Plasma C-peptide and cognitive performance in older men without diabetes.

BACKGROUND: Emerging evidence suggests that type 2 diabetes may be related to diminished cognition, but little data are available directly regarding the role of insulin levels. OBJECTIVE: The objective of this prospective cohort study was to examine the relation of insulin secretion to cognitive function among men without diabetes. SETTING: The study setting was the Physicians' Health Study-U.S. male physicians. PARTICIPANTS: Three hundred sixty-seven men who provided blood samples in 1982, when they had no lifetime history of diabetes and ranged in age from 47-65 years (mean age: 57 years). MEASUREMENTS: The authors assayed plasma C-peptide, reflecting insulin secretion, in the stored blood samples. Beginning in 2001, an average 18 years after blood collection, the authors administered telephone interviews, including tests of general cognition (Telephone Interview of Cognitive Status [TICS]), verbal memory, and category fluency. The authors used regression models to estimate mean differences in cognitive performance across levels of C-peptide controlling for a wide variety of potential confounding factors. RESULTS: On the TICS, men in the top tertile of C-peptide performed significantly worse than those in the bottom (multivariable-adjusted mean difference: -1.01 points, 95% confidence interval: -1.78 to -0.24); this apparent impact of C-peptide on cognition was equivalent to the cognitive differences the authors observed between men 6 years apart in age. Performance on the global score (combining results from all the individual tests) and verbal memory score (combining results from four tests of verbal memory) appeared lower among men in the highest C-peptide tertile, but results were not statistically significant. CONCLUSION: Higher midlife insulin secretion may be related to decreased later-life cognitive function, even among men without diabetes.     

Benign osteoblastoma of the occipital bone: Case report and literature review

We present a case of benign osteoblastoma of the occipital bone. Benign osteoblastoma is an uncommon primary bone tumor, which usually involves the vertebrae and the long bones. This tumor rarely develops in the calvaria, showing a preference for the temporal and frontal bones when it does. To the best of our knowledge, this case is only the eighth reported case of benign osteoblastoma confined to the occipital bone. A 20‐year‐old male presented with a mild tender mass lesion of the occipital area, just below the lambda. Plain X‐ray films and CT scans demonstrated an osteolytic mass surrounded by the sclerotic rim within the diploic space. MRI proved to be effective for the evaluation of the intracranial and intraosseous extensions of the tumor. However, it was very difficult to formulate a differential diagnosis against other osteoblastic tumors, or osteoid osteoma, in view of its radiological appearance. The final diagnosis was obtained by careful consideration of the histopathological characteristics of the tumor combined with its clinical and radiological features. Although generally regarded as benign, a complete resection is preferred over conventional curettage as this can guard against possible recurrence and malignant transformation.     

西咪替丁对血浆氨茶碱浓度的影响

在１６例呼吸系疾病患者观察了西咪替丁对氨茶碱血浆浓度的影响。结果表明加服西咪替丁４００ｍｇ，３次／日，３天后血浆氨茶碱谷浓度和峰浓度均明显增高（ｐ＜０．０１），其中谷浓度升高４３．０±５１．１％，峰浓度升高２７．０±２９．０％。提示二者合用时，应适当减少氨茶碱用量，以避免氢茶碱中毒的发生。     

An Unusual Form of Skin Tuberculosis Following B.C.G. Vaccination

A 25-year-old female has had brown to erythematous telangiectatic patches and grouped papules on her face, neck, arm, and trunk since childhood following B.C.G. vaccination. Histopathologically, the lesions consisted of hyperkeratosis, slight acanthosis, tuberculoid granulomas with some Langerhans type giant cells in the mid-dermis. Although various forms of cutaneous tuberculosis after B.C.G. vaccination have been reported, it was difficult for us to assign the patient's skin lesion to any specific disease entity. Remission of her cutaneous lesions occurred clinically and histopathologically after treatment with isoniazid and rifampin.     

慢性丙型肝炎患者丙型肝炎病毒核酸与IgM抗体关系的研究

本文检测了１４０例丙型肝炎病毒（ＨＣＶ）抗体（抗－ＨＣＶ）阳性的慢性丙型肝炎（ＣＨＣ）的ＨＣＶ核酸（ＨＣＶＲＮＡ）和ＩｇＭ抗体（抗－ＨＣＶＩｇＭ）两项指标。结果表明，原始诊断为不同临床型的肝炎（ＨＣ）患者，８年随访时，ＨＣＶＲＮＡ和抗－ＨＣＶＩｇＭ阳性率分别为８０．７％和９０．７％（ｕ＝２．３９Ｐ＜０．０５）．在原始诊断不同临床型ＨＣ转慢者中，上述两项指标均未发现统计学上的差别（均为Ｐ＞０．０５）。ＨＣＶＲＮＡ与抗－ＨＣＶＩｇＭ配对比较，符合率为７８．６％。基因分型初步结果表明，河北省固安ＨＣＶ以基因Ⅱ型为主。本研究提示，随访８年的ＣＨＣ患者绝大多数仍有传染性；本文方法检测的抗－ＨＣＶＩｇＭ不能代表早期感染标志，但代表慢性感染活动化或带毒，所以，在不具备检测ＨＣＶＲＮＡ的地方更具有实用价值．     

缩泉丸治疗氯氮平所致流涎的临床观察

采用双盲法观察缩泉丸治疗氯氮平所致流涎的疗效。缩泉丸治疗组21例,治疗后流涎症状较19例对照组明显减少(P<0.01)。中医辨证分型与缩泉丸治疗关系分析,表明痰湿内阻型和阳虚亏损型疗效最佳。氯氮平血浓度与流涎两者间无相关性(P>0.05)。     

通过原生质体融合获得青霉素高产菌株

采用两株分别带有不同抗药性标记的产黄青霉原生质体以1:1相混合,用30％的聚乙二醇(MW6000)原生质体融合处理。将混和物涂布在补给有两种药物同时存在的高渗性分离培养基上,培养后获得异核体菌落。洗下异核体分生孢于继续分离在补给有两种药物同时存在的分离培养基上,得到了同时带有两种抗性标记的重组体。纯化后,进行抗性稳定性和摇瓶效价的测定,将一株具有双重抗性、摇瓶发酵效价较高的菌株作出发菌株,经诱变因子处理后,获得了一株43u7c—57菌株,在摇瓶中效价比生产菌株平均提高4.94％,该菌株在40吨发酵罐试生产后,发酵效价平均提高4.4％,产量则平均增加12.15％。     

Saponins from the roots ofPulsatilla koreana

From the roots ofPulsatilla koreana, three monodesmosides(pulsatilla saponins A, B and D) and two bisdesmosides(pulsatilla saponins F and H) were isolated. The structure of these saponins have been determined as hederagenin 3-O-α-L-rhamnopyranosyl(1→2)-α-L-arabinopyranoside(A), hederagenin 3-O-β-D-glucopyranosyl(1→4)-α-L-arabinopyranoside(B), hederagenin 3-O-α-L-rhamnopyranosyl (1→2)-[β-D-glucopyranosyl(1→4)]-α-L-arabinopyranoside(D), 3-O-α-L-rhamnopyranosyl(1→2)-α-L-arabinopyranosyl hederagenin 28-O-α-L-rhamnopyranosyl(1→4)-β-D-glucopyranosyl(1→6)-β-D-glucopyranosyl ester (F) and 3-O-α-L-rhamnopyranosyl(1→2)-[β-D-glucopyranosyl(1→4)]-α-L-arabinopyranosyl hederagenin 28-O-α-L-rhamnopyranosyl(1→4)-β-D-glucopyranosyl(1→6)-β-D-glucopyranosyl ester(H) on the basis of chemical and spectral studies. Pulsatilla saponin B is the first report of its presence in plants but saponins A, D, F, and H have recently been isolated from the same genusP. cernua.     

血管内覆膜支架置入治疗降主动脉夹层动脉瘤

目的 :介绍血管内覆膜支架置入治疗降主动脉夹层动脉瘤的初步经验。材料与方法 :本组 6例 Debakey 型的慢性降主动脉夹层动脉瘤患者行血管内覆膜支架置入治疗。经股动脉将 Talent覆膜支架置于夹层动脉瘤裂口处 ,支架张开使覆膜支架固定于裂口附近的主动脉壁上将裂口封闭并阻断血流。结果 :6例病人均获得成功 ,手术和临床成功率 10 0 %。 1例患者术中出现内漏 ,置入第二枚支架后漏口封闭。平均随访 7个月 ,所有患者内膜裂口全部完全封闭 ,假腔内血栓形成无内漏 ,假腔均明显缩小。结论 :血管内覆膜支架置入治疗主动脉夹层动脉瘤具有安全可靠 ,患者术后恢复快的优点