IgA肾病血尿误诊为尿路感染血尿三例分析

目的 探讨IgA肾病的病理特点,提高诊断合格率.方法 回顾性分析3例有血尿症状的IgA肾病患者被误诊为尿路感染血尿的经过和原因.结果 3例患者均为系膜增生性IgA肾病患者,HaasⅠ级2例、HaasⅡ级1例,均于发病前出现过尿路感染,确诊后均已治愈.结论 IgA肾病的复杂性和隐匿性使其易被误诊,临床诊断要全面掌握IgA肾病的临床与病理特点,不能局限于表面症状的诊断.     

LINGUAL INFARCTION IN CRANIAL ARTERITIS

SUMMARY An unusual case is described of infarction of the tongue as a presentation of cranial arteritis. The lingual necrosis may have been precipitated in part by the use of ergotamine to relieve the headache of the temporal arteritis, mistaken initially for migraine. The patient recovered with high-dose steroid therapy.     

Measurement of transepidermal water loss in Tanzanian cot-nursed neonates and its relation to postnatal weight loss

In healthy cot-nursed Tanzanian neonates ( n = 92, gestation 26–42 weeks) measurements of transepidermal water loss (TEWL) and weight change were performed during the first 24 h after birth at an average ambient humidity of 70% and an environmental temperature of 32°C. Urine production on day 1 (ml/kg per 24h) was documented for a subgroup of 13 preterm and 8 term infants. In a limited group of preterm infants ( n = 5) TEWL measurements, weight and 24 h urine volume measurements were repeated daily for 7 days. Maximum weight loss was determined in 7 preterm (gestational age 30–36 weeks) and 6 term infants. TEWL was estimated by measuring the evaporation rate at three sites of the body using the water vapour pressure gradient method. On day 1, TEWL was highest in the most preterm infants, whereas TEWL and urine production were higher in large for gestational age infants as compared to appropriate for gestational age (AGA) infants of the same gestational age (31–36 weeks). For the whole group, weight loss on day 1 was correlated with TEWL ( r = 0.49, p <0.05). At follow-up TEWL in preterm infants remained almost constant during the first 4 days and decreased after the fourth day, at which time weight gain commenced. Preterm AGA infants (gestational age 24–37 weeks) showed a mean postnatal weight loss of 4.4% of the birth weight, while in term infants this loss was only 2.6%. A reduced postnatal weight loss as compared to Caucasian infants may be explained by a lower water loss during the first days after birth, through both skin evaporation and urine excretion.     

Postoperative hysterosalpingogram: radiographic-surgical correlation

The hysterosalpingograms of 46 patients who underwent previous uterine or tubal surgery were reviewed. Surgical procedures performed included cesarean section, myomectomy, uterine septal repair, tubal reimplantation and reanastomosis, and fimbrioplasty/cuff salpingostomy. The procedures and their resulting hysterosalpingographic appearances are discussed.     

Dynamic analysis of metabolic effects of chloroacetaldehyde and cytochalasin B on tumor cells using bioelectronic sensor chips

Purpose: To study the interplay of drugs and energy metabolism of tumor cells, metabolic changes induced by chloroacetaldehyde and cytochalasin B were analyzed in colon carcinoma cells LS174T. Methods: O₂-consumption and extracellular acidification were recorded using a bioelectronic sensor-chip system, which monitors these parameters in a culture continuously for at least 24 h. In parallel cultures cell number, cellular ATP-content, mitochondrial transmembrane potential, and the content of reactive oxygen species (ROS) were determined. Results: When cell death was induced by chloroacetaldehyde (50 μM), the rate of acidification declined gradually for the next 15 h, while O₂-consumption decreased rapidly within 30 min. This correlated with a loss in mitochondrial potential. However, cellular ATP-level showed a transient increase at 2 h; also ROS levels increased up to 6 h. In cells treated with cytochalasin B (2 μM), which inhibits glucose uptake, the rate of O₂-consumption increased and the acidification activity dropped, even upon glutamine depletion. Mitochondrial membrane potential transiently increased after 1 h, while ATP-content decreased; there was no change in the level of ROS. Conclusion: The pattern of changes in basic energy metabolism differs with the type of cell death and growth inhibition involved in the cytotoxic action of two different drugs. This work was supported by a grant from the German Ministry of Education and Research (BMBF) on the “Development and Testing of a patient-specific Tumor Chemosensitivity Assay on the Basis of a Silicon Sensor Chip".     

Cadherin-Catenin复合体在胃癌中的表达及生物学意义

目的:探讨Cadherin-Catenin复合体在胃癌癌变过程中的表达及生物学意义。方法:建立组织芯片技术平台,应用该技术和免疫组化sp法检测2种蛋白在胃癌石蜡标本中的表达。结果:126例标本的组织芯片制备成功。其中E-cad在4组中的阳性率分别为86.7%,80.7%,55%和53.8%,胃癌组与正常胃和胃炎组比较有统计学意义(P<0.05和P<0.05)。而β-cat的阳性率分别为93.3%,57.7%,55%和49.2%,其中胃癌组,胃上皮非典型增生,胃炎组与正常组比较均有统计学意义(P<0.01,P<0.05和P<0.05)。两种蛋白的表达与胃癌的组织分化和淋巴结转移显著相关,但与年龄、临床分期等无明显相关。结论:建立了组织芯片技术平台,本研究中E-cad、β-cat的表达下调指示二者与胃癌发生密切相关,且均与胃癌组织分化和淋巴结转移密切相关,联合检测E-cad、β-cat可作为预测胃癌发生和发展的肿瘤标志物。     

熔融高速搅拌法制备氢氯噻嗪缓释微丸

通过对处方和工艺进行优化和筛选 ,采用熔融高速搅拌法制备了利尿药氢氯噻嗪的缓释微丸。结果表明 :以固体石蜡和单硬脂酸甘油酯为粘合剂 ,在 6 4℃、70 0r/min条件下操作 ,成粒子后再加入少量固体石蜡和钙盐 ,继续搅拌 ,降温整粒 8min可得圆整的缓释微丸。验证了应用熔融高速搅拌法制备氢氯噻嗪缓释微丸的适用性和技术特殊性 ,为工业生产奠定了基础。     

HLA配型与肾移植术后早期急性排斥反应的关系

目的 研究ＨＬＡ配型与尸体肾移植术后早期急性排斥反应的关系。方法 将２６２例尸体肾移植受者按ＨＬＡ配型的误配率（ＭＭ）进行分组,统计各组术后１～２个月内急性排斥反应的发生次数。结果 当ＭＭ〉３时,若接受的器官ＨＬＡ抗原／基因为可接受性,术后急性排斥反应的发生率为１６．４％;若供体器官ＨＬＡ抗原／基因具免疫原性,则急性排斥反应的发生率为３３．１％,两者比较,Ｐ〈０．０５。结论 供受者间ＨＬＡ配型越好