臂丛神经血管受压征13例手术治疗的随访

目的分析臂丛神经血管受压征(胸廓出口综合征)的手术疗效。方法对13例接受手术治疗的臂丛神经血管受压征患者进行随访,平均随访时间为3．2年。随访内容以患者的主观感觉为主,包括患肢麻木、酸痛、乏力、手部精细活动、发冷及肌肉萎缩等进行疗效的评价。结果术前13例均主诉有患肢感觉异常(麻木、刺痛觉减退),术后患肢感觉异常完全缓解或明显改善者12例(12／13),占92．4％;症状无变化或症状加重者1例(1／13),占7．6％。手部肌肉萎缩恢复者或改善者11例(11／12),占91．7％;手部肌肉萎缩无恢复或加重者1例(1／12),占8．3％。自觉患肢活动改善或症状完全缓解者11例(11／12),占91．7％;症状无变化或症状加重者1例(1／12),占8．3％。术前主诉有颈肩部酸痛者5例,术后症状明显改善或完全缓解者4例(4／5),占80％;症状无变化或症状加重者1例,占20％。结论采用手术治疗臂丛神经血管受压征是较有效的方法。     

Anterior cervical discectomy and fusion with implantable titanium cage: initial impressions, patient outcomes and comparison to fusion with allograft.

BACKGROUND CONTEXT: The use of metal cage prosthetic devices in anterior cervical discectomy with fusion (ACDF) has increased rapidly. One of these devices is the titanium Rabea cage (Signus, Alzenau, Germany) [correction]. There are no peer-reviewed objective reports on the use of these cages in cervical discectomy. PURPOSE: The authors present preliminary outcomes data on the Rabea cage. This study is intended to provide adjunct data for surgeons who are using or are considering the use of these devices. STUDY DESIGN/SETTING: Patients in a private practice were studied prospectively as part of a long-term assessment of outcomes using several surgical procedures. Data were collated and analyzed by an independent researcher. PATIENT SAMPLE: Rabea cages were used in consecutive candidates (n=37) for ACDF. The results using Rabea cages were compared with two prospectively studied control groups, one historical (n=66) and one concurrent (n=28), both groups using ACDF with bone allograft and no instrumentation. OUTCOME MEASURES: Success at 6 months after surgery was determined using six major patient-reported outcome measures, including visual analog scales (VAS) for arm and neck pain, the Oswestry pain and disability scale, four-part (excellent-through-poor) scales for measurement of return to activities of daily living or to work and satisfaction with the results of surgery. Perioperative complications, number of vertebral levels fused, and worker's compensation and smoking status were also compared among the study groups. Fusion and subsidence were evaluated for the Rabea cage group. METHODS: Criteria for inclusion consisted of consecutive patients who presented with unremitting radicular arm pain, with or without neck pain, and/or a neurological deficit that correlated with appropriate level and side neural compression on magnetic resonance imaging or computed tomography. Questionnaire follow-up was at 6 months after surgery with 100% compliance. RESULTS: A total of 50 cages were implanted in the 37 patients. At 6-month follow-up, 78% of patients reported successful arm pain relief (VAS scores below 5). Patient satisfaction was successful in 78% of the cases. Other success rates included neck pain relief in 73% and Oswestry pain and disability scale in 70%. There was a median improvement in the Oswestry scores of 28 points (61% change). Worker's compensation patients fared dramatically worse than did the noncompensation patients in all outcome measurements. Combining all three study groups resulted in significantly worse outcomes for multilevel than for single-level procedures and for smokers compared with nonsmokers, but low case numbers precluded conclusive analysis for the Rabea group alone. In the Rabea group there were two complications, neither cage related, whereas none were reported for the ACDF controls. Rabea group fusion rates were 84% at 3 months and 95% at 6 months, but the clinical relevance of this radiological evidence when metal prostheses are used is questionable. The outcomes results were clinically and statistically indistinguishable from those of our control groups and were similar to published studies using other titanium cages. CONCLUSIONS: This is the first prospective, independently conducted report on Rabea cages. Results of the short-term (6 months) follow-up did not differ from outcomes results in our patients who have undergone ACDF with bone allograft. Although this is a preliminary assessment, the Rabea cage may represent an alternative to bone dowels and hip graft. As is the case for other allografts, artificial or bone, the main advantage is elimination of donor site complications, and the disadvantages include difficulty in radiographic assessment of fusion and potential for cage subsidence.     

单克隆抗独特型抗体NP30对血吸虫虫卵肉芽肿细胞凋亡的影响

目的：探索日本血吸虫单克隆抗独特型抗体NP30对血吸虫虫卵肉芽肿细胞凋亡的影响。方法：BALB／c小鼠随机两组，实验组腹腔注射 NP30主动免疫3次，对照组腹腔注射生理盐水，分别在尾蚴攻击感染后第39，49，64，108，112天处死，应用透射电镜观察肝虫卵肉芽肿细胞凋亡的形态改变，流式细胞术（FCM）和末端转移酶介导的缺口末端标记法（TUNEL）检测虫卵肉芽肿凋亡细胞。结果：透射电镜观察虫卵肉芽肿细胞有凋亡小体形成；经FCM和TUNEL检测实验组虫卵肉芽肿细胞凋亡明显多于对照组。结论：细胞凋亡在日本血吸虫虫卵肉芽肿的形成、细胞转化过程中起着重要作用。NP30抗病免疫作用的机制之一是促进虫卵肉芽肿细胞的凋亡。     

瑞安吉对窒息新生儿心肌损伤的疗效观察

目的　探讨瑞安吉对窒息新生儿心肌损伤的临床应用价值。方法　对 2 0 0 1年 6月— 2 0 0 2年 1 2月在我院住院的 46例窒息新生儿做血清LDH ,CK ,HBDH ,CK MB常规测定 ,并对心肌酶升高的 3 4例患儿中的 1 7例口服瑞安吉治疗。结果　观察组心肌酶均转为正常 ,对照组仅 8例转为正常。结论　瑞安吉口服治疗窒息新生儿心肌损伤疗效好 ,无副作用     

磁感应断层成像技术中涡流问题的有限元法仿真研究

目的 为了求解磁感应断层成像(magnetic induction tomography, MIT)技术中的涡流问题,以获得MIT正问题的有效解法.方法 推导了对应于MIT技术的涡流场的微分方程及其边界条件,采用有限元方法计算了场域内一些不同电导率或位置的扰动目标下的位函数.结果 仿真计算结果与单线圈MIT系统的测量结果相吻合.结论 本文提出的有限元计算方法适用于生物组织磁感应断层成像技术,是解决MIT正问题的一个有效方法,更完善的仿真计算模型有望进一步提高计算精度.     

Nursing students'' blood pressure measurement following CD-ROM and conventional classroom instruction: a pilot study

This paper describes a pilot investigation of first year nursing students' adherence to the recommended auscultatory blood pressure measurement procedure following three different forms of instruction; conventional classroom demonstration of the technique, a self instructional CD-ROM tutorial program, and a combination of both methods. This investigation was carried out over a 5-day time period using 27 students during normal teaching time. Students' adherence to the procedure was determined by observation using a performance checklist. Results suggest that the CD-ROM is no substitute for real life, hands on experience, although when used as an adjunct to traditional teaching methods, it can enhance learning.     

脑梗塞患者不同时期血清神经元特异性烯醇酶含量研究

目的 :研究脑梗塞患者不同时期血清神经元特异性烯醇酶 (NSE)含量变化与脑损害程度的相关性。方法 :选择住院的全部经脑CT或MRI检查确诊为脑梗塞的患者 50例 ,分别在病后 3天、1、2、3和 4周采静脉血 ,用酶联免疫分析法测定血清NSE浓度 ,将各时间段检测值进行统计学处理并与正常值比较。结果 :患者病后 3天、1周、2周、3周时血清NSE检测的平均值与健康人血清NSE平均值比较P <0 0 5 ,有显著差异 ,而第 4周患者血清NSE检测平均值与健康人血清NSE平均值比较P >0 0 5 ,无显著差异。结论 :脑梗塞患者血清NSE含量升高 ,且随病程发展不同时期升高的程度不同。NSE可以作为脑梗塞患者脑损害程度及估计预后的客观指标。     

床边检查仪与自动化凝血仪在肝素治疗时凝血功能检验的差异

目的确定床边检查（POCT）仪与全自动凝血仪在肝素治疗时凝血常规检验和监测肝素治疗中的差异。方法以接受肝素抗凝治疗的老年心血管病患者为研究对象,分别使用Hemachron Jr Ⅱ和CG02两种POCT仪器与全自动凝血仪STA-R对比检测血浆凝血酶原时间（PT）,国际标准化比值（INR）,活化部分凝血活酶时间（APTT）和纤维蛋白原含量（Fbg）,并将不同肝素水平的血浆凝血指标进行统计分析。结果干化学法床边检查仪和自动化凝血仪对凝血参数PT、INR、APTT、Fbg的检测具有较好的相关性（r分别为0．945、0．966、0．662和0．977,均P〈0．05）;监测肝素治疗时,Hemachron Jr Ⅱ与自动化凝血仪检测APTT结果差异有统计学意义（P〈0．01）。结论干化学法床边设备不适于与自动化凝血仪同时报告凝血检验结果。     

FDA acknowledges TCM belonging to whole medical systems

Recently, 2007, the U.S. Food and Drug Administration (FDA) issued a draft guidance for the industry, titled "Complementary and Alternative Medicine Products and Their Regulation by the Food and Drug     

Monocyte-derived IL-10 expression predicts prognosis of stage IV melanoma patients

There are no standard methods to predict response to treatment or outcome of stage IV melanoma. Our previous assessment of peripheral blood mononuclear cells (PBMC) from immunized patients demonstrated that interleukin (IL)-10 expression might be associated with prognosis. However, PBMC are a mixture of CD4+ cells, CD8+ cells, and monocytes. This study identified the subset of PBMC responsible for IL-10 expression and evaluated the prognostic value of IL-10 expression in immunized stage IV patients. Eighty-seven patients with stage IV melanoma were randomly selected from our database. All patients had received an allogeneic melanoma whole-cell vaccine (Canvaxin) after complete resection of clinical disease. Blood samples had been collected serially during Canvaxin administration and cryopreserved. Intracellular IL-10 expression was assessed by double staining fluorescence-activated cell sorter. CD14+ monocytes are the predominant PBMC producing IL-10. Sixteen weeks after treatment (week 16), IL-10 levels were significantly (P=0.02) higher in poor-survival patients than those with favorable outcomes. Patients were separated into 2 groups on the basis of the CD14+ monocyte IL-10 response: either increasing or decreasing IL-10 expression from preimmunization (week 0) to week 16 blood draws. Patients with increasing IL-10 levels had significantly shorter survival than those whose IL-10 levels decreased at week 16 (P<0.0001). Multivariate analysis demonstrated that trends in IL-10 levels inversely correlated with survival (P<0.0001). We conclude that CD14+ monocytes are the dominant cellular source of IL-10 among PBMC and that changes in IL-10 expression may serve as an immunologic-based surrogate for predicting outcome for stage IV patients after surgical resection.