多系统萎缩的临床分型和影像学改变特点分析

目的探讨多系统萎缩（multiple system atrophy，MSA）的临床表现类型与神经影像学改变新特征（脑桥“十字征”和“壳核裂隙征”）的关系，为临床尽早做出诊断提供依据。方法按照Gilman诊断标准回顾性分析11例MSA患者的临床表现、分型和头颅MRI资料。结果本组诊断为很可能MSA11例，其中橄榄体脑桥小脑萎缩（MSA-C型）8例。2例在发病后3年头颅MRI脑桥“十字征”达Ⅰ期；1例在病后2年达Ⅱ期；3例分别在病后1年、3年、5年达Ⅲ期；另外2例分别在病后2年和7年达Ⅳ期。8例“壳核裂隙征”均为0期。黑质纹状体变性（MSA-P型）2例：1例病后6年脑桥“十字征”0期，“壳核裂隙征”Ⅰ期，另1例发病后9年“壳核裂隙征”Ⅱ期，脑桥“十字征”Ⅳ期。Shy-Drager综合征（MSA-A型）1例：病程5年，MRI检查脑桥“十字征”和“壳核裂隙征”分期均为0期。结论临床表现与头颅MRI检查发现的脑桥“十字征”和“壳核裂隙征”可作为及早识别MSA-C型的神经影像学改变特征，“壳核裂隙征”可作为识别MSA-P型的神经影像学改变特征。     

Evaluation of plantar hyperhidrosis in patients undergoing video-assisted thoracoscopic sympathectomy

Background Sympathectomy is the treatment of choice for primary hyperhidrosis. One curious occurrence that is difficult to explain from an anatomophysiological point of view in cases of video-assisted thoracoscopic sympathectomy (VATS) for the treatment of palmar hyperhidrosis (PH) is the observed improvement in plantar hyperhidrosis (PLH). Nevertheless, current reports on VATS rarely describe the effect on PLH or just give superficial data. The aim of this study was to prospectively investigate, how surgery affects PLH in patients with PH and PLH over one-year period. Methods From May 2003 to January 2004, 70 consecutive patients with combined PH and PLH underwent VATS at the T2, T3, or T4 ganglion level (47 women and 23 men, with mean age of 23 years). Results Immediately after the operation, all the patients said they were free from PH episodes, except for two patients (2.8%) who suffered from continued PH. Compensatory hyperhidrosis (CH) of various degrees was observed in 58 (90.6%) patients after one year. Only 13 (20.3%) suffered from severe CH. There was a great initial improvement in PLH in 50% of the cases, followed by progressive regression, such that only 23.4% still presented that improvement after one year. The number of cases without overall improvement increased progressively (from 17.1% to 37.5%) and the numbers with slight improvement remained stable (32.9–39.1%). Of the 24 patients with no improvement after one year, 6 patients graded plantar sweating worse. Conclusion Patients with PH and PLH who undergo VATS to treat their PH present a good initial improvement in PLH that reduces to a lower level of improvement after the one-year period.     

急进高海拔大鼠肾素-血管紧张素-醛固酮系统的对比性研究

目的：探讨急进高海拔地区机体对低压、低氧环境的适应机制；方法：将海拔10m处的平原大鼠快速带至海拔2261m，再带入海拔3800m处，用放射免疫法测定大鼠血浆肾素、血管紧张素Ⅱ和醛固酮的浓度；结果：随海拔递增①大鼠肾素及血管紧张素Ⅱ含量呈上升趋势，醛固酮浓度逐渐下降，统计学处理有显著性差异；②急进高海拔地区，醛固酮对血管紧张素Ⅱ的反应钝化，使醛固酮处于低水平状态；结论：上述结果提示：急进高海拔，机体对水、电解质的调节会发生变化，这些变化有利于急性高原适应。     

网络化人类精子库管理信息系统的建立与应用

目的 :建立网络化人类精子库管理信息系统。　方法 :用SQLServer2 0 0 0和PowerBuilder 8.0开发人类精子库管理信息系统。　结果 :系统形成了档案管理、体检与检查管理、检验与冷冻管理、供应与随访管理 4个模块 ,系统以远程传输与实时监控的方法控制和管理供应点。　结论 :本系统具有数据容量大、安全性能好、保密性能强 ,具有远程传输与实时监控功能     

管碟法测定Nisin效价

对管碟法测定Nisin效价的条件进行了研究,考察了几个参数的影响,得出了Nisin测定的最佳条件:90mm培养皿中培养基加量为15mL,Na2HPO4·12H2O质量浓度1g/dL,菌悬液浓度109CFU/mL,琼脂质量浓度1g/dL,培养基pH值7.0,牛津杯中样品加液量100μL.在此条件下,Nisin效价在5～100IU/mL,其对数值与抑菌圈直径有较好的线性关系.     

Cytokeratin 7 and 20 as immunohistochemical markers in identification of primary tumors in craniospinal metastases: Do they have a significant role?

Cytokeratin (CK)7 and CK20, the low molecular weight cytokeratins, have been found to have a benefit in the differential diagnosis of some epithelial neoplasms. In the present study, the actual role of these markers in the search of primary tumors in 32 patients with craniospinal metastasis of an unknown primary site at presentation, is evaluated. A series of 36 patients with a known primary tumor were presented for comparison. In the first group, two CK7 and CK20 expression profiles were observed; 87% of metastatic tumors were CK7+/CK20‐ and 13% CK7‐/CK20‐. The lung was the major source (82%) of CK7+/CK20‐ metastatic tumors, whereas it represented only 38% of primary tumor in the second group of a known primary site (P = 0.006). Given the fact that metastatic tumors to the craniospinal axis of an unknown primary site are frequently CK7+/CK20‐, and they have commonly metastasized from the lung, it is doubtful that immunohistochemistry is really helpful. However, CT scan and MRI of the chest still play an important role. Many patients in the present study had to undertake these imaging studies, regardless of the CK7/CK20 result. The immunostains may be useful in cases with other expression profiles, but such examples constituted only a minority in the present study.     

Norepinephrine transporter and α2c adrenoceptor allelic variants and personality factors

It has been suggested that reward dependence, as measured by the Tridimensional Personality Questionnaire (TPQ), is related to central noradrenergic activity, a proposition supported by two studies of urinary norepinephrine metabolite. In the current investigation, 190 normal young Han Chinese were examined, with genetic polymorphisms determined for the norepinephrine transporter (1287G/A) and the α_2c‐adrenoceptor (Del322–325) to test the association with TPQ personality traits. No significant association was demonstrated for these two polymorphisms and any of the TPQ personality‐factor scores, including reward dependence and its subscales. Our negative findings suggest that the investigated polymorphisms of the norepinephrine transporter and the α_2c adrenoceptor do not play a major role in the reward‐dependence personality trait as assessed by TPQ. © 2002 Wiley‐Liss, Inc.     

网络模式下临床医师绩效评价指标体系研究

为了充分利用医院信息网络信息，更为全面、客观地对医生进行评价，阐述建立网络模式下临床医师绩效评价指标体系的原则、方法，并对的建立指标体系的可信度及合理性进行了分析。     

A quantitative analysis of valgus torque on the ACL: a human cadaveric study.

The loads needed to elicit a positive pivot shift test in a knee with an anterior cruciate ligament (ACL) rupture have not been quantified. The coupled anterior tibial translation (ATT), coupled internal tibial rotation (ITR), and the in situ force in the ACL in response to a valgus torque, an inherent component of the pivot shift test, were measured in 10 human cadaveric knee specimens. Using a robotic/universal force-moment sensor testing system, valgus torques ranging from 0.0 to 10.0 Nm were applied in nine increments on the intact and ACL-deficient knee in flexion ranging from 0 degrees to 90 degrees. At 15 degrees of knee flexion, the coupled ATT and ITR were significantly increased in the ACL-deficient knee when compared to the intact knee. Coupled ATT increased a maximum of 291% (6.7 mm, p<0.05), while coupled ITR increased a maximum of 85% (5.1 degrees, p<0.05). At 30 degrees, the increases in coupled ATT and ITR were significant at valgus loads of 3.3 Nm and greater with a maximum increase in coupled ATT of 137% (6.3 mm, p<0.05) and a maximum increase in coupled ITR of 38% (3.6 degrees, p<0.05). At 45 degrees, coupled ATT increased significantly (maximum of 69%, 4.4 mm, p<0.05), but only at torques > or =6.7 Nm. The in situ force in the ACL was less than 20 N for all flexion angles when a torque between 3.3 and 5.0 Nm was applied. Low valgus torque elicited tibial subluxation in the ACL-deficient knee with low in situ ACL forces, similar to a positive pivot shift test. Thus, application of a valgus torque may be suitable to evaluate ACL-deficient and ACL-reconstructed knees, since subluxation can be achieved with minimal harm to the ACL graft. This work is important in understanding one load component needed for the pivot shift examination; further studies quantifying other load components are essential for better comprehension of the in vivo pivot shift examination.     

苯胺衍生物掺杂的PMMA薄膜的二次非线性光学性能的稳定性研究

具有A-π-D电子结构的苯胺衍生物掺杂的玻璃态高聚物PMMA的有机薄膜经极化取向后显示很强的二次非线性光学性能,其取向弛豫是实用化的一个有待解决的重要问题。木文通过几种苯胺衍生物以不同百分比与PMMA掺杂,用紫外-可见吸收光谱、二次谐波强度测量、动态力学粘弹谱等方法进行了取向弛豫的机理研究,结果表明分子尺寸和形状以及偶极矩的大小对取向弛豫有显著影响。