Open microsurgical autograft of adrenal medulla to the right caudate nucleus in two patients with intractable Parkinson's disease

Recent experimental studies and one clinical case have suggested that grafting tissue from the adrenal medulla into the brain may ameliorate the signs of Parkinson's disease. We describe the treatment of two young patients (35 and 39 years old) with intractable and incapacitating Parkinson's disease, in whom fragments of the adrenal medulla were autotransplanted to the right caudate nucleus. Clinical improvement was noted in both patients at 15 and 6 days (respectively) after implantation and has continued in both. Rigidity and akinesia had virtually disappeared in the first patient at 10 months after surgery, and his tremor was greatly reduced. A similar degree of improvement was present in the second patient at three months. We conclude that autografting of the adrenal medulla to the right caudate nucleus was associated with a marked improvement in the signs of Parkinson's disease in two patients, but our results are preliminary and further work is necessary to see whether this procedure will be applicable over the long term in other types of patients with Parkinson's disease.     

New Furanoeremophilanes, Cacalohastin Derivatives, from Senecio linifolius

Investigation of the aerial parts of SENECIO LINIFOLIUS afforded the furanoeremophilanes maturinone and seven cacalohastin derivatives, five of them being isolated for the first time as natural compounds. Structures were elucidated by spectroscopics methods.     

国外新冠医疗防疫体系建设策略研究及启示：以新加坡、英国为例

目的 通过案例研究总结国外新冠医疗防疫体系建设策略。方法 选取新加坡和英国作为研究案例,采用深度访谈和资料研究相结合的方式,访谈对象包括政府卫生署官员、传染病学专家以及基层全科医师等各类别专业人员,访谈内容涉及受访对象所在国家的医疗防疫体系设置情况和设计逻辑等。结果 两国的新冠防疫体系以分级诊疗为重要特征,其中新加坡通过"Hot Clinic"分流患者,英国通过远程诊疗分流患者。两国的门急诊设施改建以利用现有设施为主。两国全科诊所医护基本配置都相对简单,应对新冠疫情时常通过借用全院医护、统筹安排、适当延长工作时间等方式来扩充医护数量。两国在医疗防疫体系建设中均积极采取了信息化方式,疫情数据采集和信息公开较为及时。两国坚持"平战结合"策略,在逐步放开过程中灵活调整防疫政策和资源配置方案。结论 两国案例的优势及劣势可为我国医疗防疫体系实行分级建设、规范诊疗流程、细化基础设施、完善人员配置、推进信息化建设、贯彻"平战结合"策略并落实转化方案提供参考。     

EEG and Seizures in Children with Hemolytic–Uremic Syndrome

The EEG results of 11 children, ages 1-15 years, who presented with hemolytic-uremic syndrome complicated by seizures 3-10 days after the prodrome were studied. In four children who experienced generalized tonic-clonic seizures, the EEGs demonstrated diffuse delta slowing with no focality. All recovered without neurological deficit or a residual seizure disorder. Of seven children who experienced partial seizures, six had structural lesions on cranial computed tomography and residual focal neurological deficits with epilepsy. The EEGs in two patients revealed focal spikes and slowing consistent with the lateralization of the partial seizures, in four it was characterized by atypical "burst suppression," and in one showed epochs of high-amplitude delta slowing alternating with generalized suppression. Although episodic and generalized burst suppression is usually regarded as a grave prognostic indicator, all four subjects recovered.     

Inflammatory responses in blood samples of human immunodeficiency virus-infected patients with pulmonary infections

We analyzed the characteristics of the inflammatory response occurring in blood during pulmonary infections in human immunodeficiency virus (HIV)-infected patients. A prospective study of consecutive hospital admissions of HIV-infected patients with new-onset radiologic pulmonary infiltrates was carried out in a tertiary university hospital from April 1998 to May 2001. Plasma cyclic AMP receptor protein (CRP), interleukin 1beta (IL-1beta), IL-6, IL-8, IL-10, and tumor necrosis factor alpha (TNF-alpha) levels were determined at the time of admission and 4, 5, and 6 days later. Patients were included in a protocol addressed to study etiology and outcome of disease. A total of 249 episodes of infection were included, with the main diagnoses being bacterial pneumonia (BP) (118 episodes), Pneumocystis carinii pneumonia (PCP) (41 episodes), and mycobacteriosis (36 episodes). For these three patient groups, at the time of admission the median CRP and cytokine levels were as follows: CRP, 10.2, 3.8 and 5 mg/dl, respectively (P = 0.0001); IL-8, 19, 3, and 2.9 pg/ml (P = 0.045); and TNF-alpha, 46.4, 44, and 75 pg/ml, respectively (P = 0.029). There were no significant differences in levels of IL-1beta, IL-6, or IL-10 among the patient groups. A total of 23 patients died. At the time of admission, HIV-infected patients with BP had higher plasma CRP and IL-8 levels than did PCP and mycobacteriosis patients. TNF-alpha levels were higher in patients with mycobacteriosis. An elevated IL-8 level (>61 pg/ml) at the time of admission was an independent factor associated with higher mortality (odds ratio, 12; 95% confidence interval, 1.2 to 235.5).     

大鼠肺纤维化形成中肺巨噬细胞增殖和凋亡的变化

目的:观察肺纤维化形成过程中,肺泡巨噬细胞数量、增殖和凋亡的变化。方法:气管内滴注平阳霉素(BLMA₅)(5mg/kg),观察注后14d和30d组大鼠支气管肺泡灌洗液(BALF)中肺泡巨噬细胞数量、增殖和凋亡的变化以及细胞的MTT活力。结果:(1)BLMA₅14d组和30d组大鼠BALF中巨噬细胞数分别多于sham14d和30d组,(分别P＜0.01,P＜0.05);但BLMA₅30d组的细胞数明显少于BLMA₅14d组(P＜0.05);(2)BLMA₅14d组巨噬细胞增殖指数高于sham14d组(P＜0.05),而BLMA₅30d组增殖指数低于sham30d组(P＜0.05);(3)BLMA₅14d和30d组凋亡细胞数分别多于sham14d和30d组(均P＜0.01),但BLMA₅14d组少于BLMA₅30d组(P＜0.05);(4)BLMA₅14d和30d组大鼠BALF中巨噬细胞数MTT活力分别高于sham14d和30d组,分别P＜0.01,P＜0.05。结论:在肺纤维化形成过程中,肺巨噬细胞增殖能力先增强后减弱;而肺巨噬细胞凋亡始终增加,上述变化是导致肺巨噬细胞数量和功能变化的因素之一。     

A Community-based Study of Prolonged Fatigue and Chronic Fatigue

Previous estimates of the prevalence of fatigue and chronic fatigue have derived largely from treated populations and have been biased by differential access to health-care treatment linked with gender, racial/ethnic and social class status. This study involves a community-based prevalence study of prolonged fatigue and chronic fatigue. It addresses: (1) the rate of prolonged fatigue and chronic fatigue in a socioeconomically and ethnically diverse sample of 28,673 adults in Chicago; and (2) establishes the relative prevalence of prolonged fatigue and chronic fatigue across race/ethnicity, socio-economic status and gender. Univariate and multivariate statistical techniques were utilized to delineate the overall rate of prolonged fatigue and chronic fatigue in the Chicago population and its relative prevalence by gender, race/ethnicity, and social class. Findings indicated that fatigue is common in urban populations, but that prolonged fatigue and chronic fatigue occur in about 5.00 to 7.68 percent and 2.72 to 4.17 percent, respectively, of the sample of the population. Highest levels of fatigue were consistently found among women and those with lower levels of education and occupational status.     

Plasma homocysteine concentration and its relationship with the development of preeclampsia. Effect of prenatal administration of folic acid

The increase of plasmatic homocysteine (Hc) in pregnant women, who later develop preeclampsia/eclampsia, the cause of this increment and its pathogenic role in toxemia of pregnancy, are still controversial. The objectives of the present research were to determine the plasmatic He concentrations during the first and second trimesters of pregnancy and the effect of folic acid administration on these values, and in the prevention of preeclampsia. Ninety six pregnant women of low economic background were studied on the first prenatal consultation: 27 women in the first trimester of pregnancy and 59 in the second. After 8 hours of fasting, venous blood was extracted and each patient was provided with 1 mg folic acid tablets and instructed to ingest one tablet daily, and to come back to the laboratory after three months. Plasma homocysteine and serum folic acid were determined for each patient before and after the folic acid treatment, by using the IMX system (Abbott Lab) and radioimmunoassay, respectively. Basal homocysteine concentrations were 4.0 +/- 2.1 micromol/L and 4.8 +/- 2.1 micromol/L in the first and second trimesters respectively, with no significant modifications after three months of folic acid. Although the degree of desertion from the study was high, it was possible to determine the evolution of 65 pregnancies. Ten of them developed preeclampsia (15.4%). No significant differences were found in Hc concentrations, or the frequency of hyperhomocysteinemia in the different stages of pregnancy, between women with normal gestation and those who developed preeclampsia. The small sample size of these groups, preclude any valid conclusion, however the results do not suggest that Hc concentration or folic acid administration influence the development of toxemia of pregnancy.     

Progression and regression of cervical lesions: Review of smears from women followed without initial biopsy or treatment

Cervical smears were reviewed from patients in whom a cytological abnormality was followed, after an interval without interference, either by regression to `negative' or else by progression to invasive carcinoma. Twenty-eight cases were from a previously analysed series with positive smears and an interval of at least two years before investigation, resulting from refusal or failure to trace. Slides were also reviewed from 25 cases in which `positive' smears had regressed to negative without escaping from surveillance, and from 10 patients subsequently developing invasive carcinoma whose previous slides, taken several years earlier, showed abnormalities on review. None of these 63 patients had any biopsy or other surgical procedure to the cervix between the initial smear and the outcome.

Slides showing `superficial cell dyskaryosis' and/or well-differentiated `parabasal cell dyskaryosis' were found only among the groups with subsequent regression. Those showing dissociated poorly differentiated dyskaryotic parabasal cells regressed to negative in two cases and progressed to invasion in nine. This suggests that many examples of spontaneous regression correspond to mild dysplasias which are not precancerous, and overdiagnosis must often have resulted in unnecessary surgical procedures in the past.

`Regressing' and `progressing' groups both included cases in which the spatula had removed coherent pieces of undifferentiated epithelium. These are difficult to interpret cytologically. In nine of them (including four which regressed) the cytological picture was that of carcinoma in situ. The remainder (14 cases) were probably examples of reserve cell hyperplasia, and it is noteworthy that, of the 21 cases subsequently progressing to invasive carcinoma, five were preceded by appearances of this type. It is concluded that cell aggregates suggesting an unusual degree of reserve cell hyperplasia are a danger signal and require careful surveillance.

     

App17肽防治去卵巢大鼠海马神经细胞的凋亡

目的:观察去卵巢大鼠几种神经元凋亡相关蛋白的表达,并用TUNEL试剂盒检测,研究缺乏雌激素是否引起神经元凋亡;评估App17肽是否能改善去卵巢大鼠的神经细胞凋亡,初步探讨App17肽的神经保护作用机制。方法:雌性Wistar大鼠随机分3组:假手术组(shamcontrol组),卵巢去势对照组(OVX组),App17肽实验组(17P+OVX组)。Sham组做假手术,OVX组和17P+OVX组做双侧卵巢切除术。17P+OVX组从卵巢去势第7周开始用App17肽治疗6周,用免疫组化和Westernblot方法观察AIF、Bax、Bcl-2的表达,用TUNEL法检测凋亡情况。结果:免疫组织化学和Westernblot结果表明App17肽实验组AIF、Bax表达明显少于去卵巢组;Bcl-2在App17肽实验组的表达明显高于去卵巢组。TUNEL结果表明App17肽实验组凋亡细胞明显少于去卵巢组。结论:雌激素缺乏引起去卵巢大鼠海马和皮层神经细胞凋亡相关蛋白改变和出现凋亡细胞,App17肽具有明显的防治作用。