Detection of circulating antigen by McAb-AST for evaluating the efficacy of anti-Leishmania chemotherapy.

We have adapted the simple and sensitive McAb-antigen spot test (AST) for evaluating the efficacy of anti-Leishmania chemotherapy. Serum samples from 37 kala-azar patients were tested by McAb-AST, and all showed definite positive reactions before treatment. After a course of antimony treatment, 20 turned negative, coupled with the disappearance of clinical symptoms; another 12 cases responded with weak positivity accompanied by an improvement of clinical manifestations; and the remaining 5 antimony-resistant patients showed strong positive reactions, with their conditions gradually worsening. Furthermore, all 6 cases in which the diagnosis was missed by the bone marrow smear method turned McAb-AST negative after chemotherapy. These results suggest that McAb-AST can be used to evaluate the efficacy of chemotherapy as well as to avoid missed diagnosis by the bone marrow smear method.     

顽固性癫痫的组合手术治疗

目的对部分顽固性癫痫病人，在严格充分的术前评价之后．依据结果将几种手术方式适当的组合使用，并对其临床效果进行评价。方法对同济大学东方医院神经外科收治的116例顽固性癫痫中的25例病人施行联合手术的治疗方法。发作形式为全身强直一阵挛性发作、复杂部分性发作及失神发作等，其中有14例存在两种发作形式。术前均服过多种抗癫痫药．病程后期同时服用2～3种抗癫痫药。25例病人术前均行24h脑电监测及头颅MRI检查．有19例术前行硬膜下皮层电极和深部电极检测，其中1例行头颅PET检查。手术在皮层脑电及深部电极监测下进行。13例行额颢开颅，颞前叶及海马、杏仁核切除＋额部部分区域的软膜下横切术（MST），其中7例附加胼胝体前部切开术；11例行额部开颅，额部软化灶切除＋运动区MST，其中2例附加胼胝体前部切开术；1例行双侧枕顶部开颅，左枕叶萎缩皮层切除＋胼胝体后部切开＋右侧顶枕的MST。结果术后无死亡及严重并发症。术后抗癫痫药物使用减少，术后23例服用一种抗癫痫药，2例服用两种抗癫痫药。术后随访6～12个月，17例手术效果为Engel 1级，4例为Engel2级，4例为Engel3级。40岁以下的患者手术后癫痫控制的可能性显著大于40岁以上者（P〈0．05）；病程在10年以下的患者术后癫痫无发作的可能性显著大于10年以上者（P〈0．05）。头颅MRI上有无明显的结构异常对病人的预后没有影响（P〉0．05）。结论在严格术前评价的前提下，尤其是在有精通神经电生理知识的神经外科医生综合分析下，采用多种手术方式组合治疗顽固性癫痫效果显著。     

Butyrate infusions in the ovine fetus delay the biologic clock for globin gene switching.

The switch from fetal to adult hemoglobin expression is regulated in many mammalian species by a developmental clock-like mechanism and determined by the gestational age of the fetus. Prolonging fetal globin gene expression is of considerable interest for therapeutic potential in diseases caused by abnormal beta-globin genes. Butyric acid, which is found in increased plasma concentrations in infants of diabetic mothers who have delayed globin gene switching, was infused into catheterized fetal lambs in utero during the time of the normal globin gene switch period. The globin gene switch was significantly delayed in three of four butyrate-treated fetuses compared with controls and was entirely prevented in one fetus in whom the infusion was begun before the globin switch was under way. These data provide a model for investigating and arresting the biologic clock of hemoglobin switching.     

Anulus fibrosus in bulging intervertebral disks

In this investigation the association of radial tears of the anulus fibrosus and bulging of the intervertebral disk was studied. An index of disk bulging was measured in sagittal anatomic sections in 149 lumbar disks from 31 cadavers. The indexes of disk bulging were correlated with stages of disk development and the presence of an annular tear. The largest disk-bulging indexes were always associated with radial tears of the anulus. Eighty-four percent of the disks with radial tears had disk-bulging indexes greater than 2.5 mm. Most normal adult disks had an index of less than 2.5 mm. The results challenge the concept that the anulus fibrosus is intact in bulging disks, although ruptured in herniated disks.     

新生儿血糖监测（附32例临床分析）

应用英国产“ＨＹＰＯＣＯＵＮＴＧＡ”微量血糖测定仪（氧化酶光电比色法）对同期住院新生儿不分病种连续３天进行空腹血糖监测。结果在原发疾病情况下表现出低血糖发生频率高，而低血糖症状又被原发疾病所掩盖。在３２例中足月儿２３例，足月小样儿４例，早产儿５例，在３２例９６次监测中发现低血糖１４例，其中足月儿９例，早产儿５例．发病率为４３．７％；高血糖３例。无一例死亡。提示：新生儿患病情况下，易发生低血糖，其发生与疾病、孕周有关而与体重无关。因此，在新生儿期必须注意及时喂养与补充葡萄糖，防止低血糖时间过长对脑部造成损伤。     

Disc and condyle translation in patients with temporomandibular disorder.

OBJECTIVE: The purpose of this study was to elucidate causal relationship between disc and condyle range of movement and clinical signs and symptoms in patients with temporomandibular disorders (TMD), using magnetic resonance imaging (MRI). STUDY DESIGN: The subjects comprised of a study group of 191 patients with TMD and a control group of 43 asymptomatic patients. The clinical assessment consisted of range of maximum mouth opening (MMO) and preauricular pain during mandibular function. After clinical and radiographic findings assessment, disc and condyle condition were examined by MRI and the range of movement was accordingly classified. RESULTS: Disc displacement was observed in 156/191 (81.7%) of the study group and 9/43 (20.9%) of the control group. When disc and condyle mobility was presented around the eminence, wider MMO range was maintained, P < .05. Presence of osteoarthrosis (OA) was not correlated with preauricular pain, because OA variables were mild in the study group. CONCLUSION: Maintenance of disc/condyle translation is an important factor in TMJ function, irrespective of disc displacement or arthritis.     

Hemoglobin constant spring defined by specific oligonucleotide hybridization and hemoglobin D Punjab (beta 121----Gln) in a Batak Indonesian family

A Batak Indonesian from North Sumatra with hemoglobin (Hb) D Punjab (alpha 2 beta 2 121----Gln) and hemoglobin Constant Spring (Hb CoSp) is described. The 24-year-old man did not have clinical symptoms, and his hematological indices were normal. However, he had a persistent slight elevation of fetal hemoglobin level. His mother and his brother were heterozygous for Hb D Punjab; his father had Hb CoSp trait. A sister did not have any abnormal hemoglobin. To show the exact molecular defect leading to the synthesis of Hb CoSp in this family, genomic DNA from the father was analyzed by hybridization with synthetic oligonucleotides. Genomic DNA was digested with Sst I and Hind III producing a 1.05-kb fragment from the 3' end segment of the alpha 2-globin gene, including the termination codon. Two nonadecamers were synthesized to serve as probes: one, entirely homologous to the normal 3' end of alpha 2A-globin gene sequence, including the termination codon TAA, the other different from it by a replacement of the T in the termination codon TAA with C, changing it to CAA, the codon for the amino acid glutamine. DNA from normal controls gave a positive signal with the normal alpha 2TAA oligonucleotide probe but negative with the alpha 2 CAA probe. The father of propositus who had Hb CoSp trait gave a positive signal with the normal alpha 2TAA oligonucleotide probe as well as with the alpha 2CAA oligonucleotide probe, showing him to be heterozygous for the alpha 2CAA-globin gene. This result shows that the Hb CoSp in the Batak family is indeed due to a replacement of T by C in the TAA termination codon of the alpha 2-globin gene changing it to CAA the condon for glutamine. This explains the resulting readthrough of the untranslated sequence of the mRNA.     

老年高血压妇女内皮功能、血小板活化状态及雌激素的影响

目的：了解老年高血压妇女内皮功能和血小板活化状态，以及雌激素治疗的影响。方法：已接受降压治疗的78例老年高血压妇女随机分为两组，均继续服用降压药，A组加服尼尔雌醇，B组加服安慰剂，疗程为6个月。治疗前后观察血浆一氧化氮（NO）、血管性血友病因子（vWF)、P选择素（P－selectin)和纤维蛋白原（Fbg)浓度变化。24例健康体检者作为正常对照组。结果：高血压vWF,P-selectin和Fbg显著高于对照组，NO显著低于对照组；治疗后A组vWF和P-selectin显著降低，NO明显升高，与B组比较有显著性差异。结论：已接受降压治疗的老年高血压妇女仍存在内皮损害和血小板活化，尼尔雌醇治疗具有明确的有益作用。