非胰岛素依赖型糖尿病人缺锌对部分免疫功能的影响

对３４例非胰岛素依赖型糖尿病（ＮＩＤＤＭ）患者在用一般降糖治疗后血糖稳定时加用锌剂，检测补锌前后免疫功能和血清锌含量的改变。结果发现：糖尿病红细胞受体花环（ＲＢＣ＿Ｃ３ｂＲＲ），Ｔ淋巴细胞亚群（ＣＤ３，ＣＤ４，ＣＤ４／ＣＤ８）及血清锌均低于正常对照组，而ＣＤ８及红细胞免疫复合物花环（ＲＢＣ－ＩＣＲ）高于对照组，经补锌治疗一月后，糖尿病组血清锌，ＲＢＣ－Ｃ３ｂＲＲ，ＲＢＣ－ＩＣＲ，ＣＤ３，ＣＤ４诼Ｃ     

Conformation of Replicated Segments of Chromosome Fibres in Human S-phase Nucleus

Recent statistical analysis of the folding of G0/G1 chromosomes using fluorescence in situ hybridization (FISH) allowed development of a random walk/giant loop model of chromosome structure. According to this model there are two levels of organization of G0/G1 chromosome fibres. On the first level, the fibres are arranged in giant loops several Mbp in size, and within each loop the fibres are randomly folded. On the second level, the loop attachment sites form a chromosome backbone that also shows random folding. Newly replicated segments of mammalian chromosomes may be directly visualized at high resolution in S-phase nuclei using immunofluorescent methods and appear as worm-like fibres. In our earlier study, we analysed conformation of the fibres in human cells blocked for 16 h at the G1/S boundary with 5- fluorodeoxyuridine (FdU) and then released into S-phase by the addition of a DNA prec ursor. However, long treatment of cells with FdU induces very short replicons and may promote apoptosis. In this study we analysed conformation of the fibres in normally proliferating human cells that had not been blocked with FdU for a long time. It has been found that replicated chromosome fibres visualized just after 2 h of incubation of the cells with a non-radioactively labelled DNA precursor behave as flexible polymer chains without major constraints, and that their local conformation in the range of several microns of their contour length may be considered as random. Confocal analysis of human X chromosomes visualized in HeLa cells using FISH with a specific painting probe shows that in S-phase the chromosomes occupy distinct nuclear territories and their apparent size does not differ from that in non-S-phase cells. This observation indicates that the second level of chromosome organization also exists in S-phase chromosomes. It appears, theref ore, that the random walk/giant loop model developed earlier for G0/G1 chromosomes is also valid for S-phase chromosomes.     

Public–Private Collaboration in Health and Human Service Delivery: Evidence from Community Partnerships

The collaboration among public–private partnerships that applied to the Community Care Network (CCN) demonstration program of the Hospital Research and Educational Trust is examined. These partnerships link broad-based community coalitions with health and human service providers in efforts to improve community health and local service delivery. Although they willingly collaborated in identifying community health needs, coordinating services, and reporting to the community, partnership participants showed less alacrity in joining forces to reduce redundancy and increase efficiency. Such patterns suggest that organizations might best profit from working together on activities that maintain existing power relations and that have the potential to add prestige and attract new clients. Collaboration in these areas may be essential to building a foundation of trust that leads to future cooperation in more sensitive areas.     

Ovulation by repeated human chorionic gonadotrophin in 'empty follicle syndrome' yields a twin clinical pregnancy

This case illustrates the possibility of obtaining oocytes that fertilize and cleave normally after the administration of a second ovulatory dose of human chorionic gonadotrophin (HCG) in a case of 'empty follicle syndrome'. The present patient underwent ovarian stimulation with gonadotrophin-releasing hormone analogue (GnRHa)/menotropin for intracytoplasmic sperm injection (ICSI). After the failure of the first oocyte retrieval, a second dose of HCG was administered to trigger ovulation. A total of 13 oocytes was retrieved during the second procedure and 11 good quality embryos were obtained (fertilization and cleavage rates of 92 and 91% respectively). No pregnancy was achieved after the replacement of three embryos. In a subsequent cycle stimulated with clomiphene citrate, three frozen- thawed embryos were replaced and a twin pregnancy was achieved. The patient delivered two healthy babies at term.      

Time-frequency analysis of heart murmurs. Part II: Optimisation of time-frequency representations and performance evaluation

The basic parameters of the spectrogram, the Choi-Williams, and the Bessel distributions are adjusted to provide the best time-frequency representations (TFRs) of the simulated murmur signals of mitral stenosis, mitral regurgitation, aortic stenosis, aortic regurgitation, and of two musical murmurs. The initial adjustment of the parameters of each TFR technique is performed by computing and minimising the relative averaged absolute error between the frequency contours at −3dB and −10dB of each TFR of the simulated murmurs and those of the theoretical distribution of the same signals. The results show that the spectrogram generally provides very good to excellent performance in representing the TFRs of stenotic and regurgitant murmurs. Improvements provided by the Choi-Williams and the Bessel distributions are minor but not systematic for the two signal-to-noise ratios tested (0 and 30 dB) and for the two frequency contours estimated. The Bessel and the Choi-Williams distributions provide the best performance for the musical murmurs. The study shows that although a single technique cannot be optimal for all six murmurs, the spectrogram using a Hamming window of 30 ms is an acceptable compromise to detect the six simutated heart murmurs.     

Rectus muscle flap for repair of refractory bladder fistula following renal transplantation: a case report

We report a case of refractory bladder fistula in a diabetic renal allograft recipient that recurred shortly after conventional operative repair without any detectable external cause. After reoperation and use of a vascularized rectus muscle flap the fistula closed and the patient has retained excellent graft function. It is suggested that this technique should be considered as the primary repair modality for bladder fistulas in diabetic recipients, when wound healing is impaired seriously as a consequence of the combined effects of diabetic microangiopathy and steroid therapy.     

A method of portalizing the venous blood flow of the left adrenal gland

The authors, having studied the long-term results of the operation of creating the renoportal venous anastomoses in patients with severe and malignant course of arterial hypertension, revealed anastomotic thrombosis in presence of hypotensive effect. Developed in the experiment and employed in 7 patients was the technique of dosaged narrowing the central left adrenal vein with the aim of achieving its thrombosis, inclusion of the collateral routes of the left adrenal blood outflow into the system of the portal vein and inactivation of aldosterone in the liver.     

Injury of the rotator cuff. I. Morphological and patho-physiological basis

Authors summarize the basic features of the functional anatomy and pathogenesis of the rotator cuff tears, essential for clinical practice. On the basis of literary data and own experiences a new classification of the rotator cuff tears was elaborated that can be reliably used in operative indications.