霍奇金淋巴瘤组织中H／RS细胞与其背景细胞的微切割及其IgH基因重排检测

目的 从基因水平探讨霍奇金淋巴瘤(HL)组织中H／RS细胞(Hodgkin and Reed-Sternberg cells)是否起源于B细胞、H／RS细胞的克隆性以及与背景淋巴细胞的相互关系。方法 对33例经典霍奇金淋巴瘤(cHL)石蜡刮片组织进行IgH基因重排分析，并对其中6例重排阳性的病例经B细胞特异性激活蛋白(BSAP)免疫标记，将标记阳性的H／RS细胞和背景淋巴细胞进行微切割后进一步行IgH基因重排分析。结果 16例石蜡刮片组织IgH基因重排阳性。对6例经BSAP标记的cHL成功进行了微切割，其中19管H／RS细胞中，有14管出现重排阳性，细胞数目不同的各管阳性率无显著性差异(P=0．290)；12管背景淋巴细胞有2管出现重排阳性，H／RS细胞与背景淋巴细胞的阳性率有显著性差异(P=0．002)。结论 支持H／RS细胞来源于B细胞的理论，认为部分背景淋巴细胞可能具有瘤性增生活性，参与H／RS细胞的前体细胞组成。     

The CLDN5 locus may be involved in the vulnerability to schizophrenia.

The present study was designed to detect three single nucleotide polymorphisms (SNPs) located on 22q11 that was thought as being of particularly importance for genetic research into schizophrenia. We recruited a total of 176 Chinese family trios of Han descent, consisting of mothers, fathers and affected offspring with schizophrenia for the genetic analysis. The transmission disequilibrium test (TDT) showed that of three SNPs, rs10314 in the 3'-untranslated region of the CLDN5 locus was associated with schizophrenia (chi(2) = 4.75, P = 0.029). The other two SNPs, rs1548359 present in the CDC45L locus centromeric of rs10314 and rs739371 in the 5'-flanking region of the CLDN5 locus, did not show such an association. The global chi-square (chi(2)) test showed that the 3-SNP haplotype system was not associated with schizophrenia although the 1-df test for individual haplotypes showed that the rs1548359(C)-rs10314(G)-rs739371(C) haplotype was excessively non-transmitted (chi(2) = 5.32, P = 0.02). Because the claudin proteins are a major component for barrier-forming tight junctions that could play a crucial role in response to changing natural, physiological and pathological conditions, the CLDN5 association with schizophrenia may be an important clue leading to look into a meeting point of genetic and environmental factors.     

脑血管意外尿失禁的机制探讨

目的探讨脑血管意外引起尿失禁的可能机制。方法对42例诊断为脑血管意外伴有尿失禁的患者进行尿动力学检查(包括静止期尿道压测定、充盈期及排尿期膀胱尿道功能测定)并按Burney分类进行分析,同时研究病变部位、脑血管意外性质和病变半球侧与尿动力学的关系。结果42例脑血管意外患者中,表现为逼尿肌反射亢进者31例(73.8%):其中外括约肌无抑制性松弛19例(45.2%),逼尿肌-外括约肌不协调3例(7.1%),逼尿肌-外括约肌协调9例(21.4%);逼尿肌反射减低,外括约肌协调者11例(26.2%);无逼尿肌功能正常者。发生膀胱顺应性减低5例(11.9%),发生尿感缺失者11例(26.2%)。初感尿容量(140.00±46.97)ml;膀胱最大容量(293.20±60.71)ml;最大尿道闭合压(65.14±19.83)cmH2O。逼尿肌最大收缩力(Pdetmax)为(60.98±31.11)cmH2O;最大尿流率时逼尿肌压力(Pdet-Qmax)为(35.98±17.46)cmH2O;逼尿肌收缩时间(Tcon)为(86.07±36.09)sec;最大流量(Qmax)为(9.02±5.62)ml/s。中风后尿失禁患者其发病部位多见于基底节、皮层多灶以及额顶叶,脑出血与脑梗塞患者的尿动力学表现无明显差异,左右半球病变对尿动力学也无明显差异。结论脑血管意外后尿失禁的尿动力学异常主要为逼尿肌反射亢进,部分出现逼尿肌反射减弱,但感觉正常,感觉缺失者较少见;外括约肌功能以无抑制性松弛为主,其次为逼尿肌-外括约肌协调,少数出现不协调;较少出现膀胱顺应性降低。     

经直肠超声引导下经会阴125I粒子永久植入治疗前列腺癌的初步经验

目的探讨经直肠超声引导下经会阴125I粒子永久植入治疗前列腺癌的疗效和并发症。方法本组前列腺癌患者5例。年龄61￣83岁,平均70.4岁。临床分期T2bN0M0者2例,T3aN0M0者3例。Gleason评分6分者2例,7分者1例,8分者2例。术前前列腺特异性抗原(PSA)4.5￣17.5ng/ml。T3a期患者植入治疗前先行内分泌治疗。术前制定治疗计划,经直肠超声引导下经会阴125I粒子永久植入操作。术后观察PSA水平变化,连续3次PSA升高即为生化复发,观察术后尿路和直肠并发症发生情况。结果5例患者均术后恢复顺利。术后随访18个月,PSA均明显下降,PSA为0.1ng/ml者3例,0.01ng/ml者1例,0.04ng/m1者1例。5例患者术后均出现不同程度的尿路刺激症状,但6个月后逐渐好转。4例术后出现排便次数增多,术后3个月均好转。未发现尿失禁、直肠溃疡等并发症。结论经直肠超声引导下经会阴125I粒子永久植入治疗前列腺癌的疗效确切,创伤较小。     

Outcome in Children With Significantly Abnormal Cerebral Blood Flow Detected by Doppler Ultrasonography: Focus on the Survivors

BACKGROUND AND PURPOSE: The Doppler waveform patterns of loss of diastolic flow, appearance of retrograde diastolic flow, or no detectable flow in the cerebral arteries suggest significantly abnormal cerebral blood flow (CBF). A retrospective study was performed to show that significantly abnormal CBF alone, without clinical criteria, is not necessarily specific to brain death in the young pediatric population. PATIENTS AND METHODS: Forty-seven pediatric patients, from newborn to 4 years of age, were found to have significantly abnormal CBF, including 7 patients with loss of diastolic flow, 28 with retrograde diastolic flow, and 23 with no detectable cerebral flow on serial Doppler sonographic examinations. Their clinical data and sonographic results were collected and analyzed. RESULTS: Forty-two patients died, a few of whom had only transient improvement of cerebral flow. All of the patients with no detectable cerebral flow expired. Five patients survived with or without sequelae. Their underlying conditions that caused increased intracranial pressure were treated by medical and/or surgical intervention, and diastolic reversal of CBF corrected within 1 day in all 5. CONCLUSIONS: Although no detectable flow is a lethal sign, pediatric patients with loss or reversal of diastolic flow may survive with prompt and effective treatment. Using Doppler ultrasound to diagnose cerebral circulatory arrest should be done with caution in pediatric patients.     

两种MRI序列对听神经瘤成象的比较与评价

为选择中等场强的ＭＲＩ听神经瘤成像最佳序列。收集手术和病理证实的听神经瘤１３５例，分析序列Ⅰ、Ⅱ对内听道中心层面、三叉神经显示率及ＭＲ征象的显示情况。结果：序列Ｉ择内听道中心层面及三叉神经的显示均优于序列Ⅱ，序列Ⅱ在显示肿瘤内囊变、出血、不肿优于序列Ｉ；对肿瘤钙化、肿瘤血管、脑干移位的观察，两者相仿。结果显示：序列Ｉ在中等场经下作为听神经瘤成像的首选序列，并中运用到小脑角区ＭＲＩ成像。     

小包装全氟丙烷气体动力学实验研究

为检验塑料小包装全氟丙烷气体（C3F8）在不同包装和储存方法时浓度变化，将装有5～7mlC3F8的聚氯乙烯小袋，根据不同储藏温度和外包装方法随机分成四组：（1）22℃聚乙烯外包装，（2）36℃聚乙烯外包装，（3）22℃铝箔真空外包装，（4）-29℃聚乙烯外包装；每一组C3F8小袋气体存放一定时间后，应用气相色谱分析方法进行浓度测量。结果：第3组C3F8浓度最高和稳定，第2组浓度随放置时间降低最明显，第4组是临床应用气体的储藏和包装方法，其30天样本浓度和第3组相等，但放置一年时浓度降低。结果显示：塑料小包装C3F8予以铝箔真空外包装是一种可行的方法，利于C3F8运输和普及；聚乙烯外包装的C3F8，应放在-29℃保存，时间不超过一年。     

The epidemiology and surveillance of blood lead in Taiwan (R.O.C.): A report on the PRESS-BLL project

 To monitor the lead hazards in industries and to investigate the prevalence of elevated blood lead levels (BLLs) in lead-exposed workers, a lead surveillance system (PRESS-BLLs) has been established and operated in Taiwan, Republic of China, since July 1993. A cohort of lead-exposed workers who received a periodic annual health examination at 55 accredited hospital laboratories was constructed. A total of 9807 separate BLL measurements were reported to the system in 1994. The mean BLL was 15.8 μg/dl in male workers and 11.6 μg/dl in female workers. The mean BLL of lead-exposed workers was significantly (P<0.05, z-test) higher than that of the general Taiwanese population (8.6 μg/dl for males and 6.7 μg/dl for females). In addition, the BLLs of 983 (10.0%) workers exceeded the regulatory action level (40 μg/dl for males; 30 μg/dl for females). The workplaces and homes of 57% of the workers with elevated BLLs were thoroughly investigated to determine the sources of lead contamination. These actions identified the causes of elevated BLLs and set up strategies to reduce workers’ lead exposure. The establishment of this occupational lead surveillance system represents a method for monitoring of lead hazards from occupational and environmental settings to prevent lead poisoning. The information acquired from the system can help in the setting up of a priority of prevention and the development of control measures. It is also useful for further monitoring of changes in the BLLs of the lead-exposed-worker cohort. The Health Department of Taiwan can use this information to evaluate the effectiveness of current industrial hygiene practice. Subjects with elevated BLLs have been medically treated and placed on long-term follow-up for sequelae. Received: 2 September 1996/Accepted: 29 November 1996