CT增强延时扫描在泌尿系先天性畸形诊断的应用

目的 探讨CT增强扫描在泌尿系统先天性畸形诊断的临床应用。方法 对泌尿系先天性畸形病人（包括肾盏憩室2例，膀胱憩室3例，先天性融合型横过异位肾合并巨大肾盂1例、肾盂输尿管重复畸形4例，肾盂输尿管交界部狭窄2例，巨输尿管1例、单纯输尿管囊肿1例）行螺旋CT普通扫描、增强扫描和增强延时扫描。结果 CT增强延时扫描能够明确显示憩室内囊液的延迟强化和持续长时间强化；显示发育异常的肾脏、输尿管的结构、位置和功能。结论 CT增强延时扫描在泌尿系统先天胜畸形诊断中很有价值，对某些疾病的诊断是十分必要的。     

辐射远后效应对红细胞膜阴离子转运蛋白基因表达的影响

目的：研究辐射远后效应对红细胞膜阴离子转运蛋白（band3)基因表达的影响。方法：分离10年期骨髓型急性放射病（ARS）患者骨髓有核细胞，二步法液体培养红系，取新生红细胞涂片，做band 3 mRNA原位杂交，抽提外周血有核细胞总RNA，进行RT－PCR，以β-actin作为内参照，半定量分析band3 mRNA表达丰度。结果：ARS新生红细胞中band 3 mRNA原位杂交显色不均，淡染，定量分析显示1／2患者band 3 mRNA表达强度减弱。结论：辐射远后效应可能在转录水平影响红细胞膜阴离子转运蛋白基因表达，使转录产物减少，翻译产物功能下降即阴离子转运能力减弱，红细胞成熟过程延迟。     

Innovative immunosuppression in kidney transplantation: A challenge for unmet needs

Due to the optimal results obtained in kidney transplantation and to the lack of interest of the industries, new innovative drugs in kidney transplantation are difficult to be encountered. The best strategy to find the new drugs recently developed or under development is to search in the sections of kidney transplantation still not completely covered by the drugs on the market. These unmet needs are the prevention of delayed graft function (DGF), the protection of the graft over the long time and the desensitization of preformed anti human leukocyte antigen antibodies and the treatment of the acute antibody-mediated rejection. These needs are particularly relevant due to the expansion of some kind of kidney transplantation as transplantation from non-heart beating donor and in the case of antibody-incompatible grafts. The first are particularly exposed to DGF, the latter need a safe desensitization and a safe treatments of the antibody mediated rejections that often occur. Particular caution is needed in treating these drugs. First, they are described in very recent studies and the follow-up of their effect is of course rather short. Second, some of these drugs are still in an early phase of study, even if in well-conducted randomized controlled trials. Particular caution and a careful check need to be used in trials launched 2 or 3 years ago. Indeed, is always necessary to verify whether the study is still going on or whether and why the study itself was abandoned.     

Single Immunization of Newborn Mice with Heterologous Type-II Collagen Induces Arthritic Disease

Collagen-induced arthritis (CIA) is a widely accepted model of autoimmune disease with significant similarities to rheumatoid arthritis in humans. CIA is provoked in susceptible strains upon immunization of adult mice with native type-II collagen in complete Freund's adjuvant (CFA). Neonatal exposure to antigen is supposed to result in T cell clone deletion and induction of tolerance. Here we report that the neonatal injection of bovine type-II collagen (bCII) to ICR (CD-2) mice triggers the development of autoimmune chronic joint inflammation. Compared with standard CIA significant joint swelling was not observed and anti-collagen antibodies were not detected if the second challenge with the antigen was not supplied. Histopathologic examination of the joints showed cell infiltration, synovial hyperplasia and at the later period bone destruction. Mice immunized as neonates expressed Ag-specific proliferative response and delayed type hypersensitivity (DTH) reaction to bCII.     

Delayed sleep–wake phase disorder in young adults: prevalence and correlates from a national survey of Norwegian university students

BackgroundDelayed sleep–wake phase disorder (DSWPD) during adolescence has been linked to impaired health and poor functioning. However there is a dearth of knowledge about DSWPD in young adulthood. We seek to contribute knowledge on the prevalence and correlates of DSWPD in this age group.MethodsData were drawn from a 2018 national survey of students in higher education in Norway (the SHoT-study). All 162,512 fulltime students in Norway were invited to participate and 50,054 students (69.1% women) aged 18–35 years were included (response rate = 30.8%). DSWPD was assessed by self-report, and was operationalized according to the criteria for DSWPD in the most recent edition of the International Classification of Sleep Disorders. Correlates of DSWPD were examined by validated self-report instruments covering a wide range of demographic and health domains.ResultsThe overall prevalence of DSWPD was 3.3%, and significantly higher in male (4.7%) than female (2.7%) students. DSWPD was associated with being single, having financial difficulties, having divorced parents, being overweight/obese, and physical inactivity. Students with DSWPD had more sleep problems during weekdays, and higher levels of somatic and mental health problems. Students with DSWPD also had an elevated risk of self-harm-related thoughts and behaviors as well as suicidality.ConclusionDSWPD remains a significant problem among young adults, and the high symptom load across health domains indicates that suggests a need for existing evidence-based approaches to be scaled for college students who present with DSWPD.     

Severe Mycoplasma pneumoniae infections with prolonged fever in a child: Delayed treatment is as important as macrolide resistance

We report a 7-year-old girl who got Mycoplasma pneumoniae infection with prolonged fever. Macrolide was used on day 14 of illness but fever persisted with progressive lung consolidation. Oral prednisolone was administered on day 33 then fever subsided with dramatically clinical improvement (decreased CRP and resolution of lung consolidation). In this case, delayed effective antibiotic treatment with inflammation may be the major factor contributing to the fever rather than ongoing infection.     

The effect of antecolic versus retrocolic reconstruction on delayed gastric emptying after classic non–pylorus-preserving pancreaticoduodenectomy

Background

Delayed gastric emptying (DGE) after pancreaticoduodenectomy increases length of hospital stay and costs, and may be influenced by surgical techniques.

Methods

We retrospectively compared 400 patients with antecolic gastrojejunostomy with 400 patients with retrocolic gastrojejunostomy for the occurrence of DGE.

Results

The prevalence of DGE was 15% in the antecolic group and 21% in the retrocolic group (P = .021), and median length of stay was shorter for the former (8 vs 10 days, P = .001). The difference was statistically significant with grade A DGE (9% vs 14%, P = .038), but not B or C. In a multivariate analysis, DGE was influenced by retrocolic reconstruction, as well as older age, chronic pancreatitis, preoperative bilirubin level, a history of previous upper abdominal surgery, and postoperative pancreatic fistula.

Conclusions

An antecolic gastrojejunostomy for classic non–pylorus-preserving pancreaticoduodenectomy is associated with a lower incidence of mild DGE (grade A) and a shorter length of stay.     

内耳显影对迟发性膜迷路积水诊断的意义

目的：明确鼓室内钆造影剂注射后内耳显影对迟发性膜迷路积水（delayed endolymphatic hydrops , DEH）诊断的临床价值,探讨迟发性膜迷路积水的病理机制。方法10例DEH患者行双鼓室钆造影剂注射24小时后行三维快速液体衰减反转恢复（three dimensional fluid－attenuated inversion recovery ,3D －FLAIR）序列和三维实时反转恢复（three dimensional real inversion recovery ,3D－real IR）序列扫描成像,分析患者内淋巴积水的范围及严重程度。结果10例DEH患者中9例为同侧型,1例为对侧型,均显示单侧或双侧内淋巴积水征象,其中9例同侧型DEH患者中仅1例（11．1％）患侧耳前庭内淋巴显示轻度积水,其余8例（88．9％）均显示患侧前庭内淋巴重度积水;8例（88．9％）同侧型DEH患者患侧耳蜗内淋巴积水,而1例（11．1％）同侧型DEH患者患侧耳蜗内淋巴无积水,9例同侧DEH患者对侧耳均未见前庭、耳蜗内淋巴积水。1例对侧型DEH患者的双侧前庭内淋巴重度积水,右侧耳蜗内淋巴轻度积水,而左侧耳蜗未见积水。结论内淋巴积水是DEH的主要病理因素,鼓室内钆注射后内耳显影能直观地反映出DEH患者内淋巴积水的范围及严重程度。