Onychomycosis caused by Fusarium solani in a woman with diabetes

A case of untreated fusarial onychomycosis leading to serious consequences is reported. Fusarium solani is a widespread fungus and an occasional human pathogen. It usually invades rapidly in immunocompromised hosts, and often results in a poor outcome despite treatment. We report a woman with diabetes mellitus who had untreated fusarial infection of the nails, which developed into subcutaneous fusariosis, superinfected by bacteria, and then evolved into osteomyelitis that subsequently resulted in septic shock. Early management of mycotic nails in immunocompromised hosts is crucial to prevent life‐threatening disease.     

脑出血后的抑制细胞凋亡干预

脑出血后血肿周围组织可发生继发性损伤。研究表明，细胞凋亡在脑出血后继发性损伤中起着重要作用。抑制细胞凋亡可显著改善脑出血后的神经功能缺损。     

Family-oriented nutrition intervention for a lipid clinic population

We have developed a unique, family-oriented approach to lowering plasma cholesterol concentrations in persons with familial hyperlipidemias. The approach includes individual clinic visits and group nutrition classes and uses dietary goals outlined in The New American Diet. A series of 13 nutrition classes is presented to small groups, usually composed of relatives from pedigrees with familial hypercholesterolemia or other familial hyperlipidemias. Dietary action goals, cooking demonstrations, food tasting, and finger-stick plasma cholesterol determinations are important components of the classes. Problem-solving discussion is encouraged in the group. Over the past 4 years, 143 hyperlipidemic individuals, along with at least 94 unaffected family members, have participated in 31 groups, which have met for at least six classes. Many clinic participants lower plasma cholesterol by 20% or more. Keys to the success of this program include emphasizing dietary therapy, using the family setting for nutrition intervention, providing hands-on experience with food and recipes, promoting problem solving for dietary action goals, measuring blood cholesterol during classes, and encouraging long-term follow-up for participants with physicians and dietitians.     

Changes of Unit Discharge of the Medullary Respiratory Neurons during Apnea

Changes of the neuronal discharge of 128 medullary respiratory unitswere recorded and studied during the period of expiratory apnea induced reflexlyby intracarotid sinus injection of sodium citrate in rabbits.Generally,theneuronal discharge of inspiratory units began,stopped and recovered at the sametime with those of the phrenic nerve.But,about 5% the phase-spanninginspiratory units near the obex showed a different time course with the dischargeof the phrenic nerve.They fired continuously in a low frequency while thephrenic nerve was quiet.When increasing progressively and approaching to acertain level,the firing rate increased abruptly and at the same time phrenic nervebegan to fire.So it seemed that they acted as the pacemaker of inspiration.Comparison of the cycle-triggered histograms(CTH)of these inspiratory unitswith those of phrenic nerve showed clearly the above mentioned phasicrelationship.They started firing before the phrenic nerve,but they reached theirmaximal rate and then declined and stopped quite in accordance with the phrenicnerve.It is,therefore,reasonable to assume that the central mechanism of theswitch from expiratory apnea to inspiration may originate from this kind ofneurons.Most of the expiratory units show tonic discharges during the period of apneawith a higher discharge rate than normal and then the rate decreases just beforerecovery of phrenic firing.In addition,small portion of the expiratory units weredepressed as the phrenic discharge ceased.The function of these two differentkinds of neurons in the mechanism of development of respiratory rhythm is,apparently,different.     

慢性疼痛与情绪障碍及其干预治疗效应

目的:分析慢性疼痛与情绪障碍之间的关系,探讨心理及药物治疗对慢性疼痛的干预作用。资料来源:应用计算机检索Medline1989-01/2004-05和Embase1989-01/2004-05有关慢性疼痛与情绪障碍关系的文献,检索词“Chronicache,emotionaldisorder,treament”,并限定文章语言种类为English。观察对象为疼痛持续时间超过6个月以上的患者。资料选择:选取有关慢性疼痛与情绪障碍关系及其治疗干预的文献,进行初审,删除陈旧及重复的文献,然后查找余下的文献全文。质量评价主要考察资料的真实性,调查设计是否严密,实施过程是否严格,统计学处理是否合理。资料提炼:共检索到20篇关于慢性疼痛与情绪障碍关系及其治疗干预的文献,11篇文献符合纳入标准。排除的9篇试验中,7篇系重复的同一研究,2篇是Meta分析。资料综合:11篇文献均包括观察组和对照组,其中观察组应用镇痛药合并心理治疗及抗抑郁药,对照组应用镇痛药但未合并心理治疗及抗抑郁药,对两组患者的疗效进行比较分析。结论:慢性疼痛与情绪障碍同时存在,应用镇痛药合并心理治疗及抗抑郁药可以显著缓解患者的疼痛,干预效果优于单纯应用镇痛药者。     

MMP-2、TIMP-2与碱烧伤后角膜新生血管形成的实验研究

目的:探讨基质金属蛋白酶-2(MMP-2)、基质金属蛋白酶-2组织型抑制剂(TIMP-2)在碱烧伤大鼠角膜新生血管(CNV)形成中的表达和意义。方法:采用碱烧伤大鼠角膜建立CNV模型,摘除角膜作病理切片,多形核白细胞(PMN)记数;免疫组化法检测MMP-2、TIMP-2的表达。结果:烧伤后1d角膜缘PMN开始增多,到CNV7d组PMN增加最明显,此后逐渐减少;免疫组化显示:MMP-2在CNV中阳性表达逐渐增加,于7d表达最明显,此后随炎性细胞的减少而减弱,21d后几乎无表达;TIMP-2则于早期变化不明显,7d表达开始升高,14d达高峰。结论:烧伤后CNV形成早期,MMP-2活性增高,继而TIMP-2表达增加,使MMP-2活性受抑,基底膜降解受阻,新生血管延伸停滞;CNV形成中,MMP-2的表达增加,并与角膜的炎性反应程度一致,PMN浸润可能是CNV形成的关键因素。