血脂监测在防治Ⅱ型糖尿病患者继发动脉粥样硬化中的意义

目的探讨血脂代谢紊乱跟Ⅱ型糖尿病(ⅡDM)患者继发动脉粥样硬化并症的关系。方法采用奥林巴斯Au-640全自动生化分析仪,测定Ⅱ型糖尿病患者和健康对照组的空腹血糖(GLU)、胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL-C)、载脂蛋白Al(ApoAl)和载脂蛋白B100(ApoBloo),并进行统计、比较并与患者的病情进行对比分祈,并对高血糖、血脂组患者跟踪观察、治疗。结果Ⅱ型糖尿病组同健康对照组比较、Ⅱ型糖尿病患者中有合并症组跟无合并症组、高血糖组跟血糖正常组比较,CHO、TG和ApoBloo的含量均升高(P<0.05),而HDL-C和ApoAI含量降低(P<0.05)。而高血糖、血脂组患者,已经初步出现或在随后的观察中出现了动脉粥样硬化等相关的临床表征,且治疗效果不佳。结论Ⅱ型糖尿病患者血脂的异常,特别是CHO、TG的大幅升高,提示患者在出现动脉硬化性心血管合并症之前,体内已经具备了诱发合并症的生化基础,应早期采取针性治疗和预防措施。     

Localization of a gene for otosclerosis to chromosome 15q25-q26

Among white adults otosclerosis is the single most common cause of hearing impairment. Although the genetics of this disease are controversial, the majority of studies indicate autosomal dominant inheritance with reduced penetrance. We studied a large multi- generational family in which otosclerosis has been inherited in an autosomal dominant pattern. Five of16 affected persons have surgically confirmed otosclerosis; the remaining nine have a conductive hearing loss but have not undergone corrective surgery. To locate the disease- causing gene we completed genetic linkage analysis using short tandem repeat polymorphisms (STRPs) distributed over the entire genome. Multipoint linkage analysis showed that only one genomic region, on chromosome 15q, generated a lod score >2.0. Additional STRPs were typed in this area, resulting in a lod score of 3.4. STRPs FES (centromeric) and D15S657 (telomeric) flank the 14. 5 cM region that contains an otosclerosis gene.      

Cerebellar subjects show impaired coupling of reach and grasp movements

We examined how cerebellar deficits in isolated reaching or grasping movements contribute to abnormalities in a combined reach and grasp movement, and whether people with cerebellar damage show abnormalities in the spatiotemporal relationships of reach and grasp movements. We studied subjects with cerebellar damage and matched controls as they performed a combined reach and grasp, an isolated reach, and an isolated grasp. These movements were performed under slow-accurate and fast speed conditions. Subjects were also tested for their ability to correctly estimate the target size based on visual information. We measured the three-dimensional position of the index finger, thumb and wrist joint during all tasks. Results showed that cerebellar subjects overestimated the target size to a greater extent than did controls. During movement testing, cerebellar subjects were impaired on isolated reach and isolated grasp. However, they did not worsen parameters of reach or grasp movements during the combined reach and grasp. Instead there were distinct deficits in the coupling of the reach and grasp movement. Compared with controls, cerebellar subjects showed abnormalities in the sequence of the reach and grasp movement and highly variable timing of peak grip aperture. In the slow-accurate condition, cerebellar subjects decomposed the reach and grasp movement into separate reach then grasp components, and produced multiple peaks in grip aperture. In the fast condition, cerebellar subjects did not decompose, produced a single peak grip aperture, and dropped the target more often. These results indicate that cerebellar damage can cause a specific breakdown in the coupling of reach and grasp movements. The cerebellum may be involved in combining reach and grasp movements into a single motor program.     

Pulmonary protective mechanisms in human infants

The flow of oral and nasal secretions into the pharynx is a recognized source of pulmonary aspiration during sleep in infants and adults alike. Such aspiration probably accounts for many cases of bacterial pneumonia. In infants, swallowing occurs frequently in sleep, and the rate of swallowing appears to be far greater than that of the sleeping adult. Such swallowing during sleep appears to be the major mechanism whereby oral and nasal secretions are transported to the digestive tract. Certain aspects of those swallows, such as "swallow-breaths" and their coordination with the respiratory cycle, have been documented. A brief period of airway closure is always seen during such nonfeeding swallows. Nonfeeding swallows are usually seen during mixed and obstructive apneic spells in preterm infants. The underlying reflex mechanisms responsible for such swallows during apnea are unclear. During ordinary postfeeding regurgitation, upper airway closure and swallowing occur in close temporal sequence. These events appear to be major mechanisms of airway protection during regurgitation. In certain infants, regurgitation and prolonged apnea often occur simultaneously. The mechanism underlying their association is unclear but may involve laryngeal chemoreceptors.     

L—门冬酰胺酶前体脂质体对小鼠毒性及对实验性肿瘤作用

目的：研究L－门冬酰胺酶（L－Asparaginase,L-A)前体脂质体（Proliposome,PL)[L-APL]iv对小鼠的毒性及对荷瘤小鼠的抗肿瘤活性。方法：以小鼠的急性毒性和外周血中白细胞数及血小板数为指标观察药物对小鼠的毒性及以荷瘤小鼠的瘤重和生命延和工率观察药物的抗肿瘤活性;结果：L－APL iV对小鼠的急性毒性与L－A相比明显降低,L－APL对正常小鼠外周血中白细胞数,血小板数无明显影响,而相同剂量L－A对小鼠外周血中白细胞数,血小板数明显降低。与对照组相比,L－APL和L－Aip可明显延长腹水型小鼠移瘤L1210,P388的存活天数,与同剂量L－A相比,L－APL高剂量有明显延长腹水型小鼠移植瘤的存活天数作用。L－APL及L－A ip对小鼠移植瘤Heps,EC实体型的肿瘤生长具有明显的抑制作用,两者抑瘤作用相近。结论：L－APL对小鼠的毒性明显小于相同剂量的L－A,L－APL不仅保持了L－A的抗肿瘤活性,而且有明显的增效作用。     

Laser injuries of the eye.

With the increasing use of lasers in the military and industry, a moderate number of significant retina injuries have occurred. These injuries have been due to lasers in the visible and near-infrared spectrum primarily, with a pulse duration in the nanosecond range. Use of lasers in the ophthalmic community has resulted also in structural damage to the cornea, lens, IOL, and retina. Because we have no proven treatment for most injuries to the retina, we must continue to strongly emphasize the use of wavelength-specific protective goggles to try to prevent future eye injuries.     

Postoperative adjuvant radiotherapy and 5-fluorouracil chemotherapy for rectal carcinoma

Postoperative combined modality therapy with radiotherapy and 5-fluorouracil (5FU) chemotherapy is an effective adjuvant approach that reduces locoregional and distant metastatic disease in patients with high-risk rectal carcinoma. However, this approach results in a treatment regimen of at least 6 months’duration. The present prospective study investigates the integration of radiotherapy and 5FU chemotherapy in a protocol designed to minimize toxicity and reduce the overall treatment time. A total of 40 patients with TNM stage II or III disease received postoperative radiotherapy at four fractions per week with weekly 5FU bolus injections delivered on the fifth non-radiotherapy day. Patients also received systemic chemotherapy with leucovorin both before and after pelvic irradiation, with the total treatment duration extending for only 18 weeks. Patients were able to complete radiotherapy in 90% of cases, while the delivery of full-dose chemotherapy was achievable in the vast majority. The incidence of haematologic and gastrointestinal toxicities requiring the cessation of treatment was acceptable. With a median follow-up of 20.9 months among surviving patients, the estimated progression-free and overall survival at 2 years were 71 % and 79%, respectively.