颊脂体的外科解剖及其临床意义

对30侧成人颊脂体的形态，位置和血液供应进行了观测。颊脂体血供为多源性，主要血管蒂为上颌动脉的颊动脉和面动脉的颊支。依据上述血管蒂的解剖学走向和分布，颊脂体转位可修复邻近的颌面部和口腔软组织缺损。     

Short-term suppression of plasma free fatty acids fails to improve insulin sensitivity when intramyocellular lipid is elevated.

AIMS: Metabolic responses to manipulation of the plasma free fatty acid (FFA) concentration were assessed in six healthy men via cross-over design to determine whether FFAs independently influence insulin sensitivity. METHODS: Intramyocellular lipid (IMCL) was measured by proton magnetic resonance spectroscopy and insulin sensitivity via frequently sampled intravenous glucose tolerance test (IVGTT) after 67 h of two identical low carbohydrate/high fat (LC) diets which were used to elevate IMCL and plasma FFAs. To uncouple the influence of FFAs and IMCL on insulin sensitivity, FFAs were suppressed 30 min prior to and during IVGTT in one treatment [LC + nicotinic acid (NA)] by NA ingestion. RESULTS: Vastus lateralis IMCL was significantly elevated in LC (13.3 +/- 1.1 x 10(-3)) and LC + NA (13.5 +/- 1.1 x 10(-3)) (P < 0.01 for both), but was not different between conditions (P > 0.05). Plasma FFAs were raised in LC (0.79 +/- 0.08 mmol/l) and LC + NA (0.80 +/- 0.11 mmol/l) (P < 0.01 for both) and were significantly reduced by NA ingestion prior to (0.36 +/- 0.05 mmol/l, P < 0.01) and during IVGTT (P < 0.05) in LC + NA. Despite marked differences in plasma FFA availability, insulin sensitivity and glucose tolerance were not different between LC and LC + NA (P > 0.05 for both). CONCLUSIONS: Plasma FFAs appear to exert no immediate effect on insulin sensitivity/glucose tolerance independent of their action on intracellular lipid moieties. Further research is required to elucidate the duration of FFA suppression required to restore insulin sensitivity following lipid-induced insulin resistance.     

Effect of adiposity on plasma lipid transfer protein activities: a possible link between insulin resistance and high density lipoprotein metabolism

Abstract. The mechanisms responsible for the decreased high density lipoprotein (HDL) cholesterol levels associated with obesity and insulin resistance are not well understood. Lecithin: cholesterol acyltransferase (LCAT) and cholesterol ester transfer protein (CETP) are key factors in the esterification of cholesterol in HDL and the subsequent transfer of cholesteryl ester towards apolipoprotein B-containing lipoproteins. Phospholipid transfer protein (PLTP) may be involved in the regulation of HDL particle size. We therefore measured the activities of LCAT, CETP and PLTP using exogenous substrate assays, as well as lipids, lipoproteins, insulin and C-peptide in fasting plasma from eight healthy obese men (body mass index >27 kg m^-2) and 24 non-obese subjects. The obese men had lower levels of HDL cholesterol (P<0·05) and higher levels of plasma triglycerides (P<0·05), insulin (P<0·05) and C-peptide (P<0·01), as compared to the quartile of subjects with the lowest body mass index (BMI <22·4 kg m^-2). CETP and PLTP activities were elevated in the obese men by 35% (P<0·01) and by 15% (P<0·05), respectively. LCAT activity was comparable among the quartiles. Linear regression analysis showed that CETP activity was positively correlated with body mass index (P<0·02), fasting blood glucose (P7lt;0·05) and plasma C-peptide (P<0·05). PLTP activity was positively related to body mass index (P<0·01), waist to hip circumference ratio (P<0·001), as well as to fasting blood glucose (P<0·05) and plasma C-peptide (P<0·05) It is concluded that the activities of CETP and PLTP are influenced by adiposity and possibly by insulin resistance. Elevated lipid transfer protein activities may provide a mechanism that contributes to alterations in HDL in insulin resistant states.     

Resection and augmentation of Bichat's fat pad in facial contouring

Summary The Bichat's fat pad (Corpus adiposum buccae) is of great significance in facial contouring. Resection of major parts of this fat pad results in hollow cheeks and in accentuation of the zygoma. On the other hand, hypoplasia or shrinkage of this fat pad can be augmented by means of silicone implants for improved aesthetic results.     

山东农村511名高中生伤害的现况调查

目的 调查高中生伤害的情况、危险因素及其影响，为制定高中生伤害的预防措施提供依据。方法 以整群抽样的方法在山东省利津县某高中9个班的511名高中生中进行调查和描述性分析。结果 在过去一年里所调查的高中生8种伤害(车祸、中毒、跌落、烧烫伤、电击伤、钝／锐器伤、动物昆虫叮咬伤、溺水)的总发生率为15．5％，男、女生发生率分别为18．5％、11．9％。发生率最高的前4位伤害依次是跌落伤(7．6％)、中毒(4．3％)、车辆伤(3．3％)和钝／锐器伤(3.1％)。家中常发生中毒、烧烫伤，学校常发生跌落伤和钝／锐器伤。平均每人次伤害花费最大的是车辆伤，其次为跌落伤；平均影响学习时间最长的是车辆伤，其次为烧烫伤和跌落伤。伤害发生率在性别和父亲健康状况上有显著性差异。结论 针对不同伤害特点采取相应预防措施，以降低伤害发生率，促进青少年健康，减少社会健康损失和经济损失。     

A case-control study of breast cancer among Japanese women: with special reference to family history and reproductive and dietary factors

Summary To study the effects of family history and reproductive, anthropometric, and dietary factors on the risk of breast cancer among low risk populations, we conducted a hospital-based case-control study involving 908 patients with breast cancer and their matched controls, in Japan. A positive family history of breast cancer significantly increased the risk of breast cancer (odds ratio = 1.52, 95% confidence interval: 1.14–2.03). The risk further increased with increasing number of family members affected. Obesity, single marital status, fewer births, a late childbirth, and less consumption of green-yellow vegetables and dairy products were also associated with an increased risk of breast cancer. These associations were independent in multivariate analyses. There was no increase in risk associated with consumption of high fat foods. When analyzed by menopausal status, the association with family history of breast cancer, especially in the first degree of relatives, was more evident for premenopausal breast cancer. The associations with obesity and lower consumption of dairy products were more pronounced for postmenopausal breast cancer, while those with lower parity and single marital status were stronger for premenopausal breast cancer.     

Multicoil Dixon chemical species separation with an iterative least-squares estimation method.

This work describes a new approach to multipoint Dixon fat-water separation that is amenable to pulse sequences that require short echo time (TE) increments, such as steady-state free precession (SSFP) and fast spin-echo (FSE) imaging. Using an iterative linear least-squares method that decomposes water and fat images from source images acquired at short TE increments, images with a high signal-to-noise ratio (SNR) and uniform separation of water and fat are obtained. This algorithm extends to multicoil reconstruction with minimal additional complexity. Examples of single- and multicoil fat-water decompositions are shown from source images acquired at both 1.5T and 3.0T. Examples in the knee, ankle, pelvis, abdomen, and heart are shown, using FSE, SSFP, and spoiled gradient-echo (SPGR) pulse sequences. The algorithm was applied to systems with multiple chemical species, and an example of water-fat-silicone separation is shown. An analysis of the noise performance of this method is described, and methods to improve noise performance through multicoil acquisition and field map smoothing are discussed.     

胃癌高系家族成员胃蛋白酶原C基因多态性及其诊断意义的探讨

采用限制性酶切片段长度多态性分析法，检测在胃癌高发区庄河检出的１９例胃癌高系家族成员胃蛋白酶原Ｃ基因多态性，发现三种常见片段及一种稀有片段。对其中４例携带稀有片段的受检者进行了胃镜追踪观察，２．５年后发现１例早期胃癌。本文对此作了初步探讨。     

高频喷射通气结合胸壁挤压对组胺致肺损伤犬呼吸循环功能的影响

以高频喷射通气结合胸壁挤压（ＨＦＪＶ＋ＣＷＣ）为通气模式，观察其对组胺致肺损伤犬呼吸循环功能的影响，并与单纯高频喷射通气（ＨＦＪＶ）进行比较。结果表明：与ＨＦＪＶ相比，ＨＦＪＶ＋ＣＷＣ时的功能残气量（ＦＲＣ）、ＰａＣＯ＿２和ＰＣＯ＿２均显著降低（Ｐ＜０．０１），肺泡通气量（Ｖ＿Ａ）和二氧化碳排出量（ＣＯ＿２）均显著增高（Ｐ＜０．０１），每分呼出气量（Ｖ＿Ｅ）、ＰａＯ＿２、ＰＣＯ＿２、吸气峰压（ＰＩＰ）、平均气道压（Ｐａｗ）、呼气末压（ＥＥＰ）、ＨＲ、平均动脉压（ＭＡＰ）、肺动脉压（ＰＡＰ）和肺毛细血管楔压（ＰＣＷＰ）均无显著变化（Ｐ＞０．０５）。提示：ＨＦＪＶ＋ＣＷＣ除保留单纯ＨＦＪＶ时气道开放、气道低压、良好的血液氧合、不影响循环功能等特点外，还具有增加呼气动力，改善肺泡通气，显著促进ＣＯ＿２排除等优点。