IMMUNOGENETICS OF GRAVES'' OPHTHALMOPATHY

We have performed an immunogenetic analysis of 53 patients with severe Graves' ophthalmopathy, 51 patients with Graves' disease but little or no clinically apparent eye disease, and 90 controls. The distribution of restriction fragment length polymorphisms was analysed in the three groups, using probes for the HLA-DQ alpha and DR beta regions, the T-cell receptor C alpha, V alpha, C beta and J gamma genes and the immunoglobulin gene switch regions, S alpha and S mu. There was no abnormal distribution of these polymorphisms in either group of Graves' patients, or differences between the Graves' patients with or without eye disease. It was possible to assign HLA-DR types in most patients using the polymorphisms found after probing with DQ alpha and DR beta; there was no abnormal distribution of DR types (including HLA-DR3) assigned by restriction fragment polymorphisms in the two Graves' groups. These results fail to confirm the reported associations between ophthalmopathy and HLA-DR3 and between Graves' disease and the T-cell receptor C beta polymorphism; they also argue against a strong influence of Gm allotypes in Graves' disease since these genes are in linkage disequilibrium with the S alpha polymorphisms. The association of Graves' disease with HLA-DR3, defined hitherto using serological reagents, may be less strong than previously described.     

Myxoma of the kidney

A 62-year-old man had a right renal mass incidentally diagnosed by ultrasonography. Magnetic resonance imaging revealed a well-defined right renal mass with homogenous low-signal intensity on the T(1)-weighted pulse sequence and heterogeneous high-signal intensity on the T(2)-weighted pulse sequence. A right nephrectomy was performed. The histological examination showed a myxoma, which is a very uncommon neoplasm in the kidney. Eight cases have been reported previously.     

乳腺癌患者癌因性疲乏与抑郁、焦虑情绪的调查

目的 探讨乳腺癌患者中癌因性疲乏与抑郁、焦虑情绪的发生情况及两者相关性。方法 分别采用Piper疲乏评估量表和HAD情绪测定量表,评价200例乳腺癌术后患者的癌因性疲乏与抑郁、焦虑情绪的状况,收集数据并分析。结果 在200例乳腺癌术后患者中,109例（54.5％）乳腺癌患者经历了不同程度的癌因性疲乏,整体疲乏评分为4.38±1.27。行为／严重性维度、情感维度、感觉维度、认知／情绪维度评分分别为3.73±1.67、5.06±1.84、 4.39±1.60和4.38±1.35。在各维度中,评分最高的条目分别为“疲乏对性生活的影响”、 “疲乏令自己不愉快的程度”、“感到身体虚弱”和“感到无记性的程度”。109例癌因性疲乏的患者中合并焦虑情绪者34例（31.2%）,合并抑郁情绪者45例（41.3%）,癌因性疲乏同时合并抑郁、焦虑者27例（24.8%）。存在癌因性疲乏的患者中焦虑、抑郁发病比例明显高于无癌因性疲乏患者（P＜0.001）,存在焦虑、抑郁的患者与不存在焦虑或抑郁情绪的患者在癌因性疲乏各维度评分有显著差异（P＜0.05）。结论 乳腺癌术后患者癌因性疲乏的发生率较高,疲乏水平属轻、中度,焦虑、抑郁情绪与其密切相关,癌因性疲乏的病因、治疗方法有待进一步研究。