Fractional flow reserve and complex coronary pathologic conditions.

Fractional flow reserve (FFR) is a well-validated index for assessing the physiologic significance of a coronary stenosis in most clinical conditions encountered in today's catheterisation laboratory. The aim of this paper is to provide a short overview of the theoretical background of the coronary pressure-derived FFR index and its clinical applicability in guiding complex coronary intervention procedures.     

用人工合成材料的吊带经耻骨固定或经腹壁固定治疗真性女性压力性尿失禁

目的总结用人工合成材料的吊带经不同的途径治疗女性压力性尿失禁的方法和结果。方法采用人工合成材料的吊带经耻骨固定（In—Fast）技术治疗3例，用经腹壁固定（TVT和IVS）技术治疗13例。结果绝大多数病人均排尿通畅．无尿失禁复发。但TVT组有1例排尿不畅，3个月后剪断吊带后变为轻度尿失禁。In-fast组有1例性交不适伴阴道分泌物增加。结论用人工合成材料的吊带进行悬吊技术治疗女性真性压力性尿失禁是安全、微创和有效的手术方式。经耻骨固定技术和用经腹壁固定技术这两种方法各有自己的优缺点。应根据病人的具体情况去选择使用。     

Protein-loading test, urinary albumin excretion and renal morphology in diagnosis of subclinical diabetic nephropathy.

The acute effects of protein loading (1.5 g kg-1) on glomerular filtration rate (GFR) and urinary albumin excretion (UAE) were investigated in 23 type-I diabetic patients with no clinical nephropathy, and in 7 healthy subjects (controls). The results were compared with renal morphology data. In controls and in 14 diabetic patients (group 1) GFR increased by 27 and 37%, respectively, corresponding to normal renal reserve, but in 9 patients (group 2) GFR decreased by 20%, indicating the absence of a renal reserve. Microalbuminuria was found in none of the patients in group 1 and in 50% of patients in group 2. Two hours after the load UAE increased in all groups, but the increase was most marked in group 2, despite the fall in GFR. The two groups of patients did not differ with regard to the duration and control of diabetes, but differed markedly in terms of baseline GFR (131 vs. 195 ml min-1, P less than 0.01, in groups 1 and 2, respectively). Renal morphology showed minimal non-specific glomerular injury in group 1, and signs of glomerulosclerosis in group 2. We conclude that the impaired renal response to protein load precedes other subclinical manifestations of diabetic renal injury, and may be useful in the diagnosis of latent diabetic nephropathy.     

军队官兵演习后期的心理变化

为探讨军队官兵在演习后期的心理变化，本分析了军队官兵在演习后期存在放松心理，思乡情绪，自我肯定以及发泄心理等的原因，并提出了相关对策；为稳定演习官兵的思想情绪提供参考。     

羊膜建库及其临床应用研究

目的 :制备与保存羊膜 (Amnioticmembrane,AM ) ,为临床移植治疗眼表泪液 (Ocularsur face&Teardisease ,OSTD)提供新鲜羊膜 (Freshamnioticmembrane ,FSAM )、冻干羊膜 (Frozenam nioticmembrane ,FZAM )并观察其眼表重建的特点与临床疗效。方法 :采用目前国际公认的羊膜制备与保存方法 ,制备FSAM、FZAM并进行保存研究 ,经组织染色和电子显微镜检查 ,观察保存羊膜的形态及其活性 ;并将FSAM、FZAM应用于 12例OSTD患者 ,行患眼FSAM或FZAM移植术。通过术后印迹细胞学追踪观察移植后AM上皮细胞存活与移行、替代时间 ,评估AM移植重建眼表的临床疗效。结果 :FSAM、FZAM在光镜和电镜下均与正常球结膜组织结构相近 ,主要结构为胶原纤维和网状纤维。 12例OSTD患者行羊膜移植术 (Amnioticmembranetransplantation ,AMT)后均未见明显急性排斥反应 ,术后 1～ 2周可见少量新生血管长入植片 ,AMT后印迹细胞学追踪检查 ,术后 3个月为阴性 ,4个月出现阳性反应。所有患者术后随访 5～ 18个月 ,平均 11个月 ,AM在术后 4～ 9个月逐渐溶解、消失 ,移植区眼表的色泽与结构基本恢复正常。结论 :FSAM、FZAM是目前理想的结膜替代材料并可有效地用于重建角、结膜表面 ,减轻炎症反应 ,减少新生血管的生成 ,抑制纤维组织增生 ,防止     

A rare case of nasopharyngeal angiofibroma in an elderly female

Nasopharyngeal angiofibromas occur predominantly in males in their puberty and adolescence; the incidence in other age groups and in women is exceptional. This report describes a case of a 57-year-old woman with nasopharyngeal angiofibroma presenting typical radiological findings in computed tomography, MR imaging and angiography. The tumour was successfully removed and histopathological examination confirmed the diagnosis. In 6 years follow-up the patient is free of symptoms.     

Sex differences in plasma cocaine levels and subjective effects after acute cocaine administration in human volunteers

Gender differences after acute cocaine administration have received little attention in spite of the fact that males and females respond differently to many drugs. Seven male and seven female occasional cocaine users received both an intranasal dose of cocaine hydrochloride (0.9 mg/kg) and placebo powder in a randomized order and reported subjective effects via an instrumental joystick device and various questionnaires. Blood samples were withdrawn at 5-min intervals to assess pharmacokinetic differences. Male subjects achieved the highest peak plasma cocaine levels (144.4 ± 17.5 ng/ml), detected cocaine effects significantly faster than females and also experienced a greater number of episodes of intense good and bad effects. Women studied during the follicular phase of their menstrual cycle had peak plasma cocaine levels of 73.2 ± 9.9 ng/ml, which was significantly higher than when they were studied during their luteal phase (54.7 ± 8.7 ng/ml), but there were no differences in their subjective reports of cocaine effects. In spite of the different cocaine blood levels and subjective effects, peak heart rate increases did not differ between males and females suggesting that women may be more sensitive than males to the cardiovascular effects of cocaine. These data suggest that there are significant gender and menstrual cycle differences in the response to acute intranasal cocaine administration and these differences may have implications for the differential abuse of this drug.This paper is dedicated to Xavier Lamas, MD, PhD, who lost his life while ascending Mt. Everest, August 1995     

The effects of photoperiod on olfactory c-fos expression in prairie voles,Microtus ochrogaster

Reproduction stops among the majority of prairie voles (Microtus ochrogaster) during the winter. Short day lengths suppress male reproductive function dramatically in the laboratory, but photoperiod exerts only subtle effects on female reproductive function. Thus, the regulation of seasonal breeding in this species remains partially unspecified. In contrast to commonly studied rodents, female prairie voles do not undergo spontaneous estrous cycles; rather, they are induced into estrus by exposure to chemosignals expressed in conspecific male urine. In the present study, the hypothesis was tested that seasonal breeding among female prairie voles in the field reflects photoperiod-mediated changes in the responsiveness of the chemosensory system to male urine. Responsiveness was assessed by localizing the product of the c-fos immediate early gene with an immunocytochemical procedure. Female prairie voles were maintained in either long (LD 16:8) or short (LD 8:16) photoperiods from birth until adulthood, and exposed to either male urine or skim milk. Immunocytochemistry forfos protein revealed an increased number of immunoreactive cells within the accessory olfactory system of female prairie voles, including the accessory olfactory bulbs, granule cell layer, as well as the medial and cortical divisions of the amygdala 1 h after exposure to a single drop of urine as compared to individuals exposed to skim milk. The number of immunoreactivefos cells induced in females by conspecific male urine was also affected by photoperiod; short day females displayed fewer immunoreactivefos neurons in the accessory olfactory system as compared to long-day animal. Taken together, these results indicate that similar mechanisms underlie the responses of different rodent species to the chemosignals of conspecifics and that the pattern offos expression observed in the present study has functional significance for the regulation of reproduction in prairie voles.     

运动负荷对高原地区青少年心缩间期的影响

采用逐级负荷踏车实验和阻抗心动图的方法,测定居住3417m高原13～16岁藏汉族青少年静息状态下,运动后即刻及恢复期心率和左心收缩间期,结果显示,静息状态下两组STI各数值无差异,藏族运动后即刻的PEP短于汉族,LVET长于汉族,P/L有明显差异(P<0.01),经心率矫正后藏族运动后即刻LVETI及QS_2I均长于汉族,恢复期短于汉族,形成交叉曲线,说明居住高原的汉藏族人群的心功能差别在青少年时已经出现。提示:藏族在运动状态下有良好的心力储备及对运动负荷的适应能力,其原因可能与生长发育的环境及种群遗传有关。     

Relative body fat and anthropometric prediction of body density of female athletes

Summary Ninety-one percent (n=182) of the female members of South Australian representative squads in 14 sports volunteered to act as subjects. Twenty-seven percent of them had represented Australia. The underwater weighing method together with the measurement of residual volume (RV) by helium dilution were used to determine body density (BD); the percent body fat (% BF) was then computed according to Siri.A stepwise multiple regression analysis yielded a correlation coefficient (R) of 0.863 between the criterion (BD) and the best weighted sum of predictors (anthropometric variables): BD (g·cm^–3)=1.14075–0.04959 (log₁₀ triceps, subscapular, supraspinale and calf skinfolds in mm)+0.00044 (age in decimal years)–0.000612 (waist girth in cm)+0.000284 (height in cm)–0.000505 (gluteal girth in cm)+0.000331 (breast girth in cm).Only those predictors which resulted in a statistically significant increase inR (p0.05) were included. The standard error of estimate of 0.00597 g · cm^–3 was equivalent to 2.7% BF at the mean. This equation was shown to be largely population specific. There was a range of 7.6–35.8% of BF and the overall mean of 18.5% was significantly lower (p<0.001) than that of 23.4% obtained on a moderately active reference sample of similar age (n=135). If group sizes of only one or two are regarded as too small for meaningful comparison, then the lowest mean of 13.5% was achieved by the long-distance runners (n=14). The highest averages were registered by the heavyweight rowers (24.2%;n=7) and soccer players (22.0%;n=11). The overall average for games players (n=107) was 19.4%.This study was supported by a grant from the National Health and Medical Research Council of Australia