贞芪益肾颗粒治疗慢性肾炎气阴两虚兼湿热证疗效观察

目的 :观察贞芪益肾颗粒治疗慢性肾小球肾炎气阴两虚兼湿热证的疗效。方法 :采用随机、双盲双模拟、对照方法 ,治疗组 2 8例患者服用贞芪益肾颗粒加空白模拟片 ,对照组 2 6例患者服用肾炎康复片加空白模拟颗粒。观察两组患者治疗前后中医证候积分值、尿蛋白及尿红细胞的变化情况。结果 :治疗组临床总有效率为 82 .1% ,尿蛋白总有效率为 85 .7% ;对照组均为 6 5 .4 % ,治疗组疗效优于对照组。治疗组尿红细胞总有效率为 6 8.8% ,对照组为 6 1.5 % ,两组疗效比较 ,差异无显著性。两组患者中医证候积分值治疗后均明显下降 (P <0 .0 1) ,且治疗组较对照组下降更为明显 (P <0 .0 5 )。结论 :贞芪益肾颗粒能明显改善慢性肾小球肾炎气阴两虚兼湿热证的临床表现 ,降低尿中蛋白和红细胞数量     

养阴抗毒胶囊对糖皮质激素致阴虚大鼠血浆ACTH、CORT的影响

目的:探讨养阴抗毒胶囊2号(YC2)防治糖皮质激素(GC)不良反应的机制。方法:SD大鼠60只,随机分为空白对照组,阴虚模型组,YC2(高)、(中)、(低)组,六味地黄丸组。在中药预处理及模型复制给药9 d后,取血,用放射免疫方法检测各组血浆促肾上腺皮质激素(ACTH)及皮质醇(CORT)的含量。结果:阴虚模型组ACTH及CORT含量明显高于空白对照组,各中药组血浆ACTH及CORT含量均不同程度低于阴虚模型组。结论:GC所致“阴虚”证与下丘脑-垂体-肾上腺轴(HPA)功能亢进密切相关,YC2明显改善GC作用下HPA轴功能亢进的状态,可能是其预防和治疗GC不良反应的机制之一。     

猪生殖与呼吸综合征病毒HN6株ORF5基因的克隆及其在大肠杆菌中的表达

用RT-PCR方法从河南分离的1株(HN6)猪生殖与呼吸综合征病毒(PRRSV)核酸中扩增缺失N端疏水序列的基因片段dORF5(deleting ORF5),并将其克隆到pMD18-T载体中测序,再亚克隆到原核表达载体pET-32a上。重组质粒转化大肠杆菌BL21,用不同浓度IPTG分别于37℃诱导,经SDS-PAGE分析,所表达的融合蛋白的分子质量约31.4 ku,薄层扫描分析显示,表达量占菌体总蛋白含量的28.8%。Western-blotting结果表明,重组蛋白可被PRRSV阳性血清所识别。证实,该蛋白可用于PRRSV的诊断。     

KCNE、KCNQ1与心性猝死的相关性研究进展

部分心性猝死由于缺乏明确的病理学改变,其鉴定工作一直是法医工作者的一大难题。近年来,与长QT综合征、心房颤动等致死性心律失常疾病相关基因（KCNE基因家族与KCNQl）等研究逐渐增多。国内外研究发现KCNE和KCNQ1基因编码心肌钾离子通道,其基因异常可引起严重的心律失常,甚至导致心性猝死。因此,死后KCNE和KCNQl的基因检测对于心性猝死鉴定具有重要意义。本文对KCNE、KCNQl与心性猝死的相关性研究进展进行综述,希望能为法医学研究和实践提供参考。     

Exploring gender differences in constellations of problem behaviors and associated health-related factors during adolescence

Using data from the National Longitudinal Study of Adolescent Health (Add Health), this study expands on previous research on adolescent problem behavior by (1) examining gender differences in patterns or ‘subgroups’ of adolescents based on self-reported problem behaviors and (2) identifying differences in health-related factors including service utilization, physical and mental health, and violent victimization across the identified gender-specific subgroups. The data used in this study were taken from Wave 2 of the National Longitudinal Study of Adolescent Health (Add Health) data and includes respondents under the age of 18 (n?=?10,360). Based on 16 problem behavior items measuring delinquency, substance use, risky sexual practices, and status offending, latent class analyses identified a 4-class model for the male subsample and a 3-class model for the female subsample. Important differences in health-related factors were observed across the latent classes. However, these differences were fairly consistent for boys and girls. Implications for prevention and intervention strategies, specifically focusing on the intersection of juvenile justice and public health services, are discussed.     

A Review of the Forensic Implications of Pica

Pica is characterized by the persistent eating of non‐nutritive substances over some time that is inappropriate for the maturation stage of the individual and is not culturally sanctioned. A 9‐year‐old boy with Goldenhar syndrome, significant developmental delay and pica, collapsed and died after a short history of diarrhea and vomiting. Death was due to a sigmoid volvulus resulting from filling of the distal colon with feces containing dirt, stones, and rice with evidence of ischemic intestinal necrosis. Lethal complications of pica include intestinal obstruction and perforation with peritonitis and generalized sepsis. Other findings at autopsy may include airway obstruction, heavy metal poisoning, and parasitic infestation. Presenting symptoms and signs of such complications may be subtle or masked given the nature of underlying conditions, and so careful evaluation of the medical histories of individuals with pica may be necessary to provide pertinent details of associated medical and psychiatric conditions.     

青壮年猝死综合征SCN2B、SCN4B基因检测

目的寻找SCN2B、SCN4B基因的变异位点,探讨其与青壮年不明原因夜间睡眠中猝死(SMDS)的关系。方法提取SMDS病例组及健康对照组的基因组DNA,采用聚合酶链式反应(PCR)方法扩增SCN2B、SCN4B基因编码区外显子、外显子-内含子交界区以及3'侧翼区序列,直接行DNA测序以明确遗传变异类型。结果在病例组中共检测到4个变异位点,c.237+27AG,c.*38CT,c.174CT(p.C58C)和c.*7CT。结论本研究首次对中国人SMDS病例进行了SCN2B、SCN4B基因的检测,上述基因是否为中国人SMDS的易感基因尚有待进一步研究证实。     

The Etiology of Basal Vacuolizations in Renal Tubular Epithelial Cells Evaluated in an Isolated Perfused Kidney Model

To determine whether basal lipid vacuolization characteristic of ketoacidosis could be induced with short‐term hypertriglyceridemia, adult Sprague Dawley rat kidneys were perfused in an isolated perfused kidney model with, and without, 11.3 mM (10 g/L) of triglycerides in Krebs‐Henseleit buffer, for 1 and 2 h (n = 5/group). Additional treatments included perfusion with triglycerides with 20 mM of β‐hydroxybutyrate and 2 mM of acetoacetate (n = 5) and perfusion with triglycerides with 70 mM of glucose (n = 1). Basal vacuolization was produced in all groups, but differed in morphology to that reported in postmortem studies. There was no further increase in vacuolization after 2 h of perfusion compared to 1 h (p = 0.24), and the addition of ketones did not alter the morphology or extent of vacuolization. This study using an ex vivo model has confirmed that isolated hypertriglyceridemia is sufficient to cause basal lipid vacuolization in renal tubular epithelial cells, but with different morphology to vacuoles observed in lethal ketoacidosis at autopsy.     

Sudden and Unexpected Death in Three Cases of Ehlers‐Danlos Syndrome Type IV*

Abstract: Ehlers–Danlos syndrome (EDS) type IV is a connective tissue disorder characterized by the inability to produce sufficient amounts of collagen or a defect in the structure of collagen. The most serious complications include a rupture of a viscus or vascular rupture with or without mural dissection. Death may result from internal hemorrhage. This report describes three cases of sudden and unexpected death caused by EDS type IV. Two cases involved hemothorax as a result of dissection of the subclavian artery and aorta, respectively. The third case represented spontaneous pulmonary rupture and hemorrhage. A detailed family history should be sought, and additional specimens collected to confirm the diagnosis, including skin fibroblasts for collagen testing and blood for DNA testing. The forensic pathologist should consider the possibility of EDS type IV upon discovery of spontaneous visceral or arterial rupture and should alert the family members of this hereditary and potentially fatal condition.     

Two Fatal Cases of Hidden Pneumonia in Young People*

Abstract: Acute respiratory distress syndrome (ARDS) is a severe lung disease characterized by inflammation of the lung parenchyma leading to impaired gas exchange. This condition is often lethal, usually requiring mechanical ventilation and admission to an intensive care unit. We present two fatal cases of hidden pneumonia in young people and discuss the pathophysiological mechanism of ARDS with reference to the histological pattern. A complete forensic approach by means of autopsy and histological, immunohistochemical, and microbiological, examination was carried out. In both cases the cause of death was cardio‐respiratory failure following an acute bilateral pneumonia with diffuse alveolar damage and ARDS associated with sepsis and disseminated intravascular coagulation. Our cases suggest on one side the importance of an early diagnosis to avoid unexpected death while on the other that the diagnosis of ARDS has to be confirmed on the basis of a careful postmortem examination and a complete microscopy and microbiological study.