OSAS合并原发性高血压患者血浆内皮素-1与颈动脉内膜中层厚度的变化

目的观察阻塞性睡眠呼吸暂停综合征（obstructive sleep apnea syndrome,OSAS）及OSAS合并原发性高血压（essential hypertension,EH）患者血浆内皮素-1（Endothelin-1,ET-1）、颈动脉内膜中层厚度（carotid artery intima—media thickness,IMT）的变化及相互关系。方法选择OSAS合并EH患者组50例,OSAS患者组40例及健康对照组30例,采用ELISA法测定其血浆ET-1浓度,及利用颈动脉超声检测IMT。结果OSAS合并EH组的血浆ET-1浓度均高于单纯OSAS组及对照组即（124．66±18．90）pg／mL、（54．53±10．82）pg／mL,（45．07±6．45）pg／mL,差异有统计学意义（P〈0．01）;而单纯OSAS组的血浆ET-1浓度亦高于对照组,即（54．53±10．82）pg／mL对（45．07±6．45）pg／mL,差异有统计学意义（P〈0．05）;OSAS合并心血管病组的IMT明显高于单纯OSAS组及对照组,即（1．03±0．11）mm对（0．93±0．06）mm,（0．88±0．07mm,差异有统计学意义（P〈0．01）。结论OSAS患者存在内皮功能损害,OSAS合并EH者内皮功能紊乱更严重,同时伴IMT增厚。     

血清性激素与原发性高血压病的关系探讨

目的：探讨原发性高血压（EH）发病与性激素之间可能存在的关系。方法：用放射免疫分析了87例男性EH患者及81例女性绝经后EH患者和相应正常对照组的血清性激素（LH、FSH、E2、P、T）水平,并进行高血压分期对照分析。结果：男、女EH患者血清E2、P、T水平均显著高于对照组（P〈0．01）;血清LH、FSH水平均低于对照组,其中男性EH组FSH水平和对照组相比下降不明显（P〉0．05）。Ⅰ、Ⅱ、Ⅲ期EH患者性激素水平经F检验无显著差异（P〉0．05）。相关分析显示,男性EH组E2水平和女性EH组P水平与FSH、LH水平变化无明显相关关系（P〉0．05）。结论：EH患者血清E2、P、T水平显著高于对照组,且E2、P与FSH、LH之间又无相关关系,Ⅰ、Ⅱ、Ⅲ期之间性激素水平又无显著差异。血清性激素水平的变化可能是一个高血压独立的危险因子,可作为EH病部分病因的推测和提示。     

哮喘病人气道粘膜炎症宏观表现与细胞学关系的研究

目的：通过分析经纤维支气管镜肉眼观察哮喘病人气道炎症和临床表现以及气道粘膜组织中炎性细胞的关系,以了解肉眼观察哮喘病人气道炎症的特点。方法：采用Dahl肉眼评分系统对受试对象气道炎症进行积分后,钳取气道粘膜组织,利用HE染色结合免疫组化染色方法计数气道粘膜的各种炎性细胞,比较哮喘组与对照组之间差异,分析哮喘病人Dahl计分、气道粘膜炎性细胞计数和临床病情分级之间的关系。结果：①哮喘组Dahl积分为7．35±0．88,明显高于对照组1．06±0．36（P＜0．05）,哮喘组Dahl积分与病情程度呈正相关（r＝0．73,P＜0．05）;②哮喘组气道粘膜嗜酸性粒细胞（17．9±23．3）×102／mm2,明显高于对照组（1．9±2．1）×102／mm2（P＜0．05）;哮喘组气道粘膜EG2阳性（活化分泌状态的嗜酸性细胞）细胞数（8．9±9．5）×102／mm2,明显高于对照组（0．8±0．8）×102／mm2,并且EG2阳性细胞数与病情程度相关（r＝0．65,P＜0．05）;③未发现哮喘组Dahl积分与粘膜组织的炎性细胞计数有显著相关性。结论：经纤维支气管镜对哮喘病人气道的肉眼评价是一种宏观视察气道炎症的客观指标,能够准确地反映哮喘病情程度。     

孟鲁司特钠治疗感染后咳嗽的疗效观察

目的探讨孟鲁司特钠治疗感染后咳嗽的疗效。方法收集2012年1月至2013年12月本院呼吸科门诊就诊的感染后咳嗽患者150例,按随机数字表分为观察组（n=75）和对照组（n=75）。对照组给予复方甲氧那明治疗,酌情应用阿奇霉素;观察组在对照组的基础上加用孟鲁司特钠睡前口服,疗程均为2周。比较治疗前后两组患者的日间、夜间及全天咳嗽症状积分,记录与治疗相关的不良反应。结果治疗前观察组和对照组的日间、夜间及全天咳嗽症状积分组间比较,差异均无统计学意义（均P〉0．05）。与治疗前比较,治疗后两组患者日间咳嗽症状积分均显著降低（观察组：0．41±0．25比1．97±0．63,对照组：0．52±0.31比1．82±0．71,均P〈0．05）。治疗后观察组夜间咳嗽症状积分较治疗前明显降低（0．32±0．18比2．01±0．58,P〈O．05）,而对照组治疗前后夜间咳嗽症状积分差异无统计学意义（P〉0．05）。与治疗前比较,治疗后两组患者全天咳嗽症状积分均显著降低（观察组：0．73±0．62比3．98±1．25,对照组：1．72±0．98比3．74±1．41,均P〈0．05）。观察组与对照组的不良反应发生率分别为9．3％（7／75）、10．7％（8n5）,差异无统计学意义（x2=0．074,P〉O．05）。结论孟鲁司特钠可有效控制感染后咳嗽,尤其是感染后夜间咳嗽。     

正中神经前臂段运动传导与腕管综合征严重程度的相关性研究

目的：探讨正中神经前臂段运动传导（fMCV）与腕管综合征（CTS）疾病严重程度的相关性,并初步探讨其发生机制。方法：以符合纳入标准的CTS患者66例（126只患手）为病例组,年龄、性别匹配的96例健康志愿者的非利手为对照组,均行神经电生理检测。采用正中神经末端运动潜伏期（DML）和复合肌肉动作电位（CMAP）作为CTS严重程度指标,并研究其与fMCV的相关性。结果：①尺神经：病例组与对照组的各电生理参数间比较差异均无显著意义（t检验,P〉0．05）;②正中神经：在病例组（n=126）和对照组（n=96）,DML（ms）分别为5．0±1．3、3．0±0．3,腕-掌段正中神经运动传导速度（m／s）分别为22．2±7．3、56．9±8．3,fMCV（m／s）分别为53．7±5．5、59．2±3．6,拇短展肌CMAP波幅（mV）分别为7．3±2．9、10．1±1．9。以上所有参数的值均经t检验,P〈0．05,差异有显著意义;③相关性：在病例组,fMCV与DML呈负相关（r=-0．35,P〈0．05）,与拇短展肌CMAP呈正相关（r=0．18,P〈0．05）。结论：fMCV的异常与CTS患者的严重程度相关,且正中神经逆行性变为其可能的发生机制。     

AITDs与HLA等位基因DQA1*0301、DR9的相关性研究

目的：探讨山东沿海地区自身免疫性甲状腺病（AITDs)与HLA－DQA1＊301，DR9的相关性。方法：采用多聚酶链式反应序列特异物分析（PCR－SSP）技术，扩增HLA等位基因DQA1＊0301，DR9的目的DNA片段（分别为199，236 bP)，分析2对等位基因在不同人群中表面频率的差异（χ^2检验），结果：山东沿海地区GD和HT女性患者组DQA1＊0301等位基因频率均显著高于对照组（分别为P＜0．001，OR＝4．89，P＜0．01，OR＝4．95）；DR9等位基因频率仅HT女性组显著高于对照女性组（P＜0．05，OR＝3．90），DQA1＊0301／DR9共同表达的频率，GD和HT女性组较对照女性组均显著性增高（分别为P＜0．05，P＜0．01），GD组和HT组2组间均无显著性差异（P＞0．05），结论：HLA－DQA1＊0301等位基因是山东沿海地区女性GD患者的易感基因；DQA1＊0301，DR9等位基因均是该地区女性HT患者的易感基因，2对等位基因在男性AITDs患者中的分布情况尚待进一步观察。     

血清VEGF及TGF—β1在肝纤维化患者中的表达及其意义

目的：探讨血管内皮生长因子（VEGF）及转化生长因子13。（TGF．13．）在肝纤维化患者中的表达及其意义。方法：选择66例肝纤维化患者为观察组,另选择100名体检健康者为正常对照组,采用免疫组织化学方法检测两组血清VEGF及TGF．B,浓度。结果：观察组血清VEGF及TGF-13,浓度为（110．87±22．64）ng／L和（15．08±3．27）μg／L,显著高于对照组（15．98±4．75）ng／L和（7．17±1．86）μg／L（t值分别为20．166、11．066、P均〈0．001）;观察组s1、s2、s3、及S4期患者血清VEGF分别为（84．25±16．86）、（101．87±26．70）、（118．04±20．75）、（134．65±25．73）ng／L（F=15．689,P〈0．05）,TGF-β1分别为（10．87±2,64）、（13．06±2．74）、（17．87±3．28）、（22．76±4．75）μg／L（F=12．438,P〈0．05）;肝纤维化患者血清VEGF与TGF－β1水平呈正相关（r=0．532,P〈0．05）。结论：血清VEGF与TGF-13,水平与肝纤维化的发生发展密切相关,二者联检可作为诊断及判断病情的血清学指标。     

氯化镧对大鼠生长素分泌调节影响的体外研究

目的：研究氯化湖（LaCl3）对大鼠生长素分泌调节轴的影响。方法：采用荧光法检测离体脑片培育液中单胺类神经递质含量;用放射免疫法测垂体脑片育液中生长素（GH）含量。结果：①0．01mmol／LLaCl3垂体组育液中GH含量明显高于对照组（P＜0．05）;而1mmol／LLaCl3垂体组有液中GH含量明显低于对照组（P＜0．05）。②0.01mmol／LLaCl3下丘脑＋垂体组,其有液中GH含量则明显高于对照组（P＜0．01）和同剂量的单纯垂体组（P＜0．01）;但1mmol／L下丘脑＋垂体组育液中GH含量与对照组比较无显著差异（P＞0．05）。③0．01mmol／LLaCl3下丘脑组有液中NE含量明显高于对照组（P＜0．01）,5－HT明显低于对照组（P＜0.05）。④1mmol／L下丘脑组有液中NE和DA含量明显少于对照组（P＜0．01和0．05）,而5－HT含量则明显高于对照组（P＜0．001）。结论：低剂量氯化调可通过下丘脑和腺垂体双重作用促进GH分泌。     

氨甲环酸关节腔注射联合引流管夹闭3h在单侧全膝关节置换术中止血效果分析

目的：探讨局部应用氨甲环酸联合引流管夹闭3h对单侧全膝关节置换术出血量的影响。方法2012年6月至2014年6月,前瞻性选择100例患有骨性关节炎行初次全膝关节置换术（TKA）的患者,随机分为两组：实验组（n＝51）,关节置换完成后松止血带前自引流管向关节腔注入氨甲环酸10 mL（含1000 mg）＋0．9％氯化钠10 mL,注入后引流管夹闭3 h;对照组（n＝49）,同期关节腔注入0．9％氯化钠溶液20 mL,注射后引流管未夹闭。比较两组患者术后1、7、14 d血红蛋白含量、术后最大血红蛋白丢失量、引流量、隐性失血量、总失血量、输血量、输血率、术后1 dD-二聚体值、术后7 d下肢静脉血栓（VTE）发生率、皮下瘀斑面积＞1％发生率。其中计量资料的比较采用两独立样本t检验,率的比较采用χ2检验。结果术后1、7、14 d血红蛋白平均含量实验组高于对照组,差异有统计学意义（P＜0．05）。术后最大血红蛋白丢失量、引流量、隐性失血量实验组少于对照组,差异有统计学意义（P＜0．05）。实验组、对照组患者总失血量分别为（712．6±260．5）mL、（1109．6±350．5）mL,两组比较差异有统计学意义（t＝6．45,P＜0．05）。实验组与对照组输血量分别为（27．0±49．2）mL、（232．0±119．3）mL,两组比较差异有统计学意义（t＝11．30,P＜0．05）;实验组与对照组输血患者分别为5例和21例,输血率分别为9．8％和42．9％,两组比较差异有统计学意义（χ2＝14．19, P＜0．05）。两组术后1 d D二聚体含量均升高,实验组低于对照组,差异有统计学意义（t＝2．65,P＜0．05）;术后7 d 两组患者静脉多普勒超声检查发现VTE发生率比较差异无统计学意义（χ2＝0．24, P＞0．05）,术后皮下瘀斑面积＞1％的发生率实验组少于对照组,差异有统计学意义（χ2＝4．67,P＜0．05）。     

噻氯匹定对脑梗塞患者血小板聚集功能和血液流变学的影响

以50例脑梗塞为观察组，45例健康人为对照组，观察噻氯匹定对脑梗塞血小板聚集功能和血液流变学的影响。（1）治疗前，观察组血小板聚集率（PAR）非常显著地高于对照组（P＜0.01），（2）治疗后，观察组PAR非常显著地低干治疗前（P＜0.01），与对照组比较已无显著性差异（P＞0．05），（3）观察组各亚组治疗后PAR大多非常显著地低于治疗前（P＜0．01）。（4）观察组治疗前后血液流变学指标无显著性变化（P＞0．05），（5）神经功能缺损评分：治疗前15．8±0．98；治疗后8．2±5.4，差异有非常显著意义（P＜0．01）。     

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.     

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.     

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.     

'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.     

Der Einfluß von Nahrungsmitteln und Rauchen auf die klinisch-chemische Diagnostik von Phäochromozytom,Neuroblastom und Karzinoid-Syndrom

Zusammenfassung Der Einfluß von verschiedenen Nahrungsmitteln auf Methoden zur Bestimmung von Adrenalin (AD), Noradrenalin (NA), Vanillinmandelsäure (VMS), Metanephrinen (MN), Homovanillinsäure (HVS) und 5-Hydroxyindolessigsäure (5-HIE) im 24 h-Harn zur Diagnose des Phäochromozytoms bzw. Karzinoid-Syndroms wurde untersucht. Die in die Untersuchung einbezogenen Nahrungsmittel waren: Tee, Kaffee, Mandeln, Ananas, Käse, Walnüsse, Vanillepudding, Bananen, Tomaten und Milchschokolade. Außerdem wurde der Einfluß des Zigarettenrauchens auf die Bestimmung von AD, NA, VMS und MN untersucht.Walnüsse führten zu einer starken Erhöhung der 5-HIE-Ausscheidung. Bananen erhöhten die Ausscheidung von AD, NA, VMS, MN und 5-HIE. Kaffee und Ananas bewirkten eine geringe Zunahme der MN-Werte. Rauchen von 20–30 Zigaretten/Tag beeinflußte keine der vier Variablen.Wenn die beschriebenen Methoden benutzt werden, sollte lediglich auf den Verzehr von Bananen und Walnüssen vor und während der Harnsammelperioden verzichtet werden, da die oberen Normgrenzen im Harn überschritten werden könnten. Ein Verzicht auf Kaffee und Ananas in normalen Mengen ist nicht erforderlich. Es besteht kein Anlaß, weiterhin die bisherigen umfangreichen Restriktionen der übrigen Nahrungsmittel beizubehalten.