CCMD-3与DSM-Ⅳ儿童孤独症两种诊断标准的比较

目的：比较中国精神疾病分类方案与诊断标准第三版（CCMD-3）与美国精神障碍诊断和统计手册第四版（DSM-Ⅳ）儿童孤独症诊断的一致性，探讨CCMD-3儿童孤独症诊断中存在的问题，确定诊断标准中各症状条目的出现频率。方法：运用CCMD-3和DSM-Ⅳ儿童孤独症诊断标准对连续首次就诊的255名可疑发育障碍儿童进行诊断。结果：两种诊断系统儿童孤独症、不典型孤独症、非孤独症诊断的总体一致率为96．08％；诊断差异主要来自于儿童孤独症和不典型孤独症的诊断不一致；个别症状在孤独症儿童中出现频率较低。结论：CCMD-3和DSM-Ⅳ儿童孤独症诊断标准具有较好的诊断一致性；为进一步提高诊断一致性，对CCMD-3中个别症状条目予以调整有所必要。     

尼莫地平对脑出血患者血浆ET-1和CGRP影响的临床探讨

目的：探讨脑出血患者血浆ET-1和CGRP变化以及尼莫地平治疗对血浆ET-1和CGRP的影响。方法：60例脑出血患者随机分为尼莫地平组与常规治疗组,在治疗前后进行血浆ET-1、CGRP水平测定。结果：尼莫地平组和常规治疗组治疗前血浆ET-1和CGRP均显著增高,治疗后明显下降,治疗后血浆ET-1和CGRP降低值尼莫地平组明显高于常规治疗组（P〈0．01）。尼莫地平组与常规治疗组治疗前血肿体积与血浆ET-1和CGRP水平呈显著性正相关,治疗后也呈显著性正相关。结论：脑出血患者血浆ET-1及CGRP水平显著升高,尼莫地平组治疗后明显下降。     

A Case of Eosinophilic Fasciitis Presenting as Pitting Edema of the Lower Extremities

Eosinophilic fasciitis is a rare disease characterized by diffuse fasciitis with peripheral eosinophilia and progressive induration and thickening of the skin and soft tissues. We report a 19-year-old female who presented with pitting edema in both lower extremities. She had a history of excessive physical activity before her symptoms developed. Physical examination revealed 2+ pitting edema in both lower legs. She complained of mild pain in both knee joints and feet, with no tenderness or heating sensations. Laboratory results were unremarkable except for severe eosinophilia. Parasite infection, venous thrombosis, and cardiac and renal problems were excluded. A magnetic resonance imaging study of both lower extremities revealed increased signal intensity in the subcutaneous lesions, consistent with superficial inflammation of the fascia. Mixed perivenular lymphoplasmacytic and eosinophilic infiltration in the subcutaneous lesion were observed on biopsy. The patient was treated with corticosteroids, resulting in remarkable improvement in both edema and eosinophilia.     

Asthma and Allergic Rhinitis in the Same Patients

This study from Danish general practice gives Figures about the simultaneous prevalence of asthma and allergic rhinitis and the order of onset among 7662 patients, who during 1 year consulted for one or both of these diseases. Twenty-eight percent of patients with asthma consulted because they also had allergic rhinitis, and 17% of patients with allergic rhinitis consulted because they also had asthma. Age- and sex-distributions are presented. In 25% of patients with both diseases the onset of both diseases occurred within the same year, while in 35% the onset of asthma occurred first and in 40% allergic rhinitis.
Among patients with both diseases, who did not have onset of both within the same year, more than 75% of them had onset of one disease within 2 years of the other.     

Visuomotor learning generalizes between bilateral and unilateral conditions despite varying degrees of bilateral interference

Bilateral interference, referring to the tendency of movements of one arm to disrupt the intended movements made simultaneously with the other arm, is often observed in a task that involves differential planning of each arm movement during sensorimotor adaptation. In the present study, we examined two questions: 1) how does the compatibility between visuomotor adaptation tasks performed with both arms affect bilateral interference during bimanual performance? and 2) how do variations in bilateral interference affect transfer of visuomotor adaptation between bilateral and unilateral conditions? To examine these questions, we manipulated visuomotor compatibility using two kinematic variables (direction of required hand motion, direction of an imposed visual rotation). Experiment 1 consisted of two conditions in which the direction of visual rotations for both arms was either in the same or opposing directions, whereas the target direction for both arms was always the same. In experiment 2, we examined the pattern of generalization between the bilateral and unilateral conditions when both the target and rotation directions were opposing between the arms. In both experiments, subjects first adapted to a 30° visual rotation with one arm (preunilateral), then with both arms (bilateral), and finally with the arm that was not used in the first session (postunilateral). Our results show that bilateral interference was smallest when both variables were the same between the arms. Our data also show extensive transfer of visuomotor adaptation between bilateral and unilateral conditions, regardless of degree of bilateral interference.     

Herbal medication aggravates cataract formation: a case report

We report a case of complicated cataract aggravated after taking herbal medication for atopic dermatitis. An 11-yr-old boy was referred for the evaluation of decreased visual acuity in both eyes for 2 months. Past history showed that he had been diagnosed with atopic dermatitis when he was 1 yr old. He had been treated only with herbal medication for a period of 8 months prior to visiting our clinic. He had his visual acuity checked in a local ophthalmic clinic one year before, and the visual acuity was 20/20 in both eyes at that time. When attending our clinic the ophthalmologic examination showed that his best corrected visual acuity was 20/200 in both eyes. Lenses of both eyes had severe posterior subcapsular and posterior capsular opacity. Phacoemulsification, posterior chamber intraocular lens implantation, and posterior continuous curvilinear capsulectomy were performed in both eyes. After 3 months postoperatively, the best corrected visual acuity was recovered to 20/20 in both eyes without any complication. Our case suggests that there may be a risk of aggravation of cataract or development of cataract after treatment with some unidentified herbal medication in a patient with atopic dermatitis.     

Impact of Hepatitis B and Hepatitis C Virus Infections in a Hematology-Oncology Unit at a Children's Hospital in Nicaragua, 1997 to 1999

The risk of acquiring both hepatitis B virus (HBV) and hepatitis C virus (HCV) infections in patients with hematological-oncological disorders has been documented. However, the impact and risk factors for such infections from different geographical areas vary, and the use of both immunological and molecular assays to determine HCV infections has been our approach. Children from a hematology-oncology unit (HOU) in Nicaragua were studied for both HBV and HCV serological markers; studies for the latter used both immunological (anti-HCV) and molecular (HCV RNA) assays. The children from the HOU included patients with leukemia, lymphoma, other neoplasias, and anemia and a smaller group with other hematological diseases. As a control group, children from other units at the same hospital were enrolled, as well as health care workers attending both patient populations. Pertinent clinical and personal data for each child at the HOU were obtained for statistical analysis. Of the 625 children from the HOU enrolled in this study 53.3% were infected with HCV and 29.4% had a prior or present HBV infection. In the child patient control group 3.2% had HBV markers and all were negative for HCV. The group of children with leukemia had the highest infection rate for both HBV and HCV. However, the determination of anti-HCV was found to have an overall low sensitivity in children from HOU, and a retest consisting of a molecular assay to determine HCV RNA was performed to better establish the total number of HCV-infected subjects in this group. The highest independent risk factor for infection was hospitalization. The very high prevalence rates for both HBV and HCV infection in this patient group indicate an urgent need to implement better control of known risk factors and to consider the use of both immunological and molecular assays for HCV diagnostic purposes.     

乳腺癌组织bcl—2,P53和c—erbB—2蛋白表达和相互关系及意义

为探明bcl-2、P53和c－erbB－2在肿瘤中表达之间的关系及意义。应用免疫组织化学LSAB法对145例乳腺癌组织进行检测。结果：全部阴性为19例（13．1％），全部阳性12例（83％）。仅c－erbB－2阳性者19例（13．1％），仅P53阳性者20例（13．8％），仅bcl－2阳性者20例（13．8％）c－erbB－2和P53阳性者26例（179％）c－erbB－2和bcl-2阳性者17例（11．7％）及P53和hcl－2阳性者12例（8．3％）。P53和hcl－2表达率之间有明显负相关性（P＜0．01）。P53阳性及P53与c－erbB－2共同阳性者分化差，而bcl－2阳性者分化较好（P＜0．05）。单独bcl－2阳性者坏死明显少于单独c－erbB－2阳性者和c－erbB－2与P53共同阳性者（P＜0．02）。bcl－2阳性者核分裂少，而c－erbB－2和P53均阳性者核分裂多（P＜0．05）。c－erbB－2和P53影响患者的生存期（P＜0．02，P＜0．05），而bcl-2无明显影响。二种以上蛋白表达者死亡率较高。提示这三种蛋白均参与了乳腺癌的发生发展过程，有不同的生物学作用。     

Interleukin-10, interleukin-12, and interferon-gamma levels in the respiratory tract following mycoplasma hyopneumoniae and PRRSV infection in pigs

The cytokine profile associated with either a T helper 1 (Th1) or Th2 response in a porcine respiratory disease model was assessed by measuring IL-12, IL-10 and IFN-gamma using RT-PCR and ELISA, respectively. IL-10, IL-12, and IFN-gamma levels in pulmonary alveolar macrophages and bronchial lavage fluid were increased in pigs infected with porcine reproductive and respiratory syndrome virus (PRRSV), Mycoplasma hyopneumoniae, or both pathogens. At 10 days post-infection (DPI), both IL-10 and IL-12 mRNA levels were increased in both groups infected with PRRSV. The IL-12 levels were increased in pigs infected with both pathogens and IFN-gamma protein levels were increased in pigs infected with PRRSV alone and only numerically increased in the dual infection. At 28 DPI, IL-12 mRNA levels and IL-10 protein levels were increased in all infected groups. The mRNA level of IL-12 remained elevated in the group infected with both pathogens at 42 DPI. Production of IFN-gamma did not appear to be closely correlated with elimination of virus from the respiratory tract. However, when the virus existed in the lung, the local IFN-gamma production appeared to increase. Although IL-12 mRNA levels were significantly elevated in the pigs infected with both pathogens, the increased protein levels of IL-12 may compromise the immune system's ability to clear PRRSV from the lung. This could explain the prolonged presence of PRRSV, IFN-gamma production and the increased pneumonia observed in the lungs of dual-infected pigs. The increased levels of cytokines associated with both Th1 and Th2 responses in the respiratory tract of pigs infected with PRRSV and M. hyopneumoniae provides valuable information on the pathogenesis of these diseases.     

Herpes simplex lymphadenitis

Localized herpetic lymphadenitis is an extremely uncommon complication of herpes simplex virus (HSV) infection. The authors report two cases of localized herpetic lymphadenitis, both showing well-circumscribed areas of necrosis containing cells with diagnostic intranuclear inclusions. Electron microscopic studies in both cases revealed characteristic viral particles, and in situ hybridization studies using a herpes simplex genomic probe demonstrated HSV DNA in both specimens. Immunohistochemical studies demonstrated that the cells containing the inclusions were stromal, not lymphoid, cells. Combining the current two cases with the six well-documented cases previously reported in the literature, seven of the eight cases of HSV lymphadenitis have developed in inguinal lymph nodes, with four occurring in patients with previously or subsequently diagnosed hematopoietic malignancies, including both patients in the current series.     

Delayed Hypersensitivity, Macrophage Migration, and Antibodies in Guinea-Pigs Immunized with Diphtheria Toxoid

Guinea-pigs were immunized with diphtheria toxoid (DT) or with DT-anti-toxin precipitate, both in Freund's complete adjuvant (FCA). DT-induced inhibition of peritoneal cell migration was equally strong in both groups and increased with time after immunization. Some guinea-pigs immunized with DT-antitoxin precipitate were boosted with DT or DT-antitoxin precipitate, both in FCA. This increased the antibody titre but did not affect 24-hour skin reactivity or migration inhibition. Migration inhibition did not correlate with anti-DT passive haemagglutinins, haemolysins, or cytophilic antibody on peritoneal cells, but did correlate with 24-hour skin reactivity.     

Aging of metacarpal density at midshaft and proximal end

Aging of bone density of the second metacarpal at midshaft (compact bone) and the proximal end (trabecular bone) was compared in 114 men and 115 women, 30–98 years of age. The microdensitometric (MD) pattern of the bone at both sites, area (Σ GS) and midheight (GSmid), were measured in standardized aluminun equivalents (SAE). In both sexes, Σ GS and GSmid showed a greater deviation at the proximal end than at midshaft. There was a significant correlation between both sites for each parameter. Pattern area was significantly greater at the proximal end than at midshaft(P ? 0.01), but the relation was reversed for GSmid. At both sites, Σ GS and GSmid decreased gradually with age in both sexes, especially after 69 years in women. Each parameter showed a significant negative linear regression with age at both sites in women and at midshaft in men. In both sexes, the slope of the regression curve of Σ GS with age was significantly steeper at the proximal end than at midshaft. In women, the estimated rate of decline was 0.90% and 0.56% for Σ GS, and 1.20% and 0.73% for GSmid per year at the proximal end and midshaft, respectively. The bone density loss with age may be slightly greater in trabecular than in compact bone. © 1995 Wiley-Liss, Inc.     

Impact of hepatitis B and hepatitis C virus infections in a hematology-oncology unit at a children's hospital in Nicaragua, 1997 to 1999

The risk of acquiring both hepatitis B virus (HBV) and hepatitis C virus (HCV) infections in patients with hematological-oncological disorders has been documented. However, the impact and risk factors for such infections from different geographical areas vary, and the use of both immunological and molecular assays to determine HCV infections has been our approach. Children from a hematology-oncology unit (HOU) in Nicaragua were studied for both HBV and HCV serological markers; studies for the latter used both immunological (anti-HCV) and molecular (HCV RNA) assays. The children from the HOU included patients with leukemia, lymphoma, other neoplasias, and anemia and a smaller group with other hematological diseases. As a control group, children from other units at the same hospital were enrolled, as well as health care workers attending both patient populations. Pertinent clinical and personal data for each child at the HOU were obtained for statistical analysis. Of the 625 children from the HOU enrolled in this study 53.3% were infected with HCV and 29.4% had a prior or present HBV infection. In the child patient control group 3.2% had HBV markers and all were negative for HCV. The group of children with leukemia had the highest infection rate for both HBV and HCV. However, the determination of anti-HCV was found to have an overall low sensitivity in children from HOU, and a retest consisting of a molecular assay to determine HCV RNA was performed to better establish the total number of HCV-infected subjects in this group. The highest independent risk factor for infection was hospitalization. The very high prevalence rates for both HBV and HCV infection in this patient group indicate an urgent need to implement better control of known risk factors and to consider the use of both immunological and molecular assays for HCV diagnostic purposes.     

Fused eyelids, airway anomalies, ovarian cysts, and digital abnormalities in siblings: a new autosomal recessive syndrome or a variant of Fraser syndrome?

We describe two siblings of unlike gender born to non-consanguineous parents, with similar and unique congenital malformations. These include fused eyelids, craniofacial anomalies, ovarian cyst, subglottic stenosis, specific digital abnormalities, and no detected chromosomal abnormality. The specific digital abnormalities in both patients are characterized by extension of metacarpophalangeal joints with flexion of the proximal interphalangeal joint of both index fingers with resulting overlap of the second digit over the third. Similar changes were noted in both second toes. The brain weight of both infants was less than that expected for their birth weights. We reviewed the differential diagnosis of fused eyelids, airway anomalies, and ovarian cysts, and the manifestations resemble those seen in Fraser syndrome. We conclude that the dissimilarities warrant considering that our patients have a distinct autosomal recessive syndrome.     

beta-Glucosidase in Candida albicans and its application in yeast identification.

In this report we attempt to explain the discrepancy between beta-glucosidase (EC 3.2.1.21) activity in Candida albicans as measured by commercial kits and that found in an experimental assay. beta-Glucosidase activity in American and Israeli isolates of C. albicans was evaluated with the API ZYM and YeastIdent systems (Analytab Products) and with experimental biochemical assays. Activity was found with whole cells and cell extracts of isolates from both sources. The greatest beta-glucosidase activity was found at pH 5.0 and with p-nitrophenyl-beta-glucopyranoside (PNP-BDG) as the substrate. In assays with beta-naphthyl-beta-D-glucopyranoside and 6-bromo-2-naphthyl-beta-D-glucopyranoside (6-Br-2-naphthyl-BDG), no enzyme activity was detected in whole cells and only limited activity was found in cell extracts of isolates from both sources. In studies with PNP-BDG at pH 5.0 and 7.5, 29 to 38% less activity was found at both pHs with American whole cells, and minor activity (20%) was found at pH 7.5 with isolates from both sources. Because assays with PNP-BDG in cell extracts of isolates from both sources showed no significant differences in activity, the more limited beta-glucosidase activity in American whole cells was most likely due to less efficient transport. Because the API ZYM system uses 6-Br-2-naphthyl-BDG as the substrate and because the substrate is buffered at pH 7.5 in the API YeastIdent kit, both systems appear to be of limited value for the detection of beta-glucosidase activity in C. albicans.     

Dark cell proliferation in carotid body hyperplasia

The histopathology of the enlarged carotid bodies, in both qualitative and quantitative terms, is described in two cases. One was in a woman of 80 years with systemic hypertension and the other in a man of 72 years with pan-acinar emphysema complicated by chronic hypoxaemia. In both instances there was generalized hyperplasia of sustentacular cells, perhaps with involvement of Schwann cells and fibrocytes, with superimposed focal proliferation of dark or 'pyknotic' variants of chief cells. The functional significance of both froms of tissue response in the carotid bodies is speculated upon.     

Mental Rotation Performance in Children With Hydrocephalus Both With and Without Spina Bifida

The mental rotation ability in children with hydrocephalus and those with both hydrocephalus and spina bifida in comparison to healthy controls was investigated in this study. All groups performed a chronometric mental rotation test. Compared to children with hydrocephalus, children with both spina bifida and hydrocephalus showed an impaired mental rotation performance, demonstrated by slower reaction times. No significant performance difference was found between children with spina bifida and healthy controls. Error rates were comparable between groups indicating that the impaired mental rotation performance in children with both spina bifida and hydrocephalus is primarily due to motor impairment.     

Relaxation behavior therapy as sole treatment for mild hypertension.

This study tested the efficacy of relaxation therapy as sole treatment for mild hypertension in 110 men and women recruited from a five-stage worksite blood pressure screening program. Participants were randomized to 12-weeks of relaxation therapy or support therapy. Outcome blood pressure assessments made by assessors who were unaware of group allocation revealed similar decreases in both treatment groups at post-treatment and 6-month follow-up. While body weight did not change, alcohol consumption decreased similarly in both groups, and alcohol consumption was positively correlated with both absolute diastolic blood pressure and change in diastolic blood pressure at outcome. In conclusion, a superior blood pressure effect was not associated with relaxation therapy; however, alcohol consumption decreased in both treatment groups, suggesting that both interventions facilitated changes in health risk behaviors and indirectly on blood pressure level.     

Synthesis of herpes simplex virus DNA in preparations of chromatin from infected cell nuclei.

Chromatin prepared from cells infected with Herpes simplex virus type 1 or type 2 can synthesize both virus and cell DNA in vitro. The rate of synthesis is comparable to that of isolated whole nuclei. Incorporation is limited, and both cell and virus DNA synthesis are sensitive to the presence of virus-specific antiserum and phosphonoacetate. In chromatin from cells infected with a phosphonoacetate resistant virus mutant, both types of DNA synthesis are resistant to the presence of the inhibitor.