Spontaneous hepatic hemorrhage secondary to retained intraperitoneal gallstones

We describe the first reported case of spontaneous hepatic hemorrhage as a result of retained gallstones in the region of Morison's pouch eroding into the liver parenchyma. The patient presented with acute right upper quadrant abdominal pain 7 months after laparoscopic cholecystectomy. She sustained an episode of limited spontaneous hepatic hemorrhage as noted by abdominal sonography, computerized tomography, and a 4-g/dL hemoglobin drop. Laparoscopic exploration revealed the source of hemorrhage to be an inflammatory source created by retained intraperitoneal gallstones.     

视网膜微血管异常的5年发病率及其与高血压的相关性

目的 描述“北京眼病研究”人群从2001年至2006年5年随访间非糖尿病老年人中视网膜微血管异常的累积发病率,并分析其与高血压的相关性。设计 人群为基础的队列研究。研究对象 “北京眼病研究”基线人群中参加2006年随访调查者3251人。方法 对每位受检者在基线调查和随访调查时均进行了问卷调查和全面的眼科检查,其中包括散瞳后彩色眼底照相。每位受检者随机选一眼进行眼底照片中视网膜血管异常的评价。评价指标包括局限性视网膜动脉缩窄（FN）、动静脉交叉压迫征（AVN）和视网膜病变,评价采用半定量的方法进行。问卷调查以了解一般情况、眼部及全身疾病史、治疗史和吸烟饮酒史。随访调查时进行了身高、体重和血压测量,并收集空腹血液标本检测血糖、血脂。考虑的危险因素包括：年龄、性别、城乡、人均收入、教育程度、高血压、高血脂、冠心病病史、脑卒中病史、糖尿病、体重指数（BMI）、吸烟饮酒、眼局部可能相关疾病（青光眼、老年性黄斑变性和中央/分支视网膜静脉阻塞等）和屈光状态等。通过对比基线和5年随访时受检者视网膜微血管的变化,确定视网膜微血管异常的5年发病率和改变情况（进展或消退）。根据治疗情况,将高血压患者分为血压控制的治疗组、未控制的治疗组和未治疗组。比较血压正常者与高血压病患者、不同高血压治疗情况组间视网膜微血管异常的发病率、进展率和好转率的差异。主要指标 视网膜微血管异常的发病率、进展率和好转率。结果 排除患有糖尿病或任何视网膜视神经疾病等眼局部病变的患者后,2058例受检者纳入本研究,其中女性1409例（68.5%）。平均年龄（53.8±9.5）岁。FN、AVN和视网膜病变的5年累积发病率分别为4.1%,1.4%和3.3%。高血压患者中FN、AVN和视网膜病变的5年发病率明显高于血压正常者（P均<0.01）。对年龄、性别和居住地区进行调整后,平均动脉压每增加10 mmHg,FN、AVN和视网膜病变的5年发病率分别增加1.58倍（95% CI：1.24~2.00;P<0.001）,1.55倍（95% CI：1.04~2.32;P=0.03）,1.46倍（95% CI：1.12~1.91;P=0.005）。对年龄、性别和居住地区进行调整后,高血压分级每增加1级,FN好转率减少28%。相应的,血压控制组的FN的好转率（44.4%）明显高于未控制组（22.6%）和未治疗组（11.5%）（P=0.01）。结论 在非糖尿病患者中,高血压与视网膜微血管异常的发病率和进展变化具有强相关性。血压控制理想者的视网膜微血管异常发病率较低,局限性动脉缩窄消退率较高。这表明如果高血压控制良好,作为视网膜微血管异常的早期表现,局限性视网膜动脉缩窄是可逆的。     

Effects of matrine on proliferation and apoptosis of cultured retinoblastoma cells

Background

Extracted from the traditional Chinese medicine of Kushen, matrine is an alkaloid with potential anti-neoplastic and anti-inflammatory effects. Here, we examined the effect of matrine on proliferation and apoptosis of cultured retinoblastoma cells.

Methods

The retinoblastoma cell lines Y79, WERI-RB1 and SO-RB50 were treated with matrine in increasing concentrations from 0.2-1.1?mg/ml for 24?hours, and the cell proliferation rate was measured. The cells were exposed to matrine at 50% inhibition concentration (IC50) for 12, 24 and 48?hours. Cell cycle was analyzed by flow cytometry, concentration of proteins regulating cell cycle and apoptosis was determined by Western blot, apoptosis rate was measured by TUNEL staining, and cell morphology was assessed by electron transmission microscopy.

Results

The retinoblastoma cell lines Y79, WERI-RB1 and SO-RB50 showed an increased inhibition of cell proliferation with increasing matrine concentrations. Applying the IC50 concentration of matrine, the alteration of the cell cycle, including a reduced percentage of the S phase, was significantly (P?<?0.01) associated with a longer treatment time by matrine. Correspondingly, the cell-cycle-associated proteins P21 and P27 were up-regulated and the protein cyclinD1 was down-regulated. The apoptosis-associated protein Bcl-2 was down-regulated, and Bax was up-regulated. In a similar manner, the apoptosis rate was significantly increased with longer treatment time.

Conclusions

Matrine added to cultures of immortalized retinoblastoma cells led to a reduced tumor cell proliferation, decreased rate of mitosis and an increased tumor cell apoptosis, paralleled by corresponding changes in the proteins regulating the cell cycle or apoptosis.     

Prolonged fasting in patients with chronic pain syndromes leads to late mood-enhancement not related to weight loss and fasting-induced leptin depletion

Abstract

Periods of fasting are practiced worldwide on a cultural/religious background, and related mood-enhancing effects are postulated. We aimed to assess the effect of fasting on mood and to explore the interaction with neuroendocrine activation and leptin depletion in a controlled explorative study on consecutive inpatients (BMI < 35 kg/m²) of a nutritional ward. 36 subjects (38.9 ± 7.0 years; 29 female, BMI 26.7 ± 4.1 kg/m²) participated in an 8-day modified fast (300 kcal/day), 19 patients (38.1 ± 5.9 years; 18 female, 23.5 ± 4.1 kg/m²) received a mild low calorie diet. Measurements included daily ratings of mood (VAS), weight and levels of leptin and cortisol at four time-points of the 2-week study period. Weight loss was 4.8 ± 1.2 and 1.6 ± 0.9 kg in fasters and controls, respectively. Fasters showed a more pronounced decrease of leptin (58% vs. 20%; P < 0.001) and a 17% increase of cortisol levels (P < 0.001). Mood ratings increased significantly in the late phase of fasting (P < 0.01) but were not related to weight-loss, leptin-depletion or cortisol increase. Our findings suggest that fasting induces specific mood-enhancement. The physiological mediator appears to be neither leptin nor cortisol, the role of other mechanisms has to be further studied.     

尖叶清风藤化学成分的研究

从尖叶清风藤(Sabia swinhoei Hmsl.exForb.etHemsl.)的地上部分分离出8个化合物,经理化常数测定和光谱解析,证明其中2个为新成分,分别命名为清风藤内酯(I)和清风藤酮(II),另外6个为已知化合物,即没药烯(III)、三十烷醇(IV)、β-谷甾醇(V)、二十八烷酸(VI)、齐墩果酸(VII)和胡萝卜甙(VIII)。     

Cytogenetic and histologic correlations in malignant lymphoma

Although a number of studies have indicated correlations between histologic subtypes of tumors and certain nonrandom chromosome changes, cytogenetic studies of lymphoma are in an early stage compared to those of leukemia. No comprehensive analysis of available data has so far been attempted in the literature either. Here we present an analysis of chromosome changes and their correlation with subtypes of lymphoma studied by conventional histology and cell surface markers, as observed in two sets of data: a group of 65 karyotypically abnormal tumors sequentially ascertained and studied by us during the period January 1, 1984 to April 30, 1985, and a larger data set derived by combining our data with those from two published series from the University of Minnesota that are comparable to our data. These combined data, which comprise the largest data set on the cytogenetics of lymphomas assembled so far, enabled a comprehensive analysis of correlation between chromosome change and tumor histology and the patterns of chromosome instability in these tumors. We found several significant associations, some previously described and others now recognized, between nonrandom chromosome gains, breaks, translocations, and deletions and histologic subtypes of tumors that characterize lymphomas. The data indicate that finding of chromosome breaks at certain sites (eg, 8q24, 14q32, 18q21) is of diagnostic value in dealing with cases of unusual lymphoma. Furthermore, nonrandom chromosome breakage exhibited three distinct patterns that reflected three levels of etiologically relevant genetic change.