Predictive value of islet cell and insulin autoantibodies for Type 1 (insulin-dependent) diabetes mellitus in a population-based study of newly-diagnosed diabetic and matched control children

Summary Most studies evaluating immune markers for prediction of Type 1 (insulin-dependent) diabetes mellitus have focused on first degree relatives, although only 10 % of newly-diagnosed patients have an affected first degree relative. The Swedish Childhood Diabetes Register identifies 99 % of all diabetic children at diagnosis. In this population-based study, islet cell antibodies and insulin autoantibodies in 0–14-year-old Swedish consecutively-diagnosed patients and control subjects were analysed to define their sensitivity and specificity. Over 16 months (1986–1987), 515 Swedish children developed diabetes. Plasma samples were obtained from 494 (96 %) patients, and 420 matched control children. Among patients, the frequency of islet cell antibodies was 84 % (415 of 494), insulin autoantibodies 43 % (145 of 334); 40 % (135 of 334) were positive for both and 88 % (294 of 334) were positive for one or both. Among control children, 3 % (14 of 420) had islet cell antibodies, 1 % (4 of 390) insulin autoantibodies, and 4 % (16 of 390) had either autoantibody marker. The predictive value of finding a patient with the disease was only 7% since 4 % of the control children were antibody-positive and the cumulative incidence rate up to 15 years of age is 0.38 %. None of the autoantibody-positive (n = 21) or negative control children developed diabetes during 3 to 5 years of follow-up. Longitudinal investigations of islet cell or insulin-autoantibody-positive healthy children are necessary to accurately determine the conversion rate from marker positivity to disease onset.     

脊髓栓系患者的尿动力学评估和治疗对策

目的　探讨脊髓栓系对膀胱尿道功能的影响。　方法　采用影像尿动力学检查评估36例脊髓栓系患者的膀胱尿道功能 ;以膀胱顺应性和有无膀胱输尿管返流评估膀胱的储尿功能 ;以排尿期逼尿肌压力评估逼尿肌排尿功能 ;结合膀胱尿道透视和尿动力学检查了解有无逼尿肌 外括约肌的协同性 ,并结合压力 流率曲线了解尿道的控尿功能。采用 χ2 检验比较各组参数异常发生的频数。　结果　脊髓栓系后神经源性膀胱的类型主要为逼尿肌反射不能伴低顺应性膀胱 ,占 5 0 % (18/36 ) ;逼尿肌反射亢进占 2 2 % (8/ 36 )。逼尿肌反射不能伴低顺应性膀胱者其肾功能损害的发生率83% (15 / 18) ,明显高于逼尿肌反射亢进者 (38% ,3/ 8,P <0 .0 5 )。膀胱顺应性减低者肾功能异常占81% (17/ 2 1) ,明显高于顺应性正常者 (7% ,1/ 15 ,P <0 .0 1)。顺应性减低者膀胱输尿管返流发生率6 7% (14 / 2 1) ,明显高于顺应性正常者 (7% ,1/ 15 ,P <0 .0 1)。　结论　脊髓栓系所致的神经源性膀胱类型各异 ,治疗方案的制定应以尿动力学结果为依据。顺应性减低可能是造成肾功能损害和膀胱输尿管返流的主要原因 ,泌尿外科治疗目的在于创建一低压、足够容量和控尿的膀胱以保护上尿路功能     

老年、青年急性心肌梗塞临床心电图特点对比研究

目的：探讨82例老年、青年心肌梗塞心电图的临床特点。方法：应用心电图检查对两组临床证实的心肌梗塞病人进行对比观察分析。结果：老年人发生心肌梗塞时有典型心前区疼痛仅占51．9％，远低于青年组83．3％。老年组多部位心肌梗塞占28．8％，明显高于青年组13．3％。老年组无Q波型心肌梗塞占44．2％，明显高于青年组13．3％，两组相比差异有显性意义。结论：老年和青年组心肌梗塞比较，老年组病人，临床症状、心电图不典型，易误诊、漏诊，临床上必须针对病情，结合病史，动态观察，做好综合判断，达到早期诊断，早期治疗。     

α受体阻滞剂对良性前列腺增生患者症状的影响作用

目的　分析α受体阻滞剂对良性前列腺增生 (BPH)患者症状的影响。　方法　对 14 8例BPH患者进行 4周α受体阻滞剂治疗 ,记录并分析治疗前后患者症状、IPSS评分、最大尿流率、平均尿流率及剩余尿量情况。　结果　治疗 4周后 ,患者平均IPSS评分、最大尿流率、平均尿流率及剩余尿量均有显著改善。各项症状中 ,夜尿次数的改善显著低于其它症状的改善。 35例 (2 3.6 % )患者治疗后生活质量评分没有改善 (主观不满意组 ) ,IPSS改善程度明显低于生活质量评分有提高的患者(主观满意组 ) ,但两组间最大尿流率及平均尿流率的改善差别无显著性意义。　结论　α受体阻滞剂治疗BPH患者症状的改善与尿流率的提高可能存在不同机制     

The detection of specific antibody formation to recall antigens after human bone marrow transplantation

The results of this study show that donor-derived immunity can be detected and persists in long-term survivors with and without chronic graft-v-host disease (GVHD) after human marrow grafting. Seventy-one marrow recipients (60 long-term and 11 short-term survivors) were studied for the presence of specific serum IgG antibodies to tetanus toxoid (TT), and 46 marrow recipients (35 long-term and 11 short-term) were tested for antibodies to diphtheria toxoid (DT) and measles virus after marrow grafting using an enzyme-linked immunosorbent assay. Of the 60 long-term survivors, 31 were healthy and 29 had chronic GVHD. None of the recipients were immunized to the test antigens postgrafting. Most long-term healthy recipients exhibited antibody titers to the recall test antigens, whereas only a minority of those with chronic GVHD had antibody titers to recall antigens. In healthy long-term recipients (greater than or equal to one year postgrafting) whose donors were immune to the test antigens, 25 of 31 had titers to TT, 11 of 17 had titers to DT, and 12 of 20 had titers to measles. In recipients with C-GVHD, 13 of 29 had titers to TT, six of 15 had titers to DT, and six of 15 had titers to measles virus. Within 100 days postgrafting, 11 of 11 had anti-TT titers, ten of ten had anti-DT titers, and seven of eight had antimeasles virus titers.     

鼻腔、软腭、副鼻窦纤维瘤和纤维肉瘤的CT表现(附8例报道)

目的　分析纤维瘤和纤维肉瘤的CT表现 ,为临床的诊治提供依据。方法　对经手术病理证实的硬纤维瘤 6例 (鼻腔 3例、上颌窦 2例、软腭 1例 )和纤维肉瘤 2例 (上颌窦及鼻腔各 1例 )进行回顾性分析 ,CT采用轴位扫描 ,层厚和间隔均为 5mm。结果　纤维瘤CT表现为单发圆、半圆或椭圆形实性软组织肿块 ,密度多均匀 ,边缘清楚、整齐 ,有包膜 ,带蒂或有广基 ,造影后轻 -中度强化 ;肿瘤呈膨胀性生长 ,周围骨质受压变薄或吸收 ,邻近结构受推移。纤维肉瘤则表现为此部位恶性肿瘤共同的CT征象。结论　纤维瘤的CT表现有一些特点 ,可与该部位大多数常见良性病变相鉴别。纤维肉瘤则无法与其他恶性肿瘤相区别 ,二者诊断均需依靠病理     

受精卵原核显微穿刺导入DNA制备转基因兔

目的：受精卵原核显微DNA注射是转基因动物制备的最常用、最可靠的方法．研究技术上更为简易的受精卵原核显微穿刺导入DNA制备转基因兔的可行性．方法：重组转基因载体pCA-CHA,采用细胞原核显微穿刺将DNA导入兔受精卵制备转基因兔，用PCR和Southern Blot方法鉴定转基因兔．结果：转基因处理后获得仔兔92只，以PCR检测结果计算，转基因总效率为1．63%～2．40％，整合率为11．54%～16．13％；以Southern Blot检测结果计算，转基因总效率为0．27％，整合率为1．92％．结论：受精卵原核显微穿刺导入DNA与受精卵原核显微DNA注射制备转基因兔的结果相当．