新疆地区肾棘球蚴病的多中心诊治经验

目的 提高肾棘球蚴病的诊断及外科治疗效果. 方法 回顾性分析1985年2月至2010年4月新疆医科大学第一附属医院、自治区人民医院和伊犁州友谊医院泌尿外科86例肾棘球蚴病患者资料.男59例,女27例.年龄3～59岁,平均38岁.病变位于右肾48例,左肾38例.单纯肾棘球蚴病60例,并发肝、肺等其他脏器棘球蚴病者26例.病程1个月～5年,平均2.5年. 结果 B超、CT和包虫试验检查诊断符合率分别为88％(76例)、81％(70例)、85％(73例).B超显示圆形或类圆形液性暗区,单发病灶,部分内含多个大小不等的圆形暗区及光环,形成囊中子囊征象,较大的类圆形病灶中出现“双壁征”,部分出现外囊壁钙化强回声光带.CT表现为圆形或类圆形囊性单发包块,其内有大小不一的子囊影,囊内CT值15 ～25HU,注入造影剂后囊内容物不增强.经手术治疗85例,其中包虫内囊摘除39例,穿刺抽液后内囊摘除者14例,肾部分切除术15例,外囊完整摘除术5例,肾切除者12例.随访53例,随访时间2～15年,平均7年,复发7例. 结论 B超、CT、免疫学检查是诊断肾棘球蚴病的主要方法,手术治疗仍是棘球蚴病的主要治疗方法,根据残余肾功能、包虫囊大小、数目、位置确定手术方案,肾包虫完整外囊摘除术是最理想的手术方式.     

Exacerbation of paraneoplastic pemphigus by cyclophosphamide treatment: detection of novel autoantigens and bronchial autoantibodies

A 48-year-old woman with a follicular, grade III, B-cell non-Hodgkin lymphoma developed clinical, immunopathological and histological features of paraneoplastic pemphigus. The skin symptoms flared after repeated cyclophosphamide infusions, and were preceded and accompanied by a progressive dyspnoea. Although the skin and oral mucosal disease went into remission with high-dose steroid and intravenous immunoglobulin therapy, the severe alveolitis led to death. Immunoblotting of human epidermal extracts showed that the patient's serum IgG reacted with the 210-kDa envoplakin, 190-kDa periplakin, as well as the recombinant protein of BP180 NC16a domain. IgG and IgA enzyme-linked immunosorbent assays for desmoglein 3 were positive, too. Indirect immunofluorescence studies on COS-7 cells transiently transfected with desmocollin 1-3 cDNAs showed that the patient's serum contained IgG and IgA antibodies to desmocollin 3 as well as IgG antibodies to desmocollin 2. Serum IgG and IgA strongly stained rat bronchial epithelium, corresponding to autoantibodies possibly involved in the pathomechanism of the severe lung disease. In this case, which was characterized by a mixed IgA/IgG antibody panel displaying known and unique antigenicity, the serious episodes of paraneoplastic pemphigus flared after cyclophosphamide treatment.     

Identification of desmoglein 1 as autoantigen in a patient with intraepidermal neutrophilic IgA dermatosis type of IgA pemphigus

In a 51-year-old female patient with intraepidermal neutrophilic IgA dermatosis (IEN) type of IgA pemphigus, circulating IgA, but not IgG, autoantibodies were detected to bind to the cell surface of the whole epidermis, being much stronger in the upper epidermis. In the patient's skin a heavy intraepidermal IgA staining was observed throughout the whole epidermis, accompanied by a weak IgG and a more prominent C3 staining. IgA from the patient's serum showed no reactivity either with epidermal proteins by immunoblot analysis, or with COS 7 cells transiently transfected with mammalian cell expression constructs containing full length human Dsc1, Dsc2 and Dsc3. Our patient's IgA specifically reacted with conformational epitopes of human desmoglein (Dsg) 1 but not Dsg 3, when studied in a previously established, here for IgA antibody detection modified enzyme-linked immunoabsorbent assay (ELISA) of baculovirus expression system. The immunoreactivity against keratinocyte cell surface was completely removed from the serum of the patient by pre-incubation with recombinant Dsg1 baculoprotein. This finding indicates that the sera possess only IgA antibodies against the extracellular domain of Dsg1 baculoprotein, but no antibodies against components of keratinocyte cell surface other than Dsg1. This is the first case of IgA pemphigus where Dsg1 has been identified as the autoantigen.     

Role of slow delayed rectifier K+-current in QT prolongation in the alloxan-induced diabetic rabbit heart

Aim: In diabetes mellitus, several cardiac electrophysiological parameters are known to be affected. In rodent experimental diabetes models, changes in these parameters were reported, but only limited relevant information is available in other species, having cardiac electrophysiological properties more resembling the human, including the rabbit. The present study was designed to analyse the effects of experimental type 1 diabetes on ventricular repolarization and the underlying transmembrane potassium currents in rabbit hearts. Methods: Diabetes was induced by a single injection of alloxan (145 mg kg⁻¹ i.v.). After the development of diabetes (3 weeks), electrophysiological studies were performed using whole cell voltage clamp and ECG measurements. Results: The QT_c interval in diabetic rabbits was moderately but statistically significantly longer than measured in the control animals (155 ± 1.8 ms vs. 145 ± 2.8 ms, respectively, n = 9–10, P < 0.05). This QT_c-lengthening effect of diabetes was accompanied by a significant reduction in the density of the slow delayed rectifier K⁺ current, I_Ks (from 1.48 ± 0.35 to 0.86 ± 0.17 pA pF⁻¹ at +50 mV, n = 19–21, P < 0.05) without changes in current kinetics. No differences were observed either in the density or in the kinetics of the inward rectifier K⁺ current (I_K1), the rapid delayed rectifier K⁺ current (I_Kr), the transient outward current (I_to) and the L-type calcium current (I_CaL) between the control and alloxan-treated rabbits. Conclusion: It is concluded that type 1 diabetes mellitus, although only moderately, lengthens ventricular repolarization. Diabetes attenuates the repolarization reserve by decreasing the density of I_Ks current, and thereby may enhance the risk of sudden cardiac death.     

Relevance of anxiety in the perinatal period: prospective study in a Hungarian sample

There is increasing evidence that anxiety occurs frequently during pregnancy and can be one of the most important risk factors and predictors of postpartum depression (PPD). The aim of our study was to investigate whether antenatal anxiety is an independent predictor of PPD. We used the data of 476 women enrolled in a prospective study in a single maternity unit. The first assessment was conducted between 22 and 40 weeks gestation and a second time 8–12 months postpartum. Symptoms were measured using the Edinburgh Postnatal Depression Scale (EPDS) and the State Trait Anxiety Inventory (STAI). Based on our results, antenatal anxiety measured by a subscale of EPDS has predicted better PPD than the antenatal depressive subscale. However, the most relevant predictor of PPD might be the trait anxiety level of a women measured by STAI Trait Scale, whereas a cutoff value of 38 was identified to indicate higher risk of PPD.     

不同品种和产地黄连的总生物碱含量测定

目的：评价不同产地和品种的黄连药材的内在质量。方法：以总生物碱含量作为评价黄连内在质量的主要指标,以紫外分光光度法测定不同品种和产地的黄连的总生物碱含量。结果：7个样品黄连总生物碱的含量为5．80％－9．31％,其中云[连含量最高,味连（南岸连）含量最低。结论：品种不同其含量不同,而同品种不同产地其含量也是不同的。     

中维医结合治疗艾滋病临床观察

目的:通过中维医结合治疗,观察中维药合用对艾滋病患者的临床治疗作用。方法:采用自身前后对照,纳入艾滋病患者64例,辨证给予自拟中药方平艾合剂1-4号方及维药强力玛得土力阿亚特蜜膏,采用中医症状、体征积分结合实验室检查结果判断疗效。结果:共有42例患者完成了临床观察。在治疗结束后,患者症状、体征积分的变化与治疗前相比均有所下降,其差异有统计学意义;在治疗过程中未发现不良反应。结论:中维医结合治疗具有良好的治疗效果,可以为艾滋病的治疗提供治疗思路。     

铅对大鼠海马一氧化氮合酶和一氧化氮的影响

目的 探讨慢性染铅过程中，大鼠海马一氧化氮合酶（NOS）、一氧化氮（NO）的变化。方法 Wistar大鼠经饮水加0，18．4，184．0mg/L醋酸铅（PbAc)方法染毒。海马NOS活性测定采用NOS催化L－Arg和氧分子生成NO法，海马NO（NO3^- NO2^-)浓度采用硝酸还原酶法。结果 与对照组相比，高剂量染铅组海马NOS活性在早期（7d）显著升高（P＜0．05），30d后显著低于对照组（P＜0．05）。低剂量组大鼠海马NOS活性第7天开始有增高趋势，但差异无显著性，直到60d后显著低于对照组（P＜0．05）。低剂量染铅组大鼠海马NO含量90d时明显低于对照组（P＜0．05）。高剂量组大鼠海马NO含量在60d后显著低于对照组（P＜0．05）。结论 铅可导致海马NOS活性降低，NO含量降低。NOS活性降低及NO含量减少，可能是铅对海马产生神经毒作用的机制。     

Brominated sesquiterpenes from the red alga Laurencia obtusa

Four new sesquiterpenes, (8R)-8-bromo-10-epi-beta-snyderol (1), (8S)-8-bromo-beta-snyderol (2), 5-bromo-3-(3'-hydroxy-3'-methylpent-4'-enylidene)-2,4,4-trimethylcyclohexanone (3), and the epoxide 4, have been isolated from the chloroform-methanol extract of Laurencia obtusa, together with the three known compounds alpha-snyderol (5), alpha-snyderol acetate (6), and stigmasterol. The structures of the isolated compounds were elucidated through spectroscopic analyses. Compound 1 showed antimalarial activity, with IC(50) values of 2700 and 4000 ng/mL against the D6 and W2 clones of Plasmodium falciparum, respectively.