心导纳微分环,肺导纳微分环最大向量正常值及其临床意义

本文报道３－５０岁２１４例心导纳微分环（ＣＡＤＬ）和肺导纳微分环（ＰＡＤＬ）最大向量振幅及方位正常值，结果随增龄变化振幅递减，方位递增，多数男＞女，部分组间有差异。４８例左向右分流先心病环体最大向量与肺动脉压之间呈平行关系，并探讨其临床意义。     

Heterotopic ossification in the anterior maxilla: a case report and review of the literature

A 13-year-old boy had complained of an asymptomatic swelling in the anterior maxilla for approximately 4 years. The patient reported no local trauma. The intra-oral examination revealed an exophytic lesion in the incisive papilla between the maxillary central and lateral incisor teeth. The radiographies detected no significant findings. Histopathologically, the lesion showed a dense fibrous tissue above the overlying mucosa. Bone ossification lay beneath a partially hypertrophic cartilage showing occasionally pleomorphic chondrocytes. Because of its microscopic aspects, heterotopic ossification may be mistaken for chondrosarcoma or other conditions involving periosteum, such as parosteal osteosarcoma. A case of heterotopic ossification in the anterior maxilla is presented, and clinicopathologic similarities with other osteochondromatous lesions are discussed.     

妇科腹腔内出血的临床鉴别诊断

目的　明确妇科腹腔内出血的临床特征 ,以减少误诊。方法　对我院 1999年 1月至 2 0 0 1年 12月以妇科腹腔内出血收治的 186例患者的临床资料进行回顾性分析。结果　 186例病人包括 5种疾病 ,其中异位妊娠、卵巢破裂、出血性输卵管炎及腹部卒中易相互误诊。本资料 15 0例经手术止血 ,36例经保守治疗成功 ,无 1例死亡。结论　详细询问病史 ,血HCG检测和阴道B超检查 ,后穹窿或腹腔穿刺是简便而重要的诊断手段。     

双介入并中药治疗胰腺癌35例

对３５例胰癌病人在超声引导下，局部注射纯乙醇顺铂溶液，由肿瘤远端边退针边注射，一般７－１０天注射１次，直至活栓组织中癌细胞转阴为止。并给予“胰宝康泰”辅治疗，该药具有免疫增强作用。本组３５例的半年、１年、２年活率分别为８５．７％、６８．８％、５１．４％，中位生丰了期为１０．３个月，疗效满意。     

Role of DAT‐SPECT in the diagnostic work up of Parkinsonism

The diagnosis of idiopathic Parkinson's disease (PD) can be achieved with high degrees of accuracy in cases with full expression of classical clinical features. However, diagnostic uncertainty remains in early disease with subtle or ambiguous signs. Functional imaging has been suggested to increase the diagnostic yield in parkinsonian syndromes with uncertain clinical classification. Loss of striatal dopamine nerve terminal function, a hallmark of neurodegenerative Parkinsonism, is strongly related to decreases of dopamine transporter (DAT) density, which can be measured by single photon emission computed tomography (SPECT). The use of DAT‐SPECT facilitates the differential diagnosis in patients with isolated tremor symptoms not fulfilling PD or essential tremor criteria, drug‐induced, psychogenic and vascular Parkinsonism as well as dementia when associated with Parkinsonism. This review addresses the value of DAT‐SPECT in early differential diagnosis, and its potential as a screening tool for subjects at risk of developing PD as well as issues around the assessment of disease progression. © 2007 Movement Disorder Society     

Anterior lumbar instrumentation improves correction of severe lumbar Lenke C curves in double major idiopathic scoliosis

Fifteen skeletally immature patients with double major adolescent idiopathic scoliosis with large lumbar curves and notable L4 and L5 coronal plane obliquity were retrospectively studied. Seven patients who underwent anterior release and fusion of the lumbar curve with segmental anterior instrumentation and subsequent posterior instrumentation ending at L3 were compared with eight patients treated with anterior release and fusion without anterior instrumentation followed by posterior instrumentation to L3 or L4. At 4.5 years follow-up (range 2.5-7 years), curve correction, coronal balance and fusion rate were not statistically different between the two groups; however, the group with anterior instrumentation had improved coronal plane, near normalangulation in the distal unfused segment compared with the group without anterior instrumentation. In cases involving severe lumbar curvatures in the context of double major scoliosis, when as a first stage anterior release is chosen, the addition of instrumentation appears to restore normal coronal alignment of the distal unfused lumbar segment, and may in certain cases save a level compared with traditional fusions to L4.     

随机微分方程特征值期望的上界估计

利用变分原理,从不同角度,讨论了随机微分方程特征问题特征值的性质,给出了其期望值的两个上界估计式。     

胸腹水中唾液酸含量在鉴别良恶性疾病上的价值

本文测定恶性、炎性和肝硬化3组胸腹水中的总唾液酸(TotalSialic Acid TSA)和脂质结合唾液酸(Lipid-bound Sialic Acid LSA)含量,结果表明恶性组和炎性组的 TSA 和 LSA 明显高于肝硬化组,但恶性组和炎性组的 TSA 和 LSA 则无明显差异。恶性、炎性和肝硬化组的 TSA 值分别为499.52±183.98mg/L、508.68±208.79mg/L 和117.71±70.46mg/L;LSA则分别为146.28±103.62mg/L、115.26±72.13mg/L 和58.90±35.46mg/L。以肝硬化组的 TSA+2SD 作为恶性组和肝硬化组的鉴别值,其敏感性为88%,特异性为90.47%,有效性为89.13%。LSA 则无鉴别价值。     

Effects of Polyethyleneglycol Chain Length and Phospholipid Acyl Chain Composition on the Interaction of Polyethyleneglycol-phospholipid Conjugates with Phospholipid: Implications in Liposomal Drug Delivery

Purpose. The purpose of this study was to investigate polyethyleneglycol(PEG)-phosphatidylethanolamine(PE) conjugate interaction with phospholipid bilayers, in an attempt to explain the dependence of liposome circulation time on formulation. Methods. Differential scanning calorimetry, electron microscopy, dynamic light scattering and NMR were the major methods used in the study. Results. Mixtures of PEG-phospholipid conjugates and phosphatidylcholine existed in three different physical states: a lamellar phase with components exhibiting some miscibility, a lamellar phase with components phase separated, and mixed micelles. Beyond 7 mol% of PEG(l,000–3,000)-dipalmitoyl phosphatidylethanolamine (DPPE), and 11 mol% PEG(5,000)-DPPE in dipalmitoyl phosphatidylcholine (DPPC), a strong tendency towards mixed micelle formation was observed. All concentrations of PEG(12,000)-DPPE and PEG(5,000)-DPPE beyond 8 mol% formed phase separated lamellae with phosphatidylcholine. Decreasing the acyl chain length from C_16:0 to C_14:0 caused a decrease in tendency towards micelle formation and phase separation. These tendencies increased upon increasing acyl chain length to C_18:0. Phase separation was at least partly due to PEG chain-chain interaction. This was supported by an increased fraction of PEG chains exhibiting a fast NMR transverse relaxation in DPPC/PEG(5,000)-DPPE mixtures as compared to that in distearoyl phosphatidylcholine (DSPC)/PEG(5,000)-dioleoyl-PE (DOPE). Conclusions. These phenomena are discussed in relation to both bilayer and steric stabilization of liposomes, and the lack of prolonged circulation with certain formulations is discussed.     

An evaluation of the CELL-DYN 1700® haematology analyser: automated cell counting and three-part leucocyte differentiation

The performance of the CELL-DYN 1700® (Abbott Diagnostics, Abbott Park, IL, USA) was evaluated in a tertiary care hospital laboratory using the guidelines proposed by the German Society of Clinical Chemistry. Precision, accuracy, linearity, background counts, and carry-over were satisfactory for all measured standard parameters including haemoglobin concentration, haematocrit, red blood cell count, mean corpuscular volume (MCV), red cell distribution width (RDW), white blood cell count and platelet count. With 259 selected normal and abnormal blood samples the results of the CELL-DYN 1700® (CD1700) compared very well (r > 0.96 for all parameters with exception of RDW) with those obtained with the Bayer Diagnostic H-1 and the Hoffmann-La Roche Cobas Argos systems. This study considered in particular the performance of the CD1700 three-part leucocyte differential. For those samples without instrument-generated suspect flags, the neutrophil and lymphocyte percentages were highly correlated with the results of the H-1 blood cell counter (r = 0.97 and 0.98, respectively) and with manual 400-cell differentials (r = 0.91 and 0.88, respectively). In contrast, the CD1700 mid-fraction which comprised the composite total of mono cytes, eosinophils, basophils and precursor white cells (when present) could not be directly compared to the differentials from the H-1 system or from manual microscopy. For those samples with CD1700 instrument suspect flags, the neutrophil and lymphocyte differential results also compared well with both the H-1 (r = 0.93 and 0.93, respectively) and manual estimates (r = 0.89 and 0.87, respectively). In conclusion, the CD1700 is an accurate haematology analyser for cellular blood counts and three-part leucocyte differentiation.