转化生长因子-β和碱性成纤维细胞因子在儿童原发性局灶节段性肾小球硬化肾组织中的表达

目的：通过检测转化生长因子-β（TGF-β）和碱性成纤维细胞生长因子（bFGF）在儿童原发性局灶节段性肾小球硬化（FSGS）肾组织中的表达情况,并分析其与肾小管间质病理变化的关系,以了解TGF-β与bFGF在原发性FSGS发生发展中的作用。方法：选择肾活检明确诊断为原发性FSGS患儿的肾组织共43例,其中不伴有肾小管间质病变的FSGS肾组织共16例,设为实验1组;伴有肾小管间质病变的FSGS肾组织共27例,为实验2组。另将同期因孤立性血尿入院肾活检证实为非FSGS、病理改变较轻的肾组织作为对照组,共17例。采用免疫组化法检测细胞/生长因子TGF-β、bFGF在各组中的表达。通过方差分析（ANOVA）和相关分析法分析细胞/生长因子的表达与FSGS肾组织病理变化的关系以及细胞/生长因子之间的相互作用关系。结果：TGF-β、bFGF在各组肾组织中均有表达,表达量在对照组、实验1组和实验2组中依次升高,各组间的差异均具有统计学意义（P〈0.05）;且TGF-β和bFGF的表达与肾小管间质指数呈正相关,相关系数依次为0.763和0.661。此外,TGF-β和bFGF两者的表达量经相关分析也显示呈正相关,相关系数为0.587。结论：TGF-β和bFGF在原发性FSGS患儿肾组织中高表达;随着FSGS的发展,它们在肾组织中表达量不断增加,促使肾小管间质向纤维化发展,而且两者在促进肾脏纤维化具有一定的协同作用。     

弥漫性大B细胞淋巴瘤中CD40L的表达及意义

目的探讨弥漫性大B细胞淋巴瘤（DLBCL）组织中CD40L表达与DLBCL预后间的关系及意义。方法免疫组织化学法检测27例弥漫性大B细胞淋巴瘤、20例淋巴结反应性增生组织中CD40L的表达。结果（1）DLBCL中CD40L过度阳性率（25．93％）显著低于淋巴结反应性增生（63．64％），P〈0．05。（2）CD40L在Ⅲ、Ⅳ期DLBCL过度阳性率（14．29％）低于Ⅰ、Ⅱ期（38．46％），P〈0．05。CD40L过度阳性率在有结外浸润DLBCL（11．76％）低于无有结外浸润DLBCL（40％），P〈0．05。（3）DLBCL患者CD40L的过度阳性率与远处转移、临床分期均显著相关，P〈0．05。结论（1）CD40L过度阳性率与结外器官浸润及临床分期密切相关，其可能作为判断DLBCL侵袭性及预后的指标。（2）DLBCL中CD40L表达的减少可能是影响其发病的因素之一。     

The treatment of hypertension

1 A 'retrospective' of the development of the drug treatment of hypertension is presented from the early days of ganglion blockers to the present time together with a review of the evidence of benefit from treatment.
2 Current issues and debates are summarised including shortfalls in the control of hypertension in populations, difficulties surrounding the measurement of blood pressure, disagreement on the levels of blood pressure to treat, the goal blood pressures to aim at, issues surrounding lifestyle measures such as the low salt diet and low intensity exercise, and treatment with diuretics and with calcium antagonists.
3 A 'perspective' is presented on some avenues for progress in the years ahead. These will include the identification of genetic markers to determine the hypertensive individuals with the greatest risk of death and of cardiovascular complications.     

Three antidepressants (amitriptyline,dothiepin, fluoxetine), with and without alcohol,compared with placebo on tests of psychomotor ability related to car driving

Eight female volunteers received acute doses of amitriptyline 50 mg (AMI), dothiepin 50 mg (DOT), fluoxetine 40 mg (FLU) or placebo both with and without a ‘social’ dose of alcohol (ALC) equivalent to 0·5 g/kg body weight absolute alcohol. Performance on a variety of tests of psychomotor ability and cognitive function (critical flicker fusion, choice reaction time, tracking, Maddox Wing and simulated car steering) were performed at 1·5 and 4 hours following treatment. AMI and DOT both with and without ALC impaired performance on a range of tests at either or both 1·5 and 4 hours, although the effects of AMI and AMI + ALC were more widespread and severe than those found with either DOT or DOT + ALC. FLU and FLU + ALC showed no evidence of impairment on any test at either the 1·5 or the 4 hours assessments. The results suggest that there are differences between the experimental substances, at the doses used, in their intrinsic potential for impairing aspects of psychomotor performance and cognitive function.     

不同屈光状态的模糊敏感度比较

目的分析不同屈光组模糊阈值之间的差异,探讨模糊阈值在近视发生发展中的可能作用机制。方法38名志愿者参加本实验,正视组15位,等效球镜度为0.50～-0.50D;近视组23位,其中稳定性近视组17位,屈光不正平均为(-4.76±1.40)D,进展性近视组6位,屈光不正平均为(-3.33±1.43)D。受试者在屈光全矫基础上,采用JND标准测量模糊阈值。结果正视组模糊阈值为(0.21±0.06)D,稳定性近视组为(0.27±0.05)D,进展性近视组为(0.33±0.06)D。近视组的模糊阈值高于正视组(P=0.001),近视组中,进展性近视组的模糊阈值高于稳定性近视组(P=0.028)。结论近视对模糊的敏感度下降,其中进展性近视的敏感度下降更显著,这可能是近视调节滞后增加的部分原因。     

老年黄斑变性的视网膜色素上皮及其视功能的改变

目的：应用黄斑区密集点矩阵视野并结合眼底荧光血管造影电脑眼底图像分析老年黄斑变性视网膜色素上皮损害与ＤＭＭＭ的视野光敏感度的改变，找出改变的规律有评价其应用价值。方法：用Ｈｕｍｐｈｒｅｙ－６４０视野计自行设计ＤＭＭＭ检测ＡＭＤ干性组５１人６４只眼湿性且２３人２７只眼，用Ｚｅｉｓｓ公司生产的ＫＯＮＴＲＯＮＥＬＥＫＴＲＯＮＩＫ Ｉｎａｇｅ Ａｎａｌｙｓｉｓ Ｄｉｖｉｓｉｏｎ－计算机图像分析仪总丢失量显     

Implantation of Active Can Implantable Defibrillators in the right Pectoral Region

Routinely the active can ICD is placed in the left side pectoral position, which theoretically gives optimal conditions for a low defibrillation threshold. Some patients, bowever, demand a right pectoral position, which possibly could result in a bigger defibrillation threshold. A right pectoral position was used in 3 of 85 active can ICDs implanted in our institution from 1994. the DFT was 12 J in two and 18 f in one patient. Thus, right pectoral implantation is feasible and offers an alternative approach in selected patients.     

Frontal versus transcorneal stimulation to induce maximal electroshock seizures or kindling in mice and rats

Frontal stimulation, i.e. electrical stimulation where electrodes are pressed on the skin of the intact frontal skull of mice or rats, may represent a more humane alternative to the widely used transcorneal stimulation to induce electroshock seizures. The aim of this work was to directly compare transcorneal and frontal stimulation in eliciting maximal electroshock-induced seizures (MES) in mice and the anticonvulsant effect of carbamazepine (CBZ) and phenytoin (PHT) on thus produced seizures. In addition, we stimulated mice and rats repeatedly via transcorneal and frontal electrodes to see whether kindling is produced by this procedure. Two electroshock tests were used in mice, i.e. maximal electroshock seizure threshold (MEST) test and MES generated by supramaximal stimulation (50 mA). Frontal stimulation resulted in lower convulsive threshold than in the case of corneal stimulation. Both CBZ and PHT produced dose-dependent increases in seizure threshold for both sites of stimulation, i.e. transcorneal and frontal. As regards type of electrodes, higher doses of PHT were required to increase seizure threshold in the case of frontal than transcorneal stimulation. Supramaximal stimulation (50 mA) yielded comparable ED₅₀ values regardless of the site of stimulation. Furthermore, once-daily stimulation of mice, regardless of the placement of electrodes, did not induce any changes in convulsive threshold. We also attempted to kindle mice and rats via corneal and frontal electrodes by repetitive electrical stimulation using currents which initially did not produce generalized clonic seizures. Mice were stimulated once daily for 2 s with 3 mA (corneal electrodes) or 2 mA (frontal electrodes) and rats were stimulated twice daily for 4 s at 8 mA (corneal electrodes) or 5 mA (frontal electrodes). With corneal stimulation in rats there was a clear progression of kindling development which was not the same in nature when compared with corneally-stimulated mice. Frontal stimulation did not produce kindling. Moreover, corneal stimulation was better tolerated by rats, while in mice high mortality was seen after either method of current delivery. Our data indicate that frontal electrodes can be used as an alternative to transcorneal stimulation to produce MES by supramaximal or threshold current intensities as screening procedures in antiepileptic drug (AED) development. Nevertheless, this type of stimulation cannot be used to produce minimal electroshock seizures and seems not to be useful to produce kindling in rats and mice.