Comparison of functional results with navigation-assisted minimally invasive and conventional techniques in bilateral total knee arthroplasty.

This study was undertaken to compare the clinical and radiological results achieved using navigation-assisted minimally invasive surgery (NA-MIS) and conventional (CON) techniques in 42 bilateral total knee arthroplasty (TKA) patients with a minimum follow-up of one year. Clinical evaluations were performed using range of motion (ROM), Hospital for Special Surgery (HSS) scores, and Western Ontario and McMaster University (WOMAC) scores (pain, functional, and total) at 3, 6 and 9 months and one year postoperatively. Patients' subjective preferences and radiological indices, including mechanical axis and coronal inclinations of the prostheses, were compared at one year postoperatively. NA-MIS TKA yielded better HSS and WOMAC total scores than CON TKA up to six months, and a better WOMAC pain score up to 9 months. However, these differences were not significant at one year postoperatively. ROM was comparable in both groups at all times, but more patients preferred the NA-MIS side to the CON side. Radiological results showed no differences in mean values between the two surgical groups, although the NA-MIS group contained fewer outliers than the CON group. In conclusion, NA-MIS TKA was associated with better clinical results up to 6 or 9 months after surgery, giving more accurate leg alignment than CON TKA.     

Characteristics of teenage mothers and predictors of breastfeeding initiation in the Michigan WIC Program in 1995. Women, Infants, and Children.

Although breast milk is recommended as the optimal source of infant nutrition, breastfeeding initiation is below recommended levels, especially among teenage mothers. Breastfeeding initiation rates among Michigan (US) teenage mothers (12-19 y) were compared by demographics and health behaviors. Multivariate analyses determined which factors were significant independent predictors of breastfeeding initiation among teenage mothers enrolled prenatally in the Michigan Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program in 1995. Significant predictors independently associated with breastfeeding initiation were race/ethnicity, education, marital status, postpartum anemia status, parity, prenatal trimester of WIC enrollment, and smoking. The strongest predictor of breastfeeding initiation differed for white mothers (positive predictor: education beyond high school [OR = 3.13]) and black mothers (negative predictor: multiparous [OR = 0.25]). Initiation rates for this population of teenage mothers fall below the national average for mothers of all ages and the US Healthy People 2010 goals. Research is needed concerning how breastfeeding support and education can be improved to reach the US national health goals.     

Single-shot ADC imaging for fMRI.

It has been suggested that apparent diffusion coefficient (ADC) contrast can be sensitive to cerebral blood flow (CBF) changes during brain activation. However, current ADC imaging techniques have an inherently low temporal resolution due to the requirement of multiple acquisitions with different b-factors, as well as potential confounds from cross talk between the deoxyhemoglobin-induced background gradients and the externally applied diffusion-weighting gradients. In this report a new method is proposed and implemented that addresses these two limitations. Specifically, a single-shot pulse sequence that sequentially acquires one gradient-echo (GRE) and two diffusion-weighted spin-echo (SE) images was developed. In addition, the diffusion-weighting gradient waveform was numerically optimized to null the cross terms with the deoxyhemoglobin-induced background gradients to fully isolate the effect of diffusion weighting from that of oxygenation-level changes. The experimental results show that this new single-shot method can acquire ADC maps with sufficient signal-to-noise ratio (SNR), and establish its practical utility in functional MRI (fMRI) to complement the blood oxygenation level-dependent (BOLD) technique and provide differential sensitivity for different vasculatures to better localize neural activity originating from the small vessels.     

急性脑梗死诱发全身炎症反应综合征致多器官功能障碍综合征的临床研究

目的　探讨急性脑梗死 (ACI)诱发全身炎症反应综合征 (SIRS)致多器官功能障碍综合征(MODS)的发病机制 ,以及血清肿瘤坏死因子 (TNF α)、白细胞介素 (IL 1) β含量变化在ACI诱发SIRS发生、发展并向MODS转化的临床意义。方法　 6 8例ACI患者根据病情变化分为 3组 ,其中单纯性ACI(SACI组 ) 36例 ,ACI致SIRS(SIRS组 ) 32例 ,ACI致SIRS后发展为MODS(MODS组 ) 2 4例 ;应用酶联免疫吸附法 (ELISA法 )分别测定患者不同病程中血清TNF α、IL 1β值 ,并与对照组 (为 2 8名同期健康体检者 )比较。 结果　 (1) 6 8例ACI中 4 7.0 6 %发生SIRS;SIRS时 75 %发生MODS。 (2 )血清TNF α、IL 1β的含量MODS 组 >SIRS组 >SACI组 >对照组 ,各组间比较 ,差异具有极显著性 (均P <0 0 1)。MODS重症者 (积分≥ 9分 )血清TNF α、IL 1β含量高于轻症者 (积分 <9分 ) (均P <0 0 1) ;MODS死亡者血清TNF α、IL 1β含量高于存活者 (均 P <0 0 1)。结论　 (1)ACI后出现SIRS可导致MODS的发生。 (2 )患者血清TNF α、IL 1β水平异常变化可作为判断ACI致SIRS、MODS病情进展、预后及转归的一项指标     

口服避孕药在体外受精周期中的应用进展

目前口服避孕药(Ocs)在体外受精(IVF)周期中广泛应用,但各位学者研究结果不一.多数文献认为,口服避孕药应用于卵巢高反应和低反应患者可以改善体外受精临床结局,而口服避孕药应用于卵巢正常反应患者,除在促性腺激素释放激素拮抗剂(GnRHA)周期可通过其对月经周期进行控制,有计划地安排工作以外,并不改变体外受精临床结局.口服避孕药停药后5 d或月经第3天给促性腺激素(Gn)优于停药后2 d给促性腺激素.选择合理的口服避孕药用药方案和临床适应症对改善体外受精临床结局起着重要作用.     

普南扑灵滴眼剂在视网膜脱离手术中的应用

目的　探讨普南扑灵滴眼剂在减轻玻璃体视网膜术 (VRS)和巩膜扣带术 (SBS)后炎症反应的作用。方法　将 82例 (82只眼 )随机分为研究组和对照组 ,研究组 41例 (41只眼 ) ,选用 0 .1%普南扑灵滴眼剂点眼 ,对照组 41例 (41只眼 ) ,选用 0 .0 2 5 %地塞米松滴眼剂点眼。观察指标为眼部疼痛、充血、前房闪辉、角膜炎症、虹膜后粘连。结果　选用 0 .1%普南扑灵滴眼剂的研究组在缓解术后眼部疼痛方面及减轻玻璃体切割术后前房闪辉、虹膜后粘连方面优于对照组 ,差异有显著性 (P <0 .0 5～ 0 .0 1)。结论　普南扑灵能显著的减轻 VRS及 SBS后炎症反应。     

Access编制数据库在白内障病例管理中的应用

目的 应用微机对白内障病例进行管理，实现病例管理自动化。方法 根据患者姓名、晶状体等各项临床信息，在Windows98及以上版本的操作平台上，应用Access2000建立患者信息病例库。结果 建立Access病例库管理白内障病例，病例存储量大，查询方便快捷，数据处理方便。结论 Access2000编写的数据库在临床病例的管理中值得广泛应用及推广。     

PAI－1糖基化位点突变体的构建及其在哺乳动物细胞中表达

Ⅰ型纤溶酶原激活物抑制剂（ＰＡＩ－１）是一种Ｍｒ为５０×１０３的单链糖蛋白，有３７９个氨基酸残基，３个Ｎ型糖基化位点。构建ＰＡＩ－１糖基化突变体，以便研究糖链的功能。用寡核苷酸定位突变技术将３个糖基化位点２０９，２６５，３２９位进行突变，把３个糖基化位点都发生了突变的ＰＡＩ－１ｃＤＮＡ组装到真核表达载体ｐＳＶ２中，得到真核表达质粒ｐＺＨ－ｐ１－Ｍ３Ｅ；在二氢叶酸还原酶缺陷型中国仓鼠卵巢细胞（ＣＨＯｄｈｆｒ－）中进行短暂表达，用发色底物法和夹心ＥＬＩＳＡ方法检测培养液中ＰＡＩ－１的活性和含量。结果：糖基化位点突变的ＰＡＩ－１能在ＣＨＯ细胞中表达，但表达水平及活性较低。非糖基化ＰＡＩ－１的活性和抗原分别为４．３４ＩＵ／ｍｌ和３．１５μｇ／Ｌ结论：用寡核苷酸定位突变方法获得了ＰＡＩ－１糖基化突变体，并且在ＣＨＯ细胞中得到表达。     

Thymidine labeling index in breast tumors

The relationship between primary tumor proliferative activity and clinical and pathologic characteristics was analyzed in relation to menopausal status in 32 patients with malignant or benign breast disease. The thymidine labeling index (TLI) showed significantly higher median values in the cancer patients (3.48 per cent) than in the patients with benign diseases (1.02 per cent). TLI was not significantly affected by delayed incubation at room temperature for about 1 hour. In the breast cancer patients, TLI did not significantly correlate to tumor size, the presence of axillary lymph node metastasis or pathologic nuclear grading. The only significant difference was limited to the breast cancer patients without axillary lymph node metastasis in relation to menopausal status; the TLI in the premenopausal patients (5.10 per cent) was significantly higher (p<0.05) than that in the postmenopausal patients (2.28 per cent). These data thus suggest that among premenopausal patients without axillary lymph node metastasis, those with a high TLI could be potential candidates for adjuvant chemotherapy.