Acquired pendular nystagmus: its characteristics, localising value and pathophysiology

Investigations were made of 16 patients with acquired pendular nystagmus and a further 32 cases reported in the literature were reviewed. Amongst our own patients two thirds had multiple sclerosis, almost one third a cerebrovascular accident or angioma and two had optic atrophy with squint. The nystagmus took forms which could be monocular or binocular, conjugate or disconjugate and could involve movements about single or multiple axes. Spectral analysis was used to characterise the amplitude and frequency of the movements and to estimate the degree of relationship (coherence) between movements of the two eyes or between movements of one eye about several axes. The oscillations ranged in frequency from 2·5 Hz to 6 Hz, with typical amplitudes between 3° and 5°. In a given patient all oscillations, regardless of plane, were highly synchronised. Somatic tremors of the upper limb, face and palate associated with the nystagmus were often at similar frequencies to the eye movement. The other ocular signs common to all our patients were the presence of squint with failure of convergence. Most patients also had skew deviation or internuclear ophthalmoplegia or both. The major oculomotor systems, that is, saccades, pursuit, optokinetic and vestibulo-ocular reflexes could be intact. It is inferred that the mechanism responsible for the pendular nystagmus lies at a level which is close to the oculomotor nuclei so that it can have monocular effects but is not part of the primary motor pathways. It is possible that this mechanism normally subserves maintenance of conjugate movement and posture of the eyes. The periodicity of the nystagmus is likely to arise from instability in a certain type(s) of neurone, for the associated somatic tremors have similar characteristics and yet involve very different neuronal muscular circuitry. Prognosis for cessation of the nystagmus is poor. In five patients with multiple sclerosis it was suppressed by intravenous hyoscine with, however, unacceptable subsequent side effects.     

Radiology of the orbital apex

The orbital apex, formed by the superior orbital fissure and optic canal, is the cross-road between the orbit and the intracranial structures. Pathological processes may extend intracranially via the superior orbital fissure and vice versa. In addition to intrinsic soft tissue lesions, various pathological processes may involve the surrounding osseous anatomy. Malignant lesions arising from adjacent structures or from haematogeneous metastasis may also infiltrate this region.     

急性淋巴细胞白血病(上)

急性淋巴细胞白血病是淋巴前体细胞异常引起的恶性疾病,儿童与成人均可能发生。儿童发病高峰2～5岁。有效治疗的稳步进展使本病在儿童中的治愈率80％以上,同时为新的治疗方案提供了良机,新方案将保留我们在白血病无病生存病例中获得的治疗经验,同时减轻当前强化治疗方案中的毒副作用。     

醋酸环丙孕酮／炔雌醇复方片剂在人体的药代动力学

目的建立人血浆中醋酸环丙孕酮的HPLC—ESI—MS测定方法和丹酰氯衍生化血浆中炔雌醇的HPLC—APCI—MS测定方法,测定女性志愿者口服复方醋酸环丙孕酮片1片后的药代动力学参数,并对受试制剂和参比制剂的生物等效性进行评价。方法血浆样品中的炔雌醇以乙酸乙酯提取后,与丹酰氯发生衍生化反应,进行HPLC—APCI—MS分析,流动相为10mmol·L-1乙酸铵缓冲液（1％甲酸）-甲醇（3：97）。检测离子分别为m／z530．3（炔雌醇的丹酰氯衍生物）、m／z404．3（内标,对羟基联苯的丹酰氯衍生物1。结果在10．43～625．8Pg·ml-1范同内炔雌醇的丹酰氯衍生物与内标的丹酰氯衍生物峰面积比值与浓度呈良好的线性关系,最低定量限为10．43pg·ml-1结论本实验建立的分析方法灵敏、准确、简便,且统计学结果表明两种制剂生物等效。     

癌基因c-erbB-2在膀胱移行细胞癌中的扩增

0　引言　为探讨癌基因 c- erb B- 2的扩增与膀胱移行细胞癌(TCC)的关系 ,我们以斑点杂交的方法对 40例膀胱 TCC标本中 c- erb B- 2的扩增情况进行了检测 ,以期明确 c- erb B- 2扩增与膀胱 TCC病理分级及患者预后的关系 .1　材料和方法　 40例膀胱 TCC患者术后石蜡包埋标本 ,随访 5～ 10 a. 11例正常膀胱粘膜石蜡标本作为对照 . c- erb B-c DNA p CER2 0 4质粒由东京大学提供 ,Bothringer缺口平移 DNA标记试剂盒及 32 P标记 d CTP购于北京福瑞公司 .所有石蜡标本经脱蜡及蛋白酶消化 ,以酚 /氯仿抽提 DNA,乙醇沉淀 .每份样品取…     

Can privatising selected services benefit the public healthcare system?

The evaluation of empirical data concerning private physician consultations in public hospitals in Greece suggests that privatisation of selected public services can increase patients' freedom of choice and also improve efficiency and quality of services, thus strengthening the supply side in a mixed healthcare system. The 2001 NHS health reform in Greece provides financial incentives to public hospital physicians to consult patients 'privately' at the outpatient clinics, while remaining restrained by certain provisions regarding fees. Competition between public and private hospitals is centrally regulated, and in this case cumulative data show success for the public sector. At the same time, patient satisfaction with the new arrangement measured in this study was very high. It could be argued that, under certain conditions, attracting private funds into a public health system constitutes an opportunity to reinforce the public provision of the system.     

冠心病患者实施健康信念模式干预效果评价研究

目的探讨冠心病（CHD）患者实施健康信念模式干预的效果。方法将140例CHD患者随机分对照组和干预组,各70例,对照组给予常规治疗和护理,干预组在对照组的基础上给予健康信念模式干预措施;比较两组的遵医行为、干预效果及生活质量评分。结果实施干预后,干预组的遵医行为备维度得分均明显好于对照组（P〈0．0.01）;干预组的各干预效果指标均明显好于对照组（P〈0．05）：干预组的生活质量各维度指标也明显好于对照组（P〈0．01）。结论CHD患者实施健康信念模式干预后,明显提高CHD患者的遵医行为和生活质量评分,干预效果明显。     

广州市2010年登革4型病毒的分离及其E基因进化分析

登革病毒(DEN)E蛋白在病毒与宿主细胞融合和诱导机体产生抗体等过程中发挥重要作用[1].本研究通过对分离株E基因全序列测定,从分子水平确定其型别,并与广州市历年同型DEN流行株及相关国际流行株进行同源性比较,构建系统进化树,追踪其可能输入来源.     

Interpeduncular fossa sign: CT criterion of subarachnoid hemorrhage

A retrospective study of 100 cerebral computed tomography scans interpreted as displaying subarachnoid hemorrhage was undertaken to determine the frequency of blood in the interpeduncular fossa as a useful radiographic sign. The results indicate that the interpeduncular fossa sign is second only to blood in the Sylvian fissure-circular sulcus area as a reliable indicator of subarachnoid hemorrhage on CT scans.