一例分离型抽搐发作表现为肌阵挛癫痫（英文）

概述:心因性抽搐发作经常会漏诊,并且癫痫往往会被过度治疗从而导致多种财力、社会、以及耻辱感相关的问题。肌阵挛癫痫发作本身是一种罕见的现象,当功能性运动障碍呈现肌阵挛的时候就极难找到确切的原因。在这里,我们呈现一个被误诊为肌阵挛癫痫发作障碍的病例,该患者在多处经过治疗却无好转并且最终被诊断为患有非常罕见的功能性运动障碍。     

Immediate and 18‐Month Outcome of Balloon Mitral Valvuloplasty: Comparison of Inoue and Multi‐Track System

Aims: To compare the immediate and 18‐month clinical and echocardiographic outcome of Inoue and multi‐track system for balloon mitral valvuloplasty (BMV). Methods: We included 78 consecutive patients with moderate to severe rheumatic mitral stenosis (MS) [mitral valve area (MVA) < 1.5 cm²] and clinically indicated BMV. The first 42 consecutive patients were assigned to Inoue BMV (group I), and the following 36 consecutive patients were assigned to multi‐track system (group M). Clinical and echocardiographic assessment was performed before, immediately after, 3 months after, and 18 months after the procedure. Results: The successful immediate result [MVA > 1.5 cm² and mitral regurgitation (MR) < II/IV] was achieved in 40 (95.23%) patients of group I and 34 (94.44%) patients of group M (P = 0.12). Immediately after BMV, MVA increased from 0.9 ± 0.4 to 1.7 ± 0.5 cm² in group I and from 0.8 ± 0.2 to 1.9 ± 0.3 cm² in group M (P < 0.01). Bilateral commissural splitting was significantly higher in group M (P < 0.01). This was associated with higher incidence of mild commissural mitral regurgitation. There were no significant differences of moderate to severe MR. Both procedure and fluoroscopy time were significantly shorter in group I (P < 0.001). Eighteen‐month clinical and echocardiographic evaluation was available for 66 (84.64%) patients with sustained immediate clinical and echocardiographic improvements. Conclusions: Both Inoue and the multi‐track balloon systems achieved successful immediate and 18‐month results. The multi‐track double balloon system produced significantly larger MVA, with better bilateral commissurotomy, yet with longer procedure and fluoroscopy times. (J Interven Cardiol 2012;25:47–52)     

磷脂酶A2在中性粒细胞肺内聚集损伤中的作用

磷脂酶Ａ２在中性粒细胞肺内聚集损伤中的作用刘松殷凯生朱荣刘立杨玉探讨急性肺损伤（ＡＬＩ）时，磷脂酶Ａ２（ＰＬＡ２）在多核中性粒细胞（ＰＭＮ）肺内聚集和活化以及所造成损伤中的作用。材料与方法体重１６０～２４５ｇ健康ＳＤ大鼠３６只，随机分空白对照组（Ⅰ组...     

Molecular Genetic Basis of Hypertrophic Cardiomyopathy:

Genetics of SCD in HCM. Hypertrophic cardiomyopathy (HCM) is an autosomal dominant disease caused by mutations in sarcomeric proteins. The disease is characterized by left ventricular hypertrophy in the absence of an increased external load, and myofibrillar disarray. A large number of mutations in genes coding for the β-myosin heavy chain (β-MyHC), cardiac troponin T (cTnT), cardiac troponin I, α-tropomyosin, myosin binding protein C (MyBP-C), and myosin light chain 1 and 2 in patients with HCM have been identified. Genotype-phenotype correlation studies have shown that mutations carry prognostic significance. The Gly²⁵⁶Glu, Val⁶⁰⁶Met, and Leu⁹⁰⁸Val mutations in the μ-MyHC are associated with a benign prognosis. In contrast, Arg⁴⁰³Gln, Arg⁷¹⁹Trp, and Arg⁴⁵³Cys mutations are associated with a high incidence of sudden cardiac death (SCD). Mutations in cTnT are associated with a mild degree of hypertrophy, but a high incidence of SCD. Mutations in MyBP-C are associated with mild hypertrophy and a benign prognosis. However, it has become evident that factors other than the underlying mutations, such as genetic background and possibly environmental factors, also modulate phenotypic expression of HCM.     

A novel tool for improving the interpretation of isotope bone scans in metastatic prostate cancer

Objectives:The isotope bone scan (IBS) is the gold-standard imaging modality for detecting skeletal metastases as part of prostate cancer staging. However, its clinical utility for assessing skeletal metastatic burden is limited due to the need for subjective interpretation. We designed and tested a novel custom software tool, the Metastatic Bone Scan Tool (MetsBST), aimed at improving interpretation of IBSs, and compared its performance with that of an established software programme.Methods:We used IBS images from 62 patients diagnosed with prostate cancer and suspected bone metastases to design and implement MetsBST in MATLAB by defining thresholds used to identify the texture and size of metastatic bone lesions. The results of MetsBST were compared with those of the commercially available automated Bone Scan Index (aBSI) with regression analysis.Results:There was strong agreement between the MetsBST and aBSI results (R² = 0.9189). In a subregional analysis, MetsBST quantified the extent of metastatic disease in multiple bone sites in patients receiving multimodality therapy (radium-223 and external beam radiotherapy) to illustrate the differences in bone metastatic response to different treatments.Conclusion:The results of MetsBST and the commercial software aBSI were highly consistent. MetsBST introduces novel clinical utility by its ability to differentiate between the responses of different bone metastases to multimodality therapies.Advances in knowledge:MetsBST reduces the variability in assessment of tumour burden caused by subjective interpretation. Therefore, it is a useful aid to physicians reporting nuclear medicine scans, and may improve decision-making in the treatment of metastatic prostate cancer.     

红花籽粕对小鼠的急性毒性及抗溃疡性结肠炎作用研究

目的 评价红花籽粕(红花Carthamus tinctorius的种子经过压榨提取红花籽油后的副产品)对小鼠的急性毒性及抗溃疡性结肠炎(ulcerative colitis,UC)作用。方法 C57BL/6小鼠ig不同剂量的红花籽粕,7 d后计算脏器指数,采用苏木素-伊红(HE)染色观察肝、脾、肾组织病理变化,测定血清中肝功能、肾功能及血脂水平,以评价红花籽粕的急性毒性。建立葡聚糖硫酸钠(dextran sulphate sodium,DSS)诱导的UC小鼠模型,每天记录小鼠体质量,测定疾病活动指数(disease activity index,DAI)评分、结肠长度以及脏器指数,采用HE染色和阿利新蓝-过碘酸雪夫(AB-PAS)染色评价结肠组织病理学变化,采用qRT-PCR和Western blotting检测结肠组织中炎症和黏膜屏障相关因子表达。结果 急性毒性实验中,与对照组比较,红花籽粕组小鼠脏器指数、血液生化指标没有显著差异,脏器病理切片也未见异常。红花籽粕对DSS诱导的UC小鼠具有较好的保护作用,可以显著改善体质量减轻、DAI评分升高、结肠长度缩短等临床症状(P<0.01),减轻结肠组织病理损伤,抑制肠道炎症细胞的浸润,保护杯状细胞,提高紧密连接蛋白和黏蛋白的表达(P<0.05、0.01、0.001),改善肠道屏障完整性。结论 红花籽粕具有较高的安全性,且对DSS诱导的UC小鼠具有显著的治疗作用。