丙戊酸钠致血小板减少性紫癜8例临床分析

目的探讨丙戊酸钠致血小板减少性紫癜可能发生机制.方法对8例患儿服用丙戊酸钠在(3～5.5)个月内相继全身出现紫癜样皮诊进行血小板计数,出血时间和药物血浓度监测.结果服用丙戊酸钠3～5.5个月全身出现紫癜样皮疹患儿血小板计数明显降低,出血时间延长,根据本组临床资料显示,血小板减少数量与丙戊酸纳药物血浓度正相关.结论丙戊酸钠能影响患儿的血小板计数和功能.导致血小板计数降低,出血时间延长,患儿以双下肢为主、全身皮肤出现紫癜样皮疹,其中2例并伴有牙龈出血,影响的程度可能与丙戊酸钠的剂量相关.     

氨磺必利联合丙戊酸钠治疗酒精所致精神障碍的临床效果及预后影响分析

目的 评价氨磺必利联合丙戊酸钠治疗酒精所致精神障碍（mental disorder induced by alcohol，MDIA）的临床疗效与安全性。方法 选择2015 年6 月~2017 年5 月66 例男性MDIA 患者，根据随机数字表法分为研究组和对照组，研究组予氨磺必利联合丙戊酸钠治疗，对照组予氨磺必利治疗，应用阳性与阴性症状量表（Positive and Negative Syndrome Scale，PANSS）、不良反应症状量表（Treatment Emergent Symptom Scale，TESS）评价临床治疗效果和用药安全性。结果 研究组总有效率96.97%，高于对照组的81.82%，差异有统计学意义（P<0.05）；研究组患者治疗后PANSS 评分逐渐降低，两组比较，差异有统计学意义（F=6.937，P<0.05）；研究组不良反应率9.09%，对照组6.06%，两组比较，差异无统计学意义（χ2=0.926，P>0.05）；两组TESS 评分比较，差异无统计学意义（F=0.234，P>0.05）。结论 氨磺必利联合丙戊酸钠可提高治疗MDIA 效果，安全性高。     

Biological interaction between anti-epidermal growth factor receptor agent cetuximab and magnesium

Background: Magnesium plays a role in a large number of cellular metabolic reactions. Cetuximab, by the inhibition of epidermal growth factor (EGR), is able to induce hypomagnesaemia by interfering with magnesium transport in the kidney. Objective: To investigate the interactions between magnesium homeostasis and EGF receptor (EGFR) inhibition. Methods: We performed an updated literature search using the MEDLINE database for articles published from 1 January 1966 to 15 February 2008. We comprehensively reviewed all the data published in abstract form during the most significant international meetings (American Society of Clinical Oncology, American Association for Cancer Research, European Society for Medical Oncology and European Cancer Organisation). Results/conclusion: We propose that EGFR inhibition may reduce cancer proliferation and also decrease magnesium levels. These reduced magnesium levels in turn contribute to the inhibition of angiogenesis by directly acting on endothelial cells and indirectly affecting EGFR signalling and the production of angiogenic molecules.     

Feasibility of use of magnesium reabsorbable scaffolds in complex coronary artery disease: True bifurcation,multiple overlapping scaffolds and chronic total occlusion treatment

We present first-in-human treatment with bioabsorbable magnesium scaffolds for percutaneous coronary intervention in a patient with nickel allergy. We present images from angiography and optical coherence tomography at three months. We also review the current status of these novel devices.     

Effects of aqueous soaking on the phytate and mineral contents and phytate:mineral ratios of wholegrain normal sorghum and maize and low phytate sorghum

Soaking of cereal grains has been suggested as a method to reduce their phytate content and hence increase their mineral availability. Whole and milled wholegrain, normal and low phytate sorghum and normal maize were studied. Soaking of unmilled sorghum and maize did not result in substantial reductions in phytate or mineral contents. With milled grains, phytate solubilisation was somewhat greater in maize than in sorghum after a short (1?h) soaking period but not after 6–12?h of soaking when practically all phytate had been solubilised. Also, with milled, low phyate sorghums, phytate solubilisation was not substantially higher than in their null controls. Soaking milled grain substantially reduced mineral contents and Ca?×?phytate:zinc molar ratios. However, the loss in soluble minerals could have a greater negative effect on mineral availability, compared to the positive effect of the phytate reduction. Thus, soaking does not seem to be a viable household method to improve sorghum and maize mineral availability.     

Valproate-Induced Hyperammonemic Encephalopathy Treated by Hemodialysis

Valproate-induced hyperammonemic encephalopathy is an unusual but serious complication that may occur in people with normal liver-associated enzyme levels, despite normal therapeutic doses and serum levels of valproate. Here, we describe an adolescent girl who had absence seizure and complained about progressive dizziness and general malaise several days after restarting valproate. Then, she presented vomiting and decreased consciousness three weeks after valproate use. Notably, her serum ammonia level was five times the upper limit of normal (184 μmmol/L), with normal liver-associated enzyme and supra-therapeutic valproate level. EEG showed continuous generalized slowing. The tandem mass analysis revealed carnitine deficiency. Consciousness improved after emergent hemodialysis. Ammonia level and EEG also returned to normal. Possible mechanisms, risk factors and the treatments of valproate-induced hyperammonemic encephalopathy are described. Physicians should consider this possibility when consciousness disturbance occurs in patients treated with valproate.     

孕妇应用硫酸镁对早产儿生长及预后的合理性评价

目的调查在孕妇应用硫酸镁和早产儿发生大脑性瘫痪及死亡等的关联，评价产前应用硫酸镁对早产儿的安全性及可行性。方法检索有关产前使用硫酸镁与早产儿发生大脑性瘫痪及死亡的病例对照研究文献进行Meta分析。结果符合研究纳入标准的文献9篇，共3800个研究例数，其中有5项研究是对孕妇应用硫酸镁有无导致早产儿发生死亡进行病例对照分析，4项研究对孕妇应用硫酸镁有无导致早产儿发生大脑性瘫痪进行病例对照分析。通过Meta分析，发现产前使用硫酸镁可以降低早产儿发生死亡的概率（OR：0．75；95％CI：0．59—0．95），而与早产儿发生大脑性瘫痪则无相关（OR：0．79；95％CI：0．60—1．04）。结论研究提示产前应用硫酸镁对早产儿发生死亡的几率有降低作用。     

镁离子在治疗心律失常中的研究进展

Mg^2＋是人体内重要的电解质离子，是人体细胞内含量第二丰富的阳离子，具有复杂的调节机制，对维持机体新陈代谢及其他生理功能具有极其重要的作用。目前已发现人体内超过300种酶的作用离不开其参与，其中包括Mg^2＋-K^＋-ATP酶、Ca^2＋-ATP酶等。临床上利用Mg^2＋调节这些酶的活性等特点，将Mg^2＋作为一种预防和治疗心律失常的药物在很多方面运用，但其规范化运用仍有待进一步明确。现将Mg^2＋在心律失常中的运用综述如下。