Effects of long‐chain polyunsaturated fatty acid supplementation of infant formula on cognition and behaviour at 9 years of age

Aim Long‐chain polyunsaturated fatty acid (LCPUFA) supplementation of infant formula may have a beneficial effect on cognitive development. This study aimed to investigate the effect of LCPUFA formula supplementation primarily on cognition and secondarily on behaviour at age 9 years. Special attention was paid to the potentially modifying effect of maternal smoking during pregnancy. Method A double‐blind, randomized control study was performed in two groups of healthy infants born at term: one group, constituting the control group, received standard formula (n=169) and another group received standard formula supplemented with LCPUFAs (n=146). A breastfed group (n=159) served as an additional reference. At 9 years of age, 72% of the children (control group: n=123; 71 males, 52 females; LCPUFA group: n=91; 42 males, 49 females; breastfed group: n=127, 64 males, 63 females) underwent extensive cognitive and behavioural testing. Results An interaction between infant nutrition and smoking during pregnancy was found. Among children exposed to smoking during pregnancy, LCPUFA supplementation was associated with higher mean verbal IQ scores (p=0.007) and learning and memory (p=0.006). Among children not exposed to smoking during pregnancy, LCPUFA supplementation was associated with lower mean verbal memory scores (p=0.003). Executive function scores were significantly lower in the LCPUFA‐supplemented group than in the control group (p=0.001). Breastfeeding was associated with better performance on IQ (p=0.005). Interpretation No consistent beneficial effect of LCPUFA formula supplementation on cognitive development in term‐born infants was found. The study confirmed that breastfeeding is associated with better cognition.     

Coronary arteriographic findings in a case of primary angiosarcoma of the heart

A case of primary angiosarcoma of the heart diagnosed duringlife is presented. Selective coronary arteriography providedthe clue for the correct pre-operative identification of thetumor, showing angiomatous dilatations over the area suppliedby the right coronary artery. A small left-to-right shunt wasdetected by oximetry at the atrioventricular level, furtherconfirming the angiomatous nature of the tumor.     

长达14.45秒的全心停搏一例

患者男性，73岁。因3周前无明显诱因出现眩晕于2005年7月5日入院。患者眩晕主要为体位变化和活动后发生，每次发作时间持续2～3min，休息后缓解，自发病以来，偶有打鼾，未发现睡眠呼吸暂停现象，无视物模糊，无黑嚎、意识障碍，无心悸、气促、呼吸困难，无恶心、呕吐，无肢体活动障碍。病人曾于2004年11月因头晕、胸闷，行动态心电图检查示：偶发房性早搏、偶发室性早搏、sT—T改变。冠状动脉造影示冠状动脉多支病变，行冠状动脉搭桥术。自冠状动脉塔桥术后服用：美托洛尔25mg，2次／日；地高辛0．125mg，1次／日。体格检查：心率76次／min，血压140／90mmHg（1mmHg=0．133kPa），各瓣膜区未闻及心脏杂音，双肺听诊呼吸音清。诊断：颈椎病，冠心病。行24h动态心电图检查，总心率：81244次；平均心率59次／min；最慢窦性心率24次／min（图1），最快窦性心率89次／min。〉2s的窦性停搏共799次，最长的全心停搏达14．45s（图2），发生于1：43：15睡眠时，此次停搏后恢复的第一个心搏为交界性逸搏，其后为交界性逸搏心律，窦性PP间距为24．59S；全程室性早搏30次，室上性早搏778次，短阵房性心动过速1次，ST—T水平型缺血改变，最明显时ST段压低0．20mV，长RR间距后ST—T压低无明显加重。动态心电图诊断：窦性心动过缓，窦性停搏、全心停搏，交界性逸搏心律，室性逸搏心律，频发房性早搏，短阵房性心动过速，偶发室性早搏，ST—T改变。     

Low-dose aspirin in patients recovering from myocardial infarction. Evidence for a selective inhibition of thromboxane-related platelet function

The adequacy, selectivity and long-term persistence of inhibitionin cyclooxygenase-dependent platelet function by a daily low-dose(0.45 mg kg^–1 day^–1) aspirin treatment have beenevaluated in 15 patients after a recent (less than 17 days)acute myocardial infarction. Serum thromboxane (TX) B₂, an indexof platelet TXA₂ production, was decreased by 94–98% (P<0.001)by aspirin, while urinary excretion of 6-keto-prostaglandinF^la, as an index of extraplatelet cyclooxygenase activity, remainedunchanged. Compared to placebo, aspirin induced a persistentincrease in bleeding time (% difference 45.6±21.4, mean± SD) and a decrease in platelet aggregation by ADP,epinephrine, collagen and arachidonic acid. No tendency towardsan attenuation of the effects was apparent for the period ofaspirin administration (4 weeks). Aspirin 0.45 mg kg^–1 day^–1 is adequate and selectivein the long-term inhibition of TX-related platelet functionin patients after acute myocardial infarction. The clinicaleffectiveness of such a regimen remains to be proven in clinicaltrials.     

Biotherapy for xenografted human central nervous system leukemia in mice with severe combined immunodeficiency using B43 (anti-CD19)- pokeweed antiviral protein immunotoxin

The study of central nervous system (CNS) leukemia has been hampered by the lack of a suitable animal model. We report that severe combined immunodeficiency (SCID) mice invariably develop rapidly progressive fatal CNS leukemia within 3 weeks after intravenous injection of NALM-6 pre-B acute lymphoblastic leukemia (ALL) cells. Colonization of the dura mater and subarachnoid space, usually of the distal spinal cord with occasional extension into the Virchow-Robin spaces of blood vessels subjacent to the meninges, followed involvement of bone marrow in the skull, vertebrae, and, occasionally, the appendicular skeleton. Occult CNS leukemia was detectable by polymerase chain reaction amplification of human DNA as early as 8 days postinoculation of leukemia cells. We used this in vivo model of human CNS leukemia to examine the therapeutic efficacy and toxicity of intrathecally administered B43 (anti-CD19)-pokeweed antiviral protein (PAP), an anti- B-lineage ALL immunotoxin directed against the pan-B-cell antigen CD19/Bp95. Intrathecal therapy with B43 (anti-CD19)-PAP immunotoxin at nontoxic dose levels significantly improved survival of SCID mice and was superior to intrathecal methotrexate therapy.