肝豆状核变性病例回顾及与遗传以外因素的相关性分析

目的：回顾性分析肝豆状核变性（WD ）患者的临床分型、实验室和影像学检查,加强对该病的认识并提高诊断率。方法收集2011年1月至2014年9月该院确诊的WD患者的临床资料,并进行统计学分析。结果不同年龄、民族、性别的WD患者,其初次发病年龄、临床分型、实验室检查均存在着一定的差异,男性患者的发病年龄明显早于女性,神经型WD患者的M RI均存在低密度影改变。结论遗传并不是影响WD的唯一因素,性别、年龄、民族也可能是影响WD患者初次发病年龄及临床症状的因素之一。     

复方苦参注射液联合化疗对晚期胃癌患者生活质量的影响

目的：观察复方苦参注射液联合化疗对晚期胃癌患者生活质量影响。方法：回顾性分析70例晚期胃癌患者的治疗,治疗组化疗联合复方苦参注射液20ml＋生理盐水250ml,静脉滴注1次／d,连续2周,对照组单用化疗,每3周重复,共4个治疗周期,观察治疗前后疼痛、体重、食欲、karnofsky评分。结果：在控制疼痛、食欲改善方面,治疗组均优于对照组,差异有显著性（P〈O．05）;体重治疗前后比较差异无统计学意义（P〉0．05）。结论：复方苦参注射剂联合化疗能缓解疼痛,改善症状,提高患者生存质量。     

Advanced parental age is an independent risk factor for term low birth weight and macrosomia

We aimed to investigate association between parental age and the risks of term low birth weight and macrosomia.This was a retrospective cohort study using a national database including 2,245,785 term singleton live births with complete parental age data. Old parental age was defined as 35 years or older. Odd ratios (OR) for term low birth weight and macrosomia were analyzed using univariate and multivariate logistic regression analysis.Neonatal sex, maternal occupation, parity, nationality, age, and paternal age were significant factors of term low birth weight and macrosomia, in univariate analysis. In multivariate analysis, old maternal age (≥35 years old) showed increased odds of term low birth weight and macrosomia (aOR = 1.122, 95% CI: 1.083 –1.162; and aOR = 1.166, 95% CI: 1.143 – 1.189, respectively). Similarly, old paternal age (≥35 years old) showed increased odds of term low birth weight and macrosomia (aOR = 1.090, 95% CI: 1.058 –1.122; and aOR = 1.101, 95% CI: 1.083 – 1.119, respectively). Maternal education that lasted more than 12 years had reduced odds of term low birth weight and macrosomia (OR = 0.817, 95% CI: 0.792 –0.842; and OR = 0.894, 95% CI: 0.879 – 0.91, respectively). Paternal education that lasted more than 12 years also had reduced odds of term low birth weight and macrosomia (OR = 0.865, 95% CI: 0.84 –0.892; and OR = 0.897, 95% CI: 0.881 – 0.913, respectively).This study suggests that not only maternal age but also paternal age are significantly associated with term low birth weight and macrosomia. In addition, parental education levels are also associated with term low birth weight and macrosomia.     

Age and sex effects on brain morphology

1. 1. Brain morphology can be assessed readily in vivo using magnetic resonance imaging (MRI).

2. 2. In this study, the effects of age and sex on whole-brain morphology were examined using an operator-controlled computer-segmentation protocol.

3. 3. Results indicated that age was associated with gray-matter volume reduction.

4. 4. Brain-size differences between males and females were primarily attributable to whitematter volume.

5. 5. This study confirms the importance of controlling for age and sex in brain-morphology studies.

     

New frontiers of retinal therapeutic intervention: a critical analysis of novel approaches

A recent wave of pharmacologic and technologic innovations has revolutionized our management of retinal diseases. Many of these advancements have demonstrated efficacy and can increase the quality of life while potentially reducing complications and decreasing the burden of care for patients. Some advances, such as longer-acting anti-vascular endothelial growth factor agents, port delivery systems, gene therapy, and retinal prosthetics have been approved by the US Food and Drug Administration, and are available for clinical use. Countless other therapeutics are in various stages of development, promising a bright future for further improvements in the management of the retinal disease. Herein, we have highlighted several important novel therapies and therapeutic approaches and examine the opportunities and limitations offered by these innovations at the new frontier.

KEY MESSAGES

• Numerous pharmacologic and technologic advancements have been emerging, providing a higher treatment efficacy while decreasing the burden and associated side effects.
• Anti-vascular endothelial growth factor (anti-VEGF) and its longer-acting agents have dramatically improved visual outcomes and have become a mainstay treatment in various retinal diseases.
• Gene therapy and retinal prosthesis implantation in the treatment of congenital retinal dystrophy can accomplish the partial restoration of vision and improved daily function in patients with blindness, an unprecedented success in the field of retina.

     

奈达铂联合氟尿嘧啶治疗晚期食管肿瘤的近期疗效观察

目的:探讨奈达铂(NDP)联合氟尿嘧啶(5-FU)组成NF方案治疗晚期食道肿瘤的近期疗效和毒副反应。方法:64例病人随机分为NF方案组和PF方案组各32例,前者接受NDP 5-FU化疗,后者予顺铂(PDD) 5-FU,即PF方案化疗,根据WHO标准评价疗效和毒副反应。结果:NF方案组有效率为56·2%,PF方案组有效率50%;骨髓抑制:NF方案组白细胞减少为56·2%,PF方案组为50%,其中血小板减少在NF方案组为12·5%,而PF方案组为0,胃肠道反应两组发生率分别为25%和50%。结论:奈达铂联合氟尿嘧啶组成的NF方案治疗晚期食道肿瘤毒副作用小,疗效较高,值得临床上进一步推广应用。     

中青年腰椎间盘突出症家庭康复护理

目的探讨中青年腰椎间盘突出症康复护理的方法及效果。方法急性期绝对卧硬板床做牵引治疗（以骨盆牵引法为主）;慢性期注意劳逸结合及腰部活动幅度,红外线照射以活血消肿;康复期注意腰肌、背阔肌功能锻炼。结果42例病人中急性期绝对卧硬板床结合牵引治疗〉60d者10例,随访6个月治愈率达100％,绝对卧床41-60d有7例,治愈6例（86％）;绝对卧床21～40d有14例,治愈10例（71％）;绝对卧床〈20d有11例,治愈5例（45％）,6例暂时症状消失或疼痛减轻,复发经久不能根治。结论中青年腰椎间盘突出经绝对卧硬板床结合牵引治疗足够的时间,治疗效果较好。     

颈动脉粥样硬化病变在不同年龄段冠心病患者中的特点分析

目的:探讨冠状动脉粥样硬化性心脏病(冠心病)患者超声检测的颈动脉粥样硬化病变过程和年龄增长的关系.方法:根据年龄将116名冠心病患者分为5组:＜45岁为第1组,45～54岁为第2组,55～64岁为第3组,65～74岁为第4组,＞74岁为第5组,用高分辨率超声检测所有冠心病患者和11名正常对照者的颈动脉内径、IMT、斑块及其数量,计算动脉半径和IMT的比值(R/IMT).对不同年龄段冠心病患者及正常对照者的检测值进行比较.结果:除R/IMT外,冠心病患者颈动脉粥样硬化病变各指标与年龄呈直线相关,但相关程度均不高,其中IMT与年龄的相关程度明显低于无冠心病及主要危险因素者.IMT和斑块发生率呈线性相关(r=0.316).斑块发生率、斑块数、IMT和颈动脉内径在不同年龄段冠心病患者间差异显著,但R/IMT的差异仅有临界性统计学意义,两两比较结果:斑块发生率在第4组和1、2组间有显著差异,P值分别小于0.05和0.01;斑块数在1组和4、5组间有显著差异,P＜0.05,在2组和4、5组间也有显著差异,P＜0.01;IMT在1组和4、5组及2组和5组间均有显著差异,P＜0.05;颈动脉内径在4组和1、2、3组间均有显 著差异,P＜0.01;R/IMT仅在2组和5组间有显著差异,P＜0.05.结论:(1)冠心病患者超声检测的颈动脉粥样硬化病变与年龄增长有显著的相关性,但年龄增长的生理性影响较弱.(2)65岁左右颈动脉自身代偿能力可能达到最大.     

银川地区213名正常人口服葡糖耐量试验结果

作者等在进行银川地区糖尿病患病率调查的同时,对213名正常成人进行口服葡糖耐量试验,发现该地区受试者各时限血糖均值较外地报道的数值为高,变异程度也大。造成这种结果的原因,经推测是由于本组受试者包括了一部分高龄人群,且受试者中66.7％为回民,他们的某些特殊饮食习惯(如嗜饮糖茶等)可能对糖耐量有所影响。