Visual event-related potentials in progressive supranuclear palsy, corticobasal degeneration, striatonigral degeneration, and Parkinson's disease

To determine whether there are characteristic changes in event-related potentials (ERPs) in parkinsonian syndromes we studied 8 patients with progressive supranuclear palsy (PSP), 10 patients with corticobasal degeneration (CBD), 9 patients with striatonigral degeneration (SND), and 16 patients with idiopathic Parkinson's disease (PD) with a mean duration of illness shorter than 5 years in each group. A visual oddball paradigm was employed to elicit P300. P300 to the rare target and rare nontarget stimuli and reaction time (RT) to rare target stimuli in each group were compared with those in the corresponding age-matched normal control group and to each other after age correction. The correlation of P300 and RT to motor disability score was also studied. In PSP P300 amplitude was markedly reduced while in CBD P300 latency was prolonged. P300 amplitude to rare nontargets in SND and PD was attenuated. The mean RT in the PSP and the CBD group was significantly longer than in the other two groups. The mean RT in PD and P300 amplitude to rare nontargets in both CBD and PD showed significant correlation with the severity of motor disability. Simultaneous measurement of P300 and RT may yield useful supplementary information in facilitating diagnosis of parkinsonian syndromes in addition to clinical criteria. Received: 6 April 1999, Received in revised form: 5 August 1999, Accepted: 12 January 2000     

影响药物流产效果的相关因素分析

目的:分析影响药物流产成功的相关因素,指导药物流产的临床使用。方法:对1311例早孕药物流产患者的年龄、孕产次、子宫位置及人流史与药流不全的关系进行分析。结果:总的药流不全率为40.3%。不同年龄组药流不全比例没有显著性差异;子宫位置中,后屈者药流不全率高达62.5%,前倾位者药流不全率为4.6%;初孕者药流成功率高达82.0%;随着人流次数的增多,药流不全率明显增高。结论:影响药物流产成功的因素有子宫屈位、既往分娩史及人流史。     

厂矿企业实施职工健康促进的现状研究——关于企业职工健康促进干预方案的建议

目的对在昆明市厂矿企业实施职业健康促进提出针对性建议。方法综合分析昆明市20个厂矿企业的1432名职工进行健康促进现况调查的结果。结果开展职业健康促进,提高职工整体健康水平必须采取综合干预措施,包括(1)加强领导,加强社区行动;(2)制定健康的公共政策,强化考核;(3)采取多种形式,提高职工自我保健技能;(4)创造支持性环境,维护职工身体健康。结论完善的企业健康促进方案有利于提高职工的健康水平,并可以为今后健康教育的实施、监测和效果评价奠定基础。     

腺苷蛋氨酸治疗新生儿黄疸202例

目的观察腺苷蛋氨酸(SAMe)治疗新生儿黄疸的疗效,探讨其作用机制。方法新生儿黄疸患儿278例,随机分为两组。对照组76例予以肝酶诱导剂、光疗等综合治疗;治疗组202例在综合治疗基础上加用SAMe 30~60 mg/(kg.d),静脉注射。动态检测血清总胆红素(T-BILI)、直接胆红素(D-BILI)、间接胆红素(I-BILI)。结果治疗组用药6 d后血清T-BILI、D-BILII、-BILI明显下降。治疗组较对照组治愈率明显高,与对照比较应用血液制品、清蛋白(Alb)次数及应用血液制品、Alb血浆的比例明显减少。治疗组以葡萄糖注射液溶解药物者2.68%发生浅表血管静脉炎。结论SAMe能有效地加快新生儿黄疸的消退,减少血液制品应用,是新生儿黄疸可靠、安全的治疗药物。     

计算机放射摄影(CR)的前景分析

本文针对我国大中型医院传统X线摄影的现状,结合对DR、PACS的发展分析,全面阐述了运用CR成像技术的潜力和前景.     

细菌对MLS类和糖肽类抗生素产生耐药性的作用机制

MLS类和糖肽类抗生素在人类与细菌感染性疾病的对抗中发挥着重要作用.与其他抗生素一样,随着这些抗生素的临床使用,细菌耐药性的出现和不断发展给人们带来新的挑战.本综述对这两类抗生素的细菌耐药性产生机制进行了剖析,并就已开发的若干个新型MLS类和糖肽类抗生素作了介绍.     

基于影像组学分类器术前预测直肠非黏液性腺癌淋巴结转移

目的：探讨影像组学方法在术前预测直肠非黏液性腺癌淋巴结转移中的价值。方法：回顾性分析91例手术病理切片证实为直肠非黏液性腺癌患者的影像学资料,其中61例为训练样本,30例为验证样本。基于全瘤体积,从每个原发病灶术前高分辨T2加权成像(T2-weighted imaging,T2WI)图像中提取影像组学特征1 301个。基于训练样本,利用最小绝对收缩和选择算子(the least absolute shrinkage and selection operator,LASSO)逻辑回归方法筛选关键特征并构建影像组学分类器。采用受试者工作特征(receiver operating characteristic,ROC)曲线评价影像组学分类器的辨别效能,并将其与形态学标准进行比较。在验证样本中验证影像组学分类器的价值。结果：由5个影像组学特征构建的分类器与淋巴结转移状态有关(P<0.001)。在训练样本和验证样本中,影像组学分类器诊断淋巴结转移的曲线下面积分别为0.874(95% CI：0.787~0.960)和0.878(95% CI：0.727~1.000),形态学标准诊断淋巴结转移的曲线下面积分别为0.619(95% CI：0.487~0.752)和0.556(95% CI：0.355~0.756)。无论是训练样本还是验证样本,影像组学分类器的诊断效能均高于形态学标准(均P<0.05)。结论：影像组学分类器可术前个体化预测直肠非黏液性腺癌淋巴结转移,而且其诊断效能高于形态学标准。     

脊髓型颈椎病患者三维有限元模型的构建与生物力学分析

目的：构建颈部三维有限元模型(finite element model,FEM),初步分析脊髓型颈椎病(cervical spondylotic myelopathy,CSM)患者与对照者颈部生物力学的差异,为CSM发病机制的研究提供生物力学依据。方法：以1名CSM患者作为力学模拟实验对象进行三维CT扫描,并构建颈部三维FEM依照患者的年龄、性别、身高、体重等参数选取本团队已有的健康颈部三维FEM作为对照,比较患者和对照者在颈椎正常受力情况下椎体、椎间盘、韧带及脊髓的应力差异,以及后仰伸运动后最大应力的差异。结果：成功构建CSM患者及对照者FEM模型,并进行力学分析,CSM患者颈椎椎体受力差异C5~C6节段最明显,对照者和患者的最大应力部位均在椎体前缘,CSM患者椎体前缘的最大应力小于对照者;CSM患者椎间盘应力分布不均匀,最大应力部位集中在椎间盘底部后缘的两侧;CSM患者各韧带的应力分布不均匀,其中后纵韧带应力最大。CSM患者颈椎在后仰伸运动时范围受限。结论：CSM患者相对于对照者可能存在颈部椎体、椎间盘及韧带受力平衡的改变和颈椎运动范围的受限,这可能与CSM力学发病机制相关。     

Individual and joint effects of borderline ankle-brachial index and high plasma total homocysteine on all-cause death in hypertensive adults

BACKGROUNDThe cardiovascular hazards of total homocysteine (tHcy) are long known. In addition, despite the acknowledgment on the importance of low ankle-brachial index (ABI) (< 0.9), borderline ABI (0.91-0.99) was once commonly overlooked. This study aims to explore the independent and joint effect of tHcy level and borderline ABI on all-cause death in hypertensive population.METHODSThis study included 10,538 participants from China H-type Hypertension Registry Study. ABI was described into two groups: normal ABI (1.00-1.40) and borderline ABI. tHcy level was also divided into two groups: < 15.02 and ≥ 15.02 μmo/L. Four groups were analyzed, using COX proportional hazard regression model, separately and pairwise to observe the independent and joint effect on all-cause death.RESULTSA total of 126 (1.2%) deaths were observed in the 1.7 years follow-up time. Borderline ABI has a higher predicted risk of death than normal ABI (HR = 1.87, 95%CI: 1.17-3.00) after adjusting for potential covariates. Compare with tHcy level < 15.02 μmo/L (low tHcy), those with tHcy ≥ 15.02 μmo/L (high tHcy) had higher risk to event outcome (HR = 1.99, 95% CI: 1.30-3.05). According to the cumulative hazard curve, group with borderline ABI and high tHcy level has significantly higher altitude and larger increasing rate over follow-up period compare to other groups. Among those with borderline ABI, participants with high tHcy had higher death risk than those with low tHcy, nevertheless, no significant different between borderline and normal ABI among those with low tHcy levels.CONCLUSIONSBorderline ABI and tHcy level both have independent predictive value on all-cause death. The combined group of borderline ABI and high tHcy has highest risk factor of outcomes, which suggested the mutual additive value of borderline ABI and tHcy. More attention should be given to the importance of borderline ABI in hypertensive population, especially with elevated tHcy level.

Homocysteine (Hcy) is a sulfur-containing, non-proteinogenic amino acid synthesized through the transmethylation of amino acid methionine from one-carbon metabolism. Elevated plasma total homocysteine (tHcy) level is associated with endothelial dysfunction, increased blood coagulation, and metabolic disturbance, promoting cardiovascular diseases, stroke, and coronary artery disease.^[1,2] Notably, patients with high Hcy levels and concomitant hypertension were suggested to be at particularly higher risk.^[3] Moreover, increasing studies have explored a positive association between advanced Hcy level with all-cause mortality. According to a recent dose-response meta-analysis, for each 5-μmol/L increment of tHcy levels, the risk for all-cause mortality increased by 33.6%.^[4]The ankle-brachial index (ABI) is an effective, well-established measure that is commonly used in the diagnosis of peripheral artery disease (PAD),^[5] meanwhile was well studied as an important indicator of atherosclerosis and CVD events.^[6] Although ankle-brachial index (ABI) ≤ 0.90 has been recognized as the threshold value for abnormal/low ABI, which was proven to increase the risk of all-cause mortality,^[7] a study from the American Heart Association has suggested ABI between 0.91 and 1.00 should be considered as “borderline area” in terms of cardiovascular risks,^[8] considering of prior probability and sensitivity of ABI calculation. Emerging studies have aimed to explore the predictive value of borderline ABI,^[9-11] however, controversy remains because of limited and inconsistent data. The current study aimed to explore the individual and joint effect of borderline ABI and tHcy on all-cause mortality among hypertensive adults. Although ABI level ≤ 0.90 has been and is going to remain significant in clinical practice, we believe broader concern should be placed on borderline ABI, especially for its value in risk differentiation and identification. To the best of our knowledge, there are no similar previous studies.     

Arthroscopic Management of Giant Meniscal Cysts Among Young Patients: An Average Three‐Year MRI Follow‐Up

ObjectiveTo describe an arthroscopic technique for giant meniscal cyst excision with preservation of the functional meniscus, report the short‐ and medium‐term outcomes, and assess magnetic resonance imaging (MRI) for follow‐up imaging evaluations.MethodsA total of 54 consecutive patients with symptomatic meniscal cysts were admitted to the Second Xiangya Hospital of Central South University between 2014 and 2019. Nine patients with giant meniscus cysts (six females and three males) were included in this study. The age range of the patients was 6–34 years. All patients underwent a complete physical examination, X‐ray, Doppler ultrasound, and MRI of the knee preoperatively. After an arthroscopic diagnosis of a meniscal rupture with a giant meniscal cyst, partial meniscectomy, ablation of the cyst, and suturing of the retainable meniscus were performed. Lysholm and International Knee Documentation Committee (IKDC) scores were used preoperatively and at the most recent follow‐up. Clinical outcomes were classified into four categories: excellent, good, fair, and poor. During the last visit, all patients underwent MRI to assess the recurrence of the cyst and meniscal suture healing.ResultsPreoperative MRI and arthroscopic examination revealed giant meniscal cysts combined with meniscal tears and congenital discoid meniscus, and all giant meniscal cysts occurred in the lateral meniscus. The main types of meniscal tears were horizontal and complex tears. The cysts were unicystic in one case and multicystic in eight cases. The mean size of the cysts on the MRI was 5.86 cm × 2.24 cm × 2.48 cm. The mean follow‐up periods were 37.5 (19–60) months. Clinical outcomes were excellent in six patients and good in three patients. The postoperative scores were significantly improved compared to the preoperative scores (Lysholm: 90.78 ± 4.60 vs. 54.56 ± 7.25; IKDC: 96.2 ± 3.46 vs. 61.69 ± 3.36; p <0.01). No recurrence of the cyst was indicated on the MRI, and there was good healing of the torn meniscus.ConclusionsArthroscopic cystectomy combined with the meniscus suture technique was effective to eradicate residual cyst cavities, and traffic orifices be highly recommended.