Origins of GABA(B) receptor-like immunoreactive terminals in the rat spinal dorsal horn

By means of immunohistochemistry for gamma-aminobutyric acid receptor B subtype (GABA(B)R), the origins of GABA(B)R-like immunoreactive (GABA(B)R-LI) terminals in the rat spinal dorsal horn were investigated. After dorsal root rhizotomy and/or spinal cord hemisection, the densities of GABA(B)R-LI terminals were remarkably depleted in the ipsilateral superficial dorsal horn of relevant segments, whereas GABA(B)R-LI neurons and sparsely distributed GABA(B)R-LI terminals remained. After injection of Fluoro-Gold (FG) into the left side of superficial lumbar dorsal horn, FG retrograde-labeled neurons were mainly observed in the ipsilateral rostral ventromedial medulla (RVM) and brainstem raphe nuclei. Some of the FG-labeled neurons, especially in the RVM, exhibited GABA(B)R-like immunoreactivity. Additionally, immunofluorescence histochemical double-staining revealed that the majority of GABA(B)R-LI neurons in the periaqueductal gray (PAG), RVM and brainstem raphe nuclei showed 5-hydroxytryptamine (5-HT)-like immunoreactivity. The present study morphologically proves that GABA(B)R-LI terminals in the spinal dorsal horn originate from peripheral afferents, intrinsic neurons and supraspinal structures; GABA(B)R and 5-HT co-exist in many neurons in the PAG, RVM and brainstem raphe nuclei. Considering that PAG, RVM, brainstem raphe nuclei and spinal dorsal horn are important structures involved in the pain modulation, we suggest that the descending pain modulation system might be mediated, at least in part, by GABA(B)R.     

南方食管癌高、低发区人群总N-亚硝基化合物接触水平

目的　评价南方食管癌高发区和低发区人群总N 亚硝基化合物 (TNOC)的接触水平。方法　在食管癌高发区南澳县和低发区陆丰县各随机选择 12 0名 35～ 6 4岁男性 ,采用双份饭法收集2 4h膳食和 12h尿液 ,测定TNOC、非挥发性亚硝胺和挥发性亚硝胺。结果　高发区膳食TNOC检出率(95 % )、膳食TNOC日摄入量 [(4 2 5± 0 84 ) μmol/d]和尿 12h排出量 [(1 76± 0 2 3)ng/ 12h]、膳食挥发性亚硝胺日摄入量 [(2 6 6± 31 2 ) μg/d]均高于低发区。食管癌死亡率分别与膳食TNOC日摄入量和尿TNOC排泄量呈等级正相关关系。尿非挥发性亚硝胺排泄量两地无差异。结论　南方食管癌高发区人群TNOC的接触水平明显高于低发区人群     

Dietary exposure and urinary excretion of total N-nitroso compounds,nitrosamino acids and volatile nitrosamine in inhabitants of high- and low-risk areas for esophageal cancer in southern China

We assessed the exposure of total N-nitroso compounds (TNOCs) in the inhabitants of high- and low-risk areas for esophageal cancer in southern China. Samples of 24 hr diet and 12 hr overnight urine were collected from 120 male adults in each of the 2 areas, a high-risk area (Nan'ao County) and a low-risk area (Lufeng County) for esophageal cancer. Annual standardized mortality rates of esophageal cancer in Nan'ao and Lufeng are 110/10(6) and 10/10(6) respectively. The 240 healthy male subjects (35-64 years old) were selected by a 3-stage random cluster sample procedure. Levels of TNOCs, NAAs and volatile nitrosamines in the samples were measured. The TNOC detection rate (95%) in the diet, the TNOC daily intake (4.25 +/- 0.84 micromol), TNOC excretion levels (0.04 +/- 0.01 nmol/12 hr) and daily intake of volatile nitrosamines (5.84 +/- 0.71 micromol) in the high-risk area were significantly greater than values in the low-risk area (A +/- B = mean +/- SE). The TNOC detection rate in the diet, the TNOC daily intake, TNOC excretion levels and daily intake of volatile nitrosamines in the low-risk area were 70%, 0.25 +/- 0.06 micromol, 0.02 +/- 0.01 nmol/12 hr and 3.18 +/- 0.31 micromol, respectively. NAA excretion levels showed no difference between the 2 areas (16.3 +/- 7.18 micromol/12 hr for Nan'ao and 31.2 +/- 26.4 micromol/12 hr for Lufeng). Thus, TNOCs are implicated in the etiology of esophageal cancer in southern China.     

Microsatellite instability in hematological malignancies

The replication error (RER+) phenotype, characterized by microsatellite instability (MSI) has been recently related to mutations of genes involved in DNA mismatch repair pathway. These genetic alterations were first described in hereditary non polyposis colorectal cancer (HNPCC). We examined 44 patients with hematological malignancies (27 AML, 9 MDS, 2 CML-BP and 6 T-ALL) for evidence of MSI. Twenty seven percent of our patients showed differences for only one marker. In four cases (9.1%) MSI was observed in multiple markers and these cases were described as RER+ phenotype. Presented data suggest that this phenomenon may play a role in at least a subset of patients with hematological malignancies.     

Preliminary results from a Phase II trail of conformal radiation therapy for pediatric patients with localised low-grade astrocytoma and ependymoma

PURPOSE: To estimate the local control and patterns of failure for pediatric patients with low-grade astroglial tumors (LGA) and ependymoma (EP) treated with three-dimensional conformal radiation therapy (CRT) using an anatomically defined clinical target volume (CTV). METHODS AND MATERIALS: From an ongoing, prospective Phase II trial initiated in July 1997, 102 pediatric patients with LGA (n = 38) and EP (n = 64) have been treated with CRT using an anatomically defined CTV extending 1.0 cm beyond the gross tumor volume and a 0.5-cm margin (planning target volume) extending outside of the CTV. The prescribed dose was 54 Gy (LGA) and 59.4 Gy (EP). RESULTS: Patients with EP have been followed for a median of 17 months (range 3--43 months), and six failures have occurred. Patients with LGA have been followed for a median of 17 months (3--44 months), and four failures have occurred. Three-dimensional magnetic resonance (MR) studies performed to document treatment failure were registered with the MR and computed tomography (CT) data used in the treatment planning process. Failure occurred within the CTV for 5 patients with EP, including 3 with concurrent subarachnoid dissemination. One patient with EP developed metastatic disease with no evidence of local failure. Three patients with LGA failed within the CTV and one failed immediately outside of the CTV. CONCLUSIONS: Treatment of an anatomically defined CTV, encompassing 1.0 cm of non-involved brain beyond the margin of resection or neuroimaging-defined tumor, appears to be safe for pediatric patients with LGA and EP based on these preliminary data. Normal tissue sparing through the use of advanced radiation therapy treatment planning and delivery techniques should be beneficial to pediatric patients if the rate and patterns of failure are similar to conventional techniques and toxicity reduction can be objectively documented.     

Preirradiation endocrinopathies in pediatric brain tumor patients determined by dynamic tests of endocrine function

PURPOSE: To prospectively evaluate pediatric patients with localized primary brain tumors for evidence of endocrinopathy before radiotherapy (RT). METHODS AND MATERIALS: Seventy-five pediatric patients were evaluated with the arginine tolerance test and L-dopa test for growth hormone secretory capacity and activity; thyroid-stimulating hormone surge and thyrotropin-releasing hormone stimulation test for the hypothalamic-thyroid axis; the 1-microg adrenocorticotropin hormone (ACTH) and metyrapone test for ACTH reserve; and, depending on age, a gonadotropin-releasing hormone stimulation test to determine gonadotropin response. The study included 38 male and 37 female patients, age 1-21 years with ependymoma (n = 35), World Health Organization (WHO) Grade I-II astrocytoma (n = 18), WHO Grade III-IV astrocytoma (n = 10), craniopharyngioma (n = 7), optic pathway tumor (n = 4), and germinoma (n = 1). Seven patients receiving dexamethasone at the time of the evaluation were excluded from the final analysis. RESULTS: Of 68 assessable patient, 45 (66%) had evidence of endocrinopathy before RT, including 15 of 32 patients (47%) with posterior fossa tumors. Of the 45 patients, 38% had growth hormone deficiency, 43% had thyroid-stimulating hormone secretion abnormality, 22% had an abnormality in ACTH reserve, and 13% had an abnormality in age-dependent gonadotropin secretion. CONCLUSION: The incidence of pre-RT endocrinopathy in pediatric brain tumor patients is high, including patients with tumors not adjacent to the hypothalamic-pituitary unit. These data suggest an overestimation in the incidence of radiation-induced endocrinopathy. Baseline endocrine function should be determined for brain tumor patients before therapy. The potential for radiation-induced endocrinopathy alone cannot be used as an argument for alternatives to RT for most patients. Pre-RT endocrinopathy may be an early indicator of central nervous system damage that will influence the functional outcome unrelated to RT.     

父母养育方式对护生心理健康相关因素的影响

目的：探讨护理专业大学生父母养育方式与人格、应对方式及心理健康状况的关系。方法：采用父母养育方式问卷（EMBU）、艾森克人格问卷（EPQ）、症状自评量表（SCL-90）和特质应对方式问卷（TCSQ）,对132例护理专业大学生施以团体测验。结果：护生SCL-90得分高于全国常模,尤以护理本科学生严重。父母养育方式大部分因子与精神质和情绪稳定性显著相关;父母的过分干涉保护、惩罚严厉、拒绝否认等负性情感对护生SCL-90高分影响显著;护生的情绪稳定性和母亲过分干涉保护对预测SCL-90总均分作用显著。结论：父母养育方式是影响大学生个性发展和心理健康的重要因素,不健康的养育方式通过影响护理专业大学生的人格特质,应对方式,导致不良心理健康状态。     

三江地区部分肝病患者血清中乙肝病毒基因型的检测

目的探究黑龙江省三江地区部分肝病患者血清中的乙肝病毒基因型。方法采用基因型特异引物的巢式聚合酶链式反应方法对29例乙肝携带者、9例急性肝炎、36例慢性肝炎、19例肝硬化和3例肝癌患者血清中HBV基因型进行分析。结果HBVB型31例（32．3％）、C型62例（64．6％）、有3例患者同时检出基因型B和C。结论三江地区存在HBVB和C型，而且C型为主要基因型，另外还有少数B、C型混合感染。     

谈《伤寒论》中的恒动观

《伤寒论》中处处体现着恒动观,本文拟从发病、传变、辨证、治疗等方面予以讨论。发病的恒动观主要体现在直中、合病、并病等方面;传变的恒动观主要是指外感病发展过程中的自身所固有的恒动特征;辨证的恒动观主要是指结合证候本身发展趋势进行辨证的审势思维;治疗的恒动观主要反映在针对某些证候的由轻转重、治疗中标本缓急的合理把握两个方面。掌握恒动观,是理解《伤寒论》辨证论治思想精髓及提高临证水平的关键。