547例垂体腺瘤延迟诊断原因及影像诊断分析

目的:提高垂体腺瘤特别是微腺瘤早期影像诊断率。方法:通过对所搜集病史资料完整,经医学影像学确诊和手术病理证实的547例垂体腺瘤(内有251例微腺瘤)延迟诊断原因的分析,找到影响垂体腺瘤早期诊断的因素。结果:296例垂体大腺瘤蝶鞍X线平片、CT、MR常规检查即可诊断。CT骨窗蝶鞍片有助于垂体微腺瘤的诊断,251例微腺瘤经高分辨力CT薄层冠状强化扫描和高场强MR薄层强化扫描得以明确诊断。结论:熟悉垂体腺瘤的首发症状,及时行CT、MR常规扫描可明确大腺瘤的诊断,CT骨窗片可发现垂体微腺瘤的佐证。高场强MR薄层强化扫描是目前诊断垂体微腺瘤的最佳方法,高分辨力CT冠状薄层强化扫描次之,结合神经内分泌学检查是提高垂体腺瘤影像学早期诊断率的主要措施。     

早期糖尿病视网膜病变药物治疗的药物经济学分析

目的：探讨不同方案治疗早期糖尿病视网膜病变的经济效果,找出既经济又有效的方案。方法：对目前临床常用的4种不同治疗方案（导升明、胰激肽原酶、复方血栓通胶囊、复方丹参滴丸,治疗时间均为90d）运用药物经济学方法进行成本-效果分析。结果：4种方案所需费用分别为1417.50元、810.00元、891.00元、656.10元;治疗有效率分别为94.25%、85.09%、85.17%、83.53%;成本-效果比分别为15.04、9.52、10.46、7.85。结论：复方丹参滴丸治疗效果较好,不良反应少,成本低廉。     

Pharmacokinetics of the 13C labeled anticancer agent temozolomide detected in vivo by selective cross-polarization transfer

The anticancer agent temozolomide labeled with ¹³C (8-Carbamoyl-3-13C-methylimidazo-[5,1-d]-1,2,3,5-tetrazin-4-(3H)-one), was noninvasively detected in subcutaneous RIF-1 tumors by a selective cross polarization ¹³C NMR method, at a field strength of 9.4T. Pharmacokinetics of the drug, at a dose of 150 mg/kg, were determined for intravenous and intraperitoneal modes of administration (three animals per mode). The half-life of the drug in the tumors was approximately 60 min. The uptake and clearance of the drug, however, varied significantly between individual hosts, for both modes of administration. These results demonstrate the feasibility of obtaining pharmacokinetics of anticancer agents for individual tumors without the need for a label that might modify drug activity (e.g., fluorine). The variability of the in vivo measurements, even within the same tumor model, demonstrates the necessity of directly monitoring the tumor to evaluate drug pharmacokinetics.     

HCV的检测方法

从发现丙型肝炎病毒以来 ,丙肝的检测技术发展迅速 ,灵敏度和特异性都有明显的提高 ,方法学在不断改进完善。笔者就近年来丙型肝炎的实验室检测方法作简要的综述     

带蒂胸腹轴型皮瓣早期修复上肢深度蛇伤溃疡

总结胸腹轴型皮瓣早期修复上肢不同部位的深度蛇伤溃疡的经验，评价其应用价值。本组１６例，胸脐皮瓣２例，侧胸腹皮瓣１例，髂腰皮瓣５例，下腹皮瓣６例，下腹分叶皮瓣１例，髂腰加下腹Ｙ形皮瓣１例。术后１例皮瓣远端坏死，３例轻度感染，１６例断蒂后全部成活。随访３个月～７年，皮瓣质地和弹性均好，手功能基本恢复。认为，带蒂胸腹轴型皮瓣是修复上肢深度蛇伤溃疡理想的方法。     

Influences of context on early writing development

Research on children's early writing development in the past has focused primarily on product and process. In reviewing the more recent research on early writing development, however, a new focus of context emerges. Occurrences of literacy are now being observed in the home, the school, and the community. With this new emphasis, comes the task of defining context. A definition of context reflects theoretical perspectives, areas of research interests, and types of methodologies employed in conducting research. Therefore, the purpose of this article is to address the following aspects of context: #op1#cp multidiscipline perspectives and definitions of context, #op2#cp contextual shifts observed between the home and the school, #op3#cp contextual factors present when learning how to write, and #op4#cp pedagogical implications for curriculum development.     

The composite N1 component to gaps in noise.

OBJECTIVE: To indicate whether the double peaked N(1) to gaps in continuous white noise is a composite of onset and offset responses to transients or whether it reflects higher processing such as change or mismatch detection and to assess the role of attention in this process. METHODS: Evoked potentials were recorded to two binaural stimulus types: (1) gaps of different durations randomly distributed in continuous white noise; and (2) click pairs at intervals identical to those between gap onsets and offsets in the continuous noise stimulus. Potentials to these stimuli were recorded while subjects read a text and while detecting gaps in noise or click pairs. RESULTS: Potentials were detected to all click pairs and to gaps of 5 ms or longer, corresponding to the subjects' psychoacoustic gap detection threshold. With long gap durations of 200-800 ms, distinct potentials to gap onset and gap offset were observed. The waveforms to all click pairs and to offsets of long gaps were similar and single-peaked, while potentials to gaps of 10 ms and longer, and potentials to onsets of long gaps were double-peaked, consisting of two N(1) negativities, 60 ms apart, irrespective of gap duration. The first (N(1a)), was more frontal in its distribution and similar to that of clicks. The second (N(1b)) peak's distribution was more central/temporal and its source locations and time course of activity were distinct. No effects of attention on any of the varieties and constituents of N(1) were observed. CONCLUSIONS: Comparing potentials to gap onsets, to click pairs and to gap offsets, suggests that potentials to gap onsets involve not only sound onset/offset responses (N(1), N(1a)) but also the subsequent pre-attentive perception of the cessation of an ongoing sound (N(1b)). We propose that N(1b) is distinct from change or mismatch detection and is associated with termination of an ongoing continuous stimulus. We propose to call it the N(egation)-process. SIGNIFICANCE: A constituent of the N(1) complex is shown to be associated with the pre-attentive perception of termination of an ongoing stimulus and to have distinct scalp distribution and intracranial sources.     

简单灵敏的免疫复合物抗原特异性固相酶联检测法

本文将聚乙二醇(PEG)比浊法和固相酶联免疫法(ELISA)结合,建立了—较灵敏的免疫复合物(IC)直接固相吸附抗原特异性检测法。利用牛清蛋白(BSA)为已知抗原组份的IC模型,分别对IC直接固相吸附的条件和影响因素、方法的灵敏度、重复性等进行了研究。结果发现IC在解离状态下直接固相吸附后的抗原特异性检测灵敏度明显高于未解离者。该法具有简单易行,灵敏度较高、适于临床测定大量血清样品等优点。     

老年性痴呆的病理特征与防治对策

老年痴呆症的发生与AB以及Tau蛋白的错误折叠密切相关，是蛋白质折叠相关的疾病，早期诊断是预防老年痴呆症的首要任务，而综合治疗是人类对抗老年痴呆症的必然举措。     

Nerve conduction as a means of estimating early post-mortem interval

Summary Methods in current practice for ascertaining time of death are largely based on the cooling of the body after death and are somewhat unreliable. A theoretica relationship is known to exist between the decline in the properties defining nerve conduction and time after death caused by the gradual cessation of metabolic activity in nerves. A number of such properties were measured in rats during life and after death. In most cases the relationship was found to be inconsistent. The chronaxie of the strength duration curve for the sciatic nerve was, however, found to increase consistently and reproducibly in a linear fashion over the first 90 min after death to a plateau value which was maintained beyond 135 min. These findings are discussed as the possible basis of a forensic method of determining the duration of the “post mortem interval” within the first few hours after death.