Selective Eradication of Rat Bone Marrow Erythroid Cells by Administration of Cytosine Arabinoside

The in vivo effect of a single i.p. injection of cytosine arabinoside (250 mg/kg body weight) on the rat bone marrow is reported. Cytosine arabinoside (ara-C), a potent inhibitor of DNA-synthesis, was seen to produce selective necrosis of fast cycling bone marrow erythroblasts. The depleted erythroid marrow is replenished by stem cells which are members of the lymphoid-transitional cells compartment. An indirect correlation between the degree of erythroid cell depletion and the extent of marrow lymphocytosis was noted 6–12 h after the administration of ara-C. At 24–48 h, however, the marrow returned to its normal activity. The rat bone marrow 6–12 h following a single injection of ara-C is suggested as an experimental model for providing stem cells committed to the erythroid line.     

Inactivated polio vaccine development for technology transfer using attenuated Sabin poliovirus strains to shift from Salk-IPV to Sabin-IPV

Industrial-scale inactivated polio vaccine (IPV) production dates back to the 1960s when at the Rijks Instituut voor de Volksgezondheid (RIV) in Bilthoven a process was developed based on micro-carrier technology and primary monkey kidney cells. This technology was freely shared with several pharmaceutical companies and institutes worldwide. In this contribution, the history of one of the first cell-culture based large-scale biological production processes is summarized. Also, recent developments and the anticipated upcoming shift from regular IPV to Sabin-IPV are presented. Responding to a call by the World Health Organization (WHO) for new polio vaccines, the development of Sabin-IPV was continued, after demonstrating proof of principle in the 1990s, at the Netherlands Vaccine Institute (NVI). Development of Sabin-IPV plays an important role in the WHO polio eradication strategy as biocontainment will be critical in the post-OPV cessation period. The use of attenuated Sabin strains instead of wild-type Salk polio strains will provide additional safety during vaccine production. Initially, the Sabin-IPV production process will be based on the scale-down model of the current, and well-established, Salk-IPV process. In parallel to clinical trial material production, process development, optimization and formulation research is being carried out to further optimize the process and reduce cost per dose. Also, results will be shown from large-scale (to prepare for future technology transfer) generation of Master- and Working virus seedlots, and clinical trial material (for phase I studies) production. Finally, the planned technology transfer to vaccine manufacturers in low and middle-income countries is discussed.     

Novel approach to the eradication of Pseudomonas aeruginosa in an infant with CF after outpatient treatment failure

Intravenous continuous infusion of betalactam (CIBL) antibiotic and high dose extended interval (HDEI) aminoglycoside therapy theoretically maximize bacterial killing in treatment of Pseudomonas aeruginosa (PsA) in pulmonary exacerbations of cystic fibrosis (CF). We present the case of a 3-month-old female infant with CF who failed outpatient eradication of PsA with subsequent eradication using intravenous CIBL antibiotic and HDEI aminoglycoside therapy. This antibiotic combination should be considered in order to optimize pharmacodynamics for PsA eradication in CF patients before development of chronic colonization.     

铋剂四联疗法根除幽门螺杆菌疗效研究

目的 比较不同疗程铋剂四联疗法与经典三联疗法根除幽门螺杆菌(Hp)的疗效.方法 选择403例符合条件的Hp阳性的消化性溃疡或慢性胃炎患者.随机分为三组,其中A组138例、B组142例、C组123例.A组采用果胶铋200 mg+雷贝拉唑10 mg+阿莫西林1000 mg+呋喃唑酮100 mg,2次/天,共10 d;B组采用果胶铋200 mg+雷贝拉唑10 mg+阿莫西林1000 mg+呋喃唑酮100 mg,2次/天,共14 d;C组采用雷贝拉唑10 mg+阿莫西林1000 mg+呋喃唑酮100 mg,2次/天,共14 d.观察三组患者Hp根除率、不良反应发生率及其成本-效果比.结果 A、B、C三组患者Hp根除率分别为83.33％、83.80％、71.54％,A组与B组Hp根除率比较差异无统计学意义(P>0.05),A组与C组、B组与C组Hp根除率比较均差异有统计学意义(P<0.05).A、B、C三组患者的不良反应发生率分别为1.45％、2.11％、0.81％,均差异无统计学意义(P>0.05).A、B、C三组成本-效果比分别为1.50、2.09、2.04.结论 三种治疗方案均未达到Hp根除率>90％的理想方案.但三种方案的比较中含铋剂10 d与14 d四联疗法Hp根除率较高,接近理想方案.含铋剂10 d四联疗法成本-效果比最好,建议临床使用.14 d三联疗法Hp根除率仅达71.54％,远低于理想标准,不建议临床使用.     

Significant renoprotective effect of telbivudine during preemptive antiviral therapy in advanced liver cancer patients receiving cisplatin-based chemotherapy: a case–control study

Objective. To assess the frequency of gastric cancer patients having received eradication treatment of Helicobacter pylori, and whether this treatment has any influence on the delay in the diagnosis or the stage of the tumours at the time of the operation. Material and methods. A total of 119 consecutive patients with gastric cancer were interviewed preoperatively between 2001 and 2003 at the Department of Surgery, Helsinki University Central Hospital. Abdominal symptoms, previous endoscopies, previous H. pylori testing and eradication therapies were recorded. Results. Of these patients, 112 (94%) had abdominal symptoms before the cancer diagnosis, and in 110 patients (92%) these symptoms were alarming or had changed before the cancer diagnosis. Thirty-five patients (29%) had received H. pylori eradication therapy prior to the diagnosis of gastric cancer (15 after onset or change in symptoms, 10 more than 5 years prior to the cancer diagnosis). The median duration of alarm, new or changed symptoms was longer among patients with H. pylori eradication therapy after the onset or change in their symptoms as compared to other patients (12.0 versus 4.5 months, p=0.001). However, there was no difference in the tumour stages at time of the operation between the eradication and no eradication groups. A previous gastroscopy within 2 years prior to the cancer diagnosis was performed in 17 (14%) patients. Diffuse-type cancers were missed significantly more often in endoscopies than cancers of intestinal type. Conclusion. Previous H. pylori eradication may delay the detection of gastric cancer if it is given during symptoms caused by tumour.     

荣成市消除疟疾的可行性探讨

目的探讨荣成市消除疟疾的可行性及实施消除疟疾所面临的问题,为消除疟疾提供科学依据。方法按照《国家消除疟疾试点方案》的要求进行分层随机整群抽样,抽取调查乡镇、村和居民。调查试点前后人群疟疾感染情况、学生疟疾抗体水平、村民疟防知识知晓情况、蚊媒及疟疾诊断能力。结果试点前荣成市村民疟防知识平均知晓率、村民的防蚊设施覆盖率、医务人员疟疾诊疗水平合格率分别为39．17％、83．08％和57．69％,试点后分别为95．37％、94．03％和96．67％,差异均有统计学意义（P〈0．01）。按蚊密度、镜检员镜检技术熟练程度试点前后差异无统计学意义;中小学生疟疾抗体检测均为阴性。结论通过加强卫生宣教和技术培训、提高监测能力和加强高疟区流动人口管理,荣成市消除疟疾目标可以实现。     

有螺沟渠硬化后钉螺复现原因

目的 目的 了解有螺沟渠硬化后钉螺复现的影响因素, 提出改进措施, 提高沟渠硬化工程的灭螺效果。方法 方法 采用回顾性调查与现场调查相结合的方法, 收集荆门市13个血吸虫病流行区乡 （镇） 实施沟渠硬化灭螺工程和螺情资料, 统计沟渠硬化工程的灭螺效果, 分析钉螺复现的原因。结果 结果 共调查151条硬化沟渠, 71条沟渠钉螺复现, 复现沟渠条数占 47.02%。钉螺面积灭光率为78.79%。钉螺复现的主要原因为上游螺区扩散、 硬化沟渠破损、 工程前未药物灭螺和施工带入钉螺等。结论 结论 单纯硬化有螺沟渠并不能彻底消灭钉螺; 科学规划沟渠硬化工程、 工程前药物灭螺和加强工程后期维护是提高灭螺效果的关键。     

奥美拉唑、克拉霉素、阿莫西林三联疗法根除幽门螺杆菌

目的　比较奥美拉唑、克拉霉素、阿莫西林与奥美拉唑、甲硝唑、阿莫西林两种“三联疗法”对幽门螺杆菌 (Hp)的根除效果。方法　 10 3例Hp阳性的消化性溃疡患者分为 2组 :A组 5 8例 ,以奥美拉唑 2 0mg、克拉霉素 5 0 0mg加阿莫西林 10 0 0mg口服 ,2次·d-1,疗程 7d ;B组 45例 ,以奥美拉唑 2 0mg、甲硝唑 40 0mg加阿莫西林 10 0 0mg口服 ,2次·d-1,疗程7d。活动期溃疡患者抗Hp治疗后继续服用奥美拉唑 2 0mg ,1次·d-1,疗程 2～ 4周。抗Hp治疗结束 2个月后复查胃镜并检测Hp。结果　A、B两组的Hp根除率分别为 89.3 %和 84.1% ,活动期溃疡愈合率分别为 96.7%和 10 0 % ,副反应发生率分别为 10 .3 %和 11.1% ,两组间Hp根除率、活动期溃疡愈合率和副反应发生率均无显著性差异 (均为P >0 .0 5 )。结论　克拉霉素或甲硝唑与奥美拉唑、阿莫西林组成的两种“三联疗法”疗效相当 ,而甲硝唑因价廉、安全在临床上更为实用。