The time course of post-lumbar puncture headache

According to the leakage theory, the time taken for pain to develop upon rising to the upright position will increase during the time course of post-lumbar puncture headache (PPH) as a consequence of the decreasing size of the healing dural rent, and the pain will decline. The aim of the present prospective study was to test this hypothesis, and to describe the temporal course of time and pain variables in PPH. The study showed that the course was fairly stable for all variables except on the first day, the second last day, and the last day. In the recumbent position, the headache was more severe on the first day ( p <0.05) and milder on the last day ( p <0.001) compared with the interim days; maximal headache in the upright position was milder on the second last ( p <0.005) and last days ( p <0.0001). Compared with the interim days, the time prior to increase of pain upon rising was shorter on the first day ( p <0.05) and longer on the last day ( p <0.00l), and from start of increase until maximum was longer on the last day ( p <0.01). The time to pain relief upon lying down did not vary significantly throughout the PPH period. The mobility of the patient as expressed by the PPH grade was fairly stable throughout the course of PPH until it increased in the last 2 days. The results are in good accord with the leakage theory.     

兔活体主动脉脂质斑块的腔内超声显像和病理的对照研究

１１条新西兰兔进行血管腔内超声（ＩＶＵＳ）研究。其中８条经高胆固醇饲养６个月；另３条予正常饮食对照。采用６．２Ｆ，频率２０ＭＨｚ腔内超声导管。由腹主动脉下端水平插入超声导管至升主动脉，然后逐步退出，观察主动脉内膜、中膜和外膜的形态特征。结果发现，正常兔主动脉在腔内超声观察下均无内、中和外膜三层结构之分。３９个切面管壁弥漫性增厚，其形态看似管壁的三层结构，病理证实３４个切面有脂质斑块。平滑肌增生的脂质斑块，回声影低于血管壁。部份脂质斑块存在弥漫性纤维化、胆固醇结晶和少量镜下可见的钙化灶，回声影致密，与血管壁的回声相同，但其后无声影。腔内超声测定的斑块面积和厚度与病理结果比较，差别无显著意义（Ｐ＞０．０５），两者高度相关（分别为ｒ＝０．９７，Ｐ＜０．０００５和ｒ＝０．９６，Ｐ＜０．０００５）。     

大鼠T细胞受体Vβ5.2-HSP70和Vβ8.2-HSP70基因真核表达质粒的构建及表达

目的:构建含大鼠TCR Vβ5.2-HSP70和TCR Vβ8.2-HSP70基因的重组真核表达质粒,并检测其在体内外的表达。方法:实验于2005-10/2006-09在首都医科大学免疫学系实验室完成。①以自主构建的重组表达载体pTARGET-TCR Vβ5.2和pTARGET-TCR Vβ8.2为模板,将结核杆菌HSP70的一段保守序列P111-125设计到引物中,通过PCR的方法得到TCR Vβ5.2-HSP70和TCR Vβ8.2-HSP70基因片段,将其插入到真核表达载体pTARGET中,构建重组表达载体pTARGET-TCR Vβ5.2/8.2-HSP70。②将BALB/c小鼠48只随机分为4组,pTARGET-TCR Vβ 5.2-HSP70组、pTARGET-TCR Vβ8.2-HSP70组和空质粒组肌注相应的质粒DNA100μg/次,PBS组注射PBS缓冲液100μL/次。共注射3次,每次间隔2周。于末次免疫后3d取注射部位的肌肉,用RT-PCR及免疫组化染色法检测TCR Vβ5.2/8.2-HSP70基因在注射部位的转录和表达。③将COS-7细胞分为pTARGET-TCR Vβ5.2-HSP70组、pTARGET-TCR Vβ8.2-HSP70组、空质粒组和未转染细胞组,进行相应质粒转染,24h后收集细胞,用免疫细胞化学染色法检测靶基因在真核细胞内的表达。结果:①TCR Vβ5.2/8.2-HSP70基因已被正确插入到pTARGET载体中。②pTARGET-TCR Vβ5.2-HSP70组、pTARGET-TCR Vβ8.2-HSP70组小鼠免疫处的肌肉组织RT-PCR检测显示,在500～600bp和400～500bp处出现特异的扩增带,分别与TCR Vβ5.2-HSP70和TCR Vβ8.2-HSP70基因片段的大小相符,而注射空质粒组和PBS组均未见此条带。③免疫组化结果显示转染重组质粒pTARGET-TCR Vβ5.2/8.2-HSP70的COS-7细胞的胞质及胞膜都有明显的着染。结论:成功构建了重组真核表达质粒pTARGET-TCR Vβ5.2/8.2-HSP70,并在体内外检测到其转录和表达,为进一步进行TCR DNA疫苗治疗胶原诱导性关节炎的实验研究奠定了基础。     

Streptococcus MG-intermedius endocarditis

Subspeciation of penicillin susceptible alpha-hemolytic streptococci is not routinely performed. However, Streptococcus MG-intermedius is an extremely virulent organism in this strep subgroup and is associated with abscess formation. Our patient, who had endocarditis due to this organism, remained chronically ill despite appropriate antibiotic therapy, and had a perforated aneurysm of the sinus of Valsalva with a myocardial abscess that required extensive surgical debridement. Persistent fever in patients with S MG-intermedius endocarditis should warrant further work-up for metastatic or myocardial abscess formation.     

Growth hormone responses to growth hormone-releasing factor (1-29) in euthyroid, hypothyroid and hyperthyroid rats

In order to investigate whether the impaired GH secretion associated with hypothyroidism and hyperthyroidism is due to a hypothalamic or a pituitary disorder, we have studied plasma GH responses to GH-releasing factor (1-29) (GRF) in euthyroid, hypothyroid and hyperthyroid rats. Hypothyroid rats showed a significant (P less than 0.001) reduction in GH responses to GRF (5 micrograms/kg) at 5 min (350 +/- 35 vs 1950 +/- 260 micrograms/l), 10 min (366 +/- 66 vs 2320 +/- 270 micrograms/l) and 15 min after GRF injection (395 +/- 72 vs 1420 +/- 183 micrograms/l; mean +/- S.E.M.) compared with euthyroid rats. Hyperthyroid rats showed a significant (P less than 0.05) decrease in GH responses to 5 micrograms GRF/kg after 30 min (200 +/- 14 vs 325 +/- 35 micrograms/l) but not at other time-points, or after the administration of 1 microgram GRF/kg. These data indicate that in hypothyroidism and perhaps hyperthyroidism there is an alteration in the responsiveness of the somatotroph to GRF administration.