结核性脑膜炎脑脊液分析的临床意义

目的:分析结核性脑膜炎患者脑脊液特点及与临床的关系。方法:回顾性分析2004～2009年首次确诊入院但未经治疗的90例结核性脑膜炎患者的临床及实验室资料。结果:结核性脑膜炎患者脑脊液压力、蛋白定量、糖定量、氯定量、白细胞计数、腺苷脱氨酶活性均出现不同程度异常。脑脊液白细胞数升高、单核细胞数降低与病程无相关性(P>0.05)。脑脊液蛋白水平升高与意识障碍有相关性(P<0.05)。结论:深入分析脑脊液各项指标,对结核性脑膜炎患者的治疗和预后判断具有重要作用。     

脑脊液细胞中结核早期分泌性靶抗原6的检测及其早期诊断价值

目的探讨免疫荧光染色法检测脑脊液细胞中结核早期分泌性靶抗原6(ESAT-6)对结核性脑膜炎诊断的价值。方法收集36例确诊结核性脑膜炎患者的脑脊液为病例组,45例非结核性脑膜炎患者脑脊液为对照组。用双盲法对2组脑脊液细胞进行ESAT-6免疫荧光染色,统计分析灵敏度和特异度等。结果病例组ESAT-6存在于中性粒细胞、单核细胞及淋巴细胞中,对照组脑脊液细胞中无ESAT-6表达。灵敏度为88.89%、特异度为93.33%;阳性预测值为91.43%、阴性预测值为91.30%;阳性似然比为13.33、阴性似然比为0.12;Youden指数为82.22%,ROC曲线下面积为0.94。结论免疫荧光染色检测脑脊液细胞中ESAT-6的灵敏度及特异度均较高,是结核性脑膜炎诊断的有效方法。     

结核性脑膜炎患者脑脊液基质金属蛋白酶-9的检测意义

在脑膜炎的发展过程中,基质金属蛋白酶-9(MMP-9)对降解基底膜和损伤血脑屏障发挥重要作用,结核分枝杆菌能够刺激单核-巨噬细胞过度表达MMP-9.为检测结核性脑膜炎患者脑脊液MMP-9水平,评价其对结核性脑膜炎诊断及治疗的意义,应用ELISA方法检测12例结核性脑膜炎和9例病毒性脑膜炎患者脑脊液MMP-9水平,并选取5例非肿瘤非感染性头痛患者脑脊液作对照组.结果显示,结核性脑膜炎脑脊液MMP-9的水平显著增高,中枢神经系统并发症发生率与MMP-9的水平相关.结论为脑脊液MMP-9水平对结核性脑膜炎的诊断和预后有参考价值.     

脑脊液腺苷脱氨酶测定在小儿结核性脑膜炎诊断中的应用

目的:探讨脑脊液腺昔脱氨酶(ADA)活性测定在小儿结核性脑膜炎诊断中的应用价值。方法:选择结核性脑膜炎35例、病毒性脑膜炎36例、化脓性脑膜炎32例及非脑膜炎40例,测定并比较各组患者脑脊液ADA活性及阳性率。结果:结核组脑脊液ADA活性和阳性率明显高于非结核组,差异有显著性(P<0.05);结核性脑膜炎组治疗前后脑脊液ADA活性比较,差异有显著性(P<0.05)。结论:脑脊液腺苷脱氨酶可作为诊断结核性脑膜炎的重要参考指标。     

增强CT对小儿结核性脑膜炎的临床诊断价值探究

目的：探究增强CT对小儿结核性脑膜炎的临床诊断价值。方法选择2012年1月~2013年1月来我院诊治结核性脑膜炎患儿的120例为本次研究对象,对其进行头颅CT及增强CT检查、MRI检查和CSF检查。结果利用头颅CT及增强CT对小儿结核性脑膜炎进行检查,具有较高的有效率,且对患儿的病情及病理有了全面掌握,具有典型性和可比性(P<0.05);利用MRI检查有效率相对较差,不具备典型性,而运用CSF虽然能够全面掌握患儿病情,但在典型性上还有所欠缺。结论通过增强CT对小儿结核性脑膜炎的临床诊断,能够对患儿的并且进行有效掌握,应与原有的检查方式相配合,从而确保临床诊断的客观全面性,为患儿的治疗奠定基础。     

利奈唑胺联合莫西沙星治疗结核性脑膜炎的效果

目的 探讨利奈唑胺联合莫西沙星治疗结核性脑膜炎的效果。方法 选取2017年5月~2018年6月我院收治的结核性脑膜炎患者64例,采用随机数字表法分为对照组和观察组,每组32例。对照组给予莫西沙星治疗,观察组在对照组基础上加用利奈唑胺,比较两组治疗前后腺苷脱氨酶水平、蛋白质、葡萄糖、白细胞计数及脑脊液压力,临床疗效及不良反应总发生率。结果治疗后,观察组蛋白质、葡萄糖、白细胞计数、脑脊液压力、腺苷脱氨酶水平优于对照组（P＜0.05）。观察组总有效率为93.75%,高于对照组81.25%（P＜0.05）。观察组不良反应总发生率为21.88%,高于对照组的18.75%（P＞0.05）。结论 利奈唑胺联合莫西沙星治疗结核性脑膜炎疗效显著,可有效改善脑脊液生化指标,降低脑脊液压力及腺苷脱氨酶水平,且不增加不良反应发生几率。     

改良聚合酶链反应快速诊断结核性脑膜炎

目的：建立改良的聚合酶链反应的实验方法，快速诊断结核性脑膜炎。方法：应用二步控温洽酶链反应技术检测脑脊液结核杆菌微量ＤＮＡ。结果：经是 铲的４０例结核性脑膜炎聚合酶链反应扩增脑脊液ＤＮＡ全部阳性，２４例不明原因的中枢神经系统感染患者，１６例为阳性，而其它病原体引起的中枢神经系统感染和正常对照组均无扩增反应。结论：二步控温聚合酶链反应技术快速诊断结核性脑膜炎与传统的检验方法相比较，具有快速、敏感、高     

检测结核分枝杆菌蛋白抗原b夹心ELISA的建立及其应用

目的 建立定量检测脑脊液中结核分枝杆菌蛋白抗原b的夹心ELISA,以便用于诊断结核性脑膜炎.方法 制备抗结核分枝杆菌蛋白抗原b鼠源性单克隆抗体(mAb)及兔多克隆抗体;以单克隆抗体为包被抗体,多克隆抗体为检测抗体,建立检测结核分枝杆菌蛋白抗原b的双抗体夹心ELISA;应用此方法检测正常人(n=6)、非结核性脑膜炎患者(n=26)及临床确诊结核性脑膜炎患者(n=42)的脑脊液标本中蛋白抗原b的含量,并分析其与结核性脑膜炎活动性感染的相关性.结果 成功建立了检测蛋白抗原b的夹心ELISA,敏感度可达0.4 μg/L.应用该方法在正常人及非结核性脑膜炎患者脑脊液中未检测到蛋白抗原b;在结核性脑膜炎患者脑脊液中蛋白抗原b含量显著升高.结论 建立了敏感、特异检测结核分枝杆菌蛋白抗原b含量的ELISA,为活动性结核性脑膜炎的诊断提供一种有效手段.     

单克隆抗体酶联免疫吸附试验在结核性脑膜炎诊断中的初步应用

应用单克隆抗体酶联免疫吸附试验检测38例结核性脑膜炎，33例其它脑膜炎在112例非脑膜炎患者脑脊液中的结核杆菌抗原和抗体。结果脑脊液结核抗原阳性率为81．6％，假阳性率为2．8％；结核抗体阳性率为86．6%，假阳性率为3．4％．提示本法可作为结核性脑膜炎有效的辅助诊断方法。动态观察尚可为疗效判断提供依据。     

脑脊液置换配合鞘膜腔内注射给药治疗结核性脑膜炎的临床分析

目的 评价脑脊液置换配合鞘膜腔内注射给药治疗结核性脑膜炎的效果.方法 选择2007年～2009年在本院就诊的结核性脑膜炎患者70例,入院后随机分组:35例为观察组,在常规治疗基础上联用脑脊液置换配合鞘膜腔内注射给药治疗;35例为对照组,采用常规方法治疗.结果 观察组疗效明显优于常规对照组;两组均未出现脑疝、出血、感染等并发症,亦未出现黄疸、末梢神经炎等药物明显副作用.结论 脑脊液置换配合鞘膜腔内注射给药治疗结核性脑膜炎不但疗效佳,而且也比较安全,可以建议临床进一步推广.     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

The universal muscular chain reaction,muscle spasm,Torsions, ruptures and extravasations. Chameleons of pathology and some manifestations of simple muscular disorders

Most bodily functions require the coordinated actions of complementary and supplementary paired muscle groups. Where this essential muscular cooperation is lacking, hollow organs may burst and others become literally screwed up, giving rise to many similar spastic diseases such as Torticollis, Twisted ovarian cyst, Torsion of the Testis, Volvulus of the intestines, Varicose Veins, Megacolon, Aortamegaly, Scoliosis, Erb's Palsy, Peyronie's Disease, Main-en-Griffe, Undescended Foot (Pes Cavus), Talipes, Strabismus. Spasm is “panenepidemic” and unclassified examples of Torsion Dystonia and Dyskinesia really are as common as debt and taxes.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

Hypo- und Hypermagnesämie aus kardiologischer Sicht

Zusammenfassung Eine Reihe pathologischer Zustände bedingen Magnesiummangel. Zustände mit Hypermagnesämie sind ebenfalls bekannt, doch wesentlich seltener. Für den Kardiologen beachtenswert ist, daß unter Therapie mit bestimmten Diuretica bei Herzinsuffizienz, bei Herzinfarkt, Kardiomyopathie, Digitalisintoxikation und bestimmten Herzrhythmusstörungen Hypomagnesämie beobachtet wurde. Leider kann in der klinischen Routine nur ein extracelluläres Magnesiumdefizit durch Serumbestimmungen gemessen werden; über Magnesiummangel einzelner Organe kann nichts ausgesagt werden. Hinweise für Magnesiummangel geben aber neben der Messung des Serumspiegels Anamnese, klinischer Befund, bestimmte EKG-Veränderungen wie auch evtl. Hypokalämie, ein Zustand, bei dem sich oft — besonders bei Aldosteronismus — parallele Veränderungen zeigten.Tierexperimente deuten darauf hin, daß infarktähnliche Läsionen unter Magnesiummangel entstehen, doch ob Herzinfarkt beim Menschen durch Magnesiummangel ausgelöst werden kann, ist noch ungeklärt. In Leichenherzen zeigte sich im Infarktgebiet neben Calciumakkumulation signifikanter Magnesiumverlust, wobei unklar blieb, ob sich Ursache oder Folge des Infarktes widerspiegelten. Falls ein ursächlicher Zusammenhang besteht, ist er im Myokardstoffwechsel selbst zu suchen, wie bei der Alkoholkardiomyopathie, wo myokardialer Magnesiummangel zumindest als pathogenetischer Teilfaktor anerkannt wird. Andererseits versucht man aber auch Beziehungen zwischen Atherosklerose, Blutgerinnung und Hypomagnesämie herzustellen, in der Meinung, daß Magnesiummangel auch über den coronaren Pathomechanismus des Herzinfarktes wirken könnte. Sicher scheint, daß gewisse EKG-Veränderungen und Herzrhythmusstörungen durch einen irritierten Magnesiumhaushalt bedingt sein können, da sie bei Gabe bzw. Entzug von Magnesium verschwinden. Daß Magnesiummangel die Glykosidtoleranz verringert, wird tierexperimentell bestätigt. Unter Hypomagnesämie bewirkt Acetylstrophanthidin eher und länger Rhythmusstörungen als ohne, außerdem lassen diese sich durch Magnesiumgaben eliminieren. Da in gewissen Fällen spontane und digitalisinduzierte Herzrythmusstörungen durch Magnesiuminjektionen beseitigt wurden, scheint Magnesium als Therapeuticum angebracht. Einsatz verschiedener Magnesiumsalze bei Angina pectoris, degenerativen Herzerkrankungen und Herzinsuffizienz ohne geprüften und offensichtlich gestörten Magnesiumhaushalt ist fragwürdig, weil keine eindeutigen klinischen Erfolgsbeweise vorliegen. Immerhin mag es aber larvierte, durch Serumbestimmungen nicht erfaßbare Mangelzustände geben. Allgemein erscheint es aus kardiologischer Sicht ratsam, den Magnesiumhaushalt zu überwachen und in entsprechenden Fällen auszugleichen, um möglichen Myokardläsionen oder fatalen Herzrhythmusstörungen entgegenzuwirken.     

Environmental risk factors and their role in the management of atopic dermatitis

Introduction: The etiology of atopic dermatitis (AD) is multifactorial with interaction between genetics, immune and environmental factors.

Areas covered: We review the role of prenatal exposures, irritants and pruritogens, pathogens, climate factors, including temperature, humidity, ultraviolet radiation, outdoor and indoor air pollutants, tobacco smoke exposure, water hardness, urban vs. rural living, diet, breastfeeding, probiotics and prebiotics on AD.

Expert commentary: The increased global prevalence of AD cannot be attributed to genetics alone, suggesting that evolving environmental exposures may trigger and/or flare disease in predisposed individuals. There is a complex interplay between different environmental factors, including individual use of personal care products and exposure to climate, pollution, food and other exogenous factors. Understanding these complex risk factors is crucial to developing targeted interventions to prevent the disease in millions. Moreover, patients require counseling on optimal regimens for minimization of exposure to irritants and pruritogens and other harmful exposures.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

HLA genes in Amerindians from Mexico San Vicente Tancuayalab Teenek/Huastecos

Huastecos or Teenek Amerindians are presently living at North East Mexico (San Luis Potosi State). They have probably one of the most ancient culture of Mexico and Central America together with Mayas and Olmec groups with which also show close relationships. Proximity to Atlantic Ocean/Mexican Gulf originated that Spaniards had very early contact with them at about 1519 CE or before. In the present paper we have aimed to study HLA gene profile which may be useful for HLA and disease epidemiology and transplant programs in Teeneks. HLA-DRB1*04:07, -DRB1*14:06 and -DRB1*04:11 have been found in high frequency like in other Amerindian groups. High frequency typical Amerindians HLA extended haplotypes have been found, such as A*02-B*35-DRB1*04:07-DQB1*03:02; A*68-B*39-DRB1*04:07-DQB1*03:02 and A*02-B*39-DRB1*04:07-DQB1*03:02; also new haplotypes have been described, like A*02-B*52-DRB1*04:11-DQB1*03:02, A*68-B*35-DRB1*14:02-DQB1*03:01 and A*68-B*40-DRB1*16:02-DQB1*03:01. Genetic proximity is observed not only to linguistically close Mayans, but also to Mazatecans, Mixtecans and Zapotecans, who speak an altogether different languages; it shows once more that genes and languages do not correlate. This population was greatly diminished after European contact between 1500 and 1600 years CE; in fact, North and South America First Inhabitants population was brought from 80 down to 8 million people because of diseases (i.e.: measles, smallpox or influenza), slavery and war.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.