TC指数在改良LONGA线栓法局灶性脑缺血/再灌注动物模型制备中的应用

目的观察TC指数定位血管线栓法对大鼠局灶性脑缺血模型制备的影响。方法300只雄性SD大鼠随机分为预试验组30只、原始方法组120只(按LONGA氏血管线栓法)、改良方法组150只(按动物门齿根部T点距颈总动脉分叉点C点长短而定,简称TC指数定位法)；比较两种不同造模法对血管线栓局灶性脑缺血/再灌注实验大鼠的成功率及形态学的变化。结果TC指数定位法改良的LONGA氏血管线栓再灌注制模法,比原始的LONGA氏血管线栓法大鼠脑缺血/再灌注模型成功率高,直线相关分析及统计学上均具有显著性意义；形态学表现差异无显著性。结论TC指数定位法的LONGA氏血管线栓法大鼠脑缺血/再灌注模型是一种较好的制模方法,值得实验研究中推广应用。     

Prognostic variables for response and outcome in patients with extragonadal germ-cell tumors.

BACKGROUND: This investigation evaluates prognostic variables in patients with seminomatous and non-seminomatous extragonadal germ-cell tumors (EGCT) in order to identify relevant factors for long-term outcome following cisplatin-based chemotherapy. PATIENTS AND METHODS: Patients from six countries treated at 11 centers in Europe and the USA from 1975 to 1996 were evaluated retrospectively. Uni- and multivariate analyses of prognostic variables for survival and for response to chemotherapy were performed. RESULTS: Data were available for 635 EGCT patients, 104 with seminomatous and 524 with non-seminomatous EGCT (n = 7 not specified). For non-seminomatous EGCT the following independent adverse factors were identified: presence of either liver, lung or central nervous system metastases, primary mediastinal tumor or elevation of pretreatment beta-human gonadotropin; for extragonadal seminoma (only univariate) adverse factors were: presence of liver metastases, two or greater metastatic sites or International Germ Cell Cancer Collaborative Group (IGCCCG) grouping (intermediate versus good). Integration of these variables produced the following prognostic risk groupings: 'excellent prognosis', all seminomatous EGCT (89% 5-year survival rate); 'intermediate low', 'intermediate high' and 'poor', all non-seminomatous EGCT with a 69, 55 and 17% 5-year survival rate, respectively. The decreased survival among the different groups was due to a lower rate of favorable objective remissions and a higher rate of relapses. Classification and regression tree (CART) modeling confirmed histology and location of primary tumor as the major prognosticators. For the subgroup of patients with mediastinal non-seminoma, the 2-year survival rate ranged from 34 to 84%. Multivariate testing for the probability to respond to chemotherapy revealed non-seminomatous histology, primary mediastinal tumor site, and the presence of liver, lung or CNS metastases as independent adverse factors. CONCLUSIONS: In EGCT, prognostic variables for the outcome and for the response to chemotherapy could be identified, which in part differ from gonadal GCT. The proposed model might help to better understand the specific prognosis of EGCT and to tailor risk-adapted treatment strategies. In addition, CART analysis demonstrated the heterogenous prognosis of patients with mediastinal non-seminoma.     

CT定位微创治疗高血压脑出血95例疗效分析

目的：探讨微创治疗高血压脑出血的方法、适应证及疗效。方法：回顾分析95例高血压脑出血微创清除术病例的治疗及效果。结果：术后2d血肿基本清除10例，3d56例，7d29例。预后按GOS分类：良好33例，中残40例，重残11例，睁眼昏迷2例，死亡9例。结论：CT定位微创治疗高血压脑出血具有操作简单、效果确切、经济安全、病死率低的优点，适合基层医院开展。     

Investigations on Epileptogenic Lesions in Relation between Ages of the Patients and Seizure Manifestation

Abstract: The purpose of this report is to extract the age factor from multiple contributing factors to seizure manifestations in 357 cases of the various intracranial lesions, of which the locations and the pathological types had already been proven. The age distribution of the intracranial lesions depended largely upon their biological properties. Nevertheless, it had been proven that the seizure manifestation differed by ages of the patients even in the identical lesions. The younger patients were apt to lapse into seizures which became more frequent than in the older patients. The types of seizures seemed to be converted from the generalized to the partial, as the patients go through a transition from childhood to adulthood. Recognition of such a seizure manifestation is especially important in order to detect as soon as possible epileptogenic lesions as a surgically treatable cause of chronic epilepsy.     

A 10-year study of snowboard injuries in Lapland Sweden

Snowboard injuries in a Swedish ski area were evaluated from 1989 to 1999. All injured skiers (alpine, telemark, snowboarders) who sought medical attention at the local Medical Center within 48 h of the accident, were asked to answer an injury form. Physicians assessed and treated the injured skiers. There were a total of 1775 injured skiers; 568 injured snowboarders mean age 19 years. The female/male ratio was 34/66%, the injury rate 3/1000 skier days, three times higher than that of alpine skiers. The skill level of the injured snowboard riders improved during the period. The fall/run ratio of the beginners was higher (1.0) and their risk behavior lower (3.9 on visual analogue scale 1-10) in comparison to the advanced riders (0.4 and 6.6, respectively). Injuries were in 54% located to the upper extremity, 35% were wrist/lower arm injuries. Beginners had significantly higher frequency of lower arm/wrist injuries (46%), than average (32%) and advanced riders (20%). The most frequent single diagnosis was wrist/lower arm fracture (20%). Advanced riders tend to have more head/neck injuries than beginners, 17% vs. 13% (NS). Thus, with elevated skill level the injury pattern changed. For injury prevention, wrist guards and helmets are recommended for snowboard riders.     

Motion distorts perceived depth

Two important tasks that the visual system has to perform are determining the direction of motion and the spatial location of objects. It has recently been shown that the perceived location of an object moving in the frontal-plane is displaced along the direction of motion (e.g. Nature 397 (1999) 610; Vision Research 31 (1991) 1619). The aim of the present study is to examine the extent of this interaction between motion and perceived location. The observers' task was to indicate which of two vertically separated moving stimuli was closer. The two stimuli were presented at various relative disparity offsets. The stimuli consisted of moving dot patterns (optic-flow) that simulated either fronto-parallel motion (all the dots moved one direction) or motion in depth. Motion of the dots towards the centre of the stimulus simulated object motion away from the observer and motion of the dots away from the centre of the stimulus simulated object motion towards the observer. Results indicate that motion-in-depth information can bias perceived stereoscopic-based depth. Simulated motion towards the observer made the object appear closer to the observer than the depth signalled by the disparity information and simulated motion away from the observer made it seem further away. The results of this study, when combined with those of previous studies, show that motion can distort our entire three dimensional representation of space.     

Spatiotemporal activation of the two visual pathways in form discrimination and spatial location: a brain mapping study

To address the question of the relationship between the two visual pathways, a ventral stream for object and form vision and a dorsal stream for spatial and motion vision, we measured the spatiotemporal activation patterns in the two pathways responding to an integrated visuospatial task to which form discrimination and spatial location were assigned simultaneously. The two cognitive components of form discrimination and spatial location were interwoven in the task; however, the fMRI data demonstrated that such a task still activated both ventral GTi/GF (the inferior temporal gyrus/the fusiform gyrus) and dorsal Ga/PCu (the angular gyrus/Precuneus), which are supposed to mediate form discrimination and spatial location, respectively. In addition, the source waveforms of the fMRI foci based on the source analysis of the fMRI-seeded dipole modeling and the moving dipole modeling indicated that in responding to the task combining simultaneously form perception and spatial location, the activity in Ga/PCu begins earlier than that in GTi/GF, but it peaks later and lasts longer.     

对本科生医学文献检索课教学定位的探讨

从授课时间、授课学时、授课内容、授课深度和所使用的教材等方面对医学生文献检索课教学的定位问题进行了探讨。     

Tumour location is a prognostic factor for survival in colonic cancer patients

Objective To evaluate survival and prognostic factors in a consecutive series of colon cancer patients from a defined city population in Norway. Method All patients with adenocarcinoma of the colon diagnosed between 1993 and 2000 were registered prospectively. Five‐year actuarial survival and 5‐year relative survival rates were calculated. Cox regression analyses were used to study the effect of prognostic factors on survival. Results In the study period 627 patients were admitted. Overall 5‐year relative survival was 50% in females and 52% in males. Five‐year relative survival in 410 (65%) patients operated with curative intent, was 74% for females and 79% for males. Tumour location in the transverse colon, splenic flexure and descending colon (OR = 1.8), emergency operation (OR = 1.7), TNM stage (OR = 1.8–2.9), blood transfusion of more than two units (OR = 1.8) and age (OR = 4.0–7.1) were independent negative prognostic factors. Conclusion Colon cancer located in the transverse and descending colon is associated with poor prognosis. Comparison of results from different centres is difficult due to selection and classification differences, and different methods used for calculation of survival.