坐骨神经损伤后大鼠脊髓腰段前角AChE的变化

结扎切断 SD 大鼠左侧坐骨神经或前后根后,在一定的存活时间序列里,用 Olympus显徽镜的测光装置对经 EL—Badawi 氏改良法显色处理后的脊髓腰段前角乙酰胆硷酯酶(ACHE)进行了相对变化率(Xo/Xc—1)×100%的测定。结果发现坐骨神经切断术后,术侧脊髓前角 AChE10天后增高22.1%;术后25天时减少到-20.2%;60天时又再次增高22.8%,呈双峰夹低谷的变化曲线。切断前后根后,术侧脊髓前角 AChE10天后明显下降(-21.1%);提示外周神经受损部位不同,脊髓前角 AChE 发生变化的情况不同.根据分析,本文将双峰夹低谷曲线分为1.应激期;2.调整期;3.恢复期.外周神经受损后有关神经元将出现变性和再生现象.神经变性和再生过程中形态学方面的研究至今已有百余年的历史;神经递质及其代谢酶在神经系统中正常分布的研究也有了几十的年历史;但在神经变性和再生的过程中,神经递质及其代谢酶的动态变化的研究正在兴起。神经元受损后神经递质及其代谢酶的动态性变化,在一定程度上反映了神经细胞对伤害性刺激的反应。1987年 Malatova 在狗发现 AChE 在远侧残根中是先显著下降,后轻微下降;在近侧残根中和在前角中是先升后降.但在更长时间里的变化情况怎样?以及在大鼠脊髓前角中的变化情况又如何?这种变化与外周神经损伤部位的关系又怎样?目前尚无报导。为了探讨这些问题,本文应用组化方法进行染色,利用照相显微镜的曝光时间对AChE 的染色强度作了相对量的测定。     

HIV/AIDS among pastoralists and refugees in north-east Africa: a neglected problem

The eight member states (Djibouti, Eritrea, Ethiopia, Kenya, Somalia, South Sudan, Sudan and Uganda) of the Intergovernmental Authority for Development (IGAD) have the largest proportions of cross-border mobile pastoralists and refugees in Africa. Although all IGAD countries have had national HIV/AIDS prevention, care and treatment programmes since the late 1980s, the IGAD Regional HIV & AIDS Partnership Program was (IRAPP) established in 2007 to mitigate the challenges of HIV among neglected pastoral and refugee communities. This article assesses vulnerability of pastoralists and refugee communities to HIV and interventions targeting these groups in the IGAD countries. Outcomes from this study may serve as a baseline for further research and to improve interventions. Published articles were accessed through web searches using PubMed and Google Scholar engines and unpublished documents were collected manually. The search terms were HIV risk behaviour, vulnerability, HIV prevalence and interventions, under the headings pastoralists, refugees, IGAD and north-east Africa for the period 2001–2014. Of the 214 documents reviewed, 78 met the inclusion criteria and were included. Most HIV/AIDS related studies focusing of pastoral communities in IGAD countries were found to be limited in scope and coverage but reveal precarious situations. Sero-prevalence among various pastoral populations ranged from 1% to 21% in Ethiopia, Kenya, Somalia and Uganda and from 1% to 5% among refugees in Sudan, Kenya and Uganda. Socioeconomic, cultural, logistic, infrastructure and programmatic factors were found to contribute to continuing vulnerability to HIV. Interventions need to be further contextualised to the needs of those impoverished populations and integrated into national HIV/AIDS programmes. HIV/AIDS remains a major public health concern among the pastoral and refugee communities of IGAD countries. This calls for IGAD to collaborate with national and international partners in designing and implementing more effective prevention and control programmes. Furthermore, interventions must extend beyond the health sector and improve the livelihood of these populations.     

活犀角与犀角抗惊厥作用的研究

目的：通过研究活犀角与犀角对小鼠的抗惊厥作用,探讨活犀角是否可以作为犀角的代用品。方法随机将280只小鼠（自主活动实验160只,抗惊厥实验120只）,分为活犀角与犀角各4个剂量组（700、350、175、90 mg· kg－1）,另设1个空白对照组和1个地西泮片阳性对照组,分别灌胃给予对应剂量的试验样品,连续2 d。末次给药后30 min后用自主活动记录仪记录各组20只小鼠自主活动;同时对各组另外15只小鼠采用尼可刹米诱发动物惊厥,记录小鼠出现惊厥的时间和死亡时间。结果自主活动记录结果显示,4个剂量的活犀角和犀角对小鼠均有兴奋作用;抗惊厥结果显示活犀角700、350、175、90 mg· kg－1和犀角350、175、90 mg· kg－1能明显降低小鼠的惊厥发生率和／或死亡率,且在350、175、90 mg· kg－1剂量下活犀角和犀角对小鼠的抗惊厥作用无显著性差异。结论在该验条件下,在抗惊厥作用方面可初步判断活犀角在350、175、90 mg· kg－1剂量可以作为犀角的代用品进行使用。     

Extended spectrum of antibiotic susceptibility for tuberculosis,Djibouti

In the Horn of Africa, there is a high prevalence of tuberculosis that is reported to be partly driven by multidrug-resistant (MDR) Mycobacterium tuberculosis strictu sensu strains. We conducted a prospective study to investigate M. tuberculosis complex species causing tuberculosis in Djibouti, and their in vitro susceptibility to standard anti-tuberculous antibiotics in addition to clofazimine, minocycline, chloramphenicol and sulfadiazine. Among the 118 mycobacteria isolates from 118 successive patients with suspected pulmonary tuberculosis, 111 strains of M. tuberculosis, five Mycobacterium canettii, one ‘Mycobacterium simulans’ and one Mycobacterium kansasii were identified. Drug-susceptibility tests performed on the first 78 isolates yielded nine MDR M. tuberculosis isolates. All isolates were fully susceptible to clofazimine, minocycline and chloramphenicol, and 75 of 78 isolates were susceptible to sulfadiazine. In the Horn of Africa, patients with confirmed pulmonary tuberculosis caused by an in vitro susceptible strain may benefit from anti-leprosy drugs, sulfamides and phenicol antibiotics.     

膀胱角或膀胱瓣输尿管吻合术处理下段输尿管狭窄(附16例报告)

目的：介绍两种输尿管膀胱吻合的手术方法。方法：采用膀胱角输尿管吻合术(9例)和膀胱壁瓣输尿管吻合术(7例)治疗输尿管下段长段狭窄或缺损16例，13例为盆腔输尿管下段手术或妇产科手术后继发狭窄的切除后吻合，3例为下段输尿管病变切除后缺损修复。结果：所有患者均吻合成功，尿路梗阻消除，未发生新的再狭窄。结论：该两种术式适用于各种原因引起的盆腔段输尿管长段缺损或狭窄，可修复膀胱输尿管缺损距离在3～10cm的患者。     

犀角地黄汤化裁方治疗毒蛇咬伤血分证的观察护理

目的观察犀角地黄汤化裁治疗毒蛇咬伤血分证的效果.方法选择符合条件的患者100例被毒蛇咬伤后出现血分证的患者,按随机法分为对照组和观察组各50例,2组均给予清创、局部封闭、注射五步蛇毒血清及抗生素、速尿等常规治疗;观察组加服犀角地黄汤化裁方,每次20ml,每天3次,疗程为4～15d.结果在实验室指标恢复正常时间、局部肿胀消退、疗程等方面明显优于对照组,具有显著性差异(p＜0.05).结论犀角地黄汤化裁方治疗毒蛇咬伤引起血分证有较好疗效.     

Maternal infibulation and obstetrical outcome in Djibouti

Objective: The objective of the present study was to assess the relation between female genital mutilation and obstetric outcome in an East African urban clinic with a standardized care, taking into account medical and socioeconomic status.

Methods: This was a cohort study conducted in Djibouti between October 1, 2012 and April 30, 2014. Overall 643 mothers were interviewed and clinically assessed for the presence of female genital mutilation. The prevalence of obstetric complications by infibulation status was included in a multivariate stepwise regression model.

Results: Overall, 29 of 643 women did not have any form of mutilation (4.5%), as opposed to 238 of 643 women with infibulation (37.0%), 369 with type 2 (57.4%), and 7 with type 1 mutilation (1.1%).Women with a severe type of mutilation were more likely to have socio-economic and medical risk factors. After adjustment, the only outcome that was significantly related with infibulation was the presence of meconium-stained amniotic fluid with an odds ratio of 1.58 (1.10–2.27), p value=0.014.

Conclusions: Infibulation was not related with excess perinatal morbidity in this setting with a very high prevalence of female genital mutilation, but future research should concentrate on the relation between infibulation and meconium.     

Safety evaluation of tocainide in the American emergency use program

This is a report of the safety evaluation of tocainide in the first 369 patients entered into the American Tocainide Emergency Use Program. This humanitarian protocol has made tocainide available for emergency use in the treatment of life-threatening, intractable ventricular arrhythmias in patients who were unresponsive to or unable to take the approved antiarrhythmic drugs. The most frequent adverse experiences reported were neurologic and gastrointestinal in nature and included dizziness, lightheadedness, tremors, nausea, vomiting, and anorexia. Adverse experiences resulted in the discontinuation of tocainide in 16% of these patients and were transient and reversible with no conclusive evidence of permanent organ injury. Adverse experiences having special relevance to the safety assessment of new antiarrhythmic agents are discussed, including congestive heart failure, arrhythmias and conduction disturbances, convulsions, lupus erythematosus-like illness, and deaths while on therapy. No significant abnormal trends were observed in routine hematologic and biochemical laboratory screening tests or in ophthalmologic or chest x-ray examinations. An evaluation of the effects of chronic tocainide administration on ECG intervals showed no significant change in P-R or QRS intervals but demonstrated a statistically significant decrease in Q-T duration. It is concluded that in patients with life-threatening ventricular arrhythmias, tocainide is a safe agent with a favorable risk-benefit ratio.