不同深度糖尿病大鼠烫伤模型的制备

目的探讨恒温恒压电热烫伤仪制作糖尿病大鼠不同深度烫伤模型的可行性。方法链脲佐菌素诱导正常SD大鼠制作糖尿病大鼠模型，诱导成功1、2、3、4周检测皮肤晚期糖基化终产物、胶原含量，以正常SD大鼠作为对照，判断典型糖尿病性皮肤改变所需的时间。以恒温恒压烫伤仪制作烫伤模型，制模条件为0．5kg压力下，80℃，分别作用时间4．6、12s，48h后取材行苏木素-伊红（HE）染色检测烫伤深度。结果糖尿病大鼠诱导成功后4周，皮肤晚期糖基化终产物含量为（31．40±3．45）U／mg、胶原含量为（12．60±0．57）mg／g，与正常对照组比较差异有统计学意义（P〈0．05），并出现典型的糖尿病性皮肤改变。HE染色烫伤时间4、6、12s时深度依次为浅Ⅱ度、深Ⅱ度和Ⅲ度。结论恒温恒压电热烫伤仪制作糖尿病大鼠不同深度烫伤模型简单、方便，重复性高，为研究糖尿病创面愈合提供较为理想的模型。     

Neuroimaging in Pineal Tumors

BACKGROUND AND PURPOSE: The authors report radiological findings in 11 tumors in the pineal region, which were histologically diagnosed as germinomas, pineocytomas pineoblastomas, ependymomas, teratomas, and astrocytomas. METHODS: Computed tomography (CT) was performed in seven patients and magnetic resonance imaging (MRI) was performed in all patients. RESULTS: CT showed a solid or solid/cystic mass with variable contrast enhancement. MRI showed a heterogeneous mass, with hypointense signal on T1 and iso/hyperintense signal on T2-weighted images (WI) and gadolinium enhancement. Extension to adjacent structures occurred in five patients and spread through the cerebral spinal fluid (CSF) in two. CONCLUSIONS: Pineal region tumors have no pathognomonic imaging pattern. MRI and CT are complementary in diagnosis and are important to determine localization, extension, and meningeal spread.     

Buccal mucosal graft for urethral reconstruction.

Urethral reconstruction with graft substances, such as skin and bladder mucosa, has been previously used when primary anastomosis cannot be achieved. However, stricture and meatal prolapse are associated with these grafts. We report the use of buccal mucosa for the reconstruction of urethral defects in 3 patients. One patient with failed operation for hypospadias received tube buccal mucosal graft for urethral replacement. Two patients with urethral necrosis and stricture received onlay buccal mucosal graft. All patients were disease-free during follow-up (range, 12 to 49 months; mean, 36 months). One patient had a pinhole fistula that was successfully managed with simple repair. This technique appears to be useful for urethral reconstruction when a local graft is not available, even in patients with complicated conditions.     

赖型钩体flaB2与VR1012中的CpG基序分析

目的：对问号赖型钩端螺旋体（赖型钩体）DNA疫苗[包括内鞭毛蛋白基因（flaB2)和质粒DNA表达载体（VR1012）]的CpG基序（CpG motifs)进行分析，为DNA疫苗免疫机制的阐明和提高DNA疫苗的效能奠定基础。方法：以flaB2与VR1012构建重组DNA的免疫原，对flaB2及VR1012全核苷酸序列进行计算机分析（分类、计数和定位）。结果：CpG的“C”的侧翼为两个嘌呤，“G”的侧翼为两个嘧啶，在flaB2中共3个，分别为GACGCT，GACGTC和GACGCC；在VR1012中共11个，分别为GACGTC1个，GACGCT2个，GACGCC1个，GACGTT1个，GGCGTT2个，GGCGCT2个，GGCGCC1个，AACGCT1个，其中特别重要的TGACGTCA4个和TAACGCCA有1个，位于5'端456－463；509－516；592－599；778－785和486－493；4个TGACGTCA和1个TAACGCCA均位于5'端且相对集中。结论：赖型钩体flaB2与VR1012构成的DNA疫苗含有TGACGTCA等CpG，这些基序又称免疫刺激序列，构成了DNA疫苗中的佐剂。     

多问病人一个问题改进全科医疗中抑郁症的诊断

在全科医疗诊断抑郁症时，在原有2个问题的筛查问卷基础上再增加一个问题（病人是否要求立即帮助解决抑郁症状），可增加筛查的特异性。Arroll及其同事报告了一个横向交叉诊断可靠性研究结果。该研究包括了新西兰6个诊所中19个全科医生和1000名以上连续病人。采用两个筛查问题再加一个问题的方法，全科医生正确诊断抑郁症率达到79％，对没有抑郁症者的正确评估率为94％。     

Efficacy of minor analgesics in primary dysmenorrhoea: a systematic review

Objective To quantify the efficacy and safety of naproxen, ibuprofen, mefenamic acid, aspirin and acetaminophen (paracetamol) in the treatment of primary dysmenorrhoea through a systemic overview of randomised controlled trials.
Methods MEDLINE, EMBASE and the Science Citation Index were searched for randomised controlled trials. Efficacy was assessed by measurement of pain relief, requirement for rescue analgesics, restriction of daily life and absence from work or school. The rate ratios of side effects were used to assess safety.
Results Fifty-six trials describing 55 comparisons of analgesics with placebo and 12 direct comparisons with other analgesics met our inclusion criteria. Women taking naproxen were over three times more likely to have at least moderate pain relief than those taking placebo. Ibuprofen, mefenamic acid and aspirin were also superior to placebo but acetaminophen was not. The requirement for rescue analgesics, restriction of daily life and absence from work or school were less frequent with naproxen and ibuprofen than placebo but not with aspirin or acetaminophen. Direct comparisons did not show any difference between naproxen and ibuprofen. Side effects occurred more frequently only with naproxen when compared with placebo.
Conclusion Naproxen, ibuprofen, mefenamic acid and aspirin are all effective in primary dysmenorrhoea. Ibuprofen appears to have the most favourable risk-benefit ratio. Acetaminophen appears to be less effective than nonsteroidal anti-inflammatory drugs, but there was only one trial meeting our inclusion criteria and further studies are required.