Chocolate is a migraine-provoking agent

Patients with migraine who believed that chocolate could provoke their attacks were challenged with either chocolate or a closely matching placebo. In a double-blind parallel group study, chocolate ingestion was followed by a typical migraine episode in 5 out of 12 patients, while none of the 8 patients challenged with placebo had an attack (p = 0.051). The median time to the onset of the attack was 22 h. This brief study provides some objective evidence that chocolate is able to provoke a migraine attack in certain patients who believe themselves sensitive to it.     

Assessing diagnosis in heart failure: which features are any use?

We assessed the value of symptoms, past history, medications and signs in the evaluation of patients who might have heart failure secondary to left ventricular systolic dysfunction. An open-access echocardiography service was set up to help identify patients with left ventricular systolic dysfunction who might benefit from treatment with an angiotensin-converting-enzyme inhibitor. History and examination were recorded for each of these patients. The patients were divided into groups according to whether left ventricular systolic function was preserved or not and whether various clinical features were present or not. Of 259 consecutive patients studied, 41 had impairment of left ventricular systolic function as assessed by echocardiography. Past history of myocardial infarction and displaced apex beat were the best single predictors of left ventricular systolic dysfunction as assessed by echocardiography. The combination of past history of myocardial infarction and displaced apex had the best positive predictive value of all. Patients with such clinical features or combinations of clinical features may not need echocardiography, and where access to this resource is limited, it could be reserved for patients without such diagnostic features.      

超声引导消融治疗子宫肌瘤导航系统的设计

目的:如何将消融装置精确的放置到预期的位置,是射频消融治疗子宫肌瘤中的难点,因此研究应用于超声引导下消融治疗子宫肌瘤的导航系统。方法:①设计超声引导下消融治疗子宫肌瘤的导航系统,该系统的关键是同时跟踪超声探头和射频消融针的空间位置,从而准确的将射频消融针放到准确的位置,并缩短手术时间及使手术的创伤更小。②系统主要由三维超声导航和空间定位装置组成。使用以下设备:B型超声仪(ULTRAMARK-9,ATL公司,美国);磁跟踪器(pciBirds,model6DFOB,Ascension Technology公司,美国);射频电极;图形工作站,用于采集超声图像、记录磁跟踪器提供的位置信息、导航图像显示等。利用磁定位器实时跟踪超声探头和穿刺针,构建三维超声,穿刺操作中实时显示二维超声图像平面在三维超声中的位置及与穿刺针的空间位置关系。③为了测试系统的精度和稳定性,设计了水槽模型。以30g/L的琼脂糖经水浴加热后,注入模具中,冷却凝固后取出,制成球形穿刺目标,将球体圆心和射频电极针尖到达的实际位置之间的差值作为系统误差进行对该系统进行评价。结果:利用水槽模型进行了30次实验,最大穿刺角度为60°,实验中采集的数字图像均为768*576像素的8位灰度图像。所有实验均顺利完成穿刺操作,实验的系统误差范围在3mm内。结论:利用超声引导下消融治疗子宫肌瘤导航系统可以实现三维空间的准确定位,实现灵活准确的穿刺操作。     

The dysregulated brain: consequences of spatial and temporal brain complexity for bipolar disorder pathophysiology and diagnosis

Increasingly, evidence has been accumulating emphasizing the importance of looking at bipolar disorder (BD) from a neurodevelopmental and transdimensional perspective to better understand its origins and its course. In this overview article, the problems facing pathophysiological psychiatric research in BD are addressed and interpreted in the light of brain complexity. Brain complexity can be split into spatial complexity, which constitutes the physiological levels of the central nervous system (i.e., the genetic, molecular, cellular, neuronal circuit and phenomenological levels), and temporal complexity, that is, neurodevelopment. The consequences of this consideration are discussed and suggestions for clinical practice and pathophysiological psychiatric research are made.     

The immune response of allophenic mice to the synthetic polymer L-glutamic acid, L-lysine, L-phenylalanine. II. Lack of gene complementation in two nonresponder strains

The genetic control of the immune response of inbred strains of mice to certain antigens has been demonstrated to be governed by a set of Ir genes linked to the major histocompatibility complex (H-2) of mice (1,2). Until recently, the control was thought to be governed by single, dominant genes, located within the I region of the H-2 complex. Merryman et al. (3) originally demonstrated that the immune response to the synthetic terpolymer L-glutamic acid, L-lysine, L-phenylaline (GL) is under dominant, H-2-linked Ir gene control (4-7). This was shown both by crossing two nonresponder parental strains to produce responder offspring in the F(1) generation, and by the analysis of appropriate recombinant stains of mice. The two complementing genes have been mapped in the IA and IC regions of the H-2 complex, and have been termed β and α, respectively (5,6). Thus, any strain of mouse may contain neither, one, or both genes. Only mice containing both genes are capable of responding to GL. It has been shown using F(1) hybrid and recombinant strains of mice, that the α- and β-genes can complement each other in either the cis (on the same chromosome) or in the trans (on different chromosomes) position (8). In this paper we report the results of studies aimed at answering the question of whether or not the α- and β- genes can complement each other when they are present in different lymphoid cells. To this end we have constructed allophenic mice composed of two nonresponder strains (A and C57BL/6), which show gene complementation in the F(1) generation. Allophenic mice are chimeras containing two cell types coexisting in a “normal” environment. The mice were tested for the specific cellular composition of the two parental cell types and were found to possess a complete range in the relative proportion of the two cell types. This report demonstrates that regardless of the mixture of cell types present in the allophenic mice, none of them were responders to GL. Thus no complementation of the α- and β-genes is seen when the two genes are present in different cells.     

苯巴比妥致固定性药疹1例

报告1例苯巴比妥治疗Gilbert综合征致固定性药疹的少见病例,并复习了相关文献．固定性药疹是药物过敏反应中皮肤损害的常见疹型, 但由苯巴比妥所致者较少见．对苯巴比妥过敏的部分患者可有磺胺、去痛片过敏史;某些复方制剂含有苯巴比妥,故使用苯巴比妥前应仔细了解有无磺胺、去痛片过敏史,对复方制剂必须清楚其组成成分,防止苯巴比妥引起不良反应．     

Granulocyte colony-stimulating factor "mobilized" peripheral blood progenitor cells accelerate granulocyte and platelet recovery after high-dose chemotherapy

Hematopoietic growth factors have been used to accelerate engraftment after bone marrow transplantation and to "mobilize" peripheral blood progenitor cells (PBPC). We report on the data in 85 consecutive patients with Hodgkin's disease who were treated in a single institution using different methods to obtain PB progenitor cells. Use of granulocyte colony-stimulating factor for mobilization resulted in a significantly accelerated time to recovery of granulocytes (10 days v 12 days, P < .01) when compared with "nonmobilized" PBPC recipients. Similarly, use of mobilized PBPC resulted in a significantly accelerated time to platelet engraftment (13 days v 30 days, P < .001) when compared with "nonmobilized" recipients. Moreover, there was a statistically significant difference in total costs in favor of the group receiving "mobilized" PBPC.