Association study of apolipoprotein E epsilon4 with clinical phenotype and clozapine response in schizophrenia

Schizophrenic patients with the apolipoprotein E (APOE = gene; apoE = protein) epsilon4 allele exhibited lower psychosis scores than patients without the epsilon4 allele in previous reports. The present study tested the hypothesis that the APOE epsilon4 allele confers association with the clinical manifestations of schizophrenia or clozapine response. A total of 95 schizophrenic patients who were treatment resistant were included in the study. The results demonstrated that the presence of the APOE epsilon4 allele did not influence the response to clozapine in schizophrenic patients, neither was the baseline psychopathology related to the APOE epsilon4 allele. Given the multiple functions of the apoE protein in the brain, further study of the influence of APOE on CNS medication response is needed.     

青蒿琥酯抗牛血清白蛋白免疫性大鼠肝纤维化作用的研究

目的：研究青蒿琥酯抗实验性肝纤维化的作用。方法：采用牛血清白蛋白免疫性肝纤维化大鼠模型，观察肝组织病理变化，检测肝组织中羟脯氨酸的含量及动物血清肝功能指标和血清MDA水平。结果：青蒿琥酯组能减轻假小叶形成和肝组织羟脯氨酸含量升高，并能使GPT下降。结论：青蒿琥酯具有抗肝纤维化的作用。     

Human Thelaziasis occurrence in Taiwan

A 62‐year‐old woman presented with unilateral eye swelling and itching. Subsequent examination showed the cause was an infestation of the parasitic worm Thelazia callipaeda. The vector leading to human infection is the fly. The possible mechanisms of infection for this patient are discussed. Although this is a known form of ocular infection, especially in Asia, this is one of few reported cases in Taiwan.     

Severe vitreous hemorrhage associated with closed-globe injury

Background The presence of marked vitreous hemorrhage is associated with poor visual prognosis in ocular trauma involving the posterior segment. The purpose of this study was to investigate the clinical features, prognostic factors, and visual outcomes in such eyes after closed-globe injury. Methods Retrospective chart review of patients with severe vitreous hemorrhage after closed-globe injury between January 2000 and December 2002. Results The study included 33 eyes in 32 patients with a mean age of 41.5 (range, 3–78 years) and a median follow-up period of 12 (range, 3–50 months). Presenting visual acuity was between 4/200, and there was light perception in 32 eyes (97%) and no light perception in one eye (3%). Fifteen eyes (45%) had one or more posterior segment pathologies beneath the vitreous hemorrhage. There were retinal tears in six eyes (18%), retinal detachment in six (18%), submacular hemorrhage in six (15%), choroidal rupture in three (9%), macular pucker in three (9%), retinal dialysis in one (3%), macular hole in one (3%), and retinal vessels occlusion in one (3%). Seven eyes (21%) had final visual acuity 20/40 or better, and 18 eyes (54%) had less than 20/200. Poor prognostic factors included presenting visual acuity of light perception or lower (p=0.032), hyphema (p=0.007), traumatic cataract (p=0.027), and age 55 years or younger (p=0.039). The most common cause of poor visual outcome was macular scar. Conclusion The visual prognosis of severe vitreous hemorrhage after closed-globe injury was guarded. This was frequently associated with various anterior and posterior segment pathologies. In order to provide early visual rehabilitation and management of any potentially treatable posterior pathology, early vitrectomy may be considered.     

Efficacy of multipurpose solutions for rigid gas permeable lenses

The use of multipurpose solutions for cleaning and disinfecting rigid gas permeable lenses has replaced single purpose solutions, but there are no reports of the efficacy of these multipurpose solutions, or of the effects of storage conditions on their disinfecting capacities. This study investigated activity against four bacterial and two fungal species, and the effects of storage in a refrigerator, at room temperature, at elevated temperature in both dry and humid conditions and with exposure to sunlight. The disinfecting solutions were challenged with the micro-organisms initially upon opening and then at 2-weekly intervals up to 12 weeks after being stored under the different conditions. Solutions were opened daily to simulate use. One solution failed to meet Food and Drug Administration (FDA) criteria to reduce numbers of bacteria by three log dilutions and of fungi by one log dilution. Storage reduced activity of all solutions over the 12-week period, but not below the requirements of the FDA. Storage in the refrigerator tended to reduce disinfecting capacity more quickly. Multipurpose solutions for rigid gas permeable (RGP) lenses lose activity over the 3 months recommended time of use but remain satisfactory for use over this time in the conditions tested. Practitioners need to remind patients to replace their solutions regularly and should advise against storage in the refrigerator. Multipurpose solutions for RGP lenses have simplified cleaning and disinfecting processes and the current formulations have improved disinfecting capacity compared to former disinfecting solutions, which is particularly important for wearers of orthokeratology lenses.     

Laparoscopic Ladd's procedure for intestinal malrotation: report of three cases.

Ladd's procedure for laparoscopic repair of malrotation has many advantages over conventional surgical techniques, such as earlier feeding and discharge. However, this procedure is still not commonly used in Taiwan. This report describes the results of treatment of intestinal malrotation in three patients using laparoscopic Ladd's procedure. The patients, aged 8 days, 17 days, and 3 years, underwent laparoscopic Ladd's procedure between July 1999 and September 2000. All three patients had symptoms of intermittent vomiting and were shown to have intestinal malrotation by upper gastrointestinal series study. The procedure was performed using three trocars of 5 mm diameter placed at the infraumbilical ring and the right and left lower quadrants. All procedures were completed laparoscopically. The operative times were 4.8, 3.6, and 3.5 hours, respectively. Feeding was started on postoperative Day 2 to 5, and the hospital stay was 6 to 11 days. Our results suggest that laparoscopic Ladd's procedure can be performed safely in pediatric patients. In addition, patients are expected to benefit from the smaller incision, earlier feeding, shorter hospital stay, and fewer complications compared with traditional Ladd's procedure.     

Concurrent chemotherapy-radiotherapy compared with radiotherapy alone in locoregionally advanced nasopharyngeal carcinoma: progression-free survival analysis of a phase III randomized trial.

PURPOSE: Nasopharyngeal carcinoma (NPC) is highly sensitive to both radiotherapy (RT) and chemotherapy. This randomized phase III trial compared concurrent cisplatin-RT (CRT) with RT alone in patients with locoregionally advanced NPC. PATIENTS AND METHODS: Patients with Ho's N2 or N3 stage or N1 stage with nodal size > or = 4 cm were randomized to receive cisplatin 40 mg/m(2) weekly up to 8 weeks concurrently with radical RT (CRT) or RT alone. The primary end point was progression-free survival (PFS). RESULTS: Three hundred fifty eligible patients were randomized. Baseline patient characteristics were comparable in both arms. There were significantly more toxicities, including mucositis, myelosuppression, and weight loss in the CRT arm. There were no treatment-related deaths in the CRT arm, and one patient died during treatment in the RT-alone arm. At a median follow-up of 2.71 years, the 2-year PFS was 76% in the CRT arm and 69% in the RT-alone arm (P =.10) with a hazards ratio of 1.367 (95% confidence interval [CI], 0.93 to 2.00). The treatment effect had a significant covariate interaction with tumor stage, and a subgroup analysis demonstrated a highly significant difference in favor of the CRT arm in Ho's stage T3 (P =.0075) with a hazards ratio of 2.328 (95% CI, 1.26 to 4.28). For T3 stage, the time to first distant failure was statistically significantly different in favor of the CRT arm (P =.016). CONCLUSION: Concurrent CRT is well tolerated in patients with advanced NPC in endemic areas. Although PFS was not significantly different between the concurrent CRT arm and the RT-alone arm in the overall comparison, PFS was significantly prolonged in patients with advanced tumor and node stages.     

车前的本草考证

通过本草学考证，结合现代有关车前的化学成分、药理作用的研究成果、表明本草文献中关于车前的记载与现代研究结果基本一致。历代使用车前的正品为车前科车前属植物车前Plantago asiatica L.。     

生脉注射液在气管插管后血压降低中的运用

生脉注射液具有益气养阴、复脉固脱之功效,广泛用于严重感染、血容量不足引起的血压降低.在气管插管后血压降低时,应用生脉注射液也取得了较好的临床疗效.本文对气管插管后血压降低应用生脉注射液的用法用量、注意事项等进行了归纳.