乳汁中药物浓度测定的研究进展

母乳喂养对婴儿来说是一种非常健康及有营养的获取能量的方式，对母亲和婴儿都有益处。患有某些疾病的哺乳母亲在进行药物治疗时，需要考虑药物是否会进入乳汁而对婴儿产生一些不良反应或对母亲产生影响。由于许多药物的哺乳期用药安全性并不十分明确，因此在临床治疗中不推荐哺乳期妇女使用。测定乳汁中的药物浓度可以明确合理的给药时间和给药剂量，提高用药安全性，对临床用药具有非常重要的意义。但乳汁成分复杂，含有大量脂质和蛋白质等干扰物质，使乳药浓度测定有一定困难。本文综述了国内外乳药浓度测定方法，以期为哺乳期合理用药提供参考。     

SPERM CRYOPRESERVATION PRACTICES AMONG ADOLESCENT CANCER PATIENTS AT RISK FOR INFERTILITY

To assess sperm cryopreservation among males newly diagnosed with cancer aged 13 years and older, attending oncologists assigned infertility risk (yes/no) to patients and reported whether their patients engaged in sperm cryopreservation. Only 28.1% of informed at-risk patients banked sperm. Utilization of sperm banking was significantly associated with a diagnosis of central nervous system (CNS) malignancy or non-CNS solid tumor diagnosis, higher socioeconomic status, and not being a member of an Evangelical religious group. These results suggest that sperm banking is underutilized among adolescent males newly diagnosed with cancer, and that strategies to increase the engagement in this fertility preservation method are needed.     

Expression of Inducible Nitric Oxide Synthase in Human Lungs

The aim of this study was to investigate the expression of inducible nitric oxide synthase (iNOS) in lungs of patients with or without adult respiratory distress syndrome (ARDS). We compared the expression of iNOS by immunohistochemical analysis and polymerase chain reaction in the human lungs collected during open-lung biopsy or at autopsy. The expression of iNOS mRNA was present in all lung samples; however, only 3 out of 11 lung samples showed weak staining for iNOS. Although the involvement of nitric oxide in animal models of ARDS is reported, production of nitric oxide in human lungs is still controversial. The data presented here suggest that human lungs express iNOS mRNA but that the production of iNOS protein may be tightly regulated and is expressed in pulmonary inflammation.     

Assessment of the Hemiparetic Upper Extremity

The Functional Test gives an accurate and immediate assessment of upper extremity capabilities for performance of functional activities. It has been used primarily with patients who have a residual hemiparetic upper extremity following a stroke. This seventeen task test is arranged in seven levels and can be administered in approximately thirty minutes. It is completely portable and can be used practically in many different treatment settings. The information obtained will allow therapists to set realistic functional goals and design effective programs for the patient's use of the involved upper extremity. The early research on this instrument implies that this test may be used as an alternative to some of the traditional objective and time consuming test measures that are currently used by occupational therapists.     

Holotransferrin enhances selective anticancer activity of artemisinin against human hepatocellular carcinoma cells

Artemisinin, also termed qinghaosu, is extracted from the traditional Chinese medicine ar- temesia annua L. （the blue-green herb） in the early 1970s, which has been confirmed for effectively treating malaria, Additionally, emerging data prove that artemisinin exhibits anti-cancer effects against many types of cancers such as leukemia, melanoma, etc. Artemisinin becomes cytotoxic in the presence of ferrous iron. Since iron influx is high in cancer cells, artemisinin and its analogs selectively kill can- cer cells with increased intracellular iron concentrations. This study is aimed to investigate the selective inhibitory effects of artemisinin on SMMC-7721 cells in vitro and determine the effect of holotransfer- fin, which increases the concentration of ferrous iron in cancer cells, combined with artemisinin on the anticancer activity. MTT assay was used for assessing the proliferation of SMMC-7721 cells treated with artemisinin. The induction of apoptosis and inhibition of colony formation in SMMC-7721 cells treated with artemisinin were determined by TdT-mediated dUTP nick end labeling （TUNEL） and col- ony formation assay, respectively. The results showed that artemisinin at various concentrations signifi- cantly inhibited growth, colony formation and cell viability of SMMC-7721 cells （P〈0.05）, likely due to induction of apoptosis of SMMC-7721 cells. Of interest, it was found that incubation of artemisinin combined with holotransferrin sensitized the growth inhibitory effect of artemisinin on SMMC-7721 cells （P〈0.01）. Our data suggest that treatment with artemisinin leads to inhibition of viability and pro- liferation, and apoptosis of SMMC-7721 ceils. Furthermore, we observed that holotransferrin signifi- cantly enhanced the anti-cancer activity of artemisinin. This study may provide a potential therapeutic choice for liver cancer.     

Evaluation of the sensitivity of Moroccans to shrimp tropomyosin and effect of heating and enzymatic treatments

The aim of this work was to evaluate the IgE-sensitivity to shrimp tropomyosin (ST) in a Moroccan population from Fez region, and then to study the effect of temperature and enzymatic digestion on the allergenicity of ST. This work was conducted with a questionnaire completed by a sera-bank, obtained from 500 patients recruited from Fez Hospitals. Their sera were analyzed for specific IgE-sensitivity to ST. From questionnaire, 9.8% reported allergy to fish and shellfish where shrimp was one of the most common species causing allergy in patients. Evaluation of specific IgE showed that 10.2% of patients present higher values. Further indirect ELISA and Dot-blot results indicated that ST showed a decrease in the human IgE binding under heating or pepsin hydrolysis. These results demonstrate that this population was sensitive to ST and the sensitivity could be reduced by heating and more where it was digested by pepsin.     

重组人5型腺病毒注射液局部瘤内注射治疗晚期肝癌的临床研究

目的 探讨重组人5 型腺病毒注射液局部瘤内注射治疗晚期肝癌的临床疗效及安全性。方法 选择2009 年1 月至2013 年1 月来自复旦大学附属华山医院的80 例晚期肝癌患者，分为对照组（n=40）和观察组（n=40），对照组患者只给予顺铂及5-氟尿嘧啶化疗，观察组患者在化疗基础上联合B 超引导下经皮瘤内注射重组人5 型腺病毒注射液，连续使用两个周期。比较两组患者肿瘤客观有效率、肿瘤进展时间及不良反应。结果 观察组的客观有效率为22.50%，高于对照组的5.00%，差异有统计学意义（P＜0.05）。观察组的平均肿瘤进展时间为（11.93±2.54）周，高于对照组的（8.06±2.21）周，差异有统计学意义（P＜0.05）。局部瘤内注射后48 h 观察组血液中IFN-γ、IL-1α、IL-6 及TNF-α 显著高于治疗前，差异有统计学意义（P<0.05）。两组患者治疗后ALT、AST、ALP、TBIL 及AFP 指标均有所下降，而观察组下降幅度大于对照组，差异有统计学意义（P<0.05）。观察组患者不良反应主要为发热、局部反应及流感样症状，均为Ⅰ/Ⅱ级。观察组患者生活质量提高率为55.00%，高于对照组的22.50%，差异有统计学意义（P＜0.05）。结论 晚期肝癌患者在化疗基础上局部瘤内注射重组人5 型腺病毒注射液，可提高客观有效率和患者生存期，且安全性及耐受性好。     

Principle of relative positioning of structures in the human body

The arrangement of various biological structures should generally ensure the safety of crucial structures and increase their working efficiency; however, other principles governing the relative positions of structures in humans have not been reported. The present study therefore investigated other principles using nerves and their companion vessels in the human body as an example. Nerves and blood vessels usually travel together and in the most direct way towards their targets. Human embryology, histology, and gross anatomy suggest that there are many possible positions for these structures during development. However, for mechanical reasons, tougher or stronger structures should take priority. Nerves are tougher than most other structures, followed by arteries, veins, and lymphatic vessels. Nerves should therefore follow the most direct route, and be followed by the arteries, veins, and lymphatic vessels. This general principle should be applicable to all living things.     

Unusual scalp crusted scabies in an adult T-cell leukemia/lymphoma patient

A retrospective investigation was made of the occurrence of psychiatric symptoms among 441 patients operated on for primary hyperparathyroidism in Uppsala in 1956–79, and of the relationship between such symptoms and age, sex and degree of hypercalcaemia. A follow-up, using a mailed questionnaire, was carried out 4–27 years postoperatively.

Psychiatric symptoms were found in 23% of the patients (102/441). The patients with these symptoms had the same sex distribution and serum calcium levels as the other patients, but were significantly older. Severe symptoms occurred more frequently in older patients. Such symptoms were noted not only in patients with very high serum calcium values but also in association with mild or moderate hypercalcaemia.

The most common symptoms were depressive and anxiety states, which occurred in 78 patients. Psychosis with hallucinations and paranoid ideas was found in four patients. Eight patients had an organic brain syndrome and a further 12 patients had minor cerebral impairment.

At the follow-up half of the patients reported an improvement after the first postoperative year. Most of them considered that this improvement was sustained at the time of follow-up.

This study indicates that psychiatric symptoms are common among patients with hyperparathyroidism and can occur even with moderate hypercalcaemia. Elderly patients seem to be more vulnerable and more often develop severe symptoms such as psychosis or organic brain syndrome.