广东地区散发克罗恩病患者β防御素2启动子区基因突变检测

目的:对广东地区散发克罗恩病患者β防御素2启动子区基因突变进行筛查,探讨该基因在克罗恩病发病中的作用。方法:克罗恩病组为2002-01/2006-10于南方医院消化科确诊的克罗恩病患者45例,对照组为门诊健康志愿者50例。签定知情同意书后分别取静脉血5mL,提取基因组DNA,并根据设计好的引物序列及PCR反应条件进行目的片段的扩增,阴性对照使用蒸馏水代替DNA。扩增成功的目的基因片段用DNA纯化试剂盒进行纯化,并由上海英俊公司完成测序工作。利用DNAMAN软件将患者测序结果与正常对照结果进行比对,并与基因库数据对照(http://www.ncbi.nlm.nih.gov/BLAST/),SPSS13.0进行统计学分析。并根据结果分析其与克罗恩病患者病变特点的相关性。结果:①纳入的45例克罗恩病患者与50例健康志愿者在性别和年龄上无统计学意义,并全部进入实验分析。②45例克罗恩病患者中有4例在β防御素2启动子区第-233(G→C)位发现基因突变,密码子由AGG变成AGC,编码氨基酸由精氨酸变成丝氨酸,而50例对照组未发现此改变,二者比较具有统计学意义(χ2=4.34,P<0.05)。③4例突变的患者病变均位于小肠(χ2=10.81,P<0.01)且病情较重。结论:在克罗恩患者中存在着β防御素2启动子区基因突变携带者,与患者发病年龄、病变部位、病变程度明显相关,有必要对其功能进行进一步探讨。     

用二维核磁共振技术研究野菊花三醇的结构

从野菊花(Chrysanthemum indicum L.)亲脂性极性较大的部分,分离得到一个新的倍半萜成分,命名为野菊花三醇。通过¹H-¹H COSY,¹H-¹³C COSY及远程¹H-¹³C COSY二维核磁共振谱研究,确定其属于(牛龙)牛儿烷衍生物,并确定其结构和相对立体构型。     

Pathophysiology of post-operative cognitive dysfunction: current hypotheses

Post-operative cognitive dysfunction (POCD) has been reported after a variety of surgical procedures. POCD is associated with a decline in performance of activities of daily living of elderly patients and can cause substantial damage to family and/or to social support systems. The incidence of POCD in the first week after surgery is 23% in patients between 60 and 69 years of age and 29% in patients older than 70. Cognitive dysfunction was still present in 14% of patients over 70 at three month after surgery. The risk of POCD increases with age, and the type of surgery is also important since there is very low incidence of POCD after minor surgery. For many years, it has been known that general anaesthesia is associated with persistent changes in gene expression in the brain for at least 72 hours. These observed modifications suggest an interesting hypothesis to explain the side effects of anaesthetic agents on cognitive dysfunction, particularly in the elderly. The inflammatory response to surgery is consistent with the hypothesis that inflammation contributes to cognitive decline in the elderly. Most of the drugs administered during anaesthesia interact with the cerebral cholinergic system, which seems to be impaired with ageing. One can hypothesize that this cholinergic dysfunction is a potent factor in the pathogenesis of POCD. These findings have implications for the information provided before obtaining consent from elderly patients prior to surgery; a careful evaluation of mental status is mandatory for all elderly patients undergoing general anaesthesia. Perioperative physicians should be familiar with the prevention, diagnosis, and management of postoperative cognitive dysfunction.     

Results of a public awareness campaign in Morocco regarding the sun's deleterious effects

Objective To investigate knowledge of the various sun radiation–related risks and awareness of photoprotection measures using a sample of the Moroccan population. Methods An investigation of prevalence, which was administered while a public awareness campaign on the sun's harmful effects, organized by the department of dermatology of Ibn Sina's hospital in Rabat, was running. The collection of the data was made on the basis of a questionnaire that was filled by the team of the doctors of the department. The logistic regression allowed to identify the explanatory factors for the prevalent knowledge and behaviours related to the subject in hand. Results Four hundred eleven subjects were included in the survey. The subjects' average age was 40 ± 10 years. Eighty‐four per cent were female. The analysis of the total score of knowledge related to the sunrays’ deleterious effects demonstrated low levels of knowledge among 160 participants (38.9%). Females were clearly more knowledgeable than the opposite sex (P = 0.003) and also those having a higher educational level (P = 0.006) scored high. The use of sunscreens was recognized by 52.8% of the patients and was associated with female gender and higher educational level. Conclusion Our study reports the results of the first public awareness campaign on the sun's deleterious effects on the Moroccan population, inclusive and relevant to all ages. Awareness of the sun's radiation‐related risks in a country as sunny as ours is low, whereas different measures of photoprotection are rather well known. Messages adapted to the characteristics of our population are a necessity.     

Multiple sclerosis: specificity of MR for diagnosis

The specificity of magnetic resonance (MR) imaging in the diagnosis of multiple sclerosis (MS) has not been measured systematically. Conventional MR head images with sagittal localizer and axial multiple-echo sequences with long repetition times were obtained in 92 patients with clinically verified MS (Schumacher criteria), 100 healthy volunteers, 60 subjects with hypertension, and eight patients with dementia. Two readers, without the aid of any clinical or demographic information, classified each of the 260 studies as MS or not MS. The readers classified the studies again after being supplied with the subjects' ages and sex. True-negative and true-positive diagnoses of MS were tabulated. The specificity of the MR diagnosis of MS (true-negative results in proportion to all non-MS studies) was 95%-99% with all the control groups included. There is a small risk of misinterpreting incidental periventricular white matter foci as plaques of MS in MR studies.