Idiopathic paroxysmal kinesigenic dyskinesia in Malaysia,a multi-racial Southeast Asian country

Paroxysmal kinesigenic dyskinesia is a rare disorder, and there are few reports of Asian patients with this condition. We reviewed the clinical features of all patients with idiopathic paroxysmal kinesigenic dyskinesia (PKD) seen at a major neurological centre in Malaysia. The charts of 11 patients with idiopathic PKD seen between 1995 and 2008 were reviewed retrospectively. The male:female ratio was 9:2. Ten patients were of Chinese ethnicity, and one was Malay. Three patients (from two families) had a family history of PKD. The involuntary movement was dystonia in 73% of patients. In one patient, attacks were precipitated by vestibular stimulation. One patient had generalized epilepsy. Another patient who did not have epilepsy demonstrated epileptiform discharges. Only slightly over one-quarter of patients had a positive family history. Males, and people of Chinese ancestry, seem to be affected more frequently by PKD in certain Asian populations.     

靶控输注异丙酚复合瑞芬太尼麻醉时NI与BIS监测镇静深度的比较

目的 比较靶控输注异丙酚复合瑞芬太尼麻醉时Narcotrend指数(NI)与BIS监测镇静深度的准确性.方法 择期拟在全麻下行腹部手术患者10例,性别不限,ASA Ⅰ或Ⅱ级,年龄18～56岁,体重52～67kg.麻醉诱导后采用靶控输注异丙酚(Cp 3～μg/ml)和瑞芬太尼(Cp 3～4ng/ml),间断静脉注射顺阿曲库铵0.05mg/kg维持麻醉,同时监测BIS和NI,每隔1min成对记录二者的监测值,行相关分析和一致性分析.记录镇静深度判断错误次数(Ⅰ型错误:BIS<40而NI>62;Ⅱ型错误:BIS>60而NI<20).结果 BIS和NI的相关系数=0.812,Kappa系数=0.513(P<0.01).一致性限度(-18.1,6.4);镇静深度判断错误发生率(0.46±0.39)%,其中Ⅰ型错误发生率(0.15±0.11)%,Ⅱ型错误发生率(0.31±0.26)%.结论 NI监测镇静深度与BIS的一致性尚可,可用于靶控输注异丙酚复合瑞芬太尼麻醉时镇静深度的监测.     

小鼠造血干细胞移植后移植物抗宿主病与内皮细胞损伤的关系

目的 探讨异基因造血干细胞移植后移植物抗宿主病(GVHD)与内皮细胞损伤的关系.方法 以C57BL/6小鼠为供者、Balb/c小鼠为受者,分4组进行异基因造血干细胞移植,每组受者15只:对照组(仅输入磷酸盐缓冲液)、单纯骨髓移植组(仅输入骨髓单个核细胞)、GVHD组(输入骨髓单个核细胞和脾细胞)、GVHD减轻组(在GVHD组基础上加用环孢素A).分别于移植后不同时间观察受者的表现,检测外周血中内皮细胞及组织病理学变化.结果 术后第5天,各组受者均无典型的GVHD表现及组织病理学改变;术后第9天,GVHD组受者出现明显的GVHD的表现及病理学改变,并于15 d内全部死亡.术后第5天,单纯移植组、GVHD组和GVHD减轻组受者的外周血中内皮细胞数分别为(11.51±7.40)、(7.34±1.26)和(7.36±0.16)个/μl,三组间差异均无统计学意义(P＞0.05);术后第9天,内皮细胞数分别为(10.49±5.61)、(153.64±35.35)及(47.82±4.69)个/μl,三组间差异均有统计学意义(P＜0.05).术后第5天,单纯移植组、GVHD组、GVHD减轻组受者GVHD靶器官组织病理学评分分别为3.33±0.58、4.33±1.53及4.0±1.73,三组间差异均无统计学意义(P＞0.05);术后第9天,评分分别为3.33±1.15、10.0及4.33±0.58,三组间差异均有统计学意义(P＜0.05);术后第14天,评分分别为2.33±1.25、10.33±2.58和3.33±1.15,三组间差异均有统计学意义(P＜0.05).结论 GVHD的发生再次引起内皮的损伤,同时损伤的内皮加重了GVHD.

Abstract：

Objective To study the relationship between graft-versus-host disease (GVHD) and endothelium injury following hematopoietic stem cells transplantation in mice. Methods C57BL/6 mice as donors and Balb/c mice as recipients were randomly divided into 4 groups: control group, bone marrow transplantation group, GVHD group, GVHD mitigation group. The clinical manifestations,circulating endothelial cells and tissue pathological changes were observed at different time points after transplantation. Results No manifestations of GVHD were found in each group at the day 5, while those were found in GVHD group at the day 9 and all died within 15 days. The counts of endothelial cells in peripheral blood showed no significant difference at the day 5 between GVHD group (7. 34 ±1.26 cells/μl) and bone marrow transplantation group (11.51 ± 7. 40 cells/μl) or GVHD mitigation group (7. 36 ± 0. 16 cells/μl), while among three groups there was statistically significant difference at the day 9 (GVHD group: 153. 64 ± 35. 35 cells/μl vs bone marrow transplantation group: 10. 49 ±5. 61 cells/μl and GVHD mitigation group: 47. 82 ± 4. 69 cells/μl). The scores of pathological aGVHD had no significant difference at the day 5 between GVHD group (4. 33± 1. 53) and bone marrow transplantation group (3. 33 ± 0. 58) or GVHD mitigation group (4. 00 ± 1.73), while among three groups there was statistically significant difference at the day 9 (GVHD group: 10. 0 vs bone marrow transplantation group: 3. 33 ± 1.15 or GVHD mitigation group: 4. 33 ± 0. 58) and at the day 14 (GVHD group: 10. 33 ± 2. 58 vs bone marrow transplantation group: 2. 33 ± 1.25 or GVHD mitigation group 3. 33 ± 1.15). Conclusion Occurrence of GVHD causes endothelial damage again and injured endothelium worsens the GVHD.     

P53 and p38 MAPK pathways are involved in MONCPT-induced cell cycle G2/M arrest in human non-small cell lung cancer A549

Purpose  

In previous research, we found that 10-methoxy-9-nitrocamptothecin (MONCPT) possessed potent anti-tumor activity in A549 cells in vitro and in vivo. In this paper, our purpose is to investigate the mechanism of MONCPT-induced cell cycle arrest in A549 cells.     

Case illustrations of long QT syndrome

Long QT syndrome (LQTS) is a rare potentially life-threatening condition. Physicians must remain vigilant and consider LQTS as a possible etiology in patients with a history of syncope. Prolongation of the QT interval on electrocardiogram (ECG) is an essential component for the diagnosis of LQTS, despite the limitations of this technique. Experience of analyzing the ECG and calculating corrected QTc still remain relevant and are the mainstay diagnostic tools. Often, the first sign of the problem is observed after careful evaluation of the resting ECG for the hallmark of the disorder. Unfortunately, more than 60% of physicians-even cardiologists-have been known to misinterpret the QT interval on ECG. The cases discussed in this article highlight the variable clinical presentation of prolonged QT interval and the need to be highly vigilant in clinical evaluation.     

荒漠药用植物刺山柑产地适宜性数值分析

目的:分析荒漠药用植物刺山柑产地适宜性。方法:应用"中药材产地适宜性分析地理信息系统(TCMGIS)",以新疆东部吐鲁番地区及新疆南部野生刺山柑分布区的生态因子为依据,分析刺山柑在全国适宜产地。结果:新疆、内蒙古、甘肃、青海、宁夏5省区分布着刺山柑的适宜产区,共包括183个县市,总面积为1 251 361 km2。其中新疆北疆东部和新疆南部、内蒙古阿拉善高原、甘肃河西走廊北部、宁夏中北部是刺山柑适宜分布集中区。结论:刺山柑适宜区分析结果覆盖了第3次全国中药资源普查记载的全部区域,并且与历代本草记载的刺山柑产地及现代刺山柑引种的成功实践相吻合,对荒漠药材刺山柑的引种栽培及科学区划具有重要的参考价值。     

Meta-analysis: the efficacy of anti-viral therapy in prevention of recurrence after curative treatment of chronic hepatitis B-related hepatocellular carcinoma

Aliment Pharmacol Ther 2011; 33: 1104–1112

Summary

Background The role of anti‐viral therapy in prevention of hepatocellular carcinoma (HCC) recurrence is to be defined. Aim To investigate the role of anti‐viral therapy in prevention of tumour recurrence after curative treatment of hepatitis B virus (HBV)‐related HCC. Methods A systematic electronic search on keywords including HCC and different anti‐viral therapies was performed through eight electronic databases, including Medline, EMBASE and Cochrane Databases. The primary outcome was HCC recurrence after curative treatment of HBV‐related HCC. The secondary outcomes were mortality related to HCC, mortality related to liver failure and the overall mortality. Results Nine cohort studies were included with a total number of 551 patients: 204 patients with anti‐viral treatment group and 347 patients without anti‐viral treatment (control group). There was significant difference in the incidence of HCC recurrence in favour of the anti‐viral treatment group (55% vs. 58%; odds risk (OR) = 0.59, 95% CI 0.35–0.97, P = 0.04). The risk of HCC was reduced by 41% in the anti‐viral treatment group. There were also significant differences in favour of anti‐viral treatment group in terms of liver‐related mortality (0% vs. 8%; OR = 0.13, 95% CI 0.02–0.69, P = 0.02) and overall mortality (38% vs. 42%; OR = 0.27, 95% CI 0.14–0.50, P < 0.001). Conclusions Anti‐viral therapy has potential beneficial effects after the curative treatment of HBV‐related hepatocellular carcinoma in terms of tumour recurrence, liver‐related mortality and overall survival. Anti‐viral therapy should be considered after curative treatment of hepatocellular carcinoma.     

超敏C-反应蛋白与高血压关系的病例对照研究

目的:探讨超敏C-反应蛋白(hs-CRP)与高血压及血压水平的关系。方法:病例和对照均选自社区基础上整群调查人群;采用Logistic回归模型和分层分析方法对可能影响hs-CRP水平与高血压及血压水平关系的因素进行分析。结果:hs-CRP在高血压患者及排除药物治疗的患者和对照人群中差异均无统计学意义;但女性病例组hs-CRP水平(2.67±2.82)mg/L显著高于对照组hs-CRP水平(2.14±2.35)mg/L(t=2.1034,P=0.043)。吸烟者中校正协变量后,hs-CRP水平变化与高血压的关联有显著意义,OR(95%CI)=1.145(1.001～1.309),P=0.048;排除药物治疗的患者后关联仍有显著意义,OR(95%CI)=1.251(1.041～1.503),P=0.017;而较高hs-CRP水平(>2.4mg/L)患者高血压的患病风险也显著升高,OR 95%CI)=5.065(1.597～16.067),P=0.006。在非药物治疗患者及血压正常者中,女性SBP、DBP和平均动脉压(MAP)在hs-CRP升高组和正常组中差异均有统计学意义,而在男性中未见此差异。结论:hs-CRP水平升高是高血压的重要独立危险因素,而吸烟者患病风险更高。