A meta-analysis of case-control studies on the combined effect of hepatitis B and C virus infections in causing hepatocellular carcinoma in China

We investigated whether concurrent infection by hepatitis B virus （HBV） and hepatitis C virus （HCV） in China, a hyperepidemic area for these infections, was associated with a higher risk of causing hepatocellular carcinoma （HCC） than each infection alone in a meta-analysis in China, 32 case-control studies involving 3 201 cases and 4 005 controls, identified from a computer-based literature search from 1966 to 2004. The pooled odds ratio and 95% confidence interval （CI） for HBsAg posi- tivity was 14.1 （95% CI： 10.6-18.8）; for anti-HCV/HCV RNA positivity was 4.6 （95% CI： 3.6-5.9）% for HBsAg positivity and anti-HCV/HCV RNA negativity were 15.6 （95% CI： 11.5-21.3） ; for HBsAg negativity and anti-HCV/HCV RNA posi- tivity were 8.1 （95% CI： 5.0-13.0）; and positivity for both HBsAg and anti-HCV/HCV RNA was 35. 7 （95% CI： 26.2- 48.5）. We conclude that HBV and HCV infections are important independent risk factors for HCC in China,     

The unsoftened portion of the uterus: a pitfall in gray-scale ultrasound studies during mid-trimester pregnancy

A review of 322 second-trimester gestations evaluated with gray-scale ultrasound frequently revealed a locally thickened or "unsoftened" portion of the uterus. The texture and gray-tone patterns of this region as well as the other gestational components are reviewed; pitfalls in identification are outlined, and factors responsible for difficulty in amniocentesis are reported.     

Seminal megavesicles with adult polycystic kidney disease

Adult polycystic kidney disease has been found in association with pathological dilatation of the seminal vesicles in six patients. These men appeared normal on clinical examination, but had azoospermia or severe oligozoospermia. They were investigated by scrotal exploration with vasography, renal and transrectal ultrasound scans (TRUS), and percutaneous puncture of the seminal vesicles in one case, before and after resection of the ejaculatory ducts. This revealed that the gross dilatation of the seminal vesicles was not caused by obstruction, but appeared to be due to atonicity (megavesicles). These ultrasonic appearances, when described previously, were incorrectly thought to be due to seminal vesicle cysts.      

柯萨奇病毒致小鼠心肌损害的组织形态学变化

目的:观察柯萨奇B3病毒性心肌炎小鼠心肌组织的病理特点及胶原蛋白的表达情况。方法:实验于2004-10/2006-04在广西医科大学医学科学实验中心完成。①实验分组:选择80只Balb/c纯种雄性小鼠,鼠龄4￣6周,随机分为对照组20只和模型组60只。②实验方法:模型组小鼠腹腔注射柯萨奇B3Nancy株悬液0.1mL,对照组腹腔注射不含病毒的Hep-2细胞冻存液0.1mL。模型组小鼠分别于接种柯萨奇B3后第7,14,28和42天麻醉后断颈处死10只,10只,10只和9只,颈动脉采血0.8￣1.0mL,保存血清;摘取心脏,浸泡于4%多聚甲醛溶液中;对照组20只小鼠于42d后采用上述方法处死,并留取血清及心脏。③实验评估:检测血清CVB3中和抗体滴度;心肌组织切片苏木精-伊红染色后,光镜下观察组织形态学改变;免疫组化法检测心肌Ⅰ型和Ⅲ型胶原蛋白的表达情况。结果:①行为学变化及死亡情况:模型组于接种后第3天出现行为学改变,第12天后症状逐渐缓解;从第4天开始发生死亡,第7￣10天为死亡高峰期,第12天后无死亡,总死亡率为35%(21/60)。②血清柯萨奇B3中和抗体滴度:模型组各时间点血清柯萨奇B3中和抗体滴度均高于对照组(P<0.01),以第7天滴度为最高。③心肌组织形态学特点:接种病毒后7d,心肌组织出现多灶性凝固性坏死,大量炎细胞浸润;28d后,坏死灶周围的炎细胞已近消失,代之以增殖的成纤维细胞。④心肌组织病理积分:模型组各时间点心肌病理积分均明显高于对照组,其中第7天增高最为显著(P<0.05)。⑤心肌组织Ⅰ型和Ⅲ型胶原蛋白表达:模型组各时间点心肌组织Ⅰ型和Ⅲ型胶原蛋白表达均明显增加,以第42天最为显著(P<0.01);第7天和第14天小鼠心肌Ⅰ/Ⅲ型胶原比值与对照组之间无显著性差别(P>0.05),而第28天和第42天则显著高于对照组(P<0.05)。结论:采用腹腔注射柯萨奇B3Nancy株悬液的方法可以成功构建病毒性心肌炎小鼠模型。病理表现为急性期心肌细胞大量坏死,伴多种炎细胞浸润,胶原蛋白表达活跃;缓解期,成纤维细胞大量增殖,胶原蛋白表达持续增高,最终导致心肌间质重构。     

Specificity of the Speed's test: Arthroscopic technique for evaluating the biceps tendon at the level of the bicipital groove

A positive Speed's test result is usually thought to suggest inflammation or lesions related to the biceps/labral complex. The specificity, sensitivity, and positive and negative predictive values are determined for the Speed's test. A prospective study design was developed for all patients with shoulder pain who presented between October 1, 1994 and February 28, 1995. The clinical results of the Speed's test were correlated with biceps/labral pathology by direct arthroscopic visualization. A neuroprobe is used to pull the biceps tendon into the articular portion of the glenohumeral joint so as to visualize the biceps tendon at the level of the bicipital groove. Forty-six shoulders in 45 patients, 31 men (average age, 53 years; range, 16 to 76 years) and 14 women (average age, 64 years; range, 30 to 80 years) with 26 dominant and 20 nondominant extremities were operated on during this time interval. The clinical evaluation showed that the speed's test was positive in 40 shoulders. Biceps/labral complex pathology was present in 10 of these patients. A specificity of 13.8%, a sensitivity of 90%, a positive predictive value of 23%, and a negative predictive value of 83% were calculated. Thus, it is concluded that the Speed's test is a nonspecific but sensitive test for macroscopic biceps/labral pathology. This clinical examination is positive with a various number of other pathological shoulder problems. (Arthroscopy 1998 Nov-Dec;14(8):789-96.)     

THE TREATMENT OF TETANUS REPORT OF A CASE OF LOCAL TETANUS

Tetanus is described in ancient Chinese medical literature (1). The most prevalent types now seen are tetanus neonatorum and tetanus which has developed in deep penetratin9 wounds, or in flesh wounds on which Chinese native plaster, incense powder or dirt has beenapplied as a styptic. Recently we have seen many cases of tetanus in which no prophylactic tetanus antitoxin had been given in shrapnel and bulIet penetrating wounds, especially those of a lacerating or crushing nature.