Localized proton spectroscopy of inoperable brain gliomas. Response to radiation therapy

Within vivo 1H-MRS resonances of several metabolites were simultaneously measured in cerebral gliomas and adjacent normal brain. 15 patients with inoperable brain gliomas all histologically verified were monitored with 1H-MRS and MRI before and after radiotherapy. 11 patients were evaluable. 1H-MRS technique evolved from single volume measurements to one dimensional and two dimensional 1H spectroscopic imaging. In all patients N-acetyl-aspartate signals were decreased in tumour areas compared to the normal brain hemisphere. No recovery was seen after radiotherapy. Choline signals were increased in tumour margins of high grade gliomas and more diffusely in low grade gliomas. In 5 patients the choline resonance decreased after radiotherapy, accompanied by a shrinkage of tumour diameter on MRI. Lactate signals were present in high grade and unspecified astrocytomas and absent in most low grade gliomas. In 3 patients the lactate signal disappeared after radiotherapy. These observations indicate the feasibility of 1H-MRS in monitoring metabolic responses on radiotherapy of brain gliomas.     

推按运经仪为主治疗结石300例

采用推按运经仪加中药、耳穴贴压等综合治疗结石３００例，６０例肝胆结石中，治愈２８例，显效２０例，无效１２例，有效率８０％；２４０例泌尿系结石中，治愈１３６例，显效８８例，无效１６例，有效率９３．３％。     

急性心肌梗死再灌注期间的心电变化特征

目的　探讨急性心肌梗死 (AMI)再灌注期间的心电变化特征。方法　 46例经急诊冠状动脉造影明确为成功再灌注的AMI,其中 2 4例接受溶栓治疗和 2 2例接受直接经皮腔内冠状动脉成形 ,于发病的 6小时内以动态心电图技术持续2 4小时监测心电图变化 ,并与 1 5例无灌注者进行对比。结果　①再灌注发生后 ,相应导联ST段迅速下降 ,约 2小时达较低水平 ;同时 ,T波正向振幅进行性降低 ,距再灌注 0～ 2 2 (2 7± 4 5)小时呈现T波倒置并逐渐加深。②再灌注后的 1小时内 ,室性心律失常明显增加 ,6～ 8小时后显著减少。结论　AMI早期再灌注发生后呈现特征性心电变化 ,及时识别这些特征将有助于临床评估再灌注状态和危险度分层     

穴位综合疗法对先天愚型患者智商的影响

【目的】评价中医穴位疗法对先天愚型患者智商的影响。【方法】将80例先天愚型患者随机分为穴位综合疗法治疗组(简称综合治疗组)、脑复康对照组(简称脑复康组)、空白对照组,综合治疗组取四神针(百会穴前、后、左、右各旁开1.5寸)、智三针(神庭穴和左右本神穴)、颞三针(耳失直上2寸为第1针,左右旁开1寸为第2、3针)、脑三针(脑户穴及两侧脑空穴)为主穴,进行针刺和维生素B_(12)、维丁胶性钙、脑活素穴位注射,脑复康组口服脑复康,空白组不作任何特殊治疗;4个月为1个疗程,期间嘱家长在家对患儿进行相应的教育和训练;治疗前和疗程结束后采用 《中国修订韦氏儿童智力量表》测定患儿的智商(IQ),包括语言IQ(VIQ)、操作IQ(PIQ)和总IQ(FIQ)。【结果】4个月治疗后,综合治疗组总体智力水平均有提高(与空白组比较,均P<0.01),并较脑复康组为优;并且综合治疗组治疗后IQ的提高主要为PIO各项得分的提高所贡献,与操作有关的几个项目的得分与治疗前比,均有显著意义(P<0.05),而VIQ得分治疗后未见显著性提高(均P>0.05)。【结论】穴位综合疗法能提高先天愚型患者的智商。     

金珠滴眼液治疗慢性结膜炎的临床研究

目的　探讨金珠滴眼液治疗慢性结膜炎的疗效。方法　将慢性结膜炎患者 36例 6 8眼随机分为2组 ,每组 34眼 ,实验组用 7.8%金珠滴眼液点眼治疗 ,对照组用 0 .2 5 %氯霉素点眼治疗。结果　金珠滴眼液1、2、4周疗效的综合分值判定均与对照组有显著差异 (P <0 .0 5 ) ,且无局部刺激性。结论　金珠滴眼液对慢性结膜炎有明显的治疗作用 ,可望为临床常见多发的慢性结膜炎患者消除或缓解症状     

An unusual dermatofibrosarcoma protuberans: a case report

Dermatofibrosarcoma protuberans (DFSP) previously called Morbus Darier is an intermediate grade sarcoma with a fairly high rate of recurrence, it occurs most commonly on the trunk and extremities but may also occur in the head and neck region. Treatment of choice is wide excision. A 69-year-old female patient with a 57-year history of dermatofibrosarcoma protuberans is presented. The lesion appeared on the right forehead and both eyelids at the age of 12 years. The patient required 64 surgeries mostly for the head and neck lesions.     

Surgical management for mentosternal contractures by flap procedures

Mentosternal contractures still represent a surgical challenge due to their prominent position. They require early operative treatment for both function and aesthetic reasons. Careful clinical examination of scar position and traction forces, both at rest and when functioning, in addition to proper evaluation of the surrounding soft tissue are mandatory for precise preoperative planning of the required reconstruction. In general, the technically most feasible operation is favored if the functional and aesthetic results are good and postoperative risk for recurrence is low. Between 1987 and 1994, 21 patients with cervical, mentosternal, and mentothoracic contractures were operated upon. Eight patients were reconstructed with local flaps and 13 with microvascular free flaps.     

两种后牙根管预备方法的临床效果比较

目的 :评估 2种后牙根管预备方法的临床效果。方法 :采用机用镍钛扩大锉 (ProFile)和手用不锈钢扩大锉 (K file)扩大后牙根管 ,并对 2组病例术后疼痛以及充填情况加以比较。结果 :发现机用镍钛扩大锉扩大后牙根管 ,具有去除根管感染物质彻底 ,根管形态保持良好 ,速度快 ,术后疼痛率较低的优点 ,但易出现断针。而手用不锈钢扩大锉扩大后牙根管速度较慢 ,术后疼痛率略高 ,但不易出现断针 ,操作上容易掌握。结论 :2种后牙根管方法都有优缺点 ,可结合起来使用。     

镍作业工人细胞免疫功能、血清硒和过氧化脂质含量的变化

９６名镍作业工人测定结果：非特异酯酶阳性细胞百分率（ＡＮＡＥ＋％）为７６．８％±８．０％，Ｔ细胞亚群ＣＤ２、ＣＤ４、ＣＤ８阳性细胞百分率（ＣＤ＋２％、ＣＤ＋４％、ＣＤ＋８％）及ＣＤ＋４／ＣＤ＋８比值分别为６５．６％±１０．５％、５６．３％±１２．１％、３４．３％±８．２％和１．７６±０．６；酵母多糖刺激的外周血多形核白细胞化学发光（ＰＭＮ－ＣＬ）本底和峰值分别为４８±２３和３０７３±６８４ＣＰＳ／１０６ＰＭＮ；血清硒和丙二醛含量分别为１．２２±０．２３和４．７６±０．８８μｍｏｌ／Ｌ。与非镍作业的地区对照组比较，Ｔ细胞ＣＤ＋８％增高，ＣＤ＋４／ＣＤ＋８比值下降，化学发光的本底值降低，峰值增加，血清Ｓｅ含量下降，丙二醛含量升高。分析镍作业工人工龄与后三项指标变化的关系，工龄大于２０年与小于１０年有统计学上明显差别。这些观察指标为镍作业人员医学观察增加新的监护指标提供依据。