Clinical and histopathological findings of ''psoriatic neurodermatitis'' and of typical lichen simplex chronicus

BACKGROUND: We have seen several patients with itchy lichenified plaques located bilaterally on the elbows and/or knees and have named this condition 'psoriatic neurodermatitis' (PN). OBJECTIVE: The purpose of this study was to compare clinical and histopathological characteristics of these patients to those of patients with typical lichen simplex chronicus (LSC). METHODS: Nineteen patients with PN and 34 patients with typical LSC were included. Besides clinical dermatological evaluation, the prick test was carried out on 49 patients; the Phadiatop test on 40 patients; the patch test with European standard series on 47 patients; histopathological evaluation on 39 patients; and clinical psychiatric examination on 38 patients. RESULTS: Almost exclusively, PN was seen in females and was located on the extremities. It caused more plaques than typical LSC did. In PN, the plaques were smaller, sharper, more keratotic and less excoriated, and had fewer lichenoid papules around them. Itching was usually more severe in the evening, while resting and in a hot environment in typical LSC, but not in PN. In plaques of PN, microabscesses in the horny layer, hypogranulosis, regular acanthosis and thinning of the suprapapillary plates were more frequent, and hyperpigmentation in the basal layer was less. In patients with PN, depressive disorder was found more frequently; and generalized anxiety disorder or psychosomatic characteristics, less. There were no significant differences in the results of prick, Phadiatop and patch tests between patients with PN and those with typical LSC. CONCLUSION: In our opinion, it is most likely that the so-called PN is itchy psoriasis superimposed by LSC.     

大鼠出生前接触苯妥英和褪黑素对仔代反射功能发育及自发运动的影响

目的 :探讨苯妥英 (DPH)神经发育毒性与胚胎脑组织中自由基产生和氧化应激反应的关系。方法 :Wistar孕鼠于妊娠d 11～ 14经 0 ,10 0 ,2 0 0mg·kg-1DPH或合并 4 0mg·kg-1褪黑素 (MT)染毒处理 ,研究MT对DPH的仔代反射功能发育及自发运动损害作用的拮抗效应。结果 :孕鼠在染毒期及染毒后增重下降 ,仔代体重减轻 ,哺乳期死亡率增高 ;DPH染毒仔鼠的转身运动增多 ,空中翻正反射及游泳能力发育延迟 ,成年后行走次数、站立次数、刻板动作等自发活动增多 ,旋转手比率增多 ,对阿朴吗啡“激发”反应性增强。MT和DPH合并处理可明显拮抗上述DPH仔鼠的行为异常。结论 :氧化性损伤在DPH神经发育毒性发生中发挥重要作用 ,而MT可拮抗其毒性作用。     

盐酸去甲万古霉素纯度控制方法的改进

目的：改进盐酸去甲万古霉素质量控制的方法。方法：在中国药典与美国药典方法的基础上,优化了两种不同的流动相系统(三乙胺-乙腈-四氢呋喃系统和磷酸氢二铵-甲醇系统),用梯度洗脱对盐酸去甲万古霉素及其有关物质进行分离。结果：与中国药典方法相比,分离效果显著提高,两种方法在2．5～40μg范围内,峰面积与进样量线性关系良好,检测限10ng。结论：改进后的RP-HPLC方法能更加真实的反映去甲万古霉素及其有关物质的含量。     

顶空-气相色谱法测定人参皂苷Rd原料中残留物的含量

目的 :建立人参皂苷Rd原料中溶剂和树脂残留物的测定方法。方法 :采用顶空进样 毛细管气相色谱法 ,色谱柱为CP Sil 8石英毛细管柱 (30m× 0 5 3mm ,5 μm) ;柱温 :5 0℃维持 5min ,以每分钟 15℃升温至16 0℃ ,维持 2min ;检测器 :FID ,温度 :2 80℃。用外标法测定人参皂苷Rd原料中溶剂和树脂残留物。结果 :建立的色谱方法在所考察的浓度范围内线性关系良好 ,各溶剂回收率符合要求。结论 :本实验建立的色谱方法适用于人参皂苷Rd原料中溶剂和树脂残留物的检测。     

双波长薄层扫描法测定西灵生白口服液中黄芪甲甙的含量

采用双波长薄层扫描法测定西灵生白口服液中黄芪甲甙的含量,样品直接采用水饱和的正丁醇萃取,进行薄层层析。展开剂:氨仿-甲醇-水(13:6:2);波长λ_s=530nm,λ_R=700nm。黄芪甲甙的平均回收率为95.52％(RSD=2.29％,n=6)。并对方法学的稳定性进行了考察,本法灵敏度高,重现性好,结果满意。     

针刺对准分子激光角膜切削术患者泪液中前列腺素E2含量的影响

目的：评估针刺对免疫反应的作用。方法：40例行准分子激光角膜切削术（photorefractive keratectomy,PRK)的患者用随机数字表法分为针刺治疗组20例和未接受针刺治疗的对照组20例，应用放射免疫测定法对两组患者术前及术后1，3，7，14，30和60天术眼泪液中的前列腺素E2（prostaglandin,E2,PGE2)含量进行测定。结果：对照组PGE2含量显著增加，术后第14天达最高水平，为25．30μg/L，比术前平均水平高3．5倍，随后逐渐下降，但高于术前水平（P＜0．05），针刺组PGE2含量亦显著增加，但低于同期的对照组（P＜0．05），随时间逐渐下降至正常水平。结论：PRK能诱导患者PGE2的释放，进而导致免疫反应，术后PGE2含量的变化可能是手术炎症与免疫应答的综合结果，针刺可以降低PRK术后PGE2含量。提示术后早期应用针刺疗法有利于减少PGE2的释放，抑制病理性免疫反应发生。     

Hepatitis and cholestasis in infancy: clinical and nutritional aspects

A major complication of cholestasis is fat malabsorption related to decreased intestinal bile acids, which leads to malnutrition and fat-soluble vitamin deficiency. The impaired excretion of bile acids leads to a low intraluminal micellar concentration that causes long-chain triglyceride lipolysis and absorption to be ineffective. Medium-chain triglycerides (MCTs) are more readily absorbed when there are low concentrations of bile acids and therefore are a good source of fat calories; MCTs can be administered as MCT-containing formulas. In those children who are unable to take sufficient calories by mouth, it is important to start nocturnal enteral feeding to improve nutritional status. In infants with cholestasis, the absorption of fat-soluble vitamins (A, D, E and K) that require bile acids is also impaired, and supplementation is mandatory. Vitamin K deficiency may be responsible for hypoprothrombinaemia, which may lead to bleeding diathesis, Vitamin K (phytomenadione) should therefore be promptly administered intravenously, at a dose of 1 mg. Chronic vitamin E (α-tocopherol) deficiency is associated with a progressive neuromuscular syndrome that can cause cerebellar ataxia, areflexia and peripheral neuropathy. Supplements are given orally in doses of 3–5 times the normal requirement if cholestasis is incomplete. In complete cholestasis, supplements must be given intramuscularly at monthly intervals. In infants who fail to thrive, dietary supplements of carbohydrate polymers and MCTs are required.     

谷参肠安胶囊长期毒性试验

本文报告谷参肠安胶囊大鼠长期毒性试验,结果表明,谷参肠安胶囊对动物的一般状况,体重增长、外周血象、肝肾功能及病理组织学检查等未见明显毒性。