眼前段光学相干断层扫描仪与超声生物显微镜测量中央前房深度的比较

目的 比较眼前段光学相干断层扫描仪(AS-OCT)与超声生物显微镜(UBM)测量中央前房深度(ACD)的差异和两者的可重复性.方法 分别用AS-OCT和UBM测量急性原发性闭角型青光眼(APACG)患者29例55眼(发作眼32眼,未发作眼23眼),慢性原发性闭角型青光眼(CPACG)患者4l例74眼的ACD.采用配对t检验进行不同仪器ACD测量值比较;相关分析法分析两种仪器测量值之间的相关性.完全随机法选择1只眼分别用AS-OCT和UBM依次重复测量ACD 10次,比较测量的可重复性.结果 APACG发作眼用AS-OCT测量的ACD值与UBM的测量值之间差异无统计学意义.APACG对侧眼、CPACG眼的AS-OCT测量值比UBM测量值大[(1.923+0.287)mm比(1.860±0.243)mm,(2.017±0.054)mm比(1.913±0.052)mm,均P=0.012].AS-OCT和UBM的ACD测量值呈正相关(r=0.928,P<0.001).AS-OCT与UBM测量ACD的变异系数分别为0.66%和0.82%.结论 AS-OCT比UBM测量的ACD值大,两种仪器测量值相关性良好.AA-OCT的可重复性优于UBM.     

眼前段光学相干断层扫描仪与超声生物显微镜测量中央前房深度的比较

目的 比较眼前段光学相干断层扫描仪（AS-OCT）与超声生物显微镜（UBM）测量中央前房深度（ACD）的差异和两者的可重复性.方法 分别用AS-OCT和UBM测量急性原发性闭角型青光眼（APACG）患者29例55眼（发作眼32眼,未发作眼23眼）,慢性原发性闭角型青光眼（CPACG）患者4l例74眼的ACD.采用配对t检验进行不同仪器ACD测量值比较;相关分析法分析两种仪器测量值之间的相关性.完全随机法选择1只眼分别用AS-OCT和UBM依次重复测量ACD 10次,比较测量的可重复性.结果 APACG发作眼用AS-OCT测量的ACD值与UBM的测量值之间差异无统计学意义.APACG对侧眼、CPACG眼的AS-OCT测量值比UBM测量值大[（1.923＋0.287）mm比（1.860±0.243）mm,（2.017±0.054）mm比（1.913±0.052）mm,均P=0.012].AS-OCT和UBM的ACD测量值呈正相关（r=0.928,P〈0.001）.AS-OCT与UBM测量ACD的变异系数分别为0.66%和0.82%.结论 AS-OCT比UBM测量的ACD值大,两种仪器测量值相关性良好.AA-OCT的可重复性优于UBM.     

采用眼前段光学相干断层扫描仪检测的健康人眼前段结构相关参数间的关系

目的 采用眼前段光学相干断层扫描仪(AS-OCT)测量健康人的眼前段各参数,并分析参数间的关系以及年龄对其的影响.方法 采用AS-OCT扫描211例健康人(211只眼)眼前段结构,并测量前房深度(ACD)、前房横径(ACHD)、解剖前房深度(AACD)、晶状体厚度(LT)、睫状体带长度(CBL)、晶状体位置(LP)和虹膜厚度(IT).对各参数进行性别间的比较,并分析这些参数之间的关系和受年龄的影响.结果 男性的ACD、ACHD、AACD、CBL、IT及LP均比女性大[ACD:(2.87±0.38)mm比(2.66±0.40)mm:ACHD:(11.73±0.43)mm比(11.53±0.36)mm;AACD:(3.09±0.19)mm比(3.00±0.19)mm:CBL:(0.20±0.09)mm比(0.17±0.09)am;IT:(0.36±0.08)mm比(0.34±0.08)mm;LP:(5.11±0.26)mm比(4.91±0.28)mm;均P<0.05].LT性别差异无统计学意义(P=0.955).AACD、IT、LP和CBL与年龄均无相关(均P>0.05);ACHD与年龄呈负相关(r=-0.148,P=0.032);LT与年龄呈正相关(r=0.646,P=0.000);LT与ACD呈负相关(r=-0.714,P=0.000).回归分析表明,LT的增加对LP无影响(P>0.05).结论 女性的眼前段结构比男性窄.随年龄增加ACD的变浅是IJT增加所致;随年龄以及LT的增加,健康人LP不会发生改变.     

超声乳化白内障吸出术对急性原发性闭角型青光眼眼前段的影响

目的 使用Pentacam三维前房分析仪和眼前段光学相干断层扫描仪(AS-OCT)观察超声乳化白内障吸出术对急性原发性闭角型青光眼(APACG)患者眼前段的影响.方法 收集2010年7月至12月于中山大学附属中山医院眼科就诊的伴有白内障APACG的病例共39例(39眼).常规行超声乳化白内障吸出联合人工晶体(IOL)植入术.术前和术后3个月使用Pentacam和AS-OCT测量眼前段参数.结果 术后3个月,APACG患者眼压由术前(33.08±5.21)mm Hg降至(16.36±3.44)mm Hg(1mm Hg=0.133 kPa,t=20.644,P=0.000),中央前房深度由(1.79±0.20)mm增至(3.41±0.38) mm (t=36.191,P=0.000),周边前房深度由(0.82±0.12) mm加深至(1.81 ±0.20) mm (t=40.732,P=0.000),前房容积自(74.10±9.94) mm增加至(149.72± 17.12) mm (t=54.921,P=0.000),下方前房角自(24.03±3.50).加宽至( 43.29±3.92).(t=55.489,P=0.000),鼻侧前房角自(23.02±2.96)°加宽至(42.36±4.61).(t=43.291,P=0.000),上方前房角自(21.62±3.04).加宽至(39.66±3.53).( t=43.511,P=0.000),颞侧前房角自(22.88±2.87).加宽至(41.21±3.81).(t=44.930,P=0.000).瞳孔直径由术前(3.06±1.32)mm缩小至术后的(3.00±1.21)mm,但差异无统计学意义(t=1.177,P=0.247).结论 超声乳化白内障吸出术可改善APACG患者眼前段结构的狭窄.Pentacam和AS-OCT可简便快捷和非接触地观察眼前段,有良好的应用前景.     

PI3K/Akt信号通路上调急性肺损伤大鼠肺泡上皮钠通道表达

目的 探讨PI3K/Akt信号通路对急性肺损伤(ALI)大鼠肺泡上皮钠通道(ENaC)α、β和γ亚基表达的影响.方法 成年SD大鼠随机分为对照组、ALI组(脂多糖)、胰岛素组及渥曼青霉素组,每组5只.观察肺组织病理改变,收集支气管肺泡灌洗液(BALF),测量总肺水含量,RT-PCR和Western blot测定ENaC mRNA和蛋白、p-Akt表达.结果 胰岛素组BALF蛋白含量、髓过氧化物酶(MPO)活性、总肺水含量较ALI组显著减少(P＜0.05),渥曼青霉素组BALF蛋白含量、MPO活性及总肺水含量较胰岛素组显著增加(P＜0.05).ALI组α-、β-和γ-ENaC蛋白表达显著低于对照组(0.33 ±0.06 vs 1.27 ±0.07,0.18±0.04 vs 0.72±0.04,0.37±0.04 vs0.69±0.05)(P＜0.05).胰岛素组蛋白表达α-ENaC(2.19 ±0.04)、β-ENaC(1.18 ±0.07)和γ-ENaC(1.18 ±0.08)显著高于ALI组(P＜0.05).渥曼青霉素组蛋白表达α-ENaC(0.86 ±0.09)、β-ENaC (0.58±0.05)和γ-ENaC (0.59±0.02)显著低于胰岛素组(P＜ 0.05).胰岛素组ENaC mRNA和p-Akt较ALI组显著升高(P＜0.05).渥曼青霉素组ENaC mRNA和p-Akt较胰岛素组显著降低(P＜0.05).结论 激活H3K/Akt通路上调3种ENaC亚基表达,从而清除肺水肿液.     

精神分裂症患者回忆过去和想象未来的特点

目的:探讨精神分裂症患者回忆过去事件和想象未来事件的特点。方法:选取符合国际疾病分类与诊断标准第10版的精神分裂症患者25例,以及年龄、教育水平、智商相匹配的正常对照24例,要求被试参加回忆过去和想象未来测试,即根据提供的正性、中性、负性线索词回忆过去和想象未来的具体事件,然后对这些事件从具体性和内容两方面进行评分,比较两组被试回忆及想象内容的具体性事件所占的比率以及回忆及想象事件的类别所占的比率。结果:精神分裂症组回忆过去的具体事件的比率低于正常对照组[(0.45±0.26)vs.(0.70±0.22),P0.05]。在回忆及想象事件的类别上,产生的探索娱乐事件比率[(0.07±0.07)vs.(0.10±0.07)]、关系事件比率[(0.14±0.10)vs.(0.29±0.09)]、成功事件比率[(0.04±0.05)vs.(0.06±0.04)],精神分裂症组均低于正常对照组(均P0.05);精神分裂症组与医院有关的事件比率[(0.05±0.07)vs.(0.00±0.00)]、一般事件比率[(0.49±0.22)vs.(0.35±0.14)]均高于正常对照组(P0.05)。结论:精神分裂症患者回忆过去的具体性存在缺陷,回忆和想象事件的内容和正常对照组存在显著差异。     

双胎妊娠胎儿超声多普勒血流与胎儿妊娠结局的相关性研究

目的探讨双胎胎儿超声多普勒血流与胎儿妊娠结局的关系。方法用超声多普勒测量双胎各胎儿大脑中动脉、脐动脉以及肾动脉的血流,同时追踪胎儿出生后体重及新生儿Apgar评分。结果本研究共纳入84例双胎妊娠病例,其中分娩后体重不一致(差值≥20%)者12例,体重一致(差值20%)者72例。脐动脉S/D差值在体重不一致者中为0.61±0.16,体重一致者中为0.27±0.03,(t=3.774,P=0.003);双胎脐动脉阻力指数差值在体重不一致者中为0.08±0.02,体重一致者中为0.07±0.03,(t=0.172,P=0.864);双胎大脑中动脉阻力指数差值在体重不一致者中为0.08±0.02,体重一致者中为0.06±0.01,(t=1.289,P=0.201);双胎肾动脉阻力指数差值在体重不一致者中为0.04±0.01,体重一致者中为0.04±0.00,(t=0.009,P=0.993);Apgar评分小于7分的新生儿数在体重不一致胎儿中为0,在体重一致胎儿中为1,P=1.000(确切概率法计算)。结论双胎妊娠孕期可以通过监测双胎胎儿脐动脉血流S/D值来预测胎儿出生时体重,S/D值差值越大,胎儿出生时体重差距越大。     

正常微量白蛋白尿的2型糖尿病患者肾脏磁共振扩散加权成像研究

目的 应用磁共振扩散加权成像(DWI)检测正常微量白蛋白尿(MAU)的2型糖尿病患者肾功能改变,评估其在2型糖尿病患者早期肾损害诊断中的价值.方法 2010年8月至12月在本院内分泌科门诊就诊的MAU在正常范围的2型糖尿病患者10例为观察组,同期健康体检者10例为健康对照组,每组20个肾,两组年龄、性别和体质量指数差异无统计学意义(均P＞0.05).应用单次激发平面回波DWI和常规MR序列进行双侧肾脏MRI检查,比较两组在弥散敏感梯度系数(b值)分别为400、500、600和800 s/mm2时肾实质表观扩散系数(ADC),并比较两组血清肌酐和胱抑素C水平.结果 MRI常规序列扫描显示两组肾脏形态、大小及解剖结构无明显差异,血清肌酐及胱抑素C水平差异无统计学意义(均P＞0.05).DWI检查显示,b值分别为500、600及800 s/mm2时,观察组ADC值分别为(2.15±0.06)×10-3、(2.05 ±0.07)×10-3、(1.87±0.05)×10-3 mm2/s,健康对照组ADC值分别为(2.32±0.07)×10-3、(2.16±0.04)×l0-3、( 1.95 ±0.04)×10-3 mm2/s,观察组ADC值较健康对照组均显著下降(均P＜0.05).结论 DWI可能有助于更早期地发现2型糖尿病患者肾功能损害.     

小学生学校动态绘画与学业成绩

目的:初步了解国内小学生学校动态绘画指标的特点,探讨小学生学校动态绘画与学业成绩的关系.方法:选取广州市某小学五年级学生82名施测学校动态绘画.以人物尺寸、人物距离、朋友数量、人物顺序等为绘画指标,以学生绘画前最近一次语文、数学、英语三科考试成绩的平均值作为学业成绩标准.将学业成绩排在82名同学中前27％的被试作为高学业成绩组(n=22),排名后27％的作为低学业成绩组(n=22).结果:样本学生绘画的教师像尺寸大于西方小学生[(65.7±28.3) mm vs.(54.3±25.3) mm,P＜0.05],师生距离小于西方小学生[(56.1 ±41.2) mm vs.(90.0±79.5) mm,P＜0.01];师生距离[(56.1±41.2) mm vs.(98.8±55.9) mm]、同伴距离[(34.9±33.2) mm vs.(53.2 ±30.8)mm]和朋友数量[(1.4±0.7)vs.(2.4±1.2)]小于日本小学生(均P＜0.01).高学业成绩组学生的自画像尺寸大于低学业成绩组[(59.2±20.9) mm vs.(44.0±23.5) mm; P＜0.05],同伴距离小于低学业成绩组[(22.6± 14.0) mmvs.(42.7±40.3) mm; P＜0.05].自画像尺寸(r=0.22,P＜0.05)、教师像尺寸(r=0.24,P＜0.05)与学业成绩呈正相关;朋友顺序与学业成绩呈负相关(r=-0.23,P＜0.05).结论:国内小学生的学校动态绘画指标可能与西方、日本小学生存在差异,动态绘画的某些指标与学业成绩存在相关性.     

急性冠脉综合征患者新喋呤、D-二聚体和超敏C反应蛋白水平变化

目的:观察急性冠脉综合征(ACS)患者新蝶呤(NP)、D-二聚体(DD)和超敏C反应蛋白(hs-CRP)水平变化,探讨其在ACS中的临床应用价值。方法:2016-01-2016-07武汉大学人民医院心内科住院ACS患者120例(观察组),包含不稳定性心绞痛(UA组,n=55)和急性心肌梗死(AMI组,n=65);选择同期健康人群120例为对照(对照组)。采集受试者空腹肘静脉血,采用酶联免疫吸附法测定血清NP,全自动凝血分析仪测定血浆DD,全自动生化分析仪测定血清hs-CRP水平,比较各组各指标差异。结果:观察组NP、DD和hs-CRP浓度较对照组显著升高,分别为NP(2.84±0.05ng/ml vs 1.26±0.07ng/ml),DD(0.51±0.04mg/L vs 0.22±0.06mg/L),hs-CRP(0.52±0.57mg/L vs 0.11±0.52mg/L),差异均有统计学意义(P0.01);并且AMI组NP、DD和hs-CRP水平高于UA组患者,分别为NP(2.89±0.05ng/ml vs 2.76±0.05ng/ml),DD(0.55±0.04mg/L vs 0.43±0.06mg/L),hs-CRP(0.59±0.63mg/L vs 0.37±0.19mg/L),差异亦有统计学意义(P0.05)。结论:ACS患者NP、DD和hsCRP指标检测能够有效评估患者病情,具有重要的临床应用价值。     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

What will studies of Fulani individuals naturally exposed to malaria teach us about protective immunity to malaria?

There are an estimated over 200 million yearly cases of malaria worldwide. Despite concerted international effort to combat the disease, it still causes approximately half a million deaths every year, the majority of which are young children with Plasmodium falciparum infection in sub-Saharan Africa. Successes are largely attributed to malaria prevention strategies, such as insecticide-treated mosquito nets and indoor spraying, as well as improved access to existing treatments. One important hurdle to new approaches for the treatment and prevention of malaria is our limited understanding of the biology of Plasmodium infection and its complex interaction with the immune system of its human host. Therefore, the elimination of malaria in Africa not only relies on existing tools to reduce malaria burden, but also requires fundamental research to develop innovative approaches. Here, we summarize our discoveries from investigations of ethnic groups of West Africa who have different susceptibility to malaria.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.     

The universal muscular chamber. A basic unit of the genitourinary, cardiovascular, gastro-intestinal, skeletal, cutaneous, respiratory and other systems, endocameral hypertension; and spasm, the key to their idiopathic diseases and arthropathies

Starting with the integument, we see many organs are contractile sacs or multiples thereof, which tubes or bags constitute the major part of the entire body. Recognition of this basic unit and its characteristics sheds new light, individually and collectively, on many disorders previously considered unrelated. Muscular tears and perforations develop in the walls of these chambers, being no way peculiar to those organs, wherein, hydrochloric acid occurs. So, it is not necessary to explain the absence of excessive acid from patients who exhibit holes in the gastric, uterine, aortic, duodenal, rectal, pulmonary, retina, and other walls. Muscle, not acid is the great common factor relating idiopathic disorders in the gastrointestinal tract to each other and to similar diseases in other systems. When the units are linked together, the lesions tend to appear as arthropathies, i.e. at the joints. Rephrasing common-place observations, frees us from conventional, conceptual cul-de-sacs. An observation is only as good as its interpretation, so all possibilities must be considered, otherwise, we will remain blinded by our misconceptions.