单纯分泌醛固酮的肾上腺皮质癌一例报告

患者，男性，４２岁。高血压病史３年，头晕，疲乏无力１个月，于１９９７年９月１５日入院。检查：血压２１～１７／１６～１３ｋＰａ（１ｋＰａ＝７．５ｍｍＨｇ），血钾２３±０．８２ｍｍｏｌ／Ｌ，２４小时尿量３６００±６８０ｍｌ，其中夜尿３３００ｍｌ，尿钾９...     

胰岛素对人卵泡内泡膜细胞分泌雄激素的影响

培养取自月经周期正常妇女卵泡期卵泡的内泡膜细胞，观察人绒毛膜促性腺激素（ｈＣＧ）和胰岛素（ＩＮＳ）对内泡膜细胞分泌雄烯二酮（Ａ）、１７α羟孕酮（ＯＨ－Ρ）和孕酮（Ｐ）的影响。结果表明，ｈＣＧ和ＩＮＳ均刺激内泡膜细胞增加Ａ、ＯＨ－Ｐ和Ｐ的分泌。两者刺激内泡膜细胞分泌激素增加的浓度分别是０．５ＩＵ／ｍｌ和１０ｎｇ／ｍｌ。与基础状态相比，ＩＮＳ（５ｎｇ／ｍｌ）刺激Ａ、ＯＨ－Ｐ、Ｐ的分泌分别增加２．９、４．７和２．４倍，ｈＣＧ（０．１ＩＵ／ｍｌ）分别增加７．４、３．４和２．８倍；ＩＮＳ＋ｈＣＧ共同刺激分别增加９．５、９．３和４．３倍。ＩＮＳ在人卵巢甾体激素的合成中起重要的调节作用     

肝硬变门静脉高压症患者血肾上腺素,去甲肾上腺素浓度测定

作者使用高效液相色谱检测了肝硬变门静脉高压症患者（３８例）、原发性高血压患者（２４例）和对照病人（３４例）周围静脉血及上腔静脉、周围动脉、门静脉血肾上腺素和去甲肾上腺素浓度。肝硬变组及原发性高血压组患者周围血肾上腺素浓度分别为５７．５±３７．４ｐｇ／ｍｌ和５４．９±３９．９ｐｇ／ｍｌ，差异无显著意义，但与对照组（２３．５±１１．２ｐｇ／ｍｌ）相比浓度均有显著升高（Ｐ＜０．０１）。肝硬变组及原发性高血压组患者周围血去甲肾上腺素浓度分别为４５１．１±３８１．２ｐｇ／ｍｌ和５２４．３±２１ｐｇ／ｍｌ，与对照组相比（１８３．０±８３．３ｐｇ／ｍｌ）差异有极显著意义（Ｐ＜０．０１）。术中取上腔静脉、动脉和门静脉血分别比较肾上腺素和去甲肾上腺素浓度，除上腔静脉血肾上腺素浓度的差异有显著意义外（８３．７±４６．７ｐｇ／ｍｌ与２０７．２±５５．４ｐｇ／ｍｌ，Ｐ＜０．０５），其余差异均无显著意义。本研究结果表明肝硬变门静脉高压症患者存在着明显的儿茶酚胺类递质的代谢紊乱，其对患者全身及内脏血流动力学的影响与门静脉高压症发生发展的关系值得深入研究。     

前列腺部分电切术在高危前列腺增生症中的应用

为了提高高龄高危前列腺增生症（ＢＰＨ）患者的治疗效果，对７２例高危ＢＰＨ病人采用经尿道部分前列腺电切治疗，平均随访３．５年。结果显示：电切前列腺组织平均１４．４ｇ，占预测前列腺重量的２１．９％；术后ＩＰＳＳ由２６．５±３．７降至１０．２±２．７，最大尿流率由５．９±２．５ｍｌ／ｓ提高至１４．８±２．３ｍｌ／ｓ，而术后再手术率与其他并发症并未增加。切除前列腺组织１０～１５ｇ与１５～２５ｇ两组的术后ＩＰＳＳ、尿流率无明显差异。认为经尿道部分前列腺电切适用于高龄高危ＢＰＨ病人，手术不必刻意追求前列腺切除的重量及彻底性，其效果关键在于切除的部位与方法。     

不同病变的前列腺特异性抗原临床分析

采用双抗体放射免疫法先后检测２７５例不同病变患者血清前列腺特异性抗原（ＰＳＡ），其中前列腺癌（ＰＣａ）２０例，１８例阳性，２例〈４ｎｇ／ｍｌ，假阴性率１０％；良性前列腺增生症（ＢＰＨ）１２５例，其中２５例ＰＳＡ〉１０ｎｇ／ｍｌ；成年男性其它病变（肝、肺、及胰腺、肾脏等癌和肝硬化、消化道出血等疾病）９１例，其中８７例〈６．１５ｎｇ／ｍｌ，４例〉１０ｎｇ／ｍｌ健康体检男性３５例，其中ＰＳＡ值均〈２．８     

常温体外循环不同灌注流量下组织摄氧的研究

为探讨心脏直视手术在常温体外循环不同灌注流量下组织摄氧情况，对连续２０例在常温体外循环下行成人心脏手术以４组不同灌注流量行分时段（２０分钟为一个时段）观察研究，监测动、静脉血气分析，计算氧利用率和摄氧量。Ａ组每分钟流量２．０－２．１Ｌ／ｍ２，氧供需平衡的时段占６４％，氧利用率为３６．２±９．０％，摄氧量每分钟１１０．９±４１．０ｍｌ／ｍ２；Ｂ组每分钟流量２．２－２．４Ｌ／ｍ２，氧供需平衡的时段占７１％，氧利用率３２．５±１０．９％，摄氧量每分钟１１２．２±４６．０ｍｌ／ｍ２；Ｃ组每分钟流量２．５－２．６Ｌ／ｍ２，氧供需平衡的时段占３３％，氧利用率２６．９±９．３％，摄氧量每分钟８５．３±２２．７ｍｌ／ｍ２；Ｄ组每分钟流量２．７～２．８Ｌ／ｍ，氧供需平衡的时段占２７％，氧利用率２５．１±４．１％，摄氧量每分钟８７．９±１５．５ｍｌ／ｍ２。结论为常温体外循环流量每分钟２．２－２．４Ｌ／ｍ时组织氧供需平衡较其他流量为好，过高流量供氧并不增加组织的氧摄入。     

罗哌卡因胸段硬膜外阻滞对急性心肌缺血/再灌注损伤的保护作用

目的 探讨罗哌卡因胸段硬膜外阻滞对急性心肌缺血再灌注损伤的保护作用。方法 健康杂种犬１８条,随机分为罗哌卡因组（Ⅰ组）、布比卡因组（Ⅱａ组）和生理盐水组（Ⅱｂ组）,表解雇洽麻后控制呼吸,Ｔ６－７间隙穿刺置入硬膜外导管,按分组分别硬膜外注射０．５％罗哌卡因、０．５％布比卡因或生理盐水１２ｍｌ、１５ｍｉｎ后,阻断左冠状动脉４５ｍｉｎ。分别在给药前和开放后６ｈ抽取右心房血。轻Ｃａｒｄｉａｃ试剂条测定血浆心肌肌钙蛋白Ｔ（ｃＴｎＴ）浓度,并取左心室梗塞区心肌组织作透射电镜观察。结果 阻断前血浆ｃＴｎＴ浓度三组均〈０．０５ｎｇ／Ｌ。开放６ｈ三组各有４例升高、２例无变化,其中Ⅰ组４例均〈０．１ｎｇ／Ｌ,Ⅱａ组２例〈０．１ｍｇ／Ｌ、２例介于０．１～３ｎｇ／Ｌ,Ⅱｂ组４例均介于０．１～３ｎｇ／Ｌ。Ⅰ组与Ⅱｂ组比较有显著性差异（Ｐ     

几丁糖阿霉素缓释药粒治疗骨巨细胞瘤的临床初步观察

为了观察骨巨细胞瘤刮除术后局部应用几丁糖阿霉素缓释药粒的疗效及全身反应，对４例骨巨细胞瘤刮除术后残腔应用４倍于常规静脉阿霉素用量的几丁糖阿霉素缓释药粒，检测术后１，２及５天血浆中阿霉素含量，以及术后１周、１个月及６个月的肝肾功能。结果表明，术后１，２及５天血浆中阿霉素含量分别为（１４３．０５±２７．５５）ｎｇ／ｍｌ、（５２．１７±１１．２８）ｎｇ／ｍｌ及（４．２５±３．０７）ｎｇ／ｍｌ，术后１周、１个月及６个月的肝肾功能均正常。随访７个月～１９个月，无局部复发、全身反应及Ｘ线片复发表现。认为，几丁糖阿霉素缓释药粒用于骨巨细胞瘤刮除术后是安全、有效的。     

bFGF对培养兔关节软骨细胞作用的实验研究

目的：在于了解硷性成纤维细胞生长因子（ｂＦＧＦ）对关节软骨细胞分裂增殖及其特点以及功能代谢的影响。方法：体外单层培养兔关节软骨细胞,以１ｎｇ／ｍｌ、１０ｎｇ／ｍｌ、１００ｎｇ／ｍｌ的ｂＦＧＦ作用细胞２、４、６ｄ,测ＤＮＡ含量及基质中糖醛酸含量,阐明细胞的增殖及代谢的变化。同时,在１０ｎｇ／ｍｌｂＦＧＦ作用下,采用流式细胞技术进行细胞周期亚时相分析。结果：结果显示在１～１００ｎｇ／ｍｌ浓度范围内,ｂＦＧＦ对培养软骨细胞的增殖及代谢均有促进作用,以１０ｎｇ／ｍｌ浓度作用最佳。细胞周期较对照组明显缩短,ＤＮＡ合成前期（Ｇ１期）,ＤＮＡ合成期（Ｓ期）和分裂前期及分裂期（Ｇ２Ｍ）的时间分别为１１５、１６３、７２ｈ,对照组分别为２２３、１７９、１５８ｈ。结论：ｂＦＧＦ对培养的关节软骨细胞增殖及基质代谢有促进作用,能缩短软骨细胞ＤＮＡ合成Ｇ１期及Ｇ２Ｍ期而达到缩短细胞周期、促进细胞分裂增殖的。     

5-氟尿嘧啶在胰十二指肠切除术患者血液和胰液中的动态分布

探讨５－氟尿嘧啶能否通过胰十二指肠切除术后的残留胰腺组织进入胰液中,并达有效的治疗浓度,为胰腺为临床合理化疗提供理论依据。方法通过观察胰十二指肠切除术患者胰快速推注５－氟尿嘧啶后血液和胰液中药物动态分布及相关性,术后静脉一次性快速推注５－氟尿嘧啶１．０ｇ／ｍ＾２,在给药前后按设计时间点分别采集静脉血和胰液,采用高效液相色谱法测定血浆和胰液５－氟尿嘧啶药物浓度,应用ＰＣＮＯＮＬＩＮ程序程序计算共动态     

Distribution of ciclosporin in the lymphoid tissue]

To clarify the distribution and the kinetics of ciclosporin (CSA) in the lymphatic system, we measured the CSA level of the lymph from the thoracic duct drainage (TDD) and that of the peripheral blood after oral or intravenous administration of CSA in 13 TDD pretreated patients. We also measured the CSA level of the iliac lymph nodes in 20 patients undergoing transplant surgery. The mean CSA level of the lymph was 1,647 ng/ml in the first 2 hours, 1,551 mg/dl in the next 10 hours and 254 ng/dl in the last 12 hours in orally administered patients and the mean CSA level of the peripheral blood was 746 ng/ml at 2 hours, 263 ng/ml at 12 hours and 119 ng/ml at 24 hours later. In intravenous administration, the mean CSA level of the lymph was 68 ng/ml, 58 ng/ml and 33 ng/ml and the mean CSA level of the peripheral blood was 452 ng/ml, 105 ng/ml and 88 ng/ml respectively. The mean CSA level of the lymph node was 3,222 ng/g and the mean diffusion rate from the peripheral blood to the lymph node was 17.1. There was no difference between oral and intravenous administration. These results indicated that (1) there is a second pathway in which orally administered CSA is transported from small bowel to general circulation; via mesenteric lymph duct, thoracic duct and subclavic vein and (2) CSA is selectively uptaken by lymph node. CSA might suppress the activation of T cells in the lymph node and the lymph more effectively than in the peripheral blood.     

Prostatic tissual distribution of alfuzosin in patients with benign prostatic hyperplasia following repeated oral administration

OBJECTIVES: The blood and prostatic concentrations of alfuzosin were determined in patients with benign prostatic hyperplasia (BPH). METHODS: 12 patients scheduled for BPH surgery were treated with alfuzosin 5 mg twice daily prior to surgery in an open trial. Seven doses were given over a 4-day period. Blood samples were drawn before the first and the last intake (day 3). On day 4 (surgery day), a blood and prostate tissue sample were taken simultaneously 12 hours after the last drug intake. RESULTS: Mean trough blood levels were 6.0+/-4.6 ng/ml and 5.8+/-3.7 ng/ml on day 3 and day 4, respectively, indicating a stable alfuzosin concentration. The mean prostate concentration on day 4 was 12.3+/-5.6 ng/g. Alfuzosin prostate and blood concentrations at 12 hours post dosing on day 4 were significantly correlated (r=0.804, p=0.0016); the prostate-blood ratio was 2.4+/-0.7. CONCLUSIONS: Oral administration of alfuzosin leads to a high diffusion of the drug into the prostate of BPH patients.     

急性胰腺炎大鼠脑组织TNF-α mRNA和蛋白表达及其意义

目的 探讨急性胰腺炎大鼠脑组织中TNF-α mRNA和蛋白的表达及其对胰性脑病发病机制的意义.方法 应用5%、1%的牛磺胆酸钠分别诱导急性坏死性胰腺炎(ANP)和急性水肿性胰腺炎(AEP)大鼠模型,同时设立假手术组,每组16只.分别于模型诱导后12 h,以酶联免疫吸附(ELISA)法测定大鼠血液和脑脊液标本中TNF-α的含量,RT-PCR方法测定脑组织TNF-α mRNA的表达,Western-Blot测定TNF-α蛋白的表达水平,免疫组化观察TNF-α蛋白的定位表达.结果 ANP组、AEP组和假手术组的血清TNF-α水平分别为1065.6pg/ml、577.5pg/ml和543.8pg/ml,脑脊液TNF-α水平分别为820.9pg/ml、307.4pg/ml和481.6pg/ml.ANP组血清和脑脊液TNF-α水平同AEP组和假手术组相比,差异均有显著性(P＜0.05).ANP组脑组织TNF-α mRNA和蛋白的表达明显增强.ANP组TNF-α蛋白的表达定位于大脑小胶质细胞和神经元细胞.结论 在ANP病程中,大鼠脑组织可能是细胞因子过度表达的来源之一;脑组织中,TNF-α主要由小胶质细胞和神经元细胞表达;TNF-α的过度表达可能是ANP早期脑髓鞘损伤的原因之一.     

Synovial and plasma glucosamine concentrations in osteoarthritic patients following oral crystalline glucosamine sulphate at therapeutic dose

OBJECTIVE: We investigated the synovial and plasma glucosamine concentrations in osteoarthritic patients following oral administration of crystalline glucosamine sulphate at the therapeutic dose of 1500mg once-a-day for 14 days. DESIGN: Twelve osteoarthritic patients (six males and six females) received 14 consecutive once-daily oral administrations of crystalline glucosamine sulphate soluble powder (1500mg), in an open fashion. Plasma and synovial fluid were collected simultaneously from the same patient, at baseline and, at steady state (3h after the last dose). Glucosamine was determined in plasma and synovial fluid by liquid chromatography-tandem mass spectrometry. RESULTS: Median endogenous glucosamine concentrations in plasma and synovial fluid were 52.0ng/ml (0.29microM) and 36.5ng/ml (0.21microM), respectively (P=0.001), and varied substantially among patients (41-121ng/ml and <10-67ng/ml, respectively). Three hours after the last dose, glucosamine concentrations resulted increased from baseline in all patients with median increases of 20.5 and 21.5 folds in plasma and synovial fluid, respectively, the difference being not statistically significant (P=0.11). In plasma, the median post-treatment value was 1282ng/ml (7.17microM) and ranged from 600 to 4061ng/ml (3.35-22.7microM). The median post-treatment synovial glucosamine concentration was 777ng/ml (4.34microM), i.e., significantly lower than in plasma (P=0.001), and ranged from 577 to 3248ng/ml (3.22-18.1microM). Plasma and synovial glucosamine concentrations were highly correlated and were in the 10microM range. CONCLUSIONS: Glucosamine is bioavailable both systemically and at the site of action (the joint) after oral administration of crystalline glucosamine sulphate in ostaeoarthritis patients. Steady state glucosamine concentrations in plasma and synovial fluid were correlated and in line with those effective in selected in vitro studies.     

Penetration of 99mTcO4- into cerebrospinal fluid from blood on brain scintigraphy (author's transl)]

It is well known that the permeability of the blood brain barrier and blood cerebrospinal fluid barrier changes more or less in various diseases of the central nervous system. At present, thee is no clinically available index which reflects the alteration of the permeability of the blood brain barrier and blood cerebrospinal fluid barrier. The brain scintiraphy is an examination which detects a breakdown in the blood brain barrier, its clinical usefullness is limited only in a localized and extremely pathological proces of the brain. In this report, a cerebrospinala fluid isotope measurement comined with the brain scintigraphy was presented as a clinical examination for blood brain barrier function. Thirty minutes prior to brain scintigraphy, potassium perchlorate (4 mg/kg) was given orally to reduce the accumulation of 99mTc04-in the choroid plexus and to minimize iradiation for tr other organs. Spinal tap was performed two hours after injection of 99mTc04- according to Haines's method...     

Research on the effect of atenolol on lidocaine pharmacokinetics in rats

The aim was to determine the influence of atenolol on lidocaine pharmacokinetics in rats for one hour interval of time (average of a dental intervention). The study was carried out on 2 groups of Wistar rats treated with saline solution (0.5 ml/kg), respectively with atenolol (1.5 mg/kg), administered orally 24 hours and 3 hours before intraperitoneal administration of lidocaine (1.5 mg/kg). Blood samples were collected before and 5, 10, 20, 30, 60 minutes after lidocaine administration. Lidocaine plasma concentrations were determined by HPLC. Some pharmacokinetic parameters of lidocaine were statistically significant higher (p < 0.05, ANOVA) for the rats treated with atenolol compared with control group: Cmax (196.97 +/- 2.15 ng/ml vs. 125.29 +/- 2.90 ng/ml), AUD (7734.07 +/- 129.06 ng/ ml x min vs. 4478.57 +/- 296.61 ng/ml x min), AUC1 after 5 minutes (314.23 +/- 6.59 ng/ml x min vs. 190.71 +/- 19.75 ng/ml x min). Tmax was 20 minutes, similar for both groups. CONCLUSION: local anesthesia with lidocaine might be enhanced in the presence of atenolol compared to controls.     

血小板激活因子在急性重症胰腺炎发 病过程中作用的实验研究

作者为探讨血小板激活因子在狗急性重症胰腺炎发病过程中的作用，采用１７只比格（Ｂｅａ－ｇｌｅ）狗，随机分为三组：对照组（ｎ＝５）、胰腺炎组（ｎ＝６）、治疗组（ｎ＝６）。胰腺炎组及治疗组动物制成急性重症胰腺炎动物模型。治疗组动物在模型复制后５ｍｉｎ，３ｈ分别静脉注射血小板激活因子（ＰＡＦ）拮抗剂ＢＮ５２０２１（５ｍｇ／ｋｇ）。用温氏法测定血清淀粉酶活性，血小板聚集法测定血清及胰腺组织中ＰＡＦ的含量。结果显示：急性重症胰腺炎模型复制成功后３０ｍｉｎ，胰腺炎组血清淀粉酶活性即上升到基础值的２００±４４．７％，８ｈ高达４６６．７±１１１．６％。８ｈ时与对照组、治疗组差异均有显著性意义（Ｐ＜０．０５）。胰腺炎组血中ＰＡＦ含量在３０ｍｉｎ时即开始上升，８ｈ达最高１１．８１±０．７８ｎｇ／ｍｌ，在３０ｍｉｎ之后与对照组比较即差异有非常显著的意义（Ｐ＜０．０１），而１ｈ之后与治疗组差异有非常显著的意义（Ｐ＜０．０１）。胰腺组织中ＰＡＦ含量，胰腺炎组比治疗组及对照组明显增高（Ｐ＜０．０１）。作者认为ＰＡＦ在急性重症胰腺炎的发病过程中起重要作用，ＰＡＦ拮抗剂有希望成为治疗急性重症胰腺炎的有效药物。     

8种抗生素透入犬胰组织能力的实验研究

为了解抗生素渗透胰组织的能力,以便为选择合适的抗生素治疗继发性胰腺感染提供参考依据。作者在建立犬急性出血坏死性胰腺炎模型的基础上,应用高效液相色谱法测定犬血清和胰组织中抗生素的浓度,并计算出它们的胰组织渗透率。结果：头孢噻肟,氧氟沙星,丁胺卡那霉素,氧哌嗪肯青霉素,头孢哌酮,氨苄青霉素,甲硝唑和环丙沙星的胰组织渗透率由小到大依次为１２％,１９％,２０％,４６％,５５％,６３％,７１％和１３２％。     

Beta-enolase in blood plasma during open heart surgery--comparing with CK-MB and CA-III in blood plasma

Enolase isozyme composed of the beta subunit (alpha beta or beta beta enolase) is distributed predominantly in the heart and skeletal muscles. Concentrations of beta-enolase (beta subunit of enolase) in blood plasma samples serially taken from 18 patients, who received mitral valve replacement, were estimated by using a highly sensitive enzyme immunoassay method and compared with those of CK-MB in the same samples. Plasma beta-enolase levels, that were 6.60 +/- 3.84 ng/ml at the beginning of anesthesia, increased rapidly after reperfusion reaching the plateau more than 100 ng/ml between 2 to 12 hours, showing two peak (116 +/- 45.7 ng/ml at 4 hours and 112 +/- 48.1 ng/ml at 12 hours after reperfusion), and then decreased slowly remaining high levels even when plasma CK-MB levels became normal. The beta-enolase concentrations were significantly higher in coronary sinus samples than in arterial samples early after reperfusion. Since plasma carbonic anhydrase III, which is known to be localized only in the skeletal muscle, did not increase during the surgery, it is suggested that the major portion of elevated plasma beta-enolase levels were derived from the heart muscle. Plasma levels of beta-enolase increased as quickly as those of CK-MB after reperfusion and kept high levels longer than those of CK-MB. These results indicate that the determination of beta-enolase in plasma may be useful for estimating the myocardial damage during open heart surgery.     

Norfloxacin concentration in human prostatic tissue after 3 days administration

The penetration of norfloxacin into prostatic tissue was evaluated on 36 patients with benign prostatic hypertrophy. Norfloxacin was administered orally in a dose of 200 mg three times daily for 3 days preoperatively, blood samples were taken simultaneously at the time of tissue sampling. The patients were divided into 2 groups, groups 1 and 2. In group 1, tissue sampling was done after about 17 hours of final administration of the drug. The mean concentration of norfloxacin in prostatic tissue was 0.38 +/- 0.18 micrograms/g and 0.18 +/- 0.09 micrograms/ml in serum. In group 2, sampling was done after 5.5 hours of final administration. The mean concentration of norfloxacin in prostatic tissue was 0.89 +/- 0.32 micrograms/g and 0.49 +/- 0.25 micrograms/ml in serum.