Medical Evaluation for Child Sexual Abuse: What the PNP Needs to Know

Sexual abuse is a problem of epidemic proportions. Pediatric nurse practitioners (PNPs) will most likely encounter sexually abused children in their practice, both those who have been previously diagnosed and others who are undiagnosed and require identification by the PNP. This continuing education article will discuss the medical evaluation of children with concerns of suspected sexual abuse. Acute and non-acute sexual abuse/assault examinations will be discussed. Physical findings and sexually transmitted infections concerning for sexual abuse/assault will also be discussed.     

Environmentally persistent free radicals inhibit cytochrome P450 activity in rat liver microsomes

Combustion processes generate particulate matter that affects human health. When incineration fuels include components that are highly enriched in aromatic hydrocarbons (especially halogenated varieties) and redox-active metals, ultrafine particulate matter containing air-stable, environmentally persistent free radicals (EPFRs) is generated. The exposure to fine EPFRs (less than 2.5 μm in diameter) has been shown to negatively influence pulmonary and cardiovascular functions in living organisms. The goal of this study was to determine if these EPFRs have a direct effect on cytochrome P450 function. This was accomplished by direct addition of the EPFRs to rat liver microsomal preparations and measurement of several P450 activities using form-selective substrates. The EPFRs used in this study were formed by heating vapors from an organic compound (either monochlorophenol (MCP230) or 1,2-dichlorobenzene (DCB230)) and 5% copper oxide supported on silica (approximately 0.2 μm in diameter) to 230 °C under vacuum. Both types of EPFRs (but not silica, physisorbed silica, or silica impregnated with copper oxide) dramatically inhibited the activities of CYP1A, CYP2B, CYP2E1, CYP2D2 and CYP3A when incubated at concentrations less than 0.1 mg/ml with microsomes and NADPH. Interestingly, at the same concentrations, the EPFRs did not inhibit HO-1 activity or the reduction of cytochrome c by NADPH-cytochrome P450 reductase. CYP2D2-selective metabolism by rat liver microsomes was examined in more detail. The inhibition of CYP2D2-selective metabolism by both DCB230- and MCP230-EPFRs appeared to be largely noncompetitive and was attenuated in the presence of catalase suggesting that reactive oxygen species may be involved in the mechanism of inhibition.     

不同启动子调控的PNP基因载体的构建和表达差异性分析

目的分别构建巨细胞病毒(cytomegalovirus，CMV)通用启动子和甲胎蛋白(α-fetoprotein，AFP)组织特异性启动子调控的PNP基因表达载体并分析二者表达的差异性。方法将AF0．3启动子插入载体pcDNA3．0，构建肝癌细胞特异表达载体pAF0．3；将PNP基因分别插入到pcDNA3．0和pAF0．3中，构建不同启动子调控下的PNP基因表达载体pcDNA3．0／PNP和pAF0．3／PNP；通过酶切、PCR及测序鉴定各重组体。采用脂质体介导法将两种PNP基因表达载体转染不同的细胞株，RT—PCR检测PNP基因在各细胞株中的表达，分析二者表达的不同。结果各目的片段均成功插入相应的载体中，CMV启动子调控下的PNP基因在各株细胞中均实现了表达，而AF0．3启动子调控下的PNP基因则在AFP阳性肝癌细胞中实现了组织特异性表达。结论两PNP基因表达载体是肝癌基因治疗中新型、高效的治疗载体，且pAF0．3／PNP还实现了在AFP阳性肝癌细胞中的靶向性表达。     

PNP/MeP-dR系统对肝癌细胞杀伤作用的实验研究

目的探讨新型嘌呤核苷磷酸化酶/6-甲基嘌呤-2′-脱氧核糖核苷(PNP/MeP-dR)自杀基因系统对肝癌细胞的杀伤作用。方法构建PNP基因真核表达载体pcDNA3.0/PNP,脂质体介导法将其导入HepG2细胞,利用G418筛选获得稳定转染PNP基因的细胞株HepG2/PNP。采用台盼蓝拒染法测绘细胞生长曲线,MTT法和FCM检测细胞对MeP-dR的敏感性及旁观者效应,HPLC检测PNP酶活性。结果HepG2/PNP细胞对MeP-dR十分敏感,作用4d后MeP-dR对HepG2/PNP的IC50为4.5μmol/L,而100μmol/L的MeP-dR即可最大限度地杀死HepG2/PNP细胞。100μmol/L MeP-dR作用8d后,混合细胞中HepG2/PNP比例仅占5%即可导致所有细胞死亡。HPLC结果显示,PNP基因产物能够将MeP-dR转化为6-MP。结论PNP/MeP-dR系统对肝癌细胞的杀瘤效果明显优于传统的自杀基因系统。本研究为该系统应用于肝癌体内治疗打下基础。     

Prevention of the progression of adjuvant induced arthritis by oral supplementation of Indian fresh water mussel (Lamellidens marginalis) aqueous extract in experimental rats

Aim of this study

Mussel is well accepted as food all over India. Beside for its nutritive value, people residing in Kosi river basin, Bihar, India, consume a preparation of soup, made from the footpad of molluscan species, with the belief that it gives relief from signs and symptoms of joint pain and related problems. This study was designed to explore the preventive activity of Indian fresh water mussel (Lamellidens marginalis) aqueous extract oral supplementation in experimental arthritis model.

Materials and methods

Arthritis was induced in male albino rats by intradermal injection of Freund's complete adjuvant in right hind footpad. Lamellidens marginalis extract (LME1, 500 mg/kg/day and LME2, 1 g/kg/day) peroral supplementation started from the 1st day after adjuvant injection and was continued for the subsequent 13 days. Severity of arthritis was evaluated from paw diameter, ankle diameter, paw weight, urinary hydroxyproline, glucosamine level, serum interleukin-1β, IL6, IL10, CINC1, TNFα level, lysosomal enzyme levels and from histopathological assessment.

Results

Lamellidens marginalis extract supplementation significantly (p < 0.05) decreased paw diameter, ankle diameter, and paw weight in treated groups (LME1, 500 mg/kg/day and LME2, 1 g/kg/day) as compared with arthritic group. Urinary hydroxyproline, glucosamine level, serum IL1β, IL6, CINC1, TNFα, IL10 and lysosomal enzyme levels were restored significantly (p < 0.05) in treated groups (LME1, 500 mg/kg/day and LME2, 1 g/kg/day) as compared to arthritic group. Synovial membrane damage and neutrophil infiltration in histopathological examination was restored significantly by LME supplementation as compared to arthritic group.

Conclusions

Thus, it might be concluded that experimental animals supplemented with Lamellidens marginalis extract were protected against the severity of disease progression in adjuvant induced arthritis.     

儿童嘌呤核苷磷酸化酶缺乏症1例报告并文献复习

目的分析总结儿童嘌呤核苷磷酸化酶缺乏症(PNPD)的临床特征。方法回顾分析1例PNPD患儿的临床资料,并复习相关文献。结果男性患儿,1岁9月龄,因面色苍白伴发热、咳嗽入院,既往有反复上呼吸道感染史,运动发育迟缓。血红蛋白88 g/L,网织红细胞11.35%,直接抗人球蛋白试验阳性,CD4~+/CD8~+ T细胞比值低,尿酸水平低。胸部CT示胸腺发育不良。基因测序发现患儿PNP基因存在c.722TC(p.I241T)纯合变异,其父母均为该变异携带者。患儿确诊为PNPD,于2岁3月龄死于多脏器严重感染。文献检索到78例PNPD病例,发病无性别差异,发生反复感染53例,神经功能障碍51例,自身免疫病21例,继发肿瘤性疾病6例。结论对反复感染、神经功能障碍、自身免疫性疾病、CD4~+/CD8~+T细胞比值降低、血尿酸水平低的患儿,需考虑基因缺陷致免疫缺陷病可能,基因序列分析可协助早期诊断。     

来氟米特致周围神经病变2例简

1 例64 岁和1 例46 岁女性类风湿关节炎患者,在服用来氟米特后出现双手麻木、痛觉过敏、足下垂等症状,排除其他因素引起的神经病变后,及时停药,上述症状好转;并对来氟米特致周围神经病变进行文献复习,总结其发生特点、诊断、危险因素等,-旦明确是由于药物导致的外周神经病变后,应立即停药,改善患者的临床预后.     

S-adenosylhomocysteine hydrolase activity,deoxyadenosine triphosphate accumulation,and competence of thymocyte and spleen leucocyte response to mitogens in coformycin-treated mice

The inhibition of S-adenosylhomocysteine hydrolase and accumulation of dATP in thymus, spleen and other tissues of mice treated with the adenosine deaminase inhibitor coformycin were studied in parallel with the competence of thymocytes and spleen leucocytes to undergo mitogen-induced transformation. Newborn mice were lethally sensitive to daily injections of coformycin, 0.2 mg/kg, whereas adult mice were not. Developmental profiles of enzymes of nucleoside metabolism showed adenosine deaminase and purine nucleoside phosphorylase to be greatest in thymus around day 20 and to decrease for animals older than 60 days. The most notable change was a 3-fold increase in spleen leucocyte adenosine deaminase activity between days 10 and 30. Adenosine deaminase activity was reduced to less than 10% of normal in tissues of newborns treated with coformycin for 12–14 days. S-Adenosylhomocysteine hydrolase was also reduced to 5–40% of normal with no evidence of tissue specificity. Both thymocytes and erythrocytes of coformycin-treated mice accumulated dATP whereas spleen leucocytes did not. For coformycin-treated mice, spleen leucocyte and thymocyte response to concanavalin A (Con A) was reduced to 20 and 60% of controls respectively. Coformycin, 3.6 μM, also potentiated the in vitro toxicity of adenosine and deoxyadenosine toward thymocytes or spleen leucocytes by approximately an order of magnitude. Our observations are consistent with dATP being involved in impairment of thymocyte responsiveness; however, it appears unlikely that either dATP elevation or S-adenosylhomocysteine hydrolase inhibition is involved in the mechanism of impairment of spleen leucocyte response by coformycin.