IMPROVEMENT OF ADULT HEIGHT PROGNOSIS IN PRECOCIOUS PUBERTY BY CYPROTERONE ACETATE

Three girls and one boy with idiopathic precocious puberty and one boy with operated suprasellar hamartoma and progressing precocious puberty were treated with Cyproterone acetate for periods ranging from 15 months to 4 years and 6 months. In all children, the signs of puberty were reduced. Height velocity, as related to bone age, was increased, as was the ratio of height age increment to bone age increment. An improvement of adult height prognosis in precocious puberty has been achieved by Cyproterone acetate.     

Applicability of HLA-DQB oligonucleotide typing for the TA10 and 2B3 specificities in routine HLA typing

Our group recently developed oligonucleotide probes associated to the TA10 and 2B3 specificities (1). Unambiguous typings were observed in a panel of homozygous typing cells and a family, using 32P-end labeled probes and PCR-amplified DNA (DQB exon 2). To investigate whether these TA10 and 2B3 associated oligonucleotides could be used in routine HLA-typing we extended the study to a panel of healthy, unrelated individuals. When TA10 and 2B3 typings by oligonucleotides were compared with those obtained in routine serology a complete correlation was observed for TA10. A discrepancy was seen for 2B3 typing in material obtained from DQw5- (and possibly DQw4)-positive individuals which could be explained by the CYNAP (cytotoxicity-negative, absorption-positive) phenomenon, using the IIB3 monoclonal antibody in routine tissue typing. Our results suggest that HLA-DQB oligonucleotide typing for TA10 and 2B3 is an accurate and reliable method and can be used effectively in routine HLA typing.     

Transforming growth factor-beta1 induces tumor stroma and reduces tumor infiltrate in cervical cancer

Cervical carcinomas consist of tumor cell nests surrounded by varying amounts of intratumoral stroma containing different quantities and types of immune cells. Besides controlling (epithelial) cell growth, the multifunctional cytokine transforming growth factor-beta(1) (TGF-beta(1)) is involved in the formation of stroma and extracellular matrix (ECM) and in immunosuppression. Several malignancies are known to be associated with enhanced production of TGF-beta(1), repression or mutation of TGF-beta transmembrane receptors, or mutations at the postreceptor intracellular signaling pathway. The aim of our study was to investigate the role of tumor cell-derived TGF-beta(1) on the amount of intratumoral stroma; the deposition of collagen IV, fibronectin, and laminin; and the tumor infiltrate in cervical carcinoma. The expression of TGF-beta(1) mRNA in 108 paraffin-embedded cervical carcinomas was detected by mRNA in situ hybridization. Immunohistochemistry was used to investigate the amount of tumor stroma and ECM proteins and the extent of the tumor infiltrate. Plasminogen activator inhibitor-1 (PAI-1) protein expression in tumor cells was determined to verify the biological activity of TGF-beta(1.) Cytoplasmatic TGF-beta(1) mRNA expression in tumor cells was significantly correlated with the amount of intratumoral stroma and the deposition of collagen IV. TGF-beta(1) mRNA expression in every tumor was accompanied by PAI-1 expression, indicating biological activity of TGF-beta(1). An inverse relationship between TGF-beta(1) mRNA expression in tumor cells and the extent of the tumor infiltrate was demonstrated. Our results indicate that cervical cancer cells affect the amount and the composition of the intratumoral stroma and the tumor infiltrate by the production and secretion of TGF-beta(1).     

应用简明健康测量量表评估美沙酮维持治疗患者生活质量

目的:对比接受与未接近美沙酮维持治疗的海洛因依赖者健康相关生活质量。方法:①选择2004-04/05在云南省个旧市美沙酮维持治疗门诊接受美沙酮维持治疗的海洛因依赖者作为治疗组(95例)。纳入标准:符合美国精神障碍诊断与统计手册第4版中海洛因依赖诊断标准;至2004-11时尚未脱失;采用滚雪球方法,于2004-11在该市社区内寻找从未接受过美沙酮维持治疗的海洛因依赖者作为对照组(37例),均符合美国精神障碍诊断与统计手册第4版中海洛因依赖诊断标准。纳入对象均对调查项目知情同意。②根据患者的日常海洛因使用量、使用方式、末次使用量决定美沙酮首次剂量,一般<40mg;导入期则根据患者的戒断症状控制情况逐渐加量。维持期的剂量差异较大,5～160mg/d,多超过60mg/d。同时根据治疗组患者的需求,每月定期开展心理干预小组活动。对照组患者未接受美沙酮维持治疗或任何戒毒措施、干预活动,评估期间时仍然在使用海洛因。③治疗组于治疗刚开始及治疗8个月后,对照组于治疗组治疗8个月后同期采用简明健康测量量表对两组对象进行健康相关生活质量评估。该量表包括躯体功能、躯体角色、肌体疼痛、总健康状况、生命力、社会功能、情绪角色及心理健康8个维度,评分越高表明生活质量越好。④计量和计数资料差异比较分别采用t检验和χ2检验。结果:治疗组95例和对照组37例均进入结果分析。参加美沙酮维持治疗8个月后,治疗组简明健康测量量表中6个维度躯体角色、总健康状况、生命力、社会功能、情绪角色及心理健康的评分分别为(6.59±1.48),(15.54±3.97),(16.20±3.91),(8.39±2.29),(4.72±1.17),(20.19±2.68)分,高于治疗刚开始时和对照组[(5.54±1.51),(13.37±3.58),(13.19±3.81),(7.17±2.21),(3.94±1.11),(17.05±4.24)分;(5.43±1.29),(11.83±3.84),(12.89±3.79),(6.71±2.12),(4.06±1.08),(15.77±4.45)分,t=3.02～7.03,P<0.01];躯体功能得分也较治疗前有了明显提高[(27.16±3.24),(26.48±3.34)分,t=1.96,P<0.05],但与对照组比较,差异不明显[(26.31±2.78)分,P>0.05]。治疗组肌体疼痛评分与治疗刚开始时和对照组相近(P>0.05)。结论:美沙酮维持治疗可有效提高海洛因依赖者的健康相关生活质量,但短期的维持治疗对肌体疼痛改善不明显。     

Necrotizing fasciitis: a deadly infection

Necrotizing fasciitis (NF) is a life-threatening condition, consisting of a soft-tissue infection with rapidly progressive, widespread fascial necrosis. NF may be caused by a wide variety of microbes. Indeed, NF may be an infection of one species of bacteria or may be polymicrobial. Prompt diagnosis and treatment are essential. Surgical debridement and antibiotic therapy are the primary treatment options.