48例干扰素治疗慢性乙肝不良反应的观察及护理

重组α-2b干扰素是具有抗病毒和免疫调节作用的生物学调节活性物质。近年来，国外文献报道α-2b干扰素治疗慢性乙型病毒性肝炎(CAH—B)取得较好效果。特别是基因工程问世，使大量的高纯度干扰素应用于临床。现对48例慢性乙肝患者使用干扰素后的不良反应的观察与护理，报道如下。     

急性脑血管病患者血清肌钙蛋白Ⅰ的检测及临床意义

目的 探讨血清肌钙蛋白Ⅰ(cTn-I)对急性脑血管病(ACVD)后心肌损伤的诊断价值.方法 检测160例ACVD患者入院后24h内、3d、7d的血清cTn-I和肌酸激酶同工酶(CK-MB),比较不同病程、不同类型、不同病情程度ACVD患者血清cTn-I和CK-MB的测定结果,观察预后与cTn-I、CK-MB的关系.结果 病后24h内和7d血清cTn-I较CK-MB的阳性率高;脑出血和重症患者病后7d cTn-I仍增高;病后30d内死亡者的cTn-I和CK-MB增高比例高于存活者.结论 血清cTn-I对ACVD后心肌损伤的检测具有比CK-MB更高的敏感性、特异性和更宽的诊断窗口.     

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.     

Protein ubiquitination in postsynaptic densities after transient cerebral ischemia.

The mechanisms underlying neurologic deficits and delayed neuronal death after ischemia are not fully understood. In the present study, we report that transient cerebral ischemia induces accumulation of ubiquitinated proteins (ubi-proteins) in postsynaptic densities (PSDs). By immunoelectron microscopy, we demonstrated that ubi-proteins were highly accumulated in PSD structures after ischemia. On Western blots, ubi-proteins were markedly increased in purified PSDs at 30 minutes of reperfusion, and the increase persisted until cell death in the CA1 region after ischemia. In the resistant DG area, however, the changes were transient and significantly less pronounced. Deposition of ubi-proteins in PSDs after ischemia correlates well with PSD structural damage in the CA1 region as viewed by electron microscopy. These results suggest that the ubiquitin-proteasome system fails to repair and remove damaged proteins in PSDs. The changes may demolish synaptic neurotransmission, contribute to neurologic deficits, and eventually lead to delayed neuronal death after transient cerebral ischemia.     

Laryngeal tuberculosis: a review of 26 cases.

OBJECTIVES: To review the clinical characteristics of laryngeal tuberculosis. STUDY DESIGN: Retrospective case series. SUBJECTS AND METHODS: Medical records of 26 histopathology-confirmed cases in a tertiary medical center from 1992 to 2006. RESULTS: The female patients were significantly younger than male patients. Hoarseness is the most common symptom (84.6%) because true vocal fold is most commonly involved (80.8%). Infection usually involves unilateral (66.7%) and right-side larynx but multiple subsites of the larynx (57.7%). The appearance of the affected larynx may have mixed features and change before diagnosis. Laryngeal tuberculosis is usually misdiagnosed as laryngeal cancer, especially in patients with malignant signs such as enlarged cervical lymph nodes and vocal fold immobility. Chest film is better than sputum examinations for screening. CONCLUSION: We should be especially alert about TB infection when facing young female patients with unusual laryngeal lesions. Extensive laser excision before diagnosis should be avoided because after antituberculous treatment, prognosis is usually good and vocal fold immobility could be reversible.     

原发性眼眶静脉曲张的CT和MRI表现

目的探讨原发性眼眶静脉曲张(POV)的CT及MRI表现。方法临床诊断的30例原发性眼眶静脉曲张患者,9例行CT横断位和冠状位扫描,21例行MR扫描,4例行CT和MR检查。结果30例中30只患眼,左眼18例,右眼12例,均为单侧发病。病变部位眼睑3例,眼眶前部1例,眼眶后部(球后)17例,眼睑和眼眶前部5例,眼睑、眼眶前部和眼眶后部2例,眼眶前部和眼眶后部2例。形态17例为不规则块状,4例为卵圆形,9例为不规则条状。CT冠状位,病变均显示为软组织密度,有明显强化;静脉石2例;眶骨受压变薄、眶腔扩大3例。MR扫描,颈部加压后25例均显示病变,11例呈等T1长T2信号,7例呈长T1长T2信号,1例呈等T1等T2信号,6例呈长T1长T2为主的混杂信号,增强的22例中,14例呈明显均匀强化,8例呈不均匀强化。结论CT横断位和冠状位及颈部加压或俯卧位MRI在原发性眼眶静脉曲张的诊断和鉴别诊断方面有重要价值。     

Examination of potential mechanism(s) of metallothionein induction by diethyl maleate.

Diethyl maleate (DEM) is a glutathione-depleting agent that can increase the levels of the sulfhydryl-rich protein metallothionein (MT) in liver. The purpose of the present study was to examine the mechanism(s) by which DEM increases mouse hepatic MT levels. DEM appears to be an indirect MT inducer as suggested by the lack of increase in MT levels when cultured mouse hepatocytes were exposed to DEM. Four possible mechanisms by which indirect MT inducers may cause an elevation in MT concentrations in liver were examined. Zn levels did not increase prior to the increase in hepatic MT, thus, a Zn redistribution to the liver is not the cause of the liver MT induction by DEM. The adrenal gland products were not required for MT induction in liver, as adrenalectomy did not abolish the increase in hepatic MT caused by DEM. The elevation in liver MT does not appear to be due solely to the decrease in liver glutathione (60%) in the initial hour after DEM, because phorone, which decreases liver glutathione (80%), produced only a fourfold increase in hepatic MT. Activation of macrophages does not seem to account for the rise in liver MT levels, as there was no increase in abundance of cytokine mRNAs for TNF-alpha, IL-1 beta, or IL-6 in the liver. These data suggest that the induction of hepatic MT by DEM does not occur in response to (1) an increase in liver Zn that precedes the increase in liver MT, (2) release of adrenal gland products, (3) decrease in liver glutathione, or (4) increased cytokine gene expression.     

MRI manifestations of peritoneal carcinomatosis.

Three cases of proved peritoneal carcinomatosis were examined by magnetic resonance imaging (MRI). Air was used to distend the entire gastrointestinal tract via an antegrade method. The findings included seedings along the small intestine, transverse and sigmoid colon, stellate pattern in the mesentery, plaque-like and bulky tumor masses in the mesentery and greater omentum, and focal thickenings along the right subdiaphragmatic parietal peritoneum. Stenosis caused by tumor encasement at the duodenojejunal junction and ileocolic anastomosis were first detected by MRI and later confirmed by barium studies. Ascites was present in all cases. One case showed ascites located only along the left paracolic gutter. This report shows that MRI is also able to demonstrate peritoneal carcinomatosis by using air as a gastrointestinal contrast medium.     

小儿氨基酸注射液治疗胎儿宫内发育迟缓的探讨

经临床鉴定静脉内注射小儿氨基酸对治疗胎儿宫内发育迟缓具有肯定效果。在Ｂ超监视下，使用小儿氨基酸的孕妇组于用药期间，胎儿生长参数ＢＰＤ和ＨＣ显著高于使用成人氨基酸的孕妇组。１０例足月娩出胎儿体重均达到甚至超过２．５ｋｇ。由此得出结论：使用小儿氨基酸注射液对于改善胎儿宫内发育迟缓优于成人氨基酸。     

Clinical observation of Qi deficiency syndrome in 72 patients with chronic obstructive pulmonary disease treated with Yiqi Mianyi Granule

Seventy-two patients of chronic obstructive pulmonary disease (COPD) of Qi deficiency syndrome with abnormal immune indices were treated with Yiqi Mianyi Granule (YQMYG) and the efficacy was compared with that of 30 cases treated with Zhenqi fuzheng Granule (ZQFZG) for control. Results showed that the markedly effective rate of symptomatic improvement of Qi deficiency in YQMYG group was 65.3%, the total effective rate 93.1%. 88.6% of the immune indices lower than normal were corrected and 43. 7% of them were normalized, while for indices that were higher than normal the rate were 78.2% and 52.9% respectively. These results suggested that YQMYG could improve symptom of Qi Deficiency markedly, strengthen cellular immunity and regulate immune dysfunction. Its therapeutic efficacy was obviously superior to ZQFZG (P<0.Q5).