颞下颌关节骨关节炎与关节内紊乱关系的研究

目的 :探讨颞颌关节骨关节炎 (TMJOA)与颞颌关节内紊乱 (TMJID)的关系。方法 :利用MRI金标准 ,对 44例颞颌关节紊乱病患者 88侧关节完成开闭口T1加权成像 ,观察盘突关系和骨改变。结果 :88个关节中40 .9% ( 3 6/88)表现为TMJID ,13 .6% ( 12 /88)表现为TMJOA ,骨改变的分布情况 :正常盘突关系 (NDCR)关节中 2个 ,破坏和骨赘各 1个 ;可复性关节盘前移位 (ADDR)关节中 3个全部表现为骨破坏 ;不可复性关节盘前移位 (AD DWR)关节中 7个 ,表现为髁状突变平 3个 ;表现为破坏、骨赘、硬化和短小各 1个 ,统计学分析发现TMJOA与TMJID具有显著相关性。结论 :TMJOA的发生与关节结构紊乱显著相关。由于TMJOA可独立于TMJID之外而单独存在 ,目前将TMJOA看作是与TMJID密切相关的另一类疾病较为合适。     

SARS-CoV-2 Vaccine Responses in Individuals with Antibody Deficiency: Findings from the COV-AD Study

Background

Vaccination prevents severe morbidity and mortality from COVID-19 in the general population. The immunogenicity and efficacy of SARS-CoV-2 vaccines in patients with antibody deficiency is poorly understood.

Objectives

COVID-19 in patients with antibody deficiency (COV-AD) is a multi-site UK study that aims to determine the immune response to SARS-CoV-2 infection and vaccination in patients with primary or secondary antibody deficiency, a population that suffers from severe and recurrent infection and does not respond well to vaccination.

Methods

Individuals on immunoglobulin replacement therapy or with an IgG less than 4 g/L receiving antibiotic prophylaxis were recruited from April 2021. Serological and cellular responses were determined using ELISA, live-virus neutralisation and interferon gamma release assays. SARS-CoV-2 infection and clearance were determined by PCR from serial nasopharyngeal swabs.

Results

A total of 5.6% (n?=?320) of the cohort reported prior SARS-CoV-2 infection, but only 0.3% remained PCR positive on study entry. Seropositivity, following two doses of SARS-CoV-2 vaccination, was 54.8% (n?=?168) compared with 100% of healthy controls (n?=?205). The magnitude of the antibody response and its neutralising capacity were both significantly reduced compared to controls. Participants vaccinated with the Pfizer/BioNTech vaccine were more likely to be seropositive (65.7% vs. 48.0%, p?=?0.03) and have higher antibody levels compared with the AstraZeneca vaccine (IgGAM ratio 3.73 vs. 2.39, p?=?0.0003). T cell responses post vaccination was demonstrable in 46.2% of participants and were associated with better antibody responses but there was no difference between the two vaccines. Eleven vaccine-breakthrough infections have occurred to date, 10 of them in recipients of the AstraZeneca vaccine.

Conclusion

SARS-CoV-2 vaccines demonstrate reduced immunogenicity in patients with antibody deficiency with evidence of vaccine breakthrough infection.

     

过量氟化物对软骨基质糖胺多糖,蛋白多糖代谢的影响

在偏食和过量氟喂养条件下，实验大鼠软骨组织ＰＧ、ＧＡＧ代谢受到严重干扰，表现为肋软骨基质中ＰＧ聚合体含量明显降低，低聚合的ＰＧ含量明显增加，ＰＧ单体分子量明显降低。同时观察到软骨基南中ＧＡＧ含量的明显升高，这些结果一致地表明，过量氟化物引起动物慢性中毒辣时软骨组织ＰＧ合成代谢受到抑制而其分解代谢增强     

硒和维生素E对大鼠心肌单胺类物质和单胺氧化酶的影响

本文观察了硒（Ｓｅ）和维生素Ｅ（ＶＥ）对大鼠心肌去甲肾上腺素（ＮＥ）、多巴胺（ＤＡ）、５羟色胺（５－ＨＴ）含量和单胺氧化酶Ａ（ＭＡＯ－Ａ）、单胺氧化酶Ｂ（ＭＡＯ－Ｂ）活性的影响，发现经低Ｓｅ、低ＶＥ饲料喂养１０周，并且处死前经２次冰浴刺激的大鼠心肌ＮＥ含量明显增高，ＭＡＯ－Ａ活性降低，ＭＡＯ－Ｂ活性增加，通过补充饲料中Ｓｅ和ＶＥ，对上述指标有不同程度的改善，并以联合补充Ｓｅ和ＶＥ效果最佳。本研究结     

冠状动脉病变程度与冠心病猝死间关系的实验研究

本实验用27只日本大耳白家兔通过饲喂胆固醇的方法,诱发动物发生心脏冠状动脉粥样硬化。实验分三组,11只为重病变组,饲喂17周胆固醇1g/天;10只为轻病变组,饲喂13周胆固醇1g/天;6只为对照组,喂基础饲料。实验结束时,所有动物均静注大剂量肾上腺素(50μg/kg),重病变组出现了复杂性室性早搏。三组动物的病变积分值与室性早搏Lown氏级分值呈正相关关系。重病变组猝死率高于轻病变组。本实验表明,在体内儿茶酚胺增多时,冠状动脉病变程度越重其猝死率越高。     

钙对用克山病病区粮喂养大鼠甲状旁腺激素降钙素以及生长激素分泌的影响

用模仿克山病病区易感人群膳食组成的病区粮偏食喂养大鼠，观察在该饲料中补充不同浓度的钙对大鼠内分泌及生长代谢的影响。结果表明：病区粮偏食明显低钙，仅为常规食的１／３２；用该饲料喂养的大鼠体重增长缓慢；血清总钙及血浆钙离子水平明显降低，仅约为常规食组动物的一半左右，血Ｐ升高；血清甲状旁腺激素（ＰＴＨ），降钙素（ＣＴ）和生长激素（ＧＨ）水平均明显降低，与常规食组比，均为Ｐ＜０．０１。补Ｃａ后随血清Ｃａ增加，血清ＰＴＨ、ＣＴ和ＧＨ均明显升高而接近常规食组水平。这说明钙对用克山病病区粮喂养大鼠的内分泌功能及生长代谢具有一定的调节作用，从而改善了用病区粮喂养大鼠引起的代谢偏移。     

乙型肝炎病毒基因型

乙型肝炎病毒(hepatitis B virus,HBV)是嗜肝DNA病毒家族的重要成员,所引起的慢性乙型病毒性肝炎及肝衰竭、肝硬化、肝癌等是严重危害人民健康的疾病.据统计,目前我国有慢性乙型肝炎患者2000万人,是我国现阶段最为突出的公共卫生问题之一.HBV遗传变异率很高,有8个基因型,由于独特的流行病学特性,多数又可以分为不同的基因亚型.另外DNA基因型的高度异质性使重组基因型也增加了.有研究证实HBV基因型与疾病进展关系密切.不同基因型HBV的流行病学特征不同,同时其临床感染特点和致病性也有差异.本文综述了本领域研究进展,包括HBV生物学特性、基因型与基因亚型、重组基因型、HBV基因型的流行病学特点以及HBV基因型与临床等方面.     

Diagnostic Splenectomy for Visceral Leishmaniasis

A 57-year-old-man with a history of malaise, fever,night sweats and shortness of breath presented a diagnostic challenge to his medical team. He was pancytopaenic and had splenomegaly on admission but other investigations, including bone marrow aspiration, proved inconclusive. After the patient deteriorated clinically, the general surgical team was requested to perform a diagnostic splenectomy. The histology of this showed infection with visceral leishmaniasis. He recovered completely with Amphotericin treatment. Although this is a rare condition, particularly for the general surgeon, this case highlights the difficult position surgeons are often put in when performing major surgery diagnostically.