半导体激光联合药物治疗带状疱疹

目的观察半导体激光联合药物治疗带状疱疹的疗效。方法将97例带状疱疹患者随机分成2组。对照组45例单纯药物治疗(静脉注射5%葡萄糖注射液250 ml加入阿昔洛韦0.5 g,每日2次;本院自制中药冷湿敷患处,每次15 min,每日2次)。治疗组在上述药物治疗基础上加用半导体激光照射受损的神经根部和皮损部位。疗程7 d。结果治疗组与对照组治疗后病情积分均有所下降(P<0.01),治疗组的病情积分下降明显大于对照组(P<0.01);治疗组的疼痛积分明显下降(P<0.01);对照组的疼痛积分无明显下降,治疗组有效率大于对照组,后遗神经痛发生率低于对照组。结论半导体激光联合药物治疗带状疱疹疗效优于单纯药物治疗,且可明显减轻疼痛症状,降低后遗神经痛发生率。     

Studies with the Folate Binding Protein in Chronic Granulocytic Leukaemia Cells: I. SYNTHESIS AND RELEASE OF BINDER BY CELLS IN SHORT-TERM CULTURE

Chronic granulocytic leukaemia (CGL) cells which contained a high concentration of unsaturated folate binding protein were incubated in suspension culture for a period of 5 h. Cell samples were periodically assayed for binder and these demonstrated active synthesis which was inhibited by puromycin, cyclo heximide, N-ethylmaleimide, and by incubation at 4 degrees C, but not by actinomycin D. Folate binding activity could also be demonstrated in the culture medium and this increased with the duration of incubation. This release of binder was inhibited by culturing the cells at 4 degrees C and by the addition of N-ethylmaleimide, but not by actinomycin D, puromycin, or cycloheximide. When the pre- and post-culture cell lysates were saturated with tritiated folic acid ([3H]PteGlu) and subjected to chromatography on DEAE-agrarose, approximately half of the bound folate eluted with 0.001 M phosphate buffer at pH 6.0 and the other half eluted with 0.2 M buffer at pH 7.2. The culture medium and plasma from this patient with CGL was well as serum from two normal subjects saturated with [3H]PteGlu and similarly chromatographed contained primarily the acidic binder and much less of the binder eluting with the low molarity buffer. Since a folate binding protein immunochemically similar to the binder in CGL cells has been identified in the serum of non-leukaemic subjects, these experiments suggest that the source of circulating folate binding protein may be the immature granulocyte.     

The kidneys in paroxysmal nocturnal hemoglobinuria

Long-term study of 21 PNH patients revealed an unexpectedly high incidence of functional and anatomic renal abnormalities. Most patients demonstrated varying degrees of hematuria and proteinuria distinct from hemoglobinuria. Evaluation of renal function revealed hyposthenuria, abnormal tubular function, and declining creatinine clearance. Radiologically these patients had enlarged kidneys, cortical infarcts, cortical thinning, and papillary necrosis which were confirmed by autopsy studies. Hypertension developed in eight patients. Urinary tract infection was uncommon. The renal findings bear striking similarity to those of sickle cell anemia. Contrary to the usual opinion, out studies clearly showed evidence of widespread renal pathology in PNH most likely due to repeated microvascular thrombosis similar to the venous thrombosis involving other organs in this disorder.     

脊髓延髓肌萎缩症临床及电生理特点分析

目的分析5例脊髓延髓肌萎缩症患者的临床特征,以便临床医生对该病的认识。方法收集基因确诊的5例脊髓延髓肌萎缩症患者的临床资料,分析其临床特点及血清性激素、各生化指标水平、脑脊液及肌电图特点。结果脊髓延髓肌萎缩症患者青年发病,病情进展缓慢。神经系统表现为以肢体近端和延髓部受累为主的瘫痪。舌肌受累较早,运动功能损害较轻。血清睾酮(969.3±234.9ng/dl)、雌二醇(57.1±5.3pg/ml)水平增高,男性乳腺发育出现在病史较长的患者。三核苷酸(CAG)重复序列数目43～51(平均47.2±3.6pg/ml)。患者的肌酸激酶(CK,481.8±264.8 IU/L)均增高,脑脊液检查均正常。肌电图为广泛神经源性损害。结论脊髓延髓肌萎缩症患者的早期症状不典型,易误诊,临床特征为青年起病,缓慢加重,以肢体近端无力为主的瘫痪。     

Multiple cerebral metastases: detectability with Gd-DTPA-enhanced MR imaging

Sixteen patients with suspected cerebral metastases were studied with magnetic resonance (MR) imaging before and after the intravenous administration of 0.1 mmol/kg of gadolinium diethylenetriaminepenta-acetic acid. The images were interpreted blindly by two neuroradiologists; all clinical, radiologic (computed tomographic and MR imaging), and pathologic data were reviewed to arrive at a final "best diagnosis," which was then compared with the prior blinded interpretations. Of seven patients found to have multiple metastases, six (86%) had at least one tumor nodule depicted by postinfusion MR imaging that was missed by one or both observers on review of preinfusion images alone. Lesions missed on preinfusion studies were usually small nodules hidden by or not detected next to regions of high-signal edema thought to be related to the adjacent tumor nodule. The authors believe that contrast enhancement improves detection of metastatic foci with MR imaging and that the findings indicate broader implications for the detection of multiple lesions from other causes.     

MR氢质子波谱成像在神经上皮组织肿瘤分级中的应用

目的研究MR氢质子波谱（^1H-MRS）成像在神经上皮组织肿瘤分级中的价值。方法52例颅内神经上皮组织肿瘤患者，低级别29例，高级别23例，均行MRI及^1H-MRS检查。结果52例中，Ⅱ级9例，Ⅲ级11例，Ⅳ级12例，将Ⅱ级列为低级别组，Ⅲ级、Ⅳ级为高级别组，脂质（Lip）[乳酸（Lac）]／肌酸（Cr）、Lip（Lac）／N-乙酰天门冬氨酸（NAA）、Lip（Lac）／胆碱化合物（Cho），Lip（Lac）在组间差异有统计学意义，低级别组各代谢物比值中位数分别为0．14、0．16、0．09、0．32，高级别组各代谢物中位数分别为1．64、1．24、0．87、1．68。Lip（Lac）／Cr≤0．425为低级别肿瘤，Lip（1ac）／Cr＞0．425为高级别肿瘤，诊断敏感度、特异度、阳性予测值、阴性预测值分别为87．0％、96．6％、95.2％、90．3％。常规MR图像诊断肿瘤级别敏感度、特异度、阳性予测值、阴性预测值分别为87．0％、82．8％、80．0％、88．9％。结论^1H-MRS在神经上皮组织肿瘤分级中有一定的价值，常规MR图像结合MRS可明显提高诊断准确率。