4例血清磷酸激酶改变与心电图表现的分析

目的研究电击伤后人体血清磷酸肌酶(CK)升高程度与心肌受损程度的相关性,探讨其对临床诊治的意义。方法对4例在我院诊治的电击伤患者,在电击伤后紧急检查常规心电图(ECG)、血清磷酸肌酶(CK),进行回顾性分析血清CK与常规ECG中ST-T表现的相关性。结果 4例电击伤后,均出现呼吸、心搏停止经抢救复苏后送往医院的患者。急查血清CK高达1722～15484U/L(正常值38～174U/L),比正常值高100～1000倍,同时常规ECG中ST段与T波正常。结论电击伤后,如果电击点不是直接对着心脏,心脏停搏是一种中枢性抑制,经抢救在短时间内恢复呼吸、心搏、血液循环,心肌细胞细胞不会受损伤。     

甲状腺乳头状癌79例的形态学观察及病理学分析

目的 探讨甲状腺乳头状癌(papillary thyroid carcinoma,PTC)的临床病理学特点,提高PTC的临床病理诊断水平.方法 回顾性分析79例PTC的临床病理资料和组织学表现.结果 79例患者的发病年龄为18～66岁,年龄高峰为30～40岁.女56例,男23例.右侧52例,左侧18例,双侧9例.大体观察:肿物大小不一,直径0.5～5 cm有55例,直径小于1 cm有40例,直径1～3 cm有30例,直径3～5 cm有9例.其中有完整包膜5例,有囊性变7例,囊内充满棕褐色液体,囊壁可见灰白色乳头状突起,切面灰白或棕褐色.镜下:真乳头状结构,毛玻璃样核,核沟等特征性细胞核改变、伴随改变,砂粒体形成,间质纤维化、钙化、骨化等.结论 PTC占甲状腺癌的60％～70％,是甲状腺癌中最常见的类型,预后较好.PTC的早期正确病理诊断对临床的治疗和预后的判断有指导意义.     

新毕业护士在角色转变中的压力分析

目的探讨新毕业护士在角色转变中的压力,并分析其相关因素。方法方便抽样82名应届毕业生,采用新毕业护士角色模糊及角色超负荷量表及职业压力量表进行问卷调查。结果新毕业护士职业模糊分值是（2．62±0．70）分,角色超负荷分值是（2．51±0．83）分,职业压力分值是（2．63±0．76）分,显示新毕业护士角色超负荷、角色模糊、职业压力水平在中度偏下;新毕业护士所在科室是否是其志愿科室对角色模糊、角色超负荷和职业压力无影响（P〉0．05）;新毕业护士所在科室对其角色模糊情况有影响（P〈0．05）,门急诊、手术室、ICU及专科护士的角色模糊分值高于内外科、妇产科及儿科护士;研究对象多选择偏向正面的减压对策。结论新毕业护士因角色转变而产生一定的压力,建议在管理上建立全面的人职引导计划,良好的临床督导和带教系统,以及有效的工作压力监察和应激技巧的教育。     

Development of a serial comparison program for conduction defects, acute myocardial infarction, and the use of additional leads

Serial comparison of electrocardiograms (ECGs) is a useful tool in clinical diagnostic ECG and an enhancement to computer ECG analysis. When an analysis algorithm is modified, the corresponding serial comparison program needs to be updated accordingly. The new Philips diagnostic algorithm increased the number of leads in the ECG from the traditional 12 leads to 16, making it possible to diagnose right ventricular infarct/injury based on right-sided lead V4R. To keep pace with the widespread reperfusion therapy for acute myocardial infarct, the serial comparison program was revised to recognize the rapid ECG changes in patients with ST-elevation myocardial infarct following successful reperfusion therapies. The serial comparison program was also enhanced to split “combined” statements in the category of ventricular conduction delay (includes incomplete ventricular conduction delay and bundle-branch blocks) and compare each of the statements separately.     

Gating of the MlotiK1 potassium channel involves large rearrangements of the cyclic nucleotide-binding domains

Cyclic nucleotide-regulated ion channels are present in bacteria, plants, vertebrates, and humans. In higher organisms, they are closely involved in signaling networks of vision and olfaction. Binding of cAMP or cGMP favors the activation of these ion channels. Despite a wealth of structural and studies, there is a lack of structural data describing the gating process in a full-length cyclic nucleotide-regulated channel. We used high-resolution atomic force microscopy (AFM) to directly observe the conformational change of the membrane embedded bacterial cyclic nucleotide-regulated channel MlotiK1. In the nucleotide-bound conformation, the cytoplasmic cyclic nucleotide-binding (CNB) domains of MlotiK1 are disposed in a fourfold symmetric arrangement forming a pore-like vestibule. Upon nucleotide-unbinding, the four CNB domains undergo a large rearrangement, stand up by ～1.7 nm, and adopt a structurally variable grouped conformation that closes the cytoplasmic vestibule. This fully reversible conformational change provides insight into how CNB domains rearrange when regulating the potassium channel.     

A novel method for analyzing images of live nerve cells

Analysis of images from live-cell experiments is a central activity to studying the effects of stimulation on neuronal behavior. Image analysis techniques currently used to study these effects rely for the most part on the salience of the neuronal structures within the image. In both fluorescent and electron microscopy, neuronal structures are enhanced and therefore easy to distinguish in an image. Unlike images obtained via fluorescent or electron microscopy, however, images produced via transmission microscopy (e.g., bright field, phase contrast, DIC) are significantly more difficult to analyze because there is little contrast between the object-of-interest and the image background. This difficulty is amplified when a time-dependent sequence of images are to be analyzed, because of the corresponding large data sets. To address this problem, we introduce a novel approach to the analysis of images of live cells captured via transmission microscopy that takes advantage of commercially available software and the Fourier transform. Specifically, our approach utilizes several morphological functions in MATLAB to enhance the contrast of the cells with respect to the background, which is followed by 2-D Fourier analysis to generate a spectrum from which the orientation and alignment of cells and their processes can be measured. We show that this method can be used to simplify the interpretation of complex structure in images of live neurons obtained via transmission microscopy and consequently, discover trends in neurite development following different types of stimulation. This approach provides a consistent and reliable tool for analyzing changes in cell structure that occurs during live-cell experiments.     

脑囊尾蚴病的病理改变及分期

近些年,由于显微技术和影像学技术的广泛应用以及脑囊尾蚴病的高发病率引起人们的高度重视,越来越多的人关注于其发病机制及病理变化,而关于脑囊尾蚴病的分型及分期各文献报道却不一致,该文针对其病理改变及分型分期作一综述.     

动态检测子宫内膜异位症患者血清TNF-α的临床意义

目的研究子宫内膜异位症（EM）患者血清TNF-α的水平动态变化及其在EM疗效和预后评价中的意义。方法EM组患者80例,手术前、术后7d、术后3个月、6个月、12个月、18个月、24个月用ELISA法检测外周血清肿瘤坏死因子-α（TNF-α）的水平,并与40例正常健康妇女（对照组）比较。结果EM组术前血清中TNF-α水平均明显高于对照组（P〈0.01）,且Ⅲ～Ⅳ期患者高于Ⅰ～Ⅱ期（P〈0.05）。术后1周血清中TNF-α水平下降,明显低于术前水平（P〈0.01）。EM组随访58例,未复发的52例治疗结束后血清TNF-α水平呈下降趋势,复发的6例治疗结束后血清TNF-α水平呈增高趋势。结论EM患者血清TNF-α水平与EM复发有关,EM患者血清TNF-α水平的动态检测有作为EM疗效评价、复发及预后的重要指标。     

Long-term changes in cerebellar activation during functional recovery from transient peripheral motor paralysis

Localized altered cerebellar cortical activity can be associated with short-term changes in motor learning that take place in the course of hours, but it is unknown whether it can be correlated to long-term recovery from transient peripheral motor diseases, and if so, whether it occurs concomitantly in related brain regions. Here we show in a longitudinal fMRI study of patients with unilateral Bell's palsy that increases in ipsilateral cerebellar activity follow the recovery course of facial motor functions over at least one and a half years. These findings hold true for changes in brain activity related to both oral and peri-orbital activation, even though these processes are differentially mediated by unilateral and bilateral brain connectivities, respectively. Activation of non-facial musculature, which was studied for control, does not show any change in cerebellar activity over time. The localized changes in cerebellar activities following activation of facial functions occur concomitantly with increases in activity of the facial region in the contralateral primary motor cortex suggesting that the cerebellum acts together with the cerebral cortex in long-term adaptation to transient pathological sensorimotor processing.     

乳腺导管内视镜检查对乳头溢液的诊断价值

目的 探讨乳管内视镜对乳头溢液的诊断价值.方法 应用FV-2000E日本超细光导纤维乳管内视镜系统对3267例乳头溢液患者进行乳管内视镜检查,并将检查结果进行病理学分析.结果 本组3267例患者,正常管腔499例(15.27%);导管扩张伴慢性炎症1750例(53.57%);发现乳管内占位病变1018例(31.16%)(溢液性质血性813例,浆液性165例,水样40例),在813例血性溢液中发现浸润性导管癌42例,导管内癌8例.结论 乳管内视镜检查对乳头溢液患者是一种安全有效的检查方法,应作为病因诊断的首选方法.