白细胞介素-23受体基因多态性与炎症性肠病关系的初步研究

目的 初步探讨白细胞介素-23受体(IL23R)基因中两个单链核苷酸多态性(SNP)位点(rs11209026和rs11805303)的遗传多态性和炎症性肠病(IBD)的发病易感性之间的关系.方法 采用聚合酶链反应(PCR)直接测序法检测50名健康人和81例IBD患者(其中克罗恩病41例,溃疡性结肠炎40例)的两个SNP位点基因多态性.结果 rs11209026位点基因型频率和等位基因频率在克罗恩病患者分别为7.3%和3.7%,在溃疡性结肠炎患者分别为15.0%和7.5%,在对照组分别为14.0%和7.0%,三组间差异均无统计学意义(P值均＞0.05).rs11805303位点的基因型频率和等位基因频率在克罗恩病患者分别为22.0%和52.4%,在溃疡性结肠炎患者分别为15.0%和41.2%,在对照组分别为34.0%和59.0%,三组间基因型频率比较差异均无统计学意义(P值均＞0.05),而等位基因频率在溃疡性结肠炎患者和对照组间差异有统计学意义(P=0.018).rs11805303位点基因多态性与溃疡性结肠炎患者的发病年龄、性别、疾病的活动性及发病部位均无关(P值均＞0.05).结论 IL23R两个SNP位点基因多态性与克罗恩病无相关性.rs11805303位点的多态性可能为溃疡性结肠炎患者的一个遗传标志,但与该病病变特点无显著相关.     

Neonatal lupus syndromes

Children born from mothers positive for autoantibodies against SSA/Ro and/or anti‐SSB/La ribonucleoproteins may develop heart conduction tissue damage resulting in atrioventricular block and/or transient skin rash, liver enzyme abnormalities and anaemia/thrombocytopenia. Additional transient electrocardiographic abnormalities (sinus bradycardia, QT interval prolongation) have been reported. Such clinical and laboratory manifestations are included in the so‐called neonatal lupus syndromes, independently whether the mother is suffering from a systemic autoimmune disease or is totally asymptomatic. The prevalence of the congenital heart block is around 2%, of neonatal rash around 20%, while laboratory abnormalities in asymptomatic babies can be detected in up to 40% of cases. The risk of recurrence of complete heart block is almost 10 times higher in the following pregnancies. Most of the mothers are asymptomatic at delivery and are identified only by the birth of an affected child. Their long‐term outcome is generally more reassuring than previously assumed and arthralgias and xerophtalmia are the most common symptoms. A standard therapy for heart blocks detected in uterus is still a matter of investigation, although fluorinated corticosteroids have been reported to be effective on myocarditic signs when present. Serial echocardiograms and obstetric sonograms, performed at least every two weeks, starting from the 16 weeks gestation, are recommended in anti‐Ro/SSA positive pregnant women: the goal is to detect early fetal abnormalities, that might precede complete atrioventricular block and that might be a target of preventive therapy. Transplacental passage of maternal anti‐SSA/Ro ‐SSB/La IgG is thought to be pivotal in inducing tissue damage. However, the discordant appearance of the syndrome in twins does suggest a role also for fetal or environmental factors.     

核因子κB与肺部疾病的关系及其潜在治疗意义

核因子κB(nuclear factor-kappaB,NF-κB)是一种重要的参与炎症蛋白基因转录的调节因子,在多种肺部疾病的细胞及动物模型实验中,NF-κB的活化对阐明肺部疾病的病理显得尤为关键.因此,进一步了解NF-κB的分子机制及其在一些常见肺部疾病发病机制中的作用将有助于从不同环节治疗和预防肺部疾病.     

先心病合并重度肺动脉高压手术麻醉的适应范围和限度

先心病伴重度肺动脉高压（PH）行矫正手术91例，其中危重型PH40例。危重型PH病人的手术适应范围有所扩大。作者提出5项判断术前危险性的标准：1.Pp／Ps≥1.0；2.PVR＞1500dyn·S·cm-5；3.Qp／Qs≤1.2；4.SaO2＜90％；5.存有右向左为主分流时，其4项标准应慎重权衡。     

Tampa bay catheter: A new guiding catheter for endomyocardial biopsy via femoral approach

Initially, endomyocardial biopsies were obtained almost exclusively using the jugular vein approach. Lately, the femoral vein route has gained popularity and in many centers, including ours, it is preferred. Despite this, guiding catheters specifically designed for endomyocardial biopsy via femoral vein approach are not available. Here, the experience with the Tampa Bay catheter, designed for endomyocardial biopsy using the femoral vein is described. From 1–1-89 to 1–31-90, a total of 486 endomyocardial biopsies were performed in 78 post-heart transplant patients (1–17, mean 6 per patient); 106 were performed via internal jugular vein (22%) and 380 (78%) via femoral vein. Of these, 100 were performed using the Tampa Bay catheter. The remaining 280 biopsies were done using a long sheath or a Judkin's right coronary angioplasty guiding catheter. Biopsy specimens were adequate for diagnosis of rejection in all 106 biopsies performed via internal jugular vein (100%) in 99 of 100 biopsies via femoral vein using the Tampa Bay catheter (99%) and in 274 of the 280 (98%) biopsies using the long sheath or the right Judkin's coronary angioplasty guiding catheter (NS). The femoral vein is larger and easier to find than the internal jugular vein. More important, complications such as right pneu-mothorax, Horner's syndrome, recurrent laryngeal nerve paralysis, and right phrenic nerve paralysis, known to occur when the internal jugular vein approach is used, can be completely avoided when the femoral vein approach is used.     

Value and limitations of human myocardial biopsy.

Twenty-three myocardial biopsies from 22 patients with various cardiological diseases were examined by light and electron microscopy. The amount of fibrosis, endocardial thickening, “whorling of myofibers”, “irregular running of myofibers”, fat infiltration and lipofuscein granules were compared to cardiological parameters such as the function group of the patients, cardiac index, stroke index and the pulmonary capillary wedge pressure. The histological grading showed a weak correlation to the function group of the patients and the pulmonary capillary wedge pressure, but not to the cardiac index or stroke index. While patients with an almost normal heart function had a normal histology, both normal and abnormal histology were seen in patiens with severe heart disease. It was not possible to relate any morphological changes in the myocardium, neither at the light microscopical nor at the ultrastructural level to specific heart diseases as for example primary or alcoholic cardiomyopathy. However, severe contraction artefacts disturbed both the light microscopical and especially the ultrastructural evaluation of the specimens.This problem is discussed and in order to diminish the risk of misinterpretation of myocardial biopsy specimens, recommendations are given with regard to fixation, mincing and embedding of the specimens as well as to the evaluation of both the light microscopic slides and the ultrathin sections.     

新疆1 207名老年人慢性病现状及影响因素分析

目的 探讨老年人慢性病患病现状及其影响因素.方法 对新疆乌鲁木齐市、昌吉州和吐鲁番地区1 250名60岁及以上老年人进行问卷调查,有效问卷1 207份.结果 新疆三地区1 207名老年人慢性病患病率位于前10位的依次为高血压(31.7%)、骨质疏松(27.0%)、慢性支气管炎(25.1%)、慢性胃肠道疾病(23.9%)、高脂血症(22.0%)、冠心病(19.2%)、支气管哮喘(15.1%)、胆结石(12.6%)、白内障(11.4%)、贫血(10.5%);前5位慢性病患病率的影响因素为年龄、性别、文化程度、工作类型、月收入、医疗保障形式.结论 老年人慢性病患病率高,年龄、性别、文化程度、工作类型、月收入和医疗保障形式是老年人慢性病患病率的重要影响因素,经济状况是制约老年人慢性病就诊的决定因素.     

Serum Creatine Kinase in Patients with Rheumatic Diseases

Serum creatine kinase (CK) activity is reduced in some conditions, including rheumatic diseases, but the aetiology and significance remain to be clarified. The aim of this study was to investigate relationships between serum CK activity and other muscle enzymes, muscle mass, renal function, steroid use and disease activity in patients with rheumatic diseases. Serum CK activity was measured in sera from 498 patients with rheumatic diseases: rheumatoid arthritis (RA, n= 145), systemic lupus erythematosus (SLE, n= 31), spondyloarthropathies (SpA, n= 35), polyarthralgia/arthritis (Poly, n= 74), miscellaneous group (MI, n= 46), and in non-inflammaroty arthropathies (NIA, n= 167) as controls. Serum CK level was significantly reduced in RA (45.4 ± 1.9 IU/l), SLE (46.4 ± 4.2 IU/l), SpA (64.7 ± 5.6 IU/l) and MI (63.4 ± 4.8 IU/l), but not in poly (70.2 ± 3.1 IU/l), compared to controls (78.9 ± 2.4 IU/l) (P < 0.05). CK values correlated with aspartate aminotransferase (AST), erythrocyte sedimentation rate (ESR), body mass index (BMI) and platelets (Plat) in RA; ESR and haemoglobin (Hb) in SLE, AST, ESR and Hb in SpA; lactate dehydrogenase (LDH), AST, ESR and Hb in Poly; LDH, AST, ESR, Hb and Ccr in MI; and LDH, AST and ESR in controls. In all patients with rheumatic diseases CK level was significantly corrrelated with LDH, AST, alanine aminotransferase (ALT), ESR, C-reactive protein (CRP) and BMI and prednisolone dose, but not with Ccr, age and disease duration. In conclusion, our data support the possibility that reduced CK activity is inversely correlated with inflammatory activity and correlated with other muscle enzymes, muscle mass and steroid use, but not with renal function, age and disease duration in rheumatic diseases. Received: 6 August 1999 / Accepted: 6 January 2000     

热带传染病的进展与对策--中美泰三国军方热带传染病专家交流会成果侧记

2016年5月17日至19日,中、美、泰三边军方热带传染病专家交流会在美国夏威夷檀香山举行。会议主要包括以下几个主题：抗生素耐药、军事特有传染病问题、传染病对策的进展、新发传染病、细菌与病毒性疾病监测与应对以及媒介生物传播的感染性疾病。以下就本次会议的主要内容,按照不同主题作一摘要汇总。     

Study Design and Interim Outcomes of Guangzhou Institute of Respiratory Disease COPD Biobank

Background: GIRD COPD Biobank is a multicenter observational study blood-based database with local characteristics, in order to investigate the causes, risk factors, pathogenesis, prevalence patterns and trends of COPD and promote new pathogenic insights in China.

Methods: We enrolled 855 clinically COPD patients and 660 controls with normal lung function. Extensive data collection has been undertaken with questionnaires, clinical measurements, and collection and storage of blood specimens, following Standard Operating Procedures (SOP). All surveys had similar quality controls, supervisions, and training of the investigator team.

Results: Since September 2010, a total of 1515 subjects (1116 [73.7%] males; 855 [56.4%] diagnosed with COPD) were enrolled. Analyses of the design and interim results of the GIRD COPD Biobank Study identified patients with COPD were older, lower educational level, a longer history of pack-year smoking, less in kitchen fan usage, X-ray exposure, and history of disease (P < 0.01 for all); Most of the COPD subjects belonged to moderately severe or worse, stratified according to Global Lung Function Initiative (GLI); COPD patients had relatively more co-morbidities than controls; Environmental hazard exposures might be the main contributors to the reported respiratory symptoms; Cold air, haze, and influenza acted the top three factors to induce respiratory symptoms in both COPD cases and controls.

Conclusion: The GIRD COPD Biobank Study has the potential to provide substantial novel insights into the genetics, biomarkers, environmental and lifestyle aspects of COPD. It is expected to provide new insights for pathogenesis and the long-term progression of COPD.