MPO-ANCA-positive Wegener’s granulomatosis presenting with hypertrophic cranial pachymeningitis: case report and review of the literature

We describe a case of hypertrophic cranial pachymeningitis (HCP) associated with Wegeners granulomatosis (WG) in a 60-year-old man presenting with chronic headache and multiple cranial nerve neuropathies. A test for antibodies to the neutrophil cytoplasmic protein myeloperoxidase (MPO-ANCA) was positive in this case. We review the literature on perinuclear (p)-ANCA-related HCP, including our case. This case indicates the link between MPO-ANCA-positive WG and HCP.     

Radiologic appearance of gallstones and its relationship with biliary symptoms and awareness of having gallstones

In the course of two cross-sectional epidemiological surveys carried out by the Rome Group for Epidemiology and Prevention of Cholelithiasis (GREPCO), cholecystography was performed in 82 of 126 subjects identified by means of ultrasonography as having gallstones. In four subjects gallstones were not detected by cholecystography. The x-ray characteristics of the gallbladder and gallstones of the remaining 78 subjects were related to age, sex, presence of biliary symptoms in the five years prior to the study, and awareness of having gallstones. Twenty-three of the 78 gallstone subjects (29.5%) showed a nonvisualized gallbladder. Among the 55 subjects with visualized gallbladder, 16 (29.1%) and 28 (50.9%) showed radiopaque and solitary stones, respectively. The mean diameter of the largest stone was 19.7 mm±11.2 (sd). Age was related inversely to the number of stones. X-ray characteristics of gallstones did not differ between men and women. Presence of biliary symptoms in the five years prior to the study or awareness of having gallstones were not related to any radiologic feature, either in univariate or multivariate statistical analysis which included age, sex, weight, and height as possible confounding variables. Nineteen (24.3%) of the 78 subjects showed gallstones which would have been suitable for medical therapy with bile acids (ie, radiolucent, with a diameter of less than 20 mm, and in a visualized gallbladder).Rome Group for the Epidemiology and Prevention of Cholelithiasis (GREPCO) (For the composition of GREPCO, see appendix).This study was supported by a grant from Ministero della Sanità, No. CS/30/245/3458.     

A Retrospective lyrical analysis of songs written by adolescents with anorexia nervosa

Song‐writing plays a central role in music therapy with adolescents. A retrospective lyrical analysis of songs written by adolescents with anorexia nervosa was undertaken in order to identify common themes solicited through song‐writing interventions. Fifteen participants contributed 17 songs, from which 368 lyrical units were identified. A modified content analysis approach was used with each lyrical unit being categorised to one of six themes determined from the literature and clinical experience. The theme of ‘identity’ was used most frequently (28%), with the sub‐theme of ‘exploring new behaviours, positive self‐talk’ being addressed most often (12.5% of total). The dominance of the developmentally important theme of ‘identity’ may reflect the relationship between adolescents, music and identity or may be related to the way in which anorexia nervosa has been theorised to assist the adolescent in managing challenges to the emerging sense of self. Copyright © 2006 John Wiley & Sons, Ltd and Eating Disorders Association.     

Effect of Interferon-α Treatment of Chronic Hepatitis C on Health-Related Quality of Life

Studies of interferon- (IFN-)therapy for chronic hepatitis C have focused on viralclearance; however, few have evaluated patient'shealth-related quality of life during therapy. Thisstudy evaluates health-related quality of life and theprevalence of anxiety and depression in patients withchronic hepatitis C before, during, and followingIFN- therapy. Patients undergoing IFN-therapy for chronic hepatitis C were asked to completehealth status measures as well as anxiety and depressioninventories before, during, and following IFN-therapy. These measures were compared to the results of healthy adults in the general US population.Thirty-eight of forty-eight eligible patients (79%) withchronic hepatitis C completed the questionnaires.Respondents demonstrated a significant increase in depression during the sixth month ofinterferon therapy in comparison to pretreatmentresults. Anxiety scores improved significantly after onemonth of IFN- in comparison to pretreatmentresults. Scores on the health status measures did notvary with IFN- therapy. Patient responses wereanalyzed with respect to biochemical response(normalized transaminases) to IFN-. IFN-responders, who were aware of their transaminase results,exhibited lower scores on anxiety subscales during andafter therapy (P = 0.02-0.04). Scores on the healthstatus subscale, role emotional, improved in IFN- responders compared to nonresponders during thesixth month of therapy (P = 0.02). Response toIFN- therapy was not associated with any otherdifferences on subscale analysis. Patients with chronichepatitis C exhibited health perceptions similar to thegeneral US population, and these were unchanged duringIFN- therapy. However, the incidence ofdepression significantly increased during the sixthmonth of IFN- therapy. IFN- respondersexhibited fewer emotional problems as well as a lowerincidence of anxiety during and followingtherapy.     

Down-regulated β-adrenoceptors in severely failing human ventricles: Uniform regional distribution,but no increased internalization

Summary In chronic heart failure cardiac -adrenoceptors are decreased. In this study we investigated whether a) in severely failing human ventricles -adrenoceptors are uniformly decreased or regional variations exist, and b) the -adrenoceptor decrease is caused by increased internalization or is a real loss in -adrenoceptors. For this purpose we assessed -adrenoceptor number and subtype distribution in a particulate fraction (mainly sarcolemmal plasma membranes) and a light vesicle fraction of right and left ventricular segments (obtained by cutting transversal, rings of 2 cm from the midventricular regions) of explanted hearts from 2 patients with end-stage congestive dilated cardiomyopathy (DCM) and one patient with end-stage ischemic cardiomyopathy (ICM). In all three hearts ventricular -adrenoceptor number was very low (7.5–10 and 21–26 fmol/mg protein in DCM, 15–22 fmol/mg protein in ICM compared to 68–74 fmol/mg protein in non-failing ventricles). -Adrenoceptors were uniformly decreased over the whole ventricular region and no considerable regional variations existed. The same held true for ₁- and ₂-adrenoceptors. In ICM decrease in -adrenoceptors was due to a concomitant reduction in ₁- and ₂-adrenoceptors, in DCM it was mainly caused by ₁-adrenoceptor down-regulation. In all ventricular segments investigated light vesicle -adrenoceptors amounted to about 5–7% of total ventricular -adrenoceptors and this was not significantly different from non-failing left ventricles. We conclude that a) in severely failing human ventricles -adrenoceptors are evenly down-regulated and no regional variations exist and b) the decrease in -adrenoceptors is not due to enhanced internalization but is a real loss of -adrenoceptors.Abbreviations DCM dillted cardiomyopathy - ICM ischemic cardiomyopathy - ICI 118,551 erythro-(±)-1-(7-methylindan-4-yloxy)-3-isopropylaminobutan-2-ol hydrochloride - CGP 12177 (±)-4-(3-tertiarybutylamino-2-hydroxypropoxy)-benzimidazole-2-on hydrochloride - ICYP (–) [¹²⁵I]-Iodocyanopindolol     

社区家庭护理服务内容的探讨

目的探讨社区家庭护理（CHC）服务的内容。方法选择深圳市20家社康中心,抽取20名专家实施两轮针对CHC方面的问卷咨询。另选取社区护士120名,全科医生108名以评测量表对其开展CHC服务内容和工作情况的调查。结果CHC基本服务项目总计31项：可拓展的服务项目主要是一次性导尿和导尿管更换,以及二期以上的压疮护理等：不适合提供的服务项目有替代疗法、静脉高营养的护理、气管切开的护理、B超检查以及性功能改变的调试指导等。社区护士组在基础护理和社区保健方面的工作比例,显著高于全科医生组,而在社区预防和社区康复等方面则显著低于全科医生组,差异均有统计学意义（P均〈0．05）。结论CHC已取得一些进展,但仍需明确职责,规范实施,以最佳水平服务社区人群。     

氟试剂分光光度法测定生活饮用水中氟化物的不确定度评定

目的建立氟试剂分光光度法测定生活饮用水中氟化物的的不确定度评定方法,从而找出测定过程中的关键环节及主要影响因素,为有效地提高检测工作的质量提供依据。方法建立数学模型,应用测量不确定度评定方法[1],分析测定过程中不确定度的来源,计算各不确定分量,合成和扩展不确定度。结果不确定度的主要来源为工作曲线拟合引入的不确定度、标准溶液配制过程引入的不确定度以及样品重复测定引入的不确定度。生活饮用水中氟化物浓度测定值为1.03 mg/L,计算其扩展不确定度为0.018 mg/L。结论控制测定过程中的关键环节及主要影响因素,可有效降低测定过程中引入的测量不确定度,从而保证了测定结果的准确可靠。     

2013年日照市部分食品中铬含量调查

目的调查日照市部分食品中铬含量,为食品安全风险评价提供基础资料与科学依据。方法在日照市辖区内各县、区农贸市场、超市、食堂等进行随机采样,并对食品样品中铬含量进行测定。结果在9类共120份检品中,除猪皮冻与奶糖两类食品存在部分检品含铬量超出限量1.0mg/kg外,其他各类铬含量符合要求,猪皮冻与奶糖两类食品合格率分别为76.19%与62.50%。结论在个别食品中存在以工业明胶代替食用明胶的可能,仍需加强对食品加工企业的监管。     

一测多评法同时测定水蛭中4种有效成分的含量

目的：建立同时测定水蛭药材中4 种主要成分含量的方法。方法：采用高效液相色谱法,以次黄嘌呤为内标,计算其对尿嘧啶、黄嘌呤和尿苷的相对校正因子(RCF),通过RCF计算上述3种成分的含量;以外标法测定的含量作实测值,比较计算值与实测值的差异。结果：尿嘧啶、次黄嘌呤、黄嘌呤和尿苷检测质量浓度线性范围分别为1.60～32.00 mg/ml、4.05～81.00 mg/ml、1.50～30.00 mg/ml、1.25～25.00 mg/ml(r>0.999);精密度、稳定性、重复性试验的RSD＜2.0％;加样回收率试验的RSD 分别为95.05％～99.45％(RSD＝1.73％,n＝6)、95.89％～99.38％(RSD＝1.52％,n＝6)、94.00％～97.88％(RSD＝1.74％,n＝6)、96.07％～99.35％(RSD＝1.18％,n＝6)。计算值与实测值差异无统计学意义(P＞0.05)。结论：该方法操作简便,精密度、稳定性、重复性良好,可用于水蛭药材中4种有效成分含量的同时测定。     

HPLC法同时测定多效防护霜中盐酸苯海拉明、甲氧基肉桂酸辛酯和水杨酸辛酯的含量

目的 建立同时测定多效防护霜中盐酸苯海拉明、甲氧基肉桂酸辛酯和水杨酸辛酯的含量的方法。方法 采用高效液相色谱法。色谱柱为Agilent Extend-C₁₈（4.6 mm×150 mm,5 μm）,流动相为甲醇-乙酸铵缓冲溶液（20 mmol/L,pH=7.5）,梯度洗脱,甲醇比例随时间变化为：0~10 min、甲醇→60%;10~12 min、甲醇60%→92%;12~20 min、甲醇→92%,采集时间20 min,平衡时间10 min,流速1 ml/min,紫外检测波长218 nm,柱温25℃,进样量15 μl。结果 3种成分在30 min内基线分离,方法学验证表明,线性关系良好（r>0.9995）,日内日间精密度均小于3.0%,回收率在90%~108%之间,稳定性和重复性RSD均<3.0%,符合方法学要求。按照新建立的方法测定了3个批次样品中3种成分的含量,结果符合要求。结论 本方法简便可靠,可为多效防护霜的质量控制提供依据,也为其质量标准研究奠定了基础。