急性脑梗死88例临床分析

[背景 ]比较分析 88例不同年龄组急性脑梗死患者的病因、症状、体征及头部CT所见 .[病例报告 ]将 88例急性脑梗死患者分为老年组和非老年组 ,对发病因素、症状、体征和头部CT特点进行对比分析 ,发病因素中有高血压者占 6 4 % ,心脏病者占 2 3% ,糖尿病者占 2 5 % ,有短暂性脑缺血发作病史者占 30 % ,高脂血症者占 4 5 % ,吸烟者占 5 2 % ,有家族史者占 33% .非老年组中初发者多见 ,有头痛、头晕及偏身感觉障碍等症状者比老年组多见 ,而偏瘫、四肢瘫、构音障碍及意识障碍者则老年组多见 .头部CT示单梗塞灶者在非老年组多见 ,多梗塞灶、脑白质脱髓鞘及脑萎缩者在老年组多见 .[讨论 ]脑梗死病人因年龄不同 ,其发病因素、临床表现及头部CT所见有所不同     

PULMONARY BLOOD DISTRIBUTION AFTER TOTAL CAVOPULMONARY CONNECTION OF DIFFERENT TYPES

Objective. To assess the feature of pulmonary blood flow distribution after total cavopulmonary connection (TCPC) of different types, and to provide the selection of the best type .Methods. Thirty-two consecutive survival patients after TCPC underwent radionuclide lung perfusion imaging. According to the radionuclide counts in the left and right lungs, analyses of the distribution of blood flow from superior venous cava (SVC) and inferior venous cava (IVC) and the whole pulmonary blood flow in both lungs were made. All patients were divided into 4 groups by the the anastomosis between IVC and pulmonary artery.Results. Group Ⅰ: The flow ratio of the IVC to left lung was greater than that to the right lung , P≤0. 01; the flow ratio of the SVC to right lung was greater than that to the left lung, P≤0. 01; and the whole pulmonary blood flow went dominantly to the left lung, P≤0. 05, which is not in line with physiological distribution. Group Ⅱ: the flows from the SVC and IVC were mixed in the middle of     

荧光分光光度法检测半乳糖化白蛋白磁性阿霉素纳米粒在大鼠体内分布的研究

目的观察由半乳糖化白蛋白磁性纳米粒运载的阿霉素经舌静脉给药后在大鼠体内的的分布状况.方法全部大鼠随机分为四组,经舌静脉,按分组分别注射相应药物,剂量均为阿霉素2.5 mg/kg体重.取全血、心、肺、肝、脾、肾.全血制成血浆,器官组织制成匀浆,盐酸乙醇法提取阿霉素,用荧光光度计测量.结果静脉注射同等剂量、不同剂型的阿霉素药物后,阿霉素在器官中的蓄积程度从高到低:肝:D靶肝＞D非靶肝、C＞B＞A;心脏、肾、血浆:A＞B＞D、C;脾:B＞A、C、D;肺:B＞A＞C、D.磁性阿霉素白蛋白纳米粒注入体内后,在心、肺、肝、脾、肾中的药物浓度在15～30min达峰值,而半乳糖化后,阿霉素的药物峰值提前到5 min或之前.外加磁场和未加磁场的半乳糖化白蛋白磁性阿霉素纳米粒组的药物靶向指数和药物选择指数是均高于磁性白蛋白纳米粒.结论磁性阿霉素白蛋白纳米粒经半乳糖化后,可显著增强阿霉素对肝脏的靶向性,并显著降低心、肺、脾、肾、血浆肝外器官的组织阿霉素浓度.利用外加磁场,可提高阿霉素在肝脏特定部位蓄积的能力.因此,静脉注射半乳糖化白蛋白磁性阿霉素纳米粒是可行的.     

宜昌市20年结肠镜检查大肠癌患病率回顾性分析

目的探讨该市大肠癌流行病学和临床特点。方法以所有结肠镜受检对象为研究群体,对大肠癌患病率、大肠癌患者性别、年龄、肿瘤部位进行统计分析;比较大肠癌临床症状与大肠癌患者年龄、肿瘤发生部位的关系。结果自1980年以来,大肠癌年度患病率呈非线性缓慢上升,男性大肠癌患病率7.1%;女性大肠癌患病率5.5%;在3个年限段(80年代、90年代和21世纪5年)大肠癌中位患病年龄分别为男53.5、56.7和59.0岁;女51.9、53.7和55.2岁。986例大肠癌中直肠癌691例,乙状结肠癌82例,降结肠癌18例,脾曲癌4例,横结肠癌37例,肝曲癌30例,升结肠、回盲部癌79例,大肠多发性癌45例。临床症状以便血为主,其次为腹痛、腹部包块和肠梗阻发生率较低,半数以上患者有不同程度贫血。结论该市大肠癌患病率和中位发病年龄呈缓慢上升,低于国内大肠癌高发区。大肠癌肿瘤发生部位有近移和多发趋势。便血是直肠癌主要症状,中老年患者便血发生率高于青年患者,但腹痛发生率低于青年患者。     

Pressure distribution and perceived comfort in casual footwear

The aim of this investigation was to establish the relationship between short-term perceived comfort and pressure distribution on the dorsal and plantar surfaces of the foot, while walking in a range of commercially available casual footwear. The study was carried out in the biomechanics laboratory of Manchester Metropolitan University using 15 male subjects without foot pathology. Perceived upper and plantar comfort were measured using a specially designed questionnaire, while dorsal and plantar pressure distributions were measured using a rectangular sensor pad recording at 30 Hz and a Mikro-EMED insole recording at 100 Hz respectively. Analysis of variance tests were used to determine differences in perceived comfort and pressure distribution between three pairs of shoes. The findings of this study suggest that an increase in total plantar force and force-time integral may relate to a decrease in perceived plantar comfort. For the three shoes examined in this study, overall peak plantar pressure, the pressure-time integral, and total plantar area did not appear to be linked to perceived plantar comfort. Findings for the shoe upper indicate that decreased dorsal forces and pressures may be related to decreased upper comfort. These findings suggest that the measurement of pressure distribution at the foot-shoe interface could be a useful tool in identifying the causes of discomfort in footwear.     

Sociodemographic Differences in the Prevalence of Self-Reported Headache in Icelandic School-Children

SYNOPSIS
The study considers the prevalence of headache experiences in a random national sample of 2140 Icelandic 11-12 and 15-16 year-old school-children. The study finds an overall 21.9% prevalence of "at least weekly" headache. The prevalence is significantly higher among younger children end among girls. The gender difference is found to be related to the fact that older boys have a markedly lower prevalence than younger boys. No gender difference is observed in the younger group. Social class interacts with gender, with the gender difference leveling out in the upper class. The frequency of headache experiences correlates with last months use of medication to relieve headache. The high overall prevalence of headache found in this study agrees with earlier findings, and is a matter of concern since little is being done to counter this problem of discomfort among school-children.     

~(125)Ⅰ眼镜蛇毒及抗眼镜蛇毒血清在小白鼠体内分布的比较观察

用氯胺-T法125I标记眼镜蛇毒示踪液及抗眼镜蛇毒血清。小白鼠分二组，用125I-眼镜蛇毒、125I-抗眼镜蛇毒血清分别给小白鼠尾静脉注射，于注射后的不同时间测定血、颈部肌肉、肝、肺、肾、心等脏器放射性分布。结果发现：125I-眼镜蛇毒在肌肉及肝、肺等器官中于注射后2小时过高峰，在肾脏中浓度高，在脑未见放射性分布，抗眼镜蛇毒血清与眼镜蛇毒分布相似但在肌肉及肺脏有更高的分布。证明抗眼镜蛇毒血清能跟踪分布眼镜蛇毒。     

Reflection on the geographic distribution of multiple sclerosis in France

The geographic distribution of multiple sclerosis within the 95 Départements and the 21 Régions of France was defined from a 1986 nationwide prevalence series derived from questionnaires. This indicated a significant clustering of high frequency regions in the northeastern part of the country with most significantly low areas in the south and west. Distributions were similar to those for MS death rates by Département and Région for 1968–1977, indicating geographic stability over time; but there was also evidence of diffusion over time. The 1986 prevalence distribution was also compared with all published prevalence rates for communities of France. From all these resources we conclude that all of France falls within the "high frequency zone" for MS, that the nationwide prevalence rate is at least 50 per 100000 population, and that there is evidence of geographic clustering of the disease with temporal spread of the cluster.     

Mature-age entrants to medical school: a controlled study of sociodemographic characteristics, career choice and job satisfaction

A comparison of 121 mature-age and 270 normal-age entrants who graduated from the University of Queensland Medical School between 1972 and 1987 shows that mature-age entrants are some 7 years older, are more likely to come from public (state) schools and less likely to have parents in professional/technical occupations. Otherwise, the two groups were similar in terms of gender, marital status, number of children, ethnic background and current practice location. The educational background of mature-age entrants prior to admission includes 44.6% with degrees in health-science areas and 31.4% with degrees in non-health areas. Reasons for delayed entry of mature-age entrants include late consideration of medicine as a career (34.7%), financial problems (31.4%), dissatisfaction with previous career (30.6%), poor academic results (19.8%), or a combination of the above factors. Motivations to study medicine include family influences (more so in normal-age entrants), altruistic reasons (more so in mature-age entrants) and a variety of personal/social factors such as intellectual satisfaction, prestige and financial security (similar for both groups) and parental expectations (more so in normal-age entrants). Mature-age entrants experienced greater stress throughout the medical course, especially with regard to financial difficulties, loneliness/isolation from the students and family problems (a greater proportion were married with children). While whole-course grades were similar in both groups, normal-age entrants tended to win more undergraduate honours/prizes and postgraduate diplomas/degrees, including specialist qualifications. Practice settings were similar in terms of group private practice, hospital/clinic practice or medical administration, but there was a greater proportion of mature-age entrants in solo private practice, and a smaller proportion in teaching/research. If given the time over, some two-thirds of both groups would choose medicine as a career. Reasons for job satisfaction include helping patients, intellectual stimulation and financial rewards. Reasons for dissatisfaction include pressure of work, red-tape/paperwork, 'doctor-bashing', long working hours, emotional strain, financial pressure, unfulfilled career expectations and irritation with trivial medical complaints.     

Disposition of 14C-dapoxetine in rats: Complementary experiments with whole-body autoradiographic and tissue dissection techniques

Tissue distribution studies, utilizing whole-body autoradiography and organ dissection techniques, were conducted in male Fischer 344 rats following the oral administration of ¹⁴C-dapoxetine HCl, a potent serotonin reuptake inhibitor. The preliminary study using whole-body autoradiography proved invaluable in locating radioactivity in an organ not usually harvested in a tissue distribution study, namely the preputial gland. Selected organs, based on whole-body autoradiography findings, were dissected from rats and analyzed for radiocarbon content by liquid scintillation counting and for parent drug and N-dealkylated metabolites by extraction and HPLC analysis. Highest concentrations of radiocarbon were observed in the organs of absorption and elimination (ileum, cecum, stomach, duodenum, liver, colon, and kidney) but notable quantities were observed in the lung and preputial and Harderian glands. Most tissues had returned to background radioactive levels 72 h after dosing but persistent concentrations of radiocarbon were present in the preputial gland and liver one week after the single dose of ¹⁴C-dapoxetine. Analysis by HPLC demonstrated the presence of parent drug and N-desmethyl metabolite (nor-dapoxetine) in those organs examined; however, the majority of the radioactivity remained unidentified.