Hepatitis type B virus DNA in patients receiving hemodialysis: correlation with other HBV serological markers

Possible presence of hepatitis type B virus (HBV) was assessed in 239 end-stage renal failure patients who were receiving long-term maintenance hemodialysis (average 30.8 months; duration: 1-94 months), and who had not shown any other symptom of HBV infection. Their HBV serological markers, including HBV DNA, were evaluated together with those of normal control individuals. HBV surface antigen (HBsAg) was detected in 42 of the 239 dialysis patients, 15 of whom also positive for HBV DNA (mean +/- SD = 56.2 +/- 23.7 pg/100 microliters of serum). HBV DNA was also found in 22 of the 197 (11.2%) dialysis patients who were negative for HBsAg, with an average of 36.2 +/- 19.0 pg/100 microliters of serum. This rate of detecting HBV DNA in HBV seronegative dialysis individuals was significantly higher than the rate of 1.83% found among healthy HBsAg(-) individuals. Among these 22 dialysis patients who were HBsAg(-) but HBV DNA(+), 15 were found to possess antibodies against HBsAg (anti-HBs) and/or antibody against HBV e antigen (anti-HBe). These data suggested that the absence of serum HBV antigen or the presence of antibodies against HBV markers might not be sufficient to identify possible HBV infection in immunocompromised hosts such as hemodialysis patients.     

Echocardiographic findings of mobile atrial hepatocellular carcinoma. Report of five cases

Hepatoma with cardiac metastasis is difficult to diagnose antemortem. Herein we describe five cases of hepatoma with intracardiac metastasis detected with two-dimensional echocardiography (2DE). The clinical presentations include cardiac murmur, syncope, and chest pain. The 2DE demonstrated a right atrial (RA) mass in each case and the presence of tumor echoes in the inferior vena cava connecting with the RA mass in four. In three cases the cardiac tumor was removed, whereas the other two patients agreed only to liver biopsy, which confirmed the diagnosis. This paper emphasizes the practical utility of 2DE for early detection of intracardiac hepatoma and also describes the clinicopathologic correlation of such a disease entity.     

抗角蛋白抗体、抗核周因子和抗环瓜氨酸肽抗体联合检测幼年类风湿关节炎：早期诊断及治疗评估意义

目的:评价抗角蛋白抗体、抗核周因子和抗环瓜氨酸肽抗体联合检测在幼年类风湿关节炎诊断及病情评估中的意义。方法:①观察对象及分组:选择2003-01/2005-12首都医科大学附属北京儿童医院风湿免疫病房住院治疗的76例幼年类风湿关节炎患儿及54例非幼年类风湿关节炎患儿,正常对照30例(家属均知情同意)。②检测上述人员血清抗角蛋白抗体、抗核周因子抗体和抗环瓜氨酸肽抗体水平;观察两组患儿出现临床症状、体征例数及实验室检测数据。③对幼年类风湿关节炎诊断的敏感性、特异性,阳性似然比、阴性似然比进行评价,并对幼年类风湿关节炎患儿中3种抗体联合检测阳性组阴性组的临床症状、体征及实验室检查方面的指标进行比较,资料作统计学分析。结果:两组患儿130例,正常儿童30例,全部进入结果分析。①两组患儿临床症状、体征例数及实验室检测值差异没有显著性意义。②抗角蛋白抗体、抗核周因子抗体和抗环瓜氨酸肽抗体联合检测对幼年类风湿关节炎组早期诊断缺乏有效性。③抗角蛋白抗体( )/抗核周因子抗体( )/抗环瓜氨酸肽抗体( )病例与抗角蛋白抗体(-)/抗核周因子抗体(-)/抗环瓜氨酸肽抗体(-)病例相比,关节强直病例明显增多,差异有显著性(较正χ2=3.902,P=0.048),抗链球菌溶血素“O”和C-反应蛋白均显著增高,差异有显著性(χ2=2.616,3.557,P=0.025,0.001)。结论:抗角蛋白抗体、抗核周因子抗体、抗环瓜氨酸肽抗体联合检测对幼年类风湿关节炎缺乏早期诊断意义及特异性,联合检测对判断疾病的活动性、病理损害程度和预后有临床意义。     

犬内皮与平滑肌细胞的短期静态联合培养

目的:为获得组织工程化自体血管,观察体外静态培养条件下犬内皮细胞与平滑肌细胞联合培养组织学及形态学的特征。方法:实验于2004-07/2005-06在首都医科大学宣武医院外科院级实验室完成。①实验材料:雄性杂种犬,3个月龄,体质量8～12kg。②实验方法:贴块法及酶解法对犬内皮细胞及平滑肌细胞进行原代分离培养及扩增,将第Ⅱ代平滑肌细胞以1×109L-1的密度种植于胶原膜上培养13d,再将第Ⅱ代内皮细胞接种于生长平滑肌细胞的胶原膜上2d。③实验评估:行苏木精-伊红染色同时扫描电镜和透射电镜观察平滑肌细胞和内皮细胞在胶原载体上联合培养后的形态。结果:苏木精-伊红染色见平滑肌细胞较均匀的分布于支架材料表面及内部;扫描电镜下,平滑肌细胞可以在胶原载体材料上生长,增殖明显并在短期内形成多层细胞。内皮细胞与平滑肌细胞联合培养2d就可在平滑肌细胞层表面获得连续的单层内皮细胞层。结论:在短期静态培养条件下犬的血管平滑肌细胞和内皮细胞可以在胶原载体材料上形成具有两层细胞结构的组织工程化动脉血管组织片。     

圆周转动型上肢持续被动运动机的设计特征

目的:研发一种用于完全丧失或部分丧失运动功能的上肢进行被动运动康复治疗的持续被动运动机。方法:根据上肢生物运动力学特性,利用机械原理、机构与传动、电气控制的知识,完成持续被动运动机的结构设计、外形设计和电气控制设计。结果:完成了圆周转动型上肢持续被动运动机的设计。该持续被动运动机,在结构上把电机的转动通过变速、柔性传动变为摇臂的圆周转动运动,患者上肢在与摇臂相连托架的带动下,使上肢的手心位置随摇臂做圆周转动,从而带动整个上肢做持续被动运动。在电气控制上,可实现变速、定时的功能。该机转动半径200～300mm可调,转速30～100r/min可调。上肢的弯曲程度,通过人机之间的距离进行调节。患者可以坐式、仰卧式进行被动运动。结论:持续被动运动机可使患者上臂整体同时进行持续被动运动。由于设计了托架,比较适合上肢完全失去运动功能的患者。前臂相对固定在托架上,保证了完全失去运动功能的上肢在运动过程中,始终保证其生物运动力学特性。     

白细胞介素1及白细胞介素8在心肌缺血再灌注损伤中的动态演变及药物干预效果

目的:在心肌缺血再灌注损伤中,炎症细胞因子参与其过程的多个环节。实验拟验证白细胞介素1、白细胞介素8因子在此过程中的动态变化,并分析其与药物干预的关系。方法:实验于2005-10/2006-11在新乡医学院形态学实验室完成。①实验分组:选择健康Wistar成年大鼠70只,按随机数字表法分为3组:对照组(n=10)、模型组(n=30)和药物组(n=30)。后两组又分为缺血0.5h,再灌注2,4,8,12,24h6个时相点,每个时相点5只。对照组只设12h一个时相点作为总体对照。②实验方法:大鼠麻醉后,药物组在右股静脉注入甲泼尼龙(30mg/kg),对照组及模型组注入生理盐水(0.75mg/kg)。采用夹闭左冠状动脉前降支建立大鼠心肌缺血再灌注损伤模型。对照组只开胸不夹闭。③实验评估:在各时相点观察各组大鼠缺血再灌注后的心肌细胞改变;血清学检测白细胞介素1、白细胞介素8因子的动态表达。结果:①模型组缺血再灌注12h炎细胞浸润最显著,药物组炎细胞呈散在浸润。②模型组和药物组白细胞介素1、白细胞介素8因子质量浓度明显高于对照组[缺血再灌注8h为例,白细胞介素1分别为(99.21±14.37),(85.77±11.31),(21.87±10.32)ng/L;白细胞介素8分别为(794.85±24.07),(536.95±19.72),(103.94±11.59)ng/L,P<0.05],峰值分别在缺血再灌注4,8h;同时相点药物组白细胞介素1、白细胞介素8因子质量浓度明显低于模型组(P<0.05)。结论:白细胞介素1和白细胞介素8因子在心肌缺血再灌注损伤的炎症反应中发挥着重要作用;甲泼尼龙对缺血再灌注损伤心肌有保护作用。     

多普勒超声诊断移植肾排斥反应与病理检查及肾功能指标的对比分析

目的：以病理活检结果为金标准，评估多普勒超声检查对移植肾排斥反应的诊断价值。方法：选择2003—01/2006—12在中国医科大学附属第一医院器官移植科行肾移植并在术后行超声检查的患者176例，均知情同意。①实验分组：根据术后移植肾功能分为2组，移植肾功能不良组78例，其中30例次行病理活检；移植肾功能正常组98例。②实验方法及评估：对患者移植肾行多普勒超声检查，参数选择峰收缩期流速、平均舒张期流速、阻力指数及血管显示率。血管显示率的评估标准（0～5级）：0级为肾动脉及其远侧血管未显示；5级为肾各级血管均显示良好。以病理活检结果为金标准，分别选取阻力指数=0．7，0．75，0．8，0．85为诊断界值进行诊断试验。结果：169例患者进入结果分析，脱落7例。①峰收缩期流速、平均舒张期流速不呈正态分布，无法作为肾功能评价指标。30例次病理活检中共有28例次被确诊为排斥反应，急性排斥反应15例次，慢性排斥反应13例次。②肾功能正常组患者中血管显示率5级者占63．30％，4级者占36．73％。肾功能不良组患者中血管显示率4级者占41．03％，3级者占46．15％，2级者占10．30％，1级者占2．60％。③移植肾功能不良组患者阻力指数显著高于移植肾功能正常组（P〈0．01）。移植肾功能不良组患者移植肾功能恢复后阻力指数显著低于移植肾尚未恢复时（P〈0．01），其中99％以上的患者△（阻力指数）≥0.20。④界值阻力指数=0．75的诊断试验的敏感性、特异性和准确性最高，均达到100％。结论：当移植肾血管阻力指数升高至0．75以上，特别是同一患者自身对照升高超过0.2以上和或血管显示率低于4级，结合临床表现和生化结果，提示可能出现移植肾排斥反应。     

Effect of knock down of spinal cord PSD-93/chapsin-110 on persistent pain induced by complete Freund's adjuvant and peripheral nerve injury

PSD-93/chapsin-110 is a neuronal PDZ domain-containing protein that binds to and clusters the N-methyl-D-aspartate receptor (NMDAR) at synapses in the central nervous system. It also assembles a specific set of signaling proteins around the NMDAR and mediates downstream signaling by the NMDAR. Thus, PSD-93/chapsin-110 might be involved in many physiological and pathophysiological actions triggered via the activation of the NMDAR. In the current study, we report that abundant PSD-93/chapsin-110 protein was detected in rat spinal cord, particularly in the superficial dorsal horn. The rats injected intrathecally with PSD-93/chapsin-110 antisense oligodeoxynucleotide every 24 h for 4 days displayed not only a remarkable decrease in spinal cord PSD-93/chapsin-110 expression but also a significant reduction in the paw withdrawal responses to thermal and mechanical stimuli during complete Freund's adjuvant-induced inflammatory pain and peripheral nerve injury-induced neuropathic pain. In contrast, the rats injected intrathecally with PSD-93/chapsin-110 missense oligodeoxynucleotide did not exhibit these changes. We also found that pretreatment with PSD-93/chapsin-110 antisense oligodeoxynucleotide did not change the locomotor activity or the responses to acute noxious thermal and mechanical stimuli in intact rats. The present results indicate that the deficiency of spinal cord PSD-93/chapsin-110 protein significantly attenuates thermal and mechanical hyperalgesia in complete Freund's adjuvant- or peripheral nerve injury-induced chronic pain. This suggests that spinal cord PSD-93/chapsin-110 might be involved in the central mechanism of chronic pain. Our work might provide a new target for the therapy of chronic pain.     

锻炼心理学中动机理论：自我决定理论的新进展

目的:对锻炼心理学中的自我决定理论进行简要概述与分析。资料来源:检索中国期刊网、EBSCO和UMI资料库1997-01/2006-10有关自我决定理论的文献,检索词(限制为标题)为“self-determination theory,sport and exercise”,限定语言种类为英文。资料选择:对所获得的文献进行仔细研读,从中选择有关自我决定理论在锻炼心理学中实证研究的文章,排除重复研究类文章。资料提炼:在53篇文献中,删除7篇内容重复的文献;对46篇文献进行分类整理,其中30篇选为参考文献。资料综合:自我决定论是新近发展起来的一种认知动机理论,代表着当下动机理论研究的趋向。它把人类的动机看成是一个从外在调节到内在动机之间的动态的连续体,并依据自主的程度对动机的类型进行了详细的划分,同时从满足人们基本心理需要的角度对促进外在动机内化的条件进行了探讨。结论:自我决定理论还有许多待以完善的地方,关于自我决定理论的一些假设还有待于进一步的验证。