Functional magnetic resonance studies of the reorganization of the human hand sensorimotor area after unilateral brain injury in the perinatal period.

Functional magnetic resonance imaging was used to map the hand sensorimotor area of hemiparetic adolescents and young adults who had suffered unilateral brain damage in the perinatal period. Unlike normal subjects, who exhibit cortical activation primarily contralateral to voluntary finger movements, the hemiparetic patients' intact hemispheres were equally activated by contralateral and ipsilateral finger movements. Our findings are consistent with previous clinical observations and animal experiments which suggest that the immature brain is able to reorganize in response to focal injury.     

反映手术间利用效率的统计指标与方法探讨

目的 探索反映手术室工作状态的指标和方法，为了解科室需求、合理利用手术室资源奠定基础。方法 提取医院局域网中有关手术安排、手术过程、麻醉等信息，通过常用统计指标、统计图表，反映手术室、手术科室、手术间的工作状态。结果 工作日手术问日均工作6．34小时，节假日日均工作0．6l小时。工作日13点后有近l／3的空台，14点后近l／2空台。个别手术间利用率偏低。结论 1．由在用手术间时点统计结果可见，14点后接台手术尚有一定潜力，节假日安排手术潜力更大；2．工作日间均工作时数已近满负荷，若要进一步提高手术间的利用，需加强麻醉科和手术室力量。     

大段同种异体骨移植在四肢恶性骨肿瘤保肢术中的应用

目的分析大段同种异体骨移植在治疗四肢恶性骨肿瘤切除后骨缺损中的疗效。方法 :对 130例四肢骨肿瘤 ,切除范围以Enneking分期为原则 :异体骨移植术式分 :1/ 4关节、1/ 2关节、部分骨干、全骨段、全骨段 人工假体、1/ 2关节 自体带血管骨瓣 ;内固定分 :钢板 螺丝钉、螺丝钉、普通髓内钉、带锁髓内钉 ;疗效按Mankin提出的评定标准 ,将结果分 :优、良、中、差四等 ,差为不满意。结果 :随访 6～ 15 6个月 ,本组治疗满意率为 6 3.8% ,主要并发症是感染、骨折、骨不愈合 ,其发生率 39.2 % ,保肢率 76 .3%。结论 :大段同种异体骨移植 ,在治疗四肢恶性骨肿瘤切除后骨缺损方面 ,不失为一种有效可行的方法。其并发症发生与肿瘤外科分期、是否化疗、移植骨大小、受骨区软组织条件好坏、内固定各类有关。     

Early antenatal sonographic diagnosis of conjoined syncephalus-craniothoraco-omphalopagus twins. Case report.

The paper describes the prenatal ultrasonographic diagnosis of conjoined syncephalus-craniothoraco-omphalopagus twins at 13 weeks' gestation. The mother, after genetic counseling, decided to interrupt the pregnancy. The fetal karyotype, the maternal serum and amniotic fluid alpha-fetoprotein levels were normal. The diagnosis was confirmed by pathologic examination of the fetus after termination of pregnancy.     

单道感应式人工耳蜗装置的研制

感应式人工耳蜗装置将声音信息转变并处理为适当的电信号之后,采用电磁感应的方式将此信号送至植入全聋患者内耳耳蜗靠近听神经纤维的作用电极上,刺激神经发放冲动,使全聋患者恢复音感。本装置经临床全聋患者使用,取得较满意效果。     

Insulin and acivicin improve host nutrition and prevent tumor growth during total parenteral nutrition.

The effect that a 14-day treatment program of total parenteral nutrition (TPN) combined with the glutamine antimetabolite, acivicin, and anabolic hormone, insulin, has on carcass weight and muscle sparing was investigated in tumor-bearing rats. Although TPN resulted in increased carcass weight gain as compared to chow-fed tumor-bearing rats, no savings in gastrocnemius muscle could be demonstrated. The combination of TPN with daily insulin treatment elicited significant increases in both carcass weight and muscle savings, with no alteration in tumor growth. Although combining acivicin with TPN halted tumor growth and increased carcass weight, the change in carcass weight was less than that observed with the insulin-TPN combination. No muscle savings were observed in the acivicin-TPN-treated rats. Yet when acivicin and insulin were combined with TPN, tumor growth was stopped, carcass weight was gained, and muscle mass was saved. Therefore, these experiments suggest that it is possible to add lean body tissue and stabilize tumor growth in rats that receive TPN through anabolic hormone treatment combined with an inhibitor of tumor metabolism.     

男性不育症患者中YRRM2基因缺陷的研究

YRRM基因是控制精子生成与成熟的一个重要因素，一旦该基因缺陷，将会造成无精或少精。本研究对340例无精与少精患者的外周血标本进行了PCR基因扩增筛查，结果发现7例为该基因缺陷，占2％。证明YRRM2的缺陷也是造成中国人群男性不育的一个原因，从而可作为指导医生采用适当治疗方法的一个可靠指标。在实验过程中，采用直接加热白细胞提取基因组DNA，并以此作为模板对YRRM2基因进行扩增，既节省时间和经费，又保持良好的扩增效果，使之可用于临床医院作为常规检查。     

脐血单个核细胞在半固体培养基中向神经元样细胞的分化

为观察脐血单个核细胞在甲基纤维素半固体培养基中的生长情况 ,常规方法分离脐血单个核细胞 ,接种于含 SCF、GM-CSF、G-CSF、IL-3、IL-6、EPO的甲基纤维素半固体培养基中培养。第 5 d发现有 6～ 10个细胞组成的小集簇 ,散在分布 ,细胞形态无变化。第 11d有神经元样细胞生长 ,与集簇并存。以后神经元样细胞逐渐生长 ,但集簇生长停滞 ,第 16d仍未发现集落形成。收集细胞 ,进行神经元特异烯醇化酶 (NSE)、神经丝蛋白 (NF)免疫细胞化学测定 ,显示少量神经元样细胞 NSE、NF阳性。该结果提示在半固体培养基中 ,脐血单个核细胞可向神经元样细胞分化 ,传统的用于集落培养的半固体培养基可能也适合脐血中其它细胞成分的生长     

缺血性卒中或短暂性脑缺血发作患者的卒中预防指南

这份新声明旨在为缺血性卒中或短暂性脑缺血发作存活者的缺血性卒中预防提供全面和及时的循证推荐，循证推荐包括对危险因素的控制，动脉粥样硬化性疾病的干预措施，心源性栓塞的抗栓治疗以及非心源性卒中抗血小板药的应用。另外，还为其他多种特殊情况下复发性卒中的预防提供了推荐、包括动脉夹层分离、卵圆孔未闭、高同型半胱氨酸血症、高凝状态、镰状细胞病、脑静脉窦血栓形成、女性卒中（特别是与妊娠和绝经后激素替代治疗相关卒中），脑出血后肮凝药的应用，以及该指南在高危人群中执行和应用的特殊措施。     

急性脑出血患者血清谷氨酸动态变化分析

目的通过观察脑出血（intracerebral hemorrhage，ICH）患者血清中谷氨酸的动态变化来进一步评价谷氨酸对脑出血的作用。方法选择符合条件的30例急性高血压脑实质出血患者，给予神经内科脑出血常规治疗，采用高效液相色谱法检测起病后2d内、5．6d、8-9d和15．16d的血清谷氨酸浓度，同步进行神经功能评定，同时于发病后1．3d、d5-6d及d15．16行头部CT检查了解血肿体积大小。结果脑出血患者血中谷氨酸浓度与血肿体积及神经功能缺损评分之间呈正的直线相关。经治疗后，所有病例谷氨酸水平迅速下降，在5-6d和8—9d下降速度更加明显。结论谷氨酸可能参与了自发性脑出血患者的急性期脑损伤作用。