肿瘤患者术后长时间皮下积液淋巴漏的放疗疗效分析

目的探讨肿瘤患者术后长时间皮下积液淋巴漏放疗疗效。方法 18例肿瘤患者手术后出现皮下积液淋巴漏,置管时间长达7天以上,每天引流量为15～92 ml,实行皮下清扫区域、引流区域的局部小剂量放疗。结果 18例患者放疗剂量为Dm 4.5～26.4 Gy,放疗2～11次后拔管,拔管后均未再出现皮下积液等,取得良好效果。结论小剂量放射治疗可以有效地治疗肿瘤患者术后长时间不愈的皮下积液淋巴漏。     

奈达铂每周方案同期适形放疗治疗局部晚期鼻咽癌的临床研究

目的：探讨周剂量奈达铂化疗同步适形放疗治疗局部晚期鼻咽癌的疗效及不良反应。方法：81例局部晚期鼻咽癌患者,随机分为奈达铂同期适形放疗组（CRT组）和单纯适形放疗组（RT组）。RT组患者仅行适形放疗,CRT组患者在适形放疗的基础上加用奈达铂。观察两组患者的近期疗效、远期疗效和不良反应。结果：鼻咽部肿块残存率：CRT组为12.2%（5/41）,RT组为20.0%（8/40）;颈部肿块残存率：CRT组为17.1%（7/41）,RT组为37.5%（15/40）,CRT组明显低于RT组（P〈0.05）;CRT组和RT组1、3年生存率分别为92.7%（38/41）、75.6%（31/41）和92.5%（37/40）、70.0%（28/40）（P〉0.05）。不良反应主要表现为白细胞减少和Ⅲ度口腔黏膜反应。结论：小剂量奈达铂每周化疗同步放疗可提高局部晚期鼻咽癌颈淋巴消除率,其不良反应可接受。     

阈下剂量氯胺酮用于臂丛神经阻滞镇痛镇静效果观察

目的观察阈下剂量（0．4mg／kg）加入局麻药用于臂丛神经阻滞的镇痛、镇静效果。方法60例ASA评级Ⅰ～Ⅱ级侄臂丛神经阻滞下的上肢手术患者,随机双肓法分为三组,每组20例,局麻药为0．375％布比卡因和1％利多卡因混合液20ml作肌间沟臂丛神经阻滞。A组：复合氯胺酮0．4mg／kg;B组：氯胺酮0．4mg／kg,肌注;C组：不用氯胺酮。记录麻醉起效时间、镇痛持续时间、术后12h、24h、48h视觉模拟评分（VAS）,注药后10min、30min的镇静／警觉评分（OAA／S）及麻醉期倒谵妄、多语、头晕、视物不清、呼吸抑制等不良反应。结果A组较其他两组麻醉起敬时间短,镇痛持续时间长;A组和B组术后12h、24h、48hVAS均低于C组,A组则更优于B组（P〈0．05）;A组和B组在注药后均有一定镇静作用,注药10rain后OAA／S评分A组较B组低（P〈0．05）,30rain后两组无明显区别（P〉0．05）;视物不清、头晕等发应率A组和B组无显著性差异（P〉0．05）,但较C组高（P〈0．05）。结论臂丛神经阻滞加用阈下剂量氯胺酮能缩短麻醉起效时间,有短时间的镇静作用,明显增强镇痛作用和延长术后镇痛时间。     

Characterization and pharmacokinetic analysis of aerosolized aqueous voriconazole solution

Invasive fungal infections in immunocompromised patients have high mortality rates despite current treatment modalities. This study was designed to evaluate the suitability of an aqueous solution of voriconazole solubilized with sulfobutyl ether-β-cyclodextrin for targeted drug delivery to the lungs via nebulization. A solution was prepared such that the inspired aerosol dose was isotonic with an acceptable mass median aerodynamic diameter of 2.98 μm and a fine particle fraction of 71.7%. Following single and multiple inhaled doses, high voriconazole concentrations were observed within 30 min in the lung tissue and plasma. Drug solubilization with sulfobutyl ether-β-cyclodextrin contributed to the rapid and high drug concentrations in plasma following inhalation. Maximal concentrations in the lung and plasma were 11.0 ± 1.6 μg/g wet lung weight and 7.9 ± 0.68 μg/mL, respectively, following a single inhaled dose with a corresponding tissue/plasma concentration ratio of 1.4 to 1. Following multiple inhaled doses, peak concentrations in lung tissue and plasma were 6.73 ± 3.64 μg/g wet lung weight and 2.32 ± 1.52 μg/mL, respectively. AUC values in lung tissue and plasma were also high. The clinically relevant observed pharmacokinetic parameters of inhaled aqueous solutions of voriconazole suggest that therapeutic outcomes could be benefitted through the use of inhaled voriconazole.     

CT扫描参数最优化 儿童患者辐射剂量最少化

儿童患者在CT检查中怎样有效减少辐射剂量,同时又能保证图像质量,作为从事放射工作人员应该充分认识。本文从CT检查辐射的危害性,优化扫描参数及降低GT检查辐射剂量的途径等方面加以综述。     

Estimation of Benchmark Rice Cadmium Doses as Threshold Values for Abnormal Urinary Findings with Adjustment for Consumption of Jinzu River Water

We performed this study to determine whether both eating cadmium (Cd)-polluted rice and drinking and/or cooking with Jinzu River water are associated with renal tubular dysfunction. A multiple logistic regression analysis of retrospective data indicated that both factors may contribute to this condition. Estimated threshold values of rice Cd concentration in men were 0.13–0.27 ppm and 0.09–0.18 ppm in women, without adjustment for use of Jinzu River water. The additional influence of drinking and/or cooking with Jinzu River water was estimated to be about 0.008 ppm.     

Longitudinal Mercury Monitoring within the Japanese and Korean Communities (United States): Implications for Exposure Determination and Public Health Protection

Background

Estimates of exposure to toxicants are predominantly obtained from single time-point data. Fish consumption guidance based on these data may be incomplete, as recommendations are unlikely to consider impact from factors such as intraindividual variability, seasonal differences in consumption behavior, and species consumed.

Objectives/methods

We studied populations of Korean (n = 108) and Japanese (n = 106) women living in the Puget Sound area in Washington State to estimate mercury exposure based on fish intake and hair Hg levels at two and three time points, respectively. Our goals were to examine changes in hair Hg levels, fish intake behavior, and Hg body burden over time; and to determine if data from multiple time points could improve guidance.

Results/conclusion

More than 50 fish species were consumed, with eight species representing approximately three-fourths of fish consumed by the Japanese and 10 species representing approximately four-fifths of fish intake by the Koreans. Fish species responsible for most Hg intake did not change over time; < 10 species accounted for most of the Hg body burden in each population. Longitudinal variability of hair Hg levels changed slowly across the study period. Japanese with hair Hg levels > 1.2 ppm (mean, 2.2 ppm) consumed approximately 150% more fish than those with levels ≤ 1.2 ppm (mean, 0.7 ppm). However, because many participants consumed substantial amounts of fish while having hair-Hg levels ≤ 1.2 ppm, the nutritional benefits offered from fish consumption should be obtainable without exceeding the RfD. We observed a 100% difference in fish intake between open-ended and 2-week recall fish consumption surveys. Open-ended survey data better represent Hg intake as determined from hair Hg levels. Single time-point fish intake data appear to be adequate for deriving guidance, but caution is warranted, as study is required to determine the significance of the different outcomes observed using the two survey time frames.     

Templated Open Flocs of Nanorods for Enhanced Pulmonary Delivery with Pressurized Metered Dose Inhalers

Purpose  A novel concept is presented for the formation of stable suspensions composed of low density flocs of high aspect ratio drug particles in hydrofluoroalkane (HFA) propellants, and for subdividing (templating) the flocs with aerosolized HFA droplets to achieve high fine particle fractions with a pressurized metered dose inhaler. Methods  Bovine serum albumin (BSA) nanorods, produced by thin film freezing (TFF), were added to HFA to form a suspension. Particle properties were analyzed with an Anderson cascade impactor (ACI), static and dynamic light scattering and optical microscopy. Results  The space filling flocs in HFA were stable against settling for one year. The pMDI produced high fine particle fractions (38–47%) with an emitted dose of 0.7 mg/actuation. The atomized HFA droplets break apart, that is template, the highly open flocs. Upon evaporation of HFA, capillary forces shrink the templated flocs to produce porous particles with optimal aerodynamic diameters for deep lung delivery. Conclusions  Open flocs composed of nanorods, stable against settling, may be templated during actuation with a pMDI to produce optimal aerodynamic diameters and high fine particle fractions. This concept is applicable to a wide variety of drugs without the need for surfactants or cosolvents to stabilize the primary particles.     

Characterization of acute adverse-effect profiles of selected antiepileptic drugs in the grip-strength test in mice

The aim of this study was to assess the acute adverse effects (neurotoxic) of several antiepileptic drugs (clonazepam, lamotrigine, oxcarbazepine, phenytoin, phenobarbital and topiramate) by measuring skeletal muscular strength in mice using the grip-strength test. Linear regression analysis of grip-strength in relation to drug dose-response allowed us to determine D₅₀ values, the dosages of antiepileptic drugs that reduced grip-strength in mice by 50% compared to control animals. Each of the antiepileptic drugs studied reduced skeletal muscular strength in mice in a dose-dependent manner. The D₅₀ for clonazepam was 31.7 mg/kg, lamotrigine – 47.7 mg/kg, oxcarbazepine – 87.3 mg/kg, phenobarbital – 128.7 mg/kg, phenytoin – 69.7 mg/kg, and topiramate – 509.5 mg/kg. In conclusion, the grip-strength test can aid in evaluating acute adverse effects of drugs with respect to their influence on muscular strength in experimental animals.     

咪哒唑仑对罗哌卡因致惊厥作用的影响

目的从致惊厥的行为学、安全性角度探讨咪哒唑仑对罗哌卡因致惊厥作用的影响。方法皮下注射咪哒唑仑20min后,腹腔注射罗哌卡因,观察小鼠惊厥潜伏期、持续时间、未惊厥率及其死亡率：并按序贯法分析咪哒唑仑对罗哌卡因致惊厥半数有效量（ED50）和半数致死量（LD50）的影响。结果0．5、1．0mg／kg咪哒唑仑可显著延长罗哌卡因致小鼠惊厥潜伏期（P〈0．05。P〈0．01）,显著缩短惊厥持续期（P〈0．01）,减少惊厥发生率和死亡率;且本试验剂量咪哒唑仑（0．2、1．0mg／mL与5．0、7．5mg／mL）可分别增大罗哌卡因致惊厥ED50和LD50。结论咪哒唑仑可缓解罗哌卡因的致惊厥作用,结果对临床联合用药有一定的参考意义。