郎格罕细胞组织增生症──韩—薛—柯病22例分析

报道从例韩－薛－柯病，着重就该病典型的三联征（骨质缺损，突眼，尿崩症）和皮疹等进行了介绍和分析，并对郎格罕细胞组织细胞增生症的命名进行了历史问题。此外还就该病病因，发病机理进行了探讨，指出该病可能系机体免疫能力失调疾病。     

超声对腹膜病变的诊断价值

应用超声实时显像仪，检查４９例腹膜病变，均经病理证实。结果检出结核性腹膜炎３１例，腹膜转移癌８例，腹膜原发性肿瘤１０例，超声诊断符合率分别为７０．９７％，７５．００％，９０．００％。结核性腹膜炎与腹膜肿瘤两组间。腹水的阳性率无明显差异。通过超声对腹膜改变，腹块及周围脏器间关系的观察，有助于辨别病变性质；同时对诊断尚不明确者行超声引导下穿刺腹膜病理学检查，亦使诊断更加善。     

氯胺酮异丙酚复合麻醉在小儿手术中的应用

氯胺酮具有镇痛完全 ,效果确切 ,使用方便等优点 ,是小儿麻醉中使用最广泛的麻醉药之一。但随着临床上使用氯胺酮的病例增加 ,人们已经认识到小儿麻醉中单独使用氯胺酮不仅发生呼吸循环抑制的机会较多 ,而且苏醒较迟。因此 ,近年来人们作了不少关于改变传统小儿麻醉方案的尝试。异丙酚具有镇静作用迅速、平稳、半衰期短、苏醒快的优点。我们从 2 0 0 2年 2月至 2 0 0 3年 2月应用氯胺酮异丙酚复合麻醉实施小儿手术 4 0例 ,取得较好效果 ,总结如下。1　资料与方法1.1　一般资料　 4 0例择期下腹及下肢手术患儿 ,男 2 5例 ,女 15例 ,年龄 3～ …     

The endothelial protein C receptor (PROCR) Ser219Gly variant and risk of common thrombotic disorders: a HuGE review and meta-analysis of evidence from observational studies

The endothelial protein C receptor (EPCR) limits thrombus formation by enhancing activation of the protein C anticoagulant pathway, and therefore may play a role in the etiology of thrombotic disorders. The rs867186 single-nucleotide polymorphism in the PROCR gene (g.6936A > G, c.4600A > G), resulting in a serine-to-glycine substitution at codon 219, has been associated with reduced activation of the protein C pathway, although its association with thrombosis risk remains unclear. The present study is a highly comprehensive systematic review and meta-analysis, including unpublished genome-wide association study results, conducted to evaluate the evidence for an association between rs867186 and 2 common thrombotic outcomes, venous thromboembolism (VTE) and myocardial infarction (MI), which are hypothesized to share some etiologic pathways. MEDLINE, EMBASE, and HuGE Navigator were searched through July 2011 to identify relevant epidemiologic studies, and data were summarized using random-effects meta-analysis. Twelve candidate genes and 13 genome-wide association studies were analyzed (11 VTE and 14 MI, including 37,415 cases and 84,406 noncases). Under the additive genetic model, the odds of VTE increased by a factor of 1.22 (95% confidence interval, 1.11-1.33, P < .001) for every additional copy of the G allele. No evidence for association with MI was observed.     

腹横肌平面阻滞复合静脉自控镇痛与硬膜外镇痛用于开腹结直肠手术的比较

目的 观察和比较腹横肌平面(transversus abdominis plane,TAP)阻滞复合静脉自控镇痛与连续硬膜外镇痛对开腹结直肠手术患者镇痛和康复的影响. 方法 入选84例开腹结直肠手术患者,采用随机数字表法将患者分为两组:超声引导下TAP阻滞复合静脉自控镇痛组(T组)和连续硬膜外镇痛组(E组),每组42例.主要监测指标为术后48 h VAS评分,同时比较术后补救镇痛药使用率、舒芬太尼消耗量、胃肠道功能恢复时间、早期活动时间、低血压发生率、恶心呕吐发生率、下肢感觉及运动异常、医学康复时间和实际住院时间等. 结果 最终80例患者完成本研究.两组患者术后48 h VAS评分、术后补救镇痛药使用率、胃肠道功能恢复时间、恶心呕吐发生率、医学康复时间和实际住院时间差异均无统计学意义(P＞0.05).与E组比较,T组术后低血压发生率(15％比40％)、早期活动时间[(64±13)h比(91±12)h]、下肢感觉及运动异常(0比10％)、术中及术后舒芬太尼消耗量[(49±11)μg比(43±7)μg及(88±12) μg比(45±5)μg]差异有统计学意义(P＜0.05). 结论 与连续硬膜外术后镇痛比较,TAP阻滞复合静脉自控镇痛能为开腹结直肠手术患者提供相似的镇痛与康复效果,且低血压等并发症发生率更低.     

Protective DNA vaccination against myelin oligodendrocyte glycoprotein is overcome by C3d in experimental autoimmune encephalomyelitis

Complement receptor 2 (CR2) and its physiological ligand, C3d, known for its molecular adjuvant property on the immune response, exhibit opposite effects with regard to autoimmunity. Although CR2 has been implicated in maintaining self-tolerance, recent studies reported a role for C3d signaling to CR2 in tolerance breakdown to self-antigens and the initiation of inflammatory autoimmune pathologies. In the present study, we have investigated the effect of C3d in a model of tolerogenic DNA vaccination encoding the myelin oligodendrocyte glycoprotein (MOG-DNA) which protected mice from the induction of an experimental autoimmune encephalomyelitis (EAE). We show that fusing two or three copies of C3d to MOG overcomes the protective effect of DNA vaccination. Multimeric C3d was able to revert the unresponsiveness state of specific T cells induced by MOG-DNA, independently of a modification in the Th1/Th2 cytokine pattern. Interestingly, the adjuvant effect of C3d was not sufficient to boost the anti-MOG antibody response after DNA vaccination. These findings suggest that C3d might be involved in self-tolerance breakdown and could contribute to the pathogenesis of central nervous system autoimmune disorders.     

辣椒素在疾病治疗中的研究近况

辣椒素（Capsaicin ）是辣椒属（Capsicum ）植物辣椒／胡椒（chilli pepper ）中的一种活性成分,起源于美洲。在墨西哥和南美洲辣椒是烹饪中的一种调味品,后来被欧洲人引入亚洲和非洲,现已成为中国、印度、埃塞俄比亚、韩国等地区居民烹饪的一种重要食料［1］。随着对辣椒素的不断研究,辣椒素除了用作食料外,还广泛用于临床和实验室研究,并用于治疗或预防各个系统疾病。     

瑞芬太尼与丙泊酚静脉麻醉在妇科腹腔镜手术60例中的应用体会

腹腔镜手术由于人工气腹过程对循环功能的影响,要求麻醉药物不能对心血管系统有明显的抑制作用,同时手术病人多数是接台手术,也要求术后清醒快。瑞芬太尼是一种新型的具有良好应用前景的超短效阿片类药物,具有镇痛作用强,苏醒快的优点,可安全有效地用于外科手术的麻醉[1],已逐渐在各级医院推广使用。丙泊酚是镇静催眠效果好,麻醉清醒时间短,清醒后患者感觉舒适的静脉麻醉药,目前已广泛用于麻醉诱导及术中麻醉的维持,持续输注丙泊酚能够提供一个稳定的麻醉水平。将瑞芬太尼与丙泊酚复合应用于妇科腹腔镜手术麻醉的文献较少。自2005年5~10月,…