Graves病药物治疗停药复发相关因素分析

Objective To explore the value of thyroid-stimulating antibody(TSAb) and degree of goiter in predicting the outcome of Graves'disease after antithyroid drug treatment. Methods Seventy-one patients with Graves'disease were given antithyroid drugs for (2. 8±1. 4)years and then followed up for(22±6.0)months.Finally,age,gender,thyroid function,TSAb and goiter size at the time of drug withdrawal were compared between the relapsed and relieved groups. TSAb was measured in all patients by using HEK-hTSHR cells. Results Eleven of 71 patients relapsed during the follow-up after drug withdrawal. The relapse rate (42. 9% ,6/14)in patients with positive TSAb was significantly higher than that (8.8%, 5/57) in patient with negative TSAb (X2 = 9.97, P<0.01). The relapse rates in patients with normal size thyroid, Ⅰ degree goiter,Ⅱ degree goiter were 6.25%, 12.2%,35.7% respectively. TSAb activity, positive rate and goiter size of the relapsed patients at the time of drug withdrawal were significantly higher than those of relieved patients (P<0.05 or P<0. 01). Conclusion TSAb activity and goiter size at the time of drug withdrawal are two effective prognostic markers of relapse in Graves' disease treated with antithyroid drugs.     

Gene expression changes associated with Barrett's esophagus and Barrett's-associated adenocarcinoma cell lines after acid or bile salt exposure

Background  

Esophageal reflux and Barrett's esophagus represent two major risk factors for the development of esophageal adenocarcinoma. Previous studies have shown that brief exposure of the Barrett's-associated adenocarcinoma cell line, SEG-1, or primary cultures of Barrett's esophageal tissues to acid or bile results in changes consistent with cell proliferation. In this study, we determined whether similar exposure to acid or bile salts results in gene expression changes that provide insights into malignant transformation.     

东方田鼠IgG3抗体抗血吸虫病作用研究

采用ELISA方法, 平行检测东方田鼠、 BALB/c小鼠和昆明小鼠在攻击感染前、 后的血清抗血吸虫童虫(SSA)、 成虫 (SAWA) 和虫卵(SEA) IgG3抗体水平, 并进行体内、 外试验, 观察IgG3抗体抗血吸虫效应。结果攻击感染后第4周, 东方田鼠抗SSA和SAWA的IgG3抗体水平增幅较大, 分别较感染前增加79.6%和49.6%, BALB/c小鼠IgG3抗体在攻击感染后无明显增加。野生和室内繁殖的东方田鼠的IgG3抗体所致童虫死亡率分别为昆明小鼠的5.88和2.35倍, 前者还诱生出较高的减虫率 (39.8%)。提示东方田鼠IgG3抗体可能是其抗血吸虫感染的主要免疫物质。     

药物干预非杓型高血压者恢复杓型血压昼夜节律后对血浆神经肽Y的影响

目的 :探讨通过药物干预使非杓型高血压患者恢复杓型血压昼夜节律后对血浆神经肽Y(NPY)的影响。方法 :30例非杓型的高血压患者 (非杓型组 )随机分成两组 ,采用自身对照交叉试验法 ,在总剂量及药物种类 (硝苯吡啶缓释片及依那普利 )不变的前提下 ,通过调整用药时间加强夜间降压恢复杓型节律 (a处理 )或按常规的日间降压不恢复 (或保持 )杓型节律 (b处理 )。第 1阶段两组分别接受其中一种处理 ,第 2阶段分别接受另一种处理。用放免法同步测定每一处理前后的夜间 (2 :0 0 )、日间 (8:0 0 )血浆NPY ,并复查动态血压。同时与同期的 4 5例健康体检者 (对照组 )以及 2 1例同期住院的杓型高血压患者 (杓型组 )作对照。比较非杓型组血压昼夜节律恢复前后NPY的水平。结果 :与对照组比较 ,非杓型组白天及夜间平均血压、NPY均显著增高 [分别为(97.93± 11.6 7)∶(92 .0 0± 7.34)mmHg(1mmHg =0 .133kPa) ,P <0 .0 5 ;(96 .96± 12 .31)∶(77.82± 6 .35 )mmHg ;(137.75± 5 3.6 2 )∶(10 2 .13± 2 0 .6 5 )ng/L ;(135 .4 1± 39.70 )∶(99.83± 15 .88)ng/L ,均 P <0 .0 1]。血压恢复杓型后 ,夜间平均压及NPY显著下降 (P <0 .0 1) ,日间平均压及NPY下降不显著。与杓型组比较 ,非杓型组夜间NPY/日间NPY比值 (U值 )显     

蒿甲醚和双氢青蒿素治疗维和部队疟疾93例分析

目的 为了保证维和部队的任务完成及官兵的身体健康,防治维和部队的疟疾患者并总结疟疾的防治经验.方法 对所属维和部队官兵参与进行抗疟药物分组治疗效果观察.结果 双氢青蒿素(科泰新)防治效果肯定,用于进人高疟区的易感人群疟疾防治效果显著.结论 蒿甲醚对疟疾的疗效肯定;双氢青蒿素作为一种新的选择更适应未来的战争需要.     

Comparative analysis of systolic and isolated diastolic dysfunction: Sado heart failure study

Determining the type of cardiac dysfunction is important for implementing therapeutic strategies and for prognostic insights. We characterized systolic dysfunction (SD) and isolated diastolic dysfunction (IDD) in adults referred for echocardiographic evaluation, and compared their clinical and other characteristics. In the present work, we studied 218 patients (137 males) with cardiac dysfunction (mean age, 66.3 +/- 8.3 years). SD was defined as a left ventricular ejection fraction (LVEF) of < 45%, whereas IDD was defined as a LVEF >or= 45% in addition to the standard Doppler-echocardiography diagnostic criteria for IDD. Approximately 68% of subjects had SD (70% males). The proportions of hypertension, diabetes, and dyslipidemia were 44%, 26%, and 22%, respectively, without significant association with the type of dysfunction. Myocardial infarction (MI) was found in 31% of patients, and was significantly (P < 0.001) more prevalent among SD compared with IDD cases. Cerebral stroke (18%) and malignancy (16%) were significantly associated with IDD (29% versus 13% for SD in the case of stroke, and 26% versus 11% for SD in the case of malignancy; P = 0.008 for each). In multivariately-adjusted logistic regression analysis, the following variables were found to be significantly (P < 0.05) and independently associated with IDD: female gender (odds ratio [OR] = 2.207 [95% CI = 1.302-4.608]), stroke (OR = 2.009 [1.119-3.980]), and malignancy (OR = 2.016 [1.230-4.010]). On the other hand, previous MI (OR = 2.075 [1.769-4.808]) was independently associated with SD. In conclusion, some factors/comorbidities were more likely to associate with IDD (female gender, stroke, and malignancy) or SD (previous MI) when IDD and SD were compared with each other.     

氟对大鼠成骨细胞Runx2表达的影响

目的 研究氟对体外培养大鼠乳鼠成骨细胞中Runx2表达的影响.方法 体外培养Wistar大鼠乳鼠成骨细胞,按染氟剂量分为0(对照组)、1、2.4 mg/L 4个水平,分别在48、72 h后,提取RNA,采用反转录聚合酶链反应(RT-PcR)方法检测Runx2 mRNA表达;采用酶联免疫吸附试验(EUSA)方法检测培养液上清中的Runx2蛋白质.结果 Wistar大鼠乳鼠成骨细胞在体外染氟培养48 h后,1、2、4mg/L染氟水平下Runx2的mRNA表达(0.613±0.055、0.773±0.070、0.775±0.070)与对照组(0.482±0.043)比较.差异均有统计学意义(P<0.05);在染氟培养72 h后,1、2,4 mg/L染氟水平和对照组的Runx2 mRNA表达量分别为0.969±0.048、1.229±0.061、1.255±0.063、0.724±0.036,任意两组问比较,差异均有统计学意义(P<0.05).各染氟组Runx2mRNA表达,72 h组均高于铝hm(P<0.05);染氟剂量和染氟时间有交互作用(F=189.20,P<0.05).在染氟培养48 h后,1、2、4 mg/L染氟水平下的Runx2蛋白质表达(0.141±0.007、0.143±0.008、0.143±0.011)与对照组(0.129±0.012)比较,差异有统计学意义(P<0.05);在染氟培养72 h后,1、2、4 mg/L染氟水平下的Runx2蛋白质表达(0.156±0.014、0.168±0.018、0.162±0.010)与对照组(0.137±0.016)比较.差异有统计学意义(P<0.05);各染氟剂量Rung2蛋白质表达.72 h组均高于48 h组(P<0.05),染氟剂量和染氟时间之间无交互作用(F=2.22,P0.05).结论 氟可促进成骨细胞Runx2的mRNA和蛋白质表达,与染氟的剂量以及作用时间有关.     

失代偿期肝硬化患者的终末期肝病模型预后分析

目的尝试性研究终末期肝病模型(MELD)评分系统与失代偿期肝硬化患者短期(3个月) 预后的关系;研究Child—Pugh分级与失代偿期肝硬化患者3个月预后的关系。方法应用MELD模型公式及Child—Pugh分级对110例住院治疗的失代偿期肝硬化患者进行评分及分级,同时了解其3个月内的病死率。结果39例患者在3个月内死亡。MELD10～19、20～29、≥30分患者3个月的病死率分别为38.18%、64.71%、75.00%,明显高于MELD≤9分患者(11.76%,P<0.05)。MELD≥18分患者3个月的病死率明显高于MELD<18分患者(58.06%与26.58%,x2=9.643,P<0.01)。Child A级患者3个月病死率为14.89%,B级为42.55%,C级为75.00%。结论MELD模型能准确预测肝硬化失代偿期患者短期的临床预后,而Child—Pugh分级也可准确预测失代偿期肝硬化患者3个月的病死率。     

Solitary pleural plasmacytomas manifested as a massive pleural effusion without evidence of monoclonal gammopathy

Abstract:   The majority of extramedullary plasmacytomas involve the upper respiratory tract but only a few are associated with serum monoclonal gammopathy. Most extramedullary plasmacytomas respond to local radiotherapy and have a better prognosis than multiple myeloma. Solitary plasmacytomas, involving the pleura, are very rare. This case report describes a patient with a solitary extramedullary plasmacytoma involving the pleura, and no evidence of serum, urine or pleural fluid paraproteins. Diagnosis was made by strongly positive immunohistochemical stains with CD38, CD138 and MUM-1 of the pleural tumour. The response to both radiotherapy and chemotherapy was poor and the patient died shortly after diagnosis.