髓系肉瘤2例临床分析

为了提高对髓系肉瘤（MS）的临床病理特征、诊断及治疗的认识,通过对2例MS患者的临床表现、诊断及治疗进行分析,并复习相关文献。该2例患者包括孤立性MS 1例,白血性MS 1例,均来源于急性髓系白血病,其中白血性MS 1例患者已死亡,生存时间为10个月。 MS诊断和鉴别诊断主要依靠病理形态学及免疫组织化学。白血性MS预后差,早期确诊和早期采用急性髓系白血病方案全身化疗对控制疾病进展有一定的疗效。     

代谢综合征对脑梗死病情的影响及IDF标准的适用性

目的通过了解代谢综合征(MS)对急性脑梗死病情严重程度的影响,对国际糖尿病联盟(IDF)诊断标准的适用性进行观察,以指导建立更适合中国人的MS诊断标准。方法收集2007-01～2008-12在解放军第152医院神经内科住院的急性脑梗死患者的年龄、性别、腰围、血压、血脂、血糖、平均颈动脉内中膜厚度、入院时NIHSS评分、住院天数及住院费用等临床资料,根据MS诊断标准进行分组,应用t检验等统计学方法分析以上因素与急性脑梗死患者病情严重程度的关系。结果应用IDF的MS诊断标准,合并MS的急性脑梗死患者与非MS的脑梗死患者在疾病严重程度和住院负担等方面无显著性差异。结论 IDF标准在中国急性脑梗死患者人群中可能不适用,建议使用其它标准,尤其是对腰围限制小的诊断标准。     

视神经脊髓炎患者水通道蛋白4抗体的临床观察

目的：观察水通道蛋白4（AQP4）抗体在视神经脊髓炎（NMO）、多发性硬化（MS）及其他神经系统疾病中的灵敏度和特异性。方法用间接免疫荧光法检测90例NMO、MS及其他神经系统疾病患者AQP4抗体,探讨AQP4抗体的诊断及鉴别诊断价值。结果视神经脊髓炎患者中AQP4抗体阳性70%,特异性达91%。AQP4滴度在NMO, MS及其他神经科疾病患者中差异有统计学意义（P〈0.05）。结论 AQP4抗体在诊断、鉴别诊断NMO, MS及其他神经系统疾病中有很高的应用价值。     

代谢综合征发病机制与防治研究进展

代谢综合征(metabolic syndrome,MS)是向心性肥胖、高血糖、血脂紊乱和高血压等在个体聚集的症候群.早在1923年Kylin就对MS现象进行了描述,MS曾被称为"死亡四重奏"、X综合征和胰岛素抵抗(insulin resistance,IR)综合征.1999年WHO首次提出了MS定义,2005年国际糖尿病联盟(IDF)制定了全球新的诊断标准,而且MS诊断已编入国际疾病分类第九版(临床修订版).     

代谢综合征发病机制与防治研究进展

代谢综合征(metabolic syndrome,MS)是向心性肥胖、高血糖、血脂紊乱和高血压等在个体聚集的症候群.早在1923年Kylin就对MS现象进行了描述,MS曾被称为"死亡四重奏"、X综合征和胰岛素抵抗(insulin resistance,IR)综合征.1999年WHO首次提出了MS定义,2005年国际糖尿病联盟(IDF)制定了全球新的诊断标准,而且MS诊断已编入国际疾病分类第九版(临床修订版).     

代谢综合征的预防策略

代谢综合征（metabolic syndrome,MS）已被广泛认同是一个影响人类健康的重大卫生问题。世界卫生组织（WHO）于1999年率先提出MS的工作定义,中国糖尿病学会（CDS）于2004年公布我国的MS诊断标准,2005年4月国际糖尿病联盟（IDF）发布MS的全球最新诊断标准。     

三种代谢综合征工作定义在冠心病患者中应用的比较

目的采用三种代谢综合征（MS）定义,对中国冠心病患者MS患病率及其诊断一致性进行探讨。方法收集2007年1月至2008年6月北京安贞医院2356例冠心病确诊患者的病历资料,分别用国际糖尿病联盟（IDF）、中华医学会糖尿病学分会（CDS）以及修订的美国国家胆固醇教育纲要——成人治疗专家组第3次报告（ATP III）的工作定义诊断MS,比较MS的患病率,并对诊断结果进行比较。结果按修订的ATP III诊断标准、CDS诊断标准和IDF诊断标准,2356例冠心病患者的MS患病率分别为54．0％（1273例）、46．1％（1086例）和51．3％（1208例）,修订的ATP III诊断标准总患病率高于CDS、IDF的患病率,差异有统计学意义（P〈0．05）。修订ATP III与IDF诊断工作定义的一致率为95．60％,k值为0．91;修订的ATPⅢ与CDS诊断工作定义的一致率为77．29％,k值为0．55;CDS与IDF诊断工作定义的一致率为78．69％,k值为0．57,K值的差异均有统计学意义（P〈0．05）。结论冠心病患者MS的患病率较高,IDF、修订ATPⅢ和CDS的诊断一致性较好。     

32例多发性硬化的诱发电位联合检查

多发性硬化典型病人一般在数年甚至数十年,有多次发作与缓解,复发间隔一般不能少于一个月。因此,多发性硬化患者首次发病时多不能早期确定诊断。如对早期MS病人进行VEP、SEP、BAEP联合检查,有利早期确定诊断。1　资料与方法1.1　病例选择:本组MS病人全部为我院神经内科及门诊近几年的病人。诊断标准依据我国及Poser等人MS诊断标准。32例患者均确诊MS,其中男性13例,女性19例,年龄为23～61岁,病程1到10年,半数以上病人病程在1年以上;24例有多次复发并缓解。     

多发性硬化症患者血清特种蛋白的检测分析研究

多发性硬化症（MS）为一种特定地针对中枢神经系统白质、导致其脱髓鞘的自身免疫病。典型发展过程呈慢性或间歇性,本病的病因至今尚未完全清楚,随着磁共振成像（MRI）的应用,国内报道亦趋增加。我们按1982年美国华盛顿MS诊断专题会议及1983年Poser等MS诊断标准的临床分型,收集2004--2008年间收治的20例。     

多发性硬化54例临床分析

目的 对我科2006年以来诊治的54例多发性硬化(multiple sclerosis,MS)的临床资料进行总结,以提高MS的临床诊断水平.方法 回顾性分析54例MS的临床症状、实验室资料和MRI特点.结果 54例MS患者中,症状以肢体无力、感觉异常、视力障碍、头晕及共济失调较为突出,MRI对除视神经外的MS病灶有高度...     

Efficacy of gut lavage,hemodialysis, and hemoperfusion in the therapy of paraquat or diquat intoxication

Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents.Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1–2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1–2 ppm, the clearance values for hemoperfusion were some 5–7 times higher than those for hemodialysis.In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquat less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.

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Zusammenfassung Klinische Untersuchungen und Laboratoriumsversuche wurden durchgeführt, um die Wirksamkeit von Darmspülung, Hämodialyse und Hämoperfusion bei Paraquat- und Deiquat-Vergiftungen zu prüfen.Bei einem Patienten wurde 30 Std nach Deiquat-Aufnahme durch Darmspülung 130mal mehr Deiquat entfernt als durch vollständige Aspiration des Mageninhaltes. In vitro-Versuche ergaben, daß bei Blutserumkonzentrationen von 1–2 ppm, die bei Vergiftungen oft gemessen werden, durch Hämodialyse keine toxikologisch relevanten Paraquat- oder Deiquat-Mengen entfernt werden können. Dagegen erwies sich die Hämodialyse bei 20 ppm und einer Blutumlaufgeschwindigkeit von 100 ml/min mit einer Clearance von 70 ml/min als wirksam. Die Hämoperfusion mit beschicheter Aktivkohle war in diesen Versuchen aber eindeutig überlegen, denn insbesondere bei Konzentrationen um 1–2 ppm waren die Clearance-Werte 5–7mal höher als bei der Hämodialyse.Die in vitro-Ergebnisse wurden bei einem Patienten mit einer Paraquat-Vergiftung bestätigt: Bei Konzentrationen unter 1 ppm war die Hämodialyse wirkungslos, während durch Hämoperfusion relativ hohe Clearance-Werte erreicht wurden, so daß der Serumspiegel rasch unter die Nachweisgrenze abfiel.

     

In vitro studies on sterically stabilized liposomes (SL) as enzyme carriers in organophosphorus (OP) antagonism

This study describes a new approach for organophosphorous (OP) antidotal treatment by encapsulating an OP hydrolyzing enzyme, OPA anhydrolase (OPAA), within sterically stabilized liposomes. The recombinant OPAA enzyme was derived from Alteromonas strain JD6. It has broad substrate specificity to a wide range of OP compounds: DFP and the nerve agents, soman and sarin. Liposomes encapsulating OPAA (SL)* were made by mechanical dispersion method. Hydrolysis of DFP by (SL)* was measured by following an increase of fluoride ion concentration using a fluoride ion selective electrode. OPAA entrapped in the carrier liposomes rapidly hydrolyze DFP, with the rate of DFP hydrolysis directly proportional to the amount of (SL)* added to the solution. Liposomal carriers containing no enzyme did not hydrolyze DFP. The reaction was linear and the rate of hydrolysis was first order in the substrate. This enzyme carrier system serves as a biodegradable protective environment for the recombinant OP-metabolizing enzyme, OPAA, resulting in prolongation of enzymatic concentration in the body. These studies suggest that the protection of OP intoxication can be strikingly enhanced by adding OPAA encapsulated within (SL)* to pralidoxime and atropine.     

Aquatic Insects and Trace Metals: Bioavailability,Bioaccumulation, and Toxicity

Abstract

The uptake of metals from food and water sources by insects is thought to be additive. For a given metal, the proportions taken up from water and food will depend both on the bioavailable concentration of the metal associated with each source and the mechanism and rate by which the metal enters the insect. Attempts to correlate insect trace metal concentrations with the trophic level of insects should be made with a knowledge of the feeding relationships of the individual taxa concerned. Pathways for the uptake of essential metals, such as copper and zinc, exist at the cellular level, and other nonessential metals, such as cadmium, also appear to enter via these routes. Within cells, trace metals can be bound to proteins or stored in granules. The internal distribution of metals among body tissues is very heterogeneous, and distribution patterns tend to be both metal and taxon specific. Trace metals associated with insects can be both bound on the surface of their chitinous exoskeleton and incorporated into body tissues. The quantities of trace meals accumulated by an individual reflect the net balance between the rate of metal influx from both dissolved and particulate sources and the rate of metal efflux from the organism. The toxicity of metals has been demonstrated at all levels of biological organization: cell, tissue, individual, population, and community. Much of the literature pertaining to the toxic effects of metals on aquatic insects is based on laboratory observations and, as such, it is difficult to extrapolate the data to insects in nature. The few experimental studies in nature suggest that trace metal contaminants can affect both the distribution and the abundance of aquatic insects. Insects have a largely unexploited potential as biomonitors of metal contamination in nature. A better understanding of the physico-chemical and biological mechanisms mediating trace metal bioavailability and exchange will facilitate the development of general predictive models relating trace metal concentrations in insects to those in their environment. Such models will facilitate the use of insects as contaminant biomonitors.     

Alzheimer’s disease – current trends in basic and clinical research. Highlights from the 16th ECNP

Advances in the molecular biological knowledge of neuronal nicotinic acetylcholine receptors (nAChRs) have led to a growing interest by the pharmaceutical industry in the development of novel compounds that selectively modulate nAChR function. The ability of (-)-nicotine, an activator of nAChRs, to enhance attentional aspects of cognition in animals and humans, to exert neuroprotective and anxiolytic-like effects, and presumably to mediate the negative correlation between smoking and Alzheimer's (and Parkinson's) Disease, has focused interest on the potential therapeutic utility of modulators of nAChR function for treatment of some of the deficits associated with these progressive, neurodegenerative conditions. Numerous compounds are known which activate nAChRs and which might serve as lead compounds toward the development of such agents. The pharmacologic diversity of neuronal nAChR subtypes suggests the possibility of developing selective compounds which would have more favourable side-effect profiles than existing agents. This broader class of agents, collectively called cholinergic channel modulators (ChCMs), is anticipated to encompass compounds which would have more favourable side-effect profiles than existing agents, which generally exhibit low selectivity. This selectivity may be achieved by preferentially activating some subtypes of nAChRs (i.e., Cholinergic Channel Activators, ChCAs) or inhibiting the function of other subtypes (Cholinergic Channel Inhibitors, ChCIs). An overview of the biology of nAChRs and the rationale for the use of ChCMs for the treatment of dementia related to neurodegenerative diseases are presented, followed by a discussion of lead compounds and compounds under consideration for clinical evaluation.     

Steroidal sapogenin contents in some domestic plants

In order to find out the values of the steroid resources for the future use. the compositions and contents of steroidal sapogenins from 13 domestic plants have been investigated. As a result,Dioscorea nipponica, D. quinqueloba andSmilax china were found to have large amount of diosgenin. And pennogenin inTrillium kamtschaticum andParis verticillata, yuccagenin inAllium fistulosum, hecogenin inAgave americana and neochlorogenin inSolanum nigum were appeared to be major steroidal sapogenins.