Time-related shape control modifications during erythrocyte storage with additive solutions

Summary To obtain more detailed information on the reversibility of shape alterations in blood bank stored erythrocytes, we have studied shape recovery after chemical crenation and rheological properties in 8 PAGGS-sorbitol preserved erythrocyte concentrates during a five week storage period under blood bank conditions. Our results show that red cell capability to regain a normal discoid shape after chemical crenation decreases during storage but is not lost over a five week period. Moreover there is a significant but weak correlation between red cell ATP content and both shape recovery capability and viscosity. Our results confirm suspicious that red cell shape perturbations following blood bank storage are widely reversible. Two different mechanisms may be involved in reducing shape recovery capability during storage, namely an ATP-dependent mechanism and an energy-independent one. The energy dependent mechanism may be preserved by the previous addition of solutions which maintain higher energy levels during storage.     

Viscoelastic and biochemical properties of erythrocytes during storage with SAG-M at +4 degrees C

During storage at +4 degrees C, red blood cells undergo biochemical and physicochemical modifications, which alter their rheological characteristics especially the deformability. Even so until now not precisely defined deformability is undoubtedly a function of whole cell elasticity and viscosity. In a previous study we have investigated changes of elasticity of whole RBCs during a 6 weeks storage by quasi-static experiments using our Cell-Elastometer method. Since the changes in deformability we observed with that experimental approach have not been significant we extended the hard/software capabilities of this instrument to enable dynamic measurements also. We applied this modified hard-/software set-up to examine again changes in viscoelasticity of erythrocytes from concentrates during a six weeks storage at a blood bank. The cells were resuspended in CPD-SAG-M and stored at +4 degrees C. Quasi-static and dynamic experiments were performed on stored erythrocytes and showed for both significant changes in elasticity and viscoelasticity from the fourth week on. So it can be stated that due to our experimental results decrease in deformability of RBCs during storage occurs after a four weeks period of relative stability. To get further insight in changes of underlying or related biochemical properties according experiments have been performed in parallel. Especially the decrease in ATP showed a nearly parallel time course with a significant decrease after the 4th week. All other parameters especially the 2,3 DPG level showed a nearly linear de- or increase with time which are in accordance with the results of the additionally performed elongation experiments. Our quasi-static and dynamic deformability measurements have been proven to provide a simple and reliable tool to follow up erythrocyte senescence during storage where a pronounced change in mechanical properties may be used as an indicator for a change in bioviability. This has to be verified in further experiments.     

Removal of Leukocytes from Whole Blood and Erythrocyte Suspensions by Filtration through Cotton Wool

Abstract. Using the filtration method described earlier, leukocytes were removed from units of fresh whole blood and erythrocyte suspensions (hematocrit 50%). After filtration, the units were stored for one or two weeks.
Units of whole blood and erythrocyte concentrates were stored for periods up to three weeks, the leukocytes were then removed by filtration, and the units were stored for another week.
During the storage period, the following parameters were measured: pH and concentrations of ATP + ADP, 2,3-diphosphoglycerate, hemoglobin and potassium (Hb and K+ in the cell-free supernatant).
The parameters used in the present study indicate that removal of leukocytes by filtration did not cause significant alteration to stored whole blood and erythrocyte concentrates, compared to unfiltered blood stored for the same time.     

The Treatment of Iron Deficiency Anaemia by Iron-Dextran Infusion: A Radio-Isotope Study

S ummary A ⁵⁹Fe labelled preparation has been used to follow the distribution and fate of intravenously administered iron-dextran (Imferon) in 10 patients with iron deficiency anaemia and three non-anaemic adult female subjects.
In all anaemic patients a satisfactory reticulocyte response occurred with a peak between the 8th and 10th day, and was followed by a progressive and maintained rise in haemoglobin. The mean weekly haemoglobin increments for the first 3 weeks were 1.9, 1.6 and 0.7 g. and the haemoglobin had reached normal levels in all by the 9th week.
Surface scintillation counting showed increasing radioactivity over liver, spleen and sacrum up to the end of the 1st week, followed by a gradual decrease during the next 2 weeks so that by the 21st day the radioactivity over these sites had fallen to below the initial values. The sternal counts dropped during the 1st week, then levelled off and thereafter showed a slow but maintained increase. The findings in the normal subjects did not differ significantly from those in the anaemic patients.
There were no general systemic reactions during or after the infusions, nor was there evidence of disturbance of renal or hepatic function. Local venous thrombosis occurred in two patients.
Iron-dextran is well tolerated when given intravenously. The stability of the compound is shown by the absence of untoward symptoms in the immediate post-infusion period when plasma iron levels are very high. The haematological response is rapid and complete, and the results compare favourably with those obtained by other methods of iron therapy.     

Thyroid associated components in serum during normal pregnancy

Thyroxine-binding globulin (TBG(, thyroxine-binding pre-albumin (TBPA), thyroxine (T4), free-T4, triiodothyronine (T3), and thyroid-stimulating hormone (TSH) were studied throughout apparently normal pregnancy in 290 cases grouped in 2 week intervals. TBG increased to a plateau level reached in the 24th week and was hereafter unchanged until term. T4 showed an increase until the 16th week of pregnancy and levelled off to a constant level for the rest of the pregnancy. Free-T4 declined to almost subnormal values for the non-pregnancy state which was reached around the 20th week of pregnancy. T3 showed a slight and definite increase in the beginning of pregnancy and levelled off to a constant value after the 14th week. TSH increased towards the end of pregnancy also showing its maximum during the last 4 weeks. TBPA showed constant values throughout pregnancy. The results are discussed in view of the use of modern techniques and previously missing data in literature (TBPA).     

不同保存液对自体静脉移植后血管内膜增生的影响

目的:探讨晶、胶体保存液对自体静脉移植后血管内膜增生的影响,以筛选出优良的移植血管保存液.方法:建立大鼠自体静脉移植模型,分为2组:晶体液保存组,术中移植静脉以晶体液保存;胶体液保存组, 术中移植静脉以胶体液保存.分别于术后第1 天、3天、1周、2周、4周、6周取材.对移植血管应用苏木精-伊红染色,进行组织形态学观察;应用免疫组织化学法观察增殖细胞核抗原(PCNA)、P21在移植后不同时期的表达情况.结果:晶体液保存组的静脉较胶体液保存组增厚明显;PCNA表达高峰在1～2周,晶体液保存的静脉表达较胶体液保存的静脉明显;P21在1～2周时表达水平较低,其后逐渐升高,至4周时达高峰,在同一时点,胶体液保存的静脉较晶体液保存的静脉表达明显.结论:自体静脉移植血管保存中,胶体保存液优于晶体保存液.     

The in vitro quality of washed, prestorage leucocyte-depleted red blood cell concentrates

BACKGROUND AND OBJECTIVES: No data are currently available on the quality of washed prestorage leucocyte-depleted red blood cell concentrates (RCCs). MATERIALS AND METHODS: Five groups of RCCs stored in additive solution (SAG-M) were washed. The groups differed in the age of RCCs (2-5 days or 11-15 days), the temperature during the washing procedure and a 6-h storage period (4 degrees C or room temperature) and the washing solution (saline, SAG-M or 5% albumin). We measured ATP, 2,3-diphosphoglycerate (2,3-DPG), haemolysis, blood cell count, Na(+), K(+), pH, pO(2), pCO(2) and lactate, before and after the washing procedure and hourly during the 6-h postwash storage period. RESULTS: The erythrocyte ATP content increased by 2-13%, relative to the baseline value, during the washing procedure. The 2,3-DPG level decreased by 15-35% in 2-6-day-old RCCs and by 30-40% in 11-15-day-old RCCs (relative to baseline values) during the washing procedure. In RCCs that were washed and stored at room temperature, and in 2-week-old RCCs, a further decrease in 2,3-DPG of up to 40%, relative to the baseline value, was observed during the 6-h postwash time-period. CONCLUSIONS: Washing of RCCs stored in SAG-M results in a considerable, significant loss of erythrocyte 2,3-DPG, especially in older RCCs. This loss increases in during a 6-h storage period postwash, even at 4 degrees C. This loss of erythrocyte quality might well outweigh the benefits of washed SAG-M RCCs during massive transfusion in neonates.     

Plasma 20 alpha-dihydroprogesterone, progesterone and 17-hydroxyprogesterone in normal human pregnancy

The peripheral plasma levels of 20alpha-dihydroprogesterone (20alpha-DHP), progesterone (P) and 17-hydroxyprogesterone (17-OHP) were measured by radioimmunoassay techniques in 440 samples during normal human pregnancy between weeks 4 and 41. The levels of 20alpha--DHP in plasma from the 4th to the 6th week were between 6.0 and 6.6 ng/ml. From then until the 21st week the average plasma 20alpha-DHP concentrations remained at the same level between 4.0 and 6.3 ng/ml; they then rose significantly to and beyond term, levels reaching over 40 ng/ml. The range of mean plasma concentration of P during the first trimester of pregnancy fell to a nadir in the 9th week (170 ng/ml) then rose with increased gestation until the 39th week (190.4 ng/ml) followed by a slight and not significant drop. Single measurements of plasma 17--OHP from the 4th to the 6th week of pregnancy gave value between 2.8 and 3.6 ng/ml, but from the 7th week the mean plasma 17--OHP levels gradually declined, then from week 30 the 17-OHP concentration increased to reach a mean level of 7.63 ng/ml in the 41st week. The ratio P/20alpha--DHP increased from the 4th (3.5:1) to the 24th week (15.6:1) and then decreased from 25th week (7.9:1) towards term (3.2:1).     

Inflammation of the liver causes mutations in duck hepatitis B virus genome

To investigate whether hepatitis causes mutation in the viral genome, DNA sequences in the pre-core region of duck hepatitis B virus (DHBV) DNA were analyzed in both ducks with hepatitis and without hepatitis. Five DHBV carrier ducks were injected with DHBV particle proteins purified from duck serum with Freund’s complete adjuvant (FCA) intrahepatically from 14 day posthatch for 9 weeks (immunized group). Serum was drawn at the end of the 1st and 4th week after the 1st injection of DHBV particle protein and ducks were killed at the end of the 9th week to obtain the liver. Another five ducks without treatment were used as controls. All ducks of the immunized group showed moderate to severe hepatitis at the 9th week. All ducks in the immunized group showed one mutation except one duck that showed two mutations only at the 9th week. Mutations were observed in the 5th, 13th, 21st, 22nd, and 28th codon of the precore region. All of them were point mutation at the 3rd base in the triplets. The frequency of mutation was different in each duck from 20% to 60% but not 100%. There was no mutations in ducks in control group. These results suggest that hepatitis causes mutation in the pre-core lesion genome of duck hepatitis B virus.     

MNNG诱导对日本血吸虫成虫培养细胞核仁组织区相关嗜银蛋白的影响

目的观察甲基硝基亚硝基胍（MNNG）诱导后日本血吸虫成虫培养细胞核仁组织区相关嗜银蛋白（Ag—NORs）含量的动态变化,探讨MNNG诱导后培养细胞的增殖能力。方法将日本血吸虫成虫细胞接种于小盖玻片上,置于含20％小牛血清附加常量抗生素的RPMI-1640常规培养基中培养;培养第4天,细胞随机分为实验组和对照组两组,实验组细胞以含3g／ml MNNG的常规培养基处理48h,对照组细胞则用不含MNNG的常规培养基作相同处理。细胞经彻底清洗后继续以常规培养基培养3周,然后换用含5％小牛血清的低血清培养基培养。MNNG处理后第1—9周,每周取实验组和对照组细胞采用略作修改的胶银法进行Ag—NORs染色,光镜下观察与拍照,HPIAS-2000图像分析仪测定代表培养细胞内Ag—NORs含量的吸光度（A）值,并进行统计学分析。结果培养过程中,对照组细胞着色逐渐变浅,MNNG组细胞除在第2周时着色变浅外,其余均逐渐加深,尤其在第6周（MNNG诱导后第5周）,细胞核呈深棕色,可见粗大的银染颗粒,核仁呈黑色,并观察到分裂细胞。第7—9周,两组细胞着色均逐渐变浅。定量分析发现,对照组细胞在培养初期Ag—NORs含量最高,随后逐渐降低;MNNG组的Ag—NORs含量在培养第2周时稍有降低,随后逐渐升高;在培养第6周即MNNG诱导后第5周时达到高峰,然后又逐渐下降。结论MNNG诱导可显著增强培养细胞的rDNA转录活性,提高细胞的分裂增殖能力,在MNNG诱导后第5周细胞增殖能力最强。     

Long-term effects of thyrotropin-releasing hormone and histidyl-proline diketopiperazine on the maturation of homeothermia and mitochondrial enzyme activities in neonatal rats

To elucidate the mechanism by which TRH and its metabolite, histidyl-proline diketopiperazine (cyclo(His-Pro], act on the maturation of homoiothermy, the chronic effects of intrathecal administration of the peptides on body temperature, serum thyroid hormone levels, and mitochondrial energy-producing enzyme activities were examined in neonatal rats. The two peptides or an equimolar mixture of both were injected intrathecally at a dose of 3, 6 and 9 nmol for 7 consecutive days during the 1st, 2nd or 3rd week of life, respectively. Control rats were treated with saline and they were sacrificed at 6 weeks of age. Although food and water intake were not decreased, body weight gain was slightly reduced in the rats treated with TRH or cyclo(His-Pro) during the 1st and 2nd week of life, whereas the mixture-treated rats showed normal weight gain. Body temperature at 25 degrees C was not different in the TRH- and cyclo(His-Pro)-treated groups, whereas after cold exposure (5 degrees C for 3 h), the groups treated with TRH during the 1st and 2nd week of life had an impaired thermoregulation at 5 weeks of age. Serum T4 and T3 concentrations were similar in all groups, except in the rats treated with TRH during the 2nd week of life; their thyroid hormone levels were slightly reduced. The TRH treatment suppressed mitochondrial cytochrome c reductase and glucose-6-phosphatase activities, whereas cyclo(His-Pro) reduced cytochrome c reductase and malic enzyme activities. In contrast, alpha-glycerophosphate dehydrogenase was enhanced by both treatments.(ABSTRACT TRUNCATED AT 250 WORDS)     

Serum digoxin concentrations during ethmozine antiarrhythmic therapy

The potential for pharmacokinetic drug interaction between ethmozine (moricizine HCl), a phenothiazine class I antiarrhythmic investigational drug, and digoxin was evaluated in 13 cardiac patients with normal renal function. Antiarrhythmic therapy was initiated in patients with potentially lethal (nonlife-threatening) ventricular arrhythmias (greater than 30 ventricular ectopic beats [VEB]/hr) who were receiving maintenance digoxin therapy for congestive heart failure and/or atrial fibrillation. Serum digoxin concentrations of patients were measured frequently by radioimmunoassay and plasma ethmozine concentrations by high-performance liquid chromatographic methods. Patients entered a short-term (4 weeks) single-blind, placebo controlled ethmozine protocol with an option to receive long-term (1 to 6 months) open-label maintenance ethmozine therapy. Ambulatory ECGs (48 hour) used to assess antiarrhythmic efficacy of ethmozine during each week of the short-term protocol showed that 77% of patients demonstrated greater than 90% mean hourly frequency suppression of all forms of ventricular ectopy. Serum digoxin concentrations during short-term ethmozine dosing showed a nonsignificant (p greater than 0.05) increase of 10% to 15% (mean 0.91 ng/ml to 1.13 ng/ml). The short-term protocol serum digoxin levels correlated closely with serum digoxin concentrations during placebo therapy (1st week, r = 0.90; 2nd week, r = 0.87). Serum digoxin concentrations were not significantly different (p greater than 0.05) from placebo values at the end of 1, 3, and 6 months of maintenance ethmozine therapy. Thus, we conclude that ethmozine administered in an antiarrhythmic efficacious dosage (10 mg/kg/day) showed no important clinical or statistically significant change in serum digoxin concentrations of cardiac patients with normal renal function.     

高脂血症对兔动脉壁一氧化氮系统的影响及药物的干预效果

将雄性纯种新西兰家兔36只随机分为三组,喂饲胆固醇形成实验性高胆固醇血症,部分加用麝香保心丸喂养;同时采用定量RT-PCR等技术,观察高脂血症对动脉壁一氧化氮系统代谢的影响,以及麝香保心丸的保护作用.结果表明:高脂饮食可造成动脉一氧化氮代谢的紊乱,降低动脉壁内皮型一氧化氮合酶(eNOS)基因的表达(P相似文献   

Gender and age at drinking onset affect voluntary alcohol consumption but neither the alcohol deprivation effect nor the response to stress in mice

Background: Epidemiological studies suggest that initiation of alcohol drinking at an early age is associated with an increased risk of developing an alcohol use disorder later in life. Nevertheless, relatively few studies using animal models have investigated the relationship between age of onset of drinking and ethanol drinking patterns in adulthood. Besides age at drinking onset, other factors such as gender could also affect the pattern of development of alcohol consumption. In rodents, many studies have shown that females drink more than males. However, even if it is assumed that hormonal changes occurring at puberty could explain these differences, only one study performed in rats has investigated the emergence of sex‐specific alcohol drinking patterns in adolescence and the transition from adolescence to adulthood. The aim of the present study was to compare the acquisition of voluntary alcohol consumption, relapse‐like drinking (the Alcohol Deprivation Effect—ADE) and stress‐induced alcohol drinking in male and female outbred mice that acquired alcohol consumption during adolescence or adulthood. Methods: Separate groups of naïve female and male WSC‐1 mice aged ± 28 days (adolescents) or ±70 days (adults) were given ad libitum access to water and 6% ethanol solution for 8 weeks (1st to 8th week) before undergoing a 2‐week deprivation phase (9th and 10th week). After the deprivation period, 2‐bottle preference testing (ethanol vs. water) resumed for 3 weeks (11th to 13th). During the 13th week, all animals were subjected to restraint stress for 2 consecutive days. Results: Over the entire time course of the experiment, ethanol intake and preference increased in females (both adults and adolescents). Adolescent animals (both females and males) showed a transient increase in alcohol consumption and preference compared to adults. However, by the end of continuous alcohol exposure (when all mice were adults), ethanol intake was not affected by age at drinking onset. A deprivation phase was followed by a rise in ethanol intake (ADE) that was not affected by sex or age. Finally, stress did not alter alcohol self‐administration either during or after its occurrence. Conclusions: Emergence of greater alcohol consumption in adult females does not seem to be limited to a specific developmental period (i.e., puberty). Age of voluntary drinking onset (adolescence vs. adulthood) does not affect eventual alcohol intake in adult WSC‐1 mice and does not modify the transient increase in ethanol consumption after alcohol deprivation.     

肺孢子虫感染大鼠模型的建立及ITS巢式PCR检测敏感性研究

目的 建立肺孢子虫感染大鼠模型并探讨ITS1-5.8S rDNA-ITS2巢式PCR检测卡氏肺孢子虫DNA的敏感性. 方法 大鼠分为实验组和对照组,实验组从第1周开始用每周2次每次每只皮下注射地塞米松1 mg的方法诱导,共8周,并分别在首次注射后第2、4、6、8周解剖大鼠制作肺印片、肺组织匀浆液及支气管肺泡灌洗液(BAL)涂片,并进行六亚甲基四胺银(Gomori's methenamine silver,GMS)染色镜检;对照组不作激素注射,并分别在0周和第10周剖杀染色检查.同时分别提取大鼠BAL和肺组织的肺孢子虫DNA进行巢式PCR扩增,比较GMS法和ITS巢式PCR检测的敏感性. 结果 实验组从第6周开始染色镜检,可见少量肺孢子虫包囊,第8周肺印片、肺组织匀浆液均检测到包囊,检出率为100%(10/10),BAL的检出率为80%(8/10),对照组则均未检出.用ITS1-5.8S rDNA-ITS2巢式PCR法均能检测出实验组第8周大鼠BAL和肺组织卡氏肺孢子虫DNA,阳性率为100%(10/10),对照组均为阴性.比较BAL标本、肺印片和肺组织匀浆液GMS染色法的检出率,BAL最低,肺组织匀浆液最高.其中20%(2/10)大鼠的BAL标本用GMS染色法未能检出,但用巢式PCR方法均能成功扩增.结论成功用地塞米松诱导法建立了肺孢子虫大鼠感染模型;ITS1-5.8S rDNA-ITS2巢式PCR检测卡氏肺孢子虫敏感性高、特异性强,可推广应用于临床诊断肺孢子虫肺炎.     

Corticosteroid injections in polymyalgia rheumatica: a double-blind, prospective, randomized, placebo controlled study

OBJECTIVE: To determine the efficacy and safety of shoulder corticosteroid injections in polymyalgia rheumatica (PMR). METHODS: Twenty consecutive patients with active PMR were randomized into a 7 month, double blind, placebo controlled study. Patients received either bilateral shoulder injections of 40 mg of 6-methylprednisolone acetate or placebo (1 ml saline solution). Responders were treated weekly with the same regimen for a total of 4 bilateral injections and then followed for 6 months. Response was defined as a 70% reduction in visual analog scale (VAS) score for pain and for patient and physician global assessment, and duration of morning stiffness. Bilateral shoulder magnetic resonance imaging (MRI) was performed at different times to evaluate the response of lesions to therapy. RESULTS: All 10 corticosteroid treated patients responded to the first injection with a significant reduction in duration of morning stiffness, VAS pain scale, patient and physician global assessment, erythrocyte sedimentation rate, and C-reactive protein. Interleukin 6 serum levels were significantly reduced after the 2nd injection. In 5 patients, the response persisted throughout the followup period. The other 5 withdrew within 4 weeks after the 4th injection due to recurrence of symptoms. None of the 10 patients of the placebo group responded to the first injection. The difference between the 2 groups was significant (p = 0.03). No side effects were recorded. MRI showed marked improvement of shoulder lesions one week after first injection and an almost complete resolution one week after last injection in the responders. CONCLUSION: Shoulder corticosteroid injections seem to be an effective and safe therapy for PMR.     

Alteration of epicardial lymphatics in lymphostatic canine hearts

Summary This study was conducted in an attempt to establish a method for evaluation of cardiac lymphostasis in autopsy cases and animal experiments. Ten mongrel dogs were operated on to induce cardiac lymphostasis in terms of ligation of coronary lymphatics. From the following day to 6 months after surgery, epicardial lymphatics were visualized to measure the volumes and densities of the lymphatics. The mean volume, measured after 1 week (0.27±0.09), 2 weeks (0.32±0.04), and 6 months (0.23±0.05) continued to be higher than that on the first day (0.16±0.04) (P<0.05). The density, measured after 1 week (2.6±0.3) and 2 weeks (3.7±0.7), also showed higher values, than that on the 1st day (1.7±0.7) (P<0.01). However, 6 months later, the measured value (1.9±0.03) showed no statistical difference compared to that of the 1st day. Observation under a binocular microscope revealed impressions of a progressive increase in both number and thickness of the lymphatics as late as 2 weeks after the induction. However, 6 months later, there was marked dilatation and a relative decrease in the number of lymphatics.     

The role of interleukin-6 and C-reactive protein in non-thyroidal illness in premature infants followed in neonatal intensive care unit

Objective: To investigate the role of interleukin-6 (IL-6) and C-reactive protein (CRP) in non-thyroidal illness (NTI) in premature infants.Methods: Serum levels of IL-6 and CRP, thyroid-stimulating hormone (TSH), total thyroxine (T4), free T4 (fT4), total triiodothyronine (T3), and free T3 (fT3) were determined at the 1st, 2nd and 4th weeks of postnatal life in 148 premature infants born before 33 weeks of gestation.Results: At the 1st week, serum T3 was negatively correlated with IL-6(r= -0.33, p= 0.001) and CRP (r= -0.17, p= 0.03). Serum T3 was negatively and more strongly correlated with IL-6 (r= -0.49, p= 0.001) and CRP (r=- 0.33,p= 0.03) at the 2nd week, at which time sepsis frequency and low T3 rates were the highest. At the 4th week, mortality rate was higher among infants with lower T3 levels.Conclusions: High IL-6 and CRP values related to neonatal sepsis might have a significant role in the pathogenesis of NTI in premature infants. Conflict of interest:None declared.     

Subarachnoid hemorrhage complicated with different manifestations of transient abnormal left ventricular wall motion: two case reports

Two patients with subarachnoid hemorrhage presented with transient abnormal left ventricular wall motion. Case 1 was a 56-year-old man. Electrocardiography showed ST segment elevation in leads I, II, II, aVL, aVF, V3-V6. Echocardiography showed localized left ventricular hypokinesis around the apical area (takotsubo-like cardiomyopathy). Ejection fraction was 20% (1st hospital day). Troponin T was positive. Case 2 was a 48-year-old woman. Electrocardiography showed ST segment elevation in leads I, aVL, V2-V6 and ST segment depression in leads II, III, aVF, V1. Echocardiography showed diffuse left ventricular hypokinesis. Ejection fraction was 21% (1st hospital day). Troponin T was positive. These two patients had no history of cardiac disease, and coronary angiography showed no stenosis or obstruction. Catecholamine was given for 1 day(Case 1) and for about 2 weeks (Case 2). Pimobendane was given to Case 2. Ejection fraction was 57% in Case 1 (2nd hospital day) and 33% (6th hospital day), 43% (7th hospital day)and 58% (16th hospital day)in Case 2. The recovery period of left ventricular abnormal wall motion and the medication period were longer in Case 2 showing diffuse hypokinesis than in Case 1 showing takotsubo-like cardiomyopathy.     

局部晚期胰腺癌放疗并同期5-FU对比吉西他滨的疗效分析

目的 比较放疗联合5-氟尿嘧啶（5-FU）与放疗联合吉西他滨治疗局部晚期胰腺癌的疗效及放、化疗不良反应.方法 回顾性分析第四军医大学西京医院放疗科2007年1月到2011年1月收治的56例局部晚期不可手术切除的胰腺癌患者的资料.入组患者均采用三维适形或三维适形调强放疗并同期给予单药5-FU或吉西他滨化疗.放疗剂量每次1.8 ～2 Gy,每周5次,总剂量45 ～ 50.4 Gy,共25～ 28次.同期吉西他滨化疗组共30例,在放疗期间的第1、8、15、22天以500 mg/m2体表面积的剂量、10 mg· （m2）-1·min-1微量泵泵入给药;放疗结束后休息3周,再以800 mg· （m2）-1·d-1的剂量静脉滴注,每周1次,连用3～4周.同期5-FU化疗组共26例,放疗期间以500 mg· （m2）-1·d-l剂量静脉滴注,每周第1～5天给药,14 d一个周期;放疗结束后休息3周,按照800 mg·（m2）-1·d-1的剂量静脉滴注,每周第1～5天给药,14 d一个周期,连用3～4个周期.观察疗效和不良反应,并对患者进行随访,随访截止日为2013年6月,计算患者中位生存时间和l、2年生存率.结果 全组客观有效率（CR＋ PR）为73.2％,放疗联合5-FU组总有效率为65.3％,放疗联合吉西他滨组总有效率80.0％（P＜0.05）.全组1、2年生存率分别为48.2％和14.3％,中位生存期为15.2个月,其中放疗联合5-FU组分别为42.3％、11.5％、13.3个月,放疗联合吉西他滨组分别为53.3％、16.7％、16.6个月,两组患者生存率差异无统计学意义（P=0.071）.治疗结束后全组疼痛客观缓解率（VAS评分＜4分）为83.3％,放疗联合5-FU组为75％,放疗联合吉西他滨组为90％.放疗联合吉西他滨治疗组发生3～4级骨髓抑制率显著高于放疗联合5-FU组,差异具有统计学意义（20.0％比7.6％,P＜0.05）.结论 手术不能切除的局部晚期胰腺癌患者采用放疗联合吉西他滨化疗在长期生存、疼痛缓解方面较放疗联合5-FU具有优势,但骨髓抑制的不良反应较强.