解剖型钢板治疗肱骨远端粉碎性骨折

目的：探讨解剖Ｙ型钢板的临床应用价值。方法：报告３６例解剖Ｙ型钢板内固定肱骨远端粉碎性骨折,进行临床分析讨论,其中列,女８例,平均年龄３６．８岁。３６例中均行肘后标准切口尽骨鹰嘴截骨暴整个肱骨远端,Ｙ型钢板、螺钉内固定。结果：本组随访１～５年,其中优良率８６．２％。结论：解剖Ｙ型钢板治疗治疗肱骨远端粉碎骨折,效果确切,术后有利早期活动关节,减少并发症。     

80例正常人体表标测Q-T_d~p的观察

采用９１ 导联体表电位标测法（ Ｂ Ｓ Ｐ Ｍ） 观察８０ 例正常人 Ｑ Ｔｐｄ（ Ｑ 波起点到 Ｔ 波峰值间期的离散度） ,与同步１２ 导联心电图 Ｑ Ｔ 离散度（ Ｑ Ｔｄ） 对照,探讨 Ｂ Ｓ Ｐ Ｍ 条件下测定 Ｑ Ｔｄ 的可行性。结果：① Ｑ Ｔｐ 、 Ｑ Ｔｐｄ 、 Ｑ Ｔｐｃ１ｄ（ Ｂａｚｚｅｔｔ 公式校正） 、 Ｑ Ｔｐｃ２ｄ（ Ｆｒｉｄｅｒｃｉａ 公式校正） 分别为（２９２ ．６９ ±３７ ．７５） ｍｓ 、（３６ ．７７ ±７ ．４０） ｍｓ 、（４０ ．２３ ±９ ．０４） ｍｓ 和（４０ ．１１ ±７ ．７３） ｍｓ ;② Ｑ Ｔｐｄ 与 Ｑ Ｔｄ 、 Ｑ Ｔｐｃ１ｄ 与 Ｑ Ｔｃ１ｄ 、 Ｑ Ｔｐｃ２ｄ 与 Ｑ Ｔｃ２ｄ 有良好的相关性;③３ 个年龄组（１８ ～３５ 岁、３６ ～６０ 岁、６１ ～７０ 岁） 各参数间无显著性差异;④ Ｑ Ｔｐ 女性明显大于男性（ Ｐ＜ ０ ．０５） ,其余各值男女性之间均无显著性差异。提示： Ｂ Ｓ Ｐ Ｍ 测定 Ｑ Ｔｐｄ 简便可行、较为准确,正常值可暂定为５２ ｍｓ 。     

健康人心率变异性分析

心率变异性（ＨＲＶ）分析是一种无创性检测心脏自主神经张力的方法,对指导疾病的治疗及某些疾病的预后判断有重要价值,它受多种因素的影响。ＨＲＶ测定由于操作方法、仪器、指标不尽相同,缺乏可比性,目前国内尚缺乏统一的正常值,为此,中华心血管病杂志编委会ＨＲＶ专题对策组于１９９７ 年参考了欧美两会拟定的标准化方案［１］ 制定了全国ＨＲＶ分析研究协作组研究方案,并几经修改完善［２］ 。作为该协作成员之一,该研究进行了健康人的ＨＲＶ时域和频域指标的测定。初步探讨了性别、年龄、昼夜等因素对健康人ＨＲＶ的影响。     

具有一般截面形状的平面复合曲梁正应力分析

分析工程中对于由多种材料组合而成的一般截面形状平面曲梁在载荷作用下的强度问题.在截面形状不变的假设基础上,导出了其正应力的计算公式.作为特殊情况,该梁在对称弯曲时的相应公式也可以从上述公式得到,最后给出了计算实例.     

正常压力脑积水患者分流手术适应证的选择

探讨正常压力脑积水病人脑脊液分流手术适应证的选择。方法：选择经腰穿测压压力正常的脑积水患者,分析其临床特点和ＣＴ影像的特征性表现,及颅内压监测,手术结果。分流术效果：以痴呆发病者部分病人症状减轻或消失,。以步态障碍和尿失禁发病者症状基本得到控制。     

The role of a single free {beta}-human chorionic gonadotrophin measurement in the diagnosis of early pregnancy failure and the prognosis of fetal viability

This prospective controlled study investigated the concentrationsof free -human chorionic gonadotrophin (HCG) subunit in 554women with a singleton intrauterine or tubal pregnancy. Theypresented with vaginal bleeding and/or abdominal pain in thefirst 18 weeks of pregnancy. The control group comprised 156women with musculo-skeletal pain and no vaginal bleeding. Theirpregnancies continued to term. The study group comprised 398women (141 threatened-continuing pregnancies, 37 threatened-miscarriages,185 non-continuing pregnancies and 35 tubal pregnancies). Free-HCG concentrations were significantly lower in the non-continuing,threatened-miscarriage and tubal pregnancy groups [mean 4.62,6.50 and 4.27 ng/ml respectively; 95% confidence interval (CI)3.75–-5.69, 4.46–9.48 and 2.92–6.2 respectively]than in the control and threatened-continuing groups (mean 41.61and 48.22 ng/ml respectively; 95% CI 34.53–50.13 and 42.03–55.32respectively) (P < 0.001 in all cases). A cut-off value at20 ng/ml was found to differentiate between the ‘viable’(control and threatened-continuing) and the ‘abnormal’(non-continuing, threatened-miscarriage and tubal) pregnancies,with 88.3% sensitivity and 82.6% positive predictive value.An excellent diagnostic and prognostic usability of free HCGwas confirmed by a receiver operating characteristic curve plotIn conclusion, a single serum free -HCG measurement taken inearly pregnancy is valuable in the immediate diagnosis of earlypregnancy failure and the long-term prognosis of viability.     

What is a normal family? Common assumptions and current evidence

The social and applied human sciences have been built upon the assumption that the normal family consists of a first-marriage conjugal couple cohabiting with biological children. It is taken for granted that the wife should be responsible for child and domestic work, and that the husband should be the family's economic provider and ultimate authority. In the professional literature such traditional family structure is often described as normal in the sense of most common, as well as normal in the sense of well-functioning. Current psychological, sociological, anthropological and historical studies, however, do not support the assumption that the traditional nuclear family is the most natural, common, and/or healthy form of family arrangement. The idealization of the traditional nuclear family has had implications for theory, research, mental health practice, and social policy. Scientists and practitioners have been slow to recognize pathology in traditional nuclear families. Families other than traditional nuclear ones have been rendered invisible or pathologized. It is time for contemporary social and applied human sciences to recognize that the traditional nuclear family is a culturally- and historically-specific construct. It is also time for contemporary social and applied human sciences to develop an account of, and a research agenda about, families that take into consideration their variations across time, place, social class, ethnicity, and culture.     

Reference ranges of echocardiographic measurements in the Dutch population

Reference ranges for echocardiographic measurements were determinedin 609 healthy Dutch subjects, using height, weight, age, sex,RR-interval and blood pressure (in adults only) as determinants.Endsystolic as well as end-diastolic measurements of the aorticroot as well as left ventricular inner diameter, posterior andseptal thickness were taken, as was the left atrial end-systolicdiameter. Multiple linear regression was performed of the form: =A.(age)^B.(height)^C.(weight)^D.(RR-interval)^E.(sex)^F. The residuals were calculated in order to determine the percentilelimits by means of linear interpolation. Sex and weight weresignificant determinants in all the echocardiographic parametersstudied. The results were presented twofold, with a simple versionfor males and females separately, using only weight as a determinantand allowing graphical presentation, and secondly a complexversion taking into account all determinants, which can onlybe solved with help of a calculator.     

Acute myocardial infarction with normal coronary arteries. In vivo demonstration of coronary thrombosis during the acute episode

Two cases with acute myocardial infarction are presented. Both had thrombotic occlusion of the infarct-related artery. Following successful thrombolysis with streptokinase, coronary angiography was normal. These cases prove that "myocardial infarction with normal coronaries" can be associated with coronary thrombosis in the acute stage.     

Acanthosis nigricans is a reliable cutaneous marker of insulin resistance in obese Japanese children

BACKGROUND: Acanthosis nigricans (AN) is a skin condition characterized by darkening and thickening of skin with formation of irregular folds, usually limited to a few specific areas of the body. Recently, AN has been reported to be linked to hyperinsulinemia and obesity. The aim of the present study was to determine whether or not the presence of AN in obese Japanese children is a reliable cutaneous marker. METHODS: The authors analyzed the clinical characteristics of 439 obese Japanese children (260 boys, 179 girls; mean age 10.1 years; mean percentage overweight 51.9%), who had visited Tsuruoka City Shonai Hospital in 1990-2000. Eighty-two of the 439 children were examined using an oral glucose tolerance test (OGTT). Of these children, the authors retrospectively studied 16 subjects: eight with AN and eight without AN (age range: 10.8-13.9 years; percentage overweight range: 54.3-97.0%). They were age and percentage obesity-matched males with normal glucose tolerance during OGTT. Females with normal glucose tolerance during OGTT were excluded from the 16 subjects because the number was too small and children with impaired glucose tolerance or type 2 diabetes during OGTT were also excluded because of glucose toxicity. Eighty-two children including the 16 subjects were analyzed at their first visit for the presence or absence of AN on the posterior of the neck, and for characteristics including age, birthweight, body height, bodyweight, percentage overweight, blood pressure, liver function markers serum lipid concentrations, fasting plasma glucose concentrations and insulin concentrations shown by the results of OGTT. RESULTS: (1) Children with AN showed significantly more glucose intolerance including impaired glucose tolerance and type 2 diabetes compared with those children without AN, and fasting plasma insulin concentrations were most significantly correlated with the presence of AN. (2) Insulin resistance based on fasting plasma insulin concentrations was seen in significantly more children with AN than in children without AN, even in age and percentage obesity-matched subjects with normal glucose tolerance during OGTT. CONCLUSIONS: Acanthosis nigricans could be a reliable cutaneous marker of insulin resistance in obese Japanese children.