β2-ADRENERGIC RECEPTOR GENE POLYMORPHISM IN CHINESE NORTHERN ASTHMATICS

THEβ2-adrenergicreceptor(β2-AR)ishighlyexpre-ssedonairwaysmoothmusclecellsinlung,anddefectsinβ2-ARsignalpathwaywereinvolvedinthepathogenesisofasthma.1 Humanβ2-ARgeneisanintr-onlessgenewithacodingblockconsistingof1239nucleo-tidesonchromosome5q31-32,genome-widesearchforas-thmasusceptibilitylocishowedthatmarkersonthisregionhavebeenlinkedtoasthma-associatedphenotypesinvariousethnicpopulations.2 Reihsausetal3 firstdescribedninecod-ingregionpolymorphisms,particularly,thethreecommonaminoacidsu…     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

大鼠脑出血模型中神经细胞凋亡与自由基水平的相关性

目的研究脑出血后血肿周围组织不同自由基水平对于细胞凋亡的影响。方法成年SD大鼠随机分为4组：假手术组、模型组、1mg/kg依达拉奉组、3mg/kg依达拉奉组，各组又根据造模后处死动物的不同时间（6h，12h，24h，48h，72h，7d，14d）分为七个亚组，假手术组中每个亚组1只大鼠，其余三组中每个亚组6只大鼠。左尾壳核立体定向注入白体血80μL，制作大鼠脑出血动物模型。分光光度计法检测血肿周围丙二醛（malonaldehyde，MDA）及羟自由基含量，末端转移酶标记技术（terminal deoxynucleotidyltransferase-mediated dUTP-biotin nick end labeling，TUNEL）检测血肿组织周围细胞凋亡数，并分析血肿周围组织自由基水平和凋亡相关性。结果（1）模型组羟自由基及MDA含量较假手术组明显增加，四组问进行统计学分析，具有显著性差异。（2）模型组和两种剂量的依达拉奉组均于6h即可观察到TUNEL阳性细胞，24h明显增加，72h时达到高峰，7d时明显减少，14d时于血肿周边仍可见少量阳性细胞。（3）凋亡细胞数与脑组织产生自由基能力（r=0．2003）及MDA含量（r=0．6563）具有相关性。结论脑出血后细胞凋亡数和自由基水平变化趋势相同，二者具有相关性，提示自由基可能参与诱导出血后神经元及胶质细胞凋亡。     

Endoscopic management of biliary complications after orthotopic liver transplantation

BACKGROUND: Biliary complications are a serious problem in patients after liver transplantation and often require reoperation. This study was conducted to summarize the endoscopic diagnosis and management of biliary complications after orthotopic liver transplantation (OLT). METHODS: From December 2000 to November 2003, twelve endoscopic retrograde cholangiopancreatographies(ERCPs) were performed in 7 patients after OLT at Digestive Endoscopic Center of Changhai Hospital in Shanghai, China. The therapeutic maneuvers included endoscopic sphincterotomy (EST), biliary stent placement, balloon and basket extraction, irrigation, and nasobiliary tube placement. A retrospective study was made to determine the types of biliary tract complications after OLT. The success of ERCP and therapeutic maneuvers was also evaluated. RESULTS: Biliary tract complications including biliary stricture, biliary leak, biliary sludge, and stump leak of the cyst duct were treated respectively by endoscopic sphincterotomy with sludge extraction, stricture dilation or endoscopic retrograde biliary drainage. Two of the 3 patients with proximal common bile duct stricture were successfully treated with ERCP and stent placement. Four patients with anastomotic stricture and/without bile leak were treated successfully by dilation and stent placement or endoscopic nosobiliary drainage. No severe ERCP-related complications occurred. CONCLUSIONS: ERCP is an effective and accurate approach for the diagnosis of biliary tract complications after OLT, and placement of a stent is a safe initial treatment for biliary complications after liver transplantation.     

Relationship between HBV genotypes and anti-viral therapeutic efficacy of interferon-alpha

BACKGROUND: Much evidence demonstrates that the genotypes of hepatitis B virus (HBV) present differences in pathogenicity and outcomes owing to differences in genetic structure. This study aimed to investigate the influences of HBV genotypes on the anti-viral therapeutic efficacy of interferon-α (IFN-α) in chronic hepatitis B patients, and to determine the relationship between HBV genotypes and levels of viral replication or gene variations. METHODS: The chronic hepatitis B patients who were treated with IFN-α were selected randomly. Anti-viral therapeutic efficacy was monitored in these patients. The HBV genotypes were detected by PCR microplate hybridization ELISA. The levels of serum HBV-DNA were determined by fluorescence quantitative PCR. HBV gene variation at pre-C and basic core promoter (BCP) regions were assayed by gene chip technology. RESULTS: Genotypes B and C were predominant in 94 chronic hepatitis B patients. A, E and F genotypes were not found in these patients. The HBV-DNA levels of genotype C and mixed genotypes were significantly higher than those of genotype B. The response to IFN-α in patients with genotype B was markedly better than in those with genotypes C and D, and the complete response to IFN-α was only observed in genotype B. The response to IFN-α in patients with mixed genotypes was the least sensitive. The negative transition of HBeAg was correlated with variations in the HBV pre-C and BCP regions in patientswith partial or no response to IFN-α. The variation rates of HBV pre-C and BCP regions were clearly higher in genotype C than in genotype B. CONCLUSIONS: The results suggest that HBV genotype is correlated with the serum levels of HBV-DNA, HBV gene variations and therapeutic efficacy of IFN-α. The regular detection of HBV genotypes in the clinic will be of benefit for disease prognosis and planning of anti-viral therapeutic strategies.     

Tropheryma whipplei infective endocarditis as the only manifestation of Whipple's disease

Here we describe a case of infective endocarditis caused by Tropheryma whipplei in a patient with no other symptoms of Whipple's disease. The case was diagnosed using broad-range PCR and confirmed by specific PCRs. We review the cases of infective endocarditis presenting as the only manifestation of Whipple's disease reported in the literature.     

西班牙渗出性老年性黄斑变性的相关流行病学因素(英文)

目的:报告在西班牙Castilla-Leo地区患有渗出性老年性黄斑变性(AMD)的样本人群的流行病学特点,并与一组来自同一地区和相同年龄人群进行比较。方法:在本次观察性前瞻性调查中,我们访问了在一家地区性诊所接受光动力学疗法的AMD患者。患者报告了高血压、高血脂、吸烟的病史,检查患者虹膜颜色并分为浅色(绿色、蓝色、灰色)和深色(淡褐色、褐色、黑色)。结果:共有343名患者接受了访问,平均年龄为74.9岁(55~93岁),其中64.5%为女性,35.5%为男性,有45.1%的患者虹膜颜色被划为浅色。这些患者中,有50%有动脉性高血压,15.3%接受高胆固醇血症治疗,30.2%吸烟或者已经戒烟(女性中占80.9%)。结论:在渗出性AMD患者中,虹膜颜色为浅色的频率较高。在我们的调查中,其他渗出性AMD其他的风险因素有男性的吸烟习惯、未接受高胆固醇血症治疗、患者为女性身份等。     

食管原发性恶性纤维组织细胞瘤:3例报告及文献复习

We reported three cases of polypoid tumor of the esophagus, among them one case of sarcomatous tumor partly covered with superficial squamous cell carcinoma. The sarcoma was consisted of anaplastic spindle and pleomorphic tumor cells, which was similar to malignant fibrous histiocytoma (MFH) of the soft tissue. Diagnosis of the surgery resected speci-men was confirmed by histological, immunohistochemical and electron microscopic methods. Both diagnostic and differential diagnostic problems of primary MFH of the esophagus and world medical literatures were discussed.     

COLOR FLOW IMAGING OF HEPATIC CARCINOMA

ＣＯＬＯＲＦＬＯＷＩＭＡＧＩＮＧＯＦＨＥＰＡＴＩＣＣＡＲＣＩＮＯＭＡＸｕＺｈｉｚｈａｎｇ；ＷａｎｇＷｅｎｐｉｎｇ（ＤｅｐａｒｔｍｅｎｔｏｆＤｉａｇｎｏｓｔｉｃＵｌｔｒａｓｏｕｎｄ，ＺｈｏｎｇｓｈａｎＨｏｓｐｉｔａｌ，ＳｈａｎｇｈａｉＭｅｄｉｃａｌＵｎ...