The concentration of uric acid in patients with metabolic syndrome and cardiovascular diseases

The association of elevated serum uric acid (hyperuricemia, gout) with the presence of classical coronary risk factors and coronary artery disease (CAD) or myocardial infarction (MI) has been analysed in many epidemiological studies. Numerous studies have revealed that hypertension, high body mass index (BMI), lipid disorders (especially raised triglyceride (TG) levels and low high dense lipoprotein cholesterol (HDL-C) level), and increased creatinine or insulin levels have caused hyperuricemia. Gout has often occurred with typical disorders for the metabolic syndrome X. Significant correlation of the serum uric level and the CAD presence and severity of coronary atherosclerosis confirmed by coronary angiography has been observed in women. Hyperuricemia has also indirect influence on progress of CAD by physical activity restriction, what causes sedentary mode of life and lead to obesity. Therefore, we conducted our study in order to estimate uric acid levels in patients with metabolic syndrome and coexisting cardiovascular system diseases.     

贝伐单抗应用在眼部新生血管性疾病中的研究进展

眼部新生血管性疾病是对人类视力造成损害的重要因素,近年来人们对有关眼部新生血管性疾病的防治工作进行了大量的基础和临床研究,尚未取得预期的效果。随着单克隆抗体贝伐单抗（bevacizumab,商品名Avastin）的诞生,眼部新生血管性疾病的治疗获得显著效果,现将bevacizumab治疗眼部新生血管性疾病的相关应用进展作一综述。     

Reduced sebum production in Turner syndrome: a study of twenty-two patients

Turner's syndrome (TS) is a genetic disorder caused by numeric and/or structural abnormalities of the X chromosome. In a previous study it was observed that acne is less frequent in TS than in the general population. Since the onset of acne in pre-pubertal or pubertal age is related to sebum production, this study evaluates sebum secretion in TS patients, comparing the results with those of a control group of age-matched healthy female subjects. A total of 22 patients affected by TS (mean age 26.56±7.89 years) and a control group of 23 age-matched healthy females were studied. Sebum production was measured using a Sebumeter SM810. Mean sebum secretion in TS subjects was significantly lower than in the control group (81.35±66.44 UA vs 147.09±33.62 UA, p<0.001) and this significant difference was found in every facial zone. The reduction of sebum secretion may explain, using a simple and non-invasive method, the absence or the low incidence of acne in TS patients.     

The personality and psychosomatic syndrome in patients with acquired valvular heart diseases.

Fifty patients (36 women and 14 men) aged 16-51 with valvular heart diseases qualified from surgical treatment were studied. For determination of personality traits the Self Knowledge Card by R. B. Cattell, The Minnesota Multiphasic Personality Inventory MMPI-WISKAD by Hathaway and McKinley and The Adjectives Test ACL by Gough and Heilbrun. Using these methods it was shown that patients with acquired valvular heart diseases had a much lower tolerance threshold for frustration and stressful situations and had a tendency for autoaggressive behaviour. Somatic symptoms in these patients cause a constant feeling of danger and anxiety and difficulties in adaptation to everyday life conditions with a tendency for self-effacement. Predominating needs were demonstrated in three sets: a) defense attitudes and strong self-control, b) needs connected with goal achievement and strivings, c) needs connected with normal relations with other people. A statistical comparison of the results obtained in patients with valvular heart diseases and in healthy controls showed very significant differences between them.     

糖皮质激素性高眼压对肾病综合征儿童眼屈光的影响

目的观察肾病综合征儿童全身应用激素治疗后眼球屈光度、眼轴长度(AL)和眼内压(IOR)变化,探讨高眼压与屈光度、眼轴长度之间的关系。方法肾病综合儿童147例294眼作为研究对象,在治疗之前于眼科测量双眼等效球镜(SE)并根据测量结果将患者分为非近视组、低度近视组、中度近视组、高度近视组,并测量4组患者AL、CCT和IOP,比较4组SE、AL、CCT和IOP之间的差异。在治疗6个月后,测量IOP、SE和AL变化,组内比较4组IOP、AL、SE之间的差异及组间比较4组高眼压患者的AL、SE之间的差异。结果治疗前不同屈光度组内AL、SE和IOP比较差异均有统计学意义(P<0.05)。治疗后中、高度近视组的高眼压者IOP大于非近视组、低度近视组(P<0.05)。中、高度近视组组内比较,高眼压者AL和SE均高于眼压正常者,差异有统计学意义(P<0.05)。结论肾病综合征儿童全身应用激素引起眼压增高,IOP与近视度数和AL呈正相关关系,且中、高度近视者更易出现AL值增长和SE的增加,高眼压因素对原发性肾病综合征儿童的近视发展产生了较大影响。     

Aspects of the treatment of Turner syndrome

Several issues have to be considered when taking care of girls and women with Turner syndrome. During childhood, short stature is the primary concern and treatment with growth hormone (GH) is now widely used, often in conjunction with the androgen, oxandrolone. Recent studies indicate that doses used previously in the treatment of short stature have been too small. Induction of puberty should be performed at an appropriate age with reference to the peers of the patient. In adulthood, female sex hormone substitution should be offered to possibly prevent the increased morbidity seen in Turner syndrome, which consists of increased risk of fractures and osteoporosis, a clustering of diseases like ischaemic heart disease, hypertension, stroke and Type 2 diabetes, the latter entities being involved in the insulin resistance syndrome. Furthermore, hypothyreosis are often seen and the risk of Type 1 diabetes may also be increased. Congenital malformations of the heart are frequently seen in Turner syndrome, possibly increasing the risk of dissecting aorta aneurism. Liver enzymes are often elevated in Turner syndrome and there may be an increased risk of cirrhosis of the liver. Mortality does seem to be increased in Turner syndrome and women with the 'pure' 45,X karyotype do seem to be most severely affected. In the clinical practice of Turner syndrome, a careful monitoring of glucose and bone metabolism, weight, thyroid function and blood pressure should be performed. A cardiovascular risk profile should be determined and the patient informed concerning risks and benefits from sex hormone replacement therapy. Based on the available literature, sex hormone replacement therapy is highly recommended, although at present there are no longitudinal data documenting the long-term positive effect of sex steroid substitution. However, hypogonadism is expected to explain at least part of the decreased lifespan found in Turner syndrome. Since general physicians encounter Turner patients infrequently, it is recommended that the care and treatment of Turner syndrome is centralised.     

Aspects of the treatment of Turner syndrome

Several issues have to be considered when taking care of girls and women with Turner syndrome. During childhood, short stature is the primary concern and treatment with growth hormone (GH) is now widely used, often in conjunction with the androgen, oxandrolone. Recent studies indicate that doses used previously in the treatment of short stature have been too small. Induction of puberty should be performed at an appropriate age with reference to the peers of the patient. In adulthood, female sex hormone substitution should be offered to possibly prevent the increased morbidity seen in Turner syndrome, which consists of increased risk of fractures and osteoporosis, a clustering of diseases like ischaemic heart disease, hypertension, stroke and Type 2 diabetes, the latter entities being involved in the insulin resistance syndrome. Furthermore, hypothyreosis are often seen and the risk of Type 1 diabetes may also be increased. Congenital malformations of the heart are frequently seen in Turner syndrome, possibly increasing the risk of dissecting aorta aneurism. Liver enzymes are often elevated in Turner syndrome and there may be an increased risk of cirrhosis of the liver. Mortality does seem to be increased in Turner syndrome and women with the ‘pure’ 45,X karyotype do seem to be most severely affected. In the clinical practice of Turner syndrome, a careful monitoring of glucose and bone metabolism, weight, thyroid function and blood pressure should be performed. A cardiovascular risk profile should be determined and the patient informed concerning risks and benefits from sex hormone replacement therapy. Based on the available literature, sex hormone replacement therapy is highly recommended, although at present there are no longitudinal data documenting the long-term positive effect of sex steroid substitution. However, hypogonadism is expected to explain at least part of the decreased lifespan found in Turner syndrome. Since general physicians encounter Turner patients infrequently, it is recommended that the care and treatment of Turner syndrome is centralised.     

12例Turner综合征的细胞遗传学分析

目的:了解Turner综合征的临床表型和细胞遗传学特点.方法:对12例Turner综合征患儿外周血淋巴细胞制备常规染色体标本,采用G显带技术进行核型分析,对患儿的临床表型和遗传学特点进行总结和分析.结果:12例Turner综合征的染色体核型中,45,XO共5例,占41.7%;45,XO/46,XX共2例,占16.7%;46,Xi(Xq)共2例,占16.7%;45,XO/46,Xi(Xq)1例,占8.3%;45,XO/47,XXX 1例,占8.3%;45,XO/46,XY 1例,占8.3 %;45,XO/46,XY1例,占8.3%.结论:Turn综合征不同的临床表面邓决于染色体核型异常的程度及异常核型和正常核型细胞系的比例,不同患者表现度可存在差异.     

Discontinuation syndrome associated with paroxetine in depressed patients: a retrospective analysis of factors involved in the occurrence of the syndrome

OBJECTIVE: To examine the factors that contribute to the occurrence of the discontinuation syndrome in patients who have received paroxetine to treat depression. METHOD: The clinical records of individuals from the outpatient units of two centres in the western area of Japan who had had a single episode of major depressive disorder (MDD) and had completed monotherapy with paroxetine in the previous 5 years were retrospectively reviewed. All patients had been diagnosed with MDD according to the DSM-IV criteria. The patients were divided into two groups, according to whether or not they had experienced the discontinuation syndrome when paroxetine was stopped. The syndrome was diagnosed according to standard criteria for the SSRI discontinuation syndrome. The two groups were compared for sex, age, maintenance dosage of paroxetine, duration of treatment with paroxetine, presence of adverse reactions in the early phase of treatment with paroxetine, and method of paroxetine withdrawal (abrupt or tapered). RESULTS: Of the 385 patients included in the review, 41 patients experienced the discontinuation syndrome. The occurrence of the discontinuation syndrome did not correlate with sex, maintenance dosage of paroxetine or duration of treatment with the drug. However, there was a relationship between the method of drug withdrawal and the occurrence of the discontinuation syndrome, with the syndrome occurring significantly more frequently in those patients in whom paroxetine was abruptly discontinued. There was an association between the occurrence of the discontinuation syndrome and age, but this association seemed to have been caused by the fact that younger patients were more inclined to abruptly stop taking the medication. It was also found that the discontinuation syndrome occurred at a significantly higher rate in patients who had experienced adverse reactions to paroxetine in the early phase of treatment. CONCLUSION: The discontinuation syndrome in patients taking paroxetine was more likely to occur in those patients who stopped taking the drug abruptly. The occurrence of the discontinuation syndrome was also correlated with younger age, but this association seemed to be secondary to the fact that younger patients tended to be more likely to abruptly stop taking the medication. It appears that the discontinuation syndrome can be prevented by carefully tapering the dosage of paroxetine when treatment is withdrawn. Interestingly, the discontinuation syndrome was more likely to occur in those patients who experienced adverse reactions in the early phase of treatment with paroxetine. When the drug is discontinued, additional attention should be paid to patients who have presented with adverse reactions in the early phase of paroxetine therapy.     

Annexins as potential targets in ocular diseases

Annexins (AnxAs) are Ca²⁺/phospholipid-binding proteins extensively studied and generally involved in several diseases. Although evidence exists regarding the distribuition of AnxAs in the visual system, their exact roles and the exact cell types of the eye where these proteins are expressed are not well-understood. AnxAs have pro-resolving roles in infectious, autoimmune, degenerative, fibrotic and angiogenic conditions, making them an important target in ocular tissue homeostasis. This review summarizes the current knowledge on the distribution and function of AnxA1–8 isoforms under normal and pathological conditions in the visual system, as well as perspectives for ophthalmologic treatments, including the potential use of the AnxA1 recombinant and/or its mimetic peptide Ac_2–26.     

57例Turner综合征的R带染色体分析

目的 研究Turner综合征与其细胞染色体异常的遗传学关系.方法 外周血淋巴细胞染色体R带分析.结果 57例Turner综合征患者中单体45,X,27例(47.4%),45,X/46,XX嵌合体2例(3.5%),45,X/46,Xi(Xq)(q10;q10)嵌合体12例(21.1%),46,X,i(X)11例(19....     

祛痰柠对呼吸道疾病患者的祛痰疗效

用祛痰柠(0.3gqid,10-14d一疗程)治疗严重呼吸道疾病合并咯痰困难的21例病人,共20例有效占95％。其中显效16例,占76％。证明本药有强大的祛痰效果。使用过程中未发现严重副作用。对肾功能无损害,特别有利于对年老、体弱,咳痰无力,重症、监测室病人的治疗。     

艾滋病患者外科并发症42例的诊治

目的探讨艾滋病患者合并外科疾病时合理的外科治疗。方法回顾分析42例艾滋病患者接受外科治疗后的转归，探讨合理的手术方式和手术指征。结果42例患者中，术后死亡4例。适当的手术治疗对艾滋病患者是安全的。结论艾滋病不是手术的禁忌证，合理的手术治疗是挽救部分艾滋病患者惟一有效的方法。     

粉防己碱用于眼科疾患的研究进展

粉防己碱(tetrandrine,Tet),是从中药防己、粉防己或千金藤中分离出来的一种生物碱,为双苄基异喹衍生物,具有消炎、镇痛、解热、抗过敏、降血压、扩张冠脉、抗癌等多种药理作用.临床已用于治疗高血压、矽肺、肝纤维化等疾病.眼科药理研究表明,Tet具有对实验性葡萄膜炎和角膜炎显著而强大的抑制作用;动物活体实验显示本品能明显抑制兔晶状体后囊膜混浊和人工晶状体前膜的形成,抑制术后前房中脂质过氧化反应,减轻眼局部组织的损伤;体外研究显示其对兔皮肤纤维母细胞和结膜成纤维细胞的生长增殖以及视网膜母细胞瘤生长有显著抑制作用.提示Tet可能具有广阔而良好的临床应用前景.     

急性冠状动脉综合征严重程度与血清HDL-C/LDL-C比值相关性的研究

目的：探讨急性冠状动脉综合征（ACS）患者血清HDL-C/LDL-C比值与疾病严重程度的相关性,观察分析HDL-C/LDL-C比值是否可作为判断ACS疾病严重程度的客观生化指标。方法：入选的382例受试对象,分为对照组（n=156）,稳定型心绞痛（SA）组（n=89）,不稳定性心绞痛（UA）组（n=78）和急性心肌梗死（AMI）组（n=59）,并对UA患者进行Braunwald分级,对AMI患者进行Killip分级。采集受试者清晨空腹血液标本,采用消除法测定血清HDL-C、LDL-C、CK-MB并计算HDL-C/LDL-C比值。用SPSS软件包进行统计学分析。结果：ACS患者血清HDL-C/LDL-C比值与疾病严重程度存在良好的相关性：随着Braunwald分级增高,UA患者血清HDL-C/LDL-C比值逐渐降低（三级之间及每两级之间的HDL-C/LDL-C比值的差异均有统计学意义,P〈0.05）;随着Killip分级增高,AMI患者血清HDL-C/LDL-C比值也逐渐降低（三级之间及每两级之间的HDL-C/LDL-C比值的差异均有统计学意义,P〈0.05）。血清HDL-C/LDL-C比值ACS患者明显低于SA患者（P〈0.05）。结论：ACS患者血清HDL-C/LDL-C比值与疾病的严重程度有良好的相关性,HDL-C/LDL-C比值可能会成为判断ACS疾病严重程度的客观生化指标之一。     

The predictors of cholelithiasis in female patients with metabolic syndrome

Cholesterol gallstone disease is often associated with the metabolic syndrome. Female gender is an unmodifiable risk factor for cholelithiasis and, in its turn, the metabolic syndrome features a sexual dimorphism which warns that a global approach might overlook important discrimination. We carried out a retrospective analytical case-control study in order to perform a comparative analysis between two groups of female patients with metabolic syndrome and gallstones (n=60) or without gallstones (n=65). All the patients were investigated by abdominal ultrasound and met at least three criteria for the diagnosis of metabolic syndrome. Cases and controls were compared regarding anthropometric measurements, a complex lipid profile, and liver function tests. The risks associated with the likelihood of gallstones were estimated by means of cross-tabulation. In order to rank the significant variables we developed a binary logistic regression model which identified lean body weight ≤ 46.44 kg (OR 0.165; 95% CI 0.045–0.611; P = 0.007), total cholesterol ≥ 4.9 mmol/L (OR 15.948; 95% CI 2.700–94.205; P = 0.002), and direct bilirubin > 5.1 µmol/L (OR 0.056; 95% CI 0.013–0.235; P < 0.001), as variables with significant probability of association with the risk of gallstones in women with metabolic syndrome.