have studied how production of the different members of the IL-1 family is controlled, the various biologic activities of IL-1, the distinct and various functions of the IL-1 receptor (IL-1R) family, and the complexity of intracellular signaling. Mice deficient in IL-1Beta, IL-1Beta converting enzyme, and IL-1R type I have also been studied. Humans have been injected with IL- 1 (either IL-1alpha or IL-1beta) for enhancing bone marrow recovery and for cancer treatment. The IL-1-specific receptor antagonist (IL-1Ra) has also been tested in clinical trials. The topics discussed in this review include production and activities of IL-1 and IL-1Ra molecules, the effects of IL-1 on gene expression, functions of cell-bound and soluble IL-1 receptors, the importance of the IL-1R accessory protein, newly discovered signal transduction pathways, naturally occurring cytokines limiting IL-1 production or activity, the effects of blocking cyclooxygenase and nitric oxide, and the outcomes of IL-1 and IL-1 Ra in human trials. Special attention is paid to IL-1beta converting enzyme and programmed cell death. The roles of IL-1 in hematopoiesis, leukemia, atherosclerosis, and growth of solid tumors are also discussed. This is a lengthy review, with 586 citations chosen to illustrate specific areas of interest rather than a compendium of references. At the end of each section, a short commentary summarizes what the author considers established or controversial topics linking the biology of IL-1 to mechanisms of disease.     

Erythroid marrow function in anemic patients

Erythropoietic activity is known to be closely associated with marrow iron uptake. A modification of the standard measure of plasma iron turnover has been developed in which erythron transferrin uptake (ETU) rather than iron uptake has been calculated. The ETU has the advantage of providing a parameter of erythroid marrow activity independent of change produced by plasma iron and transferrin saturation. Measurements in 80 patients with anemia were compared to the normal value of 60 +/- 12 mumol/L whole blood/d. The mean ETU for ten patients with severe aplastic anemia and for six patients with pure red-cell aplasia were 12 +/- 8 and 12 +/- 11 mumol/L whole blood/d, respectively. In ten transfusion-dependent patients with renal failure under dialysis therapy, the mean value was 35 +/- 11, while ten other dialyzed patients who were transfusion independent had a mean ETU of 73 +/- 21 mumol/L whole blood/d. Sixteen patients with hemolytic anemia had an average ETU of 400 +/- 130, while 28 patients with ineffective erythropoiesis had a mean value of 474 +/- 147 mumol/L whole blood/d. While patients with hypoproliferative anemia showed no relation between the severity of anemia and ETU, those with hyperproliferative erythroid marrow showed increasing values as the anemia became more severe. Sequential measurements in patients with aplastic anemia under treatment and in thalassemic patients under transfusion therapy showed the value of this measurement in monitoring the effects of treatment on erythroid marrow activity. It is concluded that the measurement of ETU provides a more direct ferrokinetic evaluation of erythroid activity in anemic states.