短肠综合征患者血清瓜氨酸水平与小肠吸收面积和功能的相关性

目的研究短肠综合征患者血清瓜氨酸水平的变化及其与肠道面积及吸收功能的相关性。方法采用高效液相色谱法测定22例短肠患者（短肠组）和33例健康人（对照组）血清瓜氨酸水平。短肠患者残存小肠长度及直径采用X线造影检测，并测定短肠患者尿D-木糖排泄率和肠道蛋白吸收度。分析短肠患者血清瓜氨酸与残存小肠长度、面积、蛋白及D-木糖吸收的相关性。6例行肠康复治疗的患者测定康复治疗前后瓜氨酸、D-木糖及蛋白吸收水平的变化。结果短肠组血清瓜氨酸水平显著低于健康对照组[（5．94±2．65）比（16．87±5．97）μmol／L，P〈0．01]。短肠组患者血清瓜氨酸水平与残存小肠长度（r=0.82）及表面积（r=0.86）呈正相关，与尿D-木糖排泄（r=0.56）及肠道蛋白吸收（r=0.48）也呈正相关。6例行肠康复治疗的患者治疗后血清瓜氨酸水平、蛋白及D-木糖吸收均显著增加，但3者增加百分比之间并无相关。结论血清瓜氨酸水平与短肠患者的小肠吸收面积和吸收功能呈正相关，能反映短肠患者小肠功能和衰竭程度，是康复疗效的良好指标。     

Prevalence of metabolic syndrome in adolescents from a north Indian population.

AIMS: To estimate the prevalence and distribution of the metabolic syndrome (MS) in adolescents attending school in the north Indian city of Chandigarh. RESEARCH DESIGN AND METHODS: At total of 1083 adolescents attending school (aged 12-17 years) participated in a community-based cross-sectional survey. Anthropometric examination included height, weight, body mass index, waist circumference, hip circumference, waist-hip ratio and blood pressure measurement. A fasting blood sample was taken for measurement of glucose, insulin and lipid profile. Socio-demographic characteristics were investigated using a questionnaire. The metabolic syndrome was determined by the National Cholesterol Education Program Adult Treatment Panel III definition modified for age. RESULTS: The overall prevalence of MS in adolescents was 4.2%. However, the prevalence rose to 5.8% when the fasting plasma glucose cut-off was lowered to 5.5 mmol/l. There was no gender difference in the distribution of MS. When stratified by body mass index (BMI), 5.5% adolescents were overweight (BMI > or = 95th percentile), while 4% were at risk for overweight (BMI between 85th and 95th percentile). Of the overweight adolescents, 36.6% met the criteria for MS, while 11.5% at risk for overweight and only 1.9% of the normal population had MS (P < 0.0001). Low high-density lipoprotein was the most common and abdominal obesity the least common constituent of MS. There was a significant difference (P < 0.0001) between the prevalence of MS adolescents from low to high socio-economic strata. CONCLUSIONS: A substantial number (4.2%) of north Indian adolescents and 36.6% of overweight adolescents had MS. This poses a serious threat to the current and future health of these young people.     

Testicular epidermoid cyst in Klinefelter''s syndrome

A 38-year-old Japanese man was referred to our outpatient clinic for treatment of infertility. Semen analysis showed azoospermia. Chromosome analysis revealed a 47XXY karyotype, and non-mosaic Klinefelter's syndrome (KFS) was diagnosed. Upon physical examination, the patient's right testicular volume was 30 mL and the left testicular volume was 3 mL. Laboratory tests showed normal levels of lactate dehydrogenase, alpha-fetoprotein, and human chorionic gonadotropin beta-subunit. The plasma luteinizing hormone and follicle-stimulating hormone levels were increased to 15.7 mIU/mL and 45.9 mIU/mL, respectively. The plasma testosterone was decreased to 0.25 ng/mL. Magnetic resonance imaging showed a right testicular mass of low-signal intensity on the T1-weighted image and of high-signal intensity on the T2-weighted image. Therefore, the final diagnosis was KFS with a right testicular tumor. Thus, a right high orchiectomy was performed. Histological examination revealed an epidermoid cyst of the right testis. Epidermoid cysts in cases of KFS are rare. To our knowledge, only seven cases, including ours, have been reported in the literature.     

Use of laboratory data to identify risk factors of giant coronary aneurysms due to Kawasaki disease

BACKGROUND: Although some laboratory findings are known to be indicators of the risk of giant coronary aneurysm formation among Kawasaki disease patients, an appropriate cut-off point to predict aneurysm formation is not clear. METHODS: One hundred and five patients with giant coronary aneurysms were selected from the 15th and 16th nationwide surveys of Kawasaki disease in Japan. A total of 2936 patients without Kawasaki disease were recruited from a single hospital as a control group. Odds ratios were calculated for six laboratory data with specific values as cut-off points. Receiver operating characteristic (ROC) curves were observed to determine the most appropriate laboratory tests and cut-off points. RESULTS: Hematocrit, leukocyte count, neutrophil proportion, and hemoglobin had one or more peaks of odds ratio for specific cut-off points, but they did not have a clear cut-off point for the predictor according to the receiver operating characteristic curves. Alanine aminotransferase (ALT) increased the risk of giant coronary aneurysms continuously so no clearly appropriate cut-off point was identified. Serum sodium concentration of 135 mEq/L had a peak of odds ratio, and those with <135 mEq/L had the highest odds ratio (4.78). This value seemed appropriate with a sensitivity of 78% and specificity of 57%, although the predictive positive value was as small as 5%. CONCLUSION: The author's propose that a serum sodium concentration of <135 mEq/L at the patient's first visit to hospital may be a predictor of giant coronary aneurysms due to Kawasaki disease.     

Creutzfeldt-Jakob病脑组织14-3-3蛋白表达及其意义

目的探讨Creutzfeldt—Jakob病（CJD）脑组织内14-3-3蛋白表达及其诊断意义。方法实验组为5例cJD额叶组织，对照组为4例非CJD额叶组织。采用14-3-3B和s抗体，通过链霉菌抗生物素蛋白-过氧化酶（S—P）免疫组织化学方法进行检测。并参照KB、胶质纤维酸性蛋白（GFAP）、PrP免疫组织化学染色和129基因型检测结果。结果实验组5例脑组织14—3-3蛋白有较多地表达，其中3例灰质与星形胶质细胞尤著。其表达程度与PrP沉积类型有关，而与PrP129基因型无关。对照组4例中除2例急性脑挫伤仅个别神经细胞有表达外，肾上腺脑白质营养不良与额颞叶痴呆灰质和白质均无表达。结论14-3．3蛋白在脑内较多地表达，有利于CJD的病理诊断。     

睡眠状态下人体生理信号模糊分析系统的研究

采用LabVIEW技术完成对心电、呼吸、无创血氧和无创血压信号的采集与处理,而后通过MATLAB模糊测量系统对采集的人体生理信号进行模糊预测分析。通过实验检验了人体生理信号检测、处理和模糊预测分析方法的可靠性。LabVIEW技术对人体生理信号的模糊预测分析是有效的,可用于检测阻塞性睡眠呼吸暂停患者的生理状态信号。     

创伤性膈疝并发多器官功能障碍的诊治

目的　探讨急性创伤性膈疝的发病机理 ,临床特征和处理方式。方法　回顾性分析2 6例急性创伤性膈疝的临床资料。结果　患者均为多发伤 ,有不同程度的呼吸困难 ,均行手术探查 ,膈肌修补。 2例术中死亡。 14例术后出现多器官功能障碍 ,其中 3例术后死于多器官衰竭。本组 2 1例存活。结论　外伤性膈疝早期诊断 ,及时手术 ,防治并发症可提高抢救成功率。     

输尿管梗阻合并急性肾盂肾炎的治疗(附12例临床报导)

目的:探讨输尿管梗阻合并急性肾盂肾炎的治疗方案。方法:对12例由于不同原因引起输尿管梗阻合并急性肾盂肾炎的患者,根据不同情况给予置管引流,置管碎石,肾盂穿刺引流,加有效的抗生素治疗。结果:12例输尿管梗阻合并急性肾盂肾炎患者感染得到有效的控制,为后续治疗提供保障。结论:及时置管引流或尿流改道解除梗阻加有效的抗生素治疗是治疗输尿管梗阻合并急性肾盂肾炎的有效方案。     

The plasma kallikrein–kinin system and risk of cardiovascular disease in men

BACKGROUND: The plasma kallikrein-kinin system (PKKS) has been implicated in cardiovascular disease, but activation of the PKKS has not been directly probed in individuals at risk of coronary heart disease (CHD) or stroke. OBJECTIVE: To determine the involvement of the PKKS, including factor XI, in cardiovascular disease occurring in a nested case-control study from the Second Northwick Park Heart Study (NPHS-II). METHODS AND RESULTS: After a median follow-up of 10.7 years, 287 cases of CHD and stroke had been recorded and 542 age-matched controls were selected. When FXIIa-C1 esterase inhibitor (C1-inhibitor) concentrations were divided into tertiles (lowest tertile as reference), the odds ratios (ORs) at 95% CIs for CHD were 0.52 (0.34-0.80) in the middle tertile and 0.73 (0.49-1.09) in the highest tertile (P = 0.01 for the overall difference; P = 0.01 for CHD and stroke combined). For kallikrein-C1-inhibitor complexes, the ORs for stroke were 0.29 (0.12-0.72) and 0.67 (0.30-1.52) in the middle and high tertiles, respectively (P = 0.02). FXIIa-C1-inhibitor and kallikrein-C1-inhibitor complexes were negatively related to smoking and fibrinogen (P < 0.005). FXIa-inhibitor complexes correlated strongly with FXIIa-inhibitor complexes. CONCLUSIONS: Lower levels of inhibitory complexes of the PKKS enzymes and particularly of FXIIa contribute to the risk of CHD and stroke in middle-aged men. This observation supports the involvement of the PKKS in atherothrombosis.     

多普勒超声心动图对儿童急性肾炎早期左室舒张功能的研究

目的　采用多普勒超声心动图评价儿童急性肾炎 (AGN)早期左室舒张功能 (LVDF)损害的严重程度及疗效观察。方法　将 76例急性肾炎患儿按病情程度分为轻度、重度两组与 5 4例健康对照组进行对照。应用HP - 10 0 0型超声诊断仪 ,分别于治疗前和治疗后 2周测定二尖瓣舒张早期峰值流速 (EV)、二尖瓣舒张晚期峰值流速 (AV)、EV AV比值、舒张早期充盈分数(EI)、舒张晚期充盈分数 (AI)、EI AI比值、E峰加速时间 (AT)、E峰减速时间 (DT)、DT AT比值、肺静脉收缩期最大前向血流速度(S)、舒张期最大前向血流速度 (D)、D S比值、左房内径 (LA)、主动脉内径 (AO)、LA AO比值等 11项指标。结果　EV AV、EI AI、LA AO、D S是判断LVDF损害的重要指标 ;LVDF损害与病情严重程度有关 ,其中 ,EV、EV AV、EI、EI AI、AT、D S随病情加重而降低 ,AV、AI、DT、DT AT、LA AO随病情加重而增高 ;EI、AI、AT、DT、DT AT是评价其疗效的重要指标 ;治疗后 ,LVDF恢复时间晚于临床症状恢复时间。结论　上述指标可动态检测LVDF ,对指导临床诊治具有重要意义。同时该检测方法操作简便易行、重复性强、无痛苦 ,结果较为精确。