Direct identification of Yersinia enterocolitica in blood by polymerase chain reaction amplification

Primers based on the nucleotide sequence of the virF gene in the pYV plasmid and the chromosomal ail gene were used in polymerase chain reaction (PCR) amplifications to directly identify Yersinia enterocolitica in blood. Approximately 500 bacteria seeded into 100 microL of blood can be extracted and amplified by PCR to yield positive results. PCR analyses of seven Y. enterocolitica isolates previously implicated in blood contaminations showed that only one isolate harbored the plasmid-borne virF gene; however, all seven isolates were identified effectively by the PCR product amplified from the chromosomal gene. The PCR assay has the potential for use in the identification of Y. enterocolitica contamination in stored units of blood or in the rapid diagnosis of transfusion-related bacteremia caused by Y.     

2,3-吲哚醌在大鼠体内的药代动力学研究

目的考察单次静脉注射和口服给予大鼠2,3-吲哚醌后的药代动力学,为该药的新药开发提供依据。方法大鼠给药后经眼眶静脉采大约0.25 ml血液,采集时间点为：给予受试物前（0hr）和给予受试物后5 min,15min,30 min,1 h,2 h,4 h,6 h,8 h和24 h。血液样本采集后置于冰上,并立即取出50μl全血采用甲醇蛋白沉淀进行预处理,奎硫平作为内标。预处理后样品采用LC/MS/MS法进行测定,并用药动学处理软件WinNonlin 5.2采用非房室模型计算相关药代动力学参数。结果 Sprague Dawley大鼠静脉注射和口服两种制剂的药动学参数（平均值±标准偏差）如下。静脉注射：Tmax为0.83±0.29 hr,Cmax为141.53±10.99μg/L,T1/2为1.68±0.84 hr,AUC0-t为1068.15±389.06μg.hr/L,AUC0-∞为1211.19±469.18μg.hr/L,Vz为4.13±1.41 L/kg,CLz为1.89±0.94 L/hr/kg;口服：Tmax为0.05±0.00 hr,Cmax为1725.53±469.70 ng/ml,t 1/2为4.21±2.78 hr,AUC0-t为7711.21±2533.12μg.hr/L,AUC0-∞为7986.07±2623.38μg.hr/L,以AUC0-t计算,生物利用度平均为57.75±18.97%。结论 2,3-吲哚醌大鼠体内消除较快,可能存在非线性消除,口服吸收较好。     

Juvenile chronic myelogenous leukemia and dermal histiocytosis. In Von Recklinghausen's disease.

A 4-year-old boy with multiple café-au-lait spots and a family history of neurofibromatosis had generalized edema, histiocytic rash characterized by benign histiocytic infiltration, hepatomegaly, and life-threatening infection. Six months later, progessive splenomegaly led to juvenile chronic myelocytic leukemia that eventually proved fata. The case represents an important association of diseases.     

老年性痴呆与血管性痴呆患者睡眠障碍的对照研究

目的:研究老年性痴呆(AD)和血管性痴呆(VD)患者睡眠障碍的特点及相关性。方法:对31例AD患者和30例VD患者采用阿森斯(Athens)失眠量表调查评分及临床资料比较分析。对研究对象进行筛选分组。从8个方面详细记录睡眠情况,按量表现规定进行评定。结果:AD患者和VD患者总体睡眠状况比较有显著性差异(t=2.251,P<0.05)。睡眠状况各因子比较,在总睡眠质量、白天情绪、白天思睡等3个方面无显著性差异(P>0.05)。在早醒、白天身体功能方面,两者有极显著差异(P<0.01)。在入睡时间、夜间苏醒、总睡眠时间等两者存在显著性差异(P<0.05)。结论:AD患者和VD患者都有睡眠障碍,AD患者在早醒、白天身体功能、夜间苏醒、总睡眠时间等方面都比VD患者差,而VD患者在入睡时间上比AD患者明显延迟。     

Evaluation of the detection of PML-RARα fusion gene in acute promyelocytic leukemia to monitor minimal residual disease

Objective To investigate the kinetics of PML-RARα fusion gene in acute promyelocytic leukemia(APL)to monitor minimal residual disease(MRD). Methods In induction therapy,consolidation and maintenance therapy courses, PML-RARα fusion gene was performed by RT-PCR. Results The long-term follow-up of 18 cases achieved complete remission (CR),two cases experienced molecular relapse. One case relapsed at 4 months after CR1 and achieved CR2 after induction therapy. However, molecular and hematology relapsed again at 2 months after CR2 and re-achieved CR3. The other case relapsed at 74 months after CR1 and achieved CR2 after induction treatment, who had survived for 106 months until the end of follow-up. Conclusion RT-PCR assay for detection of PML-RARα should be performed regularly during CR period so as to find molecular relapse eady. Hematological relapse could potentially be averted through treatment modification according to molecular monitoring results of PML-RARα.     

Effects of serotonin 5-HT1A agonist in advanced Parkinson's disease.

Intermittent stimulation of striatal dopaminergic receptors seems to contribute to motor dysfunction in advanced Parkinson's disease (PD). With severe dopaminergic denervation, exogenous levodopa is largely decarboxylated to dopamine in serotonergic terminals. If 5-HT1A autoreceptors regulate dopamine as well as serotonin release, in parkinsonian patients inhibition of striatal serotonergic neuron firing might help maintain more physiological intrasynaptic dopamine concentrations and thus ameliorate motor fluctuations and dyskinesias. To evaluate this hypothesis, effects of a selective 5-HT1A agonist, sarizotan, given orally at 2 and 5 mg twice daily to 18 relatively advanced parkinsonian patients, were compared with baseline placebo function during a 3-week, double-blind, placebo-controlled, proof-of-concept study. Sarizotan alone or with intravenous levodopa had no effect on parkinsonian severity. But at safe and tolerable doses, sarizotan coadministration reduced levodopa-induced dyskinesias and prolonged its antiparkinsonian response (P < or = 0.05). Under the conditions of this study, our findings suggest that 5-HT1A receptor stimulation in levodopa-treated parkinsonian patients can modulate striatal dopaminergic function and that 5-HT1A agonists may be useful as levodopa adjuvants in the treatment of PD.     

Effect of monoamine reuptake inhibitor NS 2330 in advanced Parkinson's disease.

Dopamine reuptake blockers, by enhancing and stabilizing intrasynaptic transmitter levels, could help palliate motor dysfunction in Parkinson's disease. This randomized, double-blind, placebo-controlled study compared the acute effects of the monoamine uptake inhibitor NS 2330 to those of placebo in 9 relatively advanced parkinsonian patients. At the dose administered, no change in parkinsonian scores was found when NS 2330 was given alone or with levodopa. Moreover, NS 2330 coadministration did not appear to alter dyskinesia severity or the duration of the antiparkinsonian response to levodopa. The drug was well tolerated. Under the conditions of this study, the present results failed to support the usefulness of dopamine reuptake inhibition in the treatment of advanced Parkinson's disease.     

3-O-methyldopa and motor fluctuations in Parkinson's disease

High plasma levels of 3-O-methyldopa (OMD) were found in parkinsonian patients chronically treated with levodopa, particularly in those with on-off phenomenon. However, no relation could be established between circulating levels of the levodopa metabolite and the presence of motor response fluctuations at any stage of disease. It appears unlikely that plasma OMD accumulation contributes to the pathogenesis of wearing-off or on-off responses.     

The trouble with family medicine

BACKGROUND: The trouble with family medicine is that the perceptual framework it uses to view the phenomena of health and illness is at variance with the frameworks traditionally used by medicine generally. This creates difficulties in communication between those in family medicine and those in other disciplines, and sometimes leads to misunderstanding of the nature of the discipline of family medicine and its place in the health care system. Those who practise family medicine need to be 'multilingual', able to understand and speak the language and use the metaphors of family medicine, yet equally able to use the language and metaphors of other disciplines. OBJECTIVES: This paper, which begins with a clinical scenario, reviews the contemporary biomedical paradigm, proposes an alternative, and examines the conceptual frameworks which underpin the discipline of family medicine.