家族性心脏全传导系统缺陷病(同一家族6例报告)

报告同一家族6例心脏全传导系统缺陷病。连续三代的家系调查显示:符合常染色体显性遗传特征。我们对临床症状比较明显的3例试用腺苷受体桔抗剂(氨茶碱)治疗,疗效显著。结合文献对家族性心脏全传导系统缺陷病的病因进行了探讨,认为可能与家族性腺苷或腺苷酸的代谢异常有关。     

十二指肠球部充盈缺损影像分析(附12例报告并文献复习)

目的：讨论十二指肠球部充盈缺损的诊断和鉴别诊断。方法：共１２例患者，均进行钡餐造影检查，其中６例进行ＣＴ检查。结果：分别对１２例球部充盈缺损的影像表现进行分析。其中包括球部异物２例；淋巴瘤２例；腺瘤４例；低分化腺癌、类癌、胃窦癌脱入球部、胃息肉脱入球部各１例。钡餐造影显示了１２个病变；ＣＴ检查的６例中，显示５个病变，其中１个漏诊因病变小于１０ｍｍ。结论：十二指肠球部充盈缺损少见，钡餐造影对发现球部病变的大小、形态及腔内结构有重要作用，ＣＴ在病灶的性质病灶周围情况，腔内外侵犯的程度及远处转移方面起着重要的辅助价值     

Studies on the mechanism of omega-hydroxylation of platelet 12-hydroxyeicosatetraenoic acid (12-HETE) by unstimulated neutrophils.

Stimulated platelets, in the presence or absence of aspirin, synthesize significant quantities of 12-hydroxyeicosatetraenoic acid (12-HETE), which is chemotactic and chemokinetic, and enhances mononuclear cell procoagulant activity. During a cell-cell interaction between stimulated platelets and unstimulated neutrophils, platelet 12-HETE is metabolized to 12,20-dihydroxyeicosatetraenoic acid (12,20-DiHETE) by neutrophils. Characteristics of the enzyme system in unstimulated neutrophils responsible for this omega-hydroxylation were investigated. A broad range of cytochrome P-450 inhibitors, as well as leukotriene B4, blocked formation of 12,20-DiHETE. Owing largely to released proteases, neutrophil homogenization abolished activity. Pretreatment with diisopropylfluorophosphate preserved activity in neutrophil homogenates. omega-Hydroxylation of 12-HETE was confined solely to the microsomal fraction. Specific activity increased 6.6-fold compared with neutrophil sonicates. The electron donor NADPH was a required cofactor. These results indicate that the enzyme in unstimulated human neutrophils, which metabolizes 12-HETE from stimulated platelets to 12,20-DiHETE in this cell-cell interaction, is a cytochrome P-450 monooxygenase.     

银屑病角质形成细胞凋亡与Fas／FasL表达的关系

目的探讨银屑病皮损中角质形成细胞（KC）凋亡与Fas／FasL表达的关系。方法免疫组化ABC法对银屑病患者皮损中Fas、FasL表达进行检测，TUNEL法检测皮损中KC凋亡情况。结果银屑病皮损中既可表达Fas，又可表达FasL，而在正常皮肤不表达；患者皮损中KC发生凋亡的比例明显高于正常对照组（P〈0．01），但病程的不同阶段其细胞凋亡指数（AI）不同，进行期高于静止期。结论KC凋亡参与了银屑病的发病过程，Fas、FasL对角质形成细胞凋亡有调节作用。     

A simple radiochemical assay of thromboxane B2, 12-hydroxyeicosatetraenoic acid (HETE) and 12-hydroxyheptadecatrienoic acid (HHT) synthetized by human platelets

A simple radiochemical assay of thromboxane B₂, 12-hydroxyeicosatetraenoic acid (HETE) and 12-hydroxyheptadecatrienoic acid (HHT) produced by platelets from arachidonic acid has been described.Moreover, this assay is suitable for measuring thromboxane A₂ trapped as 11-mono-O-methylthromboxane B₂ and minor products such as prostaglandins E₂, F_2α and D₂.The advantage of this technique is discussed as to its ease and specificity.     

The role of interleukin-12 in the pathogenesis of psoriasis

OBJECTIVES: To verify the role of IL-12 in the pathogenesis of psoriasis and determine its relation to IFNgamma. DESIGN AND METHODS: Skin biopsies from lesional and non-lesional skin of 30 patients and 10 healthy controls were obtained for quantitative PCR examination of IL-12 (P40) and IFNgamma mRNA as well as in situ PCR of IL-12 (P40) and IFNgamma mRNA. RESULTS: IL-12 and IFNgamma levels were higher in lesional skin than in non-lesional and control skin. A significant correlation between IL-12 and IFNgamma was found. By in situ PCR hybridization, IL-12 expression was only found in the dermis, while IFNgamma was invariably expressed in the dermis and/or epidermis. CONCLUSION: We suggest that IL-12 independently and through IFNgamma induction may have a crucial role in the development of the active psoriatic lesion itself, where it is probably produced locally in the dermis as a step in the evolution of the psoriatic lesion.     

磷酸钙骨水泥在骨缺损修复中的应用

近年来,生物材料越来越多地被应用在骨缺损的修复中。理想的骨修复材料不仅要有良好的生物相容性,还要有合适的空隙结构、表面形态和理化性能,以适应成骨细胞的生长。磷酸钙骨水泥以其良好的生物相容性、可降解性、骨传导性、可注射性和可塑性等优点,成为近年来骨缺损修复中应用较多的生物材料。本文综述磷酸钙骨水泥在骨缺损修复中的实验研究及进展。     

甲氨蝶呤对寻常型银屑病外周血TLR4及TLR9表达调控的研究

目的:研究甲氨蝶呤(MTX)对寻常型银屑病患者外周血Tol1样受体(TLR)4和TLR9表达的影响。方法:利用荧光定量聚合酶链反应法测定22例寻常型银屑病患者治疗前后外周血及20例正常对照者外周血中TLR4mRNA及TLR9mRNA的定量表达。结果:银屑病外周血中TLR4mRNA及TLR9mRNA的表达均高于正常对照者外周血的表达水平(t=11.26,P<0.001;t=8.39,P<0.001)。银屑病患者经过MTX治疗4w后,病情明显改善,外周血中TLR4mRNA及TLR9mRNA的表达水平低于患者治疗前的表达水平(t=3.49,P=0.0015;t=7.75,P<0.001),但与正常对照者的表达水平差异无统计学意义(t=1.76,P=0.0925;t=1.38,P=0.1741)。结论:TLR4及TLR9的表达增高与银屑病的发病有关。MTX能抑制寻常型银屑病外周血TLR4mRNA及TLR9mRNA的过度表达,这可能是MTX治疗银屑病的作用机制之一。     

Efficacy and safety of ustekinumab and etanercept for the treatment of psoriasis

Importance of the field: TNF-α inhibitors such as etanercept have been used for psoriasis for years. A fairly well defined efficacy and safety profile has developed. A new biologic agent, ustekinumab, an IL-12 and IL-23 inhibitor, has recently been released in the US for the treatment of moderate-to-severe psoriasis. The purpose of this article is to compare the efficacy and safety profiles of ustekinumab and etanercept.

Areas covered in this review: We examined safety and efficacy data regarding ustekinumab and etanercept from clinical reports, a head-to-head trial, review articles, and databases and registries from the last 20 years.

What the reader will gain: Evidence is reviewed about the efficacy for the treatment of psoriasis as well as the safety profiles for both agents, ustekinumab and etanercept.

Take home message: Both drugs have data to confirm efficacy and safety in patients with moderate-to-severe psoriasis in the short-term. The limited long-term data on the safety profile of ustekinumab requires careful judgment on the clinician's part, weighing well-defined benefits and potential unknown risks.     

Remodeling of neutrophil phospholipids with 15(S)-hydroxyeicosatetraenoic acid inhibits leukotriene B4-induced neutrophil migration across endothelium.

5-Lipoxygenase products, such as leukotrienes, are important stimuli for leukocyte-mediated tissue injury in acute inflammation. 15-Hydroxyeicosatetraenoic acid (15-HETE) is an eicosanoid generated by a variety of cell types via the actions of 15-lipoxygenases and, in addition, cyclooxygenases and epoxygenases. 15-HETE levels are frequently elevated at sites of inflammation, and extracellular 15(S)-HETE is esterified rapidly into neutrophil (PMN) phospholipids in vitro to levels that are comparable with arachidonic acid. We present evidence that remodeling of PMN phospholipids with 15(S)-HETE stereoselectively inhibits PMN migration across endothelium in response to leukotriene B4 (LTB4) and other chemoattractants. Esterified 15(S)-HETE causes a striking reduction in the affinity of LTB4 cell-surface receptors for their ligand and inhibition of LTB4-triggered stimulus-response coupling. As a result of these actions, esterified 15(S)-HETE attenuates the cytoskeletal rearrangements and CD11/CD18-mediated adhesive events that subserve directed locomotion of PMN across endothelium. These observations indicate that products of the 5-lipoxygenase and 15-lipoxygenase pathways can exert counterbalancing influences on PMN trafficking across endothelium. They suggest that 15(S)-HETE may be a potent endogenous inhibitor of PMN-endothelial interactions in vivo and serve to limit or reverse acute inflammation.     

紫外线治疗银屑病的进展

紫外线(UV)系不可见光线,波长范围在200—400nm之间。根据生物学作用,将UV分为长波紫外线(UVA,320—400nm);中波紫外线(UVB,290—320nm);短波紫外线(UVC,200—290nm)。UV波段不同,穿透皮肤的深度也不同,波段越短,穿透能力越差,UVA可达真皮下,而UVB、UVC在真皮层被吸收。     

Brodalumab in the treatment of chronic plaque psoriasis

ABSTRACT

Introduction

A number of highly selective biologic therapies that target specific immunological pathways of psoriasis have emerged, including molecules that target interleukin (IL)-17. IL-17 has been identified as a key effector pathogenic cytokine in psoriasis, and validated as a highly effective therapeutic target for the treatment of plaque psoriasis.     

Louse (Insecta: Phthiraptera) mitochondrial 12S rRNA secondary structure is highly variable

Lice are ectoparasitic insects hosted by birds and mammals. Mitochondrial 12S rRNA sequences obtained from lice show considerable length variation and are very difficult to align. We show that the louse 12S rRNA domain III secondary structure displays considerable variation compared to other insects, in both the shape and number of stems and loops. Phylogenetic trees constructed from tree edit distances between louse 12S rRNA structures do not closely resemble trees constructed from sequence data, suggesting that at least some of this structural variation has arisen independently in different louse lineages. Taken together with previous work on mitochondrial gene order and elevated rates of substitution in louse mitochondrial sequences, the structural variation in louse 12S rRNA confirms the highly distinctive nature of molecular evolution in these insects.     

120例银屑病患者尿酸水平、血脂代谢及其临床诊断意义

目的探讨120例银屑病患者尿酸、血脂代谢及其临床诊断意义。方法选取120例银屑病患者。检测所有患者的尿酸、血脂,比较银屑病组与对照组TC、TG、HDL-C、LDL-C、ApoA1、ApoB、尿酸值,比较不同类型银屑病患者血脂代谢情况。结果银屑病组TC、HDL-C、ApoA1水平显著低于对照组(P0.05),TG水平显著高于对照组(P0.05)。脓疱型患者TC、HDL-C、LDL-C、ApoA1、ApoB水平显著低于其他2组(P0.05);银屑病组男、女血清尿酸值均显著高于对照组(P0.05)。结论分析银屑病患者尿酸、各项血脂代谢具有非常重要的诊断意义。     

乳腺癌表皮生长因子受体,雌激素受体,孕激素受体的表达及其意义

应用免疫组化ＡＢＣ法，对１００例乳腺癌的表皮生长因子受体（ＥＧＦＲ），ＥＲ及ＰｇＲ进行了检测。结果显示：ＥＧＦＲ阳性３４例，ＥＲ阳性６１例，其中３项均阳性者５例，ＥＲ与ＥＧＦＲ，ＰｇＲ与ＥＧＦＲ阳性者各８例，结果说明乳腺癌中ＥＧＦＲ阳性率高于良性乳腺肿瘤，差异显著（Ｐ〈０．０１）。     

银屑病患者血脂水平分析

目的研究银屑病患者脂代谢紊乱情况,分析不同类型银屑病患者血脂变化特点。方法将332例银屑病患者按临床表现分为脓疱型、寻常型及红皮病型,比较各组间的血脂水平。结果与对照组比较,银屑病组总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A1(ApoA1)水平较低,差异有统计学意义(P0.05),脂蛋白[Lp(a)]水平较高,差异有统计学意义(P0.05);脓疱型银屑病型与寻常型、红皮病型相比,血清TC、HDL-C、LDL-C及ApoA1均较低,差异有统计学意义(P0.05)。结论银屑病患者体内存在脂代谢紊乱,且其紊乱严重情况可能与疾病类型有关。     

应用Amplatzer封堵器介入治疗小儿房间隔缺损的护理配合

目的探讨应用Amplatzer封堵器介入治疗小儿房间隔缺损(ASD)的护理特点.方法全组56例,男19例,女37例,平均年龄(6.2±3.4)岁.在行Amplatzer封堵器治疗前后,针对小儿特点,对其生命体征(体温、脉搏、呼吸、血压)及其出凝血情况进行监测.结果术前与患儿家属进行必要的交流,有助于解除家属心理压力,有助于手术顺利进行;术中密切观察心率、心律、血压、呼吸,以保持生命体征平稳;术后注意观察伤口有无渗血,皮肤紫斑及生命体征,以避免低血容量及出血倾向.结论应用Amplatzer治疗ASD是有效的非手术方法,护理时应针对患儿特点,进行术前、中、后有效的护理,避免低血容量、出血等各种手术并发症发生.     

Sonographic assessment of the liver in children with psoriasis

PURPOSE: The aim of this study was to compare the size and echotexture of the liver in psoriatic and healthy children. METHODS: In 70 psoriatic and 43 healthy children, longitudinal sonograms of the liver were obtained along standardized section planes defined by the anterior axillary line, medioclavicular line, and midline. The livers' size and echotexture were examined and compared between the study groups. RESULTS: The measurements of the liver along the 3 section planes were not significantly different between psoriatic and healthy children. Parenchymal liver echogenicity in psoriatic children was neither decreased nor increased. CONCLUSIONS: No abnormality in size or echotexture of the liver was found in the psoriatic children.     

经胸超声心动图对房间隔缺损封堵治疗的作用评价

目的探讨经胸超卢指导下心导管封堵术在房间隔缺损治疗中的价值。方法回顾分析40例介入治疗房间隔缺损患儿的疗效。结果其中38例封堵获得成功,2例失败,术后随访2月～2年,无不良并发症。结论经胸超声指导下封堵术治疗房间隔缺损成功率高,创伤小,并发症低,住院时间短,是一项有发展前景的治疗方法。