COMPARATIVE EFFICACY AND TOLERABILITY OF NISOLDIPINE COAT CORE AND HYDROCHLOROTHIAZIDE IN MILD-TO-MODERATE HYPERTENSION

This study compared the efficacy and tolerability of nisoldipine coat core (CC) 10-40 mg o.d. and hydrochlorothiazide (HCTZ) 25-50 mg o.d. Patients with mild-to-moderate essential hypertension received either nisoldipine CC 10 mg o.d. or HCTZ 25 mg o.d. Treatment was titrated at two-weekly intervals as necessary. The primary efficacy endpoint was a defined reduction in diastolic blood pressure (DBP). Response rates were similar for both the nisoldipine CC- and HCTZ-treated groups (74% and 70%, respectively). Secondary efficacy endpoints were reductions in both diastolic and systolic blood pressures (SBP). At treatment endpoint, the change from baseline in SBP was 16.2 mmHg for the nisoldipine CC group and 14.9 mmHg for the HCTZ group. Both drugs were well tolerated, and adverse events were generally minor and typical of these antihypertensive agents. Drug-related adverse events were greater in the nisoldipine CC- than the HCTZ-treated patients (50% and 37%, respectively). Nisoldipine CC was shown to demonstrate antihypertensive efficacy similar to HCTZ in the treatment of mild-to-moderate hypertension.     

犬自体肺组织瓣修补食管壁部分缺损的可行性

目的:分析犬自体肺组织瓣修补食管壁部分缺损的可行性。方法:实验于2003-01/2004-11在中国医科大学附属第二医院动物实验室完成。选用健康成年杂种犬20只,按随机数字表法分为2组,即支架组和无支架组,每组10只。20只实验犬经右胸第5肋间进胸,于胸内中段食管处胸内食管侧壁制成长4cm,环1/2~2/3周径全层缺损。于相应部位选择适当的肺组织,制成带蒂类舌状肺组织瓣。两组均将肺组织瓣覆盖并缝合固定于食管缺损处,支架组于食管缺损内衬自扩性记忆合金支架(管腔直径2.0cm、长6.0cm)并固定。术后抗炎及营养支持治疗。观察实验犬术后情况,并于术后2,4,6,8,10和12周定期处死实验犬行组织学观察。结果:无支架组实验犬存活7只,其中1只犬存活>24个月;支架组存活6只。①实验犬术后一般情况:存活犬于术后均能正常经口进食,早期有进食后呕吐,再吃下呕吐食物的现象,以支架组明显。②组织学观察结果:术后2周,无支架组均可见替代物表面有胶原及炎性渗出物,边缘见1~2层鳞状上皮细胞;支架组除有无支架组基本表现外,可见支架固定良好,光镜下见网架压迫处有较多中性粒细胞浸润。4~6周,两组均可见替代物表面有新生的3~5层复层鳞状上皮细胞;支架组见支架已基本陷入黏膜层内。8~10周,两组均可见管腔表面有6~8层新生复层鳞状上皮细胞;支架组网架边缘瘢痕组织增生,支架完全被包裹,炎症较重的局部有细胞爬行中断现象或新生细胞层数较薄,多为一两层。结论:应用自体肺组织瓣修补食管壁部分缺损是可行的,但支架组支架对食管修补处组织刺激大,炎性反应重,瘢痕重,因此如何选择合适的支撑物是今后替代节段性食管缺损面临的重要问题。     

Improvement of platelet storage conditions by using new polyolefin containers

BACKGROUND : Storage of pooled platelet concentrates (PCs) with yields above 3.0 × 10¹¹ platelets per unit in a 1-L PL-732 polyolefin container for 5 days often results in a drop in pH to below 6.0. Recently, new oxygen-permeable platelet containers (1-L PL-2410, 1-L and 1.5-L Compoflex) have been developed. The maximal platelet storage capacities of the new containers and the PL-732 were compared. STUDY DESIGN AND METHODS : Large platelet pools (n = 27) with platelet concentrations between 1.2 and 1.4 × 10¹¹ per L were made from 3 to 5 PCs prepared from buffy coats. The pools were divided in equal volumes among the PL-732 and the three new platelet containers. Platelet counts in the PCs ranged from 1.0 to 5.0 × 10¹¹ per unit. All PCs were stored on a flatbed shaker at 22 ± 2°C and evaluated on Days 1, 3, 5, and 7 by measuring platelet count, pH, pO₂, pCO₂, HCO₃-, glucose, lactate, platelet swirling, and soluble p-selectin. RESULTS : Day 7 storage of PCs (n = 6) with yields between 3.0 and 4.0 × 10¹¹ platelets in PL-732 showed mean ± SD pH values of 5.93 ± 0.05 and lactate values of 32.3 ± 7.9 mmol per L; in 4 of these 6 PCs, pH was below 6.0. In contrast, storage of these PCs in 1-L PL-2410 and 1.5-L Compoflex containers and of 2 of these 6 PCs in 1-L Compoflex containers showed pH values above 6.8. Lactate values were 15.5 ± 1.3, 15.3 ± 1.8, and 19.5 ± 4.7 mmol per L, respectively (p < 0.001 vs. PL-732). The platelet storage capacity of the new containers with platelet yields between 4.0 and 5.0 × 10¹¹ per unit (n = 6) was evaluated. Day 7 storage of these PCs in the 1.5-L Compoflex showed an average pH value of 6.74 ± 0.20; in 2 of 6 PCs, pH was below 6.8. The average pH value in the PL-2410 was 6.38 ± 0.31, and in all PCs, pH was below 6.8. Average lactate values were 17.8 ± 5.7 and 25.8 ± 5.6 mmol per L (p < 0.05), respectively. Soluble p-selectin values on Day 7 of storage increased approximately twofold in all PCs. CONCLUSION : The new oxygen-permeable containers showed platelet quality comparable to that with the PL-732 and for longer storage periods and at higher platelet counts.