Multiple aneurysms in Beh?et's disease

Beh?et's disease is characterized by recurrent ulcers of the mouth and genitalia and relapsing iritis. It is now recognized as a chronic multisystem disease affecting the skin, mucous membranes, eye, joints, central nervous system, and blood vessels. One of the known vascular complications of Beh?et's disease is aneurysm formation or venous thrombosis. The two patients with Beh?et's disease in this report developed multiple aneurysms over a short time span. Vascular surgeons dealing with young adults with peripheral aneurysms must be aware of this uncommon yet challenging clinical entity.     

碳酸利多卡因硬膜外麻醉用于乳腺癌根治术的评价

40例乳腺癌根治术患者，美国麻醉医师协会（ASA）分级Ⅰ-Ⅱ级，随机分为2且，第1组硬膜外阻滞＋臂丛神经阻滞，应用1．33％盐酸利多卡因＋0．15％盐酸地卡因＋1：20万肾上腺素，硬膜外阻滞首量12ml，臂丛神经阻滞20ml;第2组硬膜外阻滞，应用1．73％碳酸利多卡因＋1：20万肾上腺素，首量15ml。两组硬膜外阻滞选为T4－5间隙穿刺。首量给完后测定麻醉药效，并监测患者心率（HR）、平均动脉压（MAP）、血氧饱和度（SpO2)，在麻醉前、后30、60、120min抽取动脉血作血气分析。结果显示：第2组麻醉的起效时间、阻滞完善时间要比第1组短（P＜0．01）。感觉神经阻滞分段数要比第1组多（P＜0．01）；两组病人的HR和MAP，麻醉手术中改变不明显。麻醉后面罩给氧。两组病人的SpO2、PaO2增加，PaCO2有所下降，两组比较无统计学意义，但组内前后对照有显著差异（P＜0．05）。结果提示碳酸利多卡因硬膜外麻醉下施行乳腺癌根治术具有良好的麻醉效果和更高的安全性。     

In vitro differentiation of human adipose-derived adult stromal cells into neuron-like cells in hippocampal astrocyte conditioned medium

BACKGROUND: At present, researches on differentiating from human adipose-derived adult stromal cells (hADASC) to neuron-like cells are focus on inducing by artificial-synthetic compound solution; however, hippocampal astrocyte conditioned medium (HCAM) can induce in vitro differentiation from hADASC to neuron-like cells is still unclear. OBJECTIVE: To observe whether HCAM can induce in vitro differentiation from hADASC to neuron-like cells. DESIGN: Randomized control study. SETTING: Department of Neurology, Taixing People's Hospital; Central Laboratory, North China Coal Medical College. MATERIALS: Donor of adipose tissue was donated by female volunteers suffering from caesarean section in the department of obstetrics & gynecology in our hospital and aged 20－35 years. Adipose tissue was collected from subcutaneous tissue of abdomen during the operation. In addition, 8 male newborn Wistar rats within 24 hours with average body mass of 20 g were provided by Animal Institute of Chinese Academy of Medical Sciences. Rabbit-anti-human Nestin polyclonal antibody, rabbit-anti-human glial fibriliary acidic protein (GFAP) polyclonal antibody, rabbit-anti-human neuro-specific enolase polyclonal antibody and mouse-anti-human microtubal associated protein 2 (MAP-2) polyclonal antibody were provided by Wuhan Boster Company. METHODS: The experiment was carried out in the Central Laboratory of North China Coal Medical College from October 2004 to June 2005. hADASC was cultured with HCAM and its growth and morphological changes were observed under inverted phase contrast microscope. Immunocytochemistry, immunofluorescence and Western blotting were used to evaluate the expressions of Nestin, which was a specific sign of nerve precursor, neuro-specific enolase and MAP-2, which was a specific sign of nerve cell, and GFAP, which was a specific sign of neuroglial cells. MAIN OUTCOME MEASURES: Nestin, which was a specific sign of nerve precursor, neuro-specific enolase and MAP-2, which was a specific sign of nerve cell, and GFAP, which was a specific sign of neuroglial cells. RESULTS: On the 3rd day of culture, partial hADASC started deformation from slender shuttle-shape cells to neuron-like cells. It suggested that cells stretched out apophysis, which were mainly double-pole or multiple-pole cells. Five days later, immunohistochemical detection suggested that expression of Nestin (10.5±0.037) was found out in cells; meanwhile, expressions of GFAP (38.4±0.052) and neuro-specific enolase (NSE) (15.7±0.023) were also found out in cells; however, expression of MAP-2 was not observed. Western blot indicated that, 5 days after effect of HCAM, Nestin was found out in hADASC; meanwhile, expressions of GFAP and neuro-specific enolase were also found out; however, expression of MAP-2 was not observed. CONCLUSION: HCAM can induce the differentiation from hADASC to neuron-like cells in vitro.     

万艾可治疗ED时对BPH引起LUTS改善的研究

目的 :探索、研究万艾可在治疗阴茎勃起功能障碍 (ED)时对由良性前列腺增生 (BPH)引起的下尿路症状(LUTS)的影响。　方法 :32例ED同时伴有BPH的研究对象 ,采用IIEF 5问卷表和IPSS评分表 ,在服用万艾可前和服药后 6个月分别各填写一次 ,应用单因素方差分析对所得到的前后评分进行统计学分析。结果 :在服药前32例ED中 ,轻、中、重分别为 14、13、5例 ,BPH中轻、中、重分别为 3、15、14例 ;服药后IIEF 5评分平均上升4 2 .36 % ,IPSS评分平均下降 2 0 .14 % ,两者在统计学上都有显著性差异 ,P <0 .0 1。　结论 :在治疗中老年性ED合并BPH中 ,应用万艾可既能治疗ED ,取得完美的性生活 ,又能达到改善由BPH引起的LUTS。万艾可是一治疗ED有效的药物 ,但对于前列腺基质平滑肌亦有辅助性松弛作用 ,因此也有助于BPH时LUTS的缓解。     

病理性近视眼的研究进展

通过复习近年来相关文献,对近视眼发生发展机制与形觉剥夺之间的关系进行综合评述。认为近视眼的发生及眼轴延长与形觉剥夺有一定关系,深入研究其相关机制,对近视眼的早期防治具有重要意义。     

口腔黏膜下纤维性变S100蛋白表达

OBJECTIVE: To study the expression of S100 in oral submucose fibrosis(OSF). METHODS: Immunohistochemistry assay was performed on 10 cases of OSF, 10 cases of oral epithelial dysplasia (OED) and 8 cases of normal oral epithelium using monoclonal antibody against S100 protein. RESULTS: S100 did not express in the normal oral muscosal epithelium. The S100 positive nuclear staining was found in 50% of the OSF and OED cases, which was significantly higher than that in the normal oral epithelium (P < 0.05). But the positive staining in the OSF and OED cases had no difference (P > 0.05). CONCLUSION: S100 expression is closely related to the development of OSF and OED. The positive staining expression in the OSF and OED cases is the same.     

LONG‐TERM OUTCOME OF ENDOSCOPIC BALLOON DILATION IN OBSTRUCTIVE GASTROINTESTINAL CROHN's DISEASE

Background: Gastrointestinal strictures are the most often and serious complication in Crohn's disease. Because of the frequent postoperative recurrence in Crohn's disease, endoscopic therapy of gastrointestinal stricture is one of the best therapeutic options. Method: The present study sets out the results from a prospective study of endoscopic dilation therapy on 48 Crohn's disease patients with severe gastrointestinal stenoses. All patients who could not undergo endoscopic balloon dilation therapy (EBD) were operated on. Results: Long‐term success was attained in 32 of the 48 patients; cumulative avoidance of surgery after EBD was 86% at one year and 71% at three. Second, the most hazardous factor was recurrent inflammation causing restenosis. Patients who had strictures with oral luminal dilatation and patients with frequent recurrence had a tendency to be operated on. As a complication, perforation occurred in two cases (3.3%). Conclusions: EBD therapy for Crohn's stricture in the gastrointestinal tract is recommended before surgical intervention.     

The significance of a rapid cold hemagglutination test for detecting mycoplasma infections in children with asthma exacerbation.

BACKGROUND AND PURPOSE: Mycoplasma pneumoniae infection is a frequent cause of community-acquired respiratory infections in children and adults. However, standardized, rapid, specific methods for its diagnosis are lacking. The relationship between M. pneumoniae infection and asthma exacerbation has been recently discussed in the literature. We investigated the accuracy of rapid detection of mycoplasma infection by cold hemagglutination test compared to conventional enzyme immunoassays. The clinical characteristics of mycoplasma infection seen during emergent visits in asthmatic children were reviewed. METHODS: We retrospectively reviewed medical records of patients with asthma exacerbation visiting the Department of Pediatric Emergency, National Taiwan University Hospital, over a 12-month period. Subjects 2-18 years of age diagnosed with asthma at our outpatient clinic were included in this study. Patients with immunodeficiency, congenital anomalies, neurological diseases and irregular follow-up were excluded. RESULTS: A total of 269 children (174 males and 95 females) with a mean (+/- standard deviation) age of 6.15 +/- 3.08 years were included. The prevalence of asthma exacerbation in regular follow-up patients was 13.4%, and as many as 19.6% of cases (74/378 person-times) required hospitalization. Asthma attacks were most prevalent during December. 126 patients had both rapid cold hemagglutination testing and mycoplasma immunoglobulin M titers determined using acute blood samples drawn in the emergency room; 46 (36.5%) of these patients demonstrated mycoplasma infection. Sensitivity and specificity of the rapid cold hemagglutination test was 78.3% and 41.3%, respectively. The positive predictive value was 43.4%. Comparison of patients with or without mycoplasma infection revealed no differences in gender, age, chest X-ray findings, and most symptoms/signs and laboratory data, except that more signs of fever and auscultatory rales were seen in the non-mycoplasma infection group. CONCLUSIONS: Mycoplasma infections could be an exacerbating factor for asthma, and the rapid cold hemagglutination test should not be a guideline for prescribing macrolides in the emergency room.