海水型呼吸窘迫综合征兔肾皮质酶活性定位和图像分析

采用超微结构细胞化学和图像分析技术，对兔海水型呼吸窘迫综合征（ＳＷ－ＲＤＳ）肾皮质酶活性的变化进行了观察。ＳＷ－ＲＤＳ组肾皮质碱性磷酸酶、５’－核苷酸酶、对－硝基苯磷酸酶和细胞色素氧化酶活性明显下降，而胞嘧啶单核苷酸酶活性明显增强。这表明肾皮质一些酶活性的改变是兔ＳＷ－ＲＤＳ发病机理之一。     

Uveal effusion syndrome complicated by anterior ischemic optic neuropathy

We report on a case of idiopathic uveal effusion syndrome complicated by AION. To our knowledge such an association hasn't been previously described. We suggest that scleral thickening caused obstruction of vortex veins followed by uveal effusion and compression of posterior ciliary arteries within their intrascleral tract, leading to AION. Nevertheless it can't be excluded that AION was the result of mechanical compression on ciliary vessels of optic disc by choroidal detachment.     

原位杂交研究慢性乙型肝炎病毒感染者肝组织内HBV DNA清除模式

用地高辛素探针原位杂交技术研究52例慢性HBV感染者肝内HBV DNA分布,发现在病毒高复制期,HBV DNA阳性肝细胞以弥漫性分布为主,肝细胞HBV DNA表型为胞浆型和核型,在病毒低复制期肝内HBV DNA阳性肝细胞以小叶聚集分布为主,多分布于灶性坏死和碎片状坏死区,在病毒非复制期,HBV DNA阳性肝细胞以局灶性分布为主,表型多为包涵体型和核型。提示在漫长的HBV感染过程中,肝内HBV DNA阳性肝细胞的分布经历弥漫性—小叶聚集性—局灶性的演变过程,该过程反映肝组织内HBV的清除模式。HBeAg(+)的慢性HBV无症状感染者肝组织病变轻可能是由于HBV DNA易装配为完整的病毒排出肝细胞的结果。说明免疫活性细胞攻击的靶细胞主要是含有HBV DNA的肝细胞。     

Heart rate variability and apnea during sleep in Down's syndrome

Autonomic system dysfunction has been reported to occur frequently in patients with Down's syndrome (DS) and is constituted mainly by an imbalance between the sympathetic and vagal systems. The analysis of heart rate variability (HRV) during sleep is a quantitative reliable method for studying such a mechanism, but it has not yet been extensively and adequately applied in DS. In this study, HRV during sleep was evaluated in seven DS patients and in six normal controls, by also controlling for the presence of sleep apnea or arousal. The main results were an increased sympathetic function (low-frequency component of HRV) and a decreased vagal activity (high-frequency component of HRV) in DS with respect to normal controls, during apnea-free periods. Moreover, the presence of apnea, in DS, induced a further significant increase in low-frequency and very low-frequency components of HRV during sleep Stage 2. This study provides additional evidence of a brainstem dysfunctioning in DS, responsible for the abnormal imbalance between the sympathetic and vagal systems and confirms the brainstem involvement already suggested in the literature in order to explain brainstem-auditory evoked potential abnormalities and central sleep apnea in these patients.     

Reduced genital sensitivity in female patients with multiple system atrophy of parkinsonian type.

According to the consensus statement on the diagnosis of multiple system atrophy (MSA), erectile dysfunction is required for male patients to fulfil the urinary incontinence criterion. However, there is no equivalent item for female patients. We questioned 19 female patients with MSA of the parkinsonian type (MSA-P), 28 female patients with Parkinson's disease (PD), and 27 healthy controls on their genital sensitivity. A total of 47% of the MSA patients but only 4% of the PD patients and 4% of the control group admitted to reduced genital sensitivity, a highly significant difference (P < 0.001). Moreover, the appearance of reduced genital sensitivity in female MSA patients showed a close temporal relation to the onset of the disease. If these preliminary results can be confirmed and further specified in a larger sample, a historical item of reduced genital sensitivity in female patients might become a diagnostic feature for MSA, comparable to erectile dysfunction in male patients.     

Absence of predictable phenotypic expression in proximal 15q duplications

We describe ten individuals with an insertional duplication 15q12----q13. Phenotypic analysis of these individuals and 15 previously reported cases of proximal 15q duplications fails to show any consistent clinical manifestations. It appears that a duplication of this region is phenotypically silent.     

鞍区肿瘤术后中枢性低钠血症的诊断和治疗

目的:探讨鞍区肿瘤术后中枢性低钠血症的诊断及处理方法。方法:对我科近四年鞍区肿瘤术后并发中枢性低钠血症的58例患者进行回顾性分析,术前、手术当日及术后每日定时检测血钠,观察尿量变化,测定中心静脉压,确定低钠血症的类型并给予相应的处理。结果:56例恢复正常,1例死于严重肺部感染,1例自动出院。结论:鞍区肿瘤易出现抗利尿激素分泌不当综合症和脑性耗盐综合症两种类型。前者需限水治疗,后者应予以充分补钠、补水,根据水、钠检测水平治疗。     

河南省传染性非典型肺炎患者胸部X线表现

目的 :探讨传染性非典型肺炎的X线表现及变化规律。方法 :对河南省临床诊断的 1 5例患者发病后不同时间的系列胸片和CT进行回顾性分析。结果 :1 5例胸部X线病灶初始形态为斑片状 1 1例 (73.3% ) ,大片状 4例 (2 6 .7% ) ;双侧 9例 (6 0 .0 % ) ,单侧 6例 (4 0 .0 % ) ,均为中、下肺野 (1 0 0 % )。动态观察发现病变进展快 ,病变发展到高峰期时间为 4～ 1 4d , x±s(7.7± 3.2 )d ,双侧 1 3例 (86 .7% ) ,单侧 2例 (1 3.3% ) ,两肺叶及两肺叶以上病变者 1 4例 (93.3% )。病变开始吸收时间为 6～ 2 1d , x±s(1 1 .3± 4 .1 )d ;完全或基本吸收时间 8～ 2 6d , x±s(1 6 .4± 5 .0 )d。1 5例经治疗均痊愈出院。住院时间 1 8～ 4 2d , x±s(31 .9± 7.9)d。 结论 :传染性非典型肺炎的胸部X线特点为急性双侧或单侧多叶炎性浸润阴影 ,以中、下野常见 ,进展迅速 ,及时复查胸部X线对临床诊断及判断病情具有重要价值。     

丙型肝炎六例报告及随访观察

本文首次报告新疆6例丙型肝炎。对20例病毒性肝炎病人血清进行抗HCV检测,结果6例阳性。结合临床及化验检查,可诊断为丙型肝炎。对此6例进行分析,结果表明:本病多发生在输血后,临床表现不重,肝功能检查主要是ALT反复波动不降,易致慢性。