中风病急性期痰热证与MMP-1和MMP-3表达的影响＊

目的 研究缺血性中风病急性期痰热证与MMP-1和MMP-3表达的相关性，其相关性研究能否形成微观辨证的依据。方法 筛选发病7天内就诊于中国中医科学院西苑医院的缺血性中风痰热证患者45名，非痰热证44名，对每例患者分别作出痰湿证、气虚证、血瘀证、内风证、阴虚证和内火证的量化诊断，并用ELISA法检测血清中MMP1和MMP-3的含量。结果 痰热证组和非痰热证组MMP-1和MMP-3的表达均无明显差异。结论 MMP-1和MMP-3不能作为痰热证的微观指标，需进一步寻找微观指标对中风病痰热证证候诊断及疗效评价提供更加客观支持。     

Prevalence of heterophoria in a population of school children in central China:the Anyang Childhood Eye Study

AIM:To investigate the prevalence of heterophoria and the relationship between heterophoria and refractive error in a school-based study conducted in central China.METHODS:A total of 23637 th-grade children were recruited into the cross-sectional school-based Anyang Childhood Eye Study(ACES)by cluster sampling method.Heterophoria was examined using alternate cover and cover-uncover testing.The Maddox rod and prism test were conducted at 33 cm and 6 m distance fixation.Uncorrected viual acuity(UCVA)and best-corrected viual acuity(BCVA)were recorded as logarithm of the minimum angle of resolution(logM AR)with cycloplegic autorefraction by administrating of Mydrin-P and 1.0%cyclopentolate.Hyperopia was defined as the spherical equivalent(SE)refraction of+0.50 D or greater,and higher hyperopia was defined as+2.00 D or greater.Emmetropia was defined as the SE refraction in the range of-0.49 to+0.49 D,and myopia was in the SE refraction range from-0.50 D to less.RESULTS:Totally 2260 students in grade 7 were examined.Response rate among eligible children was 95.64%.Totally 486 children,22.66%of the population,were diagnosed with heterophoria in which 479 were diagnosed with exophoria at near distance,and 6 with esophoria.Totally 89(4.15%)children were diagnosed with heterophoria in which 82 had exophoria,and 7 had esophoria at far distance.Exophoria was common at near fixation(22.33%).Myopia was examined to be related to exophoria at near distance(OR 3.03,95%CI 2.33-3.95)and far distance fixation(OR 1.90,95%CI 1.09-3.32).CONCLUSION:Exophoria is a predominant heterophoria for 7 th-grade junior school in central China.Significant associations are discovered between heterophoria and refractive error.Hyperopia is associated with esophoria,and myopia is associated with exophoria.     

用金角径向星堆VIBE序列对胃癌进行自由呼吸动态增强MR成像的可行性:与常规对比增强三维容积插值屏气检查(3D-VIBE)序列的比较

目的探讨自由呼吸、金角径向、星堆三维(3D)梯度回波(GRE)序列对胃癌动态增强(DCE)MRI的可行性和诊断价值。方法 43例胃癌病人被分为合作组和不合作组。采用腹式呼吸门控传感器观察呼吸波动。将屏住呼吸超过15 s的病人纳入合作组,其余纳入不合作组。3 T MRI扫描协议包括3D GRE和常规屏气容积内插屏气扫描(VIBE)序列,将影像进行定量和定性比较。比较正常胃壁和恶性病变的VIBE影像的DCE-MRI参数。结果对于不合作的病人,3D GRE定性评分较高,且比传统VIBE具有更高的信噪比和对比噪声比。虽然与合作病人的常规VIBE相比,3D GRE影像在定性参数方面得分较低,但其影像伪影也较少。DCE参数在正常胃壁和病变之间差异有统计学意义,胃癌中ve较高,kep较低。结论对于胃癌的DCE-MRI,自由呼吸、金角、径向、星堆3D GRE技术是可行的,动态增强影像可用于定量分析这种恶性肿瘤。     

Early colon cancers detected by FDG-pet: a report of two cases with immunohistochemical investigation

Increased glucose uptake is one of the metabolic characteristics of tumor cells. 18F-fluorodeoxyglucose (FDG)-positron emission tomography (FDG-PET), a technique that is used widely to study this altered glucose metabolism in tumors, allows the detection of various types of malignancy. We present herein two cases of early colon cancers detected incidentally by FDG-PET. The technique was used as part of the screening examinations for preoperative staging, and for postoperative follow-up. In both cases, the lesions were removed by colonoscopic polypectomy, with no complications. Moreover, we confirmed the existence of altered glucose metabolism in the resected specimen by immunohistochemical staining using an antibody raised against Glut1. Immunohistochemically, Glut1 was expressed in vitro in both of the lesions, supporting the positive FDG-PET result obtained in vivo. To our knowledge, this is the first report to describe in vitro Glut1 expression and in vivo tumor detection using FDG-PET in colorectal carcinoma.     

Increased risk of myocardial infarction with duration of protease inhibitor therapy in HIV-infected men

BACKGROUND: In the current context of dyslipidaema, hyperglycaema and lipodystrophia observed among HIV-seropositive subjects, it is important to study the risk of myocardial infarction (MI) in this population. The French Hospital Database on HIV, which includes a large number of seropositive subjects followed for substantial periods, offers the opportunity to analyse the impact of protease inhibitors (PI) on the risk of MI among men. METHODS: Cox model was used to study the risk factors of MI occurrence. Standardized morbidity ratios (SMR) in men exposed to PI were calculated with data from the French general male population (FGMP) of the same age as reference. RESULTS: Between 1996 and 1999, MI was diagnosed in 60 men among 88 029 person-years (PY), including 49 cases among men exposed to PI. In the Cox model, exposure to PI was associated with a higher risk of MI [relative hazard (RH), 2.56; 95% confidence interval (CI), 1.03-6.34]. The expected incidence in the FGMP was 10.8/10,000 PY. The SMR relative to the FGMP was 0.8 (95% CI, 0.5-1.3) for men exposed to PI for < 18 months (G1), 1.5 (95% CI, 0.8-2.5) for men exposed for 18-29 months (G2) and 2.9 (95% CI, 1.5-5.0) for men exposed for >or= 30 months (G3). With G1 as reference, the SMR was 1.9 (95% CI, 1.0-3.1) for G2 and 3.6 (95% CI, 1.8-6.2) for G3. CONCLUSION: Our results point to a duration-related effect relationship between PI and MI, with a higher MI incidence rate among men exposed to PI for 18 months or more.     

Improved outcome for children with acute lymphoblastic leukemia: results of Total Therapy Study XIIIB at St Jude Children's Research Hospital

St Jude Total Therapy Study XIIIB for childhood acute lymphoblastic leukemia (ALL) incorporated more stringent risk classification, early intensification of intrathecal chemotherapy, reinduction treatment, and the addition of dexamethasone to postremission therapy to increase the proportion of event-free survivors without jeopardizing their quality of life. Cranial irradiation was reserved for the 12% of patients who had T-cell ALL and a presenting leukocyte count of 100 x 10(9)/L or more, or CNS-3 (5 or more leukocytes/microL with identifiable blast cells in an atraumatic sample or the presence of cranial nerve palsy) status. Among the 247 consecutive patients enrolled in the study, 117 were classified as having lower-risk leukemia and received mainly antimetabolite-based continuation therapy; the 130 cases with higher-risk leukemia received more intensive continuation chemotherapy with multiple drug pairs administered in weekly rotation. The 5-year event-free survival estimate was 80.8% +/- 2.6% (SE); the 8-year rate was 78.6% +/- 5.8%. The 5-year cumulative risk of an isolated central nervous system (CNS) relapse was 1.7% +/- 0.8%, and that of isolated plus combined CNS relapse was 3.0% +/- 1.1%. The 5-year cumulative risks of etoposide-related myeloid malignancies were 1.8% +/- 1.3% in the lower-risk patients who received a cumulative dose of 1.2 g/m(2) and 5.0% +/- 2.0% in the higher-risk patients who received a cumulative dose of up to 14.4 g/m(2) (P = .18). Independent adverse prognostic features included the presence of MLL-AF4 or BCR-ABL fusion gene and minimal residual leukemia of 0.01% or more at the end of the 6-week remission induction phase. Our results suggest the efficacy of early intensification of intrathecal chemotherapy and provide the basis for studies omitting cranial irradiation altogether.     

Variants of calpain-10 gene and its association with type 2 diabetes mellitus in a Chinese population

Variants of calpain-10 gene (CAPN 10) have recently been reported to be associated with type 2 diabetes (T2DM). Haplotype combination 112/121 defined by three single nucleotide polymorphisms (SNPs) (UCSNP-43, -19 and -63) of CAPN 10 conferred the highest risk for T2DM in Mexican-Americans. In this study, we aim to examine whether these genetic variants contribute to the susceptibility for T2DM in a Chinese population. The frequencies of these three SNPs were determined in 168 patients with T2DM and 104 controls. Distribution of alleles, genotypes and haplotypes at three loci were not significantly different between the two groups. No difference was observed in the 112/121 haplotype combination distribution. However, haplotype combination 112/221 was more prevalent in the control group than in T2DM group (16.35% versus 7.14%, p = 0.025). Control subjects with haplotype combination 112/121 had higher serum cholesterol level than others without haplotype combination 112/121 (5.7 +/- 1.4 versus 5.2 +/- 0.7, p = 0.011). Our results suggest that haplotype combination 112/221 associated with reduced risk for T2DM and haplotype combination 112/121 might be a risk factor for increased serum cholesterol in Chinese population.     

Vitreous substitutes:challenges and directions

Thenatural vitreous body has a fine structure and complex functions. The imitation of the natural vitreous body by vitreous substitutes is a challenging work for both researchers and ophthalmologists. Gases, silicone oil, heavy silicone oil and hydrogels, particularly the former two vitreous substitutes are clinically widely used with certain complications. Those, however, are not real artificial vitreous due to lack of structure and function like the natural vitreous body. This article reviews the situations, challenges, and future directions in the development of vitreous substitutes, particularly the experimental and clinical use of a new artificial foldable capsular vitreous body .     

Effects of 530 nm monochromatic light on basic fibroblast growth factor and transforming growth factor-β1 expression in Müller cells

AIM: To expose rat retinal Müller cells to 530 nm monochromatic light and investigate the influence of varying light illumination times on basic fibroblast growth factor (bFGF) and transforming growth factor-β1 (TGF-β1) expression.METHODS: Three groups of rat retinal Müller cells cultured in vitro under a 530 nm monochromatic light were divided into 6, 12 and 24h experimental groups , while cells incubated under dark conditions served as the control group. The bFGF and TGF-β1 mRNA expression, protein levels and fluorescence intensity of the Müller cells were analyzed.RESULTS:ThebFGF mRNA expression and protein levels were significantly upregulated in Müller cells in all three experimental groups compared with the control group (P<0.05), while that of TGF-β1 was downregulated (P<0.05). Also, bFGF expression was positively correlated, but TGF-β1 expression was negatively correlated with illumination time. The largest changes for both cytokines were seen in the 24h group. The changes in bFGF and TGF-β1 fluorescence intensity were highest in the 24h group, and significant differences were observed among the experimental groups (P<0.05).CONCLUSION:The expressions ofbFGF and TGF-β1 changed in a time-dependent manner in Müller cells exposed to 530 nm monochromatic light with 250 lx illumination intensity. Müller cells might play a role in the development of myopia by increasing bFGF expression or decreasing TGF-β1 expression. Changes in cytokine expression in retinal Müller cells may affect monochromatic light-induced myopia.