痢特灵药疹患者的免疫学观察及发病情况调查

痢特灵药疹患者外周血的免疫学检测显示:发疹期B细胞数增加,功能增强和CIC增高:T细胞数减少和功能降低.临床上有一定潜伏期,皮损以尊麻垂为主,伴内脏损害,提示此类药疹表现为l型血清病样反应.非特异性LTT与CIC的变化与病情间呈平行关系.治疗服用痢特灵的发疹率明显高于预防服药者.     

孕期人乳头状瘤病毒亚临床感染的母婴传播及对胎婴儿的影响

目的　探讨孕中期、孕晚期人乳头状瘤病毒亚临床感染的母婴垂直传播情况及对胎婴儿的影响。方法　采用多聚酶链反应技术对 42例孕中期、32例孕晚期妇女的宫颈分泌物、母血、胎盘、羊水、脐血、新生儿咽部分泌物标本进行HPV - 6、11、16、18型DNA检测。结果　孕中期 :12例宫颈分泌物HPV阳性 (12 / 42 ) ,11例母血HPV阳性 (11/ 42 ) ,9例胎盘组织HPV阳性 (9/ 42 ) ,2 2例羊水标本中 ,仅 1例羊水HPV阳性 (1/ 2 2 ) ;孕晚期 :2 3例宫颈分泌物HPV阳性 (2 3/ 32 ) ,18例母血HPV阳性 (18/ 32 ) ,12例胎盘组织HPV阳性 (12 / 32 ) ,31例羊水及脐血标本中 ,4例羊水HPV阳性 (4/ 31) ,12例脐血HPV阳性 (12 / 31)。 17例异常胎婴儿中有 3例胎儿窘迫、1例新生儿高胆红素血症及 1例无脑畸形儿的脐血或胎盘组织HPV阳性。结论　孕期HPV感染的母婴传播不但可经产道直接接触传播 ,还可经血液、羊水及胎盘发生宫内传播 ,其宫内传播率的高低主要与母血的HPV感染相关。新生儿脐血的HPV感染主要与母血的HPV感染相关 ,而产时新生儿咽部的HPV感染主要与宫颈分泌物HPV感染相关。妊娠期HPV感染可能与胎儿窘迫、新生儿高胆红素血症、胎儿畸形有关     

电视胸腔镜下动脉导管钳闭手术方法及疗效探讨

目的 :探讨电视胸腔镜下钳闭动脉导管的手术方法 ,总结近期及远期疗效。　　方法 :36例患者 ,平均年龄 9.0 8± 4.96岁 ,平均动脉导管直径 0 .6 2± 0 .2 5 cm,73.0 %为管状型 ,其余为漏斗型 ,均采用大号钛夹钳闭。　　结果 :所有患者均成功地在电视胸腔镜下完全钳闭动脉导管 ,无导管损伤出血、喉返神经损伤等并发症 ,术后超声心动图复查 ,无残余分流。术后最长已随访 3年 ,均未发现导管再通现象。　　结论 :电视胸腔镜下钳闭动脉导管可取得良好的近期与远期手术效果 ,值得推广应用。     

以高质量教学提高医学继续教育的效果

通过总结 5期国家级医学继续教育课程班的教学工作 ,依据“国家级医学继续教育备案表” ,分析学员的反馈意见 ,体会到 :精心策划、充分准备是确保教学组织的重要前提 ,挖掘潜力、开拓创新是优化教学质量的关键环节 ,紧扣热点、贴近临床是优化教学目标的基本策略 ,教学相长、增进沟通是优化教学效果的有效举措     

Diffusion-weighted MRI features of brain abscess and cystic or necrotic brain tumors: comparison with conventional MRI

BACKGROUND AND PURPOSE: The purpose of this study was to determine whether diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) can be used to distinguish brain abscesses from cystic or necrotic brain tumors, which are difficult to distinguish by conventional magnetic resonance imaging (MRI) techniques. METHODS: Eleven consecutive patients with brain abscesses [10 pyogenic and 1 toxoplasmosis (in an AIDS patient)] and 15 with cystic or necrotic brain gliomas or metastases were enrolled in this study. None of these lesions had apparent hemorrhage based on T1-weighted image (T1WI). The DWI was performed using a 1.5-T system, single-shot spin-echo echo-planar pulse sequence with b=1000 s/mm(2). The ADC was calculated using a two-point linear regression method at b=0 and b=1000 s/mm(2). The ratio (ADCR) of the lesion ADC to control region ADC was also measured. RESULTS: Increased signal was seen in all of the pyogenic abscess cavities to variable degrees on DWI. In vivo ADC maps showed restricted diffusion in the abscess cavity in all pyogenic abscesses [0.65+/-0.16 x 10(-3) (mean+/-S.D.) mm(2)/s, mean ADCR=0.63]. The case with multiple toxoplasmosis abscesses showed low signal intensity on DWI and high ADC values (mean 1.9 x 10(-3) mm(2)/s, ADCR=2.24). All cystic or necrotic tumors but one showed low signal intensity on DWI and their cystic or necrotic areas had high ADC values (2.70+/-0.31 x 10(-3) mm(2)/s, mean ADCR=3.42). One fibrillary low-grade astrocytoma had a high DWI signal intensity and a low ADC value in its central cystic area (0.44 x 10(-3) mm(2)/s, ADCR=0.49). Postcontrast T1WIs yielded a sensitivity of 60%, a specificity of 27.27%, a positive predictive value (PPV) of 52.94%, and a negative predictive value (NPV) of 33.33% in the diagnosis of necrotic tumors. DWI yielded a sensitivity of 93.33%, a specificity of 90.91%, a PPV of 93.33%, and a NPV of 90.91%. The area under receiver operating characteristic (ROC) curves for postcontrast T1WI was 0.44 and DWI was 0.92. Analysis of these areas under the ROC curves indicates significant difference between postcontrast T1WI and DWI (P<.001). CONCLUSION: With some exceptions, DWI is useful in providing a greater degree of confidence in distinguishing brain abscesses from cystic or necrotic brain tumors than conventional MRI and seems to be a valuable diagnostic tool.     

Characterization of LncRNA expression profile and identification of functional LncRNAs associated with unstable angina

BackgroundIncreasing evidences suggest that long noncoding RNAs (lncRNAs) play critical roles in the pathogenesis of coronary artery disease (CAD). However, the association between lncRNAs expression profiles and unstable angina (UA) remained poorly known. Thus, the present study aims to investigate expression patterns, biological functions, and diagnostic value of lncRNAs in UA.MethodsThe present study explored the lncRNA and mRNA expression profiles in peripheral blood mononuclear cells (PBMCs) of UA patients and normal coronary artery (NCA) controls using RNA‐seq. The biological function of differentially expressed lncRNAs was analyzed using gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis. The expression of the selected lncRNAs was validated in another 44 UA patients and 46 NCA controls. Receiver operating characteristic curve (ROC) was performed to evaluate the diagnostic value of lncRNAs for UA.ResultsA total of 98 lncRNAs and 615 mRNAs were observed differentially expressed in PBMCs of UA patients as compared to NCA controls. The 10 most upregulated lncRNAs were LNC_000226, DANCR, RP1‐167A14.2, LNC_002091, LNC_001526, LNC_001165, LNC_002772, LNC_000088, LNC_001226, and FAM157C, and the 10 most downregulated lncRNAs were RP11‐734I18.1, RP11‐185E8.1, RP11‐360I2.1, LNC_001302, LNC_001287, RN7SL471P, LNC_000914, LINC01506, RP11‐160E2.6, and LNC_000995. LNC_000226 and MALAT1 have high area under the curve values (AUC) for distinguishing UA from NCA patients (0.810 and 0.799, respectively), and the combination of MALAT1 and LNC_000226 increased the AUC value to 0.878.ConclusionsThe present study added our understanding about the lncRNA expression profile in UA patients and provided potential biomarkers for the diagnosis of UA.     

African Swine Fever Virus pE199L Induces Mitochondrial-Dependent Apoptosis

African swine fever (ASF) is a severe hemorrhagic disease in swine characterized by massive lymphocyte depletion and cell death, with apoptosis and necrosis in infected lymphoid tissues. However, the molecular mechanism regarding ASFV-induced cell death remains largely unknown. In this study, 94 ASFV-encoded proteins were screened to determine the viral proteins involved in cell death in vitro, and pE199L showed the most significant effect. Ectopic expression of pE199L in porcine cells (CRL-2843) and human cells (HEK293T and HeLa cells) induced cell death remarkably, showing obvious shrinking, blistering, apoptotic bodies, and nuclear DNA fragments. Meanwhile, cell death was markedly alleviated when the expression of pE199L was knocked down during ASFV infection. Additionally, the expression of pE199L caused a loss of mitochondrial membrane potential, release of cytochrome C, and caspase-9 and -3/7 activation, indicating that the mitochondrial apoptotic pathway was involved in pE199L-induced apoptosis. Further investigations showed that pE199L interacted with several anti-apoptotic BCL-2 subfamily members (such as BCL-X_L, MCL-1, BCL-W, and BCL-2A1) and competed with BAK for BCL-X_L, which promoted BAK and BAX activation. Taken together, ASFV pE199L induces the mitochondrial-dependent apoptosis, which may provide clues for a comprehensive understanding of ASFV pathogenesis.