阻塞性睡眠呼吸暂停综合征相关高血压病的临床特点

探讨阻塞性睡眠呼吸暂停综合征相关性高血压病 (obstructive sleep apnea associated hypertension,OSAAHT)的临床特点。对照分析 2 4例 OSAAHT和年龄及病期相匹配的 2 2例原发性高血压病患者 ,比较症状、体重指数、治疗前睡眠前后血压变化及 2 4h血压动态监测等指标。结果发现 OSAAHT患者白天明显过度困倦 ,睡眠监测呼吸紊乱指数 (AHI)为 (4 5 .1± 15 .3)次 / h,体重指数高于对照组 [(2 7.9± 2 .5 ) kg/ m2比 (2 3.9± 1.7) kg/ m2 ,P<0 .0 1]。OSAAHT睡前血压 (137.1± 10 .5 ) / (88.4± 6 .6 ) mm Hg,清晨血压 (15 5 .9± 14.4) / (10 1.8± 4.9) m m Hg;原发性高血压病组睡前血压 (149.2± 12 .5 ) / (91.7± 6 .2 ) mm Hg,清晨血压 (140 .7± 9.4) / (83.4± 5 .9) mm Hg;两组睡前收缩压及清晨收缩压和舒张压均有差异 ,P<0 .0 1。OSAAHT夜间血压下降率明显小于原发性高血压病对照组[(13.3± 4.9) %比 (4 .5± 1.6 ) % ,P<0 .0 1]。提示 OSAAHT除了睡眠呼吸障碍外 ,还具有以下临床特点 :清晨睡醒时血压较高 ,夜间血压下降幅度变小 ,白天过度困倦以及肥胖等     

脂质体介导人β-神经生长因子基因转染培养肌母细胞的表达研究

目的　了解含 β-神经生长因子 (β- NGF)基因的表达质粒 PSVCEP NGF- CAT在培养肌母细胞中的表达及 L ipofect AMINE阳离子脂质体介导的转染效率。方法　将表达质粒 PSVCEP NGF- CAT经 L ipofectAMINE转染至培养成的肌母细胞中 ,用免疫细胞化学方法检测基因在肌母细胞内的表达。结果　培养肌母细胞在转染 6小时吞噬脂质体最显著 ,转染 48小时后约 40 %的肌母细胞胞质内有β- NGF基因表达。结论　含β- NGF基因的表达质粒 PSVCEP NGF- CAT可以在培养肌母细胞中表达 ,脂质体转染的方法简便、有效     

Controlled trial of clinical utility of serum salicylate monitoring in rheumatoid arthritis

A crossover double-blind controlled trial was performed on 36 patients with rheumatoid arthritis to assess the necessity for serum salicylate monitoring in determining optimal dosage. There was no clinically or statistically significant increase in the clinical improvement of patients associated with serum monitoring but potentially toxic serum levels occurred without tinnitus when serum monitoring was not used.     

Allergy to laboratory animals: a retrospective and a prospective study.

Twenty four volunteers who had been allergic to laboratory animals for some years were examined by means of a questionnaire paying particular attention to symptoms associated with rats and by serological and skin tests with extracts of rat urine (retrospective study). Nasal and eye symptoms were reported by 21 and 16 individuals respectively: 13 had asthma. Positive skin tests and high levels of specific IgE antibody to rat urine extract were found in 17 of the more severely affected individuals and this group included 12 of those with asthma. Latent periods of work with animals before symptoms appeared varied from 0.5 to 12 years. Also 148 individuals were studied during their first year of work with animals (prospective study). Symptoms developing during the year were reported by 15%, asthma by 2%. IgE antibody levels to rat urine were raised in 40% of affected and 6% of the unaffected individuals but there was no significant correlation between symptoms and either antibody levels or positive skin tests. Allergic symptoms developing during the first year of postemployment were, on the whole, much milder than those seen in the retrospective study. A tentative conclusion is that most individuals who become allergic to laboratory animals develop the condition in a mild form during their first year of employment but it appears probable that atopic individuals, although having an equal chance of developing allergy as compared with non-atopic individuals, may eventually progress to a more severe form of the disease.     

Oligonucleotide fingerprint analyses of influenza C virion RNA recovered from five different isolates

Summary Five different isolates of influenza C virus which were isolated over a period of 32 years and from four different continents were compared by RNA genome oligonucleotide fingerprinting analyses. The earliest isolate of influenza C virus was reported in 1949 byTaylor (19) and served as a reference strain for this study.The results obtained using this technique of comparing relatedness between viruses clearly showed that all strains are distinct. However, the similarities in the pattern of the oligonucleotide fingerprints are marked for the more recent virus isolates (1966–1979), whereas the reference strain C/Taylor shows more pronounced differences.The results are consistant with the high degree of serological crossreaction amongst influenza C viruses isolated over a long period of time, a property which sets this group of viruses apart from type A and B members of the orthomyxoviridae.With 3 Figures     

Altered modulation of prefrontal and subcortical brain activity in newly diagnosed schizophrenia and schizophreniform disorder. A regional cerebral blood flow study.

To measure prefrontal and subcortical activity during a cognitive task, we examined 19 newly diagnosed schizophrenics and patients with schizophreniform psychosis. Seven healthy volunteers served as controls. The patients were drug naive or had received neuroleptics for a few days only. Cerebral blood flow distribution was depicted by single photon emission computed tomography at rest and during activation with the Wisconsin Card Sorting Test. A significant relative activation deficit in the left inferior-prefrontal region was revealed during the Wisconsin Card Sorting Test in the patient group. Furthermore, the patients had impaired striatal suppression on the left side during the cognitive task. The test performance was significantly impaired in the patients. The inability to reduce striatal activity may be due to a lack of corticostriatal feedback during prefrontal activation.     

Morphological and biochemical studies of a mouse mutant (fro/fro) with bone fragility.

The mutation fragilitas ossium (fro) was discovered in a random-bred stock of mice during an experiment aimed at detecting recessive lethal mutations after treatment of the postmeiotic germ cells of male mice with tris (1-aziridinyl)phosphine sulphide. The affected mice were moderately runted and had deformities in all four limbs. The radiological and histological findings indicate that the mutant is similar to human osteogenesis imperfecta. The ash content of long bones was lower in the mutant. A defect of type I collagen could not be detected. The electrophoretic patterns of alpha bands of type I and V collagen and CB derived peptides of type I collagen from bone and skin showed no abnormalities. The total collagen synthesis and secretion in cultures of dermal fibroblasts, as well as the gel electrophoresis of procollagen and collagen chains synthesized, and of their CB peptides, were the same as those found in the controls. The percentage of type I and type V collagen synthesized was similar; that of type III was lower in the mutants. Bone osteonectin was found to be decreased by 30% and bone sialoprotein by 5%. The mRNA level for osteonectin was decreased in the fibroblasts of the mutant by about 50%. Whether the defective expression of the osteonectin in fro/fro mice is due to a mutation in the gene itself or its regulatory site(s), or is secondary to other factors remains to be established. The fro/fro mouse may represent a model for some forms of human bone fragility without collagen abnormalities.     

Activation of glucocorticoid receptors and the effect of naloxone during hemorrhagic hypotension.

Evidence indicates that endogenous opioid peptides and glucocorticoids participate in the control of cardiovascular regulation during hemorrhagic shock. In the present study, we investigated a possible interaction between brain opioid peptides and adrenal corticosteroids regarding the control of arterial pressure during hemorrhage. The bleeding volumes required to lower arterial pressure to 80, 60 and 40 mmHg were studied in anesthetized sham-operated (SHAM) and adrenalectomized (ADX) rats. I.c.v. administration of 10 micrograms of naloxone resulted in a significant increase in the bleeding volume required to lower arterial pressure from 60 to 40 mmHg in SHAM animals, whereas no effect of naloxone was observed in ADX animals. Replacement therapy with a 100% corticosterone pellet (100 mg, s.c.), but not with a 12.5% corticosterone pellet (12.5 mg corticosterone and 87.5 mg cholesterol, s.c.), resulted in an effect of naloxone on the bleeding volume in ADX animals. The effect of replacement therapy could be inhibited by i.c.v. pretreatment with the synthetic glucocorticoid receptor antagonist, RU38486 (100 ng). These data suggest that (1) opioid mechanisms are involved in the regulation of blood pressure during hemorrhage, and (2) occupancy of glucocorticoid receptors is required for naloxone to exert its hemodynamic effect during hemorrhagic hypotension in ADX rats.     

Inpatient treatment of children with multiple personality/dissociative disorders and their families

A number of children who are admitted for inpatient psychiatric treatment have experienced significant trauma and abuse. It is important to evaluate them for the presence of a DD. The variety, complexity, and subtlety of the symptomatic presentation of childhood MPD makes differential diagnosis difficult, and it is probable that many cases have been missed in the past. Detailed historical information and extensive behavioral observations in a variety of settings can assist in establishing the diagnosis and in delineating areas for therapeutic intervention. Hospitalization may be necessary to conduct an adequate evaluation, develop a therapeutic alliance, safely manage behaviors that are injurious to the child or others, and/or to diffuse potentially volatile family situations. All members of a multidisciplinary inpatient team play important roles in the achievement of successful therapeutic intervention with dissociating children and their families. Skilled family therapy is often an important adjunct to therapeutic interventions focused on the child, particularly when the parent also has MPD. Knowledge of the psychodynamic issues involved in dissociation can be used to develop behavioral interventions that are successful in decreasing the child's need to dissociate, improving his or her overall functioning, and help him or her gain mastery over problematic behaviors.