组织相容性复合物DQ基因与胰岛素依赖型糖尿病易感相关性剂量效应规律的研究

为研究中国北方汉族人中组织相容性复合物ＤＱ（ＨＬＡ－ＤＱ）基因与胰岛素依赖型糖尿病（ＩＤＤＭ）遗传易感性相关的剂量效应规律，采用聚合酶链反应和序列特异性寡核苷酸探针杂交技术，对５４例胰岛素依赖型糖尿病患儿和４０例正常成年供血员ＨＬＡ－ＤＱ基因进行了研究。结果：携带４个易感性基因的个体只见于患者，携带３个易感性基因的个体在患者中为３３．３％，正常对照中为１０％；携带２个或１个易感性或保护性基因的个体在正常对照中频率较患者为高，但差异无显著意义；携带３个保护性基因的个体只见于正常对照。提示：ＩＤＤＭ易感性基因具有部分隐性遗传的特点且具有累加效应。个体中１个或２个易感性基因的存在不能对ＩＤＤＭ构成显著的易感性，３个或３个以上易感性基因的存在方可对ＩＤＤＭ构成显著易感性。ＤＱ保护性基因具有部分显性遗传的特点并且也具有累加效应。携带１个或２个保护性基因的个体患ＩＤＤＭ的机会将大大减少，而携带３个保护性基因的个体则可以不发生ＩＤＤＭ。     

Postprandial glycaemia after regular and lispro insulin in children and adolescents with diabetes

We compared the postprandial blood glucose (BG)-levels following preprandial regular insulin or lispro insulin before and after eating in adolescents with diabetes. Lispro is a rapidly absorbed insulin analogue. Lispro insulin injected immediately before breakfast reduced the postprandial BG-rise significantly compared to the 20 min preprandially administered regular insulin (P<0.01). Postprandial lispro injection resulted in similar BG values as the standard treatment with regular insulin 20 min preprandially. Conclusion Lispro insulin injected immediately before the meal leads to lower postprandial BG levels and seems to be an option for teenagers who use multiple preprandial insulin injections. Postprandial lispro administration could be a benefit in certain situations since it resulted in similar BG values to preprandial regular insulin. Received: 13 March 1997 / Accepted: 26 May 1997     

4种用药方案治疗2型糖尿病的成本-效果分析

目的:探讨4种用药方案治疗2型糖尿病的经济效果。方法:对格列齐特(A)、二甲双胍(B)、伏格列波糖(C)、罗格列酮(D)4种用药方案进行成本-效果分析。结果:A、B、C、D4组药物治疗成本分别为226.23、179.00、580.80、486.40元;总有效率分别为90.6%、81.5%、96.4%、82.8%;成本-效果比分别为249.7、219.6、602.5、587.4;A、C、D组相对于B组的增量成本-效果比分别为519.0、2696.6、2260.3。结论:B方案为4种用药方案中最具临床推广价值的治疗方案。     

Medical treatment of vulvar squamous cell hyperplasia.

OBJECTIVE: To evaluate symptomatic response and recurrence rates of graduated topical fluorinated corticosteroid in patients with vulvar squamous cell hyperplasia. METHODS: Nine hundred seventy-six patients with biopsy-proven vulvar squamous cell hyperplasia from 1990 to 2003 were reviewed in this retrospective study. All patients were treated with graduated topical fluorinated corticosteroid. Data were obtained from hospital records. Symptomatic remission and recurrence rates were noted following six months local therapy. RESULTS: The mean age was 42.55+/-10.93 (15-85). The remission rate was 93.8% in six months. The remission rate was non-significantly higher in postmenopausal patients than that in their premenopausal counterpart (94.9% vs 93.0%, p=0.15). The disease recurred in 6.9% of patients. Of the patients that suffered recurrence 47.5% had persistent disease initially. The patients with following factors older ages (>40 years), postmenopausal period had significantly higher recurrence rates. Four patients with recurrent disease and six patients with persistent disease in the form of vulvar intraepithelial neoplasia I-II or atypical squamous hyperplasia, were treated with skinning vulvectomy. CONCLUSION: Corticosteroid in the treatment of vulvar squamous cell hyperplasia yielded excellent response rates. In the evaluation of patients without symptomatic relief, the first step should be a vulvar biopsy to exclude the presence of atypical components.     

哮喘患儿生活质量与吸入糖皮质激素治疗的相关性分析

目的探讨吸入糖皮质激素(ICS)治疗哮喘对患儿生活质量、肺功能的改善情况与吸入治疗依从性的关系,并分析患儿不服从规范吸入治疗的原因。方法对具有应用ICS治疗指征并能完成填写儿科哮喘生存质量调查问卷(PAQLQ)和平行测量肺功能的83例患儿的资料作回顾分析,评估其生活质量、肺功能改善情况与吸入治疗依从性的关系。结果急性发作期,治疗组的FEV1(1秒钟用力呼气量)和PAQLQ评分均值在治疗前后有显著性差异(p<0.05);坚持治疗时间越长,改善越明显。对照组患儿在急性发作期治疗前后FEV1无改善(p>0.05),PAQLQ评分更低。治疗组与对照组的FEV1、PAQLQ评分均值都有显著性差异(p<0.05);非急性发作期,两组治疗前后的FEV1、PAQLQ评分均值无显著性差异(p>0.05)。结论坚持规范使用ICS治疗的哮喘患儿,其生活质量、肺功能改善比治疗不依从的患儿明显提高,发作时严重程度减轻。     

不同时程吗啡给药大鼠部分脑区超微病理变化观察

目的:观察不同时程吗啡依赖大鼠依赖相关脑区超微病理结构变化。方法:背部皮下递增注射吗啡建立不同时程吗啡依赖大鼠模型,应用透射电镜对吗啡依赖大鼠依赖相关脑区LC、中脑导水管周围灰质、黑质、豆状核、杏仁核、海马进行观察,并与空白对照组进行比较。结果:吗啡依赖大鼠依赖相关脑区部分神经细胞肿胀或固缩,神经毡灶性水肿,有髓神经纤维髓鞘分离,线粒体肿胀、畸形,内质网扩张,多聚核糖体解聚,轴突、树突灶性水肿,细胞器稀疏,突触小泡密集并向活性区聚集。空白对照组未见异常。结论:吗啡依赖大鼠依赖相关脑区神经细胞呈缺血、缺氧性及退行性改变。     

海洛因依赖性人格概念的建构及其与心理健康的关系

目的:了解海洛因依赖性人格的概念结构,建立海洛因依赖性人格量表。方法:对10 5名海洛因戒除者的海洛因依赖性人格问卷的测试数据进行验证性因素分析。结果:(1)海洛因依赖性人格由海洛因渴求感和戒除效能感两个维度构成,二维模型对样本数据的拟合度较好;(2 )海洛因渴求感α=0 .86 6 ,戒断效能感α=0 . 92 3,所有项目与所属因素因子分的相关系数在0. 6 81- 0 . 876之间,P <0 .0 0 1,两个分量表的相关系数r =- 0 4 4 2 ,P <0 . 0 0 1;(3)海洛因渴求感和戒除效能感与自尊、孤独、抑郁的相关系数的绝对值在0 . 2 2 1- 0. 5 11之间,达到显著性水平;回归分析的结果显示,戒断效能感可解释自尊、孤独和抑郁14 . 4 %、10 . 8%和2 6 . 2 %的变异。结论:海洛因依赖性人格的概念的构想合理,其量表具有良好的项目区分度、内部一致性信度和效度。     

武汉市海洛因依赖者流行病学回顾性调查

目的:了解武汉市海洛因依赖者的流行病学变化。方法:回顾性调查研究2002年-2004年3a在湖北省各戒毒所收治的武汉市户籍海洛因依赖者的社会人口学特征及滥用情况。结果:(1)人口学特征比较:3a来女性吸毒人口所占比例明显上升(P<0.01),无业人员所占比例逐年加大(P<0.01);(2)毒品滥用情况比较:3a来吸毒年限、戒毒次数和静脉注射滥用方式比例逐年增加(P均<0.01)。结论:武汉市常住居民中海洛因滥用形势仍相当严峻,禁毒工作仍需加强。且应加强在吸毒群体中的宣教工作。     

肩关节注射治疗冻结肩的研究进展

冻结肩是导致肩关节疼痛及活动受限的常见疾病,肩关节注射是治疗冻结肩的最常用方法,包括糖皮质激素注射、液体扩张疗法、玻璃酸钠注射等。近年来肩关节注射治疗的研究较多,且有较多高质量随机对照研究,该文就糖皮质激素注射与其它治疗手段之间以及注射治疗的不同方式之间在疼痛缓解、活动度及功能改善等方面的疗效及安全性比较作一综述。     

Regional specificity of manganese accumulation and clearance in the mouse brain: implications for manganese‐enhanced MRI

Manganese‐enhanced MRI has recently become a valuable tool for the assessment of in vivo functional cerebral activity in animal models. As a result of the toxicity of manganese at higher dosages, fractionated application schemes have been proposed to reduce the toxic side effects by using lower concentrations per injection. Here, we present data on regional‐specific manganese accumulation during a fractionated application scheme over 8 days of 30 mg/kg MnCl₂, as well as on the clearance of manganese chloride over the course of several weeks after the termination of the whole application protocol supplying an accumulative dose of 240 mg/kg MnCl₂. Our data show most rapid accumulation in the superior and inferior colliculi, amygdala, bed nucleus of the stria terminalis, cornu ammonis of the hippocampus and globus pallidus. The data suggest that no ceiling effects occur in any region using the proposed application protocol. Therefore, a comparison of basal neuronal activity differences in different animal groups based on locally specific manganese accumulation is possible using fractionated application. Half‐life times of manganese clearance varied between 5 and 7 days, and were longest in the periaqueductal gray, amygdala and entorhinal cortex. As the hippocampal formation shows one of the highest T₁‐weighted signal intensities after manganese application, and manganese‐induced memory impairment has been suggested, we assessed hippocampus‐dependent learning as well as possible manganese‐induced atrophy of the hippocampal volume. No interference of manganese application on learning was detected after 4 days of Mn²⁺ application or 2 weeks after the application protocol. In addition, no volumetric changes induced by manganese application were found for the hippocampus at any of the measured time points. For longitudinal measurements (i.e. repeated manganese applications), a minimum of at least 8 weeks should be considered using the proposed protocol to allow for sufficient clearance of the paramagnetic ion from cerebral tissue. Copyright © 2012 John Wiley & Sons, Ltd.