Effect of acute tyrosine depletion in using a branched chain amino-acid mixture on dopamine neurotransmission in the rat brain.

Central dopamine function is reduced by decreasing the availability of the catecholamine precursor, tyrosine, using a tyrosine-free amino acid mixture containing multiple large neutral as well as branched chain amino-acids, which compete with tyrosine for uptake into the brain. Current mixtures are cumbersome to make and administer, and unpalatable to patients and volunteers. Here, we investigate whether individual or limited amino-acid combinations could reduce brain tyrosine levels and hence dopamine function. Measurements of regional brain tyrosine levels, catecholamine and indoleamine synthesis (L-DOPA and 5-HTP accumulation, respectively) were used to identify an effective paradigm to test in neurochemical, behavioral and fos immunocytochemical models. Administration of leucine or isoleucine, or a mixture of leucine, isoleucine, and valine reduced tyrosine and 5-HTP, but not L-DOPA accumulation. A mixture of leucine, valine, and isoleucine supplemented with tryptophan reduced brain tyrosine and L-DOPA, but not 5-HTP. In microdialysis experiments this amino-acid mixture reduced basal and amphetamine-evoked striatal dopamine release, as well as amphetamine-induced hyperactivity. This mixture also reduced amphetamine-induced fos expression in striatal areas. In conclusion, the present study identified a small combination of amino acids that reduces brain tyrosine and dopamine function in a manner similar to mixtures of multiple amino acids. This minimal mixture may have use as a dopamine reducing paradigm in patient and volunteer studies.     

重组人生长激素治疗15例原发性扩张型心肌病的初步观察

目的　观察重组人生长激素 (rh GH)对扩张型心肌病 (DCM)患者左心室形态及功能的影响、疗效及安全性。方法　 2 8例 DCM心力衰竭患者随机分为 rh GH治疗组 (1 5例 )和对照组 (1 3例 )。两组病例均接受常规抗心衰治疗 (ACEI、利尿剂、地高辛 ) ,rh GH治疗组在常规抗心衰治疗的基础上肌肉注射 rh GH8.0 IU,每周 2～3次 ,共 3个月 ,治疗前后记录观测指标。以二维超声心动图、 X线胸片及心功能变化评价左心室形态及功能的改变。结果　 rh GH治疗组 3个月后左心室舒张末期内径 (L VED)由治疗前 (70 .0 4± 2 .2 1 ) mm缩小至治疗后 (6 0 .2 0±2 .32 ) mm ,P<0 .0 1 ;心胸比率由治疗前 0 .6 6± 0 .0 6缩小至治疗后 0 .5 5± 0 .0 5 ,P<0 .0 1 ;左心室射血分数(L VEF)由治疗前 (31 .30± 2 .89) %提高到治疗后 (4 3.32± 4 .78) % ,P<0 .0 1。结论　初步临床观察表明 ,基因重组分泌型人生长激素对 DCM心力衰竭患者左心室形态及心功能改善具有一定的作用 ,近期治疗中未发现明显不良作用     

甲状腺乳头状腺癌152例治疗分析

对１９７４～１９８６年甲状腺乳头状腺癌１５２例的手术治疗进行分析。方法１．分型：包膜内型２３例（１５％），腺内型７１例（４７％）和腺外型５８例（３８％）；２．手术方式分为腺叶＋峡部切除和甲状腺癌联合根治术（功能性和根治性）。结果１０年以上无瘤生存率：总生存率为７４．３４％，其中包膜内型１００％，腺内型９１．５５％，腺外型４３．１０％。结论包膜内型仅行腺叶＋峡部切除即可，腺内型和腺外型拟行甲状腺癌联合根治术（功能性或根治性）。     

2型糖尿病患者臂踝脉搏波传播速度与微量白蛋白尿的关系

目的 探讨微量白蛋白尿（MAU）与2型糖尿病（T2DM）患者臂踝脉搏波传播速度（baPWV）之间的关系。方法 T2DM患者160例，男性84例，女性76例；根据尿白蛋白检测分成2组，即MAU组42例和正常白蛋白尿组（NAU组）118例。动脉硬化诊断仪测量baPWV。结果 MAU组年龄、血压、baPWV均较NAU组高（均P％0．05），MAU与baPWV正相关（r=0．58，P％0．05）。调整年龄、性别、体质量指数、心率、血压、血糖、血脂和糖基化血红蛋白后，多元逐步回归提示只有MAU与baPWV独立相关（SE[B]=0．376，P％0．005）。结论 MAU与T2DM早期动脉粥样硬化相关。     

Treatment of periungual vitiligo with erbium-YAG-laser plus 5-flurouracil: a left to right comparative study

Despite the multiple treatment modalities available for vitiligo, none of them gives satisfactory results in the periungual type. In this study we tried to explore and evaluate the effects of the combination treatment of erbium:YAG laser resurfacing and topical 5-flurouracil in periungual vitiligo. Nine adult patients presenting with periungual vitiligo lesions were included in this prospective left-right comparative study. The desirable inflammation was achieved after a mean of 4.7 days of 5-flurouracil application. The mean re-epithelization time in the treatment sessions was 11.3 days. The patients received a mean of 3.4 sessions in a mean duration of 7.6 months. The mean overall response to therapy in the treated group was 47.8% while in the control group it was 1.1% (P < 0.0001). No side effects necessitated the stoppage of treatment. This study points to the efficacy and safety of this combination in the treatment of periungual vitiligo.     

Diagnostic potential of virtual bronchoscopy: advantages in comparison with axial CT slices, MPR and mIP?

The aim of this study was to evaluate the diagnostic potential of virtual endoscopy (VE) and to compare it with axial CT slices, multiplanar reconstructions (MPR), minimal intensity projections (mIP), and bronchoscopy in patients diagnosed with bronchogenic carcinoma. Thirty patients underwent a spiral CT. Axial CT images were transferred to an Onyx workstation (Silicon Graphics, Sun Microsystems, Mountain View, Calif.) for performing virtual endoscopy. Accuracy for this procedure was tested by three radiologists on a monitor in comparison with axial CT slices, MPR, mIP, and bronchoscopy concerning the localization and degree of stenoses. Endoluminal tumors were identified by virtual bronchoscopy with no statistically significant difference of localization or grading of stenosis in comparison with bronchoscopy, axial CT slices, MPR and mIP. Axial CT slices, MPR, and mIP showed poorer results with over- or underestimation of stenoses compared with VE and bronchoscopy. Passing of stenoses was only possible with VE in 5 patients. Virtual endoscopy is a non-invasive method for identification of endoluminal tumors and is comparable to real bronchoscopy. Received: 18 March 1999; Revised: 21 May 1999; Accepted: 22 July 1999     

Microdialysis of GABA and glutamate: analysis, interpretation and comparison with microsensors

GABA and glutamate sampled from the brain by microdialysis do not always fulfill the classic criteria for exocytotic release. In this regard the origin (neuronal vs. astroglial, synaptic vs. extrasynaptic) of glutamate and GABA collected by microdialysis as well as in the ECF itself, is still a matter of debate. In this overview microdialysis of GABA and glutamate and the use of microsensors to detect extracellular glutamate are compared and discussed. During basal conditions glutamate in microdialysates is mainly derived from non-synaptic sources. Indeed recently several sources of astrocytic glutamate release have been described, including glutamate derived from gliotransmission. However during conditions of (chemical, electrical or behavioral) stimulation a significant part of glutamate might be derived from neurotransmission. Interestingly accumulating evidence suggests that glutamate determined by microsensors is more likely to reflect basal synaptic events. This would mean that microdialysis and microsensors are complementary methods to study extracellular glutamate. Regarding GABA we concluded that the chromatographic conditions for the separation of this transmitter from other amino acid-derivatives are extremely critical. Optimal conditions to detect GABA in microdialysis samples--at least in our laboratory--include a retention time of approximately 60 min and a careful control of the pH of the mobile phase. Under these conditions it appears that 50-70% of GABA in dialysates is derived from neurotransmission.     

用基因芯片技术研究糖尿病性心肌病大鼠心肌组织的部分基因表达谱

目的 比较正常大鼠和糖尿病性心肌病大鼠心肌组织中基因表达的差异，探讨糖尿病性心肌病的发病机制。方法 （1）实验大鼠分为两组，一组为正常对照组，另一组为糖尿病性心肌病组；（2）从心肌组织中抽提mRNA，经逆转录分别用Cy3,Cy5荧光标记，获得丙组动物来源的cDNA探针；（3）cDNA探针与基因表达谱芯片杂交，结果由扫描仪扫描并用软件进行分析统计。结果 （1）氧化应激相关基因和能量代谢相关基因的表达水平在糖尿病性心肌病时明显下调；（2）S腺苷蛋氨酸合成酶和精氨酸酶的表达水平在糖尿病性心肌病时明显上调。结论 （1）氧化应激和能量代谢障碍在糖尿病性心肌病发病机制中起重要作用；（2）S腺苷蛋氨酸合成酶，精氨酸酶通过影响糖尿病性心肌病大鼠心肌组织中同型半胱氨酸，一氧化氮的含量在糖尿病性心肌病发病机制中起重要作用。     

E-选择素基因A561C多态性与糖尿病并发冠心病的关系

目的 :探讨E 选择素基因A5 6 1C多态性与 2型糖尿病 (T2 DM)并发冠心病 (CHD)的关系。方法 :用聚合酶链反应 限制性片段长度多态性 (PCR RFLP)方法探查E 选择素基因A5 6 1C多态性在对照组、CHD组、T2 DM组、T2 DM并发CHD组中的基因频率分布。结果 :CHD组、T2 DM并发CHD组E 选择素的C等位基因频率明显高于对照组 (P <0 .0 5 ) ,不同基因型间血浆E 选择素水平差异有显著意义 (P <0 .0 1)。结论 :E 选择素基因A5 6 1C多态性与CHD及T2 DM并发CHD的发生有关     

肝外伤46例治疗分析

肝脏创伤由于其突发、病情严重、抢救和手术的难度大等特点，受到临床高度重视。近10年来肝脏外伤发病率已等同或超过脾破裂，跃居腹外伤的首位。严重肝外伤病死率高达31％～76％，准确、及时、恰当选择治疗方法是降低病死率的关键。我院自1995-2004年间收治46例，报告如下。