Ultrastructural Changes Suggestive of Focal Segmental Glomerulosclerosis in Atypical Minimal Change Nephrotic Syndrome

In an attempt to recognize early stages of focal segmental glomerulosclerosis (FSGS) in patients with a clinical course suggesting a diagnosis other than minimal change disease (MCD) and normal histology, or minor, nondiagnostic changes on light microscopy (LM), we used a protocol for systematic and extensive electron microscopy (EM) examination of kidney biopsies obtained from such patients. By this method ultrastructural pathology was found in 8 patients. These changes were localized, involving only portions of single glomerular segments. The findings included mild to moderate increase of the mesangial matrix, focal wrinkling of the capillary basement membrane, and early obliteration of the normal architecture of individual capillary loops, as well as electron-dense deposits in a mesangial and subendothelial distribution. Of these 8 patients, 2 are at present in remission without therapy (in 1, following therapy with cyclophosphamide); 3 are in remission on steroid therapy; 1 developed massive proteinuria during pregnancy, after a spontaneous remission lasting almost 2 years; 1 patient advanced to terminal renal failure 3 1/2 years after biopsy; and 1 died of sepsis 1 month after biopsy. We believe that the ultrastructural changes found may represent early or mild FSGS and that the protocol described can add valuable information in clinically worrisome patients in whom renal histology appears normal.     

肝脏局灶性小占位的磁共振信号强度比与病灶性质的相关性

目的 计算肝细胞癌、肝转移瘤、肝脏海绵状血管瘤和肝囊肿的病灶／肝脏磁共振信号强度比（SIR）,并评价其与病灶性质的关系。方法 随机选择经确诊的肝细胞癌、肝转移瘤、肝海绵状血管瘤和肝囊肿病例共92例（148个病灶）行前瞻性磁共振成像（0．5T）研究。计算4种病灶的SIR,并进行统计学分析。结果 在T1W图像上,肝海绵状血管瘤与恶性肿瘤的SIR值间差异无显著性（t=1.799,P=0.075);质子加权像上,良恶性肿瘤的SIR之间无统计学意义（t=0.691,P=0.491);T2WI上,良性病变的SIR显著高于恶性肿瘤（P＜0．01）,且4种病变的SIR值与回波时间（TE）之间均存在线性正向相关关系。结论 在T2WI个测得的SIR可用于区分肝脏占位性病灶的性质。     

Nocturnal Paroxysmal Dystonia with Short-Lasting Attacks: Three Cases with Evidence for an Epileptic Frontal Lobe Origin of Seizures

The epileptic or nonepileptic origin of nocturnal paroxysmal dystonia (NPD) has been debated. We studied three patients with frequent attacks during non-REM sleep. During prolonged video-EEG monitoring, two patients had a convulsive seizure after a typical NPD episode and on these occasions EEG showed epileptiform discharge. In the three patients, attacks occurred repeatedly with different intensity, representing "fragments" of the same seizure. These fragments of the attack could occur periodically every 20-40 s. We postulate that short NPD attacks are actually epileptic seizures originating from the frontal lobes. The rhythmicity of the episodes may be due to rhythmic oscillation of cortical function during non-REM sleep.     

实验性局灶性脑缺血再灌注Fos蛋白的表达

目的　探讨大鼠局灶性脑缺血再灌注Fos蛋白表达的意义及其机制。方法　采用免疫组化法观察Fos蛋白在大鼠局灶性脑缺血再灌注后皮层和基底节区的动态变化。结果　Fos蛋白在大脑中动脉阻断 1h后 ,随再灌注时间延长其分布不同。基底节区持续时间长 ,阳性细胞多 ,而皮层持续时间短 ,阳性细胞少。其中再灌注 90min ,Fos蛋白表达最显著。大脑中动脉供血中心区皮层几无表达。结论　Fos蛋白的表达与神经细胞存活密切相关 ,出现Fos蛋白表达的区域神经元易于耐受缺血性损害而存活 ,可能是神经细胞自我保护机制之一 ,Fos蛋白的表达存在扩散抑制     

加速型肾小球硬化动物模型的建立

目的 建立一种病变稳定、制作周期短、重复性好、最接近人类肾小球硬化病理改变的动物模型。方法 在摘除一侧肾脏的基础上,通过两次尾静脉注射柔红霉素,定期观察血、尿及肾脏组织病理学改变。结果 模型组大鼠于用药后第４周时,出现水肿、大量蛋白尿、低蛋白血症、高脂血症,病理形态上开始出现典型的节段性肾小球硬化;第９周时血清肌酐、尿素氮水平显著升高（Ｐ〈０．０５）,８０％的肾小球出现节段性硬化。结论 此模型制作     

大鼠局灶性脑缺血再灌注后Hsp70的表达及与细胞凋亡的关系

目的：研究大鼠局灶性脑缺血再灌注后热休克蛋白（ｈｅａｔ ｓｈｏｃｋ ｐｒｔｅｉｎ,Ｈｓｐ）７０的表达及与细胞凋亡的关系。方法：用线栓法制备ＭＣＡＯ模型,用免疫组化法测定Ｈｓｐ７０阳性细胞及用ＴＵＮＥＬ法测定凋亡细胞。结果：缺血２ｈ即有Ｈｓｐ７０阳性细胞,６～２４ｈ明显,４８ｈ减弱,３ｄ消失。ＴＵＮＥＬ阳性细胞于再灌注后２ｈ出现,２４～４８ｈ达高峰,７２ｈ减弱。结论：脑缺血再灌注后早期即有Ｈｓｐ７０表达及细胞凋亡发生。     

Paroxysmal dystonia and paroxysmal tremor in a young patient with multiple sclerosis

A 16-year-old patient with multiple sclerosis (MS) showed paroxysmal movement disorders during a recurrence of the disease. The paroxysms took the form ot brief unilateral dystonic posturings of the right body suggestive of paroxysmal dystonia (PD); they completely receded with acetazolamide. A single episode of a high amplitude, rythmic slow and coarse generalized tremor, present at rest and increasing with movement, particularly involving the head in a no-no movement, occurred soon after recovery from PD and lasted three hours. The present report provides evidence that MS has to be considered in the diagnostic approach to symptomatic childhood PD and underlines the efficacy of acetazolamide in the treatment of PD attacks. It also describes a rare paroxysmal movement disorder, defined as paroxysmal dystonic tremor, that can be considered as falling within the spectrum of PD.This study was partially supported by the Paolo Zorzi Association for Neurosciences, and the Harry De Jur Foundation.     

银杏叶注射液对实验性大鼠局灶性脑缺血的保护作用

以行为障碍、脑梗死范围、脑含水量、脑组织病理改变为观察指标,研究银杏叶注射液（ＧＢＥ）对大鼠大脑中动脉闭塞所致局部脑缺血的防治作用。结果表明,ＧＢＥ２０、４０ｍｇ／ｋｇ静脉注射可显著降低大鼠脑梗死范围和脑含水量,改善行为障碍。脑组织形态学检查显示,ＧＢＥ４０ｍｇ／ｋｇ组动物脑组织缺血病变较轻。提示ＧＢＥ对局灶性脑缺血具有保护作用。     

丹参及生脉液对阿霉素所致大鼠肾小球硬化的实验性治疗作用

观察丹参及生脉液对阿霉素所致 Ｓ Ｄ 大鼠肾小球硬化实验性治疗作用。摘除大鼠左肾７ ｄ 后,尾静脉注射阿霉素（６ ｍ ｇ·ｋｇ － １） 。隔日腹腔注射丹参及生脉液,８ 周后处死大鼠。观察血红蛋白（ Ｈｂ） 、血尿素氮（ Ｂ Ｕ Ｎ） 、胆固醇（ Ｃｈ） 及２４ ｈ 尿蛋白含量; Ｅ Ｌ Ｉ Ｓ Ａ 法测定肾皮质Ⅳ型胶原（ Ⅳｃｏｌ ．） 及层粘连蛋白（ Ｌ Ｎ） ;用免疫组化法,计算机图象分析肾小球系膜区Ⅳｃｏｌ ．及 Ｌ Ｎ 含量。结果显示：模型丹参及模型生脉液组肾皮质、肾小球系膜区Ⅳｃｏｌ．及 Ｌ Ｎ 含量明显低于模型对照组（ Ｐ ＜ ０ ．０５） ,高于正常对照组（ Ｐ ＜ ０ ．０１） 。提示丹参及生脉液能减轻阿霉素所致肾小球硬化的程度。