3例美罗华鞘注治疗中枢神经系统非霍奇金淋巴瘤临床分析

目的 探讨美罗华鞘注治疗中枢神经系统非霍奇金淋巴瘤的有效性和安全性.方法 3例(1例原发,2例继发)具有中枢神经系统侵犯和对化疗耐药的复发性非霍奇金B细胞淋巴瘤(B细胞 NHL)患者,接受了鞘内注射美罗华(intrathecal rituximab,IT RTX)治疗;采用RTX递增剂量20～50mg,每周1次,连续6～8周用药.结果 在应用药物第2～3周后患者临床症状明显改善,脑脊液(CSF)中淋巴细胞清除,治疗后2个月行头颅MRI扫描显示,脑膜或者脑实质内淋巴瘤浸润性病灶明显缩小或者消失.结论 结果表明IT RTX方法治疗难治/复发性中枢神经系统B细胞NHL是安全、有效的.     

小儿急性淋巴细胞白血病中枢神经系统白血病诊治现状

中枢神经系统白血病(CNSL)的防治是小儿急性淋巴细胞白血病(ALL)治疗的一部分。诊断时高白细胞计数、T细胞型及分子遗传学为t(4;11)和Ph 是CNS复发的危险因素,脑脊液不同检查结果的预后价值有待明确。头颅放疗已不用于标危ALL患儿,头颅放疗的预防剂量已减为12Gy,鞘内及全身化疗对CNSL的治疗有重要作用。部分小儿CNS复发经挽救治疗可以长期存活,早期CNS复发的患儿应在第2次CR期进行异基因骨髓移植。     

经外周置入中心静脉导管与周围静脉留置针在危重新生儿中应用效果比较

目的评价经外周置入中心静脉导管(PICC)和周围静脉留置针(PIV)在危重新生儿静脉输液中的临床效果。方法回顾性总结2001年8月至2007年2月113例放置PICC和102例置PIV的新生儿的临床资料,比较两组的临床应用情况。结果PICC组置管期间并发症的发生率为31.6%,PIV组为70.4%,两组差异有统计学意义(P<0.05)。PICC组静脉治疗持续时间为(22.5±13.4)d,PIV组静脉治疗持续时间为(14.7±9.6)d,两组差异有统计学意义(P<0.05)。置管期间PICC组患儿的体重增长为(16.6±12.5)g/d,PIV组体重增长为(14.4±22.1)g/d,差异无统计学意义(P>0.05)。结论PICC可显著减少静脉导管相关并发症的发生和静脉穿刺的次数,延长静脉留置时间。     

新型提神醒脑药物莫达非尼的合成

以二苯甲基氯和巯基乙酸乙酯为起始原料,经醚化,氨解,氧化三步反应得到新型提神醒脑药物莫达非尼（１）,总收率：４１％,实验结果表明：该方法具有合成路线短,反应条件温和,产物易纯化,收率高等优点,完全适合工业化生产。     

Positron Emission Tomography in Patients with Primary CNS Lymphomas

This article reviews possible clinical applications of positron emission tomography (PET) in patients with CNS lymphomas. PET allows quantitative assessment of brain tumor pathophysiology and biochemistry in vivo. Therefore, it provides different information about tumors when compared to histological or neuroradiological methods. In a diagnostic setting, PET cannot differentiate between primary lymphomas of the CNS, brain secondaries, or malignant gliomas, since various brain tumors share biochemical alterations. In HIV patients with contrast-enhancing brain tumors, however, data from the literature suggest that PET with the tracer F-18 fluoro-deoxyglucose may help to discriminate neoplastic (CNS lymphoma) from inflammatory (e.g. toxoplasmosis) lesions. Assuming that tumor biochemistry is highly abnormal in the most malignant parts of tumors, PET may also assist in defining targets for stereotactic biopsy. With regard to treatment evaluation, the prediction of individual treatment response is among the most challenging clinical applications of PET. On the one hand, this could be achieved on the basis of measures like tumor perfusion, oxygen consumption, or hypoxia. On the other hand, PET tracer methods may allow to quantify the expression of gene products following gene therapy. However, in CNS lymphoma patients these topics have yet not been addressed with PET.     

视网膜静脉阻塞患眼振荡电位的频域和时域分析

目的：探讨视网膜静脉分支阻塞和中央静脉阻塞患眼振荡电位的频域和时域参数及其临床应用。方法：测定了ＢＲＶＯ９例９只眼,ＣＲＶＯ９例９只眼和４０只正常眼的ＯＰＳ,并经快速富里叶变换昨到ＯＰＳ的频谱。对ＢＲＶＯ、ＣＲＶ患眼和正常眼的ＯＰＳ频域和时域各参数进行了比较。结果：与正常对照眼比较ＢＲＶＯ患眼的ＯＰＳ在１１０－２５０ＨＺ频率范围内主频率显著下降;平均频谱的幅度、总功率、最大振幅和最大功率无显著改变     

Pharmacological reversal of behavioral and cellular indices of cocaine sensitization in the rat

Rationale and objectives: Behavioral sensitization has been proposed as an animal model for the intensification of drug craving in cocaine addiction. Interactions between dopamine and glutamate systems are important for the induction and maintenance of sensitization. The goal of this study was to determine if established cocaine sensitization could be reversed by pharmacological manipulation of these transmitter systems. Methods: Rats received 15 mg/kg cocaine (IP) on days 1–10 and were challenged with cocaine (10 mg/kg) on day 13 to verify that sensitization had occurred. On days 14–20, separate groups of sensitized rats received daily injections of dopamine D₁- or D₂-class agonists, an NMDA receptor antagonist, or a dopamine agonist with an NMDA antagonist. Three days or 2 weeks later, all rats were again tested for their response to cocaine to determine if sensitization had been reversed. Results: Reversal of sensitization was produced by repeated administration of either a D₁-class agonist (SKF 81297) or the combination of an NMDA receptor antagonist and a D₂-class agonist. Effective combinations were cocaine+MK-801, quinpirole+MK-801, quinpirole+CGS 19755, and pergolide+memantine. The latter drugs are approved for human use. Reversal of sensitization persisted for at least 2 weeks after cessation of drug treatment. Electrophysiological studies revealed that these drug treatments also reversed dopamine D₁ receptor supersensitivity in the nucleus accumbens, a cellular correlate of sensitization. Conclusions: These results demonstrate that pharmacotherapy can reverse behavioral and cellular adaptations associated with repeated cocaine administration, and may do so without the need for continued medication. Received: 1 October 1999 / Accepted: 19 March 2000     

47例99mTc-ECD脑血流灌注显像结果分析

目的：评价脑血流灌注显像在各种神经系统疾病中诊断价值。方法：对４７例脑外伤、脑血管病等神经系统疾病进行９９ｍＴｃ标记双半胱乙酯（９９ｍＴｃＥＣＤ）脑血流灌注断层显像,部分检查和ＣＴ进行比较。结果：１０例轻度脑外伤和４例脑挫裂伤显示局部脑血流量（ｒＣＢＦ）减少,在１５例轻度脑外伤,单光子断层成像（ＳＰＥＣＴ）和ＣＴ诊断阳性率分别为４０％和１３％;１１例脑血管病中９例显示病灶处ｒＣＢＦ减少,其中５例出现交叉性神经功能联系中断。在１１例脑血管病中ＳＰＥＣＴ和ＣＴ阳性率分别为８２％和７３％。另有老年性痴呆、癫痫和偏头痛各１例显示ｒＣＢＦ异常。结论：９９ｍＴｃＥＣＤ脑血流灌注显像对中枢神经疾病的诊断和研究有重要意义。