白细胞三烯拮抗剂ONO－1078对豚鼠迷走神经电刺激引起气道痉挛及微血管渗漏作用

阿托品预先处理的豚鼠，电刺激迷走神经（１０Ｈｚ，５ｍｓ，２Ｖ或１０Ｖ，９０ｓ）引起气道阻力增高，气管、主支气管和肺内气道的依文思蓝渗出量增加，并随刺激强度加大而增强。白细胞三烯拮抗剂ＯＮＯ－１０７８（０．０３，０．１ｍｇ·ｋｇ－１，ｉｖ）对气道阻力的增高无明显影响；但显著抑制微血管渗漏，在刺激强度低（２Ｖ）时更明显。结果提示白细胞三烯类参与神经原性炎症时的气道微血管渗漏反应。     

Fat and K-ras mutations in sporadic colorectal cancer in The Netherlands Cohort Study

Associations between dietary intake of various fats and specific K-ras mutations in colorectal cancer (CRC) were investigated within the framework of The Netherlands Cohort Study on diet and cancer (NLCS). After 7.3 years of follow-up and with exclusion of the first 2.3 years, 448 colon and 160 rectal cancer patients and 2948 subcohort members (55-69 years at baseline) were available for data-analyses. Mutation analysis of the K-ras gene was performed on all archival colon and rectal adenocarcinoma specimens. Case-cohort analyses were used to compute adjusted incidence rate ratios (RR) and 95% confidence intervals (CI) for colon and rectal cancer cases and for K-ras mutation subgroups. The intake of total, saturated and monounsaturated fat was not significantly associated with colon or rectal cancer. High intake of dietary polyunsaturated fat and, specifically, linoleic acid is associated with an increased risk of mutated K-ras colon tumours. The RRs for 1 SD of increase of polyunsaturated fat and linoleic acid were 1.21 (95% CI 1.05-1.41) and 1.22 (95% CI 1.05-1.42), respectively, and similar associations were observed for both G > A transitions and G > T or G > C transversions in the colon. In contrast, no significant associations were observed with rectal cancer risk, overall nor with specific K-ras mutation status. A high intake of polyunsaturated fat, in particular linoleic acid, may be an important dietary risk factor for K-ras mutated colon tumours, possibly by generating G > A transitions or G > T or G > C transversions in the K-ras oncogene.     

Maternal HIV and drug use: effect on health and social morbidity

A retrospective analysis of routine child health surveillance information was performed on health visitor records of 459 children, to examine the independent effects of maternal HIV infection and drug use during pregnancy on morbidity in the first 3 years of life. No significant differences were observed in the developmental progress of children born to HIV infected or drug using women when compared to community controls. The pattern of medical consultations in the first 18 months of life was significantly different, maternal drug use exerting a negative influence on outpatient visits (odds ratio 0.6, 95% confidence interval 0.4 to 1.0). At 6 weeks, the majority of children lived with their birth parent(s), and no differences were observed between the groups. By 10 months of age, only 81% of children born to HIV infected drug using women lived with their parent(s). While maternal drug use and HIV did not have adverse effects on child health and development, these findings highlight the social implications for children affected by the heterosexual spread of HIV.     

Paleoimaging: The Use of Radiography, Magnetic Resonance, and Endoscopy to Examine Mummified Remains

An examination of a person of purported known provenance using medical imaging procedures is discussed. Because this nontraditional application uses more than X-ray-based modalities, such as magnetic resonance imaging and video endoscopy, this field has become known as paleoimaging. The approach used to modify existing medical techniques to compensate for dehydrated tissues is described. The types of information that can be obtained from imaging studies to elucidate the health status of a person and circumstances that may have contributed to his/her death are discussed. In addition, the importance of an interdisciplinary team approach, including a radiologist, is necessary for an accurate interpretation of the data.     

异基因造血干细胞移植治疗慢性粒细胞白血病63例

目的:观察异基因造血干细胞移植治疗慢性粒细胞白血病的疗效,并分析63例患者治疗后的生存状况。方法:病例来源于1989-06/2007-04在解放军总医院血液科行异基因造血干细胞移植的63例慢性粒细胞白血病患者,男52例,女11例,中位年龄33.5岁。患者均经血液形态学和细胞遗传学确诊,并对治疗知情同意。10例行HLA相合同胞供者异基因骨髓移植,39例行HLA相合同胞供者异基因外周血干细胞移植,3例行非血缘关系骨髓移植,6例行非血缘关系外周血干细胞移植,5例行HLA相合的同胞异基因非清髓外周血干细胞移植。预处理采用改良的BuCy方案和全身放疗加环磷酰胺方案。以霉酚酸酯、环孢菌素A加短疗程的甲氨喋呤预防移植物抗宿主病。移植后按每3个月定期进行随访,观察患者生存情况。结果:63例患者均完成随访,并进入结果分析。63例患者中有39例移植后5年无病存活(61.9%)。移植后100 d内死亡11例,死亡原因分别为急性移植物抗宿主病、播散性感染、复发和植入失败。移植后100d至2年内死亡12例,死亡原因分别为慢性移植物抗宿主病、巨细胞病毒感染和疾病复发。1例于移植后1413d死亡,死亡原因为慢性移植物抗宿主病合并感染。其余移植超过2年均存活。结论:异基因造血干细胞移植可使部分慢性粒细胞白血病患者获得长期无病存活。     

单次与两次自体造血干细胞移植治疗血液肿瘤的远期结局比较：150例资料回顾

目的:对没有与供者HLA配型相合的血液恶性肿瘤患者来说,自体造血干细胞移植不失为一种积极有效的治疗方法。评价比较单次与两次自体造血干细胞移植治疗血液肿瘤的效果。方法:①实验对象:选取1988～2001年解放军总医院血液科行自体造血干细胞移植的150例患者,对本实验均知情同意。其中两次自体移植25例(两次骨髓移植3例、两次外周血造血干细胞移植1例、1次骨髓移植 1次外周血造血干细胞移植21例),单次自体移植125例(骨髓移植44例、外周血造血干细胞移植81例);急性非淋巴细胞白血病75例,急性淋巴细胞白血病43例,非霍奇金淋巴瘤22例,霍奇金淋巴瘤10例。②实验方法:应用化疗使白血病患者在移植前达到完全缓解,淋巴瘤患者要求移植前至少骨髓中没有肿瘤累及。动员化疗方案原则上采用对相应肿瘤有效的联合化疗方案,并适当增加剂量。骨髓移植及外周血造血干细胞移植患者回输单核细胞中位数分别为2.68×108/kg,4.20×108/kg。115例患者采用环磷酰胺/全身放疗方案,35例患者采用不含全身放疗的高剂量化疗方案。③实验评估:自体造血干细胞移植5年后血液肿瘤患者的无病存活率。结果:①急性非淋巴细胞白血病:69例患者单次移植,5年无病存活率58.0%(40例),复发率29.0%(20例),移植相关死亡率13.0%(9例)。6例患者两次移植,其中1例M5患者复发死亡,5例无病存活。②急性淋巴细胞白血病:29例患者单次移植,5年无病存活率34.5%(10例),复发率34.5%(10例),移植相关死亡率31.0%(9例)。14例患者两次移植,5年无病存活率42.9%。③非霍奇金淋巴瘤:18例患者单次移植,5年无病存活率61.1%(11例),复发率16.7%(3例),移植相关死亡率22.2%(4例)。4例患者两次移植,其中1例CR1期患者在首次移植后21个月复发,化疗获得PR后行第2次自体造血干细胞移植,17个月后复发死亡;其余3例均无病存活。④霍奇金淋巴瘤:9例患者单次移植,5年无病存活率100%。1例患者行两次移植,首次移植前13个化疗疗程未缓解,行自体外周血造血干细胞移植后达到部分缓解,9个月后行自体骨髓移植后完全缓解,无病存活。结论:①自体造血干细胞移植是治疗血液肿瘤安全有效的方法。②自体造血干细胞两次移植5年无病存活率明显优于单次移植效果,可改善血液肿瘤患者预后。     

Molecular epidemiology of acute hepatitis B in the Netherlands in 2004: nationwide survey

To gain insight into hepatitis B virus (HBV) transmission in the Netherlands, epidemiological data and sera were collected from reported cases of acute HBV infections in the Netherlands in 2004. Cases were classified according to mode of transmission. A fragment of the S-gene of HBV (648 bp) was amplified, sequenced, and subjected to phylogenetic analysis. Of the 291 acute HBV cases reported in 2004, 158 (54%) were available for genotyping. Phylogenetic analysis identified 6 genotypes: A (64%), B (3%), C (3%), D (21%), E (5%) and F (5%). Of HBV infected men having sex with men, 86% were infected with genotype A, accounting for 43% of all patients infected with this genotype. There were only three reported cases of injecting drug use of which one was available for sequencing (genotype A). Unlike the genotype A cluster, sequences within the genotype B-E clusters were heterogenic. Within genotype F, several isolates had identical sequences, but patients could not be epidemiologically linked. Sexual transmission, particularly by men having sex with men was the most important transmission route for HBV. Injecting drug use plays a minor role. Genotype A is predominant in the Netherlands, especially among men having sex with men. In addition to imported strains, there seems to be a pool of related but non-identical strains circulating among chronic carriers in the migrant population, from which occasionally new patients are infected, primarily by heterosexual transmission.     

自体造血干细胞移植治疗急性淋巴细胞白血病43例:远期疗效分析

目的：异基因造血干细胞移植治疗急性淋巴细胞白血病的疗效已不容置疑，在不具备异基因造血干细胞移植条件下，评价自体造血干细胞移植治疗急性淋巴细胞白血病的疗效。 方法：选取1989—05／2000—07解放军总医院血液科43例急性淋巴细胞白血病患者，所有患者均同意行自体造血干细胞移植。中位年龄24．5（11～48）岁。单次移植29例，其中移植前首次完全缓解期23例，二次缓解期5例，未缓解期1例。双次移植14例，其中首次移植和第二次移植前为二次缓解期各1例，其余移植前均为首次完全缓解期。预处理方案：包括含全身放疗（26例）、全淋巴放疗（14例）与不含全身放疗的高剂量化疗方案（3例）。移植后治疗：化疗长春新碱＋泼尼松／6-巯基嘌呤＋甲氨蝶呤方案和白细胞介素2免疫维持治疗。 结果：单次自体造血干细胞移植29例5年无病存活10例，其中移植前首次完全缓解期9例，二次缓解期1例。5年无病存活率34．5％。双次移植14例5年无病存活6例，5年无病存活率为42．9％。两次移植前均为首次完全缓解期。 结论：在不具备异基因造血干细胞移植条件下，可采用自体造血干细胞移植治疗急性淋巴细胞白血病，双次自体造血干细胞移植疗效较好。