Dose-response effect of fetal cocaine exposure on newborn neurologic function

BACKGROUND: Studies of fetal cocaine exposure and newborn neurologic function have obtained conflicting results. Although some studies identify abnormalities, others find no differences between cocaine-exposed and cocaine-unexposed infants. To determine the effects of prenatal cocaine exposure on intrauterine growth and neurologic function in infants, we prospectively evaluated 253 infants shortly after birth. METHODS: Women who delivered a live singleton >36 weeks by dates were eligible for enrollment. Maternal exclusionary criteria were known parenteral drug use, alcoholism, and acquired immunodeficiency syndrome; infant exclusionary criteria were Apgar scores 相似文献   

鼻种植相关的切牙管三维重建的影像学研究

目的:明确切牙管区的解剖结构,为鼻缺失后种植体支持的赝复体修复提供依据,以明确种植钉植入部位及方向。方法:对60例正常咬合人群的上颌骨进行64排螺旋CT扫描和三维重建,观察切牙管开口的形状及周围骨质形态,并在中切牙之间的矢状位截面上测量切牙管的长度、鼻腔和口腔开口的纵径、与鼻底平面所成角度及与牙槽骨前壁的距离。结果:研究得出了切牙管口腔开口的形态、平均长度、口腔和鼻腔开口的矢状径、切牙管口腔开口和鼻腔开口距牙槽骨前壁的距离、切牙管前壁与鼻底平面的交角∠α、上前牙牙槽突与鼻底平面的交角∠β。结论:切牙管与牙槽骨前壁之间可植入直径5mm以内的种植体1枚,方向由后上方向前下方,与鼻底所成的角度介于∠α与∠β之间;双侧中切牙之间水平向可植入长度<5mm的种植体1枚。     

Hutchinson-Gilford progeria syndrome: oral and craniofacial phenotypes

Objective:  Hutchinson-Gilford progeria syndrome (HGPS) is a rare early-onset accelerated senescence syndrome. In HGPS, a recently identified de novo dominant mutation of the lamin A gene ( LMNA ) produces abnormal lamin A, resulting in compromised nuclear membrane integrity. Clinical features include sclerotic skin, cardiovascular and bone abnormalities, and marked growth retardation. Craniofacial features include 'bird-like' facies, alopecia, craniofacial disproportion, and dental crowding. Our prospective study describes dental, oral soft tissue, and craniofacial bone features in HGPS.
Methods:  Fifteen patients with confirmed p.G608G LMNA mutation (1–17 years, seven males, eight females) received comprehensive oral evaluations. Anomalies of oral soft tissue, gnathic bones, and dentition were identified.
Results:  Radiographic findings included hypodontia ( n  = 7), dysmorphic teeth ( n  = 5), steep mandibular angles ( n  = 11), and thin basal bone ( n  = 11). Soft tissue findings included ogival palatal arch ( n  = 8), median sagittal palatal fissure ( n  = 7), and ankyloglossia ( n  = 7). Calculated dental ages (9 months to 11 years 2 months) were significantly lower than chronological ages (1 year 6 months to 17 years 8 months) ( P  = 0.002). Eleven children manifested a shorter mandibular body, anterior/posterior cranial base and ramus, but a larger gonial angle, compared to age/gender/race norms.
Conclusion:  Novel oral-craniofacial phenotypes and quantification of previously reported features are presented. Our findings expand the HGPS phenotype and provide additional insight into the complex pathogenesis of HGPS.     

脑缺氧是影响严重颅脑创伤患者短期预后的独立危险因素(英文)

Background:Brain hypoxia(BH)can aggravate outcome after severe traumatic brain injury(TBI).Whether BH or reduced brain oxygen(Pbto2)is an independent outcome predictor or a marker of disease severity is not fully elucidated.Objective To analyze the relationship between Pbto2,intracranial pressure(ICP),and cerebral perfusion pressure(CPP)and to examine whether BH correlates with worse outcome independently of ICP and CPP.Methods We studied103patients monitored     

多重PCR法检测金黄色葡萄球菌耐药基因及致病毒素基因

目的：了解金黄色葡萄球菌（简称金葡菌）耐药基因及所携带致病毒素基因PVL与TSST-1的特点。方法：应用多重PCR法检测mecA基因、TSST-1基因及Py￡基因。结果：84株金 葡球经多重PCR法对其mecA基因进行检测．检出率为58．3％（49／84）。PVL基因阳性菌株的分离率为23．8％（20／84）,州￡阳性的MRSA为13株（13／49,26．5％）,PyL阳性的MSSA为7株（7／35,20．O％）,差异无统计学意义（P〉0．05）;未检出TSST-1基因。结论：金葡菌的耐药性呈上升趋势,且金葡菌可产生多种毒素,在分离金葡菌的同时,应加强其耐药基因及毒素基因的检测。     

成釉细胞瘤及牙源性角化囊肿中ICAM-1和VCAM-1的表达

目的探讨细胞间黏附分子-1(ICAM-1)和血管细胞黏附分子-1(VCAM-1)在成釉细胞瘤(AB)及牙源性角化囊肿(OKC)中的表达及其与AB、OKC病理学特征的关系。方法对38例AB、10例OKC、7例正常口腔黏膜(NOM)组织进行免疫组织化学SP法检测,结合病例病理特征进行分析。结果ICAM-1和VCAM-1在AB、OKC和NOM3组表达组间比较,具有显著统计学差异(P<0.05)。ICAM-1在AB中的阳性率达65.2%,显著高于NOM(14.3%),OKC(60.0%)与NOM未见显著统计学差异。VCAM-1在AB中的阳性血管数也显著高于OKC和NOM。ICAM-1和VCAM-1表达与AB的组织病理分型、年龄、性别和发生部位无明显相关性(P>0.05)。结论细胞黏附分子ICAM-1和VCAM-1与AB及OKC的发生、发展及细胞分化与增殖有关。     

NEWER CONCEPTS AND MANAGEMENT OF NEONATAL SEPSIS

Despite extensive research into its patho-physiology, investigations and treatment, sepsis remains an important cause of neonatal morbidity and mortality. The incidence in developing countries is 10 times that in the developed world. A large number of pro-and anti-inflammatory cytokines (interleukins, eicosanoids, tumour necrosis factor-alpha, nitric oxide) have been identified, the interplay of which leads to the Systemic Inflammatory Response Syndrome (SIRS) which can have devastating consequences on all systems of the body. In India the common organisms include Staphylococcus, E coli, Klebsiella and Candida. A number of maternal and neonatal risk factors have been identified. The initial signs and symptoms are subtle and can easily be missed. Early investigations and screening tests are important and a promising number of new tests are being studied. The gold standard for diagnosis is a positive culture from a body fluid or local source in the presence of SIRS. The threshold for starting antibiotics should be low in high-risk neonates and broad spectrum antibiotics covering the likely organisms should be given intravenously in all suspected cases in a hospital setting. This should be continued for at least 24-48 hours (till negative reports are available) in suspected cases and for 2-3 weeks in proven cases. Prophylaxis is aimed at preventing nosocomial and cross infections. Strict hand-washing, meticulous asepsis protocols, identification of high risk groups and prompt and better screening tests are essential in controlling this problem.KEY WORDS: Neonate, Sepsis, Systemic inflammatory response syndrome     

Digital colposcopy: ready for use? An overview of literature

The aims of this review were to summarise the various methods of digital colposcopy and to provide an overview of their efficacy. We conducted a literature search and focused on papers that described a technique for colposcopy, other than conventional colposcopy, and compared this with conventional colposcopy and/or histology and included digitalisation of the process. All papers have been classified in one of the following categories: digital imaging and telecolposcopy, spectroscopy, computerised colposcopy, optical coherence tomography and confocal microcolposcopy. Among the most promising developments is spectroscopy, allowing a more or less automated analysis and interpretation of the colposcopic image.     

肥胖与青少年多囊卵巢综合征

多囊卵巢综合征（PCOS）是育龄妇女常见生殖内分泌疾病。近年发现,随着儿童肥胖患病率增加,青少年PCOS发病率也逐年提高。肥胖可通过增加外周循环胰岛素水平影响PCOS发病机制,PCOS患者高雄激素血症也会增加内脏脂肪沉积。肥胖会增加与PCOS相关的代谢和心血管方面的并发症的患病风险,如胰岛素抵抗（IR）、高脂血症、高血压以及临床症状不明显的动脉粥样硬化等。早期识别青春期PCOS,有利于及时纠正、阻断其内分泌紊乱,防止近期及远期并发症发生。     

肾上腺外伤性血肿的CT诊断

目的:评价肾上腺外伤性血肿的CT检查的意义。方法:回顾分析了经临床随访证实6例肾上腺外伤性血肿的CT资料。结果:6例肾上腺外伤性血肿均发生于右侧,6例在外伤10d内行CT检查。CT平扫:表现为卵圆形、梭形块影。病灶最大径4.5 cm×2.0 cm,其中,高密度4例、等密度1例、低密度1例。CT值在24~62 Hu之间。增强扫描:病灶不强化,2例在血肿边缘可见强化的肾上腺,其外周可见等密度条索影;4例合并少量腹水;2例合并肝撕裂伤。结论:CT可以早期明确肾上腺外伤性血肿的诊断。对于腹部闭合性损伤患者应早期行CT检查,必要的增强扫描,对于肯定和/或排除肾上腺血肿的诊断有重要价值。