Extracranial internal carotid artery aneurysm presenting as symptomatic hypoglossal and glossopharyngeal nerve paralysis

Aneurysms of the extracranial portion of the internal carotid artery are rare, particularly in young patients. They usually develop following trauma, or secondary to infection involving the parapharyngeal space that extends to the vessel wall. This is a case of an internal carotid artery aneurysm presenting acutely following chiropractic neck manipulation with hypoglossal and glossopharyngeal nerve palsy. The imaging findings and subsequent operative management are described.     

Dermatomyositis developing in a Duchenne muscular dystrophy carrier

SIR, Duchenne muscular dystrophy (DMD) is the commonest musculardystrophy and its clinical manifestations are well recognized.Less commonly female carriers can become symptomatic, with symptomsranging from mild generalized weakness to inability to walk.Manifesting carriage of DMD is a rare but important cause ofproximal muscle weakness in females, but other diagnoses needto be excluded. A 42-yr-old lady presented with a lifelong history of fluctuatingproximal muscle weakness, fevers, clumsiness and falls. Herbrother had died at 19 yr     

尿微量蛋白与老年2型糖尿病合并缺血性心脏病关系的研究

目的探讨在老年2型糖尿病合并缺血性心脏病患者中尿微量蛋白在加重缺血性心脏病进展方面的作用。方法将66例老年2型糖尿病合并缺血性心脏病患者按24h尿微量蛋白排泄量分为:尿微量蛋白正常组及尿微量蛋白阳性组,分别对血脂、空腹血糖、血清胰岛素、胰岛素敏感指数、纤维蛋白原、颈动脉内-中膜厚度、颈总动脉粥样硬化等级积分、硬化斑块指数、心脏彩超室间隔厚度及射血分数等加重缺血性心脏病进展等指标进行比较分析。结果66例老年2型糖尿病合并缺血性心脏病患者尿微量蛋白阳性组高密度脂蛋白、载脂蛋白A、胰岛素敏感指数、年龄、纤维蛋白原、硬化斑块指数、颈总动脉粥样硬化等级积分、室间隔厚度及射血分数显著高于尿微量蛋白阴性组(P<0.05,P<0.01)。结论尿微量蛋白的出现能够加速糖尿病合并缺血性心脏病的发展进程,它的出现预示着缺血性心脏病的预后不良。     

Detection of carbamyl phosphate synthetase 1 deficiency using duodenal biopsy samples

The activity of urea cycle enzymes was assayed in duodenal biopsy specimens obtained from a female infant who presented with neonatal hyperammonaemia. All enzyme levels were normal except N-acetyl glutamate-dependent carbamyl phosphate synthetase 1 (CPS1) which was half the mean activity in normal control specimens. A similar deficiency of CPS1 was also shown in duodenal specimens from the patient's mother who became slightly symptomatic after relatively high protein meals and during pregnancy, and had spontaneously modified her diet to one with protein restriction. The patient is growing normally on a dietary regimen similar to that spontaneously adopted by her mother. Urea cycle enzyme activity in the duodenal biopsy material from the controls was similar to that found in the normal human liver and appears to have distinct advantages as a means of assaying for urea cycle defects in patients with hyperammonaemia and their relatives.     

虚拟模拟器在输尿管镜培训中应用的初步探讨

目的 评估虚拟模拟器UroMentorTM在输尿管镜培训中的应用价值. 方法 30名泌尿外科医师按单独完成输尿管镜例数＜ 20例和≥20例分成2组,分别为18名及12名.应用左输尿管下段取石模拟操作进行初评,包括:总操作时间、输尿管插管时间、损伤致出血点的数目、尝试插管次数以及综合总体评分(GRS),连续训练48 h后复评并与初评比较. 结果 经过模拟器训练后所有受试者总操作时间明显缩短[( 333±32)s及(228±18)s,P=0.001],GRS评分明显改善(24.4±2.1及28.1±1.2,P=0.010).少(无)经验组和有经验组初评总操作时间[(405±40)s及(262±22)s,P=0.014]、复评总操作时间[(276±12)s及(179±9)s,P=0.000]及初评GRS评分(19.6±2.5及29.2±1.3,P＝0.009)、复评GRS评分(25.0±1.1及31.2±0.7,P=0.002)差异均有统计学意义.独立完成的输尿管镜例数与GRS评分相关(初评r=0.705,复评r=0.756). 结论虚拟模拟器URO MentorTM可以成为输尿管镜技能培训及评估的有效工具.     

大豆异黄酮对阿尔茨海默病大鼠海马RAGE介导的信号转导通路的影响

目的观察大豆异黄酮(soybean isoflavones)对阿尔茨海默病(Alzheimer’s disease,AD)大鼠高级糖化终产物受体(receptor for advanced glycation end products,RAGE)介导的信号转导系统的影响。方法采用β淀粉样蛋白25-35片段(amyloidβ25-35,Aβ25-35)双侧海马注射建立AD大鼠模型,60只大鼠随机分为模型组、大豆异黄酮高剂量组[30mg/(kg·d)]、大豆异黄酮低剂量组[10mg/(kg·d)]、雌激素组[0.4mg/(kg·d)]及假手术组,每组12只。大豆异黄酮高、低剂量组和雌激素组造模后3天灌胃给药(2mL/只),模型组与假手术组给予等体积的0.5%羧甲基纤维素钠(CMC-Na)灌胃,连续21天。酶联免疫吸附法观察各组大鼠海马组织RAGE、白细胞介素-6(interleukin-6,IL-6)的含量。分光光度法检测大鼠海马组织天冬氨酸特异性半胱氨酸蛋白酶-3(cysteine-containing aspartate-specific protease-3,Caspase-3)活性。免疫组织化学法观察大鼠海马组织磷酸化细胞外信号调节激酶1/2(phosphorylation extracellular signal-regulatedkinase1/2,P-ERK1/2)的表达。结果与模型组比较,大豆异黄酮可显著降低AD大鼠海马RAGE蛋白、IL-6含量、Caspase-3活性及ERK1/2蛋白磷酸化水平(P<0.01)。结论大豆异黄酮对AD大鼠海马组织RAGE介导的炎症信号通路具有下调作用,减弱炎症反应,降低Aβ的神经毒性,抵抗海马神经元凋亡。     

药用红树植物桐花树的生药学鉴别

目的 对药用红树植物桐花树药材进行生药学鉴别.方法 采用性状鉴别、显微鉴别、理化鉴别等方法进行研究.结果 桐花树的根坚韧,具皮孔,根皮层具木栓孔结构;茎横断面有木质部棕色同心环,中柱鞘有石细胞群和纤维束组成的厚壁细胞环,髓部有分泌腔散在;叶上、下表面有盐腺分布;粉末中可见石细胞、盐腺、气孔及导管等特征.紫外扫描有明显的吸收峰;薄层色谱展开良好.结论 上述特征可作为桐花树药材鉴定的参考依据.