新疆喀什1499名中小学生舌象调查分析

对西域古城喀什1499名中小学生做舌象调查,舌体适中约2/3,胖大略高于1/3,齿痕合约1/4,舌裂15.8%;舌质以淡红为主(86.9％),舌苔以白薄苔为常见(94.2％,82.5％)。资料分析表明舌体、齿痕舌与体重相关;同时舌体、花剥舌与性别有关;舌胖、舌裂与花剥苔还随年龄增大而增多。但关系最密切的还是舌象与民族有关,即维吾尔族舌裂、绛红舌质、花剥苔、齿痕舌均高于汉族,而后者的厚苔、黄苔和舌边尖瘀点则高于维吾尔族。     

Influence of acute and chronic graft-versus-host disease on relapse and survival after bone marrow transplantation from HLA-identical siblings as treatment of acute and chronic leukemia [published erratum appears in Blood 1989 Aug 15;74(3):1180]

To assess the influence of graft-versus-host disease (GVHD) on recurrent leukemia and survival after allogeneic marrow transplantation, we studied 1,202 patients with acute nonlymphocytic leukemia (ANL), acute lymphocytic leukemia (ALL), and chronic myelogenous leukemia (CML) given unmodified marrow grafts from HLA- identical siblings. Proportional hazards regression models using acute GVHD and chronic GVHD as time-dependent covariates demonstrated a significant association of GVHD with a decreased relative risk (RR, 0.33 to 0.42) of relapse in patients with ANL, ALL, and CML transplanted in advanced disease. Among patients developing either acute or chronic GVHD, treatment failure (that is, mortality or relapse) was decreased in patients with ALL transplanted in relapse (RR = 0.70, P less than .033) and CML in blast crisis (RR = 0.37, P less than .009). This effect was independent of age, sex, preparative regimen, GVHD prophylaxis, or length of follow-up. Five-year actuarial estimates were derived for the subset of 657 patients who survived in remission 150 days after transplant and were at risk for development of chronic GVHD. Among patients with ANL in first remission or CML in chronic phase, GVHD had an adverse effect on survival and no apparent influence on relapse. Among patients with ANL and ALL transplanted in relapse, the probability of relapse after day 150 was 74% without [corrected] GVHD, 45% with acute and chronic GVHD, 35% with [corrected] only acute GVHD, and 34% with only chronic GVHD (P less than .001). Actuarial survival in these four GVHD groups was 25%, 34%, 59%, and 62%, respectively (P less than .009). Among patients with CML in acceleration or blast crisis, the probability of relapse after day 150 was 65% without GVHD and 36% with acute and/or chronic GVHD (P less than .017). We conclude that acute and chronic GVHD were associated with a durable antileukemic effect and improved survival in patients transplanted in advanced stages of ALL and CML.     

Temporomandibular joint: comparison of single- and double-contrast arthrography

Lower-space, single-contrast arthrography and dual-space, double-contrast arthrotomography were sequentially applied to 58 fresh temporomandibular joint (TMJ) autopsy specimens, and the findings were compared with observations in corresponding cryosections. Both modalities had high accuracy rates (greater than or equal to 84%) and no statistically significant differences between the two techniques were found. A side-by-side comparison of the two types of arthrograms, however, revealed that video tape recording of lower-space, single-contrast arthrography was superior in demonstrating joint dynamics and that dual-space, double-contrast arthrotomography was superior in demonstrating the soft-tissue anatomic features of the joint. It appears that lower-space, single-contrast arthrography can be recommended for examination of patients with clicking, catching, and intermittent locking, and that dual-space, double-contrast arthrotomography is preferable when information about morphologic alterations is clinically more important than information about joint dynamics.     

Combined surgical and radiologic intervention for complicated cholelithiasis in high-risk patients

Ultrasound-guided surgical cholecystostomy with local infiltration anesthesia was combined with radiologic removal of gallstones in 36 elderly patients with acute calculous gallbladder disease who were considered to be at high risk due to multiple coexisting diseases. At cholecystostomy, the fundus of the gallbladder was sutured to the anterior abdominal wall resulting in a short surgical track to the gallbladder. This permitted early percutaneous stone removal through the cholecystostomy track under fluoroscopic guidance. All gallstones were removed in 31 of 36 patients, for an overall success rate of 86%. The success rate was 97% for gallbladder stones, 86% for cystic duct stones, and 63% for common bile duct stones that were removed by traversing the cystic duct. The treatment in the five patients in whom radiologic stone removal was incomplete or unsuccessful consisted of elective cholecystectomy in three, with common bile duct exploration in two of these; endoscopic sphincterotomy and stone extraction in one; and expectant management in one. There were no deaths or serious complications. This technique has thus proved safe and effective in these 36 high-risk patients.     

妄想性与非妄想性抑郁症的临床对照研究

为探讨妄想性与非妄想性抑郁症的临床特征差异,对71例妄想性抑郁症与132例非妄想性抑郁症进行了临床对照研究。结果显示,妄想性抑郁症的精神病家族史、幻觉、自责自罪、绝望、自杀行为等出现率显著高于非妄想性抑郁症;妄想性抑郁症的自杀行为危险性是非妄想性抑郁症的1.99倍;妄想性抑郁症可能需联合治疗。提示妄想性抑郁症可能是抑郁症中的一种独特的亚型,值得进一步探讨。