Acute pustulosis of the legs in diverticulitis with sigmoid stenosis: an overlap between bowel-associated dermatosis–arthritis syndrome and pustular pyoderma gangrenosum

BACKGROUND: Bowel-associated dermatosis-arthritis syndrome denotes the occurrence of diarrhoea with arthritis and skin lesions related to bowel disease with or without bowel bypass. In this condition, the histological finding of cutaneous aseptic neutrophilic cell infiltrate is non-specific and common to a wide spectrum of neutrophilic dermatoses, including pyoderma gangrenosum. OBSERVATION: We describe a 78-year-old woman with fever, abdominal discomfort and arthralgias, who developed grouped pustular lesions on her shins with histologically spongiform pustule formation. Aetiological assessment disclosed diverticular disease with sigmoid stenosis. CONCLUSION: Although clinical and histological features in our case fit the diagnosis of bowel-associated dermatosis-arthritis syndrome, they may also correspond to a pustular variant of pyoderma gangrenosum. Our observation raises the question of the nosological classification of bowel-associated dermatosis-arthritis syndrome within the spectrum of neutrophilic diseases.     

中下段颈椎的应力松弛特性及前、后路手术对其的影响

目的 研究中下段颈椎的应力松弛特性，并评估椎间盘切除植骨术与椎板切开术对其影响。方法 6例新鲜尸体完整颈椎及手术后颈椎，在模拟生理状态下进行屈曲及伸展位的应力松弛实验。结果 在恒应变条件下，绘制术前及不同术式后的中下段颈椎的应力松弛函数及曲线；术后的中下段颈椎的应力和初始化应力比值G(t)比术前明显增大，前路椎间盘切除植骨术后的G(t)值比椎板切开术大，两者均有统计学意义。结论 在恒应变条件下，颈椎具有快速应力松弛敏感性，屈曲位比伸展位大。椎板成形术及颈椎前路椎间盘切除植骨术都使颈椎的应力松弛能力减弱，前路椎间盘切除植骨术的影响更大。     

极外型腰椎间盘突出症的临床特点与神经节位置的相关性研究

目的 探 讨极 外 型腰 椎间 盘 突出 症患 者 的临 床特 点 与神 经节 位 置的 相关 性 方 法:通过 术前 神 经根 造影 : 。确定 受压 神 经根 的背 根 神经 节的 位 置,根 据 其神 经节 的 位置 ,将 27 例极 外侧 腰 椎间 盘突 出 症患 者 分为 三 组 :椎管内 组,5 例;椎间 孔内 组 ,15 例 ;椎 间孔 外组 ,7 例 。分 别比 较神 经 节的 位置 与 临床 参数 ,如 受压 神 经根 的水 平 ,直腿 抬高 试 验的 度数 ,术 前和 术 后症 状(腿痛 ,下 腰痛 和 行走 能力 )及 体 征(感 觉 和运 动障 碍 )的 严重 程 度 及 与恢复率 之间 的 关系 。结 果:与椎 管 内和 椎间 孔 内组 相比 ,椎 间孔 外 组患 者直 腿 抬高 试验 的 度数 较低 ,下 腰 痛的 程度较轻 ,术 前的 腿痛 明 显重 ,而 行走 能 力低 于椎 管 内和 椎间 孔 组。 背根 神 经节 的位 置 与术 前的 感 觉和 运 动 障 碍以及手 术效 果 没有 明显 差 异。结论 :神 经节 的 位置 会影 响 极外 型腰 椎 间盘 突出 患 者根 性症 状 (腿痛 和 行走 能力 )的严重 程度 。     

Why study transport of peptides and proteins at the neurovascular interface

The blood–brain barrier (BBB) is an immense neurovascular interface. In neurodegenerative, ischemic, and traumatic disorders of the central nervous system (CNS), the BBB may hinder the delivery of many therapeutic peptides and proteins to the brain and spinal cord. Fortunately, the mistaken dogma that peptides and proteins do not cross the BBB has been corrected during the past two decades by the accumulating evidence that peptides and proteins in the periphery exert potent effects in the CNS. Not only can peptides and proteins serve as carriers for selective therapeutic agents, but they themselves may directly cross the BBB after delivery into the bloodstream. Their passage may be mediated by simple diffusion or specific transport, both of which can be affected by interactions in the blood compartment (outside the BBB) and within the endothelial cells (at the BBB level). Although the majority of current delivery strategies focuses on modification of the molecule to be delivered, understanding the mechanisms of transport will eventually facilitate regulation of the BBB directly. We review the different aspects of interactions and discuss recent advances in the cell biology of peptide/protein transport across the BBB. Better understanding of the nature and regulation of the transport systems at the BBB will provide a new direction to enhance the interactions of peripheral peptides and proteins with the CNS.     

大鼠脊髓损伤修复差异表达cDNA文库的构建

目的　 运用改良消减杂交技术构建大鼠脊髓损伤修复过程中出现的差异表达基因文库 ,为寻找在脊髓损伤后的修复过程中起关键作用的分子提供帮助。方法　在经典消减杂交的基础上引进SMART反转录、长距离PCR、磁性分离系统、离心柱色谱等方法建立改良消减杂交技术 ,通过两轮消减杂交构建差异表达基因的cDNA消减文库 ,并对文库中的差异基因进行批量克隆与生物信息学分析。结果　 将两轮消减杂交后的差异表达基因转化大肠杆菌JM10 9以建立差异表达基因文库 ,库容量大小为 2× 10 3。从文库中随机挑取 90个克隆进行酶切鉴定与测序分析 ,得到 4 0个差异基因序列 ,其中 32个已知序列 ,8个新序列。 结论　 通过改良消减杂交成功建立了脊髓损伤修复过程中出现的差异表达基因文库 ,为筛选在大鼠脊髓损伤修复过程中起关键作用的基因 ,进一步探讨脊髓损伤修复的分子机制奠定了基础     

还原型谷胱甘肽和L-NAME对体外培养的脊髓运动神经元的影响

目的 :探讨还原型谷胱甘肽 (GSH)和L NAME对体外培养的脊髓运动神经元的保护作用。方法 :不同浓度的GSH和L NAME作用于脊髓运动神经元 ,3d后计算存活率。并测量存活率高的两组和对照组的免疫细胞化学标本的神经元形态学指标。结果 :GSH 10mmol·L-1和L NAME 1× 10 -3 mol·L-1组存活率最高。两实验组轴突长度、树突总长度、树突分叉点数目和胞体面积高于对照组。结论 :抗氧化剂和NOS抑制剂可以提高脊髓运动神经元的存活率 ,促进神经元生长     

球囊二尖瓣扩张术后心房纤颤复律的临床研究

目的探讨二尖瓣狭窄合并心房纤颤患者在球囊二尖瓣扩张后,转复心房纤颤的临床效果及影响心房纤颤转复后窦性心律维持的相关因素.方法 206例二尖瓣狭窄合并心房纤颤患者在球囊扩张术后,采用口服胺碘酮及电复律治疗心房纤颤,对复律成功的患者给予小剂量胺碘酮维持窦性心律并随访1年.结果服用胺碘酮者58例,17例转复成功(29.3%);189例行电转复,178例转复成功(94.2%),电转复成功率明显高于胺碘酮转复(P＜0.01).心房纤颤复发组与保持窦性心律组相比,左心房内径明显扩大(P＜0.01),心房纤颤持续时间明显长(P＜0.01),中度二尖瓣关闭不全人数的比率明显高(P＜0.05).随访1年,有45例患者心房纤颤复发.影响心房纤颤转复后维持窦性心律的相关因素有左心房内径扩大、心房纤颤持续时间长及明显的二尖瓣关闭不全.结论对左心房内径明显扩大、心房纤颤持续时间过长及有明显的二尖瓣关闭不全的患者,在选择心房纤颤转复时应慎重.     

The Rigiflex TTS: A New Method to Dilate Benign Esophageal Stenosis

Abstract: This paper dicusses the use of esophageal dilatation with a Rigiflex TTS balloon. This method was used 45 times on 11 patients affected by anastomotic or a severe grade peptic esophageal stenosis. Fluoroscopic guidance was used in 36 procedures (80%) without effecting the mean duration of the treatment (12 minutes). The results were considered satisfactory when these goals had been achieved: a) dilatation of the stenosis over 15 mm; b) a dysphagia free-time of more than 6 months. A satisfactory result was achieved in 10 patients (90.9%), without deaths and major complications. 5 patients received 1 dilatation and the other 5 needed, 3-3-4-7–11 procedures respectively to obtain a satisfactory result. On these basis we consider that its great efficacy, security and tolerability depend on the following characteristics of the Rigiflex TTS balloon: 1) “radial” dilatation; 2) the possibility of introducing the balloon through the operative channel of the fiberscope; 3) direct visualization of the stenosis during dilatation. The following disadvantages with this method are: the absence of a tactile sensation of dilatation and the elevated cost of the instrument. We conclude that the Rigiflex TTS balloon is an important alternative to guide-wire techniques, especially for the treatment of severe esophageal strictures.     

肾动脉狭窄介入治疗前后血清脑利钠肽水平的变化及意义的研究

目的探讨肾动脉狭窄介入治疗前后血清脑利钠肽BNP水平的变化及意义。方法采用回顾性调查方法，对肾动脉狭窄介入治疗前后血清脑利钠肽水平的变化进行分析。结果肾动脉狭窄介入治疗再通后，血清BNP水平出现下降（P〈0．01）。结论血清BNP水平的变化对肾动脉狭窄介入治疗后疗效的评价具有一定的临床指导意义。