HLA-Ⅱ类基因单倍型与中国北方汉族人皮肌炎/多发性肌炎的相关性研究

目的：探讨HLA-DRB1、DQB1基因单倍型与中国北方地区汉族人皮肌炎，多发性肌炎的相关性。方法：采用聚合酶链反应，序列特异性引物(PCR-SSP)技术，检测中国北方汉族皮肌炎，多发性肌炎患者的HLA-DRB1、DQB1等位基因。结果：与100例正常对照组比较，在52例皮肌炎，多发性肌炎患者中HLA-DRB1^#040x-DQB1^#0301、DRB1^#040x-DQB1^#0401单倍型频率明显增高，经统计学检验两组差别有显著意义，P值分别为0.0307、0.0033。HLA-DRB1^#150x-DQB1^#0602单倍型频率明显降低，P值为0.0201。在38例皮肌炎组中，HLA-DRB1^#040x-DQB1^#0301、DRB1^#040x-DQB1^#0401、DRB1^#070x-DQB1^#0201、DRB1^#120x-DQB1^#0303单倍型频率明显增高，P值分别为0.0292、0.0015、0.0450、0.0192，两组差别有统计学意义。在14例多发性肌炎患者中HLA-DRB1^#070x-DQB1^#0301单倍型频率明显增高，P值为0.0141。结论：特异单倍型可能是决定皮肌炎，多发性肌炎发病及皮肌炎、多发性肌炎异质性的重要因素。     

Combined hormone therapy in postmenopausal women with features of metabolic syndrome. Results from a population-based study of Swedish women: Women's Health in the Lund Area study

OBJECTIVE: To delineate the influence of hormone therapy (HT) on features of metabolic syndrome with special reference to the composition and mode of administration of three specific HT regimens, all containing estradiol (E2) + norethisterone. DESIGN: The Women's Health in the Lund Area project screened all women (n = 10,766), born between 1935 and 1945. Complete data were obtained from 6,917 women. Those at or above defined cutoff limits were considered positively screened (n = 3,593) for metabolic syndrome. All of them were invited to undergo an oral glucose tolerance test; 2,923 women accepted. After excluding 200 women with impaired fasting glucose, 2,723 women were included in the present analysis. Serum lipids were determined by conventional standard methods at the department of clinical chemistry of Lund University Hospital. RESULTS: According to World Health Organization criteria, 2,123 women had normal glucose tolerance and 600 women had impaired glucose tolerance (IGT). IGT was less common (P = 0.001) among users of a transdermal patch [CYC-TRANS; E2 50 microg + norethisterone acetate (NETA) 250microg] compared with the two-combined oral regimen [CON-O (continuous oral E2 2 mg + NETA 1 mg) + CYC-O (sequential oral E2 2 mg + NETA 1 mg)]. Furthermore, IGT was more common among CON-O users when compared with either the CYC-O + CYC-TRANS group (P = 0.002) or the CYC-TRANS only group (P = 0.001). There were no significant differences between CYC-O versus CYC-TRANS or CON-O. Serum levels of total cholesterol were higher in the CYC-TRANS group than in the combined CON-O + CYC-O group (P < 0.05); they also were higher (P = 0.05) when comparing the CYC-O + CYC-TRANS versus CON-O as well as higher in CYC-TRANS versus CON-O (P < 0.05). Serum high-density lipoprotein cholesterol levels were higher in the CYC-O (P = 0.001), CYC-TRANS (P < 0.05), and the CYC-O + CYC-TRANS (P = 0.001) groups when compared with the CON-O users. There were no differences in the mean age, blood pressure (systolic and diastolic), body mass index, waste-hip ratio, or the rate of cigarette and alcohol consumption between the different hormone regimens. CONCLUSION: The risk of having a pathological glucose load was lower in transdermal versus oral users of HT. Transdermal HT could be regarded as first-line treatment in women at risk of developing diabetes.     

Prenatal paracetamol exposure and risk of asthma and elevated immunoglobulin E in childhood

BACKGROUND: We recently found that paracetamol (acetaminophen) use in late pregnancy was associated with an increased risk of early wheezing in the offspring. OBJECTIVE: To see whether use of paracetamol in late pregnancy is associated with an increased risk of asthma, wheezing and other atopic outcomes in the child at school age. METHODS: In the population-based Avon Longitudinal Study of Parents and Children, we measured associations of paracetamol and aspirin use in late pregnancy (20-32 weeks) with asthma, hayfever, eczema (n = 8511) and wheezing (8381) in the offspring at 69-81 months, and with atopy (positive skin prick test to Dermatophagoides pteronyssinus, cat or grass, n = 6527) and blood total IgE (n = 5148) at 7 years. We used logistic and linear regression to analyse binary outcomes and log-transformed IgE, respectively, controlling for potential confounders. RESULTS: Use of paracetamol, but not aspirin, in late pregnancy was positively associated with asthma (odds ratios (ORs), comparing children whose mothers took paracetamol 'sometimes' and 'most days/daily' with those whose mothers never took it, 1.22 (95% confidence interval (CI): 1.06-1.41) and 1.62 (95% CI: 0.86-3.04), respectively; P trend = 0.0037), wheezing (ORs 1.20 (95% CI: 1.02-1.40) and 1.86 (95% CI: 0.98-3.55), respectively; P trend = 0.011), and total IgE (geometric mean ratios 1.14 (95% CI: 1.03-1.26) and 1.52 (95% CI: 0.98-2.38), respectively; P trend = 0.0034), but not hayfever, eczema or skin test positivity. The proportion of asthma attributable to paracetamol use in late pregnancy, assuming a causal relation, was 7%. CONCLUSION: Paracetamol exposure in late gestation may cause asthma, wheezing and elevated IgE in children of school age.     

小学生中抑郁症状现况调查

目的：初步了解儿童中抑郁障碍的患病现况，探讨儿童抑郁的常见表现。方法：使用儿童抑郁自评量表(DSRSC)调查长沙市某小学二年级到六年级的565名小学生，并对量表总分≥划界分的学生进行面谈。结果：在565名小学生(男生290名，女生275名)中，量表总分≥划界分的有97名，占总人数的17．17％。使用CCMD-3成人抑郁发作的诊断标准对量表总分≥划界分的93名进行了面谈(面谈率为95．90h，)，发现符合抑郁发作的症状学标准的有38名(其中男生28名，女生10名)，占面谈者的40．9％，无一名达到病程标准和严重程度标准。结论：在儿童中抑郁症状存在较普遍，但真正构成抑郁症临床诊断的极少。     

舒必利与氯丙嗪合用治疗慢性精神分裂症阴性症状的对照研究

目的 探讨舒必利与氯丙嗪及舒必利,氯丙嗪治疗慢性精神分裂症阴性症状的疗效。方法 将60例以阴性症状为主要表现的慢性精神分裂症病人随机分为舒必利合并氯丙嗪组(研究组)及舒必利组,氯丙嗪3个组。用临床疗效评定标准和BPRS量表评定疗效。结果 研究组的显效率(显进 痊愈)明显比氯丙嗪组及舒必利组高,x~2检验P<0.05提示舒必利合并氯丙嗪治疗比单一用药疗效显著。舒必利组氯丙嗪组显效率比较无显著性差异(P<0.05)。结论 舒必利合并氯丙嗪治疗慢性精神分裂症阴性症状的疗效比单一用药更好,副作用更少。     

Zur histogenese und cytogenese des tapetum lucidum cellulosum der katze

Zusammenfassung Die postnatale Entwicklung des Tapetum lucidum cellulosum der Katze wird mit licht- und elektronenmikroskopischen Methoden untersucht. Bereits am ersten postnatalen Tag sind im Bereich des prospektiven Tapetum zwei Zellarten voneinander zu unterscheiden: 1. mesenchymale Bindegewebszellen und 2. prospektive Tapetumzellen, die durch elektronendichte Tapetumstäbchen gekennzeichnet sind. Die Mesenchymzellen unterteilen als parallel zur Retinaoberfläche ausgebreitete Zellplatten in der Choriodea am hinteren Augenpol den weiten extracellulären Raum in 20–25 etwa 5 m hohe Schichten. Die Tapetumzellen liegen zwischen den Mesenchymzellplatten und wachsen im Verlaufe der ersten vier postnatalen Wochen innerhalb der Schichten in die Breite, bis sie den extracellulären Raum vollständig ausfüllen und als polygonale Zellen direkt aneinander grenzen. Im weiteren Verlauf der Entwicklung werden die Mesenchymzellplatten rückgebildet, so daß bei der adulten Katze die Tapetumzellschichten direkt übereinander liegen und nur von Netzen elastischer und kollagener Fasern getrennt sind.Die von einer Elementarmembran umgebenen Tapetumstäbchen enthalten einen elektronendichten, in den ersten postnatalen Wochen mit einer Periode von 100 Å quergestreiften Kern. Zunächst nehmen sie an Zahl und Länge zu und füllen am Ende der vierten postnatalen Woche, zu Bündeln von parallel verlaufenden Stäbchen geordnet, das Cytoplasma der Tapetumzellen. Dann nehmen die Tapetumstäbchen an Dicke zu, und ihre Querstreifung wird von einem elektronendichten Material überlagert. Die Entwicklung der Tapetumstäbchen hat eine starke Ähnlichkeit mit der in der Literatur beschriebenen Entwicklung von Melanosomen in Melanocyten. Das Tapetum lucidum cellulosum wird als ein dichter Verband hochdifferenzierter extrakutaner Melanocyten angesehen.

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Summary The postnatal development of the tapetum lucidum cellulosum of the cat was studied by light and electron microscopy. Already by the first postnatal day two cell types can be distinguished in the prospective tapeta area: 1. mesenchymal cells and 2. prospective tapetal cells, characterized by electron dense, membrane bound, rod-like inclusions. The flattened mesenchymal elements form 20–25 separate layers of cells, which are arranged parallel to the surface of the retina, subdividing the extracellular space of the chorioidea at the posterior pole of the eye into 5 m high compartments. These compartments contain the tapetal cells which enlarge (in their longitudinal axis) during the first four weeks post partum until they occupy the extracellular space almost completely. At this stage, the tapetal cells are polygonal in shape and closely attached to each other. During the subsequent period of development there is a gradual involution of the mesenchymal cell plates. Thus, in adult cats the individual layers of tapetal cells are only separated from each other by networks of collagen and elastic fibers.The tapetal rods are bound by unit membranes and contain an electron dense core which, during the early postnatal weeks, exhibits a periodic cross-striation (100 Å). The tapetal rods increase in number and length during the first four weeks post partum; by the end of the fourth week, they occupy the whole cytoplasm of the tapetal cells. Parallelly arranged rods are grouped into individual bundles coursing inside the cytoplasm in different directions. Thereafter, the tapetal rods increase in thickness and their cross-striation becomes obscured by an electron dense material. This development of the tapetal rods closely resembles that of melanosomes.Thus the tapetum lucidum cellulosum can be regarded as a compact tissue made up of modified extracutaneous melanocytes.

Auszugsweise vorgetragen auf der 69. Versammlung der Anatomischen Gesellschaft in Kiel, Juni 1974.     

Exploring cancer register data to find risk factors for recurrence of breast cancer – application of Canonical Correlation Analysis

Background  

A common approach in exploring register data is to find relationships between outcomes and predictors by using multiple regression analysis (MRA). If there is more than one outcome variable, the analysis must then be repeated, and the results combined in some arbitrary fashion. In contrast, Canonical Correlation Analysis (CCA) has the ability to analyze multiple outcomes at the same time.     

双胎妊娠44例临床分析

本文对我院1990～1995年间44例双胎妊娠的分娩方式进行了分析。指出双胎妊娠由于胎位异常、产力异常及妊娠并发症多等因素,难产及手术产率均较单胎明显增高。在25例经阴道分娩的双胎中,阴道手术产率为64％,本组双胎剖宫产率为43.22％。本文认为双胎妊娠的分娩方式应掌握以下原则:当第一胎儿为臀泣、第二胎位为头位,尤其是胎儿较大、羊水较少时,应考虑剖宫产。而单纯的第二胎儿臀位可以经阴道分娩,不必常规剖宫产。