卡介苗膀胱灌注后尿后尿白细胞介素2及肿瘤坏死因子含量测？…

目的：寻找能早期评估表浅膀胱癌术后行卡介苗（ＢＣＧ）免疫治疗效果的精确指标。方法：分析采用ＣＴＬＬ－＾３Ｈ－ＴｄＲ掺入法及夹心法酶联免疫吸附试验，测定３２例表浅膀胱癌术后行ＢＣＧ膀胱灌注者尿液中白细胞介素２（ＩＬ－２）及肿瘤坏死因子（ＴＮＦ）含量。结果：全部病例均获随访２６￣６７个月，平均４３．５个月。３２例中有６例复发（１８．７％），复发患者灌注后尿液中ＩＬ－２及ＴＮＦ含量分别为（１４．３４±６     

检测白细胞介素预测卡介苗灌注预防膀胱癌术后复发的疗效

目的：寻找早期评估卡介苗（BCG）灌注治疗预防浅表性膀胱癌术后复发的疗效指标。方法：对37例膀胱癌患者术后应用BCG灌注治疗，检测治疗前及治疗6周后的血及尿中IL－2，IL－6，IL－8的含量，并结合病理及临床资料，探讨其与BCG疗效的关系。结果：全组患者治疗前后血清IL－8的含量差异有显著性意义（P＜0．05），未复发组治疗后尿IL－2，IL－6，IL－8含量明显高于治疗前，而复发组治疗前后无明显变化。结论：检测尿液中IL－2，IL－6，IL－8等的含量变化，对早期评估BCG的疗效有重要价值。对血清中IL－2，IL－6，IL－8等的研究对深入理解BCG的作用机制，有较大的帮助。     

BCG-CWS联合IL-2预防浅表性膀胱癌术后复发

目的：探讨介苗细胞壁骨架（BCG－WCS）＋白细胞介素2（IL－2）膀胱灌注预防浅表性膀胱癌术后复发的临床效果。方法56例浅表性膀胱癌局部手术后随机分为两组,每组28例。分别采用BCG－CWS加IL－2和单用丝裂霉素C（MMC）进行膀胱灌注。结果：56例随访12－30个月,平均22．9个月,BCG－WCS＋IL－2组有1例肿瘤复发,MMC组有5例肿瘤复发,两组肿瘤复发率判别有显著性意义（P＜0．05）;MMC灌注组的毒副反应较BCG－WCS＋IL－2组多。结论BCG－CWS联合IL－2预防浅表性膀胱癌术后复发疗效较好,副反应少,临床使用安全可靠。     

膀胱切缘注射白细胞介素2及术后灌注白细胞介素2加卡介苗预防膀胱癌复发(附33例报告)

目的：寻求预防膀胱癌术后复发的更有效方法。方法：采用术中膀胱切缘注射白细胞介素2（IL-2）和术后灌注IL-2加卡介苗（BCG）治疗33例膀胱癌患者。结果：随访4～77个月，复发率为9．1％。结论：采用此法预防膀胱癌术后复发安全有效。     

卡介苗膀胱灌注前后尿IL-8变化的临床意义

目的　探讨浅表性膀胱癌患者术后卡介苗 (BCG)灌注治疗前后IL 8及 pH值变化与疗效的关系。　方法　对 32例浅表性膀胱癌患者术后应用BCG膀胱灌注治疗 ,采用免疫化学发光法及常规尿液分析法检测治疗前、治疗 1次及 6次后IL 8及pH值变化情况。　结果　 32例患者随访6～ 2 5个月 ,5例肿瘤复发 ,复发者治疗前IL 8、pH值分别为 (181.2± 92 .3)ng/L及 5 .6± 0 .8,治疗 1次后为 (16 1.3± 6 4 .5 )ng/L及 6 .0± 1.4 ;未复发组治疗前为 (2 5 5 .6± 82 .9)ng/L、6 .1± 1.3,治疗 1次后为 (5 79.4± 77.8)ng/L ,6 .2± 0 .9,提示IL 8水平下降与肿瘤复发密切相关 (P <0 .0 1) ;但同期pH值的差别无显著性意义。 　结论　尿IL 8检测在预测BCG灌注治疗膀胱癌的疗效中有重要意义     

重症急性胰腺炎大鼠脾脏巨噬细胞Toll样受体4的表达及分泌细胞因子水平的变化

目的 观察重症急性胰腺炎（SAP）大鼠脾脏巨噬细胞（sMΦ）T0u样受体4（TLR4）基因表达及分泌细胞因子水平的变化。方法 建立大鼠SAP模型，分别于6、12、24、72h分离sMΦ，观察sMΦ静息状态下和经1mg／L脂多糖（LPS）刺激后分泌肿瘤坏死因子（TNF）-α、白细胞介素（IL）-6、白细胞介素（IL）-10水平的变化，逆转录-聚合酶链反应（RT-PCR）法检测sMΦ TLR4mRNA表达。结果 予LPS刺激后，对照组sM（I）分泌TNF-α、IL-6和IL-10水平显著升高，分别由（1．1844±0．3490）μg／L、（214．14±33．41）ng／L、（20．26±3．71）ng／L升至（9．3110±1．9962）μg／L、（519．01±52．64）ng／L和（55．43±6．28）ng／L，TLR4 mRNA表达亦由0．9091±0．2763明显升高至2．1944±0．6098；而模型各亚组分泌TNF-α和IL-6水平较刺激前无明显变化，同时TLR4 mRNA表达出现不同程度下调，且各指标均明显低于对照组。结论 SAP大鼠sMΦ对内毒素耐受的发生与TLR4 mRNA表达下调有关。     

BCG膀胱灌注对局部免疫细胞功能的影响

对２７例表浅膀胱癌术后ＢＣＧ膀胱灌注前后膀胱壁Ｔ＿３、Ｔ＿４、Ｔ＿８、ＩＬ－２Ｒ表达及尿液中肿瘤坏死因子（ＴＮＦ）含量进行了研究。结果表明，ＢＣＧ膀胱灌注后膀胱壁大量淋巴细胞浸润，Ｔ＿４／Ｔ＿８比值由灌注前０．６上升至１．９，２０例患者膀胱壁形成淋巴肉芽肿，粘膜下散在淋巴细胞表面广泛表达ＩＬ－２Ｒ，但肉芽肿淋巴细胞表面几乎不表达ＩＬ－２Ｒ。灌注后２４小时尿液中ＴＮＦ含量显著升高（Ｐ＜０．０１），实验结果提示：Ｔ＿４、巨噬细胞在ＢＣＧ抗肿瘤效应中起着非常重要的作用。     

胰腺肿瘤缺血再灌注加微球栓塞后血清细胞因子的变化

目的探讨胰腺缺血再灌注加微球栓塞对鼠胰腺癌血清肿瘤坏死因子（TNF）-α、白细胞介素-1（IL-1）和λ-干扰素（IFN-λ）含量及肿瘤生长的影响。方法大鼠胰腺尾部胰腺肿瘤形成后,阻断及开放胰腺尾部主要供血血管脾下动脉各30min,并经脾下动脉注入微球栓塞微血管,然后结扎脾下动脉。分别于术前及术后14d采用酶联免疫吸附法测定血清TNF-α、IL-2和IFN-λ的含量及观察胰腺肿瘤体积的变化。结果胰腺肿瘤缺血再灌注加微球栓塞组（E组）术前血清TNF-α、IFN-λ和IL-2的含量和胰腺肿瘤体积与阳性对照组（B组）和胰腺肿瘤缺血组（C组）及胰腺肿瘤缺血再灌注组（D组）之间比较差异均无显著性（P>0.05）。术后14dE组血清TNF-α、IFN-λ和IL-2的含量〔（79.5±8.7)ng/L、(106.0±10.8)ng/L、(346.1±13.1)ng/L〕明显高于B组〔（30.5±3.5)ng/L、（76.7±5.8）ng/L、（137.5±8.1）ng/L〕、C组〔（53.6±6.3）ng/L、（91.4±7.3）ng/L、（203.4±7.9）ng/L〕和D组（P<0.01）;且D、E组肿胰腺瘤体积也明显小于B、C组。结论胰腺肿瘤缺血再灌注加微球栓塞可导致鼠胰腺肿瘤血清TNF-α、IFN-λ和IL-2含量明显升高,并可使胰腺肿瘤体积明显缩小,其效果明显优于单纯的胰腺肿瘤缺血或胰腺肿瘤缺血再灌注。     

联合检测血清和尿液中透明质酸诊断膀胱癌的探讨

目的：探讨血清和尿液中透明质酸（HA）与膀胱癌的关系及其临床意义。方法：应用放射免疫分析（RIA）方法对47例膀胱癌患者术前血清和尿液中HA水平进行测定，并对其进行对比分析。结果：膀胱癌患者术前血清和尿液中HA水平分别为（221．04&#177;86．04）ng／ml和（381．21&#177;97．12）ng／ml，明显高于正常对照者（P〈0．01）；膀胱癌患者术前尿液HA水平与肿瘤的分级和分期密切相关（P〈0．01），但血清HA水平与肿瘤的分级和分期无相关性（P〉O．05）；术前尿液中的HA水平稍高于血清水平，但差异无统计学意义（P〉0．05）。以大于正常对照者血液和尿液中HA水平上限102．91ng／ml、144．70ng／ml为阳性界值时，检测血清和尿液HA的阳性率和敏感性为85．10％和89．36％，两者差异无统计学意义（P〉0．05），其阳性预测值分别为100％、97．67％，阴性预测值分别为100％、64．28％。结论：HA在膀胱癌患者外周血和尿液中均表达增高，可能参与膀胱癌的发生和发展，可作为检测膀胱癌的指标。     

膀胱局部的毒副作用与BCG用量之间关系的研究

为了解BCG用量与膀胱局部的毒副作用之间的关系,将37例膀胱癌术后行腔内BCG灌注病人随机分为三组:常规剂量BCG120mg组,BCG 60mg+10万u IL2组,及BCG 60mg组。观察第三次灌注后24小时内的局部毒副反应,及PCR方法检测灌注后不同时间尿结核杆菌的阳·性率。结果显示:低剂量BCG两组的膀胱刺激症状要明显小于常规剂量组,血尿的程度与膀胱刺激症状相一致;而常规剂量组的尿结核杆菌阳性的持续时间要长于两低剂量BCG组,BCG 60mg组与BCG 60mg+IL2组之间无明显差别,膀胱癌复发率短期之内各组之间无差别,提示:减低BCG用量或与IL-2合用可以从主观及客观上减轻BCG的毒副作用,且不影响近期疗效。     

Reversal of vecuronium with neostigmine in patients with diabetes mellitus

Reversal of vecuronium-induced neuromuscular blockade with neostigmine was compared in two groups of 16 subjects: patients with Type 2 diabetes mellitus and normal controls. When the first twitch of the train-of-four had returned to 25% of the control value, neostigmine 40 microg x kg(-1) and atropine 20 microg x kg(-1) were given to reverse the neuromuscular blockade. The train-of-four ratio was lower at 3 min, 6 min, 9 min, 12 min and 15 min after reversal in the diabetic group than in the control group but the differences did not reach statistical significance. Fifteen minutes after reversal, the number of patients in whom recovery from neuromuscular blockade was judged insufficient to guarantee good respiratory function (train-of-four ratio < 0.74) did not differ between the groups. However, 15 min after reversal, the number of patients with a train-of-four ratio < 0.9 was significantly higher in the Diabetic Group than in the Control Group (15 vs. 10, p = 0.033).     

Tomographic studies of rCBF with99mTc-HM-PAO SPECT in comparison with PET in patients with primary brain tumors

^99mTc-hexamethyl-propyleneamine-oxime (HM-PAO) was developed as a radiotracer of regional cerebral blood flow (rCBF) with SPECT. THe purpose of this study was to investigate if HM-PAO is able to trace rCBF in primary brain tumors. In 10 patients with glioblastoma grade IV the intracerebral distribution of HM-PAO was studied in comparison with C¹⁵O₂ steady state inhalation technique and PET for rCBF evaluation. In all instances the cerebral HMPAO distribution was comparable with rCBF pattern as confirmed by a significant correlation of tumor to cortex ratios. The results indicate the clinical usefulness of HMPAO for tracing rCBF in brain tumors.     

Electrophysiological effects of sevoflurane in comparison with propofol in children with Wolff-Parkinson-White syndrome

OBJECTIVE: To evaluate the electrophysiological effects of sevoflurane in children with Wolff-Parkinson-White (WPW) syndrome undergoing radiofrequency ablation. METHODS: We performed a prospective study of 15 patients with WPW syndrome who were scheduled for an electrophysiological study (EPS) and radiofrequency ablation. Anesthesia was induced with fentanyl (2 microg/kg), propofol (3 mg/kg), and vecuronium (0.1 mg/kg), and initially maintained using propofol (100 microg/kg), with bolus administration of fentanyl and vecuronium as required. Four intracardiac catheters were introduced for the EPSpropofol, which included measurements of sinus-node function, sinoatrial-node conduction, refractory periods (atrial, AV-node, accessory pathway anterograde and retrograde, and ventricular), and the characteristics of induced orthodromic tachycardia. The propofol was then replaced with sevoflurane (1 MAC adjusted for age) and the measurements were repeated (EPSsevoflurane). The EPSpropofol and EPSsevoflurane data were compared using the Wilcoxon signed-rank test. RESULTS: The mean (SD) age was 9.3 (6) years. After administration of sevoflurane, the duration of the antegrade effective refractory period of the accessory pathway increased (EPSpropofol, 283 (22) ms; EPSsevoflurane, 298 (25) ms; P = .004), as did the duration of the minimum pacing cycle with 1:1 atrioventricular conduction (EPSpropofol, 244 (41) ms; EPSsevoflurane, 273 (28) ms; P = .028). No significant changes were observed in the other parameters. Ablation of the accessory pathway was achieved in all patients. CONCLUSIONS: Sevoflurane partially modified the properties of the accessory pathway but did not prevent ablation.     

Treatment of Osteoporosis in Men with Fluoride Alone or in Combination with Bisphosphonates

Alendronate has been approved as a first antiresorptive drug for treatment of osteoporosis in men. Except for fluoride, in some countries so far there has been no approved anabolic substance for the treatment of male osteoporosis. From small studies in men and male patients included in studies on postmenopausal osteoporosis there is sufficient evidence that fluoride has the same osteoblast-stimulating potency in men and women. In our own study on 64 men with idiopathic osteoporosis without prevalent fractures, a low-dose intermittent fluoride regimen (15 mg fluoride ions 3 months on, 1 month off) resulted in an average gain of lumbar spine BMD of 3% per year and a lower rate of incident fractures as compared with patients treated with calcium only. A combination of fluoride with an antiresorptive drug may improve the therapeutic results in terms of pattern of biochemical marker response and gain in BMD. This was shown for postemopausal osteoporosis in several studies using fluoride and hormone replacement therapy (HRT). Encouraged by a Dutch study using etidronate/fluoride in corticoid-induced osteoporosis, we performed a pilot study in 33 men with severe established primary osteoporosis giving cyclically etidronate for 14 days followed by fluoride plus calcium/vitamin D for 76 days. This combined regimen resulted in significantly higher increases of BMD than fluoride or etidronate alone. In an ongoing trial we are studying a continuous, combined treatment of alendronate and fluoride plus calcium/vitamin D in established idiopathic osteoporosis in men. The results of a preliminary evaluation look very promising. A large study with a bisphosphonate plus fluoride, taking fractures as the primary endpoint and bone biopsies to assess safety, would be very valuable.     

Chemiluminescence of neutrophils in patients with glomerulonephritis treated with methylprednisolone

The effect of high dose methylprednisolone (Solu-Medrol, Up John) (1000 mg) on chemiluminescence (CL) of peripheral blood neutrophils in patients with various primary glomerulopathies was determined. Contrary to the well-established influence of corticosteroids onin vitro suppression of leukocytic chemiluminescence, our studies disclose a remarkable enhancement of neutrophil chemiluminescent activity in patients receiving pulse methylprednisolone infusion. Subsequent administrations of the drug did not result in any significant change of the analysed parameters. Increased chemiluminescence returned to the pretreatment values within approximately seven days. A possible explanation for the observed phenomenon is discussed.     

Comparison of clofibrate with halofenate in diabetics with hyperlipidaemia.

In a double-blind, randomized study which lasted 48 weeks the effects of clofibrate and halofenate were compared in maturity-onset diabetics with hyperlipidaemia. With the use of both clofibrate and halofenate serum cholesterol values were lowered only slightly. Both agents significantly reduced triglyceride values, but the decreases were modest and transient. Both drugs significantly lowered serum urate values, although the effect of halofenate was distinctly greater. Halofenate, but not clofibrate, had a considerable hypoglycaemic effect on the patients, most of whom were also receiving oral antidiabetic medicines. The drugs produced a number of clinical and biochemical adverse reactions, and in about 20% of all patients the trial had to be discontinued prematurely. The management of hyperlipidaemia in maturity-onset diabetics is briefly discussed, and it is concluded that neither clofibrate nor halofenate is to be recommended.     

Detection of Endoparasites with Zoonotic Potential in Dogs with Gastrointestinal Disease in the UK

We report a substantial prevalence study in symptomatic pet dogs of important zoonotic parasitic enteric infections. A total of 4526 dogs which had a faecal sample submitted to a diagnostic laboratory in the UK between 2003 and 2005 were included in the study. The most common parasite was Giardia spp., which was found in 380/4526 dogs (8.4%, 95% CI 7.6–9.2%). Surprisingly, Cryptosporidium spp. infection was detected in only 29/4526 (0.6%, 95% CI 0.4–0.9%). Toxocara canis was found in 63/4526 dogs (1.4%; 95% CI 1.1–1.8%). Prevalence of Giardia (P < 0.001) was significantly higher in dogs <12 months of age, with nearly one‐fifth of all symptomatic dogs under 6 months being infected with Giardia. Some seasonality was detected with a higher prevalence of Cryptosporidium oocyst shedding found from October to December. These data are of importance for veterinarians in judging the likelihood of enteric parasitic infection in an individual with clinical signs. Moreover, they provide information to direct future work in determining the risk to the human population from parasitic zoonoses of dogs.