Arthritis Susceptibility in Mice Expressing Human Type II Collagen in Cartilage

Collagen type II (CII) induced arthritis (CIA) in mice is an experimental model for rheumatoid arthritis. Induction with non-self (e.g. human) CII induces severe arthritis whereas the mice are less susceptible to induction with self CII (i.e. mouse). To analyse whether an autoimmune response to human CII can develop and is pathogenic the authors have established transgenic mice expressing human CII in cartilage and backcrossed them into two different gene backgrounds susceptible to CIA (DBA/1 and C3H.Q). The transgenic human CII expression was restricted to cartilage and did not disturb cartilage morphology or lead to chondrodystrophy. In addition, development of stress-induced arthritis was not affected by the transgene. The cartilage specific expression of human CII reduced, but did not eliminate, the susceptibility to CIA irrespective of the species source (human, bovine, chick, rat) of CII used for immunization. A common denominator between these heterologous CII in comparison with mouse CII is the previously defined CII 256–270 epitope. An expression level dependent T-cell tolerance was seen in this epitope as well as to the entire CII. However, all human transgenic mouse lines could still mount significant autoreactive T- and B-cell responses. Approximately 10% of the transgenic mice developed arthritis after immunization with human CII. These findings show, therefore, that cartilage-located human CII induce tolerance but can nevertheless be a target for development of arthritis.     

Risk of insomnia and hypnotics use among emergency physicians

This study investigated the risk of insomnia and hypnotics use among emergency physicians. This cross-sectional study recruited physicians working in Taiwanese hospitals in 2015 and the general population as the participants. Data from 1,097 emergency physicians obtained from the National Health Insurance Research Database were grouped into the case group, whereas 14,112 nonemergency physicians and 4,388 people from the general population were categorized into the control groups. This study used logistic regression and conditional logistic regression to compare the risks of insomnia between emergency and nonemergency physicians and between emergency physicians and the general population, respectively. The prevalence of insomnia among emergency physicians, nonemergency physicians and general population was 5.56%, 4.08%, and 1.73%, respectively. Compared with nonemergency physicians and the general population, emergency physicians had a significantly higher risk of insomnia. The proportions of emergency physicians, nonemergency physicians, and general population using hypnotics were 19.96%, 18.24%, and 13.26%, respectively. Among emergency physicians who used hypnotics, 49.77%, 25.57%, and 24.66% used only benzodiazepines, only nonbenzodiazepines, and both benzodiazepines and nonbenzodiazepines, respectively. Nonpharmacological interventions to improve insomnia and reminder of safe use of hypnotics to emergency physicians can serve as references for hospitals in developing health-promoting activities.     

EB病毒与原发性鼻咽部B细胞性淋巴瘤有关与继发性者无关

目的：对１９ 例鼻咽部Ｂ细胞性恶性淋巴瘤与ＥＢ 病毒（ＥｐｓｔｅｉｎＢａｒｒ ｖｉｒｕｓ,ＥＢＶ） 感染的相关性进行研究。方法：利用免疫组织化学及原位杂交方法对ＥＢＶ 进行检测,并用免疫组化及原位杂交双染法标记肿瘤细胞,以鉴定ＥＢＶ阳性的细胞为Ｂ淋巴瘤细胞。结果：ＥＢＶ 编码的小ｍ ＲＮＡ探针（ＥＢＥＲ） 原位杂交显示,８ 例原发性鼻咽部Ｂ细胞性恶性淋巴瘤中３ 例绝大多数肿瘤细胞呈阳性表达,１ 例潜在性膜蛋白１（ｌａｔｅｎｔ ｍｅｍｂｒａｎｅ ｐｒｏｔｅｉｎ １,ＬＭＰ１）阳性。而１１ 例继发性鼻咽部Ｂ细胞性恶性淋巴瘤ＥＢＥＲ全部为阴性。全部病例进行了ＬＭＰ１ 检测,除１ 例原发者,全部阴性。利用ＥＢＥＲＩＳＨ（ＥＢＥＲ原位杂交） 和免疫组化ＣＤ 标记物进行双标记染色证实,ＥＢＥＲ 和ＬＭＰ１阳性细胞为ＣＤ２０ 阳性,ＣＤ４５ＲＯ 阴性。鼻咽部原发性Ｂ细胞性恶性淋巴瘤ＥＢＶ 表达４／８ ,而继发者为０／１１。结论：ＥＢＶ 与鼻咽部原发性Ｂ细胞恶性淋巴瘤有较高的相关性,而与继发性者无关。     

SALMONELLA BACTERAEMIA OCCURRING CONCURRENTLY WITH THE FIRST PRESENTATION OF SYSTEMIC LUPUS ERYTHEMATOSUS

There is increasing recognition of the association between Salmonellainfections and systemic lupus erythematosus (SLE). However,these infections have usually occurred in patients with establishedSLE who were receiving immunosuppressive therapy. We describetwo young women with previously undiagnosed SLE who developedSalmonella bacteraemia. Neither of these patients had receivedimmunosuppressive drugs. From these and two previously reportedpatients, it may be concluded that SLE per se is likely to beassociated with a defect in host defences to Salmonella bacteria. KEY WORDS: SLE, Non-typhoid Salmonella, Septicaemia     

穿龙薯芋中两种水难溶性甾体皂甙的结构研究

中国科学院成都生物研究所等单位用四川汶川,茂汶产的穿龙薯芋根茎为原料,研制成治疗冠心病,抗动脉粥样硬化的药——“穿龙冠心宁”,经鉴定有一定疗效。我们从“穿龙冠心宁”的原料穿龙薯芋(Dioscorea nipponica Makino)中提取出两种水难溶组分:其一为无色针状晶体,熔点275.5～280℃(分解),[α]_D~(21)-118°(C=0.39吡啶),易溶于吡啶,氯仿一甲醇(3:1)混合液和热甲醇,稍溶于氯仿,微溶于乙醇,不溶于水,命名为Da;其二亦为无色针状晶体,熔点293～295℃(分解),[α]_D~(21)-81°(C=0.31吡啶),易溶于吡啶,热正丁醇—乙醇—水(3:1:1)混合液,可溶于甲醇,微溶于乙醇,不溶于水,命名为Db。Da、Db与水溶性成分共存时,则具有较大的水溶性。     

Proteus syndrome

Abstract: This female Asian (Malay) baby had clinical features of Proteus syndrome. She had a large right facial lipolymphangioma with hyperpigmentation of the overlying skin. There was a smaller lymphangioma over the left side of her neck with excess nuchal folds, macrodactyly and bilateral talipes equinovarus. Despite the extensive hemifacial swelling, there was no evidence of upper respiratory tract obstruction. Generalized seizures developed on the sixth day of life which were controlled with phenobarbital. The lymphangiomas were excised without recurrence.     

氯胺酮麻醉前不同时间肌内注射阿托品对小儿呼吸道的影响

目的探讨氯胺酮麻醉前不同时间肌内注射阿托品对小儿呼吸道的影响。方法将2012年1月至2013年6月在廊坊市第四人民医院住院的100例患儿按随机数字表法分为两组:A组(50例)于氯胺酮麻醉前30~60 min肌内注射阿托品(0.02 mg/kg),B组(50例)阿托品(0.02 mg/kg)与氯胺酮同时间肌内注射。两组患儿均于氯胺酮肌内注射2~4 min后入室准备手术,术中观察记录两组患儿呼吸道和肺部的听诊变化及脉搏血氧饱和度(Sp O2)变化。结果 A组Ⅰ级(即呼吸道未受影响)44例,Ⅱ级以上(即呼吸道受到不同程度影响)6例,阳性率为12%(6/50);B组Ⅰ级33例,Ⅱ级以上17例,阳性率为34%(17∕50)。两组患儿呼吸道受影响程度的比较,差异有统计学意义(P<0.01)。结论小儿氯胺酮麻醉前30 min肌内注射阿托品,能有效降低氯胺酮对患儿呼吸道的影响,提高术中患儿的安全系数。     

Morphology of the Cardiac Conduction System in Patientswith Electrophysiologically Proven Dual Atrioventricular Nodal Pathways

Conduction System in Dual AV Nodal Pathways. Introduction: Although the electrophysiologic criteria for dual atrioventricular nodal pathways are well established, the anatomical substrate is still unclear.
Methods and Results: We examined the hearts from 10 patients who had been studied electrophysiologically prior to cardiac transplantation. All 10 patients were male, aged 22 to 60years. Nine of the 10 patients had dual atrioventricular nodal pathways according to acceptedcriteria. Histologic studies of the atrioventricular conduction system showed normal structureof the atrioventricular node in all 10 hearts, with minor variations within the node in 3 cases, within the penetrating bundle in 3 cases, and within the nonbranching bundle in 3 cases. Theatrial approaches to the atrioventricular node were generally scanty in 6 hearts. The solitarycase that was shown electrophysiologically to lack dual pathways had no obvious difference inthe structure of the nodal area other than sparsity of transitional cells. We were unable tolocate any extranodal atrial tracts as described by other investigators.
Conclusion: The anatomical substrate for conduction over dual pathways may he too subtleto be detected by gross morphologic studies. Since dual pathways were unmasked in allpatients but one during electrophysiologic studies, it may be that the potential for these pathways is ubiquitous.     

CLINICAL,PHYSIOLOGICAL AND PATHOLOGICAL OBSERVATIONS IN A CASE OF PROGRESSIVE AUTONOMIC NERVOUS SYSTEM DEGENERATION ASSOCIATED WITH HOLMES-ADIE SYNDROME AND PERIPHERAL NEUROPATHY

The case history is reported of a woman aged 40 years who presented with weight loss, postural hypotension and paræsthesia in the hands and feet. The diagnosis of widespread autonomic nervous system degeneration with associated peripheral neuropathy and Holmes-Adie syndrome was made from the results of a series of clinical and physiological tests. Laboratory investigation failed to disclose a cause for the degenerative changes, and symptomatic treatment with 9-alpha fluorohydrocortisone and digitalis was commenced in an effort to combat the patient's postural hypotension. On this régime there was transient improvement in her clinical state, but over a period of six months her general condition gradually deteriorated and she eventually died. At autopsy, widespread amyloid infiltration of the sympathetic ganglia, peripheral nerves, heart and alimentary canal was found, and this appears to have been the pathological basis for the clinical and physiological findings.