缩窄性心包炎的外科治疗

报告12例缩窄性心包炎外科治疗的体会，本组病例的特点是病史长，入院前误诊率高（41.6%)，心增厚达0.5-2cm，龟壳样变。结果：12例手术资料随访1-6a，手术疗效满意，认为对诊断明确者应及早手术治疗，尽可能彻底剥脱缩窄的心包是手术疗效的关键。     

Mechanisms of epileptogenicity in focal malformations caused by abnormal cortical development.

In this article, the authors review the cellular mechanisms of epileptogenicity in malformations caused by abnormalities of cortical development as related to neuronal excitation, reduced inhibition, disorganized synaptic connections, and glial function (or dysfunction).     

应用皮瓣移植修复足跟部皮肤软组织缺损

目的通过8种不同皮瓣的临床应用,总结足跟部皮肤软组织缺损的修复效果。方法采用了游离足背皮瓣、游离背阔肌皮瓣、游离肩胛皮瓣、桥式胫后动脉岛状皮瓣、桥式携带背阔肌皮瓣或桥式携带肩胛皮瓣、胫后动脉岛状皮瓣、胫后动脉皮支岛状皮瓣、跖底内侧动脉岛状皮瓣,对足跟部皮肤软组织缺损进行修复的临床应用。结果95块皮瓣修复足跟部皮肤软组织缺损,成活93块,成功率为97.9%。随访1～15年,治疗效果满意。结论应用皮瓣移植的方法,才能使足跟部皮肤软组织缺损得到有效的修复。     

Contribution of genetic factors for melanoma susceptibility in sporadic US melanoma patients

Abstract:  The risks of developing malignant melanoma (MM) include ultraviolet irradiation and genetic factors. To examine the contribution of rare and common variation within known MM genes in sporadic US MM patients, coding regions of known MM susceptibility genes [cyclin-dependent kinase inhibitor 2A ( CDKN2A ), cyclin-dependent kinase 4, melanocortin 1 receptor ( MC1R ) and tyrosinase ( TYR )] were resequenced in 109–135 MM cases. The significance of variants was examined by comparing their frequencies in 390 cancer-free controls. Potential deleterious mutations in CDKN2A were found in two patients and two others had variants of unknown significance. Cases were more likely than controls to harbour the MC1R 'R' variants known or predicted to alter its function ( P  = 0.002), particularly the R160W variant ( P  = 0.0035). The associated TYR R402Q variant (rs1126809*A) was found in 29% of cases, similar to what has been described previously. One MM patient with a family history of MM, who had developed other skin cancers, was homozygous for a novel TYR variant (P406L) of unknown significance. Hence, rare variants in TYR may be important risk factors for skin cancer.     

中医辨证治疗肿瘤

七种中医辨证治疗肿瘤方法：1．清热解毒法：应用于邪实正气未衰，多为各种肿瘤早期及体质较强壮者，发热身痛，口干舌燥，便秘尿黄，     

SNAP-II predicts mortality among infants with congenital diaphragmatic hernia.

OBJECTIVE: Outcomes analysis in congenital diaphragmatic hernia (CDH) requires a validated risk-adjustment tool. The purpose of this study was to use the Canadian Neonatal Network (CNN) database to validate the Score for Neonatal Acute Physiology, Version II (SNAP-II) for prediction of mortality among CDH infants admitted to a neonatal intensive care unit (NICU), and to compare this to the predictive equation recently developed by the Congenital Diaphragmatic Hernia Study Group (CDHSG). STUDY DESIGN: Infants with CDH in the CNN database were identified. Bivariate and multivariable logistic regression models were used to identify risk factors predictive of mortality. Model predictive performance and calibration were assessed using the area under the receiver operator characteristic curve and the technique of Hosmer-Lemeshow, respectively, and compared with the CDHSG predictive equation. RESULTS: There were 88 patients with CDH among 19,507 admissions to CNN hospitals. The mortality rate among CDH patients surviving to NICU admission was 17%, and 12.5% received extracorporeal membrane oxygenation therapy. Gestational age and admission SNAP-II score predicted mortality. Model predictive performance and calibration were optimized with these variables combined. The CDHSG equation was equally predictive of mortality, but was only marginally calibrated. CONCLUSIONS: SNAP-II is highly predictive of mortality among patients with CDH, and can be used to risk-adjust these patients.     

嵌体与全冠治疗牙间食物嵌塞的临床应用比较

目的:比较嵌体与全冠治疗牙间食物嵌塞的临床操作及修复效果.方法:对纳入标准的78例患者随机分组,分别用嵌体和全冠进行修复并进行随访观察,并对两种方法的临床应用效果进行比较.结果:在对牙龈及牙周保护方面,嵌体与全冠有显著性差异;在边缘密合、重塑邻接关系及牙齿敏感方面,二者无显著性差异.结论:嵌体较全冠修复牙间食物嵌塞临床操作简便省时,更有利于保护牙髓及牙周组织健康,美观经济.     

远程医疗在社区护理中的应用与前景

远程医疗自20世纪60年代在美国问世以来,已受到世界各国的广泛关注,其跨时空、零距离、实时互动等特点,被巧妙地应用于社区卫生保健中,并逐渐显现出其快捷、便利、优化资源配置等优势,使社区居民足不出户,通过电脑网络即可得到健康服务,成为社区卫生保健的新选择。在信息时代,远程医疗很快就会随着商业与教育的信息技术发展,开创医疗卫生事业的新纪元。本文中就远程医疗在社区护理中的应用进行综述,并展望远程医疗在中国的发展前景,以期为我国社区远程医疗的发展提供参考与帮助。1概述1.1远程医疗服务Telehealth(Telecare),内地普遍称为远…     

Delta hepatitis virus infection in China

To assess the prevalence, epidemiological features and prognostic implications of hepatitis D (Delta) in Sichuan Province, The People's Republic of China, 649 sera (515 from HBsAg positive patients and 134 from HBsAg negative subjects) were tested by radioimmunoassay (RIA) for antibody to the hepatitis D virus (anti-HD). Forty-seven sera (7.2%) showed some degree of reactivity. Serial dilutions of these sera indicated that prozoning was not responsible for the equivocal results. Thirty-four of the 47 sera were submitted under code to a second laboratory for independent analysis. According to those results anti-HD antibodies were detected in four of these sera. The overall prevalence of anti-HD in the HBsAg positive patients therefore was 0.8% (4/515). On the basis of clinical, biochemical and histological data 427 HBsAg positive sera were further divided into acute Type B hepatitis, chronic Type B hepatitis, healthy carrier state and hepatocellular carcinoma (HCC) subgroups. Two of 65 (3.1%) anti-HD positive sera belonged to the acute Type B hepatitis group; one of 104 (0.9%), the chronic Type B hepatitis group and one of 246 (0.4%), the healthy carrier group. No antibody was detected in sera from 12 HBsAg positive HCC patients. All HBsAg negative patients were negative for anti-HD antibody. The results of this study indicate that despite a high prevalence of hepatitis B virus infection, positive serology for delta virus is uncommon in Sichuan Province, The People's Republic of China.     

三维立体培养法诱导去分化软骨细胞Ⅱ型胶原的重新表达

目的用藻酸盐三维立体培养法及离心管聚集体诱导培养法促进去分化的永生化软骨细胞第50代(IHACs50)重新表达软骨细胞的Ⅱ型胶原标志性表型。方法利用藻酸盐三维立体培养法以及离心管聚集体诱导培养法分别诱导培养去分化的永生化人关节软骨细胞第50代,然后用Ⅰ、Ⅱ、Ⅲ型胶原的免疫组织化学染色、Ⅱ型胶原的逆转录-聚合酶链反应(RT-PCR)检测、激光共聚焦显微镜检测、胶原定量检测该永生化软骨细胞的Ⅱ型胶原表型表达情况。结果免疫组织化学染色、激光共聚焦显微镜检测、RT-PCR检测分别提示藻酸盐三维立体培养法和离心管聚集体诱导培养法使去分化永生化人关节软骨细胞的Ⅱ型胶原染色阳性以及621 bp的Ⅱ型胶原mR- NA表达,Western blot和3H-脯氨酸标记SDS-PAGEⅡ型胶原定量检测发现前者促进Ⅱ型胶原分泌较后者多。结论去分化永生化人关节软骨细胞可以经不同的诱导方法而重新表达Ⅱ型胶原表型,藻酸盐三维立体培养法因与软骨细胞的生理环境相似,故促进Ⅱ型胶原重新表达较多。