特发性黄斑裂孔的光学相干断层扫描图像特征

目的 观察特发性黄斑裂孔的光学相干断层扫描(optical coherence tomography,OCT)图像的形态特征。 方法 对65例直接检眼镜或三面镜检查诊断为特发性黄斑裂孔的患者的70只患眼进行OCT、眼底彩色照相和/或荧光素眼底血管造影(fundus fluorescein angiography,FFA)检查,结合临床特征对OCT图像进行分析。 结果 70只眼中,1,2,3,4期黄斑裂孔分别为11,12,36,11只眼。OCT图像特征1期者表现为黄斑中心凹变浅或消失,神经上皮层浅脱离,中心凹平均厚度为(324.55±139.92)μm;2期者为视网膜表层部分缺失伴小的视网膜组织全层缺损,裂孔的表面有一个可贴附的盖,裂孔平均孔径为(241.75±107.08)μm;3期者为神经上皮层全层缺损,游离盖或无盖,裂孔周围可伴有不同程度囊样水肿,裂孔孔径为(699.78±160.99)μm;4期者图像特征与3期相似,但伴黄斑区和视盘玻璃体后脱离,裂孔孔径(631.36±243.46)μm。 结论 OCT能直观、清晰地显示特发性黄斑裂孔的横截面形态特征,同时能精确地测量裂孔的大小。 (中华眼底病杂志, 1999, 15: 205-208)     

One-year prevalence and incidence of depression among first-year university students in Japan: a preliminary study

A structured interview was used to examine the 1-year incidence and prevalence of depression among 116 first-year university students. While 24 of the subjects (20.7%) met the Diagnostic and Statistical Manual of Mental Disorders 4th ed. (DSM-IV) criteria for Major Depressive Episode (MDE), 62 (53.4%) met the Diagnostic and Statistical Manual of Mental Disorders 3rd ed. Revised (DSM-III-R) criteria for MDE, and 27 (23.3%) also met the Research Diagnostic Criteria (RDC) for Major Depressive Disorder (MDD) for the 12 months prior to the interview. Moreover, 23 of the subjects (19.8%) had onset of the DSM-IV criteria for MDE, 54 (46.6%) had onset of the DSM-III-R criteria for MDE, 24 (20.7%) had onset of the RDC for MDD, during the same time period. These high rates of depression may be explained by the students' difficulties in and by their readjustment after entering university.     

迷路纤维化的诊断及人工耳蜗植入3例分析

目的：探讨迷路纤维化的影像学诊断及对人工耳蜗植入术的效果。方法：结合文献复习，报告3例迷路纤维化患者行人工耳蜗植入术的临床资料。结果：术前CT扫描3例均未发现异常。1例术前MRI提示耳蜗基底间纤维状，1例术后提示对侧耳蜗纤维化。2例病变较轻者成功地进行了人工耳蜗植入术，术后恢复良好；1例因病变严重电极未能植入。结论：MRI在迷路纤维化的诊断中有重要价值。慢性化脓性中耳炎为迷路纤维化的病因之一。慢性化脓性中耳炎一期手术清理中耳病变后，具有进行人工耳蜗植入的可行性。     

面神经液压与面神经电图的相关性研究

目的　探讨面神经电图作为面神经减压手术指征的病理生理学基础。方法　利用电生理仪和伺服微变量微压系统 ,对正常和压榨伤后面瘫不同时期的豚鼠 ,作面神经电图检查 ,再采用微创测压法进行面神经液压的测量 ,得出面神经损伤后不同时期的面神经动作电位降幅及相应的面神经液压 ,并观察不同时期面神经光镜和电镜下的组织学改变。结果　面神经损伤 3d至 3周 ,随着面神经液压的升高 ,面神经动作电位降幅百分数亦增加 ,二者间有明显相关性 ,损伤后 2周和 3周 ,面神经液压和面神经动作电位降幅的相关系数分别为 0 88和 0 51。神经液压的变化与面神经Wallerian变性各期组织学改变相一致。结论　在面瘫 3周内 ,面神经电图的改变可间接反映面神经液压的变化 ,并可为面神经减压术的时机提供客观、可靠的实验依据。     

A new case of malonyl coenzyme A decarboxylase deficiency presenting with cardiomyopathy

A new case of mitochondrial malonyl coenzyme A decarboxylase deficiency is described. The patient presented with an initial episode of metabolic acidosis, seizures, hypoglycemia, and cardiac failure at 2 months of age which slowly resolved. Subsequent evaluations at 4 years of age for developmental delay revealed a prominent elevation of malonic acid in urine. Malonyl carnitine was also elevated. The activity of malonyl CoA decarboxylase in cultured fibroblasts was 7% of normal. Conclusion Malonyl CoA decarboxylase deficiency may result in inhibition of fatty acid oxidation, which may account for the cardiomyopathy. Received: 12 April 1996 / Accepted: 24 September 1996     

Endometrial cancer in patients undergoing diagnostic curettage

We made a retrospective review of in 2769 patients in whom curettage was performed. Of 1468 women under 50 years of age, only one (0.08%) had endometrial cancer. Of 834 patients presenting with postmenopausal bleeding 31, (3.7%) had endometrial cancer. Received: 24 June 1997 / Accepted: 24 September 1997     

儿童气管、支气管非金属异物的影像学诊断

目的 探讨气管、支气管非金属异物的影像学表现，提高对该病的早期诊断率。方法 回顾性分析了60例气管、支气管非金属异物的临床与影像学征象。结果 本组60例中，右侧支气管异物32例，左侧支气管异物22例，主气管异物6例。常见的影像学表现为阻塞性肺气肿51例，纵隔摆动48例。结论 病史及影像学表现是诊断气管、支气管非金属异物的主要手段。     

抗菌药使用中药物治疗错误的研究

目的：研究抗茵药使用中药物治疗错误（ME）的发生情况，探讨其防范重点。方法：药师深入中心ICU病房，通过调查病历、直接观察的方式发现抗茵药ME。结果：10个月研究期间共发现ME301次，其中可预防药物不良事件（ADE）19次（3．3％），潜在ADE94次（16．2％）。有潜在危害ME（可预防的ADE＋潜在ADE）中有生命威胁6次（5．3％），严重88次（77．9％），明显19次（16．8％）。结论：抗茵药使用中ME经常发生，其中约1／3有潜在危害且往往带来严重后果，应该采取措施防范ME、特别是有潜在危害ME的发生。     

Violence in the Schools: Clinical Issues and Case Analysis for High-Risk Children

School violence in rural communities has gained considerable attention nationally. Examined are theoretical considerations involving escape theory, the risk and protective factors for school violence, case analyses of recent case studies, and discussion of recent school violence involving fatal injuries to others. Also discussed are diagnostic issues in understanding children who are at-risk for school violence and ways school violence maybe managed in the schools. Suggestions and recommendations including recommendations provided by the National School Safety Center for school personnel are offered, as are steps to be taken in creating a safe school environment. This information may be helpful to child psychiatry and clinical personnel who provide services to school aged children.