Esophageal Surveillance Practices in Esophageal Atresia Patients: A Survey by the Eastern Pediatric Surgery Network

IntroductionEndoscopic surveillance guidelines for patients with repaired esophageal atresia (EA) rely primarily on expert opinion. Prior to embarking on a prospective EA surveillance registry, we sought to understand EA surveillance practices within the Eastern Pediatric Surgery Network (EPSN).MethodsAn anonymous, 23-question Qualtrics survey was emailed to 181 physicians (surgeons and gastroenterologists) at 19 member institutions. Likert scale questions gauged agreement with international EA surveillance guideline-derived statements. Multiple-choice questions assessed individual and institutional practices.ResultsThe response rate was 77%. Most respondents (80%) strongly agree or agree that EA surveillance endoscopy should follow a set schedule, while only 36% claimed to perform routine upper GI endoscopy regardless of symptoms. Many institutions (77%) have an aerodigestive clinic, even if some lack a multi-disciplinary EA team. Most physicians (72%) expressed strong interest in helping develop evidence-based guidelines.ConclusionsOur survey reveals physician agreement with current guidelines but weak adherence. Surveillance methods vary greatly, underscoring the lack of evidence-based data to guide EA care. Aerodigestive clinics may help implement surveillance schedules. Respondents support evidence-based protocols, which bodes well for care standardization. Results will inform the first multi-institutional EA databases in the United States (US), which will be essential for evidence-based care.Level of EvidenceThis is a prognosis study with level 4 evidence.     

酥胆麒麟膏用于痔瘘术后换药的药效学与毒理学研究（二）

本文通过设一个阳性对照组（马应龙鹰香痔疮膏），一个空白对照组（凡士林）及酥胆麒麟膏大、中、小三个剂量组（１０％、２０％、４０％浓度）进行三个方面的实验研究，证实酥胆麒麟膏具有止血、抗菌、生肌长皮等综合作用，局部外用无毒副作用，安全性高。其止血、生肌长皮作用，优于马应龙麝香痔疮膏；抗金葡萄茵的作用与银灰散相同；抗大肠杆菌的作用犹于银灰散。尤其是２０％酥胆麒麟膏的以上多种作用优于１０％浓度的，等效于４０％浓度的，可作为临床使用时的最佳浓度。     

Deliberate self-poisoning with dapsoneA case report and summary of relevant pharmacology and treatment

We report the case of a 14-year-old girl who deliberately ingested 8–9 g of dapsone and presented with severe methaemoglobinaemia and altered mental status. Prompt treatment with repeated doses of methylene blue and organ support brought about control of the methaemoglobinaemia and averted organ failure.     

桂枝镇痛效应的药理学研究

目的　探讨桂枝的镇痛作用。方法　采用热板法和扭体法观察该药的镇痛作用。结果　桂枝对小鼠热致痛和醋酸致痛均有明显的抗痛作用 ,与颅痛定镇痛效果比较均无显著差异 (P >0 .0 5 ) 。结论　桂枝具有镇痛效应 ,对临床应用、镇痛药开发具有借鉴和指导意义。     

论河北省卫生系统办公自动化管理系统

系统采用基于TCP/IP协议的国际互联网为基础,采用B/S结构,客户端采用IE浏览器,服务器端采用WINDOW2000的IIS作为服务器。其主要功能:工作督办、工作信息、电子邮件、收文、发文、图书管理、档案管理、车辆管理、日程管理、待办事宜、电子论坛、考勤管理等。     

Benzylamine oxidase in normal and atherosclerotic human aortae

Assays of serum benzylamine oxidase (BzAO) have led some workers to postulate a relationship between elevated BzAO activity and diseases characterized by proliferating connective tissue. The present study was designed to determine whether BzAO activity of a cellular tissue is also affected. BzAO was assayed in homogenates of normal and atherosclerotic human aortae. Characterization done in normal aortae showed that BzAO is not a classical monoamine, diamine, polyamine, or lysyl oxidase, nor is it a ceruloplasmin. The enzyme is heat stable at 60 degrees C and is associated primarily with the microsomal fraction on density centrifugation. Compared with phenylethylamines and indoleamines, benzylamine is the best substrate. BzAO is sensitive to inhibition by hydrazines and chymotrypsin but not trypsin, and is insensitive to Triton X-100 and sulfhydryl-group blockade. BzAO activity of atherosclerotic plaque (expressed per gram wet weight or per milligram protein) was decreased markedly compared to that in adjacent, nonplaque regions and in normal aortae. However, on a per milligram DNA basis, the BzAO activity of plaque did not differ from that of nonplaque tissue. We conclude that there is a decreased cell population density in plaque, a contention supported by kinetic analysis. Plaque BzAO showed a decreased Vmax with no change in the Km of benzylamine compared with nonplaque tissue. Thus, if a relationship exists between BzAO activity and proliferating connective tissue, it is not apparent at the level of the cellular enzyme in atherosclerotic aortae of man.