Relation of uric acid levels to aortic root dilatation in hypertensive patients with and without metabolic syndrome

Objective:Uric acid(UA) is considered to be a powerful predictor of cardiovascular risk and hyperuricemia might be involved in the metabolic syndrome(MS).This study aims to investigate the relation between UA levels and aortic root dilatation.Methods:A total of 348 hypertensive patients [age(67.5±9.8) years] with or without MS were included in the study.The aortic root diameters at the aortic annulus,the sinuses of Valsalva,the sinotubular junction,and the proximal part of the ascending aorta were measured using a two-dimensional(2D) echocardiography.Serum UA levels were also measured for all patients.Results:A high UA level is independently associated with aortic root diameters at the sinuses of Valsalva(P=0.001) and the proximal ascending aorta(P0.0001) in the hypertensive patients without MS.In contrast,aortic root diameters were not significantly related to UA levels in the hypertensive patients with MS.Furthermore,increased UA levels were associated with an increased risk for aortic root dilatation in the patients without MS(sex-adjusted hazard ratio 1.75,95% confidence intervals(CI) 1.27-2.41),but not in those with MS.Conclusions:This study demonstrated an independent relationship between the aortic root dimensions and increased levels of serum UA in the hypertensive patients without MS.Further understanding of the mechanisms underlying these associations may allow a clearer interpretation of the potential value of specific urate-lowering treatment on cardiovascular disease.     

Pancreatic somatostatinoma with obscure inhibitory syndrome and mixed pathological pattern

Somatostatinoma is a very rare neuroendocrine tumor that originates from D cells and accounts for less than 1% of all gastrointestinal endocrine tumors. The duodenum is the most frequent site for this tumor, followed by the pancreas. We here describe a 46-year-old Chinese woman who developed pancreatic somatostatinoma presenting with the characteristic “inhibitory” syndrome, but the symptoms were obscure and seemingly uncorrelated. This case is also unique for its large tumor size and mixed pathological pattern. Distal pancreatectomy was performed, and the patient has remained well since operation. As the syndromes of somatostatinoma may be obscure and atypical, clinicians should review all clinical findings to obtain an accurate diagnosis. Aggressive surgery is preferred to improve the survival.     

A case of overlapping Bickerstaff＇s brainstem encephalitis and Guillain-Barre syndrome

Objective： There is no report on Bickerstaff s brainstem encephalitis （BBE） patients in China. We here report the first case of BBE in China. Methods： Clinical features, results of electromyography, eleetroencephalography （EEG）, magnetic resonance imaging （MRI） and cerebrospinal fluid （CSF） examination were studied to clarify the characteristics of this syndrome. Results： A 44-year-old man presented himself at our inpatient department with somnolence and dizziness as his initial symptoms. He developed multiple cranial nerves paralysis especially internal and external ophthalmoplegia, ataxia and tetraparesis within 1 week. His condition rapidly deteriorated, and he experienced coma. Electromyography showed indications of peripheral nerve dysfunction, electroencephalography revealed loss of basic rhythm, MR1 demonstrated high-intensity abnormalities on T2-weighted images of medulla oblongata, and CSF albuminocytological dissociation was defined abnormally as high protein. Ten months later, he almost completely recovered. Conclusion： BBE, fisher syndrome （FS） and Guillain-Barre syndrome （GBS） are similar clinically; BBE and FS were proposed to be the variant of GBS.     

A probiotic treatment containing Lactobacillus, Bifidobacterium and Enterococcus improves IBS symptoms in an open label trial

INTRODUCTION Irritable bowel syndrome (IBS) is the most common functional gastrointestinal disorder. The typical symptoms are abdominal pain, flatulence, and irregular bowel movement. Prevalence rates are re- ported to be as high as 30% in the general population (Drossman et al., 1982), corresponding to about 25%~50% of all patients who need gastroenterolo- gist’s help (Everhart and Renault, 1991). Despite this high prevalence, the cause of IBS is unknown. Many factors are likely to …     

肉鸡猝死的病因分析与防制措施

1肉鸡猝死综合症的临床诊断1.1临床症状本病多发生于3—5周龄的雏鸡。患病鸡突然发病,平衡失调,两翅猛烈扑打,肌肉强痉挛,尖叫翻滚,呈仰卧姿势,头颈扭曲而亡。从发病到死亡经过不足一分钟。多发于生长快、外表健康、体状良好的鸡只。1.2病理变化对患病死亡后的鸡只剖检,发现冠髯和泄殖粘膜及脾脏充血,全身肌肉苍白,消化道内充满食物,肝脏肿大、质地易碎;肺肿大,弥漫淤血水肿,呈暗红色,气管内有泡沫状渗出物;心脏明显增大2—4倍,心肌松软,心包渗出液增多,静脉怒张。采集病料进行微生物培养阴性。1.3鉴别诊断本病与澳大利亚报道的肉鸡峰型死亡…     

Training reading and phoneme awareness skills in children with Down syndrome

The authors report a short-term reading intervention study involving 15 children with Down syndrome (DS) who attended mainstream schools. The intervention programme taught children phoneme segmentation and blending skills in the context of learning letter-sounds and working with words in books. The children were taught by their learning support assistants, who received special training for this purpose. Compared to a waiting group, a group of eight children with DS improved significantly on measures of early literacy skills (letter-sound knowledge, Early Word Recognition) following eight weeks of intervention. The waiting group started to make progress once they received the intervention. Both groups maintained progress on the literacy measures five months after the intervention had finished. The results suggest that children with DS can benefit from structured, phonics-based reading intervention.     

The role of output speech in literacy acquisition: Evidence from congenital anarthria

A case study of literacy acquisition in acongenitally speechless child (SM) isreported. In spite of a complete oral apraxia(due to bilateral focal brain damage), SMdeveloped normal intelligence and acquired complete mastery of reading and writing skills.Furthermore, both his verbal memory andmetaphonological skills were surprisinglypreserved. However, he showed a relativeimpairment in writing non-words. Theimplications of these findings for thedevelopmental interactions between language andliteracy are discussed.     

Polymorphisms in genes involved in folate metabolism as maternal risk factors for Down syndrome in China

Objective: To explore the relationship between genetic polymorphisms in methylenetetrahydrofolate reductase (MTHFR), methionine synthase reductase (MTRR), the central enzymes in folate metabolism that affects DNA methylation and synthesis, and the risk of Down syndrome in China. Methods: Genomic DNA was isolated from the peripheral lymphocytes of 64 mothers of children with Down syndrome and 70 age matched control subjects. Polymerase chain reaction and restriction fragment length polymorphism were used to examine the polymorphisms of MTHFR 677C→T, MTRR 66A→G and the relationship between these genotypes and the risk of Down syndrome was analyzed. Results: The results show that the MTHFR 677C→T polymorphism is more prevalent among mothers of children with Down syndrome than among control mothers, with an odds ratio of 3.78 (95% confidence interval (CI), 1.78～8.47). In addition, the homozygous MTRR 66A→G polymorphism was independently associated with a 5.2-fold increase in estimated risk (95% CI, 1.90～14.22). The combined presence of both polymorphisms was associated with a greater risk of Down syndrome than the presence of either alone, with an odds ratio of 6.0 (95% CI, 2.058～17.496).The two polymorphisms appear to act without a multiplicative interaction. Conclusion: MTHFR and MTRR gene mutation alleles are related to Down syndrome, and CT, TT and GG gene mutation types increase the risk of Down syndrome.     

更年期综合征的中医辨证疗法举隅

更年期是人生的重要阶段，是生命之秋，也是多病多难之时。更年期综合征的临床常见证型有：肝肾阴虚型，脾肾阳虚型，心脾两虚型，肝郁脾虚型。准确的辨证是治疗本病的关键，治以“绝经后着重在脾”为要点，     

慢性疲劳综合症的神经内分泌免疫研究进展

慢性疲劳综合症是现代医学新认识的疾病,发病机制复杂.最近研究发现,细胞免疫功能和细胞因子表达的异常、内分泌功能的紊乱以及神经系统功能的异常可能参与该病的病理机制,因此神经内分泌免疫系统的失调是引发慢性疲劳综合症的重要因素.