Accuracy and Precision of Acetabular Component Placement With Imageless Navigation in Obese Patients

Background

Obesity is a risk factor for acetabular component malposition when total hip arthroplasty is performed with manual techniques. The utility of imageless navigation in obese patients remains unknown. This study compared the accuracy and precision of imageless navigation for component orientation between obese and nonobese patients.

开放式护理实验室的管理与教学模式探讨

目的探索科学实用的开放式护理实验室的管理与教学模式。方法在开放式护理实验室中实施学生参与型的管理模式和基础技能训练、综合技能训练及设计技能训练3个层次的教学模式。结果实验室开放式学时数显著增加，学生学习成绩和优良率显著优于管理前（P〈0.01，P〈0.05）。学生认为开放式护理实验室的管理和教学模式有利于教学，能提高动手能力、分析问题和解决问题能力及增强协作精神。结论开放式护理实验室管理和教学模式提高了实验室利用率，有助于学生护理技能的提高。     

下尿路梗阻性肾积水患者逼尿肌功能变化

目的：探讨下尿路梗阻性肾积水患者逼尿肌功能变化。方法：对20例（3．5－73岁）下尿路梗阻导致的肾积水组和10例（13－67岁）无肾积水的对照组进行膀胱压力容积测定与压力－流率测定，并记录不同膀胱灌注量的逼尿肌基础压力。结果：下尿路梗阻性肾积水组逼尿肌－括约肌协同失调（DSD）11例（55％），逼尿肌功能过度活跃5例；而对照组仅发现1例（10％）DSD，未发现有逼尿肌功能过度活跃。下尿路梗阻性肾积水组平均膀胱顺应性显著低于对照组（P＜0．05），而下尿路梗阻性肾积水组平均逼尿肌基础压力，平均逼尿肌最大收缩压和残余尿量均显著高于对照组（P＜0．05），且下尿路梗阻性肾积水组在灌注量逐渐增加时高逼尿肌基础压力发生率逐渐增加。结论：下尿路梗阻性肾积水多伴有逼尿肌功能异常，提示膀胱逼尿肌功能改变与下尿路梗阻性肾积水的形成及发展有一定的相关性。     

老年脑出血的CT扫描与预后

本组老年脑出血发病率５７％，明显高于中、青年组脑出血。首要病因是高血压病，社会环境变迁是老年脑出血的重要因素。ＣＴ扫描特点为①型别：壳核出血最多（３５．４％）、其次为丘脑（２９％）、脑叶（２１．４％）、其它型别均低于５％；②血肿量：小量出血最多（６８．８％）。预后特点是存活率较高８７．２％、死亡率仅１２．８％。     

Paraneoplastic hypercalcemia associated with adenosquamous carcinoma of the endometrium

Paraneoplastic hypercalcemia associated with adenosquamous carcinoma of the endometrium is described. This is the first reported case of a gynecologic cancer in which the paraneoplastic syndrome has been conclusively shown by immunohistochemical analysis to be due to ectopic parathormone.     

CA 125 regression: a model for epithelial ovarian cancer response

The rate of decline of CA 125 in effectively treated epithelial ovarian cancer is described by the exponential regression curve CA 125 = EXP [i - s (days after surgery)]. In this equation i, the y-axis intercept, measures initial tumor burden whereas s, the slope of the regression curve, is determined by the extent of cytoreductive surgery and the subsequent response to chemotherapy. Departure from the regression curve uniformly results in progressive disease. In patients whose cancers had been completely removed, we calculated the mean half-life of CA 125 to be 10.4 days (range 4 to 21). In this case s = 0.0835 and characterizes the ideal regression rate. The model predicts that high-dose cisplatin chemotherapy (s = 0.0671) is more effective than low-dose cisplatin (s = 0.0380) (p less than 0.03) in eliminating residual cancer. Because s can be calculated within 2 to 3 months of treatment and then compared with s for the ideal regression curve and with the values of s reported for standard chemotherapy, evaluation of any new treatment protocol can be facilitated with this method.     

"重返社区技能训练"对精神分裂症康复的作用

目的 :探讨重返社区技能训练对缓解社区精神分裂症患者的精神症状和改善其社会功能方面的作用。方法 :将 5 0例非急性期的社区精神分裂症患者随机分为技能训练组 (以下简称训练组 ;2 5例 )和对照组 (2 5例 ,其中脱落 2例 )。对技能训练组进行技能训练共 4周 ,然后随访 12周。采用阳性症状与阴性症状量表 (PANSS)、MorningSide康复状态量表 (MRSS)对患者进行评估。结果 :训练组患者的PANSS评分(3 9 96± 7 44 )、阴性量表总分 (11 92± 5 13 )、一般精神病理量表总分 (2 0 60± 2 95 )优于对照组 (分别为45 77± 8 95、 15 13± 4 79、 2 3 5 0± 5 3 7,P <0 0 5 ) ;训练组患者的MRSS总分 (3 1 60± 17 3 7)、依赖量表总分 (7 2 8± 5 41)、活动能力缺乏量表总分 (9 0 8± 5 5 2 )均优于对照组 (分别为 44 68± 13 61、 11 77± 5 17、15 0 0± 4 48) ;训练组的复发率 (4 % )低于对照组 (17% ) ,但差异无显著性。结论 :在药物治疗的基础上 ,重返社区技能训练能改善精神分裂症患者的症状及其社会功能     

CFTR 5T variant has a low penetrance in females that is partially attributable to its haplotype.

PURPOSE: The study's purpose was to understand the molecular basis for different clinical phenotypes of the 5T variant, a tract of 5 thymidines in intron 8 of the cystic fibrosis transmembrane conductance regulator (CFTR) gene, which disrupts processing of CFTR mRNA and reduces synthesis from the corresponding CFTR alleles. METHOD: We analyzed the polymorphic TG dinucleotide repeat adjacent to the 5T variant in intron 8 and the codon 470 in exon 10. Patients selected for this study were positive for both the 5T variant and the major cystic fibrosis mutation, Delta F508. Almost all Delta F508 mutation alleles occur in a 10TG-9T-470M haplotype. Therefore, it is possible to determine the haplotype of the 5T variant in trans. RESULTS: Of the 74 samples analyzed, 41 (55%) were 11TG-5T-470M, 31 (42%) were 12TG-5T-470V, and 2 (3%) were 13TG-5T-470M. Of the 49 cases for which we had clinical information, 17.6% of females (6/34) and 66.7% of males (10/15) showed symptoms resembling atypical cystic fibrosis. The haplotype with the highest penetrance in females (42% or 5/12) and more than 80% (5/6) in males is 12TG-5T-470V. We also evaluated 12 males affected with congenital bilateral absence of vas deferens and positive for the 5T variant; 10 of 12 had the 12TG-5T-470V haplotype. CONCLUSION: Overall, the 5T variant has a milder clinical consequence than previously estimated in females. The clinical presentations of the 5T variant are associated with the 5T-12TG-470M haplotype.     

Acute inflammatory response to cowpox virus infection of the chorioallantoic membrane of the chick embryo.

The chick embryo chorioallantoic membrane was used to study the acute inflammatory response in the absence of contributions from the immune system. In preliminary experiments, lesions of wild-type cowpox virus strain Brighton (CPV-BR) and a 38K gene deletion mutant of CPV-BR (CPV-BR.D1) were compared with vaccinia virus (strains WR and Copenhagen), fowlpox virus, laryngotracheitis virus, and infectious tenosynovitis virus, and were ranked for degree of induced inflammation. The maximal and minimal inflammatory responses were observed with CPV-BR.D1 and CPV-BR viruses, respectively. CPV-BR.D1 lacks a 38K gene which encodes an anti-inflammatory 38-kDa protein that has homology to SERPINs. The kinetics and character of the inflammatory response were examined further in the wild-type CPV-BR and mutant CPV-BR.D1 infections using cell counts, electron microscopy, and assays for inflammatory cell activation. CPV-BR virus infection rapidly spread through the ectoderm, uniformly infecting all cells with the production of large amounts of virions and viral-induced cytopathic effect, but evoking little or no inflammatory response until 144 hr p.i. The CPV-BR.D1 infection, on the other hand, was rapidly contained by a dexamethasone-sensitive inflammatory response mainly of activated heterophils which was advanced by 36 hr p.i. Both infections resulted in disseminated disease with similar numbers of liver lesions and only a slight difference in the LD50, with the CPV-BR.D1 values being higher than that for CPV-BR virus. In this model, the acute inflammatory response alone is unable to prevent disseminated disease and associated mortality.