幽门螺杆菌感染诊断方法的比较

338例病人同时进行了快速尿素酶试验(简称RUT)。Warthin-Starry染色(简称W-S染色)、培养法、~(13)C-尿素呼气试验(~(13)C-UBT)、血清IgG、IgM等6种诊断方法中任意3种检查,以同时2种(或以上)检查方法一致的结果作为诊断幽门螺杆菌(Hp)是否存在的标准。对上述6种方法的敏感性、特异性、符合率、阳性预测值、阴性预测值分别给予评价,结果显示:RUT、W-S染色、~(13)C-UBT三法诊断Hp的敏感性、特异性等较高,均接近或高于90％。     

《金匮要略》黄疸病篇有关条文之我见

《金匮要略》是我国现存最早的一部诊治杂病的专著,是仲景创造辨证理论的代表作。该书简明扼要,首创以病为纲、病证结合、辨证论治的杂病诊疗体系,为临床诊治提供思路。现就《金匮要略》黄疸病篇条文1、条文2、条文8提出笔者自己的理解,供学者参考。     

Decreased Serum Epinephrine in Children With Positive Skin Prick Test

Objectives

To evaluate the association between catecholamine levels and skin prick test results among children.

Methods

Two hundred eight first grade children from one elementary school were invited to participate in this study. Skin prick test (SPT) for six allergens (2 house dust mites, cat, dog, mugwort, and pollen mixture) was performed, and patient demographic information was recorded. The parents were surveyed using questionnaires about rhinitis-related symptoms. Finally, venous blood sampling was done to measure catecholamine levels (epinephrine, norepinephrine, and dopamine) by high-performance liquid chromatography.

Results

Out of 208 children, 174 (106 boys and 68 girls) enrolled in this study. Ninety-six of the children (55%) had negative SPT (nonsensitization group), while 78 (45%) had a positive SPT to at least one of six allergens (sensitization group). The diagnosis of chronic rhinitis was more prevalent in the sensitization group (35.9%) than nonsensitization group (26.0%), however the finding was not significant (P=0.186). Epinephrine levels were decreased between the sensitization group compared to the nonsensitization group (P=0.004). There was no difference in norepinephrine and dopamine levels (P>0.05).

Conclusion

Epinephrine levels are lower in children with positive SPT compared to controls, however, the level of the catecholamine was not associated with the presence or absence of rhinitis symptoms.     

Identification of the major allergenic proteins from silkworm moth (Bombyx mori) involved in respiratory allergic diseases

Introduction and ObjectivesMoths are a significant source of indoor and outdoor aeroallergens. High prevalence of IgE-mediated sensitization was demonstrated in a group of patients with allergic respiratory diseases. There are no studies on adult stage of these moth species allergens involved in allergic respiratory reactions - the aim of this study.Material and Methods36 participants were included in an experimental study, submitted to skin prick test with Bombyx mori wing extract and six other common allergens, as well as Western blot analysis with incubated nitrocellulose membrane impregnated with silkworm moth extract and human IgE-antibody. The participants were divided into 3 groups: 1) 21 allergic patients whose skin prick test was positive to Bombyx mori wing extract, 2) eight allergic patients whose skin prick test was positive to mite and negative to Bombyx mori extract 3) seven negative non-allergic subjects.ResultsAmong the 21 participants from group 1, 19 serum samples reacted to Bombyx mori extract by Western blot. All of them reacted to a protein at 80 kDa and five other proteins (66, 50, 45, 37 and 30 kDa) were identified in more than 50% of the individuals tested, considered as major allergenic proteins. Sera from seven out of eight patients sensitized to house dust mite demonstrated IgE-reactivity to Bombyx mori extract by Western blot analysis. Serum samples from healthy participants did not react at all.ConclusionSix major reactive proteins by immunoblot analysis from moth’s wings sensitized patients can be potential allergens. The one at 80 kDa is the major protein, seen in all IgE-reactive patients from group 1 and in none from group 2, yet to be identified. Future studies should be conducted to better characterize these proteins.     

3R疗法对阿尔茨海默病患者认知功能和血浆β淀粉样蛋白_(1-42)的影响

目的评价3R疗法对轻、中度阿尔茨海默病患者认知功能和血浆β淀粉样蛋白_(1-42)(Aβ_(1-42))的影响。方法选择轻、中度阿尔茨海默病患者34例,随机分为2组,每组17例。对照组给予药物常规治疗,治疗组在药物常规治疗基础上,采用3R疗法进行认知功能训练。测定血浆Aβ_(1-42),并进行神经心理学指标检查:简易智能状态检查量表、日常生活活动能力量表(ADL)、社会功能活动调查(FAQ)、神经精神量表(NPI)以及事件相关电位P300的基线评定,在开始实施训练后的第3、6个月时,分别对患者进行各项指标的评定与分析。结果治疗组经过3、6个月的3R治疗后,ADL、FAQ、NPI评分较治疗前明显减低,且明显低于对照组(P<0.05,P<0.01);P300潜伏期明显缩短,波幅明显增加(P<0.01);治疗组经过6个月的3R治疗后,血浆Aβ_(1-42)含量较治疗前明显下降,且较对照组明显下降(p<0.05)。结论 3R疗法能有效提高阿尔茨海默病患者生活自理能力、社会活动能力,从而延缓认知功能减退;3R治疗后,认知功能改善可能与血浆Aβ_(1-42)含量变化有关。     

Elevated plasma S100B levels in high altitude hypobaric hypoxia do not correlate with acute mountain sickness

Abstract

Objectives:

Ascent to high altitude may result in a hypobaric hypoxic brain injury. The development of acute mountain sickness (AMS) is considered a multifactorial process with hypoxia-induced blood–brain barrier (BBB) dysfunction and resultant vasogenic oedema cited as one potential mechanism. Peripheral S100B is considered a biomarker of BBB dysfunction. This study aims to investigate the S100B release profile secondary to hypoxic brain injury and comment on BBB disturbance and AMS.

Methods:

A prospective field study of 12 subjects who ascended Mt Fuji (3700 m) was undertaken.

Results:

The mean baseline plasma S100B level was 0·11 μg/l (95% CI 0·09–0·12), which increased to 0·22 μg/l (95% CI 0·17–0·27) at the average of three high altitude levels (2590, 3700, and 2590 m on descent) (P < 0·001). The mean level for the seven subjects who experienced AMS rose from 0·10 to 0·19 μg/l compared to 0·12 to 0·25 μg/l for the five subjects who did not develop AMS (P = 0·33).

Conclusion:

Ascending to 3700 m resulted in elevated plasma S100B levels but this was not associated with AMS.     

《金匮要略》“纳药鼻中”之“药”考释

[目的] 探讨《金匮要略·痉湿暍病脉证并治第二》“纳药鼻中”之“药”所指的具体方药。[方法] 从历代注家注疏入手,对不同观点进行源流上的梳理。同时,通过文字学考证,对“药”字在古汉语中的含义展开探讨。[结果] 对于“纳药鼻中”之“药”,历代注家观点大致可归纳为三类,即随文注解、认为“药”为具有某些特性的药物、认为“药”为瓜蒂散或其类方,其中认为“纳瓜蒂于鼻中”的观点流传较广。通过文字学考证,“药”在楚方言中有指代“白芷”之意,“纳药鼻中”即是“纳白芷于鼻中”,白芷治疗鼻病也为历代医家所习用。[结论] “纳瓜蒂于鼻中”与“纳白芷于鼻中”两种观点都具有一定证据支持,但从文献学角度和仲景书体例而言,“纳药鼻中”原意应为“纳白芷于鼻中”。     

Hepatic safety of once-monthly injectable extended-release naltrexone administered to actively drinking alcoholics

Background:  Hepatoxicity has been reported with oral naltrexone. Hepatic safety data were examined from a 6-month study evaluating the efficacy and safety of a now available extended-release formulation of naltrexone (XR-NTX) in patients with alcohol dependence.
Methods:  In all, 624 patients (68% male; median age of 44 years) were randomly assigned to XR-NTX 380 mg ( n  = 205), XR-NTX 190 mg ( n  = 210), or placebo ( n  = 209).
Results:  There were no significant differences in alanine aminotrasferase, aspartate aminotransferase, or bilirubin levels between the study groups at study initiation or at subsequent assessments. Gamma-glutamyltransferase in the XR-NTX 380 mg group was lower compared with placebo at weeks 4, 8, 12, and 20. Both high (>3 times the upper limit of normal) liver chemistry tests (LCTs) and hepatic-related adverse events were infrequent in all study groups. In patients who were drinking heavily throughout the study, obese subjects, or those taking nonsteroidal anti-inflammatory drugs, there was no increase in frequency of high LCTs or hepatic-related adverse events in patients receiving XR-NTX (either dose) compared with placebo.
Conclusion:  Extended-release formulation of naltrexone does not appear to be hepatotoxic when taken at the recommended clinical doses in actively drinking alcohol-dependent patients.     

动态喉镜下嗓音声学测试的研究进展

嗓声学临床检测分为依赖于主观的听觉能力检测和客观性声学检测。两种检测方式所产生的检测效果有所区别,在很长时间一段时间内,由于先进诊断方式的缺乏,对于嗓音学的测试往往主要依靠主观检查。而主观检查靠测试者工作经验、主观感受等进行,虽可获得一定诊断价值,但仍有进步的空间。由此可见,嗓音检测很大程度上满足了嗓音医学发展的客观需求。伴随多媒体技术的快速发展,嗓音检测技术被逐渐应用于临床,为临床诊断提供客观参考依据。本研究检测和分析各种参数,对嗓音声学评价提供客观参考,先将其综述如下。