正常人眼球直肌Pulley功能位置的动态磁共振成像研究

目的研究正常人眼球运动动态磁共振成像（MRI）4条直肌Pulley（滑车）的功能性位置。方法采用西门子公司Sonata1.5T超导型MRI扫描仪,应用眼球运动动态MRI技术,获取20名正常人（20个眼眶）眼球原在位及上转、下转、内转、外转20度时垂直于眶轴的眼眶冠状位MRI图像。以眼球中心为原点建立三维坐标系,应用ScionImage医学图像测量软件分别测量各层面眼球垂直转动时水平直肌、眼球水平转动时垂直直肌的横截面质心。根据各层面直肌横截面质心的坐标值建立直线回归方程,分别求得眼球垂直转动时内、外直肌径路及眼球水平转动时上、下直肌径路直线回归曲线斜率变化最大的一点,即为该直肌Pulley的功能性位置。对4条直肌Pulley相对于眼球中心的坐标值（X、Y）进行统计。结果内直肌Pulley位于眼球中心后4mm,内14.7mm,下0.3mm;外直肌Pulley位于眼球中心后8mm,外9.8mm,下0.3mm;上直肌Pulley位于眼球中心后6mm,内1.6mm,上11.5mm;下直肌Pulley位于眼球中心后6mm,内4.4mm,下12.7mm。结论应用眼球运动动态MRI技术,分析眼球转动时直肌径路的变化,可证实4条直肌Pulley的存在并确定其功能位置。     

High affinity neurotrophin receptors in the human pre-term newborn, infant, and adult cerebellum

The immunohistochemical occurrence of the high affinity neurotrophin (NT) receptors trkA, trkB, and trkC is shown in the pre-term newborn, infant, and adult human post-mortem cerebellum. Immunoreactive neuronal perikarya and processes were observed in all specimens examined, where they appeared unevenly distributed in the cerebellar cortical layers and deep nuclei, and showed regional differences among cerebellar lobules and folia. The trk receptor-antibodies, tested by Western blot on human cerebellum homogenates, revealed multiple immunoreactive bands for trkA and single bands for trkB and trkC. The results obtained show the tissue localization of the trk receptor-like immunoreactivity in the human cerebellum from prenatal to adult age. The analysis for codistribution of the receptors with the relevant ligand and among the receptors in discrete cortical and deep nuclei tissue fields shows a wide variety of conditions, from a good similarity in terms of type and density of labeled structures, to a lack of correspondence, and suggests the possibility of colocalization of trk receptors with the relevant neurotrophin and among them in the cerebellar cortex. These results sustain the concept that the neurotrophin trophic system participates in the development, differentiation, and maintenance of the human cerebellar connectivity and support the possibility of a multifactorial trophic support for the neurotrophins through target-derived and local mechanisms.     

压力调节容量控制通气对肺损伤犬血流动力学、呼吸力学和呼吸功能的影响

目的 探讨压力调节容量控制(PRVC)通气模式对健康及急性肺损伤(ALI)模型犬的血流动力学、呼吸力学和呼吸功能的影响。方法 PRVC和间歇正压通气(IPPV)两种通气模式在呼气末压为0、0．5、1．0和1．5kPa时，分别测定健康犬及油酸诱发ALI犬的血流动力学、呼吸力学及血气参数。结果 健康犬PRVC较IPPV模式下除了在PEEP为0．5kPa时，气道峰压(PIP)、肺动态顺应性(Cdyn)和肺血管阻力(PVR)的影响差异有显著性，对血流动力学、呼吸力学及呼吸功能的影响差异均无显著性。ALI犬PRVC较IPPV模式下各PEEP水平的PIP、平均气道压(mPaw)、Cdyn、动脉血氧分压[pa(O2)]和氧耗(VO2)的影响均有显著意义，但两种通气模式对血流动力学的影响差异无显著性。结论 与IPPV相比，PRVC通气模式能降低PIP，增加Cdyn和提高pa(O2)，两模式对血流动力学的影响差异无显著性，PRVC更适用于ALI／ARDS的治疗。     

氯喹对全肝缺血再灌注大鼠肺损伤的保护作用

目的 探讨氯喹对全肝缺血再灌注大鼠急性肺损伤（Au）的保护作用及其机制。方法 健康SD大鼠90只，雌雄不拘，体重300～350g，随机分为3组：假手术组（A组）、全肝缺血再灌注组（B组）、全肝缺血再灌注＋氯喹组（C组），每组30只。阻断肝门及肝上、肝下下腔静脉20min时开放血流，建立大鼠全肝缺血再灌注模型。C组于缺血前即刻经股静脉注射氯喹10mg／kg，A、B组给予等量生理盐水。于缺血20min、再灌注4h时每组分别处死10只大鼠，抽取门静脉血，测定血浆D-乳酸、内毒素（ETX）、肿瘤坏死因子-a（TNF-a）浓度，另外10只用于观察再灌注48h时大鼠生存率，并在电镜下观察肺组织超微结构的改变。结果 缺血再灌注可导致大鼠缺血期和再灌注期门静脉血D-乳酸、ETX、TNF-a浓度升高，大鼠生存率降低，肺组织超微结构严重受损，氯喹可减弱全肝缺血再灌注导致的上述改变。结论 氯喹对全肝缺血再灌注大鼠ALI有一定的保护作用，通过抑制磷脂酶A2激活，降低肠粘膜屏障通透性升高，降低肠黏膜内毒素移位。     

A Case of Fibrous Histiocytoma Associated with Xanthogranulomatous Alteration

We report here an unusual case of fibrous histiocytoma in which an area of xanthogranuloma was observed histologically. Our case suggests that adult xanthogranuloma is a variant of fibrous histiocytoma.     

成人结核性脑膜炎误诊原因分析

报告了成人结核性脑膜炎11例误诊,并收集国内报告的221例误诊病例,对结核性脑膜炎的误诊原因进行了综合分析。     

瑶族体型的Heath—Carter人体测量法研究

的　探讨瑶族成人体型的特点与规律。方法　应用Heath -Carter人体测量法 ,对广西田林县利周乡 2 18例(男 116 ,女 10 2 ) 2 0～ 45岁盘古瑶族成人体型进行活体测量。结果　瑶族平均体型男性为均衡的中胚层体型 ( 1.8-4 .9-2 .2 ) ,女性为偏内胚层的中胚层体型 ( 3 .1-4 .3 -1.9) ;瑶族男性 2 0～ 40岁间各年龄组 ,内因子值和中因子值变化不大 ,外因子值略有减少 ,内、中因子值的最小值及外因子值的最大值均在 40～ 45岁组 ;女性 2 0～ 45岁间各年龄组 ,随着年龄增加 ,外因子值明显增加 ,中、内因子值略有减少 ;瑶族男女间体型各年龄组比较差异均有显著性或高度显著性 ,P<0 .0 5或P <0 .0 1。结论　瑶族与其他群体体型比较 ,体脂少 ,骨骼肌肉较发达 ,身体线性度适中。     

Risk factors of type 2 diabetes among Korean adults: The 2001 Korean national health and nutrition examination survey

This study aimed to identify risk factors for type 2 diabetes (T2D) in Korea, a rapidly changing country. Data of 5,132 adults aged 20-85 were used from the 2001 Korean Health and Nutrition Examination Survey. Multiple logistic regression was carried out to identify risk factors for T2D. Three models were specified: (i) socioeconomic and demographic factors (model 1: age, gender, education, poverty income ratio, employment), (ii) behavioral risk factors and covariates (model 2: obesity, physical activity, smoking, alcohol drinking, dietary quality, family history of T2D, co-morbidity) and (iii) socioeconomic, demographic, and behavioral factors (model 3). The prevalence of T2D was 7.4%. Less education (OR 1.41, 95% CI 1.08-1.84), age (OR 2.19, 95% CI 1.56-3.08 in 40-59 yrs, OR 4.05, 95% CI 2.76-5.95 in 60 yrs + comparing to 20-39 yrs) and abdominal obesity (OR 2.24, 95% CI 1.79-2.82) were risk factors for T2D even after controlling for other factors simultaneously. There was a significant association of T2D with ever smoking (OR 1.34, 95% CI 1.06-1.67). The relationship of age with T2D was modified by gender in model 1 and the relationship of smoking with T2D was modified by obesity in model 2. Less educated, older, obese or ever smokers were more likely to have T2D. Gender mediated the relationship of age, and obesity mediated the relationship of smoking, with T2D. Intervention programs for T2D in Korea should take the interactions among risk factors into account.     

成人肾母细胞瘤的诊断与治疗(附9例报告及文献复习)

目的探讨成人肾母细胞瘤的诊断和治疗方法。方法回顾性分析9例成人肾母细胞瘤的临床表现、分期、治疗及预后。结果9例患者按照美国国家肾母细胞瘤研究组（National Wilms Tumor Study,NWTS）分期：Ⅰ期3例,Ⅱ期3例,Ⅲ期2例,Ⅳ期1例。9例均行肾切除术,其中术前分别辅以化疗1例、放疗1例、肾动脉介入栓塞化疗2例。9例术后辅以放疗和化疗。8例获得随访,随访1-6年,7例生存。结论成人肾母细胞瘤是一种比较少见的恶性肿瘤,早期诊断、手术治疗、辅以放疗和化疗等可明显提高治愈率并改善其预后。     

5-溴脱氧尿嘧啶核苷标记示踪脂肪成体干细胞体内成骨分化的研究

目的 观察经成骨诱导后的脂肪成体干细胞(ADASCs)在体内的成骨分化行为.方法 分离培养兔ADASCs,用5-溴脱氧尿嘧啶核苷(BrdU)标记,并通过免疫组织化学方法检查标记结果.将标记的ADASCs体外成骨诱导培养2周后与脱钙骨基质(DBM)复合,共培养7d后植入自体肌袋内.术后8周取材,固定、脱钙、包埋后切片染色,镜下观察.结果 大量ADASCs被标记,标记率达(82.3±8.6)%;体外标记后的ADASCs可以向成骨方向分化;切片苏木素-伊红(HE)染色示体内有新生骨形成,切片BrdU免疫组织化学染色示新生骨处有阳性细胞.结论 ADASCs经体外成骨诱导后植入体内能够继续维持成骨分化,并进一步形成新生骨.