浊毒论治溃疡性结肠炎临证举隅

胡根和从浊毒方面论治溃疡性结肠炎的经验。认为浊毒贯穿本病的始末,并运用解毒化浊方法结合临床病案治疗该病,取得不错的疗效。     

T－2毒素对雏鸡软骨肝脏蛋白质DNA合成的抑制

雏鸡出壳次日起按１００μｇ／日剂量经口投与Ｔ－２毒素，为期８周，发现，Ｔ－２毒素对雏鸡的软骨和肝脏组织蛋白质、ＤＮＡ合成有明显抑制作用。实验组与对照组相比，肝脏组织蛋白质含量比值为０．６０∶１．００，ＤＮＡ含量比值为０．４９∶１．００；软骨组织中，蛋白质含量比值为０．６４∶１．００，ＤＮＡ含量比值为０．３９∶１．００。经琼脂糖凝胶电泳观察，未见实验组软骨和肝脏组织ＤＮＡ有断裂现象发生。     

偏侧咀嚼肌痉挛3例报告并文献复习

目的 加强对偏侧咀嚼肌痉挛这一罕见疾病的认识.方法 对我科收治的3例偏侧咀嚼肌痉挛患者的临床资料进行回顾分析,并对相关文献进行复习.结果 3例青年患者,病程长,反复发作性一侧咀嚼肌痉挛,累及咀嚼肌和颞肌,发作时不能张口,病初发作程度较轻,随病程发展,痉挛发作的持续时间及频率加重.诱发痉挛发作的常见因素有咀嚼、咬牙以及说话等.短暂的痉挛通常不伴有肌肉疼痛,严重时可以伴有疼痛.1例患者伴有痉挛侧面部肌肉肥大,2例伴有痉挛侧面部萎缩,无其他神经系统阳性体征.肌电图显示痉挛的咀嚼肌运动单位电位持续发放.2例患者经肉毒毒素局部注射治疗效果显著.结论 对于偏侧咀嚼肌痉挛,肉毒毒素局部注射治疗通常能够获得满意疗效.     

Abnormal motor cortex excitability during linguistic tasks in adductor‐type spasmodic dysphonia

In healthy subjects (HS), transcranial magnetic stimulation (TMS) applied during ‘linguistic’ tasks discloses excitability changes in the dominant hemisphere primary motor cortex (M1). We investigated ‘linguistic’ task‐related cortical excitability modulation in patients with adductor‐type spasmodic dysphonia (ASD), a speech‐related focal dystonia. We studied 10 ASD patients and 10 HS. Speech examination included voice cepstral analysis. We investigated the dominant/non‐dominant M1 excitability at baseline, during ‘linguistic’ (reading aloud/silent reading/producing simple phonation) and ‘non‐linguistic’ tasks (looking at non‐letter strings/producing oral movements). Motor evoked potentials (MEPs) were recorded from the contralateral hand muscles. We measured the cortical silent period (CSP) length and tested MEPs in HS and patients performing the ‘linguistic’ tasks with different voice intensities. We also examined MEPs in HS and ASD during hand‐related ‘action‐verb’ observation. Patients were studied under and not‐under botulinum neurotoxin‐type A (BoNT‐A). In HS, TMS over the dominant M1 elicited larger MEPs during ‘reading aloud’ than during the other ‘linguistic’/‘non‐linguistic’ tasks. Conversely, in ASD, TMS over the dominant M1 elicited increased‐amplitude MEPs during ‘reading aloud’ and ‘syllabic phonation’ tasks. CSP length was shorter in ASD than in HS and remained unchanged in both groups performing ‘linguistic’/‘non‐linguistic’ tasks. In HS and ASD, ‘linguistic’ task‐related excitability changes were present regardless of the different voice intensities. During hand‐related ‘action‐verb’ observation, MEPs decreased in HS, whereas in ASD they increased. In ASD, BoNT‐A improved speech, as demonstrated by cepstral analysis and restored the TMS abnormalities. ASD reflects dominant hemisphere excitability changes related to ‘linguistic’ tasks; BoNT‐A returns these excitability changes to normal.     

Systematic Reviews Published in the April 2015 Issue of the Cochrane Library

The Cochrane Library of Systematic Reviews is published quarterly as a DVD and monthly online (http://www.thecochranelibrary.com). The April 2015 issue (first DVD for 2015) contains 6390 complete reviews, 2410 protocols for reviews in production, and 36,600 short summaries of systematic reviews published in the general medical literature. In addition, there are citations of 848,000 randomized controlled trials, and 15,700 cited papers in the Cochrane Methodology Register. The Health Technology Assessment database contains some 15,000 citations. One hundred new reviews have been published in the previous 3 months, of which five have potential relevance for practitioners in pain and palliative medicine. The impact factor of the Cochrane Library stands at 5.939. Readers are encouraged to access the full report for any articles of interest, as only a brief commentary is provided.     

Immunology of Helicobacter pylori: insights into the failure of the immune response and perspectives on vaccine studies

Helicobacter pylori infects the stomach of half of the human population worldwide and causes chronic active gastritis, which can lead to peptic ulcer disease, gastric adenocarcinoma, and mucosa-associated lymphoid tissue lymphoma. The host immune response to the infection is ineffective, because the bacterium persists and the inflammation continues for decades. Bacterial activation of epithelial cells, dendritic cells, monocytes, macrophages, and neutrophils leads to a T helper cell 1 type of adaptive response, but this remains inadequate. The host inflammatory response has a key functional role in disrupting acid homeostasis, which impacts directly on the colonization patterns of H pylori and thus the extent of gastritis. Many potential mechanisms for the failure of the host response have been postulated, and these include apoptosis of epithelial cells and macrophages, inadequate effector functions of macrophages and dendritic cells, VacA inhibition of T-cell function, and suppressive effects of regulatory T cells. Because of the extent of the disease burden, many strategies for prophylactic or therapeutic vaccines have been investigated. The goal of enhancing the host's ability to generate protective immunity has met with some success in animal models, but the efficacy of potential vaccines in humans remains to be demonstrated. Aspects of H pylori immunopathogenesis are reviewed and perspectives on the failure of the host immune response are discussed. Understanding the mechanisms of immune evasion could lead to new opportunities for enhancing eradication and prevention of infection and associated disease.     

Diphtheria‐toxin based anti‐human CCR4 immunotoxin for targeting human CCR4+ cells in?vivo

CC chemokine receptor 4 (CCR4) has attracted much attention as a promising therapeutic drug target for CCR4+ tumor cells and Tregs. CCR4 is expressed on some tumor cells such as T‐cell acute lymphoblastic leukemia (ALL), adult T‐cell leukemia/lymphoma (ATLL), adult peripheral T cell lymphoma (PTCL) and cutaneous T cell lymphoma (CTCL). CCR4 is also expressed on majority of Tregs, mainly effector Tregs. In this study we have successfully developed three versions of diphtheria‐toxin based anti‐human CCR4 immunotoxins (monovalent, bivalent and single‐chain fold‐back diabody). Binding analysis by flow cytometry showed that all three versions of the anti‐human CCR4 immunotoxins bound to the human CCR4+ tumor cell line as well as CCR4+ human PBMC. The bivalent isoform bound stronger than its monovalent counterpart and the single‐chain foldback diabody isoform was the strongest among the three versions. In vitro efficacy analysis demonstrated that the bivalent isoform was 20 fold more potent in inhibiting cellular proliferation and protein synthesis in human CCR4+ tumor cells compared to the monovalent anti‐human CCR4 immunotoxin. The single‐chain fold‐back diabody isoform was 10 fold more potent than its bivalent counterpart and 200 fold more potent than its monovalent counterpart. The in vivo efficacy was assessed using a human CCR4+ tumor‐bearing mouse model. The immunotoxin significantly prolonged the survival of tumor‐bearing NOD/SCID IL‐2 receptor γ−/− (NSG) mice injected with human CCR4+ acute lymphoblastic leukemia cells compared with the control group. This novel anti‐human CCR4 immunotoxin is a promising drug candidate for targeting human CCR4+ tumor cells and Tregs in vivo.     

大骨节病病因研究报告

世界上只有中国、俄国和朝鲜北部少数地区有大骨节病。我国病区主要分布在从川藏到东北的狭长地带，处于东南沿海温暖、潮湿季风区与西北干旱、寒冷内陆的交界线上，反映出病区的气候、气象学的特征。但作为病区的充分条件还须有其他许多因素起作用。致病因子通过病区生产的小麦、玉米进入人体，大米不传病。病区小麦、玉米受镰刀菌污染严重可检出多量的Ｔ－２毒素（全距２．０～１５４９．４ｎｇ／ｇ），非常显著地高过对照点。在重病区采用换粮措施，办儿童食堂或者种植水田主食大米即可控制和杜绝新患发生。用病区谷物分离的镰刀菌接种于非病区玉米，制成菌粮按１０％比例加入正常饲米喂养雏鸡，或者用Ｔ－２纯品按１００ｕｇ／ｋｓ·ｄ投与雏鸡，５周即可出现膝关节骺板软骨深层带状坏死，类似人类大骨节病的早期改变。谷物镰刀菌产生的Ｔ－２毒素是大骨节病的原因，它的流行受制于自然、社会、生产的多种因素。