低位上颌窦患者多后牙缺失倾斜种植体修复的初步研究

目的:探索低位上颌窦患者多后牙连续缺失,倾斜种植体修复的效果。方法:上颌前磨牙和磨牙或单纯磨牙3～5个单位连续缺失4例共5侧,在上颌窦前后方呈倒"八字"倾斜植入种植体11枚,固定桥修复。结果 :随访期最短18个月,最长66个月,平均29个月,种植体周围软组织健康,无明显骨吸收。结论:多牙倾斜种植,可作为低位上颌窦患者骨量不足问题的解决方法之一。     

Defective interleukin-2 induction of lymphokine-activated killer (LAK) activity in peripheral blood T lymphocytes of patients with monoclonal gammopathies.

The recombinant interleukin-2 (rIL-2) generation of lymphokine-activated killer (LAK) cells was investigated in peripheral blood T lymphocytes (PBT) of 16 patients with monoclonal gammopathy of undetermined significance (MGUS) and 32 patients with multiple myeloma (MM). LAK activity was significantly decreased in MM, but not in MGUS patients, and was partially recovered in MM in the remission phase. This finding was unexpected, because CD8+ CD11b+ cells, which contain LAK precursors, are significantly increased in MM. LAK activity was investigated in purified CD8+ CD11b+ lymphocytes to discriminate between an intrinsic defect or a defective regulation by other T cell subsets. These cells were intrinsically unable to generate LAK activity fully following rIL-2 stimulation. MM showed the more pronounced LAK deficiency, while MGUS patients showed intermediate values. Phenotyping revealed significantly increased proportions of Leu7+ and HLA-DR+ cells in MM patients. These data reveal another dysregulation of T cell effector functions in patients with monoclonal gammopathies and offer further evidence of the impairment of their cell-mediated immunity.     

Transient hypoglycemia with hyperinsulinemia in a newborn infant with Rubinstein–Taybi syndrome

A newborn boy with Rubinstein–Taybi syndrome who had profound neonatal hypoglycemia is presented. The infant was a discordant fraternal twin with intrauterine growth retardation. The hypoglycemia was due to transient hyperinsulinemia, a condition often seen in small-for-gestational-age infants. Neonatal hypoglycemia may be common in infants with Rubinstein–Taybi syndrome, especially if they also have intrauterine growth retardation.     

控制性减压术对重度颅脑损伤后脑梗死的防治效果

目的探讨控制性减压术对重度颅脑损伤后脑梗死的防治效果。方法研究对象选取2012-05—2016-03我院诊治的86例重度颅脑损伤患者,以入院先后编号,采用随机简单抽样的方式纳入观察组和对照组,每组43例。观察组给予控制性减压术治疗,对照组给予大骨瓣减压术治疗,术后随访6个月,观察2组术后脑梗死发生率、颅内压、Barthel指数、GOS评分。结果观察组颅内压、脑梗死发生率明显低于对照组,差异有统计学意义(t=5.442,χ2=4.745,P0.05);Barthel指数、GOS评分均显著高于对照组(t=4.882、4.961,P0.05)。结论相比传统标准大骨瓣减压术,控制性减压术治疗重度颅脑损伤效果更佳确切,在减少术后颅内压和脑梗死的同时,利于患者脑功能恢复,提高患者生活自理能力。     

选择性多靶点毁损治疗难治性精神病：154例报告

目的探讨脑立体定向下选择性多靶点毁损术对难治性精神病的临床治疗效果。方法对154例难治性精神病应用现代脑立体定向技术对颅内的多个靶点进行选择组合射频毁损治疗。术后随访6～24个月。应用临床疗效总评量表（CGI）、简明精神病症状分级评定量表（BPRS）、社会功能量表（SDSS）、阳性症状量表（SAPS）、魏克斯勒儿童智力量表（WISC）和临床记忆量表（CMS）对治疗效果进行评价。结果154例经CGI评定总有效率为90％（优22例，显著进步68例，进步50例，无变化14例）。手术前后BPRS分别为68．86±14．40和32．40±8．66；SAPS为26．54±2．28和9．96±2．54；SDSS为15．82±1．20和8．62±1．60，均有明显差异（P〈0．01或P〈0．05）；CMS、WISC检测术前与术后无显著差异。本组术后均无严重并发症和后遗症。结论脑立体定向技术微创、安全，是难治性精神病的有效治疗方法；根据不同的症状设计不同的靶点组合，对提高疗效、降低并发症有较大意义。     

Preserved network functional connectivity underlies cognitive reserve in multiple sclerosis

Cognitive reserve is one's mental resilience or resistance to the effects of structural brain damage. Reserve effects are well established in people with multiple sclerosis (PwMS) and Alzheimer's disease, but the neural basis of this phenomenon is unclear. We aimed to investigate whether preservation of functional connectivity explains cognitive reserve. Seventy‐four PwMS and 29 HCs underwent neuropsychological assessment and 3 T MRI. Structural damage measures included gray matter (GM) atrophy and network white matter (WM) tract disruption between pairs of GM regions. Resting‐state functional connectivity was also assessed. PwMS exhibited significantly impaired cognitive processing speed (t = 2.14, p = .037) and visual/spatial memory (t = 2.72, p = .008), and had significantly greater variance in functional connectivity relative to HCs within relevant networks (p < .001, p < .001, p = .016). Higher premorbid verbal intelligence, a proxy for cognitive reserve, predicted relative preservation of functional connectivity despite accumulation of GM atrophy (standardized‐β = .301, p = .021). Furthermore, preservation of functional connectivity attenuated the impact of structural network WM tract disruption on cognition (β = ?.513, p = .001, for cognitive processing speed; β = ?.209, p = .066, for visual/spatial memory). The data suggests that preserved functional connectivity explains cognitive reserve in PwMS, helping to maintain cognitive capacity despite structural damage.     

重型颅脑损伤患者早期肠内营养支持治疗的临床分析

目的探讨早期肠内营养对重型颅脑损伤患者救治的效果。方法将我院2006年8月至2007年4月收治的58例入选病例随机分为治疗组和对照组，治疗组27例早期应用肠内营养乳剂治疗，对照组31例按传统方法鼻饲流质，其余治疗两组无差异。分析两组病人的营养指标、并发症及预后情况。结果治疗组27例病人中，除1例因发生较重的并发症而暂时中断肠内营养外，其余病例均顺利接受了早期肠内营养，其营养指标及预后均明显优于对照组（P〈0.05），且并发症明显减少。结论肠内营养方便、经济、并发症少，可以提供患者所需要的营养素，增强免疫，减少感染；绝大多数病人能顺利接受早期肠内营养支持治疗；早期胃肠内营养在重型颅脑损伤病人的治疗中非常重要，可明显降低致残率和死亡率，应高度重视。