补肺健脾益肾方治疗对老年COPD稳定期患者T淋巴细胞亚群、BODE指数及生活质量的影响

目的:评价补肺健脾益肾方治疗老年慢性阻塞性肺疾病(COPD)稳定期的疗效及对患者外周血T淋巴细胞亚群、BODE指数及生活质量的影响.方法:将80例中医辨证为肺脾肾气虚型COPD稳定期患者随机分组,对照组(40例)仅采取常规西医治疗,而观察组(40例)在常规西医治疗的基础上联合补肺健脾益肾汤,治疗8周后比较临床疗效及患者外周血T淋巴细胞亚群、BODE指数及生活质量的变化.结果:经治疗后观察组BODE指数及BMI积分、FEV1积分、MMRC积分、6MWT积分均较对照组明显减少,差异具有统计学意义(P＜0.05);经治疗后观察组CD3+、CD4+及CD4+/CD8+较对照组明显升高,CD8 +水平较对照组明显降低,差异具有统计学意义(P＜0.05);两组经治疗后肺功能指标FEV1和FEV1/FVC均较治疗前有明显改善,差异具有统计学意义(P＜0.05);两组治疗后SGRQ评分均较治疗前明显降低,但观察组治疗后SGRQ评分明显低于对照组,差异具有统计学意义(P＜0.05).结论:补肺健脾益肾方用于老年COPD稳定期治疗可改善患者肺功能及BODE指数,提高生活质量,增强细胞免疫功能.     

Epidemiology of pityriasis versicolor in Adana, Turkey

Pityriasis versicolor is a common superficial mycoses of the skin. It is now recognized that the causative organisms of this infection are different species of Malassezia . The aim of this study was to determine the distribution of Malassezia species in patients with pityriasis versicolor in Adana, Turkey. In total, 97 patients positive for Malassezia elements, namely, yeast cells and short hyphae in microscopic examination, were included in the study. All samples were inoculated in plates containing modified Dixon's medium. However, only 44 of the patients (45.4%) showed Malassezia spp. in culture. Malassezia globosa (47.7%) was the most commonly isolated species followed by Malassezia furfur (36.4%) and Malassezia slooffiae (15.9%). Mixed Malassezia species were not isolated. In conclusion, M. globosa was found to be the predominant PV isolate in Adana, Turkey.     

Hepatic portoenterostomy for biliary atresia. A comparative study of histology and prognosis after surgery

Specimens of excised tissue from the porta hepatis in 26 infants with extrahepatic biliary atresia undergoing hepatic portoenterostomy were analysed histologically for the presence and size of biliary ductules. No correlation could be found between the establishment of effective biliary drainage and the number or size of biliary ductules. it is suggested that prognosis after surgery may be related to the intrahepatic lesion and age of the child at operation rather than to the histology of the extrahepatic bile duct remnants.     

Effect of oral and inhaled salbutamol in infants with bronchiolitis

The response of bronchiolitis to bronchodilator drugs is controversial. The present study was designed to evaluate the efficacy of oral or metered dose inhaler (MDI) salbutamol using a coffee cup as a spacer device in bronchiolitis. In the trial, 31 hospitalized patients between 6 and 24 months of age, who exhibited the first episode of acute bronchiolitis without any other predisposing illness such as cystic fibrosis, congenital heart disease etc., were randomly assigned to receive oral salbutamol (n=11, 0.1 mg/kg per dose, four times a day), or MDI salbutamol (n = 12, 200 μg per dose, every 3 h) or formed the control group without any bronchodilator therapy (n = 8). All of the patients were given supplemental oxygen as needed and adequate hydration was maintained. The patients were evaluated with clinical symptom scores. There were no differences in the beneficial or side effects of salbutamol, or the number of days in hospital between the treatment groups and the control group. It was concluded that there is no beneficial effect in using bronchodilators in infants with bronchiolitis. Supplemental oxygen and maintenance of normal hydration may be adequate.     

Applicability of LDLR flanking microsatellite polymorphisms for prenatal diagnosis of homozygous state for familial hypercholesterolemia

Analysis of newly identified microsatellite polymorphisms flanking the low density lipoprotein receptor (LDLR) gene was undertaken in the kindred of a child with apparent homozygous LDLR deficiency. The applicability of these approaches to prenatal diagnosis is considered and compared with previous approaches applying functional studies of the LDLR in amniotic fibroblasts.     

Controlled ovarian hyperstimulation and intrauterine insemination for treating male subfertility: a controlled study

In this randomized crossover trial we investigated whether the use of controlled ovarian hyperstimulation with low-dose human menopausal gonadotrophin in couples with male subfertility leads to a higher probability of conception when intrauterine insemination (IUI) is applied. We also investigated whether the efficacy of IUI in natural or stimulated cycles was related to the severity of male subfertility. Seventy-four couples completed 308 treatment cycles. Thirteen pregnancies occurred after IUI in a natural cycle (pregnancy rate per completed cycle: 8.4%) and 21 after IUI in a stimulated cycle (pregnancy rate per completed cycle: 13.7%). The difference between the two treatment modalities was not statistically significant. The efficacy of IUI in stimulated cycles was related to the severity of the semen defect. In couples with a total motile sperm count < 10 x 10(6), ovarian stimulation did not improve treatment outcome, while it did in couples with a total motile sperm count > or = 10 x 10(6). Compared with the expected chance of conceiving spontaneously without treatment, both natural and stimulated cycles improved the probability of conception. We conclude that, for the group as a whole, ovarian stimulation did not improve the probability of conception. However, in couples with less severe semen defects, ovarian stimulation did improve the probability of conception.      

定性及定量分析脆性组氨酸三联体基因蛋白表达在食管癌变过程中的临床意义

目的定性和定量分析脆性组氨酸三联体基因蛋白（Fhit蛋白）在食管癌及癌前病变（不典型增生）组织中的表达,探讨Fhit蛋白与食管癌发生发展的关系.方法收集色素内镜初筛并经组织病理学证实标本94例,应用免疫组化及流式细胞术（FCM）,定性及定量检测Fhit蛋白在食管癌变过程中的表达情况.结果①从食管鳞状上皮→不典型增生（癌前病变）→原位癌→浸润癌,随着食管病变的加重,定性及定量检测Fhit蛋白表达均呈逐渐降低趋势;②免疫组化结果显示：正常组、不典型增生Ⅰ级组、不典型增生Ⅱ级组、不典型增生Ⅲ级组、原位癌组、浸润癌组中Fhit蛋白表达分别为82.35%、75.00%、43.75%、35.29%、30.00%、33.33%;正常组与食管不典型增生Ⅰ级组Fhit蛋白表达差异无统计学意义（P＞0.05）,与其余各组相比差异有统计学意义（P〈0.05）;浸润癌组与正常组、不典型增生Ⅰ级组差异均有统计学意义（P〈0.05）,浸润癌组与不典型增生Ⅱ级、Ⅲ级组、原位癌组差异无统计学意义（P＞0.05）;③FCM结果显示：不典型增生Ⅰ级、Ⅱ级组间Fhit蛋白表达量差异有统计学意义（P〈0.001）,不典型增生Ⅱ级、Ⅲ级组间差异有统计学意义（P〈0.05）,不典型增生Ⅱ级与正常组间差异有统计学意义（P〈0.001）,不典型增生Ⅲ级与食管癌组间差异无统计学意义（P〉0.05）.结论 Fhit蛋白表达缺失是食管癌变过程的早期事件,随病理组织学分级的增高Fhit蛋白表达阳性率逐渐降低,其蛋白表达的缺失在食管癌发生、发展过程中可能起着重要作用.     

LINGUAL INFARCTION IN CRANIAL ARTERITIS

SUMMARY An unusual case is described of infarction of the tongue as a presentation of cranial arteritis. The lingual necrosis may have been precipitated in part by the use of ergotamine to relieve the headache of the temporal arteritis, mistaken initially for migraine. The patient recovered with high-dose steroid therapy.     

Measurement of transepidermal water loss in Tanzanian cot-nursed neonates and its relation to postnatal weight loss

In healthy cot-nursed Tanzanian neonates ( n = 92, gestation 26–42 weeks) measurements of transepidermal water loss (TEWL) and weight change were performed during the first 24 h after birth at an average ambient humidity of 70% and an environmental temperature of 32°C. Urine production on day 1 (ml/kg per 24h) was documented for a subgroup of 13 preterm and 8 term infants. In a limited group of preterm infants ( n = 5) TEWL measurements, weight and 24 h urine volume measurements were repeated daily for 7 days. Maximum weight loss was determined in 7 preterm (gestational age 30–36 weeks) and 6 term infants. TEWL was estimated by measuring the evaporation rate at three sites of the body using the water vapour pressure gradient method. On day 1, TEWL was highest in the most preterm infants, whereas TEWL and urine production were higher in large for gestational age infants as compared to appropriate for gestational age (AGA) infants of the same gestational age (31–36 weeks). For the whole group, weight loss on day 1 was correlated with TEWL ( r = 0.49, p <0.05). At follow-up TEWL in preterm infants remained almost constant during the first 4 days and decreased after the fourth day, at which time weight gain commenced. Preterm AGA infants (gestational age 24–37 weeks) showed a mean postnatal weight loss of 4.4% of the birth weight, while in term infants this loss was only 2.6%. A reduced postnatal weight loss as compared to Caucasian infants may be explained by a lower water loss during the first days after birth, through both skin evaporation and urine excretion.