Less reduced gray matter volume in the subregions of superior temporal gyrus predicts better treatment efficacy in drug-naive,first-episode schizophrenia

Decreased gray matter volume (GMV) in the superior temporal gyrus (STG) has been implicated in the neurophysiology of schizophrenia. However, it remains unclear whether volumetric reduction in the subregions of the STG can predict treatment efficacy for schizophrenia. Our cohort included 44 drug-naive, first-episode patients, 42 unaffected siblings and 44 healthy controls. Voxel-based morphometry and pattern classification were utilized to analyze the acquired imaging data as per the anatomical subdivision by a well-defined brainnetome atlas. The patients presented lower GMV values in left TE1.0/1.2 (TE, anterior temporal visual association area) than the siblings, and lower GMV values in the left/right TE1.0/1.2 and left A22r (rostral area 22) than the controls. A positive correlation is observed between the GMV values in the right A38l (lateral area 38) and baseline Positive and Negative Syndrome Scale (PANSS) total scores in the patients. Support vector regression (SVR) results exhibited a significant association between predicted (based on the GMV values in the right A38l) and actual symptomatic improvement based on the reduction ratio of the PANSS total scores (r = 0.498, p = 0.001). Our results suggest that normal structure in the right A38l of the STG may be an important factor indicative of the effects of antipsychotic drugs, which can be potentially used to monitor drug effects for first-episode patients at an early stage in clinical practice.

     

胸廓内动脉前穿支岛状瓣修复面颈部创面

目的：针对面颈部烧伤常系及前胸无法运用局部皮瓣转移术,而另作选择修复创面。方法：依胸三角区解剖特点结合临床经验,采用胸廓内动脉第二、三前穿支岛状辩转移结合辞下滴注bFGF进行修复治疗21例。结果：18例全部成活,面颈部修复效果良好,2例部分坏死,1例全部坏死。结论：采用胸廓内动脉前穿支岛状辩修复面颈部创伤,减少了前胸部瘢痕对皮瓣选择的限制;bFGF促进血管新生,改善创面微循环,提高了皮瓣成活率。     

545例汉族成人ABO血型调查

血型与输血有着密切的关系.血型除了可提供输血和受血的依据之外,大量临床实践证明,不同血型的人,各种疾病的发生率也不一样.因此调查人群中血型分布对指导血库储存不同血型的血量、预防疾病有重要意义.本文通过调查545例汉族成人ABO血型情况,旨在分析汉族成人ABO血型分布情况.     

主辅钢板内固定治疗胫骨中下1/3骨折的初步临床研究

目的探究主辅钢板内固定技术能否为胫骨中下1/3骨折提供一个可选择的治疗方案。 方法回顾性收集山西医科大学第二医院骨科单一团队于2015年6月至2021年7月期间收治的胫骨中下1/3骨折患者40例,AO分型为42A（11例）、42B（5例）、42C（24例）。男性33例,女性7例;左侧21例,右侧19例;年龄18~67岁,平均年龄为（43.4±14.3）岁。所有患者经由同一团队以同一方法完成主辅钢板手术治疗,术后指导患者康复锻炼,出院后定期门诊复查,观察并记录骨折对位、对线和骨折愈合情况,记录患者并发症以及不良反应,评价踝关节功能情况,随访患者直至骨折完全愈合。 结果35例患者得到随访,失随访患者5例,失访率12.5%。随访时间为4~33月。骨折愈合时间为12~20周,中位数为16（14,18）周。踝-后足AOFAS评分显示该方法治疗胫骨中下1/3骨折优良率为97.1%。其中1例患者外踝部皮肤出现轻度感染破溃,经过换药和抗炎治疗后伤口愈合。1例Gustilo I型的患者胫前皮肤出现破溃,螺钉尾帽外露,经过换药缝合后伤口愈合。1例患者出现胫骨轻度外翻畸形（外翻角度约为8°）,末次随访时,步态正常,X线片显示骨折愈合,患者可无痛行走。 结论在胫骨中下1/3骨折的治疗中,主辅钢板技术提供了坚实的内固定,有效防止了骨折断端术后移位,患者能更早的进行康复锻炼,减少了踝关节僵硬等并发症;降低了骨折延迟愈合、不愈合的发生率;取得了良好的临床效果。     

用钢丝张力带治疗肱骨髁间骨折

根据肘关节关节内骨折的特殊生物力学原理,设计出钢丝张力带内固定方法并对２１例肱骨髁间骨折用此方法治疗,有效地解决了肘关节在内固定条件下早期功能恢复及骨折愈合的问题,具有操作简单,固定牢固等优点。     

精氨酸对胰腺癌介入治疗患者血清sTNFR-1和T淋巴细胞rDNA转录活性的影响

目的：探讨精氨酸增强的胃肠外营养对胰腺癌患者介入治疗术后血清可溶性肿瘤坏死因子受体-1（sTNFR-1）和T淋巴细胞rDNA转录活性水平的影响及其临床意义。方法：分别用双抗体夹心酶联免疫法（ELISA）和核仁形成区相关蛋白银染技术测定50例中晚期胰腺癌患者行动脉栓塞化疗术治疗前后血清sTNFR-1和外周血T淋巴细胞rDNA转录活性的改变，并与健康对照组比较分析。结果：胰腺癌组介入治疗前sTNFR-1增高，外周血T淋巴细胞rDNA转录活性降低，与对照组比较有显著性差异（p〈0．01）；行化疗栓塞术后，患者血清sTNFR-1降低，外周血T淋巴细胞rDNA转录活性增高，治疗前后有显著性的差异（p〈0．05）；应用精氨酸治疗组较未用组血清sTNFR-1下降和外周血T淋巴细胞rDNA转录活性升高更显著（p〈0．05）。结论：检测胰腺癌患者血清sTNFR-1和外周血T淋巴细胞rDNA转录活性的水平．有助于了解病人的免疫状况，介入治疗能改善机体免疫功能．辅以合理的免疫营养素能增强这种作用。     

Region‐specific insular volumetric decreases in drug‐naive,first‐episode schizophrenia and their unaffected siblings

Decreased insular volume may be one of the anatomical alterations caused by schizophrenia. The possibility of region‐specific insular volumetric reduction as an endophenotype and/or a possible treatment predictor is a critical issue with great implications for the diagnosis and prognosis of the disease. The sample of the current study comprised 44 drug‐naive and first‐episode patients, 42 unaffected siblings, and 44 healthy controls. A computational anatomy toolbox (CAT12) was applied to analyze the structural images with a fine‐grained, cross‐validated brainnetome atlas. Correlation analysis and support vector regression (SVR) were used to determine the relationship between insular deficits and symptomatic severity among patients. The gray matter volume (GMV) values in the left hypergranular insula (G) exhibited the following pattern: patients < siblings < controls. GMV values in the right ventral agranular insula (vIa) and baseline Positive and Negative Syndrome Scale negative symptoms subscale scores among patients showed a positive correlation (r = 0.384, p = .010). Further SVR analysis exhibited a significantly positive correlation between GMV values in the right vIa and negative symptomatic improvement among patients (r = 0.537, p < .001). Results suggested the presence of region‐specific insular volumetric decreases in first‐episode schizophrenia. Thus, volumetric decrease in left G might be a potential endophenotype for schizophrenia, and GMV values in right vIa might be used to predict negative symptomatic improvement in schizophrenia.     

重度低肺功能肺癌的外科治疗

目的探讨重度低肺功能肺癌患者围手术期安全性及疗效。方法35例肺癌患者术前肺功能检查最大通气量占预计值（MVV％）均低于50％,手术治疗并随访5年。结果术后并发症总发生率54．3％,无一例手术死亡。术后1、2、3、5年生存率分别为71．4％、42．86％、37．14％、17．14％。结论低肺功能肺癌患者手术风险大、术后并发症发生率高,但有选择开展这类患者手术治疗、加强围手术期处理,能安全度过围手术期,改善生存质量,亦可获得良好的近、远期治疗效果。     

T型钢板治疗Pilon骨折

目的：介绍用“T”型钢板治疗Pilon骨折的手术方法及临床效果。方法：1996年至1999年应用该术式对17例Pilon骨折进行了手术。结果：16例获得随访，平均随访时间1年8个月。骨折临床愈合时间为10-14个月。优良率为96%。结论：该钢板在骨折面处覆盖面积大，内固定牢固，患可早期进行功能锻炼。促进了血液循环和骨折愈合。     

胫腓骨中下段骨折切开复位单侧外固定器治疗的体会

报告1994至1996年5月应用切开复位+Batiani型单边式外固定支架治疗胫腓骨中下段骨折34例,平均随诊1年6个月。无骨不愈合及固定失败,该支架对软组织创伤小,且固定可靠,能防止骨感染发生并有利于早期功能锻炼。