Interleukin-2, its soluble receptor,and soluble T8 antigen in acute ischemic stroke

The treatment of neoplasia with interleukin-2 (IL-2) can be complicated by neurological deficits resembling transient Ischemic attack and stroke. We investigated whether interleukin-2 contributes to the natural course of cerebrovascular ischemia and particularly to the pathogenesis of infection-associated stroke. Plasma levels of interleukin-2 were below the level of detectability in almost all measurements. Patients with and without previous infection (n = 11, 805 ±445 U/ml vs n = 19, 824 ± 501 U/ml) did not have significantly higher levels of soluble interleukin-2 receptors than control subjects with (n = 14, 667 ± 229 U/ml) or without vascular risk factors (n = 17, 567 ± 176 U/ml). Receptor levels increased in patients during the first week after stroke (n = 15, 1157 ± 1013, p < 0.02). Levels of soluble T8 antigen (sT8) were higher in patients (n – 26, 320 ± 112 U/ml) than in healthy control subjects (n = 15, 246 ± 92 U/ml; p < 0.05) and sT8 levels increased during the first week after stroke (p < 0.05). These results reflect an immunological response to the cerebral infarct; they do not indicate a general role of the IL-2 system in the pathogenesis of ischemic stroke with or without previous infection.     

Molecular oncogene markers and their significance in cutaneous malignant melanoma

Background: Oncogenes and other molecular tumor markers that predict tumor aggressiveness may allow individualization and optimization of surgical therapy of intermediate-thickness malignant melanoma. We examined the expression of selected markers, including the HLA-DR antigen, the heat shock protein-70 (HSP-70), and the c-myc oncogene in primary melanoma and regional nodes and related these findings to metastatic potential and survival. Methods: Forty patients with primary melanoma (1.5–4.0 mm) were studied, all of whom had prophylactic lymph node dissection and were followed for 18 months to 7 years. The primary tissue and nodes were examined using immunohistochemical techniques for the presence of HLA-DR antigen and HSP-70 protein and the expression of the c-myc oncogene. Results: Of 40 patients, there were 23 with lesions 1 to 2.9 mm thick and 17 with lesions 3 to 4 mm thick. Nodal metastases were present in 25 of the 40 patients who had elective node dissection. HLA-DR antibody stained the primary tumor in 10 patients (25%), but there was no correlation with survival in this group. HLA-DR antibody stained the stroma and cellular infiltrates surrounding the primary tumor in 28 of 40 patients; in this group there was a correlation of HLA-DR staining of the peritumoral stroma with improved survival overall. HLA-DR staining of the peritumoral stroma also influenced survival when patients were stratified by tumor thickness groups 1 to 2.9 mm and 3 to 4 mm and presence of nodal metastases. HSP-70 was demonstrated in the primary tumor in 25% of patients, who were also shown to have significantly improved survival when compared with those whose primary tumor did not stain with HSP-70. C-myc was expressed in the primary tumor in 25%, but showed no correlation with survival. None of these proteins correlated with or predicted the presence of nodal metastases. Conclusion: We conclude that the use of specific molecular-oncogene markers in intermediate-thickness primary melanoma may identify patients at high risk for conventional treatment failure and reduced survival who may profit from more aggressive surgery, adjuvant therapy, or both.Presented at the 48th Annual Cancer Symposium of The Society of Surgical Oncology, Boston, Massachusetts, March 23–26, 1995.     

Risk factors for coronary heart disease among inpatients who have mild intellectual disability and mental illness

Background Coronary heart disease (CHD) is a major cause of morbidity and mortality in the UK. The aim of this study was to screen inpatients with mild or borderline intellectual disability, many of whom also have mental illness, for risk factors for CHD. Methods Cross sectional survey. Participants were interviewed, measured and had blood samples taken. Results Of the 53 participants, 20 (37.7%) were overweight and 18 (34.0%) obese. The mean body mass index (BMI) of those participants prescribed regular antipsychotics was higher than those who were not. Nine (20.9%) had waist circumference measurements placing them at increased risk of CHD and 21 (48.8%) were at substantially increased risk. Twenty-eight (52.8%) were current smokers. Of the 49 participants who had their blood pressure measured, 3 (6.1%) had readings above the reference range. Of the 19 participants who had random blood tests, one (5.3%) had an elevated cholesterol level. Conclusions In this population there was a high prevalence of two risk factors for CHD (obesity and smoking), requiring ongoing monitoring and long-term measures to reduce risk.     

The child with recurrent respiratory infections: normal or not?

Respiratory infections (RI) are one of the major complaints in children and adolescents, and represent a demanding challenge for the pediatrician. It has been estimated that at least 6% of Italian children younger than 6 yr of age present recurrent respiratory infections (RRI). Children with RRI are not affected by severe alterations of the immune system. RRI represent essentially the consequence of an increased exposure to infectious agents during the first years of life, when immune functions are still largely immature. Several social and environmental factors, such as day-care attendance, family size, air pollution, parental smoking, and home dampness, represent important risk factors for airway diseases and may contribute in various degrees to determine the incidence of RRI. The main problem for the pediatrician is to discriminate normal children with high RI frequency related to an augmented exposure to environmental risk factors from children affected by other underlying pathological conditions (immunological or not), predisposing to infectious diseases. When RRI diagnosis has been formulated, removal of environmental risk factors (i.e. precocious day-care attendance, smoking in the household) must first be suggested.     

武汉西马街社区成人健康相关危险因素调查

目的 探讨当地成人健康相关危险因素构成，尝试低费用下开展此类监测的方法。方法 依托教育系统对武汉市江岸区西马街地区成人进行随机抽样入户问卷调查。结果 人群吸烟率32．4％，男性吸烟率60．6％，中年人高于老年人，女性吸烟率5．9％；92．5％的人不愿意自己的孩子在将来成为烟民；人群饮洒率为26．5％，其中男性饮洒率51％，23．5％的饮酒者存在违意饮酒情节；33．3％的成人有体育锻炼习惯，其比例随文化程度的升高而升高；19％的人每周户外活动时间达不到1天1小时；35．6％的人存在体重过重问题，分解19．2％为超重，14．7％为肥胖，1．7％为Ⅱ度肥胖。人群自述（非现场测量）高血压患病率为11．1％，自述糖尿病患病率为2．8％，但自觉有糖尿病典型症状而从未检测血糖的比例达16％。结论 落实社区人群基础医学检查任务迫切，依托教育系统进行的成人健康相关危险因素监测方法足当前经济适用的监测方法。     

A review of incisional hernia repairs: preoperative weight loss and selective use of the mesh repair

At the Shouldice Clinic pre-operative weight loss is used prior to incisional hernia repairs. Mesh repair is selectively used, based on specific hernia characteristics. A series of 236 patients were reviewed and followed up for 36 months. Data were available on 188 patients (80%). There were 15 recurrences (8%). The number of obese patients was reduced from 67 (35.6%) to 25 (13.3%) through the weight loss program. The hernia diameter, gastrointestinal complications, and surgical site infection were significantly related to recurrence but not the type of repair, obesity, location, or previous recurrences. The risk factors of incisional hernias include size, intestinal complications and infections. A selective use has a comparable result to the exclusive use of mesh repair. Weight reduction has yet to be shown to affect the rate of recurrence, and further prospective studies are required.     

外源性NGF对坐骨神经损伤后脊髓前角细胞CNTF表达的影响

目的　探讨坐骨神经损伤后脊髓前角细胞睫状神经营养因子 (CNTF)表达变化及外源性神经生长因子(NGF)与CNTF表达的关系。方法　采用大鼠坐骨神经损伤动物模型 ,分为给药组和对照组 ,每只大鼠又分为损伤侧组 (L组 )和健侧组 (R组 )两个亚组。用原位杂交、免疫组化技术检测CNTF的表达水平 ,观察各组在 1d、7d、1 4d、2 1d及 2 8d时的变化。用计算机图像自动处理系统进行定量分析研究。结果　给药组损伤侧脊髓前角细胞中CNTF表达水平除 1d、7d组外其余均多于对照组 (P <0 .0 5 ) ;而两组健侧脊髓前角细胞中CNTF表达水平无统计学意义 (P >0 .0 5 )。结论　①外源性NGF能促进坐骨神经损伤后损伤侧脊髓前角细胞中CNTF表达水平的增加 ;而对健侧CNTF表达水平无明显作用。②坐骨神经损伤后损伤侧脊髓前角细胞中CNTF表达水平在最初的 3周内逐渐下降 ,然后开始恢复 ,但至第 4周尚未恢复到开始时的水平 ;而两组健侧CNTF表达水平则无明显差异 (P >0 .0 5 )。     

传染病流行的社会因素及社会控制策略刍议

传染病与社会文化因素的关系密切。应重视社会因素对传染病的发生发展影响，从社会根源上探究其发病原理，包括经济因素、科学技术、文化、人口、卫生服务和其它社会因素。人类要有与传染病长期斗争的思想准备，并制定包括大卫生观和技术合作等相应的社会策略。     

非霍奇金淋巴瘤85例临床及预后分析

目的：分析多种因素对非霍奇金淋巴瘤(NHL)预后的影响。方法：通过SABC法进行免疫分型，采用Kaplan—Meier法分析患者治疗后的生存期，采用Cox比例风险模型分析影响预后的因素。结果：B细胞来源-NHL(B-NHL)发病率为63．3％。T细胞来源-NHL(T—NHL)为36．7％；低度恶性占17．6％，中、高度恶性占74．1％。1、2、3、5年生存率：低度恶性患者为92．1％、84．5％、65．1％、45．1％；中、高度恶性患者为84．9％、67．5％、47．6％、28．4％。I、Ⅱ期患者为98．8％、91.5％、87．5％、70．3％；Ⅲ期、Ⅳ期患者为62．1％、55．5％、40．1％、23．8％。T—NHL为70．8％、53．5％、47．7％、30．2％；B-NHL为82．1％、70．5％、61．1％、50．1％。结论：年龄、乳酸脱氢酶水平、恶性程度、临床分期、免疫分型、身体状况评分(PS)是影响NHL预后的重要因素。     

Postgraduate qualifications of British doctors

Among British-qualified doctors of 1974 and 1977, about 80% held postgraduate qualifications of some kind. The commonest qualifications were DRCOG, MRCP and MRCOG. There were considerable differences between medical schools in the numbers of qualifiers taking various examinations. Apart from the MRC Psych, DRCOG and Family Planning Certificate, qualifications were more commonly held by men than women. Tables show the type of work being done 9-13 years after leaving medical school by holders of various postgraduate qualifications; e.g. 60% of MRCP holders were working in medicine or a medical specialty and 84% of FRCS holders in general surgery or a surgical specialty. Discussion deals with the plurality, specificity, variability, perceived necessity, sufficiency, international utility and career significance of British postgraduate qualifications.