Maternal Cigarette Smoking, Metabolic Gene Polymorphism, and Infant Birth Weight

Context  Little is known about genetic susceptibility to cigarette smoke in relation to adverse pregnancy outcomes. Objective  To investigate whether the association between maternal cigarette smoking and infant birth weight differs by polymorphisms of 2 maternal metabolic genes: CYP1A1 and GSTT1. Design, Setting, and Participants  Case-control study conducted in 1998-2000 among 741 mothers (174 ever smokers and 567 never smokers) who delivered singleton live births at Boston Medical Center. A total of 207 cases were preterm or low-birth-weight infants and 534 were non–low-birth-weight, full-term infants (control). Main Outcome Measure  Birth weight, gestation, fetal growth by smoking status and CYP1A1 MspI (AA vs Aa and aa, where Aa and aa were combined because of small numbers of aa and similar results), and GSTT1 (present vs absent) genotypes. Results  Without consideration of genotype, continuous maternal smoking during pregnancy was associated with a mean reduction of 377 g (SE, 89 g) in birth weight (odds ratio [OR], 2.1; 95% confidence interval [CI], 1.2-3.7). When CYP1A1 genotype was considered, the estimated reduction in birth weight was 252 g (SE, 111 g) for the AA genotype group (n = 75; OR, 1.3; 95% CI, 0.6-2.6), but was 520 g (SE, 124 g) for the Aa/aa genotype group (n = 43 for Aa, n = 6 for aa; OR, 3.2; 95% CI, 1.6-6.4). When GSTT1 genotype was considered, the estimated reduction in birth weight was 285 g (SE, 99 g) (OR, 1.7; 95% CI, 0.9-3.2) and 642 g (SE, 154 g) (OR, 3.5; 95% CI, 1.5-8.3) for the present and absent genotype groups, respectively. When both CYP1A1 and GSTT1 genotypes were considered, the greatest reduction in birth weight was found among smoking mothers with the CYP1A1 Aa/aa and GSTT1 absent genotypes (-1285 g; SE, 234 g; P<.001). Among never smokers, genotype did not independently confer an adverse effect. A similar pattern emerged in analyses stratified by maternal ethnicity and in analyses for gestation. Conclusions  In our study, maternal CYP1A1 and GSTT1 genotypes modified the association between maternal cigarette smoking and infant birth weight, suggesting an interaction between metabolic genes and cigarette smoking.      

人胎儿晶状体上皮细胞增殖及相关因子的动态研究

目的：观察增殖细胞核抗原（PCNA）及转化生长因子－β1（TGF－β1），表皮生长因子（EGF）在人胎和晶状体上皮细胞的表达，并探讨其在晶状体发育中的作用。方法：用SP免疫细胞化学法对48例人胎儿不同胎龄晶状体上皮细胞进行PCNA，TGF－β1，EGF免疫细胞化学染色。结果：PCNA，TGF－β1，EGF在人胎儿不同胎龄状体上皮细胞内均有表达；免疫阳性细胞随着胎龄的增加而减少。PCNA阳性细胞核为桔黄色或棕黄色；TNF－β1，EGF阳性细胞浆为桔共色或棕黄色的颗粒状或斑块状；经相关分析，TGF－β1与EGF以及TGF－β1，EGF与PCNA均呈正相关。结论：PNCA，TGF－β1，EGF在人胎儿不同胎龄晶状体上皮细胞内均有表达，TGF－β1，EGF具有协同作用，共同促进晶状体上皮细胞的增殖。     

Clinical Use of Low Porosity Woven Ultrafine Polyester Fiber Grafts

Abstract: A woven fabric graft made of ultrafine polyester fibers (UFPF) (Toray Graft, water porosity: 100 ml/ min/cm²:120 mm Hg H₂O) was clinically applied in 81 cases (28 thoracic aortic aneurysms, 6 thoracoabdominal aortic aneurysms, 42 abdominal aortic aneurysms, and 5 atherosclerotic obstructions of the peripheral arteries). Eight patients died after surgery due to causes unrelated to the graft. The other 73 patients were in good condition after surgery. For operations requiring extracorporeal circulation, the graft was presealed with human albumin. For the abdominal aortic aneurysms, the graft was pre-clotted in situ with nonheparinized autoblood after the completion of the proximal anastomosis. It took about 2 min to complete the preclotting. A nonsealed graft was used for the reconstruction of peripheral arteries for theintraaortic balloon pumping procedure. The graft was easy to handle. There was no cut edge fraying problem with the graft in any direction of cutting. Even after pre-sealing, the graft was soft and pliable enough to enable easy adaptation and anastomosis. Just after implantation, bleeding was minimal from the graft wall, anastomotic sites, and suture pores, and it stopped spontaneously. These clinical data showed that the woven UFPF graft exhibited both easy handling despite in spite of low porosity and safe application in the reconstruction of arterial systems even under totally heparinized conditions during extracorporeal circulation.     

脊椎结核的CT表现及其应用价值(附48例报告)

目的:讨论脊椎结核的CT表现和CT诊断的价值。材料与方法:本文报告48例脊椎结核患者,均经临床、X线、CT和手术病理证实。男32例,女16例,以30～39岁多见。结果:CT表现为(1)骨质破坏(48例),(2)骨质密度增高(10例),(3)椎间盘破坏(12例),(4)死骨片形成(20例),(5)椎旁脓肿(32例),(6)骨性椎管狭窄(12例)。结论:脊椎结核的CT表现具有一定的特征性,椎体前缘破坏、椎间隙变窄和椎旁脓肿形成为本病的主要CT征象。此外,CT还可以清晰地划出椎管脓肿和椎管内脓肿的大小及范围,显示椎管狭窄的程度,为手术提供依据。     

Release of sulfur mustard-modified DNA bases by Escherichia coli 3-methyladenine DNA glycosylase II

The toxic effects of sulfur mustard have been attributed toDNA modification with the formation of 7-hydroxyethyl-thioethylguanine, 3-hydroxyethylthioethyl adenine and the cross-link,di-(2-guanin-7-yl-ethyl)sulfide. To investigate the action ofbacterial 3-methyladenine DNA glycosylase II (Gly II) on theseadducts, calf thymus DNA was modified with [¹⁴C]sulfur mustardand used as a substrate for Gly II. Gly II releases both 3-hydroxyethylthioethyladenine and 7-hydroxyethylthioethyl guanine from this substrate.In comparison with the activity of Gly II towards methylatedDNA, 3-hydroxyethylthioethyl adenine is released somewhat moreslowly than 3-methyladenine, while 7-hydroxyethylthioethyl guanineis released much more readily than 7-methylguanine. Glycosylaseaction may play a role in protecting cells from the toxic effectsof sulfur mustard.     

高原人体体力测试及相互比较

本文研究了平原人移居海拔3680m后,不同时间体力状况,并与条件相近的藏族世居者进行了比较。研究结果表明,移居者的屏气时间较短,表明其缺氧耐受力低。低氧环境对60m跑和握力等无氧运动项目的影响不大。世居者与平原人相比,Vo_2rmax等指标均低于平原人,表明即使对低氧环境产生习服的人体,也不可能达到平原水平,机体的代偿调节能力是有限的。移居者的Vo_2rmax和HBmax等经过7～15个月的适应,可接近世居者水平。但1000m跑成绩大大低于世居者,可能是两种人群对Vo_2rmax的利用率不同引起。     

MRI增强扫描对脑转移瘤的诊断价值

目的 总结磁共振增强扫描在脑转移瘤诊断中的重要价值。方法 脑转移瘤32例，均经病理和临床证实，全部病例均做了Gd-DTPA增强前后扫描。结果 脑转移瘤单发15例，多发17例，发生在幕上26例，幕下6例，幕上幕下并存4例。病灶最大径在0．5cm～6cm，平均2．4cm。发现病灶数：T1WI40个，T2WI56个，增强后发现116个。结论 增强扫描发现的脑转移瘤病灶明显多于平扫，并且能分清病灶与瘤周水肿的界限，从而明确其发生的部位、数目、形态、和大小，结合临床和影像学特征，容易作出正确诊断。     

Research on Autoantibodies Against Myocardial β1-adrenergic and M2 Cholinergic Receptors in Patients With Chronic Keshan Disease

Objectives To explore the relationship between serum autoantibodies against myocardialβ1-adrenergic, M2-cholinergic receptors and chronic Keshan disease (CKD). Methods The second extracellular loops ofβ1 and M2 receptors on human cardiomyocytes were used as the antigens. Enzyme linked immunosorbent assay (ELISA) was applied to determine serum autoantibodies against myocardialβ1 and M2 receptors in 32 CKD patients. 31 healthy subjects from endemic area were selected as the control. Results Positive rate of autoantibodies against myocardialβ1 adrenergic (51.3%, 17/32) and M2 cholinergic (56.3% , 18/32) receptors were significantly higher than those in the control (9.7%, 3/ 31; 12.9%, 4/31) (both P< 0.01). Both positive rate and liters of above autoantibodies in NYHAⅡ-ⅢCKD patients were significantly higher than those in NYHAⅣ, demonstrating an apparently positive correlation between serum antibodies against myocardialβ1 and M2 receptors (r=0.95). Conclusions Autoantibodies against myocardialβ1 and M2 receptors were found in sera of CKD patients; distribution of positive rate and liters of the auloanlibodies in CKD patients in various NYHA classes of cardiac function are significantly different.     

心肌缺血再灌注时内皮细胞损伤功能改变与心肌梗塞面积的关系

目的旨在探讨内皮细胞损伤、功能改变在心肌缺血再灌注（ＭＩＲ）损伤中的发病机制及其与心肌梗塞面积的关系及卡托普利的保护作用。方法用２４只麻醉兔随机分为三组，（１）ＭＩＲ组，（２）ＭＩＲ＋卡托普利治疗组，（３）假手术对照组，观察心肌缺血半小时，再灌注０．５、１．５、６小时血循环内皮细胞（ＣＥＣ），一氧化氮（ＮＯ），内皮素（ＥＴ）的含量变化及其与心肌梗塞面积的关系，静注卡托普利观察其对梗塞面积及上述指标的影响。结果（１）与假手术组比较，再灌注半小时，血ＮＯ下降，ＥＴ升高，其变化于再灌注６小时最明显（Ｐ＜０．０５），ＣＥＣ则以再灌注１．５小时明显增高（Ｐ＜０．０５）；（２）再灌注６小时心肌梗塞范围较治疗组明显增加（Ｐ＜０．０５），且同一时相点血ＮＯ与心肌梗塞面积呈负相关（ｒ＝－０．９６１，Ｐ＜０．０１），血ＥＴ与心肌梗塞面积呈正相关（ｒ＝０．９２３，Ｐ＜０．０５）；（３）用卡托普利干预后，血ＮＯ有所回升，ＥＴ明显下降，心肌梗塞面积明显缩小。结论ＭＩＲ可诱发内皮功能紊乱，而内皮功能紊乱是再灌注心肌损伤加重的始动因素     

Giant bronchogenic cyst masquerading as tension pneumothorax radiographic and CT findings

Pulmonary bronchogenic cysts with tracheobronchial communication may occasionally mimic tension pneumothorax leading to unnecessary thoracostomy. We describe such a case to emphasize that cautious identification of the direction of displacement of the collapsed lung tissue on chest radiograph or computed tomography (CT) may help in differentiating these two diseases. Tension pneumothorax should lead to centripetal compression of the ipsilateral lung toward the hilum while giant bronchogenic cysts result in centrifugal displacement of the adjacent lung away from the hilum.