Fatal meningoencephalitis due to Bacillus anthracis

Abstract: We report the first case of fatal anthrax meningoencephalitis in Hong Kong over the past 60 years. A 13 year-old boy presented with right lower quadrant pain, diarrhoea and progressive headache. Lumbar puncture yielded gram positive bacilli initially thought to be Bacillus cereus, a contaminant. He was treated with ampicillin and cefotaxime, but died 3 days after hospitalization. The organism isolated from blood and cerebrospinal fluid was later identified as Bacillus anthracis.     

Erythromycin treatment for gastrointestinal dysmotility in preterm infants

To report our clinical experience on the use of oral erythromycin for the treatment of severe gastrointestinal dysmotility in preterm infants.

Methodology:

A case series study of seven preterm infants (six were very low birthweight) with severe intestinal dysmotility in a tertiary neonatal centre.

Results:

All responded favourably without adverse effects and tolerated full enteral feeding within 1–2 weeks of the commencement of the drug.

Conclusions:

As prolonged total parenteral nutrition carries significant risk of complications, this therapy could be considered in selected preterm infants who fail to establish enteral feeding after an extended period, and in whom an anatomically obstructive lesion of the gastrointestinal tract has been excluded. Meanwhile, we would caution against the widespread implementation of this therapeutic approach until formal evaluation by randomized controlled trials have established the exact role of erythromycin, or its analogues, in the treatment of intestinal dysmotility in preterm infants.     

幽门螺杆菌中国菌株致病相关基因cagA、iceA、vacA及HP0519分布分析

目的分析中国不同人群及不同胃部疾病病例来源的幽门螺杆菌致病相关基因cagA、iceA、vacA及HP0519的分布.方法采用特异引物聚合酶链式反应（PCR）方法分析150株幽门螺杆菌上述基因的多态性分布特点,并对其分布作初步统计分析.结果93%（139/150）中国菌株cagA基因3′端重复序列的PCR产物具有东方菌株特征.75%（113/150）菌株iceA基因为iceA1,19%（29/150）为iceA2,不同地区间iceA基因的分布差异无统计学意义.云南菌株iceA1、iceA2的分布与菌株分离个体的种族特点及临床疾病类型无显著关系.96%中国菌株（144/150）vacA基因s区的等位基因为s1;m区等位基因m2、m1b和m1b-m2的比例分别为57%（85/150）、27%（41/150）和11%（16/150）,仅2株福建菌株为m1a.不同地区间vacA s1、m2、m1b分布的差异无统计学意义.云南菌株m1b-m2的分布高于福建和北京菌株.云南菌株vacA s区等位基因的多样性与分离个体的种族及临床疾病类型无显著关系.vacA m区等位基因的多样性与分离个体的临床疾病类型无显著关系,但不同民族间m2的分布有显著差异,白族人群m2的分布显著少于汉族和纳西族.93%（140/150）的中国菌株HP0519基因具有24 bp和15 bp DNA插入和缺失的多态性特点.不同地区间HP0519基因的多态性无显著不同.云南菌株HP0519的多态性与菌株分离个体的临床疾病类型无显著关系,但来源不同民族菌株的HP0519基因存在差异.结论幽门螺杆菌中国菌株cagA 3′端JF/TR特异引物的扩增结果具有东亚菌株特点.中国菌株vacA基因多为s1,其分布与菌株分离个体的临床疾病类型无关.中国菌株vacA基因m区的分布具有多样性.中国菌株HP0519基因具有24 bp和15 bp插入和缺失的多态性特点.     

女贞子对去卵巢大鼠钙代谢及维生素D依赖型基因表达的影响

目的研究补肾中药女贞子对去卵巢大鼠钙代谢及维生素D依赖型基因表达的影响。方法大鼠去卵巢手术处理4周后,ig给药治疗14周。血清、尿液及粪便中钙水平采用比色法测定。RT-PCR技术分析小肠及肾脏基因表达。结果大鼠去卵巢后体内钙流失显著增加,表现在血钙下降,尿钙及粪钙排泄增加。女贞子可以有效防止尿钙及粪钙排泄增加,并恢复血钙水平。RT-PCR分析表明雌二醇和女贞子都可以抑制去卵巢引起的小肠维生素D受体(VDR)mRNA表达下降。女贞子对肾脏25-羟基维生素D 1-羟化酶(1-OH ase)及25-羟基维生素D 24-羟化酶(24-OH ase)mRNA无明显作用,但却可以提高肾脏钙结合蛋白-9k(C aBP-9k)及钙结合蛋白-28 k(C aBP-28k)的基因表达。结论女贞子能够改善雌激素缺乏所引起的钙失衡状态,主要是通过提高小肠对活性维生素D的敏感性及加强肾脏对钙的重吸收而发挥作用的。     

罗格列酮单用或者与阿伐他汀联合使用对于2型糖尿病患者心血管疾病的非传统标志物的作用

背景和目的:罗格列酮与阿伐他汀联合疗法已经被证实对于2型糖尿病患者的血糖控制以及脂质水平都有益处。本试验将通过检测罗格列酮与阿伐他汀联合疗法对于2型糖尿病患者的生物标记水平的作用来研究该联合疗法对血管炎的作用。方法:30例患有2型糖尿病和高脂血症的患者被纳入治疗。对这些患者给予罗格列酮单一疗法4mg/d,持续3个月,然后在接下来的3个月中给予这些患者阿伐他汀10mg/d作为联合疗法。在研究开始时,罗格列酮单一疗法之后以及罗格列酮与阿伐他汀联合治疗之后测量炎性生物标记物,包括高敏C-反应蛋白(hs-CRP)、基质金属蛋白酶9(MMP…     

斑蝥、青娘子、红娘子鉴别研究(英文)

目的:研究建立斑蝥(Mylabris)、青娘子(Lytta)、红娘子(Huechys)3个毒性药材的鉴别分析方法。该3个药材具有特殊的药理活性如抗体活性、抗子宫颈癌等。方法:除形态外观和显微鉴别外,本文研究建立气相色谱和毛细管电泳鉴别特征成分指纹图谱的方法。气相色谱分析主要测定药材中斑蝥素成份而毛细管电泳指纹图谱则集中药材的氨基酸分布。结果:所建立的方法可为验证该3个药材的质量提供参考。结论:研究发现青娘子与斑蝥一样含有斑蝥素但含量很低,而红娘子不含斑蝥素。     

淫羊藿提取物对去卵巢大鼠骨转换率增强的抑制作用

目的研究淫羊藿提取物对去卵巢大鼠骨转换的影响。方法取3月龄SD大鼠手术切除双侧卵巢,1个月后ig给予阳性药17β-雌二醇(2mg/kg)以及淫羊藿提取物混悬液(110mg/kg),连续给药3个月。采用全自动生化分析仪测定血清中钙(s-Ca)、磷(s-P)的量和碱性磷酸酶(ALP)的活性及尿中钙(u-Ca)、磷(u-P)和肌酐(Cr)的量。利用ELISA试剂盒测定尿脱氧吡啶酚(DPD)的量。取胫骨近端制成不脱钙骨切片进行骨组织形态计量学分析。结果与假手术组相比,去卵巢大鼠s-Ca、s-P没有变化,ALP活性增强,u-Ca排出显著升高,尿中DPD与Cr的比值(DPD/Cr)显著增加,子宫萎缩。骨小梁面积百分比降低,骨小梁间隙增加。ig给予雌二醇或淫羊藿提取物3个月,血清ALP活性降低,u-Ca排出量减少,尿中DPD/Cr降低,骨小梁增加,且骨小梁间隙减小。雌二醇组大鼠子宫增生,淫羊藿组大鼠子宫与模型组相比没有变化。结论淫羊藿提取物能够显著抑制由于雌激素缺乏引发的骨转换增强,调整骨形成和骨吸收的关系,对遏制去卵巢造成的骨质疏松有一定的作用,且长期服用对子宫没有刺激作用。     

浙江省1997至2000年肾综合征出血热监测分析

目的：通过对肾综合征出血热（HFRS）监测分析,掌握全省HFRS的流行规律,控制其暴发流行,进一步降低该病的发病率,为制定防制措施提供依据。方法：采用直接免疫荧光（FAT）法,检测鼠肺HV抗原,采用间接免疫荧光（IFAT）法检测HFRS病人,健康人血清及鼠血中HV抗体,结果：1997－2000年全省共发病9041例,年均发病率为5．08／10万,死亡48人,病死率为0．53％,病例仍主要分布在沿钱塘江两岸的浙东和浙西丘陵区,浙南山区次之,浙北平原区和海岛区病例较少,全省11个地市均有发病,以浙东和浙西丘陵区的绍兴,宁波,台洲,衢州,杭州和金华6市发病最多。宿主动物野外以黑线姬鼠为优势种,占80．79％,室内以褐家鼠为优势种,占80．91％,结论：需要进一步加大监测力度,同时接种HFRS疫苗。     

Clinical and familial study of arrhythmogenic right ventricular cardiomyopathy

Objective　To explore the characteristics of arrhythmogenic right ventricular cardiomyopathy (ARVC). Methods　Seven patients with arrhythmogenic right ventricular cardiomyopathy and 34 members of three families were studied. All patients and family members underwent history collection, clinical examination, electrocardiogram (ECG), two-dimensional echocardiography (2-DE) and a signal averaging electrocardiogram. Programmed ventricular stimulation was performed in five patients. Results　All patients and family members had normal morphologic characteristics and normal function of the left ventricular by 2-DE. Fourteen persons had abnormal findings indicating ARVC. Five had enlargement of the right ventricular with diffused hypocontractility, eight had thin and systolic bulging in the focal anterior wall with hypokinesia and one had bulging of the inferior wall. Twenty-five persons (seven patients and 18 family members) had abnormal findings in ECG. Positive ventricular late potential was recorded in 13 persons (six patients). Two to three monomorphic ventricular tachycardia (VT) with left bundle branch block (LBBB) configurations were induced in five patients. Ventricular fibrillation was induced in two patients during the electrophysiologic study (EPS). Five patients had very high pacing threshold and/or ineffective pacing in one or many regions of the right ventricle. Two members of one family died suddenly. One member was a dwarf with ARVC. Spontaneous VT with a left bundle branch block (LBBB) configuration was recorded in five patients, polymorphic VT with extremely short coupling interval in one, and premature ventricular complexes with LBBB configuration in 12 (six patients). Conclusion　Our familial study strongly suggests that ARVC may be a hereditary disease and it is helpful in the diagnosis and detection of ARVC. The most common manifestations were abnormal structure and function of the right ventricle and abnormal ECG of repolarization and ventricular arrhythmia which originates from the right ventricle.     

朱震亨从脾胃病探析误诊误治

[目的] 通过探析《局方发挥》之脾胃病误诊误治,以期指导与改进现代医家临床治疗。[方法] 对《局方发挥》之脾胃病误诊误治进行整理分析,揭示朱震亨从脾胃病探析误诊误治的特色。[结果] 朱震亨从脾胃病论误诊误治的特色:1)《和剂局方》具有误导性脾胃病治疗的中医知识,导致当时医者与患者误诊误治脾胃病。2)《和剂局方》引起的脾胃病误诊误治问题,主要可分成两类:辨证失误和治法失误。3)辨证失误所导致的误诊误治包括忽视审证求因、认为“诸寒为病”、误辨寒热虚实等。4)治法失误包括“一方通治诸病”、滥用辛香燥热药组方、利用砒丹巴硇行积垢、修改汤剂为丸剂、用峻剂盲目祛邪及错误滋补等。[结论] 朱震亨在《局方发挥》指出当时脾胃病的误诊误治问题,显示出了其独特见解,对现代医家治疗脾胃病,具有一定的指导作用与参考价值。