Leukemia,lymphoma, and multiple myeloma following selected medical conditions

The role of selected prior medical conditions in the etiology of hematopoietic malignancies was examined in a case-control study of members of two regional branches of the Kaiser Permanente Medical Care Program (USA). Past history of chronic infectious, autoimmune, allergic, and musculoskeletal disorders was abstracted from medical records for leukemia (n = 299), non-Hodgkin's lymphoma (NHL, n = 100), and multiple myeloma (n = 175) cases and matched controls (n = 787). Little difference was found between cases and controls for most of the chronic conditions evaluated, including sinusitis, carbuncles, urinary tract infections, pelvic infections, herpes zoster, asthma, rheumatoid arthritis, psoriasis, bursitis, and gout. Only three statistically significant elevated risks were found, i.e., with combined disc disease myeloma among patients with prior eczema and disk and other musculoskeletal conditions, and NHL following tuberculosis. Only two of these associations showed consistent patterns by sex and geographic region (myeloma with eczema and with musculoskeletal conditions). While prior history of eczema and musculoskeletal conditions may slightly increase risk of myeloma, this study provided little if any support for an association of chronic infectious, autoimmune, allergic, and musculoskeletal conditions with subsequent occurrence of the leukemias or NHL. Additionally, these data did not support a role for chronic antigenic stimulation, as defined in previous epidemiologic studies, in the etiology of hematopoietic malignancies.Ms Doody and Drs Linet, Pottern, Boice, and Fraumeni are with the Epidemiology and Biostatistics Program, National Cancer Institute. Dr Glass is with the Kaiser Permanente Medical Care Program, Northwest Region, Portland, Oregon, USA. Dr Friedman is with the Kaiser Permanente Medical Care Program, Northern California Region, Oakland, California, USA. Address correspondence to Ms Doody, Radiation Epidemiology Branch, National Cancer Institute, Executive Plaza North, Room 408, Bethesda, MD 20892, USA. This research was supported in part by National Cancer Institute contracts NO1-CP-01047, NO1-CP-01054, NO1-CP-11009, NO1-CP-11037, NO1-CP-31035, and NO1-CP-61006.     

广西百色地区肝病患者及受血者HCV感染现状调查

笔者应用ＥＬＩＳＡ法对广西百色地区１７９例各类肝病患者及４１例受血者血清进行了抗－ＨＣＶ检测。结果各类肝病抗－ＨＣＶ阳性率为１７．９％，受血者抗－ＨＣＶ阳性率为３１．７％。在急性肝炎（急肝）、慢性肝炎（慢肝）、肝硬化和肝癌中，抗－ＨＣＶ阳性率各为４．３％（１／２３）、１２．８％（１０／７８）、２８．６％（１２／４２）和２５．０％（９／３６）。抗－ＨＣＶ阳性率有随肝病慢性比而增高的趋势，肝硬化的抗－ＨＣＶ阳性率明显高于急肝或慢肝（Ｐ＜０．０５），而肝癌的抗－ＨＣＶ阳性率与急肝或慢肝相差不显著（Ｐ＞０．０５或０．１），且发现ＨＢｓＡｇ阴性肝病者的抗－ＨＣＶ阳性率明显高于ＨＢｓＡｇ阳性患者（Ｐ＜０．５），肝病患者抗－ＨＣＶ的检出率与ＡＬＴ活性无关（Ｐ＞０．０５）。在受血者中，抗－ＨＣＶ的检出率与受血次数、ＡＬＴ活性关系非常密切。因此，加强对ＨＣＶ的检测是当前预防输血后肝炎的紧迫任务。     

山西省卫Ⅳ项目地区农民因病致贫研究

目的 研究项目地区农民因病致贫严重程度及预防措施。方法 利用扩展线性支出系统界定贫困标准，观察因病致贫率并研究因病致贫人群特点。结果 农民因病致贫率3．44％，因病致贫人群收入低，健康状况差，馒性病患病率高。2周就诊和年住院率高，年家庭医疗费用支出远高于对照人群。结论 通过住院医疗保险和慢性病防治措施缓解农民因病致贫。     

国产4环／7层PET仪初试

对我国１９９６年研制成功的４环／７层ＰＥＴ仪（轴向视野８ｃｍ）进行试用。先进行模型试验和动物实验，然后对１例正常志愿者和７例患者进行１８Ｆ脱氧葡萄糖（ＦＤＧ）ＰＥＴ显像。静脉注射１８ＦＦＤＧ３７０ＭＢｑ后约１５小时显像，成人全身显像行１１个床位采集，约１５小时，心脑局部显像行２～３个床位采集，约半小时。直径１～３ｃｍ的阴模和阳模皆可显示。８例全身冠状和矢状断层影像清晰，正常志愿者（正常进食）可见脑和心肌显影，膀胱内放射性较多。２例恶性肿瘤患者的６处病变浓聚１８ＦＦＤＧ。２例恶性肿瘤患者手术和化疗后无复发征，显像阴性。２例良性病变处未见１８ＦＦＤＧ浓集。１例陈旧性心肌梗塞患者１８ＦＦＤＧ心肌断层显像与９９ｍＴｃ甲氧基异丁基异腈心肌血流灌注显像匹配良好。正常心肌显影与否受葡萄糖负荷的影响。８例脑皮质横断影像良好，基底节和丘脑影像有时尚欠清晰。初试结果表明，该ＰＥＴ仪相当于至今尚在国外广泛使用的８０年代中期４环／７层ＰＥＴ仪水平，但具有９０年代ＰＥＴ仪全身整体冠状和矢状断层显像的功能，可用于全身肿瘤显像、心肌活性判断和功能性癫痫灶术前定位，但仪器操作性能和软件功能尚需进一步完善。     

Cavernous sinus thrombosis following odontogenic and cervicofacial infection

Summary Cavernous sinus thrombosis (CST) is rarely seen clinically as a complication of infectious processes since the discovery of penicillin. At the present time, dental abscess is an uncommon cause of CST. We now report our experiences with a 60-year-old diabetic male, who developed CST 38 days after extraction of an infected upper third molar tooth. The importance of eradicating regional cervicofacial foci of infection is stressed.     

Orbital Hydatid Cyst: CT and MRI

Orbital hydatid cyst is rare. We present a case with CT and MRI, emphasizing the superiority of the latter. Received: 19 August 1996 Accepted: 9 September 1996     

缺指(趾)综合征

本文报告—缺指(趾)综合征之家族。在4代62人中手足畸形者20人,对3代7人拍照了双手足正位X线片,发现足部2-4跖趾均缺如,1、5跖趾呈现跖外翻,趾内曲。外形酷似龙虾爪样。手部1-3指大多数病人缺如。也有2、3指并指畸形或指骨分叉畸形。全身其他骨关节正常,智力发育良好。本文讨论了该病的命名、分类和有关鉴别诊断。     

经鼻给予神经生长因子对沙林染毒大鼠梨状皮质神经元的影响

目的 探讨经鼻给予神经生长因子(NGF)对沙林染毒大鼠脑组织梨状皮质区神经元的影响.方法 建立大鼠沙林染毒模型,常规治疗后经鼻给予NGF或生理盐水,24 h后采用HE染色和免疫组织化学染色观察梨状皮质区神经元的变化.结果 与空白对照组相比,经鼻给予生理盐水的大鼠梨状皮质区可见较多变性、坏死的神经元,神经元数量[(404.75±25.17)个/mm2]明显减少(39.44%);而经鼻给予NGF组变性、坏死的神经元较少,神经元数量[(651.94±36.02)个/mm2]减少不明显.结论 经鼻给予NGF可以减轻沙林染毒大鼠梨状皮质区损伤程度.经鼻给予NGF有可能成为针对沙林所致脑损伤的有效治疗手段.     

浙江人群幽门螺杆菌cagA/vacA优势基因型和不同基因型混合感染的调查

目的　了解消化性溃疡和慢性胃炎患者感染的幽门螺杆菌 (Hp)cagA vacA优势基因型及不同基因型Hp感染、混合感染与疾病的关系。 方法　选择胃窦、胃体双份活检标本均培养出Hp的 42例慢性胃炎 (CG)和 3 6例消化性溃疡 (PU )患者作为研究对象 ,采用聚合酶链反应 (PCR)检测156份Hp分离株的cagA基因、vacA基因的信号区 (s)和中间区 (m )亚型 ,分析Hp基因型及多株Hp混合感染在CG和PU中的分布。结果　胃窦标本cagA基因的检测中 78例患者中有 75例 (96.2 % )为cagA阳性 ,相应的胃体标本中 ,76例患者 (97.4% )为cagA阳性 ,有 1例 (1.3 % )患者胃窦、胃体检出cagA状态不一的Hp混合菌株。在胃窦标本的vacA基因分型中 ,s1a m1、s1a m2、s1a m1b、s1a m1b m2 4种vacA基因型在 78例患者中所占比例分别为 6.4% (5 78)、55.1% (43 78)、2 6.9% (2 1 78)和 1.3 % (1 78) ,多株混合感染为 3 .8% (3 78) ;而相应的胃体标本中 ,前述四种vacA基因型所占比例依次为 6.4% (5 78)、53 .8% (42 78)、2 5.6% (2 0 78)和 3 .8% (3 78) ,多株混合感染为 5.1% (4 78)。cagA+ s1a m2和cagA+ s1a m1b在胃窦标本中占 51.3 % (40 78)和 2 6.9% (2 1 78) ,而在相应的胃体标本中占 52 .6% (41 78)和 2 5.6% (2 0 78)。少量胃窦、胃体