Occipital horn syndrome: report of a patient and review of the literature

We report an 18-year-old boy with occipital horn syndrome and we review the 20 cases previously published with this syndrome. The distinctive features common to all patients were unusual facial appearance, skeletal abnormalities, chronic diarrhea and genitourinary abnormalities. The skeletal abnormalities included occipital horns, short, broad clavicles, deformed radii, ulnae, and humeri, narrowing of the rib cage, undercalci-fied long bones with thin cortical walls and coxa valga. Occipital horn syndrome is inherited in an X-linked recessive fashion. Our analysis indicates that occipital horn syndrome is associated with a recognizable characteristic phenotype.     

抗癌药物紫杉醇的发现,化学及构效关系

自从利用生物试验从植物提取物筛选新的抗癌化合物以来，已经发现了许多新的活性成分．但仅极少数化合物如长春碱、长春新碱、秋水仙碱、紫杉醇（Taxol）等，被最终研究开发成新的抗癌药物，而其中最令人们瞩目的则是近年来开发的紫杉醇．迄今发表。。有关紫杉醇及其类似物（taxoids）的研究资料颇为丰富，且有更加增多的趋势，已成为当今天然药物化学研究的“热点”．研究内容十分广泛，车要有植物化学（提取分离、结构测定）、分析、生理活性、化学修饰、合成、构效关系、生物技术、细胞生物学和分子生物学以及临床等。发表了许多综述、…     

Reclaiming 'Big Nurse': a feminist critique of Ken Kesey's portrayal of Nurse Ratched in One Flew Over the Cuckoo's Nest

Reclaiming 'Big Nurse': a feminist critique of Ken Kesey's portrayal of Nurse Ratched in One Flew Over the Cuckoo's Nest Nurse Ratched or 'Big Nurse' in Ken Kesey's counter-culture novel One Flew Over the Cuckoo's Nest is one of popular culture's most arresting and memorable images of the nurse. She is, however, deemed to be remarkable primarily for her malice and authoritarianism. This paper argues that such a purely realist reading fails to fully appreciate the significance of the character of Nurse Ratched. A feminist critique of the novel contends that die importance of 'Big Nurse' is less related to how realistic/unrealistic or good/bad she is as a nurse. Nurse Ratched is important because she exemplifies all diat traditional masculinity abhors in women, and particularly in strong women in positions of power and influence. This paper explores the stereotype of 'Big Nurse' and argues that Kesey's vision of her ultimate 'conquest' is not a progressive allegory of 'individual freedom', but a reactionary misogyny which would deny women any function other than that of sexual trophy.     

计算机在医学领域中的应用及展望

对计算机在医学文献检索、医学统计软件包的编制、疾病诊断、医院管理等医学领域中的应用作了简要的综述，并对未来的发展进行了预测。     

Intratympanic steroid therapy for inner ear diseases, a review of the literature

To evaluate the value of clinical trials on intratympanic steroid therapy in Ménière’s disease (MD), idiopathic sudden sensorineural hearing loss (ISSNHL) and rapidly progressive sensorineural hearing loss (RPSNHL). Medline and Pubmed databases from 1966 to present were searched for clinical studies on intra- or transtympanic (cortico)steroid therapy of MD, ISSNHL and RPSNHL. Results were cross-checked with additional databases to obtain a complete data set. Clinical trials were evaluated on the basis of comparability, internal and external validity. Articles were judged using the following questions: was a randomised double-blind controlled trial performed? Which criteria were used to confirm the diagnosis of MD, ISSNHL, RPSNHL? Which therapy was evaluated? How long was the follow-up? Which criteria were used to evaluate the results? Reliable evidence on the efficiency, optimum dosage and administration schedule of intratympanic steroid therapy in MD, ISSNHL and RPSNHL is lacking, therefore further investigation is required.     

Using online databases to find peer-reviewed journal articles on injury prevention and safety promotion research: a study of textword queries by SafetyLit users.

OBJECTIVE: To assess the capacity of textword queries to provide a comprehensive listing of articles on injury prevention and safety promotion (IPSP) concepts in a literature database. METHODS: All terms used to search SafetyLit (a database of scholarly literature selected for its relevance to the IPSP field) during the years 2000-2005 were listed and then examined to identify terms that are synonyms for the same concept. Terms were grouped by concept, the number of queries that used terms within each concept category were summed, and the concepts were then ordered by the total number of searches for each concept category. For each textword, the proportion of all articles for that concept that could be found by using it alone was calculated. RESULTS: Each of the 25 most searched-for concepts has 4 to 40 synonyms. Sixteen of the concepts required queries using two or more terms to find 75% of the available articles. Few searchers used a sufficient number of textword synonyms in their queries to return a complete listing of the available material. CONCLUSION: On the basis of this study, queries using only one or two textword terms are insufficiently sensitive to find all relevant journal articles about an IPSP concept.     

Valproinsäure in der prophylaktischen Behandlung der Migräne

Zusammenfassung Im Jahr 1988 wurde erstmals von der m?glichen Wirksamkeit der Valproins?ure in der Migr?neprophylaxe berichtet. Seit 1992 sind insgesamt 359 Patienten in 5 Doppelblindstudien untersucht. In allen Studien ergab sich eine signifikant überlegene Wirksamkeit im Vergleich zu Placebo, eine Studie belegt einen gleichen Effekt wie Propranolol. Es fehlen noch Wirksamkeitsanalysen, die sich am Plasmaspiegel orientieren. Die Nebenwirkungen entsprechen denen aus der Epilepsietherapie, scheinen aber im Vergleich zu Propranolol etwas h?her zu liegen. International und nach den Empfehlungen der Deutschen Migr?ne- und Kopfschmerzgesellschaft gilt Valproins?ure mittlerweile als etabliertes Mittel der zweiten Wahl.      

核苷酸结合寡聚化结构域样受体蛋白3炎症小体在脑卒中后认知障碍中的研究进展

脑卒中后认知障碍(PSCI)是脑卒中患者常见的并发症,严重影响患者的生活质量。目前,PSCI在临床治疗中尚未发现有效的针对性治疗措施。大量研究证实核苷酸结合寡聚化结构域样受体蛋白3(NLRP3)炎症小体的活化在PSCI中起关键作用,且对其进行的许多抑制性治疗显示出了改善认知障碍的功效。为此,本文总结了NLRP3炎症小体的活化和影响因素及其与PSCI的关系,发现在PSCI的细胞和动物模型中,针对NLRP3或其炎症小体成分的抑制措施可以减轻炎性反应和相应的病理特征,从而促进其认知功能的恢复,因此,靶向NLRP3炎症小体可能是PSCI治疗的新趋势。然而到目前为止,尽管许多药物和治疗措施已成功鉴定出能够抑制NLRP3炎症小体的活化,但其在临床中的治疗效果和安全性仍有待进一步验证。     

慢加急性肝衰竭诊断标准的研究进展

慢加急性肝衰竭(ACLF)是指在慢性肝病基础上遭受急性打击后,出现严重的急性肝功能失代偿,其因病情进展迅速、短期死亡率极高,引起了全球肝病学家的关注。但由于不同国家(地区)ACLF的病因及临床特征等存在明显的差异,目前国内外ACLF的诊断标准多达十余种。本文通过回顾几种较为常用的ACLF定义,以及ACLF诊断标准相关研究,比较各ACLF诊断标准之间的差异,以期帮助临床医生更好地识别ACLF、优化临床决策。目前全球尚无公认的ACLF诊断标准,国内外ACLF的诊断标准存在着较大差异,临床医生在实际工作中选用何种ACLF诊断标准应根据患者慢性肝病的病因、临床特征等因素综合考虑。     

肺部、肠道菌群及其相互作用与慢性阻塞性肺疾病发生发展的研究进展

慢性阻塞性肺疾病（COPD）是一种常见的慢性呼吸系统疾病,对人类健康造成极大威胁。研究发现,COPD患者与健康人群相比,肺部菌群及肠道菌群的组成结构发生了显著改变,导致黏膜屏障功能及机体免疫稳态被破坏,进而加重病情。积极调节肺部、肠道菌群平衡对于干预COPD的发生、发展有着至关重要的作用,但目前关于肺部、肠道菌群及其相互作用机制在COPD中作用的总结和认识还有待进一步阐明。本文就健康人群以及COPD患者肺部、肠道菌群的组成特点及可能的相互作用机制,以及现阶段基于肺部、肠道菌群及其相互作用防治COPD的最新研究成果进行综述,以期为COPD的发病机制、早期诊断、预防与治疗研究提供新思路。