Psychiatric comorbidity in refractory focal epilepsy: A study of 490 patients

We studied the prevalence and associated factors of psychiatric comorbidities in 490 patients with refractory focal epilepsy. Of these, 198 (40.4%) patients had psychiatric comorbidity. An Axis I diagnosis was made in 154 patients (31.4%) and an Axis II diagnosis (personality disorder) in another 44 (8.97%) patients. After logistic regression, positive family history of psychiatric comorbidities (O.R. = 1.98; 95% CI = 1.10–3.58; p = 0.023), the presence of Axis II psychiatric comorbidities (O.R. = 3.25; 95% CI = 1.70–6.22; p < 0.0001), and the epileptogenic zone located in mesial temporal lobe structures (O.R. = 1.94; 95% CI = 1.25–3.03; p = 0.003) remained associated with Axis I psychiatric comorbidities. We concluded that a combination of clinical variables and selected structural abnormalities of the central nervous system contributes to the development of psychiatric comorbidities in patients with focal epilepsy.     

乙型肝炎及其相关病变中FoxB1检测和临床意义

目的研究FoxB1在乙型肝炎发生、发展中表达的临床意义。方法①收集临床确诊为乙型肝炎并排除甲、丙、丁、戊型肝炎病毒合并感染的乙肝住院病人血清278例,其中进展为肝硬化阶段者14例,肝癌阶段者12例,并随机抽取60名健康者血清,检测乙型肝炎病毒（HBV）DNA载量、FoxB1浓度和丙氨酸氨基转移酶活性;②分析乙型肝炎病人血清中FoxB1浓度与HBV—DNA载量谷丙转氨酶（ALT）活性的相关性,并依据乙型肝炎患者不同病情进展程度,分别比较肝癌组、肝硬化组、乙型肝炎组与健康组之间FoxB1因子浓度的差异。结果@278例肝炎病人血清中,HBV—DNA载量≥10^5拷贝／ml组FoxB1因子浓度为（12．5±6．9）pg／ml,HBV—DNA载量〈10^5拷贝／ml组为（12．7±9．3）pg／ml,健康人群组为（12．2±9．7）pg／ml,三组间FoxB1浓度无统计学意义（P〉0．05）。②278例ALT异常组血清中FoxB1浓度为（17．4±20．5）pg／ml,健康对照组血清中FoxB1浓度为（12．2±9．7）pg／ml,ALT异常组FoxB1浓度略高于健康对照组（P〈0．05）,血清FoxB1水平与ALT呈正相关（r=0．701）。③乙型肝炎组FoxB1浓度为（12．6±8．7）pg／ml,肝硬化组为（60．1±38．1）pg／ml、肝癌组为（68．5±37．3）pg／ml,肝癌组、肝硬化组中FoxB1浓度显著高于乙型肝炎组（P〈0．05）,而肝癌组与肝硬化组之间比较差异无统计学意义（P〉0．05）。结论FoxB1水平与肝细胞损伤ALT释放有关,可能参与肝癌病变,对乙型肝炎演化为肝硬化、肝癌有一定的预示作用,可作为病情进展的风险因子,并且可能成为治疗乙型肝炎病毒所致肝硬化、肝癌的新靶标。’     

Cenani–Lenz syndrome restricted to limb and kidney anomalies associated with a novel LRP4 missense mutation

Cenani–Lenz syndrome (CLS) is a rare autosomal recessive developmental disorder of the limbs. The disorder is characterized by complete syndactyly with metacarpal fusions and/or oligodactyly sometimes accompanied by radioulnar synostosis. The clinical expression is variable and kidney agenesis/hypoplasia, craniofacial dysmorphism and teeth abnormalities are frequent features as well as lower limb involvement. CLS was recently associated with mutations in the low-density lipoprotein receptor-related protein 4 (LRP4) gene and dysregulated canonical WNT signaling. We have identified a large consanguineous Pakistani pedigree with 9 members affected by CLS. The affected individuals present with a consistent expression of the syndrome restricted to the limbs and kidneys. Symptoms from the lower limb are mild or absent and there were no radioulnar synostosis or craniofacial involvement. Genetic analysis using autozygosity mapping and sequencing revealed homozygosity for a novel missense mutation c.2858T > C (p.L953P) in the LRP4 gene. The mutation is located in a region encoding the highly conserved low-density lipoprotein receptor repeat class B domain of LRP4. Our findings add to the genotype–phenotype correlations in CLS and support kidney anomalies as a frequent associated feature.     

温阳解毒化瘀方对肝衰竭大鼠内毒素血症的影响

目的:动态观察温阳解毒化瘀方对肝衰竭大鼠内毒素血症(ITEM)的影响。方法:将85只SD大鼠随机分为正常组、模型组、对照组(予乳果糖+三联活菌溶液)及温阳解毒化瘀颗粒组(实验组),采用D-半乳糖胺(D-gal)腹腔注射致肝衰竭ITEM大鼠模型。正常组在腹腔注射生理盐水12小时后处死,其余各组分别于造模后12小时、24小时各取10只大鼠处死,检测各组大鼠血清转氨酶(ALT、AST)、肝组织病理学、门静脉及结肠内毒素水平。结果:模型组12小时时ALT和AST较正常组升高(P<0.05),24小时时门静脉及结肠内毒素水平明显升高(P<0.01),肝组织大面积坏死;实验组及对照组在造模后12小时各观察指标与模型组比较,差异无显著性意义,造模后24小时两组ALT和AST、门静脉及结肠内毒素水平较模型组降低(P<0.05),肝组织病变减轻。结论:D-gal腹腔注射可建立大鼠肝衰竭ITEM模型,温阳解毒化瘀方可通过降低门静脉及结肠内毒素水平减轻ITEM而达到抗肝衰竭的效应。     

22例伪膜性结肠炎临床特征分析

背景:我国不合理使用抗生素的现象严重,抗生素相关性腹泻如伪膜性结肠炎(PMC)的发病率呈上升趋势。目的:综合分析PMC的临床特征以提高其诊治水平。方法:收集2007年6月～2012年2月于湖南省人民医院住院治疗,经结肠镜检查确诊的PMC患者,对其病史资料进行回顾性分析。结果:共22例PMC患者纳入研究,其中70岁以上者18例(81.8%),18例患者存在基础疾病。所有患者均于使用抗生素过程中出现腹泻,并可伴有不同程度的腹痛、发热、血便等其他症状。使用头孢菌素类抗生素者最多见(14例),20例患者联合使用两种或两种以上抗生素。21例接受结肠镜检查者均可见典型伪膜样病灶,内镜分型轻度9例,中度7例,重度5例。经停用原有抗生素以及使用甲硝唑、万古霉素、益生菌制剂等治疗后,21例患者好转出院。结论:PMC多发生于有基础疾病的老年人,病程早期缺乏特异性临床表现。结肠镜检查是诊断PMC的重要手段之一,确诊后应尽早停用原有抗生素,使用足量、足疗程的甲硝唑和万古霉素以及益生菌制剂。     

Repair of avascular meniscal injuries using juvenile meniscal fragments: An in vitro organ culture study

We investigated whether the implantation of juvenile allograft and minced meniscal fragments could improve the healing of avascular meniscal injuries, which cannot heal spontaneously. Concentric cylindrical explants were excised from the inner two‐thirds of swine medial menisci. The inner cylinder consisted of a “sandwich” structure, with minced juvenile meniscal fragments, juvenile meniscal columns, minced mature meniscal fragments, or mature meniscal columns implanted in the middle. The explants were cultured in vitro for 2, 4, or 6 weeks. Interfacial meniscal repair was assessed by histology, immunohistochemistry, biomechanical testing, and confocal laser scanning microscopy. Histology and confocal microscopy results revealed that tissue repair and cell accumulation at the interface were best at all time points in the juvenile meniscal fragments group, followed by the juvenile columns, minced mature fragments, and mature columns groups, respectively. At 6 weeks, the implantation of juvenile allograft and minced meniscal fragments increased the shear strength, peak force, and energy to failure in the peripheral interface. Picosirius red/polarized light microscopy and immunohistochemistry results showed concurrent expression of type I and II collagen in the interfacial repair tissue. In conclusion, implantation of juvenile allograft and minced meniscal fragments could increase the healing of avascular meniscal injury in vitro. © 2013 Orthopaedic Research Society Published by Wiley Periodicals, Inc. J Orthop Res 31:1514–1519, 2013     

Downregulation of MicroRNA‐320d predicts poor overall survival and promotes the growth and invasive abilities in glioma

Previous studies have demonstrated that miRNAs play an important role in tumor development and progression. The role of miR‐320d has been studied in several cancers except for glioma. The aim of the study was to investigate the expression levels, biological function, and mechanism of miR‐320d in glioma. The expression levels of miR‐320d were detected in glioma tissues and cell lines (U87 and U251) by RT‐qPCR. Cell proliferation, colony formation, apoptosis, cell cycle, and transwell assays were performed in glioma cell lines transfected with miR‐320d mimics or controls to evaluate the effects of miR‐320d in vitro. The expression levels of invasive‐related proteins were determined by Western blot analysis. Results showed that the expression of miR‐320d was significantly decreased in glioma tissues and cell lines. Overexpression of miR‐320d could significantly suppress cell growth, migration and invasion, and induced cell apoptosis as well as cell cycle at G0/G1 arrest in U87 and U251 cell lines. Additionally, expression levels of MMP‐2, MMP‐9, N‐cadherin, and integrin‐β1 reduced, while E‐cadherin increased in miR‐320d mimic group. Overall, this study is the first to demonstrate that miR‐320d may serve as an independent prognostic factor, indicating that miR‐320d is a biomarker for prognosis and therapy in glioma.     

基因3型慢性丙型肝炎患者直接抗病毒药物治疗后复发1例

正丙型肝炎病毒容易导致慢性感染,是我国慢性肝病主要病因之一。近年来,直接抗病毒药物(direct-acting antiviral agent,DAA)的出现,为慢性丙型肝炎的治疗带来了革命性的变化。与传统的干扰素联合利巴韦林的治疗方案相比,DAA抗病毒治疗的效果好,且口服方便、不良反应少,适用范围广[1-2]。目前,随着国民经济水平的提高和药物购买的方便性,部分慢性丙型肝炎患者可以通过购买仿