尿毒症患者血透中血液动力学监测

目的：观察尿毒症患者血透过程中血液动力学改变，方法：尿毒症患者20例，均在透析放血前，放血后，30min,60min,120min,180min，回血前，回因后测定血压，脉搏，中心静脉压，平均直接动脉压，结果：透析过程中血压，脉搏以及直接平均动脉压较稳定，中心静脉压放血前较正常为高，且高于血透过程中其它时间段（P＜0．05），结论：血透过程中血液动力学稳定，且中心静脉压的变化有利于心功能的改善。     

输精管结扎对家兔心功能及心肌NE含量的影响

本实验用日本大耳白兔复制输精管结扎的长期动物模型，分为结扎２５月组（ＶＧ２５），同龄假手术２５月组（ＳＯＧ２５）；结扎６月组（ＶＧ６），同龄假手术６月组（ＳＯＧ６）。记录各组家兔心功能，检测心肌及血清ＮＥ含量，称取心重（ＷＨ）。结果表明，左心室收缩期末压（ＬＶＳＰ），ＶＧ略高于ＳＯＧ；左心室舒张末压（ＬＶＥＤＰ），Ｖ６２５显著的低于ＳＯＧ２５Ｐ＜０．０５），ＶＧ６与５ＯＧ６比较虽无显著差异，也呈低值；±ｄｐ／ｄｔｍａｘ，ＶＧ均明显高于ＳＯＧ（Ｐ＜０．０１）。相关检验表明，＋ｄｐ／ｄｔｍａｘ与血清及心肌ＮＥ含量无相关性；心重与＋ｄｐ／ｄｔｍａｘ呈明显正相关，Ｐ＜０．０５；在２５月组，ＬＶＳＰ与＋ｄｐ／ｄｔｍａｘ呈正相关，Ｐ＜０．０５。提示输精管结扎可提高心肌收缩功能。     

Pygmaeoherin: A Novel Coumarin from Pygmaeopremna herbacea

A new 6-oxygenated coumarin, pygmaeoherin, was isolated from roots of PYGMAEOPREMNA HERBACEA. Its structure was determined by spectroscopic methods. An NOE experiment played an important role in confirming the structure.     

GALC transduction leads to morphological improvement of the twitcher oligodendrocytes in vivo

Globoid cell leukodystrophy (GLD, Krabbe disease) is a severe demyelinating disease caused by a genetic defect of beta-galactocerebrosidase (GALC). To date treatment to GLD is limited to hematopoietic stem cell transplantation. Experimental approaches by means of gene therapy in twitcher mouse, an authentic murine model of human GLD, showed significant but only marginal improvements of the disease. To clarify whether the introduction of GALC could provide beneficial effects on the oligodendrocytes in GLD, we transduced twitcher oligodendrocytes by stereotactically injecting recombinant retrovirus encoding GALC-myc-tag fusion gene into the forebrain subventricular zone of neonatal twitcher mouse. In vivo effects of exogenous GALC on twitcher oligodendrocytes were studied histologically by combined immunostaining for the myc-epitope and the oligodendroglial specific marker, pi form of glutathione-S-transferase, at around 40 days of age. We show here that GALC transduction led to dramatic morphological improvement of the twitcher oligodendrocytes comparing with those in untreated twitcher controls. This study provided direct in vivo evidence that GALC transduction could prevent or correct aberrant morphology of oligodendrocytes in GLD which may be closely related to the dysfunction and/or degeneration of oligodendrocytes and the demyelination in this disease.     

多脏器恶性肿瘤术后肝黏膜相关淋巴组织淋巴瘤

目的 探讨肝黏膜相关淋巴组织淋巴瘤的临床病理特征。方法 对1例罕见多脏器恶性肿瘤术后肝黏膜相关淋巴瘤病例结合文献进行临床、病理和免疫组化分析。结果 患者于8年和3年前先后发生胃恶性间质瘤、阴囊阴茎皮肤湿疹样癌，有长期化疗史。肿瘤组织学以单核样B细胞为主，并有淋巴滤泡和淋巴上皮病变形成。免疫表型示瘤细胞CD45、CD79α、CD20阳性，CD5、CD10、ALK、TdT阴性，bcl—2、Ki—67少数肿瘤细胞阳性。结论 肝黏膜相关淋巴瘤可以发生于多脏器恶性肿瘤术后，其发病可能与长期使用免疫抑制剂有关，诊断本病时需与肝继发性淋巴瘤及肝的炎性假瘤鉴别。     

Emergency department visits for asthma: the role of frequent symptoms and delay in care.

BACKGROUND: Use of the emergency department (ED) for asthma care is a costly form of health care that is largely preventable. However, little is known about how to reduce the number of people using the ED for asthma care. OBJECTIVE: To identify modifiable factors related to ED visits for asthma among a diverse nonelderly adult population. METHODS: This study used cross-sectional data from the 2001 California Health Interview Survey. A total of 4,359 adult respondents ages 18 to 64 years who reported being diagnosed as having asthma and experiencing symptoms in the past year were included. Any ED visits due to asthma in the previous 12 months among all nonelderly respondents with asthma, with stratification by those with daily or weekly symptoms and with less frequent symptoms, were examined. RESULTS: Adults with daily or weekly asthma symptoms, with fair or poor health status, and who delayed care for asthma because of cost or insurance issues were more likely to visit the ED for asthma. Stratification of the study population into those with daily or weekly symptoms and those with less frequent symptoms revealed that delay in care due to cost or insurance issues and fair or poor health status remained significant for both groups. Latinos and women were more likely to visit the ED in the severe asthma group, whereas Asian, African American, and uninsured adults were more likely to visit the ED in the group with less severe asthma. CONCLUSIONS: Results suggest that to prevent ED visits for asthma, it is important to control asthma symptoms. However, it is equally if not more important to reduce delays in receiving asthma care.     

Measurement of human cytomegalovirus loads by quantitative real-time PCR for monitoring clinical intervention in transplant recipients

Quantitative monitoring of human cytomegalovirus (HCMV) infection is helpful in determining appropriate antiviral management of transplant recipients. Quantitative PCR technologies have demonstrated accuracy in measuring systemic HCMV loads. A total of 298 consecutive whole-blood specimens submitted to the Clinical Virology Laboratory at Vanderbilt University Medical Center from 15 February to 31 October 1999 were included in the study. In addition to a qualitative colorimetric microtiter plate PCR assay (MTP-PCR) and a semiquantitative pp65 antigenemia assay, each specimen was measured for HCMV loads by a quantitative PCR assay performed on an ABI PRISM 7700 Sequence Detection System (TaqMan). Compared to results of the MTP-PCR, the sensitivity, specificity, positive predictive value, and negative predictive value were 70.5, 97.5, 87.8, and 92.8% for the antigenemia assay and were 96.7, 92.0, 75.6, and 99.1% for the TaqMan assay, respectively. There was a high correlation between antigenemia values and HCMV loads as determined by the TaqMan (r = 0.989; P < 0.001). Antigenemia values of 0, 1 to 10, 11 to 100, 101 to 1,000, and over 1,000 positive cells per 2 x 10(5) leukocytes corresponded to median HCMV loads measured by TaqMan of 125, 1,593, 5,713, 16,825, and 5,425,000 copies/ml, respectively. Corresponding to antigenemia values of 1 to 2, 10, and 50 positive cells per 2 x 10(5) leukocytes, HCMV viral loads of 1,000, 4,000, and 10,000 copies/ml are proposed as cutoff points for initiating antiviral therapy in patient groups with high, intermediate, and low risk of CMV diseases.     

脑缺血大鼠海马超微结构的形态定量研究

对大鼠双侧颈总动脉夹闭2小时,经透射电镜观察海马,用Weibel氏形态定量法分别测量了海马1区和3区的线粒体和突触的表面积密度(Svi)、表面积—体积比(Si/Vi),并与对照组进行了比较。结果表明:缺血时海马1区受损较严重,表现为线粒体体积缩小,数量减少,Svi下降;突触数量有增多的趋势,但突触的Svi与Si/Vi变化不明显。缺血组海马3区受损较轻,线粒体和突触的结构基本正常,其Svi、Si/Vi与对照组差别不显著,提示了3区对缺血有较强的耐受性。