脾大部切除加断流术治疗小儿门静脉高压症(附16例临床分析)

目的探讨脾大部切除加断流术治疗小儿门静脉高压症的临床疗效。方法对16例确诊为门静脉高压症的患儿行脾大部切除加断流术。随访患儿恢复情况。结果16例患儿手术顺利,恢复良好,无死亡病例。无再发消化道出血、脾功能亢进表现,无脾切除术后凶险感染出现。结论保留脾脏的脾大部切除加断流术是治疗小儿门静脉高压症一种较好的手术方法。     

山医群体中国地鼠近交E家系RAPD分析

目的　分析山医群体中国地鼠E家系的遗传纯度。方法　应用经过筛选的 3 1条随机引物对中国地鼠E家系 12只个体基因组DNA进行RAPD扩增 ,计算近交个体间的相似系数。结果　所有样品的相似系数0 943 1到 0 9978之间变动 ,平均相似系数为 0 9749,聚类分析得到了这些个体的同源树资料。结论　山医群体E家系有较高的遗传纯度     

THE EFFECTS OF ALCOHOL ON EYE MOVEMENTS DURING READING

In an experimental double-blind placebo study of 18 subjects(mean age 26.2 years), we investigated the effect of three bloodalcohol concentrations (0.0%, 0.05% and 0.1%) on five visuo-motorreading parameters: (1) number of eye fixations per 100 wordsread; (2) the number of words read per minute; (3) the numberof regressions per 100 words read; (4) the saccadic length;(5) the duration of eye fixations. The number of fixations andthe duration of eye fixations increased significantly as a functionof increased breath alcohol concentration. There were no significantchanges in the other visuo-motor reading parameters.     

A Group-Based Training Programme for General Practitioners: A Norwegian Experience

Westin S, stensen A I, Lvslett K, Prytz J, Telje J, TelstadW and Lie A. A group-based training programme for general practitioners:a Norwegian experience. Family Practice 1988; 5: 244–252. There are approximately 3000 general practitioners in Norway,serving a population of slightly above four million people.A three year postgraduate education scheme for general practitionershas been in effect since 1973, to be replaced by a five yearvocational training programme from January 1985, making generalpractice a fully recognized specialty from that date. The educationalrequirements consist of one year of hospital training, fouryears of training in general practice, and a total of 400 hoursof course education, mainly in clinical subjects. The core elementof the training is attendance at a group-based structured educationalprogramme of two years' duration. This article describes theconcepts and content of this decentralized group-based education,as well as some of the conflicting considerations which eventuallyled to this new Norwegian model of general practice training.The first evaluation studies indicate that the educational programmehas met a long standing need among general practitioners.     

EXT1基因1633-26(C→A)突变可能致多发性外生性骨疣

目的研究1例散发多发性外生性骨疣患者的基因突变情况，确定其致病基因。方法采用聚合酶链反应结合DNA直接测序法检测EXT1以及EXT2基因的突变热点区域；并应用错配引物PCR扩增引入酶切位点结合限制性片段长度多态性方法检测和鉴定突变。结果经测序证实在患者EXT1基因的第7内含子3’剪接位点上游26bp处发现一杂合突变，此杂合突变不存在于其表型正常的父母双亲中，是一个新生突变；错配引物扩增与限制性片段长度多态性分析结果表明在150名家系外正常对照者中没有此突变。结论EXT1基因1633-26（C→A）突变可能是导致这个患者发生多发性外生性骨疣的致病突变。     

Altered Natural Killer Cell Activity in Childhood Acute Non-lymphoid Leukaemia

Peripheral blood and bone marrow mononuclear cells from 25 children with acute non-lymphoid leukaemia were analysed for natural killer cell activity and for cells with the Leu-7 and Leu-11b (CD 16) markers. Significantly reduced spontaneous cytotoxicity was detected in peripheral blood from children with untreated and active acute non-lymphoid leukaemia compared with that of the controls (P = 0.01 and P less than 0.05). Patients in remission, however, had normal natural cytotoxicity and normal numbers of Leu-7 and Leu-11b (CD 16)-positive cells. The natural killer cell activity in bone marrow from patients with untreated acute non-lymphoid leukaemia was also significantly reduced (P = 0.025). On the other hand, patients in remission had both an increased percentage of Leu-7 and Leu-11b (CD 16)-positive cells (P less than 0.05) and an increased natural killer cell activity (P less than 0.0005) in their bone marrow cells in comparison with the control group. This augmented natural killer cell activity is most probably a result of anti-leukaemic treatment. Stimulation with recombinant alpha interferon and recombinant interleukin 2 caused an increase in natural killer cell activity that was both significant and normal in both peripheral blood and bone marrow from children with acute non-lymphoid leukaemia.     

儿童青少年肌肉质量与心血管疾病危险因素的关系

目的 探讨儿童青少年肌肉质量与心血管疾病危险因素的关系,为心血管疾病的早期预防提供理论依据。方法 采用现况研究设计,以整群抽样的方法于2017—2020年抽取宁夏银川市12~17岁儿童青少年共1 622名为研究对象。对所有参与测试者进行问卷调查、体格测量、实验室检查、体成分检查。结果 总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)与肌肉质量指数(SMMI)呈负相关(r＝-0.105,-0.094,P<0.001);甘油三酯(TG)与全身肌肉质量(SMM)呈负相关(r＝-0.067,P<0.01)。高SMMI者患高血压、高TC、高TG分别是低SMMI者的0.60(95%CI: 0.37~0.97)、0.54(95%CI: 0.33~0.89)倍和0.53(95%CI: 0.32~0.87)倍(P<0.05);SMMI良好、充足患高脂血症的风险分别是SMMI严重不足的0.32(95%CI:0.15~0.70)、0.23(95%CI: 0.08~0.65)倍(P<0.05)。SMMI良好患血脂异常的风险是SMMI严重不足的0.44(95%CI:0.22~0.89)倍(P<0.05)。结论 儿童青少年肌肉质量与心血管疾病危险因素关系密切,低肌肉质量为高血压、高脂血症的危险因素。     

生长年限对滇重楼中甾体皂苷活性成分和生物量积累的影响

目的 探究云南重楼Paris polyphylla var.yunnanensis（滇重楼）根茎中甾体皂苷活性成分和生物量积累随生长年限的变化状况,以期为滇重楼的质量控制提供科学依据。方法 以7、8、9、11、12、13、14、15年生滇重楼为研究对象,采用HPLC法和直接称重法测定不同年限滇重楼根茎中8种甾体皂苷（重楼皂苷Ⅰ、Ⅱ、Ⅵ、Ⅶ、Ⅲ、H、V和纤细薯蓣皂苷）含量和生物量。结果 8种甾体皂苷活性成分线性关系良好（R²≥0.999 5）,精密度、重复性、稳定性和加样回收率的RSD值均小于3%,验证了该方法的可行性;随着年限的增长,滇重楼根茎生物量呈逐渐增长的趋势,其生长发育可分为增长缓慢期（第1～4年）、增长快速期（第5～10年）和增长平缓期（第11年后）3个阶段,其中7年生滇重楼根茎生物量增长最快,平均年增长量达（31.843±14.225）g;滇重楼根茎中8种甾体皂苷成分含量在不同生长年限的变化呈随机波动、无规律,《中国药典》2020版规定的3个指标成分重楼皂苷Ⅰ、Ⅱ、Ⅶ含量之和与8种甾体皂苷总和的变化趋势一致;用4个主成分对不同年限滇重楼药材进行综合评价,结果显示7年生样品在所有样品中的综合得分位于前7名。结论 建立了同时测定滇重楼中8种甾体皂苷活性成分含量的方法,可用于滇重楼的质量评价;滇重楼并非种植年限越长越好,建议以7年生滇重楼采收入药为最佳。     

车祸致颅脑损伤患者家属心理健康状况与社会支持相关性研究

目的 了解车祸致颅脑损伤患者家属的心理健康状况和社会支持状况,探讨其相关性。方法 采用自编一般资料调查表、症状自评量表（SCL - 90）和社会支持量表（SSRS）,对225名到精神专科医院就诊的车祸致颅脑损伤患者家属进行问卷调查。结果 车祸致颅脑损伤患家属的SCL - 90总分为（178.45±82.56）分, SCL - 90总分、阳性项目数和9个因子分均显著高于肿瘤患者家属和全国常模(P＜0.05)。社会支持总分为（38.52±8.23）分,社会支持水平与家属的心理健康状况呈显著的负相关（r = - 0.416, P＜0.05）。多元线性回归分析显示,社会支持总分可以负向预测家属的心理健康状况（β = - 0.399,P＜0.05）。结论 车祸致颅脑损伤患者家属的心理问题发生率较高,应从个人、家庭和社会层面为家属提供社会支持资源。     

Value of ambulatory electrocardiographic monitoring to identify increased risk of sudden death in patients with left ventricular dysfunction and heart failure

To examine the predictive value of ventricular arrhythmias onambulatory electrocardiographic (ECG) monitoring, 211 patientswith left ventricular dysfunction and congestive heart failure(76% men, age 63±4 years, left ventricular ejection fraction0.26 ± 0.10) were studied. During a follow-up of 21 ±11 months, there were 45 cardiac deaths: 22 were due to progressivepump failure and 23 were sudden. Patients with a low left ventricularejection fraction ( 0.27) and ventricular tachycardia on 24h ECG were at higher risk of dying suddenly and from progressivepump failure (both P<0.0001). Patients who died suddenlywere found to have significantly longer (P=0.003) and faster(P=0.029) ventricular tachycardias on their baseline ambulatoryECG, than survivors. This association was not observed in patientswho died of progressive pump failure. Therefore, low left ventricularejection fraction and ventricular tachycardia on 24 h ECG recordingpredict an increased risk of cardiac mortality. Our resultsalso suggest that longer and faster ventricular tachycardiarecorded by 24 h ECG may identify patients at risk of suddendeath, a finding which has not been described before.