Perimetric severity in hospital‐based and population‐based glaucoma patients

Background: The aim was to compare the severity of glaucoma among newly diagnosed patients presenting to a hospital‐based glaucoma care centre (HBGS: Sankara Nethralaya, Medical Research Foundation) with that of age matched subjects from the population‐based Chennai Glaucoma Follow‐up Study (CGFS). Methods: Newly diagnosed subjects with primary glaucoma from HBGS and age‐ and gender‐matched subjects from the urban arm of CGFS examined during the same time period were included. All subjects underwent comprehensive ocular examinations including Humphrey visual field (HVF: 24‐2 SITA Standard). Glaucoma was defined as: an intraocular pressure (IOP) of 22 or greater mmHg in either eye; vertical cup‐to‐disc ratio (VCDR) of 0.7 or greater or asymmetry 0.2 or more or the presence of focal thinning, notching or a splinter haemorrhage. All subjects had a minimum of three follow‐up visits and reliable visual fields. The IOP, vertical cup‐to‐disc ratio, mean deviation (MD) and pattern standard deviation (PSD) of the Humphrey field measurements at the third follow‐up visit of CGFS were compared for assessing the severity of glaucoma with the HBGS group. Results: Forty‐seven age‐matched subjects from both the study populations were selected. Significantly higher (p = 0.04) IOP was noted in the HBGS population than the CGFS, with a difference in mean IOP of 2.80 mmHg (95% CI of diff: 0.14 to 5.46). The mean ± SD of the mean deviation and pattern standard deviation were ‐6.92 ± 6.53 dB and 6.05 ± 4.20 dB among the HBGS and ‐4.47 ± 4.19 dB and 3.26 ± 2.69 dB among the CGFS population, respectively, the difference in the mean deviation (p = 0.036) and pattern standard deviation (p = 0.0001) were statistically significant. The mean vertical cup‐to‐disc ratio did not vary between populations (p = 0.14). Conclusion: Patients from the HBGS group had higher IOP and more severe visual field defects than the CGFS group. Hence, results from hospital‐based studies on severity and the rates of progression should be interpreted with caution.     

携带半乳糖苷酶报告基因重组腺相关病毒体内转染骨组织的实验观察

目的:腺相关病毒载体因具有安全性好、免疫源性低、能感染分裂和非分裂细胞且能介导外源基因稳定长期表达等优点而备受瞩目,是最有希望应用于临床的病毒类载体。观察携带半乳糖苷酶报告基因的重组腺相关病毒(rAAV-LacZ)体内转染骨组织的效果。方法:实验于2005-01/2006-01在北京大学医学部第三医院和皖南医学院弋矶山医院骨科实验室完成。实验材料:8周龄雄性SD大鼠8只,体质量220g左右。rAAV-LacZ载体(本元正阳公司,病毒滴度为6×1012v·g/mL);Ⅰ型胶原海绵载体(上海其胜公司)。实验分组:将大鼠随机分为实验组和对照组,每组4只。实验方法:实验组4只大鼠在胫骨前外侧做骨缺损槽后,将滴有6×1011v·g病毒量的rAAV-LacZ和Ⅰ型胶原载体复合物植入骨缺损槽;对照组4只大鼠仅在胫骨骨缺损槽内植入Ⅰ型胶原载体。实验评估:①手术后6周取材行x-gal染色后,分别行标本大体病理观察和组织学观察以了解β-半乳糖苷酶特异表达的情况。②同时提取实验部位以远器官肝和心脏组织RNA,反转录-聚合酶链反应检测这些部位有无β-半乳糖苷酶特异表达。结果:8只SD大鼠均进入结果分析。①大体病理观察结果:实验组动物胫骨骨缺损处取材经x-gal染色后可见骨质蓝染,即有特异性β-半乳糖苷酶表达,而骨缺损临近处肌肉也表达β-半乳糖苷酶,Ⅰ型胶原载体植入部位以远的骨质和肌肉则没有特异性β-半乳糖苷酶的表达。②组织学观察结果:实验组骨缺损处肌肉肌纤维特异性表达β-半乳糖苷酶且没有明显的淋巴细胞局部浸润。蓝染的骨皮质切片显示骨陷窝内的骨细胞特异性表达β-半乳糖苷酶。对照组则没有实验组上述特异性β-半乳糖苷酶的表达。③反转录-聚合酶链反应结果:实验组实验部位有特异性β-半乳糖苷酶的表达,而其以远的心、肝器官内没有特异性β-半乳糖苷酶的表达。而对照组实验部位和实验部位以远的心、肝器官内均没有特异性β-半乳糖苷酶的表达。结论:腺相关病毒载体直接注射到骨缺损和骨折部位可以有效转染骨和临近肌肉组织,并能长期(6周)表达所携带的外源基因,具有一定的安全性。     

葛根素对缺血再灌注损伤心肌组织热休克蛋白70表达的影响

目的:葛根素注射液已初步被证实具有抗氧化自由基,减轻缺血再灌注后心肌超微结构损伤的药理作用.观察心肌缺血再灌注损伤时热休克蛋白70的表达变化及葛根素对其的影响,寻求其新的心肌保护机制.方法:实验于2005-03/2006-04在江西省心血管病研究所完成,动物实验方法符合动物伦理学要求.①实验材料及分组:选用健康雄性SD大鼠48只,按随机数字表法分为缺血再灌注模型组及葛根素组(n=24),每组再根据再灌注时间不同分为缺血20min再灌注0.5,4及8h组(n=8).②实验方法:结扎大鼠左冠状动脉前降支建立心肌缺血/再灌注模型,葛根素组在结扎冠状动脉前降支前10min经腹腔给予葛根素注射液50mg/kg;缺血再灌注模型组则给予等容量的生理盐水.③实验评估:于再灌注后0.5,4,8h各时相点,应用链霉抗生物素蛋白-过氧化物酶法检测心肌热休克蛋白70含量;采用分光光度法检测血清髓过氧化物酶活性;应用透射电镜观察心肌组织超微结构.结果:48只大鼠全部进入结果分析.①热休克蛋白70主要在心肌细胞的胞浆表达,以细胞核的核周最为明显,细胞核很少表达.②随着再灌注时间延长心肌热休克蛋白70含量表达逐渐增强,心肌缺血再灌注后0.5,4,8h葛根素组大鼠心肌热休克蛋白70含量均显著高于缺血再灌注模型组(P＜0.05～0.01).③随着再灌注时间延长髓过氧化物酶活性呈现下降趋势,心肌缺血再灌注后0.5,4,8h葛根素组大鼠血清髓过氧化物酶活性均显著低于缺血再灌注模型组(P＜0.01).④缺血再灌注模型组大鼠心肌纤维排列不规则,部分发生断裂、溶解;线粒体排列紊乱,明显肿胀.葛根素组大鼠心肌纤维排列规则,结构完整;线粒体排列整齐.结论:葛根素能明显减轻心肌缺血再灌注损伤,其心肌保护途径可能是通过上调热休克蛋白70表达、降低血清髓过氧化物酶活性来实现的.     

CCR5△32 mutation does not influence the susceptibility to HCV infection, severity of liver disease and response to therapy in patients with chronic hepatitis C

AIM: To study whether CCR5△32 mutation was associated with viral infection and severity of liver disease.METHODS: Two hundred and fifty two histologically proven, chronic HCV patients (mean age: 41 ± 14 years;M/F: 164/88) were genotyped. PCR based genotyping of 32 bp deletion at the CCR5 locus was done. Fourhundred and eight matched healthy controls were studied to assess susceptibility to HCV infection. To assess correlation of immune gene polymorphism with severity of HCV related liver disease, patients with chronic HCV infection were divided into those with a fibrosis score of ≤ 2 (mild) or ＞ 2 (severe) and histological activity index (HAI) of ≤ 5 or ＞ 5. For correlation between CCR5△32 mutations and response to therapy, 129 patients who completed therapy were evaluated.RESULTS: The majority (89.4%) of the patients were infected with genotype 3. The frequency of homozygous CCR5△32 mutants was comparable to HCV patients as compared to the healthy controls (0.7% vs 0%, P = 0.1).Further more, the frequency of CCR5△32 mutation was comparable in patients with mild or severe liver disease.(P = NS). There was also no association observed with response to therapy and CCR5△32 mutation.CONCLUSION: CCR5△32 mutation does not have a role in disease susceptibility, severity or response to therapy in patients with chronic hepatitis C infection.     

Effect of feed temperature and phototherapy on gastric emptying in the neonate

The effect of feed temperaturae and phototherapy on the rate of stomach emptying was studied in healthy infants during the first week. Emptying rate was measured by the modified serial test meal technique using 10% Dextrose feeds. The results show that emptying rate is independent of feed temperature and is not affected by phototherapy.     

Calcium, phosphorus, and magnesium concentrations in plasma during first week of life and their relation to type of milk feed

Serial changes in plasma levels of calcium, phosphorus, magnesium, alkaline phosphatase, and total proteins have been investigated in 138 healthy, term Caucasian infants. Blood samples were obtained for each infant from cord blood and on day 1 and day 6. The infants were studied in three groups according to whether they were breast fed, received 'Ostermilk No. 1' or 'Cow and Gate V' formulas. Levels of calcium, phosphorus, magnesium, alkaline phosphatase, and total proteins did not differ between the groups at birth or on day 1. By day 6 calcium levels were higher and phosphorus levels lower in the breast-fed infants compared with either of the artificially-fed groups. Phosphorus levels were lower in the V Formula group compared with the Ostermilk group but the mean calcium levels of these two groups did not differ significantly. However, only 2-8% of the V Formula group developed hypocalcaemia compared with 18-2% of the Ostermilk group. The only infant developing clinical tetany belonged to the group fed Ostermilk. Evidence is also given which suggests that those infants with low calcium levels on day 1 who were fed the high-solute milk tended to show a fall in calcium by day 6. This did not apply to the two other groups. It is concluded that the use of adapted cows' milk preparations for infant feeding should lead to a reduction in the incidence of neonatal tetany.     

The brain: integrated three-dimensional display of MR and PET images

Three patients with intractable epilepsy, two with brain tumors, and one with encephalitis were imaged with magnetic resonance (MR) and positron emission tomography (PET). MR data were used to construct a three-dimensional (3D) computer model of the brain surface depicting the precentral (movement), postcentral (sensation), left inferior frontal (speech), and left superior temporal (hearing) gyri. PET-derived measurements of average surface metabolism were encoded as colors and mapped onto the 3D model by means of a retrospective technique for registering the two scans. The integrated 3D model depicted the location of PET-detected metabolic abnormalities with respect to the gyral anatomy visualized with MR. In each case, the predicted relationships were confirmed intraoperatively by means of inspection of the brain and electroencephalography. Multimodality 3D displays are likely to be particularly valuable for interpreting PET studies of epileptic patients and others with normal MR anatomy.