纸质病案保存期限的思考

本文作者比较了不同时期的纸质病案的使用率,讨论了旧病案的缺点,如难于保存,占用空间及实用价值不大.作者提出了改进保存病案的办法.     

SOME ANATOMICAL DATA RELATED TO THE TRANSNASO- SPHENOIDAL RESECTION OF PITUITARY FOSSA TUMORS

Since the beginning of this century, trans- naso-sphenoidal resection of the pituitary fossa tumors has been widely used clinically. It has more merits than other operative approaches used before. In China it has been adopted by both ENT doctors and neurosurgeons since 1959.1 In order to afford some relevant anatomical data, we measured 137 adult sagittal plane skulls with distinct landmarks.     

An intracellular self protein synthesized in macrophages is presented but fails to induce tolerance

Mice deficient for the fifth component of murine complement (C5), unlike normal mice, do not possess the secreted form of C5 in their body fluids and can be readily immunized to serum-derived normal C5. Although macrophages from C5-deficient mice do not secrete C5, they synthesize the precursor form (pro-C5). Therefore contact of T cells with autologous pro-C5 presented by macrophages is theoretically possible. We show that macrophages from C5-deficient mice can indeed stimulate a class II restricted C5-specific T cell clone without addition of exogenous C5. Immunization of C5-deficient mice with autologous pro-C5 induces vigorous C5-specific T cell proliferation and pro-C5 is recognized by C5-specific T cells in vitro, demonstrating that this protein fails to induce tolerance under physiological conditions. Thus, intracellular pro-C5 is processed and presented by C5-deficient macrophages and can activate T cell clones in vitro, yet is neither immunogenic nor tolerogenic for T cells in vivo.     

Quantitative three-dimensional power Doppler ultrasound predicts the outcome of placental chorioangioma.

The relationship of large and vascularized chorioangiomas to adverse pregnancy outcome is well recognized. We present a patient with a large placental tumor and signs of impending fetal cardiac failure. The angioarchitecture of the tumor depicted by three-dimensional (3D) power Doppler ultrasound enabled us to accurately diagnose a placental chorioangioma. During the follow-up period, quantitative flow data obtained using 3D power Doppler indicated altered hemodynamics in the tumor and concomitant improvement in the condition of the fetus, enabling us to manage the mother conservatively. Spontaneous delivery occurred at 38 weeks without any complications. This report demonstrates the potential value of 3D power Doppler in prenatal diagnosis and monitoring of pregnancies complicated by large, vascularized chorioangioma.     

EEG findings in the persistent vegetative state.

The definition of the persistent vegetative state (PVS) is relatively straightforward, but its diagnosis can be challenging. We reviewed a series of EEG performed in patients with PVS to assess the diagnostic value of EEG. We reviewed records of all hospital patients with a diagnosis of persistent vegetative PVS. EEG findings included normal, continuous generalized slowing, intermittent generalized slowing, background slowing, background suppression, alpha, generalized periodic pattern, PLEDS, and triphasic waves. EEG findings had no association with etiology and varied from one pattern to another in the same patients' EEGs obtained at different times (see table). We conclude that EEG findings in PVS are heterogeneous and too variable to be of diagnostic value.