Renal Transplantation in Indo-Asian Patients in the UK

Membership of some ethnic groups has an effect on renal transplant outcome but little is known about the impact of Indo-Asian ethnicity, despite this group's high incidence of renal disease. We compared outcomes in Indo-Asians and Caucasians at the Hammersmith Hospital (Indo-Asians, N = 46; Caucasians, N = 90), in the Long-Term Efficacy and Safety Surveillance (LOTESS) database of cyclosporin-treated renal transplant recipients (Indo-Asians, N = 254; Caucasians, N = 4262) and the National Transplant Database held by UK Transplant (Indo-Asians, N = 459; Caucasians, N = 4831). The baseline demographic and co-morbid characteristics of the two ethnic groups were comparable, save for more diabetes in the Indo-Asian community. Following transplantation, the incidence of delayed graft function and steroid-resistant acute rejection were also comparable, as were graft and patient survival (out to 5 years) and graft function. In addition, post-transplant blood pressure, levels of cholesterol and triglycerides and exposure to corticosteroids and cyclosporin were comparable. However, when patients who were not diabetic before transplantation were studied separately, there was an increased incidence of diabetes in the Indo-Asian community (Hammersmith data: Indo-Asians 10.9% vs. Caucasians 3.3%, p = 0.02; LOTESS data Indo-Asians 5.5% vs. Caucasians 1.6%, p < 0.0001). Subsequent management of this group should pursue immunosuppressive regimens less likely to impair post-transplant glucose tolerance.     

原发性胆囊癌CD44v5、CD44v6表达及其临床病理意义的研究

目的 检测胆囊癌组织中CD44v5、CD44v6的表达,并探讨其在胆囊癌发生发展过程中的临床病理意义.方法 采用SP免疫组织化学方法,检测49例胆囊癌、10例胆囊结石伴慢性胆囊炎组织和10例正常胆囊组织中CD44v5、CD44v6蛋白表达情况.结果 CD44v5、CD44v6阳性表达率在胆囊癌组织明显高于良性组织.在胆囊癌中,CD44v5基因表达阳性率与组织学分级无关,CD4 4v6基因表达阳性率与组织学分级有关.有淋巴结转移的胆囊癌组织中,CD44v5、CD44v6阳性表达率明显高于无淋巴结转移者.结论 CD44v5、CD44v6可能在胆囊癌的淋巴结转移中起着重要的作用,CD44v5、CD4 4v6可能是了解胆囊癌病变发生发展生物学行为,淋巴结转移的重要生物学指标.     

含碘食物对Graves病患者甲状腺^131I与^99mTc摄取的不同影响

目的 探讨含碘食物对Graves病患者摄取^99mTc与^131I的影响。方法 选择曾食含碘食物的Graves病患者20例，在禁食含碘食物前后分两次进行摄^131I试验与甲状腺^99mTc显像．前者测定3、24h摄^131I率，后者计算摄锝指数(TI)及估算甲状腺质量(TW)。采用Wilcoxon符号秩和检验对数据进行对比分析。结果 20例患者禁止含碘食物前后的摄^131I率显著不同，所有患者禁食含碘食物后3和24h摄^131I率均显著增高。TI2例未变、2例增高、16例降低；TM18例减小、2例增大。较未禁食含碘食物的首次检测，两者均有显著性变化。结论 含碘食物对甲状腺摄取Na^99mTcO4的影响与Na^131I显著不同，含碘食物100％减低甲状腺^131I的摄取而90％锝摄取增高。     

超声探讨室间隔缺损合并动脉导管未闭的诊断方法

目的:超声探讨室间隔缺损合并动脉导管未闭(VSD PDA)患者的动脉导管未闭(PDA)显示方法.方法:超声测量41例VSD PDA和41例单纯室间隔缺损(VSD)患儿的主动脉峰值流速(Vp),平均流速(Vm),流速时间积分(VTI)和心排指数(CI).除常规在胸骨旁大动脉短轴切面探查以外,彩色多普勒超声心动图在胸骨旁肺动脉分叉切面、胸骨上主动脉弓长轴,向短轴扫查切面及剑突下主动脉短轴切面探查PDA.结果:41例VSD PDA患者检出PDA 29例,占70.73%,漏诊12例,漏诊率29.27%.VSD PDA患者的Vp、Vm、VTI和CI参数明显高于单纯VSD患者,P<0.001.4例在胸骨旁大动脉短轴切面未显示的PDA,其中2例在胸骨旁肺动脉分叉切面发现PDA,1例在胸骨上主动脉弓长轴向短轴扫查切面显示PDA,1例在剑突下主动脉短轴切面显示PDA.结论:VSD患儿主动脉Vp、Vm、VTI和CI参数增高时提示合并PDA存在.探查VSD患儿胸骨旁肺动脉分叉切面、胸骨上主动脉弓长轴向短轴扫查切面及剑突下主动脉短轴切面有助于发现PDA.     

胃癌高系家族成员胃蛋白酶原C基因多态性及其诊断意义的探讨

采用限制性酶切片段长度多态性分析法，检测在胃癌高发区庄河检出的１９例胃癌高系家族成员胃蛋白酶原Ｃ基因多态性，发现三种常见片段及一种稀有片段。对其中４例携带稀有片段的受检者进行了胃镜追踪观察，２．５年后发现１例早期胃癌。本文对此作了初步探讨。     

体表胃电传导特性的研究

本文以胃钡餐X线照片为依据,选择胃体中央、胃体窦交界处和胃窦中央作为电极定位点,分别为E_1、E_2、E_3点,同步检测胃电图。实验结果表明:胃电慢波E_1先出现,呈现从E_1点向E_3点传导的现象;胃电慢波幅值E_1,E_2、E_3点餐前分别为274±55、554±196、726±145μV,餐后分别为294±41、606±188,801±240μV;试餐前及试餐后,各点胃电图优势频率均值之间差别无统计学意义(P>0.05)。提示体表胃电存在传导特性,传导方向从胃体中央扩播至胃窦中央。越近胃窦波幅越高,但优势频率不变。     

Inhibitory effect of moricizine on reperfusion induced tachyarrhythmias in rats--a comparison study with disopyramide and mexiletine.

Acute ligation of proximal left coronary artery was performed on forty male Sprague-Dawley rats. Five min later, occlusion was released in order to evaluate the effectiveness of the 3 antiarrhythmic drugs in eliminating reperfusion ventricular arrhythmias. The drugs evaluated were moricizine (5 mg/kg), disopyramide (DSP) (5 mg/kg) and mexiletine (MXT) (5 mg/kg), which were administered intravenously 5 min before ligation of the coronary artery. Compared to control rats that underwent identical experimental procedures, all 3 drugs significantly lowered the mortality rate from 90% of the control group to 20, 20 and 0% for moricizine, DSP and MXT groups. The incidence of ventricular fibrillation (Vf) was also decreased significantly by these drugs. The duration of ventricular tachycardia (VT) and Vf of surviving rats in drug groups were 111.7 +/- 35.0 sec, 71.6 +/- 29.4 sec and 32.9 +/- 14.6 sec for moricizine, DSP and MXT, respectively. Many of the drug treated rats could be restored to the normal sinus rhythm and survived. All 3 drugs slowed the heart rate significantly, but as for the blood pressure only MXT showed significant suppressing effect. In conclusion, moricizine has the same significant preventive effect on reperfusion induced ventricular tachyarrhythmias as DSP and MXT.     

Pseudomonas pseudomallei and melioidosis in China.

Though melioidosis has been reported since 1912, it is still a new problem for most Chinese physicians and medical scientists. Because of the lack of understanding and clinical experiences in melioidosis, none had been reported until 1990 in the mainland of China. In view of China's open policy and health work the natural foci of Pseudomonas pseudomallei in South China, ie. Hainan, Guangdong and Guangxi Provinces, should be given sufficient concern. Efforts should be made in training physicians in the endemic areas to improve their knowledge about the disease and to avoid misdiagnosis.

     

精神发育迟滞儿童特殊教育三年随访

采用Ｈ－ＮＴＬＡ量表及婴儿～初中学生社会生活能力量表对太原市一个培智学校４４例精神发育迟滞患儿从１９８９～１９９２年连续４次测查智力，２次测查适应行为。结果显示３年间ＩＱ值变化无显著统计学意义，但视觉联想、概念关系、注意力及视觉识知能力有明显提高。患儿适应行为明显提高。经多元逐步回归分析显示，精神发育迟滞儿童智商的提高和母亲文化程度较高、患儿智力低下程度较轻、母亲职业为科技或行政管理人员、患儿初始教育年龄早呈正相关。