β Chain deficiency in three patients with dysfunctional C8 molecules

Structural and functional studies were performed on a dysfunctional C8 molecule present in the serum of two siblings and an unrelated individual. The C8 in these three sera exhibited a pattern of partial immunologic identity with C8 in normal serum but was devoid of functional activity. The C8 was immunoprecipitated from the three sera and from a control serum with an antihuman C8 antiserum and analyzed by SDS-PAGE using highly purified human C8 as a reference. A selective absence of a band of 62,000 mol. wt was observed in the immunoprecipitates from the sera containing dysfunctional C8. Experiments performed with the purified α-γ and γ subunits showed that the hemolytic activity of the C8 deficient sera could be reconstituted by the addition of the β chain but not the α-γ dimer. Binding of the dysfunctional C8 to C$\text{567}$ was excluded by the following observations: (1) EAC 1–7 treated with the C8 deficient sera and then washed could not be lysed after the addition of the β subunit and C9; and (2) the abnormal molecules did not interfere with the consumption of normal C8 by the soluble complex SC5b-7.     

晚期肿瘤的治疗及其价值

晚期肿瘤是否有治疗意义的讨论越来越受到社会的关注。作者从医学及伦理学两方面论述晚期肿瘤的治疗意义,认为治疗有助于疾病的控制,有利于提高患者的生存质量。指出晚期肿瘤的治疗并非无效治疗,患者能从治疗中得益。     

幽门螺杆菌感染与肝硬化关系的研究

目的：研究肝硬化患者的幽门螺杆菌（HP）感染状况及其对肝性脑病和上消化道出血的影响。方法：用尿素酶快速染色和瑞一姬染色确定HP的感染,分析肝硬化与十二指肠疾病患者HP感染率的差异;HP感染对肝硬化患者血氨浓度的影响;随访HP阳性与阴性肝硬化患者肝性脑病的发生率;观察肝硬化并上消化道出血与非出血患者间HP感染的差异。结果：肝硬化与胃十二指肠疾病患者HP感染无明显差异;HP感染能使肝硬化患者血氨浓度增加,从而使肝性脑病发生率增高;肝硬化并出血与非出血组HP感染无明显差异。结论：肝硬化患者的HP感染无特异性;HP感染能促使肝性脑病的发生;HP感染在肝硬化并上消化道出血中未起主要作用。     

二尖瓣-主动脉瓣置换术近期和远期效果的评价

目的 :评价单瓣与双瓣置换术的近期与远期效果。方法 :70例风湿性心脏病人采用国产上海碟瓣行机械瓣置换术 ,其中单纯行二尖瓣 (MV)置换术者 47例 ,二尖瓣加主动脉瓣 (AV)双瓣置换术者 2 3例。生存者 10 0 %随访 1～ 7年 (平均 4.76± 1.7年 )。结果 :院内死亡 4例 ,死亡率为 5 .71%。随访中死亡 2例 ,远期死亡率为 0 .63 %人·年。 7年生存率为 95 .69% ,10年生存率为 93 .89%。 94.0 0 %术后心功能均改善Ⅰ～Ⅱ级。结论 :房颤 (Af)并Ⅱ度房室传导阻滞的病人应暂缓手术 ;国产上海碟瓣有良好的血流动力学特性 ;只要处理恰当 ,双瓣手术的危险性不比单瓣手术的危险性高。     

头高位倾斜时心血管反应的仿真

仿真头高位倾斜时心血管系统的反应,进一步研究有关立位应激的生理机制。方法以仿真下体负压时心血管反应的模型为基础,在血液重新分配子模中引入了重力致血液重新转移的环节,在压力反射控制子模型中考虑了心水平与颈动脉压力感受器间的流体静压差。     

综合医院确诊的39例肺结核患者转诊结果随访调查

目的;了解并评价综合医院内科确诊的活动性肺结核病例转诊结果。方法：对我院呼吸内科１９９５年８月－１９９８年８月确认的３９例活动性肺结核患者（不包括结核性胸膜炎）转往结构防治专业机构的结果进行信访和电话随访。结果：仍的３９例活动性肺结核患者中有３５例在确诊后１周内结核病接受０．５ａ－１ａ的全地化疗,３３例获得良好效果,２例死亡,死因分别为肺间质纤维化合并感染肺心病及呼吸衰竭。３例慢性纤维空洞型肺结核     

国产房水引流物置入术治疗难治性青光眼远期疗效观察

１９９３年７月～１９９８年１月为１０３例（１０６只眼）难治性青光眼患者施行国产房水引流物（ＨＡＤ）置入术。术后平均随访３２８月。术后１年时平均眼压２２±１．４ｋＰａ。术后１～５年的手术成功率分别为８３８％,８０４％,７７１％,７１０％及６４３％。术中联合应用丝裂霉素Ｃ的病例,其术后１年时的成功率为８９５％。术后常见的并发症有持续性浅前房,局限性脉络膜脱离及眼压升高等。认为ＨＡＤ可用于治疗难治性青光眼。     

戴镜传统遮盖加精细作业法治疗儿童弱视的疗效观察

目的：探索儿童弱视的治疗方法及其疗效关系。方法：对９２ 例１３８ 弱视眼行戴镜、遮盖加精细作业法弱视治疗。结果：基本痊愈１０８ 眼（７８．０６％ ）;进步２２ 眼（１５．９４ ％） ,有效率９４．２０％ 。３～１２ 岁各组儿童弱视基本痊愈率、无效率无显著差异（Ｐ＞０．０５） ,但是达基本痊愈所需的治疗时间有显著差异（Ｐ＜ ０．０５） 。年龄越小,疗程越短;弱视程度越轻,疗程越短。屈光不正性弱视和斜视性弱视疗效优于屈光参差性弱视。结论：用此法治疗儿童弱视是有效的,且经济可行,适宜在广大农村地区开展。     

Barriers to follow‐up of abnormal screening mammograms among low‐income minority women

Objective. To describe factors related to compliance diagnostic follow‐up among minority women of low socioeconomic status with abnormal screening mammograms.

Methods. A retrospective cross‐sectional survey using a structured telephone interview. Three cancer screening clinics at an urban inner‐city public hospital. All women with abnormal screening mammograms between September 1990 and January 1992 were eligible; women were interviewed in August 1992. Abnormal mammograms were those requiring specific, non‐routine clinical follow‐up; non‐compliance was defined as delayed follow‐up (four to six months after the date of the mammogram), or no follow‐up at the time of interview (more than 6 months after abnormal).

Results. Sixty‐two of 442 screened women had abnormal results; the overall rate of non‐compliance with follow‐up was 50%. Among the 42 (68%) women who agreed to be interviewed, non‐compliers were less likely to state that they had been told to receive follow‐up than compilers (65% versus 100%; p = 0.008). Non‐compliant women were less likely to have suspicious mammography interpretations (p = 0.05), and more likely to report barriers to follow‐up, such as cost of lost wages and medical care, system barriers, or fears, than compliant women (61.9% versus 9%, p = 0.01). There were no differences between the two groups for age, education, insurance, source of care, family history, knowledge or attitudes.

Conclusions. These preliminary results suggest that follow‐up of low income, minority women with abnormal screening mammograms could be enhanced by improved communication of results. Future studies should extend these findings with larger samples and in other settings and populations.     

Deposition of β/A4 protein along neuronal plasma membranes in diffuse senile plaques

Summary The origin of the extracellular -amyloid protein (/A4) found in senile plaques and the cellular mechanisms responsible for its deposition in cerebral tissues are still an unresolved issue in Alzheimer's disease. In this study we analyzed in detail the distribution of various epitopes of /A4 in relation to local cellular elements in diffuse plaques of the hippocampal region. We also correlated our findings with the presence and distribution of non-/A4 epitopes of the amyloid precursor protein (APP) and with synaptophysin immunoreactivity in the cortical neuropil. Discontinuous /A4-immunoreactive deposits were found along dendrites, and around the soma of neurons included in the plaques. Furthermore, increased synaptophysin reactivity with slightly dilated synaptophysin-immunolabeled presynaptic terminals were found in diffuse plaques. APP epitopes could not be found in diffuse plaques. However, some of the APP antibodies, mainly those to the C-terminal portion of APP, and antibodies to /A4 recognized clusters of flat vesicular profiles (0.6–1.4 m in width and 2–3 m in length) in the neuropil of cortical areas where plaques had developed. Our findings are compatible with a neuronal origin of /A4 in diffuse plaques and with a primary release of /A4 at synaptic sites along the immunostained neurites. They also suggest that diffuse plaques might be preceded by minute lesions of the neuropil where /A4 is not yet released from the precursor molecule.