Delta hepatitis virus infection in China

To assess the prevalence, epidemiological features and prognostic implications of hepatitis D (Delta) in Sichuan Province, The People's Republic of China, 649 sera (515 from HBsAg positive patients and 134 from HBsAg negative subjects) were tested by radioimmunoassay (RIA) for antibody to the hepatitis D virus (anti-HD). Forty-seven sera (7.2%) showed some degree of reactivity. Serial dilutions of these sera indicated that prozoning was not responsible for the equivocal results. Thirty-four of the 47 sera were submitted under code to a second laboratory for independent analysis. According to those results anti-HD antibodies were detected in four of these sera. The overall prevalence of anti-HD in the HBsAg positive patients therefore was 0.8% (4/515). On the basis of clinical, biochemical and histological data 427 HBsAg positive sera were further divided into acute Type B hepatitis, chronic Type B hepatitis, healthy carrier state and hepatocellular carcinoma (HCC) subgroups. Two of 65 (3.1%) anti-HD positive sera belonged to the acute Type B hepatitis group; one of 104 (0.9%), the chronic Type B hepatitis group and one of 246 (0.4%), the healthy carrier group. No antibody was detected in sera from 12 HBsAg positive HCC patients. All HBsAg negative patients were negative for anti-HD antibody. The results of this study indicate that despite a high prevalence of hepatitis B virus infection, positive serology for delta virus is uncommon in Sichuan Province, The People's Republic of China.     

NEUROTROPIN IMMUNOSTIMULATING ACTION ON IMMUNOCOMPETENT CELLS

Neurotropin (NSP) is an extract isolated from the skin of rabbits inoculated with vaccinia virus. The present study examines the possible action of NSP on the number and function of immunocompe tent cells in mice. The experiment showed that NSP had no effect on both T and B lymphocytes of nor- malimmunized mouse spleen. The degree of plaque forming cell reaction and titre of specific antibody showed no significant differences when the NSP treated group and controls were compared. How- ever, NSP exhibited promotive effect on specific antigen binding cells in the early stage of immune responses. It was also noted that the rosette forming capacity of human T lymphocytes in vitro was restor- ed markedly by NSP. These results suggest that NSP possesses certain immunostimulating activity, particularly on the specific antigen binding cells and human T lymphocytes.     

1例脊髓空洞症侧脑室延髓池内分流术的护理

1 病例介绍病人,男,34岁,左下肢步态不稳10年,加重伴酸麻、隐痛1年,于2004年4月入院.入院时精神欠佳,生活不能完全自理,左上肢肱二腱、肱三腱反射和下肢膝反射亢进,右上肢肱二腱、肱三腱反射减弱,右前臂及手部触觉消失,左下肢膝关节以下触觉、位置觉、浅感觉消失.MRI示脊髓空洞症.术前检查未发现手术禁忌证,行全身麻醉下环枕畸形减压、侧脑室延髓池内分流术.手术顺利,术中输红细胞悬液400 mL,放置皮下引流管1根,术后恢复好,无并发症发生,病人生活上基本自理,出院随访1年,情况良好.……     

对我院护士继续教育学分未达标的原因分析及对策

应用继续医学教育管理系统对我院2004年度护士学分进行审核,从继续教育管理、参加人员的认识水平、工学矛盾对学习的影响等方面分析34名护士学分未达标的原因,制定并加强政策宣传,提高认识水平;完善规章制度,加大管理力度;对上网学习者提供指导,避免错误操作;拓宽学习渠道,缓解工学矛盾等管理措施,以提高护士继续教育学分达标率.     

Pathways from first health care seeking to diagnosis: obstacles to tuberculosis care in rural China.

OBJECTIVE: To examine health care seeking pathways for patients with tuberculosis (TB) and barriers related to these pathways in counties under the National TB Control Programme in rural China. METHODS: A cross-sectional study was conducted in two counties of east China in 2004-2005. A total of 557 TB patients were recruited and interviewed by physicians at the time of TB diagnosis. RESULTS: Of 557 participants, 13.3% had presented to a specialised county TB dispensary (CTD) directly after onset of symptoms, 31.4% had first sought care at a village health station and 51.2% had visited a township or county hospital first. The proportion of referral by a first health care provider to a CTD was highest in county level hospitals (73.5%) and lowest in village health stations (21.7%). The most prompt pathway from first health care seeking to TB diagnosis was to visit a CTD directly, with a median provider's delay of only one day. There was an increase in provider's delay when more health facilities were involved. CONCLUSION: To improve direct referral from general health care providers, especially village health care workers, to TB specialists would significantly shorten the delays in TB diagnosis in rural China.     

Neurochemical studies on the mesolimbic circuitry of antinociception

Previous studies using the technique of microinjection into brain nuclei indicated that the periaqueductal gray (PAG), nucleus accumbens, habenula and amygdala play an essential role in pain modulation and that these nuclei possibly act through a ‘mesolimbic neural loop‘ to exert an analgesic effect, in which Met-enkephalin (MEK) and β-endorphin (β-EP) have been implicated as the two major opioid peptides involved in antinociception. In the present study performed in rabbits, intracranial microinjection was supplemented with push-pull perfusion and radioimmunoassay to determine whether the release of enkephalins (ENK) and β-EP was increased in these nuclei when the putative neural circuit was activated by morphine administered into one of the nuclei. The results showed: (1) microinjection of morphine into the PAG increased the release of ENK and β-EP in the N. accumbens, and vice versa; (2) microinjection of morphine into the N. accumbens increased the release of ENK and β-EP in the amygdala, and vice versa; (3) morphine microinjected into the PAG caused an increase in the release of ENK and β-EP in the amygdala and vice versa, although the release of ENK in PAG was statistically not significant. These results indicate that PAG, N. accumbens and amygdala are connected in a network served by a positive feedback circuitry.     

Infantile spasms. A retrospective study of 105 cases.

This paper is a summary of our observations on 105 cases of infantile spasms. The age of onset was around six months after birth, but the patients came for treatment mainly about one year after onset. Fever of unknown cause, asphyxia, birth injury, infection of the central nervous system, tuberous sclerosis, phenylketonuria and recent immunization etc. were complained. Clinically, it is characterized by head nodding, mental retardation, myoclonic jerks and various neurologic deficits. EEG findings showed classical or modified arrythmia or other epileptiform patterns. About one third of 22 cases examined had abnormal brain stem auditory evoked potentials. Among 42 patients who underwent CT scanning before ACTH treatment, 18 were normal and 7 abnormal; during ACTH treatment 3 normal and 4 abnormal; after completion of treatment, 4 normal and 6 abnormal, suggesting no further atrophy of the brain. Examination of trace elements of the hair by particle-induced X-ray emission (PIXE) method in 23 patients revealed a significant difference in lead, calcium and zinc contents between patients and 101 controls, but no statistical difference in iron and copper contents between the two groups. Sodium valproate, prednisone and ACTH appear to be effective in the treatment of infantile spasms. Eight patients fully recovered, and they can go to school without difficulty. Many patients derived various degrees of improvement to the satisfaction of their parents. Two patients were still amented and often attacked by myoclonus. The effects, side effects of these drugs, and the possible pathogenesis were discussed.