Cause-specific and total mortality in the Canterbury (New Zealand) insulin-treated Diabetic Registry population: a 15-year follow-up study.

AIMS: To establish all-cause and cause-specific death rates, and risk factors for mortality in insulin-treated diabetic individuals living in the province of Canterbury, New Zealand. METHODS: Insulin-treated diabetic subjects (n = 995) on the Canterbury Diabetes Registry were followed up over 15 years and vital status determined. Death rates were standardized and hazard regression was used to model the effects of demographic covariates on relative survival time. RESULTS: There were 419 deaths in 11 226.3 person-years of follow-up with a standardized mortality ratio (SMR) of 2.0 (95% confidence interval (CI) 1.8-2.2). Relative mortality was greatest for the group aged 0-29 years (SMR 3.0 (95% CI 2.4-3.7)). After controlling for diabetes duration and gender, a 10-year increment in age of onset was associated with a 33% decrease in relative hazard (95% CI 29-36%), indicating that excess mortality due to diabetes declines with rising age of onset. After controlling for age of onset and gender, each 10-year increment in duration of diabetes is associated with a 26% decrease in relative hazard (95% CI 24-29%), indicating that with longer survival the mortality hazard approaches the general population hazard. Relative mortalities were increased for cardiovascular, renal and respiratory disease, but not malignancy. Relative mortality from acute metabolic complications was increased in the subgroup with age of onset of diabetes < 30 years and requiring insulin within 1 year of diagnosis. CONCLUSIONS: Mortality rates are high for insulin-treated diabetic individuals relative to the general population.     

体外诱导条件下大鼠骨髓基质细胞骨钙素和Ⅰ型胶原mRNA的表达

目的　研究体外培养大鼠骨髓基质细胞诱导条件下 ,成骨分化标志骨钙素和 型胶原 m RNA水平的表达。方法　采用成骨诱导剂 (含地塞米松 10 - 8mol/ L、β甘油磷酸钠 10 mm ol/ L和抗坏血酸 AA 5 0μg/ml)对培养状态下的不同代大鼠骨髓基质细胞进行成骨诱导 ,提取 RNA,采用 RT- PCR方法 ,以β-肌动蛋白 c DNA为内参照 ,检测骨钙素和 型胶原 m RNA的表达。结果　与对照组相比 ,接受成骨诱导剂作用的大鼠骨髓基质细胞随诱导时间的延长骨钙素和 型胶原 m RNA出现高表达 ,且维生素 D为诱导骨钙素 m RNA表达的必需成分。结论　体外培养的大鼠骨髓基质细胞保持成骨未分化状态 ,无骨钙素和 型胶原 m RNA的表达 ,诱导后可向成骨分化 ,骨钙素和 型胶原 m RNA表达升高     

发育期大鼠高热惊厥前后海马γ-氨基丁酸B受体亚基表达的变化

目的：研究高热惊厥(febrile seizures，FS)对发育期大鼠脑内γ-氨基丁酸(γ-aminobutyric acid，GABA)B受体亚基GABABR1与GABARR2蛋白表达的影响。方法：采用热水浴诱导大鼠高热惊厥模型。隔日诱导惊厥1次，共诱导10次，末次惊厥后24h处死大鼠。发育期大鼠随机分为3组：对照组(n＝24)，1次高热处理组(n＝28)，10次高热处理组(n＝40)。高热处理组根据是否出现惊厥再分为1次高热惊厥组(FS1，n＝16)与1次高热未惊厥组(F1，n＝12)，10次高热惊厥组(FS10，n＝15)与10次高热未惊厥组(F10，n＝13)。采用免疫组化方法观察不同次数高热惊厥大鼠脑内GABABR1与GABABR2蛋白表达的变化。结果：FS10大鼠海马齿状回、CAl-CA3区GABABRl和GABABR2蛋白表达明显低于F10、F1、FSl和对照组；F10大鼠上述脑区GABABRl和GABABR2蛋白表达低于F1、FS1和对照组；F1及FS1大鼠与对照组相比差异无显著性；海马各区GABABR1与GABABR2表达的改变大部分平行，但10次高热惊厥后GABABR2在CA1—CA3区下降更明显，而GABABR1在齿状回下降更明显。结论：反复高热惊厥及反复高热均可使发育期大鼠脑内GABABR亚基蛋白表达降低，高热惊厥的影响较单纯高热更为明显，提示GABABR亚单位与发育期大鼠高热惊厥及其脑损伤密切相关。GABABR1与GABABR2改变的不平行可能与受体亚单位组合的可塑性改变有关，这种改变可能导致抑制功能的改变。     

脾脏钝伤的CT诊断

本文回顾性分析了３２例脾脏钝伤ＣＴ平扫的表现；对脾损伤进行ＣＴ分类；指出腹腔积血和脾周血块（“哨兵血块征”）在诊断脾损伤方面的作用。ＣＴ平扫诊断钝性脾脏损伤是一种敏感、可靠的方法，可帮助外科医生制订治疗方案。ＣＴ平扫诊断钝性脾损伤的灵敏度为９４％，诊断正确率为９１％     

Human interleukin 4 regulates the phenotype of lymphocytes generated during mixed lymphocyte culture and inhibits the IL-2-induced development of LAK function in normal and leukaemic cells

This study examined the immunoregulatory role of recombinant interleukin 4 (IL-4), also known as B-cell stimulating factor 1, on the generation of cytotoxic effector cells from normal and leukaemic human blood mononuclear cells. When tested on cells from normal individuals, the addition of IL-4 to mixed lymphocyte cultures led to a dose-dependent proliferation of T-helper cells (CD3, 4 positive) with a concomitant decrease in phenotypic and functional cytotoxic T cells and natural killer (NK) cells. IL-4 also inhibited the interleukin-2 (IL-2)-induced generation of lymphokine-activated killer (LAK) activity when added at the beginning of mixed lymphocyte culture. When tested on mature leukaemic NK cells, IL-4 also inhibited the ability of IL-2 to induce LAK function using a short-term culture system. These results show that IL-4 acts on both normal and leukaemic cells and suggests that it acts at more than one level during the development of LAK function.     

Clinical Study on Long-Term Treatment of Ankylosing Spondylitis with Integrative Medicine

Ａｎｋｙｌｏｓｉｎｇｓｐｏｎｄｙｌｉｔｉｓ（ＡＳ）ｉｓａｒｈｅｕｍａｔｉｃｄｉｓｅａｓｅｗｉｔｈｈｉｇｈｉｎｃｉｄｅｎｃｅ，ｉｎｄｕｃ ｉｎｇｄｉｓａｂｉｌｉｔｙａｎｄｉｎｖａｄｉｎｇｔｈｅｓｐｉｎａｌａｘｉａｌｊｏｉｎｔａｓｉｔｓｃｈｉｅｆｃｈａｒａｃｔ     

Stereoselectivity of actions of the calcium sensitizer [+]-EMD 60263 and its enantiomer [-]-EMD 60264

The thiadiazinone derivative [+]-EMD 60263 ((+)-5-(1-(α-ethylimino-3,4-dimethoxybenzyl)-1,2,3,4- tetrahydroquinoline-6-yl)-6-methyl-3,6-dihydro-2H-1,3,4 -thiadiazine-2-on) is a Ca²⁺-sensitizing agent with only minor phosphodiesterase inhibitory activity. Our aim was to characterize the inotropic and electrophysiological effects of [+]-EMD 60263 and its enantiomer [-]-EMD 60264 in several cardiac muscle preparations. The Ca²⁺-sensitizing activity resided in the [+]-enantiomer only. [+]-EMD 60263 (3 μM) shifted the EC₅₀ of Ca²⁺ for contractile activation of skinned fibers of pig heart from 2.41 μM to 0.73 μM, whereas [-]-EMD 60264 (30 μM) was ineffective. In Langendorff-perfused guinea pig hearts, [+]-EMD 60263 and [-]-EMD 60264 induced concentration-dependent positive and negative inotropic effects, respectively; both enantiomers reduced spontaneous heart rate but did not influence perfusion pressure. The maximum increase in force of human atrial trabeculae was 35 % of pre-drug control with [+]-EMD 60263 in comparison to 113 % with forskolin. In guinea-pig papillary muscles, [+]-EMD 60263 and [-]-EMD 60264 had opposite inotropic responses, however, both agents similarly prolonged action potential duration. Both enantiomers concentration-dependently blocked the rapidly activating component I_Kr of the delayed rectifier in guinea-pig myocytes. The block saturated at potentials positive to +30 mV, closely resembling the effects of the antiarrhythmic agent E-4031 which had been originally used to define I_Kr. It is concluded, that the positive inotropic action of [+]-EMD 60263 can be explained by prevalence of the Ca²⁺-sensitizing effect. The accompanying prolongation in action potential duration is caused by block of the I_Kr component of the delayed rectifier. While the inotropic effects are stereoselective, most of the electrophysiological actions are clearly independent of sterical configuration. The combination of Ca²⁺-sensitizing with class-III antiarrhythmic action may provide an interesting pharmacological profile of potential therapeutic use. Received: 7 January 1997 / Accepted: 25 February 1997     

青年人群血清流感抗体水平纵向监测

通过对北京４０５例青年１９９２～１９９４年流感抗体的纵向监测结果表明，３年中Ｂ型流感表现很活跃，抗体分别在１９９３年和１９９４年春出现高峰。Ａ型流感抗体在１９９３年春出现高峰。其中２１８例个体连续３年６次抗体检测，据抗体波动提示：３年中流感３个亚型总的感染频率为４４０％，每个体每年平均为１．４次，其中Ａ１型感染频率最高，每个体３年内平均１．８次；Ａ３型次之为１．５２；Ｂ型为１．０６。流感３个亚型抗体在机体内有６７％～７３％高水平抗体个体可在０．５～１年内下降至≤２０的低水平。２１８例个体中Ａ１型抗体３年内长期低水平者有３％，Ａ３有９％，Ｂ有３８％。