Rheumatoid arthritis and membranoproliferative glomerulonephritis: an unusual case

SUMMARY: Renal involvement is not uncommon in rheumatoid arthritis (RA). Many RA patients have renal dysfunction either secondary to the drugs used to treat arthritis or because of the chronic inflammation. Renal pathologies have often included amyloidosis, drug-related renal disease and mesangial glomerulonephritis. However, membranoproliferative glomerulonephritis has only been rarely reported. We report a case of rheumatoid arthritis associated with membranoproliferative glomerulonephritis that rapidly progressed to end-stage renal disease.     

CONSTRUCTION，EXPRESSION AND BIOLOGICAL ASSESSMENT OF BPI23—Fcγ1 RECOMBINANT PROTEIN PROKARYOTIC EXPRESSION VECTOR

INTRODUCTIONGram－negativesepsis（GNS）andinfectiousshockarechallengestocliniciansbecauseofhighmortality（１）．Routineantibiotictherapydoesnotworkwellbe－causeoftheincreasingoccurrenceofresistantstrainsand（２）．Anti－lipopolysaccharide（LPS）monoclonal     

两种剂量氟碳部分液体通气治疗犬吸入伤的比较研究

目的：对比研究两种剂量氟碳（PFC）部分液体通气（PLV）对蒸气吸入性损伤犬的血气和血流动力学的影响，方法：将健康犬15条随机分面两组，即PFC6ml/kg组（PFC－6）和PFC 12ml/kg(PFC-12)组，采用蒸气吸入造成吸入性损伤模型后经气管内注入PFC实施部分液体通气（PLV）治疗，观察治疗后30min,60min,90min血气，血流动力学参数的变化，结果：PFC－6组PaO2在PLV治疗30min后明显升高（P＜0．05），在治疗60min,90min生的PaO2与致伤值比较无统计学意义，而PFC－12组的PaO2在PLV治疗后30min,60min,90min均明显升高（P＜0．05），与PFC－6组相比，PFC－12组的PaO2,PvO2均呈上升趋势，但未达显著水平（P＞0．05），在PLV治疗后各时间点的PaCO2HR,MAP,CVP 致伤值相比均无明显变化（P＞0．05），两组之间比较，各对应时间点的PaCO2,HR,MAP,CVP也均无明显变化（P＞0．05），结论：氟碳部分液体通气是一种新的通气技术，它能明显改善蒸气入伤犬的氧合作用，对血液动力学参数无不良影响，两种剂量氟碳部分液体通气治疗蒸气吸入性损伤未呈现明显剂量一效应关系。     

88例恶性淋巴瘤预后相关资料分析

目的：了解恶性淋巴瘤（ML）发病、病理及免疫分型特点，探讨基因分型在诊断中的作用。方法：通过标准链菌素生物素－过氧化物酶标记物法（SABC法）对病理标本进行免疫分型，PCR检测病理及骨髓标本IgH（FR2A，3A）和TCR（β，γ）基因重排，同时对临床及病理资料进行多因素分析。结果：（1）ML非霍奇金淋巴瘤（NHL）较霍奇金淋巴瘤（HL）发病率高，发病率随年龄增长而递增，60岁以上发病者占38．6％；其平均生存时间明显低于60岁以下者。（2）B－NHL发病率为68．6％，T－NHL为28．6％；B－NHL的3年生存率高于T－NHL。（3）低度恶性NHL占42％，中、高度恶性占58％；低度恶性组平均生存时间较中、高度恶性组长，但统计学上差异无显著性。生存期分析显示I－Ⅱ期NHL预后明显优于Ⅲ－Ⅳ期。（4）PCR检测病理及骨髓标本的IgH和TCR重排，B－NHL FR2A的阳性率分别为66.7%及56．2％；FR3A阳性率分别为90．4％及81．2％；T－NHL中TCRβ、γ阳性率分别为91．7％及75．0％；病理标本的阳性率略高于骨髓，T、B分型与免疫分型相符。结论：年龄，T、B分型和临床分期是影响NHL预后的重要因素；分子生物学检测作为辅助手段可以肯定免疫分型结果并补充其不足，骨髓及外周血检测除协助分型外可用于肿瘤微小残留病的监测。     

Acute subdural hematoma: Outcome and outcome prediction

Patients with traumatic acute subdural hematoma were studied to determine the factors influencing outcome.Between January 1986 and August 1995, we collected 113 patients who underwent craniotomy for traumatic acute subdural hematoma. The relationship between initial clinical signs and the outcome 3 months after admission was studied retrospectively.Functional recovery was achieved in 38% of patients and the mortality was 60%. 91% of patients with a high Glasgow Coma Scale (GCS) score (9–15) and 23% of patients with a low GCS score (3–8) achieved functional recovery. All of 14 patients with a GCS score of 3 died. The mortality of patients with GCS scores of 4 and 5 was 95% to 75%, respectively. Patients over 61 years old had a mortality of 73% compared to 64% mortality for those aged 21–40 years. 97% of patients with bilateral unreactive pupil and 81% of patients with unilateral unreactive pupil died. The mortality rates of associated intracranial lesions were 91% in intracerebral hematoma, 87% in subarachnoid hemorrhage, 75% in contusion.Time from injury to surgical evacuation and type of surgical intervention did not affect mortality. Age and associated intracranial lesions were related to outcome. Severity of injury and pupillary response were the most important factors for predicting outcome.     

An in vitro study of nonadrenergic-noncholinergic activity on the cavernous tissue of mouse

The relaxant effects of electrical field stimulation (EFS) and exogenously applied acetylcholine (ACh) or acidified NaNO₂ (a-NaNO₂) were investigated in the isolated mouse corpus cavernosum precontracted with phenylephrine hydrochloride (PE). Tetrodotoxin (TTX) blocked the relaxant effects of EFS completely, whereas it had no effect on the responses to ACh or a-NaNO₂. Guanethidine and indomethacin failed to affect the electrically or ACh-induced relaxations. Atropine completely blocked the effect of ACh; however, it caused a slight reduction in the relaxation evoked by EFS.N ^G- Nitro-l-arginine (l-NOARG) reduced the effects of EFS and ACh significantly, but it was ineffective on the relaxations induced by a-NaNO₂. The inhibitory action ofl-NOARG was partly restored byl-arginine, but not byd-arginine. Methylene blue (MB) and hydroxocobalamin (HC) exhibited significant inhibition on the relaxations evoked by EFS, ACh and a-NaNO₂. Hydroquinone (HQ) reduced relaxation due to a-NaNO₂, but did not affect that of EFS and ACh. Our findings suggest that EFS-induced relaxations of mouse cavernosal tissue are mediated by a transmitter which probably resembles an organic nitrate.     

Testicular torsion: Evaluation of contralateral testicular histology

Infertility may occur in patients with unilateral testicular torsion whose contralateral testis is intact. Depending on this observation, the physicians have begun to examine the contralateral testis. In the present prospective study we aimed to examine the histopathologic alterations occurring in the contralateral testicle with time. Sixty adult male albino rats were included in the programme, and following experimental torsion the histopathologic findings, especially those in the contralateral testis, were evaluated after 4–12 weeks. Long-term and high degree torsion of the testicle led to varying degrees of deterioration in the germinal epithelium and interstitial cells of the contralateral testicle. Histopathologic alterations were reversed in 12 weeks. Tubular diameter and testicular volume also decreased in accordance with the histopathologic alteration. In our opinion, orchiectomy following torsion of one testicle will limit potential histopathologic alterations in the contralateral testicle.     

Orbital hydatid cysts: Report of four cases

Hydatid cysts of central nervous system are rare and comprise only 2% to 3% of all hydatid cysts reported. Orbital localization is very uncommon and has been reported less than 1 % of all hydatid diseases. The primary treatment of hydatid disease is surgical. The most important complication of the surgical treatment is secondary hydatidosis due to spillage of the cyst contents. Because of the difficulties of the orbital localization, total extirpation of the cysts without rupture is almost impossible. Preventing spontaneous rupture of the cysts during surgery and postoperative antihelmintic treatment should be taken into consideration in these cases.This study includes four cases who underwent surgery for orbital hydatid cysts. Radiological characteristics, operative technique and postoperative medical therapy are discussed.