BMP-2 gene polymorphisms and osteoporosis: the Rotterdam Study.

After reported associations of variations in the BMP-2 gene with osteoporosis in small populations, we studied the association of the BMP-2 gene polymorphisms Ser37Ala and Arg190Ser with osteoporosis in 6353 men and women from the Rotterdam Study. We did not observe an association of these variants with BMD, bone loss, hip structural analysis parameters, and fracture risk. INTRODUCTION: Bone morphogenetic protein 2 (BMP-2) plays a role in osteoblast differentiation. BMP-2 gene variation has previously been associated with osteoporosis in various small populations, but current evidence remains inconclusive about the exact association with osteoporosis. Therefore, we studied the association of two polymorphisms located in the BMP-2 gene (Ser37Ala and Arg190Ser) and haplotypes defined by these polymorphisms with BMD, rates of bone loss, parameters of hip structural analysis (HSA), and fractures in the Rotterdam Study, a large prospective cohort study of diseases in the elderly. MATERIALS AND METHODS: Databases were searched for polymorphisms and haplotype blocks in the BMP-2 gene region. Allele frequencies for Ser37Ala and Arg190Ser were determined in 60 blacks and 110 Chinese from Coriell panels. Genotype data on Ser37Ala and Arg190Ser were available for 6353 individuals from the Rotterdam Study population. Haplotype alleles defined by Ser37Ala and Arg190Ser were inferred using PHASE software. Genotype and haplotype analyses for BMD (measured at the lumbar spine and femoral neck), bone loss per year (measured at the femoral neck), and HSA were performed using AN(C)OVA. Fractures were analyzed using a Cox proportional-hazards model and logistic regression. All outcomes were adjusted for age, height, and weight. RESULTS: Allele frequencies were 2.5% for Ala37 and 40.2% for Ser190, whereas haplotype allele frequencies were 57.28% (Ser37Arg190), 40.19% (Ser37Ser190), 2.50% (Ala37Arg190), and 0.02% (Ala37Ser190). For BMD, bone loss, HSA outcomes, and (incident) fractures, no differences could be seen between genotype and haplotype groups. Conclusions: In this large population-based cohort of Dutch whites, we conclude that the BMP-2 Ser37Ala and Arg190Ser polymorphisms or haplotypes thereof are not associated with parameters of osteoporosis.     

后牙两段式可摘局部义齿的设计与制作

目的:改进常规可摘局部义齿设计的不足,增进固位、稳定。方法:采用两段式义齿结构、两个就位方向和插销锁连接固定。结果:义齿的固位、稳定效果明显提高。结论:插销式分段义齿是对常规可摘局部义齿的一种补充,对主基牙过度倾斜、固位要求高的患者,能够明显改善修复效果。     

PINK1 mutations in sporadic early-onset Parkinson's disease.

Pathogenic PINK1 mutations have been described in PARK6-linked Parkinson's disease (PD) patients of Asian origin. However, data on the frequency of PINK1 mutations in sporadic early-onset Parkinson's disease (EOPD) Asian patients are lacking. The objectives of this study were to report the frequency of PINK1 mutations of sporadic EOPD in an Asian cohort comprising of ethnic Chinese, Malays, and Indians, and to highlight a PINK1-positive patient who presented with restless legs symptoms. Eighty consecutive sporadic EOPD patients from the movement disorder clinics of two major tertiary institutions in the country were included. We performed sequence analysis of all the coding and exon-intron junctions of the PINK1 using specific primer sets. In addition, we genotyped polymorphisms detected from the analysis in a group of sporadic PD patients and controls. Three different mutations (two homozygous nonsense and one heterozygous missense) in the putative kinase domain were found in three patients, giving a 3.7% frequency of PINK1 mutations in our EOPD cohort. All the mutations were absent in 200 healthy controls. One patient with a novel homozygous nonsense PINK1 mutation presented unusually with restless legs symptoms. Separately, analysis of the frequency of four PINK1 polymorphisms in a group of sporadic PD and controls did not reveal any significant differences. We highlight a 3.7% frequency of PINK1 mutations in an Asian cohort (ethnic Chinese, Malay, and Indian) of EOPD. The phenotypic spectrum associated with PINK1-positive patients may be wider than previously reported. Polymorphisms of PINK1 do not appear to modulate risk of PD in our population.     

电切除治疗女性膀胱颈硬化症病人的护理

随着现代泌尿外科的迅速发展,腔内泌尿外科应用越来越广泛,而经尿道膀胱颈电切术是其重要组成部分。尤其适用于膀胱颈硬化症等病症,其优点为:①手术创伤小,适宜体弱、高龄及有其他疾患不适于开放手术的病人;②其解除梗阻较为彻底,病人易于接受,且术后疗效好;③膀胱颈损伤不大,黏膜大部分完整,减少术后瘢痕形成;④手术操作易于掌握。女性膀胱颈硬化症多见于中老年妇女[1],是发生于女性下尿路的少见疾病。临床主要依据尿流动力学测定、内镜检查和超声等方法明确诊断。症状与男性前列腺炎或前列腺肥大有相似的地方,如尿频、尿急、尿痛、排尿困…     

暗纹节菱孢所致皮肤真菌病组织病理学及超微结构观察

本文报告了暗纹节菱孢[Arthinium phaeospemum（Corda）Ellis]所致皮肤真菌病的组织病理学及超微结构观察。HE、PAS、镀银染色（Szatri）法及铅铀染色，对皮损的组织病理改变，进行了光镜及透射电镜观察。光镜下发现暗纹节菱孢引起真皮及皮下脂肪组织广泛性病理浸润，由多种细胞构成的肉芽肿，尤其对皮肤附属器严重破坏。在病理浸润中可见球形、卵圆形、菱形及晶体形，玫瑰红色、棕色及褐色孢子。透射电镜下见真皮成纤维细胞胞浆内吞噬多数界线清楚的圆形小体，空泡内也有相同的小体，胞浆空泡甚多，胞核完整。同时见到破坏的溶酶体。病理浸润内形态各异的孢子及不同颜色，是孢子生长的不同阶段。     

Efficacy and safety of herbal medicines for idiopathic Parkinson's disease: a systematic review.

The objective of this study is to assess the efficacy and safety of herbal medicines (HMs), as a monotherapy or adjunct therapy, compared to placebo or conventional approaches in the treatment of idiopathic Parkinson's disease (PD). We conducted a systematic review of randomized controlled trials from both conventional and alternative medicine sources. Outcome measures were overall improvement, quality of life, reduction of levodopa dose, and adverse events. Nine studies were included, each testing a different HM. Six of the trials had limited internal validity due to major flaws in design, including the lack of proper randomization; insufficient blinding; unclear inclusive criteria in terms of diagnostic criteria, baseline staging, and duration of disease; lack of proper sample size calculation; and insufficient data analysis. Imbalances in gender and ethnicity among the patients in the included trials were observed. No major adverse events emerged, and no specific pattern was detected from the trials describing such data. In addition to major methodological defects, heterogeneity in (1) HM tested, (2) control treatment, and (3) outcome measure hindered in-depth data analysis and synthesis. Current evidence is insufficient to evaluate the efficacy and safety of various HMs. Further studies with improved trial design and reporting, with assessment on cost-effectiveness, quality of life, and qualitative data are warranted.     

重视老年胃癌患者的围手术期处理(附370例报告)

目的 总结老年胃癌的临床特点及围手术期处理经验。方法 回顾性分析我院1990年1月至2003年1月间共收治的370例老年胃癌患者的临床资料。结果 370例老年胃癌中290例（78．4％）伴有高血压、心脏病、糖尿病等老年常见病；术后发生并发症110例次，死亡16例；手术前有共存病者术后并发症的发生率（34．5％）明显高于无共存病者（12．5％），P〈0．01。结论 加强围手术期处理是降低老年胃癌患者并发症和死亡率的关键。     

游泳对新生儿健康状况的影响

[目的]探讨游泳对新生儿健康的影响。[方法]将200例新生儿随机分为两组,各100例,对照组采用传统沐浴的方法,观察组采用游泳和抚触。[结果]观察组新生儿生理性体重下降和生理性黄疸程度较轻,新生儿安静,易入睡,且睡眠时间长,新生儿神经行为可安慰性强,颈紧张反射、手握持反应良好,觅食反射活跃,与对照组比较有统计学意义(P<0.05)。[结论]游泳可使新生儿情绪稳定,对外界适应能力增强,促进神经系统发育和智能的成熟,增加食欲和体重,改善体温调节功能。     

骨髓干细胞参与小鼠急性肾小管坏死修复的实验研究

【摘要】 目的 观察在生理和病理情况下,骨髓来源的干细胞(BMSC)能否分化成肾小管上皮细胞。 方法 绿色荧光蛋白(GFP)标记的C57BL/6转基因小鼠提供骨髓细胞。同种无荧光标记的C57BL/6小鼠100只分为正常对照组、全身照射组、缺血再灌注组、骨髓移植组、骨髓移植+缺血再灌注组。受体鼠的骨髓重建经血液常规检查和流式细胞仪检测确认,并采用荧光组织化学、免疫组织化学等方法观察绿色荧光标记的BMSC在受体鼠肾脏的分布及数量。 结果 全身致死剂量γ射线照射未造成小鼠肾脏组织结构和生理功能的明显改变。骨髓移植后第56、84天的受体鼠肾小管中有少量GFP阳性细胞的存在[(78.75±5.99)%、(79.58±4.60)%],激光共聚焦显微镜进一步证实这些细胞位于肾小管,并表达肾小管上皮细胞特异性的功能蛋白megalin。 结论 在生理和病理情况下,骨髓干细胞均可以向肾小管上皮细胞转分化,参与肾小管上皮细胞的更新,并且在急性肾小管坏死的病理条件下,骨髓干细胞的肾向转化率与肾脏受损程度有关。