Nocturnal enuresis and obstructive sleep apnoea in two children

Nocturnal enuresis was a symptom of childhood obstructive sleep apnoea, OSAS. We reported two children with secondary nocturnal enuresis which disappeared after tonsillectomy and adenoidectomy for proven OSAS. Pathogenesis of secondary nocturnal enuresis in OSAS was discussed.     

抗原穴位注射增强机体免疫功能的神经免疫调节作用

目的 探讨神经免疫调节在抗原穴位注射增强机体免疫功能的作用。方法 采用免疫组化、免疫荧光标记和RT－PCR定量分析技术,观察了不同途径免疫的大鼠中枢神经的下丘脑外侧区（LH）和杏仁核区（AA0中IL－1β、IL－6的表达与脾脏单个核细胞的IL－1β、IL－2γ变化的关系。结果 抗原穴位注射组小鼠LH和AA脑区IL－10β、IL－6的表达明显高于皮下注射组。但阳性细胞表达的高峰时间相似。免疫荧光标记结果显示细胞因子阳性细胞为神经元。穴位免疫组脾脏单个核细胞IL－2和IFN－γ的表达明显高于皮下免疫组,IL－1β的表达无差异。结论 结果提示抗原经不同注射途径（皮下、穴位）免疫动物,动物中枢神经系统的神经免疫调节功能活动的作用时程是相似的,仅表现为神经免疫调节的作用强度不同;LH和AA脑区IL－1β、IL-6介导的神经免疫调节功能与机体的免疫功能状态呈正相关;神经元神经免疫调质／递质的来源。抗原经穴位注射增强机体免疫功能的作用机制可能为穴位免疫可更有效的动员中枢神经系统的免疫相关脑区的神经免疫调节功能,参与对免疫系统的功能调节。     

Range of motion and lordosis of the lumbar spine: reliability of measurement and normative values

STUDY DESIGN: Repeated measures for intratester reliability were performed. OBJECTIVES: To investigate the intratester reliability of a new measurement technique that evaluates lumbar range of motion in three planes using a pelvic restraint device, and to examine the reliability of lumbar lordosis measurement by inclinometer technique. Preliminary normative data on lumbar range of motion and lumbar lordosis were collected for comparison with the findings of previous studies. SUMMARY OF BACKGROUND DATA: Various noninvasive measurement methods have been developed for recording lumbar range of motion. However, pelvic movement was not effectively restricted during the use of these measurement techniques. The use of the pelvic restraint device to measure lumbar range of motion has not been investigated previously. Very few studies have investigated the reliability of quantifying lumbar lordosis by the inclinometer technique. METHODS: Normative values were measured in 35 healthy men, and 12 of these subjects were included for the reliability study. Pelvic motion was limited by the pelvic restraint device during lumbar range of motion measurement in standing. An inclinometer was used for evaluation of lumbar flexion, extension, lateral flexion, and lumbar lordosis, whereas a lumbar rotameter was used to measure axial rotation. RESULTS: Good intratester reliability was shown in the lumbar range of motion and lordosis measurement. Most of the intraclass correlation coefficient and Pearson's r values (accompanied with nonsignificant paired t tests) were greater than 0.9, and most of the intrasubject coefficients of variation were less than 10%. The values of lumbar range of motion in three planes and lumbar lordosis found in the current study were comparable with those from most of the previous studies on these measurements in the normal population. CONCLUSIONS: Inclinometer and lumbar rotameter measurements with the use of a pelvic restraint device are reliable for measuring lumbar spine range of motion. Use of the inclinometer technique to record lumbar lordosis also is a reliable measure.     

Validation of a new immunoblot assay for the diagnosis of Helicobacter pylori in the Asian population

BACKGROUND: Performance of commercial serological tests for Helicobacter pylori varies in different populations, largely due to strain heterogeneity and variations in antigenic preparations. Currently available serology tests often show sub-optimal accuracy when used for Asian patients. AIM: This study evaluated a recombinant antigen-based immunoblot for the diagnosis of H. pylori infection in Chinese patients, and compared it with a conventional ELISA test. METHODS: Dyspeptic patients referred for diagnostic endoscopy were recruited. The gold standard for H. pylori infection was based on two or more positive results among rapid urease test, histology and (13)C-urea breath test. Serological diagnosis of H. pylori infection was conducted by an ELISA test (pylori DTect; Diagnostic Technology) and an immunoblotting against a novel recombinant antigen (C1S; Genelab), which was constructed by immunological screening of the genomic DNA library of H. pylori. RESULTS: A total of 87 patients were evaluated and H. pylori infection was diagnosed in 40 (46%) by the reference tests. The sensitivities of the ELISA and immunoblot were 80% (95% CI: 64--91%) and 90% (95% CI: 76--97%), whilst the specificities were 96% (95% CI: 86--96%) and 87% (95% CI: 74--95%), respectively. The respective likelihood ratios of the two tests were 18.6 and 7.0. CONCLUSIONS: Satisfactory performance is obtained by the use of the new recombinant antigen-based immunoblot for diagnosing H. pylori infection in Chinese patients.     

Low molecular weight heparin-induced liver toxicity

The authors report two cases of hepatotoxicity induced by low molecular weight heparin. A 26-year-old woman and a 33-year-old man were treated with low molecular weight heparin for pulmonary embolism and cerebral infarction, respectively. They both developed derangement in liver function tests a few days after commencement of the low molecular weight heparin. The derangement in liver function tests was associated with a decreased serum complement 3 activity. Their liver functions recovered over a period of 2 to 3 months after low molecular weight heparin was stopped. Liver biopsy in the woman demonstrated balloon degeneration with scattered foci of hepatocytic necrosis, suggesting a complement-mediated hepatocellular damage.     

Crowding and violence on psychiatric wards: explanatory models.

OBJECTIVE: Violence is widely prevalent on acute-care psychiatric wards, and crowding has been identified as a major risk factor. This paper explores why patients may respond to crowding with violence. METHOD: We carried out a literature review on Medline, using the key words "violence" and "crowding." We conducted an additional hand search of the references collected from the reviewed papers. RESULTS: Factors specific to the relation between crowding on acute-care inpatient psychiatric wards and violence can be divided under the following headings: 1) patient density, privacy, and control; 2) ward architecture; 3) the social organization of psychiatric wards; 4) interpersonal space; 5) phylogenic theories; and 6) anthropological theories of human behaviour. CONCLUSIONS: We offer explanatory models for this relation and suggest strategies to counter the effects of crowding. Recommendations are made for future studies.     

Encephalopathy associated with respiratory syncytial virus bronchiolitis

Respiratory syncytial virus is an extremely common cause of childhood respiratory infections resulting in significant morbidity and mortality. Although apnea is a well-known complication in young infants with respiratory syncytial virus bronchiolitis, the encephalopathy associated with this infection is not well recognized. Our study reveals an incidence of encephalopathy of 1.8% in a total of 487 patients with respiratory syncytial virus bronchiolitis studied over a period of almost 4 years. Seizures were the presenting complication. Based on our study of a cohort of children with respiratory syncytial virus bronchiolitis, we believe that neurologic complications, although relatively uncommon, represent a significant component of this common childhood illness. Furthermore, respiratory syncytial virus has been shown to release several mediators that could directly or indirectly be neurotoxic and induce an encephalopathy associated with the respiratory illness.     

Audiogenic seizure susceptibility in thyroid hormone receptor beta-deficient mice

As early-onset hypothyroidism produces audiogenic seizure susceptibility (AGS) in rodents, the role of TR alpha 1 and TR beta thyroid hormone receptors in AGS was investigated. AGS occurs in mice lacking specifically TR beta (Thrb(tm1/tm1)) and is marked by early onset and persistence, thereby differing from mouse strains where AGS is age-restricted. Thrb(tm1/tm1) mice display AGS whether on a mixed 129/Sv x C57BL/6J or congenic C57BL/6J background. 27% of wild-type mice on the mixed and 0% on the congenic background exhibited AGS. The inability of Thrb(tm1/tm1) mice to downregulate the response to sustained acoustic stimulation may reside in the brain or in the auditory system itself as Thrb(tm1/tm1) mice also display auditory deficits. The AGS phenotype identifies a novel neurological role for TR beta.