Congenital abnormalities of the aortic arch: MR imaging

Thirty-four patients, 1 month to 63 years old, with known or suspected congenital abnormalities of the aortic arch underwent magnetic resonance (MR) imaging. Sixteen patients were studied retrospectively, 18 prospectively. In all retrospective studies, the aortic arch abnormality was seen with MR imaging. In the prospective studies, MR imaging enabled diagnosis in 15 of 18 (83%) patients. Twenty-nine of 34 patients underwent two-dimensional echocardiography; nine were studied retrospectively, 20 prospectively. In the prospective studies, echocardiography enabled diagnosis in 13 of 20 (65%) patients. Although two-dimensional echocardiography has a high sensitivity in the detection of aortic arch abnormalities in the neonate, arch abnormalities in the neonate, its sensitivity is lower in older children, adults, and postoperative patients. The authors' experience shows that MR imaging is an important, noninvasive modality in the evaluation of older children, adults, and postoperative patients with congenital aortic arch abnormalities.     

Anxiety in patients undergoing MR imaging

To determine and quantify the major sources of anxiety for patients undergoing magnetic resonance (MR) imaging and to suggest means by which to eliminate or diminish their negative effects, the authors studied anxiety in 46 subjects. Of these, 20 randomly selected subjects who successfully completed the examination participated in exit interviews. Six subjects who terminated the examination before completion also completed exit interviews. Pre-imaging and postimaging questionnaires (state-trait anxiety inventory) were administered to measure anxiety in the 20 other subjects. Anxiety was associated with the constrictive dimensions of the magnet bore, examination duration, coil noise, and temperature within the bore. Preparation at the point of referral was consistently absent, incomplete, or misleading. Patients used identifiable strategies to cope with the examination: blinding, breathing relaxation techniques, visualization of pleasant images, and performance of mental exercises.     

Codeine concentrations in human samples in a case of fatal ingestion

Summary Capillary gas chromatography coupled to mass spectrometry was employed to quantify codeine in biological fluids and tissues in a death attributed to oral codeine ingestion. The blood concentration of codeine was 22.1 mg/1. Results are discussed in the light of the existing literature.     

雷公藤春碱和雷公藤新碱的免疫抑制作用

雷公藤春碱(wilfortrine)和雷公藤新碱(euonine)ip 40及80 mg/kg对以溶血素反应为指标的体液免疫具有明显的抑制作。用雷公藤春碱ip 160mg/kg对GVHR为指标的细胞免疫也具有抑制作用。雷公藤新碱对DNCB所引起迟发超敏反应具有显著的抑制作用,并且能够降低小鼠碳廓清率和脾脏、胸腺的重量。     

Bronchial artery embolization: monitoring with somatosensory evoked potentials. Work in progress

Surgery remains the treatment of choice for massive and recurrent hemoptysis. In some instances, however, immediate surgical intervention is contraindicated. In these situations, bronchial artery embolization (BAE) has proved to be a successful definitive treatment for non-surgical candidates and a palliative therapy in patients requiring hemodynamic stabilization prior to surgery. The most serious complication of BAE is spinal cord ischemia. This relates directly to the potential anastomotic connections between the bronchial circulation and the anterior spinal artery. Somatosensory evoked potentials (SSEPs) have been used in the past to monitor spinal cord ischemia during procedures that threaten the vascularity of the spinal cord. The authors report two cases in which SSEPs were employed to monitor spinal cord ischemia during bronchial artery embolization.     

蜂胶乔松素对脂多糖诱导人脐静脉内皮细胞的保护作用

目的:观察蜂胶乔松素对脂多糖诱导人脐静脉内皮细胞的影响,探讨其对人脐静脉内皮细胞可能的保护作用。方法:实验于2006-03/10在泰山医学院生命科学研究所(省重点实验室)完成。①实验材料:取出生1h内新生儿脐带,患者知情同意。②实验分组及方法:培养人脐静脉内皮细胞,建立脂多糖损伤模型(以10mg/L的脂多糖培养液培养细胞12h),实验分为空白对照组(加等量D-Hank’s液)、脂多糖组(10mg/L)、乔松素组(加10mg/L脂多糖预孵育12h后,按50,100,200mg/L分别加入乔松素),各组设8个复孔,共同孵育24h。③实验评估:光镜下观察细胞形态,MTT法观察乔松素对人脐静脉内皮细胞活性的影响,ELISA方法检测培养上清中血管假血友病因子的含量,TUNEL检测细胞凋亡率。结果:①细胞形态:空白对照组细胞紧密贴壁,呈铺路石状生长。脂多糖组可见多数细胞呈圆形;乔松素组见上述细胞较脂多糖组明显减少。②乔松素对人脐静脉内皮细胞活性、凋亡及血管假血友病因子含量的影响:与对照组比较,脂多糖组能明显诱导人脐静脉内皮细胞的凋亡(P<0.01),不同浓度乔松素组可改善内皮细胞形态,组织活性明显升高(P<0.05),同时抑制内皮细胞血管假血友病因子的释放(P<0.05),使脂多糖诱导的人脐静脉内皮细胞凋亡细胞数明显减少(P<0.05)。结论:乔松素能增强人脐静脉内皮细胞活性,抑制脂多糖诱导人脐静脉内皮细胞的凋亡,从而发挥可能的内皮细胞保护功能。     

SEVENTY-TWO HOUR COMPARISON OF METHYLPREDNISOLONE SULEPTANATE AND METHYLPREDNISOLONE SODIUM SUCCINATE IN PATIENTS WITH ACUTE ASTHMA

SUMMARY The efficacy and safety of the methylprednisolone prodrugs methylprednisolone suleptanate and methylprednisolone sodium succinate were evaluated in a multicentre, randomised, double-blind, double-dummy parallel study of 88 patients hospitalised with acute asthma. Each study drug was administered as a bolus intravenous injection of 40mg methylprednisolone equivalents every 6 hours for 48 hours. Methylprednisolone 32mg was administered orally 6 hours after the last dose. Pulmonary function, medical events, and clinical laboratory values were assessed at predefined intervals before and during the 72-hour study. The primary response measure of pulmonary function was per cent predicted forced expiratory volume in one second (FEV₁) at 48 hours. Secondary response measures were peak expiratory flow rate (PEFR) and FEV₁/forced vital capacity (FVC) ratio. Although both drugs demonstrated within-group mean changes from baseline (starting at 6 hours) that were statistically significant for each response, there were no statistically significant differences between the two groups. The mean percent predicted FEV₁ at 48 hours and mean per cent change from baseline were 64% and 13% (p<0.0001) for the methylprednisolone suleptanate group and 67% and 17% (p<0.0001) for the methylprednisolone sodium succinate group, respectively. The mean PEFR and FEV₁/FVC ratio at 48 hours were 5.77 l/s and 73% for the methylprednisolone suleptanate group and 5.78 l/s and 76% for the methylprednisolone sodium succinate group, respectively. There were no clinically or statistically significant between-group differences in any of the safety parameters. In this study, methylprednisolone suleptanate and methylprednisolone sodium succinate have been shown to be therapeutically equivalent in the treatment of patients hospitalized with acute asthma.     

转化生长因子β1在大鼠纤维化腹膜组织中的表达及作用

目的:检测转化生长因子β1在腹膜透析大鼠腹膜内表达,并探讨其在腹膜纤维化中的意义。方法:实验于2005-06/2006-03在中南大学湘雅二医院肾内科实验室完成。①实验材料:雄性SD大鼠,体质量180～240g,由中南大学湘雅二医院动物实验中心提供。②实验方法:将28只大鼠按随机数字表随机分为4组,每组7只。正常对照组不予任何干预;生理盐水组腹腔注射20mL生理盐水;低糖透析液组腹腔注射20mL1.5%葡萄糖透析液;高糖透析液组腹腔注射20mL4.25%葡萄糖透析液,均为1次/d。4周后,向大鼠腹腔注射4.25%葡萄糖腹膜透析液20mL,4h后于大鼠右下腹缓慢插入带有多个侧孔的10号静脉留置针,缓慢低位引流腹透液,量取引流液。③实验评估:取大鼠壁层腹膜组织,以苏木素-伊红染色,镜下测量腹膜厚度,采用免疫组织化学方法检测大鼠腹膜中转化生长因子β1及纤连蛋白。结果:28只大鼠均进入结果分析。①高糖透析液组、低糖透析液组超滤量均明显低于正常对照组与生理盐水组,并且高糖透析液组超滤量明显少于低糖透析液组(P均<0.05)。②高糖透析液组腹膜明显增厚,表面粗糙,间皮细胞肿胀,脱落,间皮下有大量血管生成以及胶原纤维沉积,还可见单核细胞等炎症细胞浸润,与其他组比较,腹膜厚度明显增加(P<0.05)。③高糖透析液组转化生长因子β1、纤连蛋白表达量均明显高于其他组;低糖透析液组转化生长因子β1、纤连蛋白表达量均明显高于正常对照组与生理盐水组(P<0.05)。④大鼠腹膜组织转化生长因子β1蛋白与纤连蛋白表达量、腹膜厚度之间呈明显的正相关(r=0.86,0.83,P<0.05)。结论:葡萄糖透析液可诱导腹膜组织转化生长因子β1明显上调,腹膜转化生长因子β1高表达与腹膜透析腹膜纤维化密切相关。