阿尔茨海默病、阿尔茨海默病混合型及血管性痴呆患者心理及行为症状的比较

目的 比较阿尔茨海默病(Alzheimer Disease，AD)、AD混合型痴呆(Mixed dementia，MD)、血管性痴呆(Vascular dementia，VD)心理和行为症状(Psychological and behavioral symptoms of dementia，PBSD)的特征。方法 AD、MD及VD患者各30名参加本研究。采用Alzheimer病行为症状评定量表(The Begavioral Pathlolgy in Alzheiner Disease Rating Scale，BEHAVE—AD)、Cohen—Masfield激惹性问卷(The Cohen Mansfield Agitation Inventory，CMAI)评定痴呆患者BPSD。结果 AD患者激惹、焦虑与恐惧发生率较高，VD患者无目的游荡发生率、严重程度较低，MD患者BPSD症状无特异性。结论 AD、VD患者BPSD症状有特异性，MD患者BPSD表现无特异性。     

人胃癌肿瘤浸润树突状细胞的形态学观察

目的　探讨人胃癌肿瘤浸润树突状细胞 (TIDC)的形态学特征。方法　应用免疫组织化学、光镜和电镜的方法观察人胃癌TIDC的分布和形态学变化。结果　TIDC主要分布癌周区 ,病变早期TIDC比病变晚期数量 (P <0 0 1)。电镜下 ,TIDC体积较大 ,形态不规则 ,表面有许多树突状突起 ,细胞核不规则 ,可见核仁 ,胞质内有丰富的线粒体、核糖体、高尔基复合体和内质网。TIDC与肿瘤浸润淋巴细胞 (TIL)和肿瘤接触方式和形式上呈多样性 ,一对一 ,一对多 ,或形成簇的接触方式 ,有紧密膜接触、指状膜接触和球状膜接触形式。结论　本实验提示TIDC数量多少与肿瘤的进展有关 ,TIDC与肿瘤浸润淋巴细胞和肿瘤细胞之间关系密切。     

基于PACS的MRI影像多媒体教学与报告系统的研究

目的：开发基于医院影像归档和通讯系统（picture archiving and communication system，PACS）环境的MRI（磁共振显像）影像多媒体教学与报告系统。方法：医院PACS系统符合DICOM3.0标准，采用1000M光纤主干网，100M交换到桌面；在临床医生浏览工作站安装多媒体教学系统，在诊断工作站安装教学系统与报告系统；科学内容按部位分类，以树枝模式管理。教学字资料来源于具有一定权威的教科书、专及期刊。图像资料来源于各部位经病理及临床证实的病例，直接从PACS系统提取，经标注说明后，以件形式存放于PACS图像服务器硬盘。结果：MRI辅助影响教学系统能够实时调阅最合适病种的MRI征象、临床特点、病理、鉴别诊断、典型图像及注释、正常断面解剖等，供教学、诊断和报告参考。结论：PACS环境下MRI辅助影像学系统，能满足临床医生和低年资影像诊断医生对MRI影像知识进一步继续医学教育的需求，能为影像诊断医生提供教学及科研工具，提高MR室工作质量和工作效率。     

中西医结合治疗腰椎管狭窄208例

目的探讨腰椎管狭窄临床治疗的方法。方法230例腰椎管狭窄病人，采用中两医结合治疗，治疗时间10～30天，平均20天，回顾性分析其治疗效果。结果经1～3年随访(平均20个月)，按照中华骨科学会脊柱外科的评定标准优62例(29．8％)，良127例(61％)，差19例(9．2％)，优良率90．8％。结论对于腰椎管狭窄症采用卧床休息，适当运动，合理锻炼，骶管疗法，中药的辨证施治等措施，结果表明，本方法为治疗腰椎管狭窄症的一种好方法。     

儿少心理问题筛查表的编制和信效度分析

目的：编制一个用于儿童和青少年的心理问题筛查表，检验其信度和效度。方法：用新编的心理问题筛查表测查全国12个省（市）9278名儿童或他们的父母和143名临床样本，间隔5周的重测样本87人，父母和儿童报告一致性检验样本56人，效标效度样本65人。用相关分析和因素分析考查量表的信度和效度。结果：新编筛查表具有较好的信度（重测信度为0．761、Crobacha系数为0．949、分半信度为0．868、评定者信度为0．799）；正常儿童在筛查表上的得分显著高于临床样本的得分；新编筛查表总分和分量表与儿童行为量表总分和类似分量表有显著的相关：探索性因素分析和验证性斟素分析与量表编制者的理论构想一致。结论：儿少心理健康量表具有较好的信度和效度．可以用于儿童和青少年的心理问题的筛查．     

DicomWorks: Software for Reviewing DICOM Studies and Promoting Low-cost Teleradiology

DicomWorks is freeware software for reading and working on medical images [digital imaging and communication in medicine (DICOM)]. It was jointly developed by two research laboratories, with the feedback of more than 35,000 registered users throughout the world who provided information to guide its development. We detail their occupations (50% radiologists, 20% engineers, 9% medical physicists, 7% cardiologists, 6% neurologists, and 8% others), geographic origins, and main interests in the software. The viewer’s interface is similar to that of a picture archiving and communication system viewing station. It provides basic but efficient tools for opening DICOM images and reviewing and exporting them to teaching files or digital presentations. E-mail, FTP, or DICOM protocols are supported for transmitting images through a local network or the Internet. Thanks to its wide compatibility, a localized (15 languages) and user-friendly interface, and its opened architecture, DicomWorks helps quick development of non proprietary, low-cost image review or teleradiology solutions in developed and emerging countries.     

经下颌下咽后入路颅颈交界腹侧区手术的应用解剖

目的:为临床经下颌下咽后入路处理颅颈交界腹侧区病变提供解剖学基础。方法:对15例(30侧)带颈头颅标本模拟经下颌下咽后入路进行显微外科解剖,同时进行了有关的数据测量。结果:该入路浅层的重要结构均位于各自的筋膜层中,以这些结构为解剖学标志可鉴别各层并引导手术进行。咽结节是显露的上限,限制骨窗侧方显露范围的各重要结构的内缘距正中线的水平距离分别为寰枢外侧关节,左(7.78±1.03)mm,右(7.81±1.01)mm;寰枕关节,左(9.27±1.86)mm,右(9.22±1.69)mm;舌下神经管内口,左(12.76±2.77)mm,右(12.81±2.53)mm及椎动脉C2水平,左(18.36±2.27)mm,右(18.47±2.14)mm;C1水平左(25.35±2.31)mm,右(25.18±2.33)mm;穿硬膜处,左(12.69±2.42)mm,右(12.72±2.39)mm。结论:(1)经下颌下咽后入路解剖上大致可分为3个层次:浅层,深层和骨、韧带及硬膜层。(2)掌握每个层次的解剖特点及操作要点,有助于安全充分的显露和处理咽颅颈交界腹侧区病变。     

胃粘膜相关淋巴组织型淋巴瘤形态学研究

目的：研究胃粘膜相关淋巴细胞（ＭＡＬＴ）型淋巴瘤及共与胃粘膜套细胞淋巴瘤和滤泡性淋巴瘤的鉴别诊断。方法：应用ＨＥ染色和免疫组化ＡＢＣ法检测胃ＭＡＬＴ型淋巴瘤，内镜作幽门螺杆菌培养基尿素试验检测ＨＰ感染。结果：３１例胃ＭＡＬＴ型淋巴瘤中低度恶性２７例，高度恶性４例。细胞类型以ＣＣＬ型最常见。免疫表型以ＩｇＭ为主，缺乏ＩｇＤ，３１例中２８例有ＨＰ感染（占９０．５２％），结论：（１）低恶ＭＡＬＴ型淋巴瘤     

B-cell function in patients with chronic lymphocytic leukemia

Summary Using a reverse hemolytic protein A plaque assay, spontaneous and pokeweed mitogen (PWM)-induced immunoglobulin (Ig) secretion was determined in peripheral blood from 22 patients with B₁-chronic lymphocytic leukemia (CLL), one patient with B₂-CLL, and one patient with suppressor T-CLL. Diagnoses were established by cytological and histological criteria as well as several marker analyses. Lymphocytes from B₁- and B₂-CLL patients were unable to secrete Ig either spontaneously or after PWM stimulation. In T-CLL lymphocytes, spontaneous Ig secretion was suppressed very probably by the OKT-8-positive leukemic population, since, after cultivation with PWM, a normal Ig secretion could be demonstrated which was paralleled by a decrease in the OKT-8-positive cells. Cocultivation experiments with freshly isolated, unseparated lymphocytes from normal subjects and lymphocytes from patients were of no informational value, since isolated normal B-cells alone already showed a high rate of Ig secretion. However, coculture experiments with separated subpopulations after PWM stimulation revealed an intrinsic B-cell defect in lymphocytes from B₁-CLL patients, whereas their T-lymphocytes were found to be normal helper cells.

---

Abbreviations CLL Chronic lymphocytic leukemia - PWM Pokeweed mitogen - ISC Immunoglobulin-secreting cells - Ig Immunoglobulin(s) Supported by the Deutsche Forschungsgemeinschaft (Ru 215/2)     

Systems biology: integrating technology,biology, and computation

The Human Genome Project has changed the worlds of biology and medicine-helping to catalyze two major paradigm changes: systems biology and predictive, preventive and personalized medicine. These two themes will dominate 21st century biology and medicine. I will discuss these changes and indicate how they may interface with with the process of aging.