椎弓根螺钉的不同结构特点对螺钉电阻的影响

目的:研究椎弓根螺钉的不同结构特点(实心与空心螺钉、直径)对螺钉电阻的影响,进而探讨其对刺激肌电监测椎弓根螺钉置入准确性的可能影响.方法:选择临床常用的两个厂家(强生和美敦力公司)的12枚椎弓根螺钉,每个厂家各6枚,强生公司实心与空心螺钉的直径均为5.0mm、6.0mm和7.0mm;美敦力公司实心与空心螺钉的直径均为4.5mm、5.5mm和6.5mm.用万用电表测量通过椎弓根螺钉的电流,用电位差计测量螺钉杆上间隔20mm节段的电位差,通过欧姆定律计算椎弓根螺钉的电阻值.结果:美敦力公司的4.5mm实心与空心椎弓根螺钉电阻分别为(0.142±0.003)Ω和(0.398±0.002)Ω,5.5mm实心与空心椎弓根螺钉电阻分别为(0.110±0.007)Ω和(0.347±0.003)Ω,6.5mm实心与空心椎弓根螺钉电阻分别为(0.086±0.002)Ω和(0.290±0.003)Ω.强生公司的5.0mm实心与空心椎弓根螺钉电阻分别为(0.149±0.001)Ω和(0.291±0.001)Ω,6.0mm实心与空心椎弓根螺钉电阻分别为(0.123±0.004)Ω和(0.237±0.001)Ω,7.0mm实心与空心椎弓根螺钉电阻分别为(0.095±0.001)Ω和(0.148±0.001)Ω.相同直径的空心椎弓根螺钉较实心椎弓根螺钉具有较大的电阻,差异有统计学意义(P＜0.05).无论实心椎弓根螺钉或空心椎弓根螺钉,随着直径的增大,椎弓根螺钉的电阻值逐渐减小,差异有统计学意义(P＜0.05).结论:长度与直径相同的空心椎弓根螺钉较实心螺钉具有较大的电阻,长度相同的实心或空心小直径椎弓根螺钉具有较大的电阻,应用刺激肌电监测椎弓根螺钉置入时要注意其带来的影响.     

三孔法完全腹腔镜永久性粘膜管道式胃造口术

目的:总结三孔法完全腹腔镜永久性粘膜管道式胃造口术的手术经验与技巧。方法:回顾分析2010年8月至2012年10月为11例患者行三孔法完全腹腔镜永久性粘膜管道式胃造口术的临床资料,其中晚期食管癌9例,晚期贲门癌2例,均完全或几乎不能经口进食。结果:本组手术均获成功,无一例中转开腹;手术时间50～120 min,平均(55.0±22.5)min;术中出血量5～30 ml,平均(10.0±7.4)ml;术后住院3～9.5 d,平均(6.0±1.6)d。术后均无并发症发生,胃造口术后顺利开放并维持正常肠内营养。结论:三孔法完全腹腔镜永久性粘膜管道式胃造口术具有操作简便、微创、患者疼痛轻、康复快、启用造口早、安全可靠及舒适等优点,疗效满意,值得推广应用。     

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胆胰肠结合部损伤因其特殊的位置,出现医源性损伤后往往难于在术中发现。结合可造成该部位损伤的相关医疗过程及术后症状和影像学检查可做出该部位损伤的判断,一旦确定诊断即应积极手术治疗。手术原则是:采用简单而短时间的手术充分清理和引流损伤局部及感染灶,彻底分流胆汁、胃肠液和胰液减少和控制胰酶的激活。     

Mitochondrial haplogroups and hypervariable region polymorphisms in schizophrenia: A case-control study

Previous studies have detected associations between mitochondrial haplogroups and schizophrenia (SZ). However, no study has examined the relationship between major mitochondrial DNA (mtDNA) haplogroups and SZ in the Chinese population. The aim of this study was to assess the association between mtDNA haplogroups and SZ genesis in the Chinese Han population. We used a case-control study and sequenced the mtDNA hypervariable regions (HVR1, HVR2, and HVR3) in the Han population. We analyzed mtDNA haplogroups and HVR polymorphisms in 298 SZ patients and 298 controls. The haplotypes were classified into 10 major haplogroups: A, B, CZ, D, F, G, M, N, N9a, and R. Statistical analysis revealed that only N9a showed a nominally significant association with protection from SZ [1.68% vs. 6.38%, p=0.004, OR=0.251 (0.092–0.680); after adjustment for age and sex: p=0.006, OR=0.246 (0.090–0.669)]. Three HVR polymorphisms were found to be nominally significantly different between subjects with SZ and controls, and all except one (m.204T>C) are linked to the N9a haplogroup. Our results indicate that mtDNA haplogroup N9a might be a protective factor for SZ.     

脑血管病危险因素在神经内科门诊患者中的知晓率调查分析

目的了解神经内科门诊缺血性脑血管疾病患者对导致脑血管病的主要危险因素的知晓情况,为脑卒中筛查工作提供依据。方法2013年2～7月,对1389例神经内科患者进行问卷调查,测量身高、体重、腰围、臀围、血压,同时测定空腹血脂、空腹血糖。并进行脑血管意外危险因素知晓率的流行病学调查。结果l389例神经内科门诊患者中,高血压病患病率55．6％,知晓率32．6％;糖尿病患病率46．2％,知晓率22．8％;高脂血症患病率82．6％,知晓率43．5％;肥胖患病率57．5％,知晓率33．0％;冠心病患病率67．1％,知晓率32．7％。其中35~44岁年龄（青壮年）组患者对患高血压病、糖尿病、高脂血症、肥胖和冠心病的知晓率更低,分别为8．7％、0、15．4％、9．4％、3．6％,与其他年龄组比较,差异有统计学意义。结论各年龄组患者的高血压病、糖尿病、冠心病、高血脂、肥胖的患病率均较高;对脑血管病的主要危险因素知晓率均较低;以35～44岁组的知晓率最低。对35～44岁组患者加强血脂、血压、血糖筛查,提高知晓率,对降低脑卒中的发病率具有重要意义。     

Spin基因在维甲酸诱导神经管缺损的表达验证

目的探讨印讥基因在神经管缺损的表达及其作用机制。方法用中密度芯片基因比较正常小鼠与神经管缺损小鼠胚胎9．5、10．5d时神经管组织中Spin基因的表达差异,并经Northern杂交验证。结果通过比较发现：印讯基因在正常神经管组织表达上调趋势（Cy5／Cy3〉2．0）,而在维甲酸诱导的神经管缺损组织中呈现下调趋势（Cy5／Cy3〈0．5）。结论Spin基因参与神经管缺损发生和发展过程,可能在神经管异常发育中具有重要作用,对该基因的研究有助于阐释神经管缺损的发病机制。     

Variants in 9p21 Predicts Severity of Coronary Artery Disease in a Chinese Han Population

Recent genome‐wide association studies identified the common genetic variants in 9p21 were associated with the coronary artery disease (CAD). However, whether this locus could predict the severity of CAD in Chinese Han population is unclear. 499 CAD patients who underwent coronary angiography (CAG) have been enrolled for this study. The single‐nucleotide polymorphisms rs2383207 and rs2383206 in 9p21 were genotyped in 499 CAG cases and 1519 controls in Chinese Han population. The gene dosage of 9p21 was stratified by the degree of vascular lesions and tested for association with the severity of CAD. Rs2383207 and rs2383206 demonstrated significant associations with 2‐vessel and 3‐vessel disease (P = 2.0×10^?3 and 1.9×10^?4, respectively). GG genotypes of rs2383206 occurred higher proportion of left main trunk (LM) disease (P = 6.0×10^?3). GG genotypes of rs2383207 occurred higher proportion of left anterior descending artery disease (LAD) and right CAD (RCA) (P = 2.7×10^?6 and 1.6×10^?4, respectively). The risk allele G of rs2383207 was associated with severity of CAD estimated by the Gensini score (P = 3.6×10^?5). Rs2383207 may strongly influence the development of CAD in Chinese Han population. The gene dosage in 9p21 could predict the severity of CAD.