Hysterosalpingo contrast sonography (HyCoSy) with SH U 454 (Echovist) for the assessment of tubal patency

A total of 88 Fallopian tubes from 44 patients was examined with hysterosalpingo contrast sonography (HyCoSy), hysterosalpingogram (HSG), and laparoscopic chromopertubation (LC) in order to assess their relative accuracy for measuring tubal patency. HyCoSy was done by transvaginal ultrasound and the contrast was SH U 454 (Echovist). The flow of multiple fractions of the contrast medium through each Fallopian tube was observed in real time in appropriate imaging planes by means of a transvaginal probe. Compared with laparoscopic results, we found a sensitivity of 85.2%, a specificity of 85.2%, a positive predictive value (PPV) of 71.9%, a negative predictive value (NPV) of 92.9% and concordance (HyCoSy/LC) of 85.2%, while the corresponding values for HSG were sensitivity = 85.2%, specificity = 83.6%, PPV = 69.7%, NPV = 92.7% and concordance (HSG/LC) of 84.1%. Compared with HSG results, HyCoSy obtained a co-positivity of 66.7%, a co-negativity of 81.8% and a concordance of 76.1%. In conclusion, HyCoSy with SH U 454 proved to be a reliable and safe modality for evaluating tubal patency; it is suitable as an outpatient diagnostic procedure to be used before more invasive procedures.      

IGF-I和hCG对大鼠Leydig细胞葡萄糖转运蛋白基因表达调控研究

背景与目的:研究胰岛素样生长因子-I(Insulin-likegrowthfactor-I,IGF-I)和人绒毛膜促性腺激素(humanChorionicGonadotropin,hCG)对成年大鼠Leydig细胞中葡萄糖转运蛋白(Glucosetransporters,GLUTs)基因表达的影响,为进一步探讨Leydig细胞中睾酮的合成与葡萄糖代谢关系提供依据。材料与方法:采用改良的Klinefelter方法从成年大鼠睾丸中分离获得Leydig细胞,并用反转录-聚合酶链技术检测IGF-I和hCG对Leydig细胞中GLUTs基因表达的调控作用。结果:分离得到纯度为98%的Leydig细胞,与空白对照组相比,hCG可显著增加Leydig细胞中GLUT8基因mRNA的表达,并且此作用具有剂量依赖性与时效性。100ng/mlIGF-I可显著增加Leydig细胞中GLUT8基因mRNA表达,并且IGF-I可和hCG协同作用,显著提高GLUT8基因mRNA表达,该结果与100ng/mlIGF-I和10ng/mlhCG协同作用显著增加睾酮合成的结果相吻合。然而,在大鼠Leydig细胞中,无论是10ng/mlhCG或100ng/mlIGF-I单独作用或同时作用于细胞,都不影响GLUT1和GLUT3基因mRNA水平。结论:在成年大鼠Leydig细胞中,IGF-I和hCG对细胞中GLUT8基因表达的调节作用具有特异性,IGF-I和hCG能协同作用显著提高细胞GLUT8基因mRNA水平,从而增强细胞摄取葡萄糖的能力,可为细胞提供更多的代谢能源,最终增加了Leydig细胞睾酮合成与分泌。     

Pre-existent immunity to the HER-2/neu oncogenic protein in patients with HER-2/neu overexpressing breast and ovarian cancer

Immunomodulatory strategies, such as antibody therapy and cancer vaccines, are increasingly being considered as potential adjuvant therapies in patients with advanced stage breast cancer to either treat minimal residual disease or prevent relapse. However, little is known concerning the incidence and magnitude of the pre-existent breast cancer specific immune response in this patient population. Using the HER-2/neu oncogenic protein as a model, a well-defined tumor antigen in breast cancer, we questioned whether patients with advanced stage HER-2/neu overexpressing breast and ovarian cancers (III/IV) had evidence of pre-existent immunity to HER-2/neu. Forty-five patients with stage III or IV HER-2/neu overexpressing breast or ovarian cancer were evaluated for HER-2/neu specific T cell and antibody immunity. Patients enrolled had not received immunosuppressive chemotherapy for at least 30 days (median 5 months, range 1–75 months). All patients were documented to be immune competent prior to entry by DTH testing using a skin test anergy battery. Five of 45 patients (11%) were found to have a significant HER-2/neu specific T cell response as defined by a stimulation index 2.0 (range 2.0–7.9). None of eight patients who were HLA-A2 had a detectable IFN secreting T-cell precursor frequency to a well-defined HER-2/neu HLA-A2 T cell epitope, p369-377. Three of 45 patients (7%) had detectable HER-2/neu specific IgG antibodies, range 1.2–8.9g/ml. These findings suggest that patients with advanced stage HER-2/neu overexpressing breast and ovarian cancer can mount a T cell and/or antibody immune response to their tumor. However, in the case of the HER-2/neu antigen, the pre-existent tumor specific immune response is found only in a minority of patients.     

β-榄香烯抑制大鼠血栓形成及其机理研究

目的;探讨β－榄香烯的抗血栓作用及其机理。方法：采用血栓法观察了大鼠口服β－Ｅｌｅ４０￣１６０ｍｇ／ｋｇ／ｄ１０ｄ后对血栓形成的影响,采用比浊法和放免法分别测定其抗血小板聚集性和ＴＸＡ２及ＰＧＩ２的含量。     

重型颅脑损伤后高血糖82例

1　临床资料　 1996 - 0 8/ 1999- 0 8我科共收治重型颅脑损伤患者 82 (男 5 8,女 2 4)例 ,年龄 7～ 81(平均 32 .4)岁 .本组患者伤前均无糖尿病史 .GCS评分均 <8分 .其中 6～ 8分的 42例 ;3～ 5分的 2 8例 ;3分以下的 12例 .发病至入院时间均在2 4h以内 .应用美国产“One Touch”血糖仪每日在床旁测空腹血糖 1次[1 ] ,连续测 7d.对于空腹血糖 >10 mmol· L者 ,给予低糖饮食 ,不用激素 ,少量应用甘露醇 ,适当应用胰岛素及乳酸林格液等治疗 .在 82例中 ,首次测血糖值 >10 mmol· L[2 ] 的 49例 ,最高值为 19.4mmol· L ;经上述治疗 ,结果…     

Platelet dopamine: D2 receptor binding in patients with migraine

Clinical, genetic and pharmacological evidences suggest an abnormality of the dopaminergic system in the pathogenesis of migraine. Direct evidence of an abnormal metabolism of dopamine in migraine, however, is lacking. Platelets are a useful model to understand brain dopaminergic mechanisms. The present study has been undertaken to study the status of platelet dopamine receptor binding by carrying out radioligand receptor binding assay. Binding of ³H-spiperone to platelet membranes, known to label dopamine (DA)—D2 receptors, was conducted in 20 patients with migraine and an equal number of healthy controls. The equilibrium dissociation constant (Kd) in patients with migraine (1.71 ± 0.19 nM) was found to be significantly lower ( P  < 0.001) as compared with controls (3.14 ± 0.33 nM). However, no significant change was observed in the maximal number of binding sites (Bmax) in patients with migraine. No relationship of Kd with type of migraine, presence of vomiting, family history, frequency of attack, duration of illness and menstrual migraine was observed. The findings of the present study provide support for the involvement of the dopaminergic system in migraine.     

Bifocal nummular headache: the first three cases

Nummular headache (NH) has been defined as a focal head pain that is exclusively felt in a small area of the head surface. Here we describe three patients who presented with focal head pain in two separate areas. This finding seems to be consistent with bifocal NH and further enlarges the clinical diversity of this headache disorder. The pathogenic mechanisms of NH may be active in multiple cranial areas in some particular patients.     

Factorial structure of the Chinese version of the 12‐item General Health Questionnaire in adolescents

Aims. To evaluate the underlying factor structure of the Chinese version of General Health Questionnaire‐12 using exploratory and confirmatory factor analyses in Chinese adolescents and find out which factor model proposed by previous empirical research is the best‐fit model. Background. The 12‐item General Health Questionnaire has been extensively used with adolescents in the West. Yet, it has not been used with adolescents in a Hong Kong Chinese context. Design. A cross‐sectional study was employed. Method. Chinese students between the ages of 12–19 from four secondary schools were invited to participate in the study using the multiple‐stage stratified random sampling method during the period from December 2007–February, 2008. The total sample size included in the final analysed was 1883. Results. The General Health Questionnaire‐12 was found to be internally consistent. The results of exploratory factor analysis showed that there are two factors underlying the General Health Questionnaire‐12. Of nine factor models were tested by means of confirmatory factor analysis, only three factor model: the eight‐item two‐factor model, 12‐item three‐factor model and 10‐item two‐factor model, demonstrated good model fit across all model fit indices. Conclusion. This study addressed a gap in the literature by evaluating the factorial structure of the Chinese version of General Health Questionnaire‐12 using exploratory and confirmatory factor analyses in Chinese adolescents. The findings revealed that the eight‐item two‐factor model is the best‐fit model. Relevance to clinical practice. The adolescent mental health problem is alarming and aggravating and warrants special attention. It is essential for community nurses to differentiate psychological distress in adolescents and to identify those adolescents who are at a higher risk of suffering from mental health problems. The availability of a valid and reliable instrument that measures adolescents’ psychological distress is crucial before any nursing interventions to promote their mental health can be appropriately planned, implemented and evaluated.     

Evolvement of left ventricular assist device: the implications on heart failure management

Heart failure (HF) is a potentially fatal disease that affects increasing number of people worldwide. Although heart transplant is the “gold standard” therapy for HF, due to the limited availability of organs, many patients died when waiting for the transplant. Left ventricular assist device (LVAD), as a mechanical circulatory support, has become a new light for patients with HF. With the technical advancements, LVADs work not only as a bridge to transplant, but also assist heart recovery and even as a destination therapy in long-term treatment. This observation paper reviewed the development of LVAD and its clinical roles. The challenges and possible solutions in nursing care for patients with LVAD at different stage of implantation were discussed. The healthcare professionals could obtain a better understanding about the LVAD treatment for HF patients.