侧颅底肿瘤手术入路(附44例报告)

目的:探讨切除侧颅底肿瘤的最佳入路.方法:44例患者中,采用下颌外旋入路17例,耳后C形切口入路16例,上颌外旋入路7例,颞额入路4例.结果:25例良性肿瘤术后无复发;19例恶性肿瘤中,术后生存不足1年2例,1年以上4例,2年以上7例,3年以上6例.结论:下颌外旋入路适用于切除咽旁间隙、颞下窝、鼻咽部、口咽部、蝶骨、斜坡及上颈椎肿瘤;耳后C形切口入路适用于切除颞骨肿瘤.     

GNAS gene mutations affecting XLαs and bone health: A long neglected relationship

The GNAS locus is an imprinted site. The α-subunit of the stimulatory G protein (Gsα) and extralarge variant (XLαs) are the two important products of the GNAS locus. The abnormal expression of Gsα is associated with pseudohypoparathyroidism (PHP) and related disorders, including Albright hereditary osteodystrophy (AHO), pseudopseudohypoparathyroidism (PPHP), and progressive osseous heteroplasia (POH). XLαs protein can mimic the catalytic intracellular synthesis of cyclic adenosine monophosphate (cAMP) by Gsα in response to parathyroid hormone (PTH) stimulation, which may be involved in the pathogenesis of PPHP and POH in patients with paternal GNAS defects. A paternally inherited nonsense variant in the first exon of XLαs in an adult patient may be associated with fractures and osteopetrosis. The relationship between the XLαs product of the GNAS locus and bone remodeling may have been overlooked. Here, we summarize the phenotypes of genetic mouse models and clinical cases of XLαs variations and suggest that the abnormal paternal expression of XLαs may be associated with the development of POH and affect osteoblast and osteoclast differentiation.     

电化教育在医学生素质教育中的作用

电化教育随着时代的变迁和社会的发展以及医学科学特点,在医学教育中的地位不断加强,尤其是在医学素质教育中,发挥着重大作用。     

Messenger-rnas for activin and activin receptors are expressed in fetal bovine heart endothelial-cells

Inhibin and activin, members of transforming growth factor beta (TGF beta) superfamily, have been localized immunohistochemically in fetal bovine heart endothelial cells (FBHE), suggesting that these cells produce inhibin/activin proteins. In addition, the mRNAs coding for alpha-, and beta A-subunits of inhibin/activin, and activin receptor II were expressed in these cells by in situ hybridization technique. It is concluded that inhibin/activin and activin receptor are expressed in FBHE and activin may have autocrine functions in these cells.     

微波治疗耳鼻喉科疾病疗效观察

探索耳鼻喉慢性炎症的简便有效疗法。方法：对１０２例病人表麻下用微波辐射探头定量向病 变组织输入电磁波。结果：随访观察半年以上,治愈率达８８．２４％,有效率达１００％。结论：此方法操作简便,疗 效好,病人痛苦小,值得临床推广。     

咬合板治疗颞下颌关节紊乱病的时机与疗效

目的：通过对颞下颌关节紊乱病（ＴＭＤ） 的临床表现及咬合板治疗的疗效进行分析,探讨ＴＭＤ 的最佳治疗时机。方法：对１５６ 例经咬合板治疗的ＴＭＤ患者就诊时间及治疗２ 个月后治疗效果做分类统计分析。结果：治疗２ 个月后疼痛、弹响及张口受限的总治愈率分别为８１．４％ 、４９．０％ 和８１．５％ 。其中于发病４ 周内就诊的患者治愈率分别为９３．２％ 、７７．３％ 和９３．２％ ,于４ 周后就诊的患者治愈率分别为７３．９％ 、４０．８ ％ 和３０．０ ％ ,两组差异显著（ 弹响及张口受限, Ｐ＜ ０．０１,疼痛Ｐ＜０．０５）。结论：ＴＭＤ在发病４ 周内进行咬合板治疗效果满意。     

聚合酶链反应检测细菌16S rRNA基因

根据细菌１６ＳｒＲＮＡ基因的高度保守性,设计合成所有细菌、革兰氏阳性细菌及革兰氏阴性细菌的共同引物,采用聚合酶链反应检测已知细菌１３株,三对引物分别扩增的阳性率为１００％,倍比稀释法能检出细菌的最低浓度为４ＣＦＵ·ｍｌ－１,同时检测临床样本４０份,阳性率为６７５％（２７／４０）,同期细菌培养阳性率为４５％（１８／４０）,二者比较差异有显著性（Ｐ＜０．０５）。结果提示聚合酶链反应检测细菌１６ＳｒＲＮＡ基因具有高度的特异性和敏感性。     

Development and clinical application of dental spot weld & heat-treat tri-uses device]

A spot weld & heating treatment tri-uses device based on modern mechanical-electric technique, was developed for dental spot weld, stainless steel orthodontic wire heating-reversion and Ni-Ti orthodontic wire heating-overload metamorphism. The device will be very helpful instrument in orthodontic clinic. The paper not only described the operating methods of the device, but also discussed the Performance-improved principles of stainless steel orthodontic wire and the principles of heating overload metamorphism of Ni-Ti orthodontic wire.     

Predictors of an acute antidepressant response to fluoxetine and sertraline.

Sertraline and fluoxetine have different pharmacologic and pharmacokinetic profiles which may be of clinical relevance in the determination of response in different subtypes of depression. A randomized, double-blind, 6-week study comparing sertraline (50-100 mg/day) with fluoxetine (20-40 mg/day) in 286 outpatients with major depression, who had demonstrated comparable efficacy and tolerability for the two drugs, was analysed by subgroups of patients at baseline with melancholia, severe depression, single depressive episode, multiple depressive episodes, high anxiety, low anxiety, psychomotor retardation and psychomotor agitation. Multiple logistic regression with regressors including treatment-by-subgroup variables revealed that, within certain subgroups, the efficacy might differ substantially from that of the whole treatment group. However, the only treatment-by-subgroup interaction term that was significant was anxiety (P < 0.05). There was no evidence of interaction in single or recurrent episode subgroups, and these were not included in subsequent analyses. Subsequent two-sample statistical comparison tests of response (i.e. Hamilton Depression Scale reduction > or = 50%) rates at study endpoint between treatment groups demonstrated that patients with melancholic depression and those with symptoms of psychomotor agitation yielded a significantly greater proportion of responders with sertraline compared to fluoxetine (P < 0.05). Response rates in sertraline- and fluoxetine-treated patients, respectively, were: overall study 59%, 51%; melancholia 59%, 44%; severe depression 59%, 41%; low anxiety 71%, 55%; high anxiety 47%, 48%; psychomotor retardation, 48%, 46%; and psychomotor agitation 62%, 39%. Multiple logistic regression adjusting for possible confounding factors, that included a treatment by anxiety interaction term, also led to similar findings. In particular, the analysis showed that significant differences existed in favour of sertraline in patients with low anxiety in the melancholia and severe depression subgroups (P < 0.05), indicating that these characteristics predicted a superior response to 6 weeks of treatment with sertraline relative to fluoxetine. Sertraline also demonstrated advantages over fluoxetine on parameters such as sleep and weight disturbance in severely depressed patients, and sleep disturbance, weight, cognitive disturbance and retardation in melancholic patients.