91例甲状腺疾病临床病理诊断分析

在临床病理手术切除中甲状腺疾病很常见，其疾病的良恶性鉴别和具体类型诊断有一定难度。因甲状腺疾病的病因复杂，有多病变并存现象，且密切相关、相互影响，如何合理准确地进行病理诊断是指导临床治疗和随诊的重要依据。现将我科2002年1月至2004年12月91例甲状腺病理活检材料进行回顾性分析，以进一步提高甲状腺疾病诊断和鉴别诊断水平。     

CLINICAL NEUROPHARMACOLOGY OF CALCIUM ANTAGONISTS

Summary— Experimental and clinical data clearly demonstrate that calcium antagonists (CA) may have an action on the central nervous system (CNS). The cerebrovascular action of CA justifies their use in cerebral ischaemia, vasospasm and hypoxia. Several clinical trials have demonstrated such beneficial effects. On the other hand a number of reports indicate that CA may have a direct neuronal effect, although most of such trials have not been verified or are mere case reports. In addition, the large number of conditions susceptible to being corrected by CA is impressive: epilepsy, pain, dystonia, dyskinesia, psychiatric conditions, etc. Other papers are disconcerting that report extrapyramidal disorders induced by flunarizine and cinnarizine in the elderly, whereas nicardipine does not produce such side effects and may even alleviate some parkinsonian symptoms. In various experimental models (e.g. stroke, oedema), pharmacological effects have been shown to vary from one compound to the other. Two main questions are yet to be answered: 1) has the direct neuronal effect of CA been clearly established? 2) are the multiple clinical effects on the CNS really linked to calcium antagonism?     

Epidemiological study of myasthenia gravis in Sardinia, Italy (1958–1986)

From 1.1.1958 to 31.12.1986, 110 cases of MG were observed in Sardinia, with a mean annual incidence of 2.5 x 1,000,000 inhabitants and prevalence rates of 7.5, 17.6, 31.4 and 45.0 x 1,000,000 inhabitants respectively (prevalence days: 15.10.1961, 24.10.1971, 25.10.1981 and 31.12.1986). The disease was found to be more frequent in women. There were no differences in the distribution of MG in various areas of the island. The muscle group more frequently involved at onset was the ocular. In 6.4% of patients an association with thyroid disorders was observed. The mortality of MG patients was significantly higher than expected. Removal of the thymus, carried out in 58 patients, was shown to be useful in the treatment of the disease, particularly in patients without thymomas. No familial cases were observed.     

871例干部体检的X线胸片分析

871例干部体检的X线胸片分析结果表明:正常者254例,正常率仅29.2％,且随年龄的增长而降低。主要病变有慢性支气管炎、主动脉增宽与迂曲,而且还发现了3例肺癌,说明胸部平片检查在体检中仍具有重要的意义。     

慢性肝病和肝癌中HCV核心区三种寡肽抗原的抗体检测

检测１４８例慢性肝病和肝癌患者血清中丙型肝炎病毒核心区３种寡肽抗原的抗体，结果显示其阳性率在慢性迁延型肝炎、慢性活动型肝炎、肝炎肝硬化和原发性肝癌患者分别为７．７％，２３．１％，，２３．５％和１６．３％。在抗体阳性者中８０％以上有乙型肝炎病毒感染证据，提示我国ＨＢＶ和ＨＶＣ重叠感染较为常见。     

被动吸烟与婴幼儿呼吸系统疾病及生长发育关系的研究

目的 探讨被动吸烟对婴幼儿乎吸系统疾病发病及对生长发育的影响。方法 将我院保健科负责保健的0～3岁的婴幼儿400名，以家长是否吸烟分为被动吸烟组和对照组，每组200名，定期询问患病史，同时翻身高、体重对其进行评价，追踪观察，经统计学处理后进行分析。结果 婴幼儿乎吸系统疾病的发病与被动吸烟密切相关，被动吸烟影响婴幼儿的生长发育，与国内外的相关报道基本一致。结论 被动吸烟对婴幼儿健康速成严重损害，如不加以保护，有演变为严重社会问题的危险。     

In vivo comparison of two through-plane MR velocity mapping methods: Fast fourier encoding and phase mapping

Magnetic resonance imaging maps of velocity were acquired with a 1.5-T system in 10 subjects in a plane perpendicular to the main pulmonary artery. Velocity images were successively acquired with a method developed from Fourier-encoding velocity imaging (FEVI) principles with eight gradient steps and one excitation, and with two-point phase-subtraction mapping. Reconstruction in FEVI was implemented by zero-filling interpolation around the eight gradient steps and then around the four central steps. The methods were compared by using estimates of noise in velocity measurements based on the difference between the experimental map and a smooth fitted map. For the same acquisition time, FEVI with four encoding steps was more precise in velocity measurements than phase mapping. Precision was further increased by the use of eight encoding steps, but acquisition time was doubled.     

Late onset unilateral asterixis secondary to posterior cerebral artery infarction

Unilateral asterixis developed in a 56 year old man, 5 months after an infarct in the posterior cerebral artery territory, involving the posterolateral nuclear complex of the thalamus, documented by CT-scan and MRI. Unilateral asterixis in rarely reported in association with thalamic lesions and usually develops as an immediate postictal phenomenon. We discuss possible physiopathological mechanisms explaining the occurrence and the delayed onset of these involuntary movements.

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Sommario Un uomo di 56 anni ha sviluppato un'asterixis unilaterale, 5 mesi dopo aver presentato un infarto nel territorio dell'arteria cerebrale posteriore, che coinvolgeva i nuclei postero-laterali del talamo, come evidenziato dalla TC e dalla MRI. Asterixis unilaterali si sviluppano raramente in seguito a lesioni vascolari a livello del talamo e generalmente rappresentano un evento immediatamente successivo all'ictus. Nel caso descritto invece, i movimenti involontari si sono manifestati a notevole distanza di tempo. Gli autori discutono i possibili meccanismi fisiopatologici alla base di questi movimenti involontari e della loro insorgenza a distanza di tempo dall'ictus.

     

体感诱发电位在椎管内占位显微手术中的监测

目的　评价体感诱发电位 (SEP)在神经外科脊髓疾病显微手术中的监测作用 ,避免或减少医源性脊髓损伤。方法　 2 8例病人行术前、术中SEP全程监测 ,包括脊髓SEP(SSEP)及皮层SEP(CSEP) ,术中及时把监测信息反馈给术者。并将术中监测结果与术后疗效对照分析。结果　椎管内占位手术在行髓内肿瘤切除时最易引发SEP波幅降低及潜时延长。术中监测按Frankel分级D、E级患者波幅较基准电位下降不超过 50 % ,潜伏期延长不超过7% ;B、C级患者波幅较基准电位下降不超过 40 % ,潜伏期延长不超过 5 %。术后不会引起脊髓功能不可逆损害。结论　脊髓手术时行SSEP和CSEP联合监测可及时反映出脊髓功能的变化 ,提高术者术中操作的安全性 ,避免或减少术后并发症     

肢体不同延长速度对局部血流量的影响

本文报告20只兔胫骨以不同速度延长时用末梢微循环测定系统动态连续监测局部血流量变化的结果,发现一次延长>1 mm时,局部肌肉血流量开始急骤下降,恢复延长前血流量所需的时间>8 h。作者认为肢体的血管、肌肉等组织对1 mm/次/d延长速度有相当大的生物适应性。延长速度>1 mm/次/d易造成局部血流量大幅度减少。延长肢肌肉萎缩、肌力减弱可能与血流量减少有关。