Graves病骨生化标志的变化初探

目的 探讨Graves患者骨生化标志的改变。方法 对38例Graves患者进行血AKP、Ca、P、ICTP、DPD、BGP、U-HOP/Cr及BMD测定。结果 Graves组的BMD显著低于正常对照组(P<0.01),Ca、ICTP、DPD、BCP、U-HOP/Cr显著高于对照组,Graves组的BMD与ICTP和DPD,BGP有很好的相关性(r=0.36,r=0527、r=0.401)。结论 Graves组骨吸收增加,骨形成减少。     

五型病毒性肝炎的暴露因素与临床表现的比较

比较急性病毒性肝炎患者感染打危险因素，同时比较五型肝炎的症状和体征。连续收集急性病毒性肝炎患者血清２９３份，用ＥＬＩＳＡ法检测了五型肝炎病毒的病原学指标，并进行了流赞美同学调查。暴露因素：丙肝的肠道外暴露外明显多于甲肝；甲肝和戊肝有较高的“甲肝”患者接触史；乙肝，丙肝和丁肝有高的“乙肝”接触史，与甲肝，戊肝相比差异显著。     

Identifying incident cases of parkinsonism among veterans using a tertiary medical center.

To better understand the impact of incident Parkinson's disease (PD) on the Veteran's Health Administration (VHA) and to develop methods applicable to future epidemiological research, we performed a medical record review study at a tertiary referral VHA medical center. Searching the local data base, we identified 782 veterans with diagnostic codes for PD or secondary parkinsonism (SP) between 1998 and 2000. Based on structured medical record review, a movement disorders specialist confirmed diagnoses for incident parkinsonism cases. Among the 782, 191 incident parkinsonism cases were identified (100 PD, 75 SP, and 16 Parkinson's Plus). Incident PD cases were older at diagnosis (74.5 vs. 70.4 yr; P < 0.05) and more likely to be white (81% vs. 62; P < 0.07) than incident SP cases. Diagnostic codes were insufficient to distinguish between incident PD and SP (positive predictive value, 57% and 39%, respectively), and VHA sources failed to identify 21% of confirmed deaths among the incident PD cohort by November 2004. Although the large number of incident cases identified suggests PD is an important cause of disability among elderly VHA users, observed limitations of VHA sources for identifying incident PD cases and determining their vital status should be considered when designing future studies.     

Clinical characteristics of severe peripheral neuropathy induced by docetaxel (Taxotere)

Background: Docetaxel, a semi-synthetic taxane may cause a usuallymild sensory neuropathy. We describe the clinical characteristics of fivepatients who developed a more severe neuropathy following treatment withdocetaxel.Patients and methods: All patients were treated in phase II studieswith 100 mg/m² docetaxel in three weekly cycles, withoutsteroid administration.Results: The clinical picture in these patients was dominated by asensory neuropathy, but in one case severe weakness was present. Anotherpatient developed Lhermitte's sign. Signs and symptoms are usually reversibleafter discontinuation of docetaxel administration, but in three patientssymptoms worsened for some time after the end of treatment before improvementoccurred.Conclusion: Severe docetaxel neuropathy may especially occurfollowing treatment with cumulative dosage over 600 mg/m²; inpatients treated with this dosage a moderate or severe neuropathy may not berare.     

HBsAg阳性患者中HBV-DNA(PCR)与其它HBV复制标志物的关系

本文应用聚合酶链反应(PCR)对125例乙型肝炎病毒患者血清进行了HBV-DNA检测,根据其检测结果与乙型肝炎病毒的其它复制标志物HBcAg(检测125例)、HBeAg(检测115例)、PreS_2Ag(检测92例)、PHSA-R(检测114例)、Anti—HBclgM(检测118例)进行比较。HBV-DNA阳性血清中HBcAg、HBeAg、PreS_2Ag、PHSA-R、Anti-HBcIgM的检出率分别为83.75％(67/80)、62.34％(48/77)、61.02％(39/59)、74.03％(57/77)、72.97％(54/74)。经统计学处理,显示五项复制标志物与HBV-DNA的相关关系应是:HBcAg>PHSA-R>Anti-HB-cIgM>HBeAg>PreS_2Ag。在HBV-DNA(PCR)阳性血清中,HBcAg的检出率为最高。提示在除HBV-DNA(PCR)外,上述五项标志物中,HBcAg可能是HBV-DBA复制的最佳指标。HBeAg在HBV复制过程中的地位仍有待今后进一步探讨。     

模特征对伴单侧坐骨神经痛的腰椎间盘突出症的诊断价值

目的：介绍与验证一种反映腰椎间盘突出伴单侧坐骨神经痛的体征——模特征。方法：选取72例经腰椎MRI证实有腰椎间盘突出（L4，532例，L5／S1 40例）并伴单侧坐骨神经痛的患者，男49例，女23例，年龄32～68岁，平均50．7岁。每例患者人院当日由两位医师间隔2h分别检查，患者背对检查者，嘱其取最能缓解坐骨神经痛的站立姿势，若患者出现患侧屈髋屈膝、骨盆倾向患侧的姿势，记为“模特征阳性”，否则记为“模特征阴性”。同时行直腿抬高试验（SLR），阳性患者记录诱发下肢放射痛的最小角度。结果：70例患者两检查者结果完全相同，其中阳性60例，阴性10例，敏感性为85．7％；仅2例患者两检查者结果不一致，重复性97．2％。SLR均为阳性。结论：模特征是诊断伴单侧坐骨神经痛腰椎间盘突出症的简单、敏感的临床体征。     

Relationship of clonogenic capacity to plating efficiency and vital dye staining of human periodontal ligament cells: implications for tooth replantation

The survival rate of avulsed permanent teeth following replantation is affected primarily by the duration of the extra-alveolar period and the nature of the storage conditions. These factors are believed to strongly affect the viability of periodontal ligament (PL) cells but in vitro assays of cell viability based on vital dye assays are only weakly correlated with the tooth survival rate after replantation. The aim of the present study was to examine the relative dependence of cell membrane integrity, attachment and clonogenic capacity of human PL cells on the temperature and duration of the extra-alveolar period and the type of storage medium. Twenty-four premolar teeth were extracted for orthodontic reasons from 9 patients 11–18 years of age. Teeth were maintained at 4°C or 23°C for 15, 30, 60 or 120 min in either milk or dry conditions. Cell membrane integrity was determined by BCECF/AM dye inclusion. Plating efficiency was determined by measurement of cell attachment at 3 and 6 h. The clonogenic capacity of progenitor cells was estimated by limiting dilution and colony counts. For all assays teeth stored in milk at 4°C showed the highest percentages of BCECF positive, attached cells with clonogenic capacity. Increased storage time (15–120 min) was associated with a 50% relative reduction of BCECF staining and a 5-fold relative reduction of cell attachment regardless of storage conditions. However, the clonogenic capacity of progenitor cells decreased 25-fold over the same duration of storage. These data demonstrate that in vitro assays of clonogenic capacity are much more sensitive to extra-oral storage time and storage conditions than dye inclusion or cell attachment. We suggest that in comparison with in vitro measures of cell membrane integrity, the clonogenic capacity of PL cells is more closely linked to tooth survival rate, probably reflecting the capacity of PL progenitor cells to recolonize the root surface after replantation.     

Chameleon voices: Interpreting for deaf parents

As interpreters for their deaf parents, hearing children are a cultural link between two often separate worlds: the Deaf and the Hearing. Data from a 4 year study of adult hearing children throughout the United States indicate significant differences between hearing daughters and hearing sons. Not only were daughters more likely than sons (regardless of birth order or age differences) to interpret for their parents, but daughters were also far more likely to be bilingual: fluent in both spoken English and American Sign Language. A similar gender bias has been observed among the general hearing public: women are far more likely to attend sign language classes and to work as interpreters for the deaf. This paper explores the social mechanisms and cultural values which determine the gender of the way we communicate with one another. Informants' narratives suggest that sign language and the practice of interpreting often touched upon a larger pattern of socialization and status differences between women and men. The discussion then turns to consider how these differences affect the cultural identity of hearing sons versus hearing daughters.     

大骨节病儿童手部X线征与年龄的关系

本文分析了2800例4～13岁大骨节病儿童掌指骨X线病变与年龄的关系,结果表明手部掌指骨干骺端X线征随年龄增加而趋于下降,骨端、骨骺、腕骨X线征的类型与检出率则随年龄而呈上升趋势,反映出大骨节病关节病变的范围有随年龄增长而扩大和增重的趋势。