The geographical distribution of multiple sclerosis,rheumatoid arthritis,rheumatic heart disease and poststreptococcal nephritis in Sardinia: Climatic and socioeconomic factors

Summary The comparative geography of multiple sclerosis (MS) and non-neurological diseases considered to be autoimmune is of great interest. But there are few appropriate investigations. Some have found an increase in the frequency of MS, rheumatoid arthritis and rheumatic heart disease depending on the geographic latitude. Nevertheless, the significance of the latitude effect as an indicator of a possible etiological relationship between MS and these conditions has been questioned. In this paper, the frequency of MS, rheumatoid arthritis, rheumatic heart disease and poststreptococcal nephritis is reported from Sardinia where appreciable differences in climatic and socioeconomic conditions exist. There was a positive correlation of the distribution of MS with the distribution of rheumatic heart disease and poststreptococcal nephritis. On the other hand, no correlation was found with the distribution of rheumatoid arthritis.

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Zusammenfassung Die Ähnlichkeit zwischen Multipler Sklerose (MS) und nicht neurologischen autoimmunen Erkrankungen veranlassen zur Annahme, daß einige gemeinsame ätiologische Mechanismen im Spiele sein könnten. Das Problem der vergleichenden geographischen Verteilung von Multipler Sklerose und autoimmuner Krankheit ist wenig untersucht. Einige Forscher fanden eine ähnliche Zunahme der Häufigkeit der MS, rheumatoider Arthritis und rheumatischer Herzkrankheiten bei zunehmenden Breitengraden. Es besteht allerdings Zweifel, ob tatsächlich dieser latitude effect als ein wirklicher Indikator von ätiologischen Gemeinsamkeiten zwischen den genannten Krankheiten anzusehen ist. Wir berichten in der vorliegenden Arbeit über die Häufigkeit von MS, rheumatoider Arthritis und rheumatischen Herzkrankheiten sowie Nephritis nach Streptokokkeninfektionen in Sardinien, wo nennenswerte Unterschiede in Bezug auf klimatische und sozioökonomische Gegebenheiten bestehen. Die Verteilung der MS zeigte eine positive Korrelation mit der Verteilung rheumatischer Herzkrankheiten und von Nephritis nach Streptokokkeninfektion. Andererseits wurde keine Korrelation mit der Verteilung der Polyarthritis rheumatica festgestellt.

     

活血软坚方对家兔膜性肾病肾组织病理学及细胞因子的影响

目的：观察活血软坚方对家兔膜性肾病肾组织形态及血浆细胞因子的影响。方法：选择健康、雄性大耳白种家兔４０只，随机分为空白组、模型组、雷公藤组、活血软坚组４组。模型复制参考Border方法，从正式免疫第１d起，活血软坚组与雷公藤组分别予活血软坚汤剂及雷公藤、空白组与模型组灌服同体积生理盐水。结果：活血软坚方能减少家兔膜性肾病原位免疫复合物的形成，减轻基底膜的增厚，阻止新月体和肾小球毛细血管内微血栓的形成，能够抑制膜性肾病家兔血浆中肿瘤坏死因子（TNF-α）活性，减低血浆中白细胞介素（－１(IL-1)、白细胞介素－６（IL-6)、血小板活化因子（PAF)的含量。结论：活血软坚方能减轻家兔膜性肾炎肾小球 病理损害，从而达到延缓肾小球硬化发生发展的作用。     

通脉口服液治疗慢性肾炎气虚血瘀证32例疗效观察

目的：探讨纯中药制剂通脉口服液对慢性肾炎的治疗作用。方法：按要求选择62例患者，随机分为2组，治疗组32例给予通脉口服液（含黄芪、三七等），对照组30例给予金水宝口服液。疗程均为6月。观察用药前后2组患者临床症状以及肾功能、尿蛋白、免疫功能、血液流变学及血脂变化情况。结果：治疗组总有效率93．75％，对照组总有效率60．0％；2组疗效比较，差异有非常显著性意义（P＜0．01）。结论：通脉口服液可以明显地改善患者的临床症状，具有改善肾功能，减少尿蛋白含量、调整免疫功能、改善血液流变学、降低血脂等作用。     

雷公藤多甙对狼疮性肾炎患者血浆IL-13含量的影响

目的　探讨雷公藤多甙 (TW )对狼疮性肾炎 (LN)患者血浆白介素 - 13(IL - 13)含量的影响及治疗价值。方法　分别将激素诱导缓解治疗后的LN患者 ,按其活动指标分为活动期和非活动期 2组 ,活动期患者加用TW治疗 ,观察治疗 3个月后血浆IL - 13水平的变化和肾炎的缓解情况。结果　血浆IL - 13水平明显下降 ,尿蛋白减少 ,狼疮活动性免疫指标、血尿和肾功能改善。结论　TW可抑制血浆IL - 13的产生 ,对控制LN的活动有一定的治疗价值。     

狼疮性肾炎中医病机与治法探讨

结合临床对狼疮性肾炎的病机与治法进行探讨。认为本病的发生以肾虚为内在基础，热毒为重要诱因，湿热与瘀血贯穿于整个病程，是病情发展演变的关键因素，水湿、湿浊和溺毒则是病变进展之危象。在病变活动期以热毒、湿热为主，缓解期以脏腑虚损为主，而在疾病后期则是虚中挟瘀、挟湿浊。治疗上应以清热利湿解毒、护肾化瘀活血为大法，活动期强调解毒清利湿热，缓解期重视扶正，病后期则应护肾培元化瘀泄浊。     

牛角地黄冲剂对大鼠免疫性血小板减少模型血浆血栓素A2、前列环素I2的实验研究

观察牛角地黄冲剂对大鼠免疫性血小板减少模型血栓素A2(TXA2)、前列环素I2(PGI2)的影响.将100只SD大鼠随机分成正常对照组、模型对照组、强的松对照组、牛角地黄冲剂高剂量组、牛角地黄冲剂低剂量组.除正常组外,各组均以注射免抗大鼠血小板血清(APS)造模,分别灌药和蒸馏水,每日1次,连续11天,分别在第7天和第11天各测一半大鼠血浆血栓素B2(TXB2)、6-酮-前列腺素F1α(6-keto-PGF1α)值,并作骨髓涂片检查.结果显示强的松组6-keto-PGF1α水平明显高于正常组水平(P＜0.05)而牛角地黄冲剂高剂量组6-keto-PGF1α浓度明显高于模型组,且接近正常组水平.而各组TXB2水平改变均不显著.说明牛黄地黄冲剂有改善ITP出凝血功能低下的作用,且不改变机体生理平衡.     

静脉丙种球蛋白加地塞米松治疗小儿特发性血小板减少性紫癜临床观察及护理

目的探讨静脉丙种球蛋白(IVIG)加地塞米松治疗小儿特发性血小板减少性紫癜(ITP)的疗效及护理。方法对34例ITP患儿随机分为激素组和静脉丙种球蛋白加地塞米松组(简称丙球组)。结果丙球组出血症状改善迅速，血小板上升时间、峰值时间较激素组明显缩短，两组比较差异有显著意义。结论静脉丙种球蛋白加地塞米松治疗TIP疗效显著。     

Prevalence and treatment of chronic idiopathic thrombocytopenic purpura of childhood in Sweden

The frequency and treatment of children with chronic idiopathic thrombocytopenic purpura in Sweden were characterized using a national enquiry based on a questionnaire. Seventy-five children diagnosed as having chronic idiopathic thrombocytopenic purpura on 1 September 1993 were identified. The prevalence in children between 0.5 and 15.5 years of age was calculated to be 4.6/100 000. The median age at the time of diagnosis was 5 years and the male/female ratio was 1:1.2. Almost half of the patients (43%) were not treated at all during the disease. Steroids (43%) and intravenous immunoglobulin (25%) were most commonly used. Only two children were splenectomized.     

HELLP syndrome in a pregnant patient with a past history of splenectomy for idiopathic thrombocytopenic purpura. Case report

Case: We present a case of HELLP syndrome occuring in a patient who at the age of 8 years had undergone a splenectomy for idiopathic thrombocytopenic purpura. She was diagnosed as having HELLP syndrome 37 weeks of gestation and had a cesarean section. Received: 4 June 1996 / Accepted: 7 October 1996     

Platelet proteins as autoantibody targets in idiopathic thrombocytopenic purpura

Idiopathic thrombocytopenic purpura (ITP), caused by autoantibodies directed against certain platelet antigens, is the most common entity of the immune thrombocytopenias. ITP is an acquired disorder and can affect both children and adults. However, the clinical syndromes of ITP are distinct between children and adults. Childhood (acute) ITP characteristically is acute in onset, occurs within 1-2 weeks of an infection, usually of viral origin, resolves spontaneously within 6 months. Adult (chronic) ITP has an insidious onset and rarely resolves spontaneously. Over the last decade considerable new information has accumulated as to the pathophysiological mechanisms of immune thrombocytopenias. In addition, most of the knowledge on this disorder has been obtained from studies of adult patients with chronic ITP. The present work gives an updated overview of the platelet autoantigens and the molecular immunological reactions in ITP.