环氧化酶-2基因启动子甲基化及表达与胃黏膜病变的关系

目的 探讨环氧化酶2(COX-2)基因启动子区甲基化水平和蛋白表达与胃黏膜病变的关系,并对其相关的影响因素进行研究.方法 以1201例患有不同胃黏膜病变的高危人群为研究对象,采用免疫组织化学方法榆测COX-2表达,用亚硫酸氢钠-变性高效液相色谱(DHPLC)对COX-2启动子甲基化率进行定量分析,采用13C尿素呼气实验(13C-UBT)对幽门螺旋杆菌(H priori)感染状况进行测定.结果 COX-2甲基化率中位数随胃黏膜病变的加重逐渐升高,在浅表性胃炎和慢性萎缩性胃炎(SG/CAG)、肠上皮化生(IM)及不确定性异型增生和异璎增生(Ind DYS/DYS)病变中分别为10.6%、11.8%、13.8%,各病变组之间差异有统计学意义(X2=8.312,P=0.016).分层分析显示,在H pylori感染阴性病例中,COX-2甲基化率仍随病变加重明显升高,在SG/CAG、IM、Ind DYS/DYS病变中其中位数分别为8.8%、10.6%、14.1%(X2=6.629,P=0.036).进一步分析发现,COX-2甲基化率随着COX-2表达强度的增强而降低,由COX-2弱阳性表达的13.3%降至强阳性表达的7.6%(X2=10.400,P=0.015).结论 COX-2启动子甲基化水平与胃黏膜病变程度及H pylori感染状况密切相关,并与COX-2表达强度呈负相关,说明COX-2启动子区异常甲基化可能在胃黏膜病变的演变过程中起重要作用.     

贝那普利降压疗效与校正QT间期的关系

目的探讨原发性高血压患者心电图心率校正QT间期(QTc)和贝那普利降压疗效之间的关系.方法采用前瞻性队列研究方法调查安徽A县899名高血压病患者的基线心电图、治疗15 d前后的血压变化及相关临床和流行病学特点等情况.结果 QTc和血压下降呈负相关.QTc每增加0.1秒1/2,收缩压和舒张压的下降值分别减少3.6 mmHg和3.3 mmHg,且差异均有显著性(P＜0.05).将QTc三等分后,随着QTc等分的增加,收缩压和舒张压的下降值均逐渐减少,且差异具有显著性(P＜0.05);将QTc等分后的变量放入方程中进行趋势性分析,发现在收缩压和舒张压组中的负相关关系具有显著性(P＜0.05).随着QTc等级的增加,舒张压有效率逐渐降低,且有显著性差异(P＜0.05),收缩压的效应关系不如舒张压明显.结论 QTc和贝那普利降压疗效呈负相关,对贝那普利短期降压疗效具有重要的预测价值.     

不同剂量地塞米松鞘内注射治疗蛛网膜下腔出血头痛的临床研究

目的 探索地塞米松鞘内注射治疗蛛网膜下腔出血（SAH）头痛的适宜剂量。方法 所选病例分为4组，分别用0，5，10，20mg地塞米松鞘内注射观察止痛效果。结果 根据疗效判定标准，4组总有效率分别为25．00％，50．00％，92．31％，100．00％；头痛缓解时间随地塞米松（DXM）用量增加而延长。结论 DXM 10mg疗效比小剂量疗效高，与大剂量疗效;相同剂量越大缓解头痛时间越长。     

Intracranial Extramedullary Hematopoiesis in β-thalassemia Major

A case of β-thalassemia major with a huge mass of hernatopoictic tissuc firmly attached tothe dura mater was reported This is the first case reported in China.     

Point mutation in the parkin gene on patients with Parkinson’s disease

Summary To investigate the distribution of possible novel mutations from parkin gene in variant subset of patients with Parkinson’s disease (PD) in China and explore whether parkin gene plays an important role in the pathogenesis of PD, 70 patients were divided into early-onset group and late-onset group; 70 healthy subjects were included as controls. Genomic DNA from 70 normal controls and from those of PD patients were extracted from peripheral blood leukocytes by using standard procedures. Mutations of parkin gene (exon 1–12) in all the subjects were screened by PCR-single strand conformation polymorphism (SSCP), and further sequencing was performed in the samples with abnormal SSCP results, in order to confirm the mutation and its location. A new missense mutation Gly284Arg in a patient and 3 abnormal bands in SSCP electrophoresis from samples of another 3 patients were found. All the DNA variants were sourced from the samples of the patients with early-onset PD. It was concluded that Parkin point mutation also partially contributes to the development of early-onset Parkinson’s disease in Chinese. WANG Tao, male, born in 1961, Associate Professor This work was supported by grants from the key program of the special scientific project of Scientific & Technologic Agency of Hubei Province (Serial No. 2001AA308B01) and the Hygienic Research Project of Hygienic Agency of Hubei province (Serial No. WJ 01529).     

大鼠翼腭神经节SIF细胞的年龄变化

用醛诱发荧光法观察了不同年龄组大鼠翼腭神经节小强荧光（ＳＩＦ）细胞的数量，发现出生１天时ＳＩＦ细胞数量最少，１周内急剧增加，１－２周数量无明显，至４周数量继续增加，成年时数量最多，老年时比成年时无明显的数量变化，表明大鼠翼腭神经节ＳＩＦ细胞的数量随年龄增长而增加。     

A study on various symptoms of chronic hepatitis treated with radix astragali and its regulative effect to levels of serum hormone

Sixty-seven cases of chronic hepatitis were treated with Radix Astragali. After treatment (2-month course), the clinical improvement rate in 38 cases of the Stagnation of the Liver-Qi and Deficiency of the Spleen type was 92.1%, and in 26 cases of the Deficiency of Liver Yin and Kidney Yin type was 88.5%, more effective than in the control group (P<0.05). The regulative effect to the levels of serum hormone was observed in the patients of the Stagnation of the Liver-Qi and Deficiency of the Spleen type treated with this medicine. The results showed that the levels of serum triiodothyronine, estradiol (female) and testosterone (male) were increased after treatment (1.40±1.38 ng/dl, 129.30±1.23 pg/ml and 496.24±1.47 ng/dl). Pre-treatment levels were 1.22±1.49 ng/dl, 104.60±1.45 pg/ml and 398. 17±1.55 ng/dl respectively (P<0.05); however, the level of serum prolactin (2.75±4.46 ng/ml) was lower after treatment than before treatment (3.20±3.82 ng/ml,P<0.05). No obvious changes were observed in the levels of serum follicle stimulating hormone, luteinizing hormone, thyroid stimulating hormone, thyroxine, triiodothyronine uptake ratio and cortisol after treatment.     

Sexual abuse of children: an area with room for professional reforms

The cases of 46 children who had been abused sexually an average of 2.6 years previously, were reviewed and the non-offending parents were interviewed with emphasis on how they viewed the professional persons who had seen their children, and their opinions of the legal processes that were instituted. The parents found most professional groups helpful, with officers from the Department of Youth and Community Services being seen as the least helpful. Twenty-one of the cases went to court; in 12 cases this resulted in a conviction, and prison sentences were imposed on six of the offenders. Children found the court experience distressing and most parents expressed dissatisfaction with the outcome of the court hearing. Children were more likely to be required to give evidence in court if the offender had legal representation. Persisting behavioural problems and poor school performance were more likely to occur in those cases in which there had been court hearings. A review of Police Department records of children who had attended the hospital for the management of sexual assault, showed that 10 of the 107 children who are now aged over 14 years, have themselves been convicted of violent crimes since their episode of sexual assault. Long-term intervention is required to help many of these children, some legal reforms are necessary to reduce the stress that they experience when there is a court hearing, and all the professional groups that are likely to become involved with the problem of the sexual abuse of children need to be better informed about its seriousness and consequences.     

旁正中动脉入口部梗死82例临床分析

目的探讨急性桥脑旁正中动脉入口部梗死(branch atheromatous disease,BAD)的临床特点。方法回顾性分析1997～2003年本院神经内科收治的82例桥脑BAD的临床表现、MRI影像特点、脑干听觉诱发电位(BAEP)表现、危险因素。结果本组病例的临床特点是:平均发病年龄69.2岁,男性/女性=46/36,56/82病情呈进行性发展,75/82有构音障碍,72/82有肢体偏瘫,29/82为高度肢体瘫痪,27/82有轻度意识障碍,6/82伴有不全Homer征,49/82出现面部或(和)偏侧肢体感觉减退,25/82出现周围性面瘫,42/82有非旋转性头晕;13/82有眼球运动障碍。MRI表现有:梗死灶位于桥脑中上部、达桥脑表面,楔形,内侧位于桥脑旁正中、呈类似直线,可显示出基底动脉壁不整;危险因素方面除高血压外还与糖尿病、脂质代谢异常有关。结论根据临床特点及MRI表现正确诊断出桥脑BAD,以指导进一步的病因治疗及预防。