Wegener氏肉芽肿的临床和胸部影像表现

本文报道Wegener氏肉芽肿22例，男18例，女4例，年龄在16～58岁之间。根据有无肾、肺及其它器官受累情况分为局限型和全身型。本组两型病例数相等。结果显示：病变侵及上下呼吸道（100％）、肺（50％）、肾（32％）、皮肤（23％）、胃肠道（19），以及其它器官。全身型胸部影像表现有渗出（6／11）、支气管血管束增粗（10／11）、圆形结节（4／11）、空洞性结节（4／11）。CT扫描能够发现大量的胸部损害，对估计Wegener氏肉芽肺肺侵犯程度很有帮助。     

Factors associated with death in hospitalized pneumonia patients with 2009 H1N1 influenza in Shenyang,China

Background  

During the spring of 2009, a pandemic influenza A (H1N1) virus emerged and spread globally. We describe the clinical characteristics and factors associated with the death of patients who were hospitalized with 2009 H1N1 influenza pneumonia in Shenyang, China, from November to December 2009.     

Steroids for the treatment of methimazole-induced severe cholestatic jaundice in a 74-year-old woman with type 2 diabetes

Methimazole is a widely used antithyroid agent. Although methimazole is generally well tolerated, rare but severe cholestatic jaundice may occur. We described a 74-year-old woman who had a 10-year history of type 2 diabetes had developed severe jaundice and itching 1 month after receiving methimazole (10 mg tid) and propranolol (10 mg tid) for the treatment of hyperthyroidism. Clinical investigations revealed no evidence of any mechanical obstruction in the common bile duct or other obvious causes of hepatic injury, and the diagnosis methimazole-induced cholestasis was made on the basis of the temporal relationship between initiation of methimazole and onset of cholestasis. Methimazole was hence discontinued. However, the patient experienced a progressive worsening in cholestasis after receiving 2 weeks of ursodeoxycholic acid (UDCA) therapy. Prednisone therapy was then attempted. Liver function tests eventually improved with combination of glucocorticoids and ursodeoxycholic acid therapy. This case clearly showed that glucocorticoids could be a possible additional way of treatment for some cases of drug-induced cholestatic jaundice even in diabetic patients.     

环孢素治疗药物监测质控规则的比较与评价

目的通过不同质量控制方法的比较,确定本院实验室条件下环孢素治疗药物监测的质量控制规则,及时发现测定误差成因,确保血药浓度监测质量。方法对本院实验室2009年质控数据进行统计学分析,并使用不同的质控方法评价,根据临床检验质控设计评价方法选择最佳质控规则。结果 Levey-Jennings控制方法的结果均在控,累计和质量控制方法检出3次失控,Z-分数控制图法检出8次失控,修改的Westgard多规则控制方法达到了极高的误差检出率和较低的假失控概率。结论修改的Westgard多规则控制方法简便易行,误差检出率高,成本低,符合本院实验室的质量控制要求,提高了实验室测定数据的准确性,能为临床提供更加真实有效的数据。     

连续性血液滤过对多脏器功能衰竭患者血清诱导的血管内皮细胞凋亡及内质网应激的影响

目的探讨连续性静脉-静脉血液滤过(continuous veno-venous hemofiltration,CVVH)对多脏器功能衰竭(multiple organ dysfunction syndrome,MODS)患者血清体外诱导的脐静脉内皮细胞凋亡及内质网应激的影响及其机制。方法分别用10例健康志愿者的血清及10例MODS患者CVVH治疗前、治疗6 h、治疗20 h的血清体外诱导人脐静脉内皮细胞(human umbilical vein endothelial cells,HUVEC)24 h,TUNEL法检测HUVEC细胞凋亡率,免疫荧光观察细胞GRP78蛋白表达,RT-PCR检测细胞GRP78、CHOP、TNF-α、IL-6 mRNA表达,比色法检测健康志愿者及CVVH治疗不同时间组血清中SOD活性、MDA含量。ELISA法检测健康志愿者及CVVH治疗不同时间组血清中TNF-α、IL-6含量。结果与健康对照组相比,CVVH治疗前组细胞凋亡率明显升高(P<0.01),GRP78、CHOP、IL-6、TNF-αmRNA表达量也显著增高(P<0.01)。与CVVH治疗前比较,CVVH治疗6、20 h组细...     

肾移植受体93例生存质量调查研究

目的 回顾性调查研究肾移植受者的生存质量状况及相关影响因素.方法 采用国际通用SF-36、症状经历量表、焦虑抑郁量表以及自制一般资料量表对1998-2008年在我院行肾移植手术并且移植肾良好的93例肾移植受者进行回顾性调查.结果 肾移植受者生存质量显著优于血液透析患者(P<0.01);男性、家庭成员年总收入较高、文化程度较高、术后返回工作的肾移植受者生存质量较好;肾移植受者在术后的存活过程中普遍经历多种症状(13.37±7.41)种,症状经历的多少与生存质量之间存在统计学差异(P<0.05);肾移植受者的焦虑、抑郁状况显著优于透析患者(P<0.01).多因素回归分析显示,症状经历是生存质量躯体健康方面和心理健康最显著影响因素(标准偏回归系数0.477和0.649),焦虑、抑郁状况是生存质量心理健康方面重要影响因素(标准偏回归系数0.281).结论 肾移植术后患者生存质量较血液透析患者改善,但仍受到多种因素影响,需要采用标准量表测量并有针对性地进行关注.症状经历与焦虑抑郁状况是影响肾移植受者生存质量最显著的因素.     

Involvement of microglial activation in the brainstem in experimental dental injury and inflammation

Objective

The purpose of this study was to determine the effect of dental injury and inflammation on microglia in the trigeminal subnucleus caudalis (Vc).

Methods

Pulp exposure (PX) was performed on the first maxillary molar of 35 rats. Specimens were collected at 1, 3, 7, 14, 21 and 28 days after PX. Teeth were processed for H&E staining and immunohistochemical staining for OX-42, a marker of microgial activation, in the Vc.

Results

We observed that there was a progressive and persistent inflammation in the tooth. At 21-28 days after PX, the inflammation extended out into periodontal ligament. Simultaneously, significant microglial activation was observed which starting at 2 weeks and peaking at 4 weeks.

Conclusion

Dental injury and inflammation induced microglial activation in the Vc. The results indicate that activation of microglia may be implicated in the central mechanisms of pain that can be associated with dental inflammation.     

板层状鱼鳞病患者外周血白细胞生长、分化相关基因的表达

目的:探讨板层状鱼鳞病(LI)患者外周血白细胞有关生长、分化的基因的表达情况.方法:LI患者与健康人各8例,分离外周血白细胞,采用原位杂交和RNA斑点印迹方法,检测c-fos、ras、c-myc、EGFR、iNOS 基因的表达;应用免疫细胞化学染色和蛋白质斑点印迹方法,检测MAPK、CyelinD1、Filaggrin、Involucrin及K10蛋白的表达.结果:LI组外周血白细胞c-fos、ras、c-myc、EGFR、iNOS基因和MAPK、Filaggrin、Involucrin、K10蛋白的表达较健康对照组降低(P<0.01),而CyelinD1的表达差异无统计学意义(P>0.05).结论:LI患者外周血白细胞有关生长、分化的基因多旱现表达下调.     

Effects of PPM1K rs1440581 and rs7678928 on serum branched-chain amino acid levels and risk of cardiovascular disease

ObjectiveThis study aimed to investigate the effects of PPM1K rs1440581 and rs7678928 single nucleotide polymorphisms (SNPs) on the serum branched-chain amino acids (BCAAs) levels and cardiovascular disease (CVD) risk.MethodsAnthropometric and biochemical examinations were performed at baseline and the end of 4 years in 234 individuals who were randomly recruited from the Diabetes Prevention Programme in Huai’an and received lifestyle intervention and follow up for 4 years. Serum BCAAs (leucine, isoleucine and valine (Val)) levels were measured by hydrophilic interaction chromatography-tandem mass spectrometric method and the PPM1K rs1440581 and rs7678928 were detected by high-throughput SNP genotyping at baseline. The associations of rs1440581 and rs7678928 with serum BCAA levels and risk for CVD after 4 years were further evaluated.ResultsThe distribution frequencies of PPM1K rs1440581 and rs7678928 met the Hardy-Weinberg equilibrium (p> .05). The baseline serum levels of Val (p = .022) and total BCAAs (p = .026) in subjects with rs1440581 CC genotype were higher than in those with TT genotype. There were no significant differences in the serum levels of BCAAs among subjects with different genotypes of rs7678928. After 4-year follow-up, the subjects with rs1440581 CC genotype had higher systolic blood pressure (SBP) (p = .027), diastolic blood pressure (DBP) (p = .019), triglycerides (TGs) (p = .019) and lower high-density lipoprotein cholesterol (HDL-c) (p = .008) than those with TT genotype, and had higher AST level than those with TT (p = .030) or TC (p = .003) genotype; the subjects with rs7678928 TT genotype had higher SBP (p = .039) and DBP (p = .019) and lower HDL-c than those with CC (p = .017) genotype. Lifestyle intervention had little influence on the serum levels of fasting plasma glucose (FPG), TG, HDL-c, alanine aminotransferase (ALT), AST and creatinine (CREA) in subjects with rs1440581 CC genotype or rs7678928 TT genotype (p> .05). The incidences of CVD and non-alcoholic fatty liver disease (NAFLD) in subjects with rs1440581 CC genotype were higher than in those with TT genotype; the incidence of CVD in subjects with rs7678928 TT genotype was higher than in those with CC (p < .05) genotype.ConclusionsAllele C of PPM1K rs1440581 was associated with elevated serum Val, total BCAAs and CVD risks. rs1440581 CC genotype may be a better marker than baseline serum BCAAs in predicting the risk for CVD.Trial registrationDiabetes Prevention Programme in Huai’an of Huai’an Second People''s Hospital, ChiCTR-TRC-14005029.

KEY MESSAGE

1. Allele C of PPM1K rs1440581 was relevant to elevated serum Val and total BCAAs.
2. PPM1K rs1440581 CC and rs7678928 TT genotypes were associated with CVD risk.
3. PPM1K rs1440581 CC genotype carriers were more likely to have liver injury and develop NAFLD.

     

Identification of small-molecule inhibitors of autotaxin that inhibit melanoma cell migration and invasion

Autotaxin (ATX) is a prometastatic enzyme initially isolated from the conditioned medium of human melanoma cells that stimulates a myriad of biological activities, including angiogenesis and the promotion of cell growth, survival, and differentiation through the production of lysophosphatidic acid (LPA). ATX increases the aggressiveness and invasiveness of transformed cells, and ATX levels directly correlate with tumor stage and grade in several human malignancies. To study the role of ATX in the pathogenesis of malignant melanoma, we developed antibodies and small-molecule inhibitors against recombinant human protein. Immunohistochemistry of paraffin-embedded human tissue shows that ATX levels are markedly increased in human primary and metastatic melanoma relative to benign nevi. Chemical screens identified several small-molecule inhibitors with binding constants ranging from nanomolar to low micromolar. Cell migration and invasion assays with melanoma cell lines show that ATX markedly stimulates melanoma cell migration and invasion, an effect suppressed by ATX inhibitors. The migratory phenotype can be rescued by the addition of the enzymatic product of ATX, LPA, confirming that the observed inhibition is linked to suppression of LPA production by ATX. Chemical analogues of the inhibitors show structure-activity relationships important for ATX inhibition and indicate pathways for their optimization. These studies suggest that ATX is an approachable molecular target for the rational design of chemotherapeutic agents directed against malignant melanoma.