α_1肾上腺素能受体阻滞剂萘哌地尔治疗慢性非细菌性前列腺炎的临床研究

目的:探讨α1肾上腺素能受体阻滞剂萘哌地尔(Naftopidil)治疗慢性非细菌性前列腺炎的有效性及安全性。方法:采用开放、自身对照、多中心的临床试验方法,应用萘哌地尔25mg,每日1次,对106例慢性非细菌性前列腺炎(NBP)患者进行了为期4周的治疗。以美国国立卫生院慢性前列腺炎症状评分(NIHCPSI)、前列腺液(EPS)WBC计数及最大尿流率(MFR)为疗效指标,对其有效性及安全性进行观察。结果:服药4周后,可评价病例105例。全组患者NIHCPSI总评分治疗前后平均减低12.0分(P<0.001),症状评分平均减低7.9分(P<0.001),生活质量评分平均减低4.1分(P<0.001)。EPS中WBC计数治疗前及治疗后分别为(15.2±15.1)、(9.5±12.0)个/HP(P<0.01)。MFR治疗前及治疗后分别为(19.2±4.8)、(22.7±4.9)ml/s(P<0.01)。按症状改善评价,治愈2例(1.9%),显效32例(30.5%),有效55例(52.4%),无效16例(15.2%)。总显效率为32.4%,总有效率为84.8%。3例有轻度头晕,1例食欲不佳,不良事件发生率3.81%。结论:萘哌地尔治疗慢性非细菌性前列腺炎安全、有效。     

Der modifizierte erweiterte distal gestielte sapheno-fasziokutane Suralislappen

Zusammenfassung Nach Verifikation der anatomischen Voraussetzungen wurde eine modifizierte Technik des erweiterten saphenofasziokutanen Suralislappen für große kombinierte Knochen-Weichteil-Infekt-Defekt-Situationen sogenannte Typ-C-Läsionen bei Risikopatienten mit ersatzschwachem bzw. ersatzunfähigem Lager (traumatische ipsilaterale arterielle Hauptgefäßläsion, tiefe ipsilaterale Venenthrombose, diabetische Polyneuropathie mit Mikroangiopathie bzw. PAVK Stadium 3) in einer prospektiven Studie angewendet. Zehn Weichteildefekte zwischen 80–180 cm² im Mittel-Rückfuß- bzw. distalen Unterschenkelbereich wurden einzeitig komplett mit einem retrograd gestielten modifizierten saphenofasziokutanen Suralislappen aus dem proximalen Unterschenkel gedeckt. Alle Lappen heilten ohne Lappennekrosen ein. Die Entnahmestellen wurden siebenmal mittels primärer Naht und dreimal einzeitig mit Meshgraft verschlossen. Bei der Nachuntersuchung aller Patienten nach im Mittel 22 Monaten bestanden vitale Lappen, keine Hebedefektmorbidität, kein Suralisneurom und es war kein sekundäres Debulking oder andere lappeninduzierte Revisionen erforderlich.     

The prognostic significance of serum alpha 1-fetoprotein in children and adolescents with malignant extracranial non-testicular germ cell tumors]

The cooperative therapy study MAKEI 83/86 included an examination of the prognostic value of the AFP in children and adolescents with extracranial non-testicular yolk sac tumors. The serum AFP values of 72 protocol- and follow-up-patients were documented at diagnosis and up to the ninth month of treatment. 32 of these patients had saccrococcygeal tumors, 27 had tumors of the ovary and 13 suffered from extragonadal germ cell-tumors. 4 children showed progressive disease under initial chemotherapy and 1 patient died of therapy, 10 of 72 patients relapsed. The AFP measurements were plotted on semilogarithmic charts. They were compared to the measurements of healthy children up to the age of 1 year. According to the development of the patients' AFP values compared to the reference curves the following classifications could be made: 1. Patients with a normal AFP-decrease id est 50% in less than or equal to 6 days during the 1st month of therapy: 48/72 patients 2. Patients with slow AFP-decrease: 17/72 patients 3. Patients with transient AFP-decrease: 5/72 patients 4. Patients with no AFP-decrease: 2/72 patients According to Kaplan-Meier life table analysis, patients with a normal AFP-decrease had an event-free survival of 89% +/- 4%, whereas all other patients showed an event-free survival of 63% +/- 10% (p less than 0.05). Regarding primary therapy id est tumor resection or preoperative chemotherapy an equal distribution of the patients among those with a normal and slow AFP-decrease was observed.(ABSTRACT TRUNCATED AT 250 WORDS)     

Elimination of bacteria on different implant surfaces through photosensitization and soft laser. An in vitro study.

Microbiologic examinations of implants have shown that certain micro‐organisms described as periodontal pathogens may have an influence on the development and the progression of peri‐implant disease. This experimental study aimed to examine the bactericidal effect of irradiation with a soft laser on bacteria associated with peri‐implantitis following exposure to a photo‐sensitizing substance. Platelets made of commercially pure titanium, either with a machined surface or with a hydroxyapatite or plasma‐flame‐sprayed surface or with a corundum‐blasted and etched surface, were incubated with a pure suspension of Actinobacillus actinomyetemcomitans or Porphyromonas gingivalis or Prevotella intermedia. The surfaces were then treated with a toluidine blue solution and irradiated with a diode soft laser with a wave length of 905 nm for 1 min. None of the smears obtained from the thus treated surfaces showed bacterial growth, whereas the smears obtained from surfaces that had been subjected to only one type of treatment showed unchanged growth of every target organism tested ( P <0.0006). Electron microscopic inspection of the thus treated platelets revealed that combined dye/laser treatment resulted in the destruction of bacterial cells. The present in vitro results indicate that lethal photosensitization may be of use for treatment of peri‐implantitis.     

Acute megakaryocytic leukemia in children. Clinical, immunologic, and cytogenetic findings in two patients.

An unusual presentation of acute megakaryocytic leukemia (AMKL) is reported in two young children. The first child had a 10-day history of ptosis of the right eyelid as the initial manifestation of AMKL, a clinical picture not previously described in this variant of leukemia. Computed tomographic scanning showed multiple intracranial mass lesions, and the diagnosis of AMKL was confirmed by immunophenotyping of bone marrow blasts. The second child had Down syndrome and received alkylating agents and radiation therapy for treatment of metastatic rhabdomyosarcoma of the orbit. She had AMKL as second malignancy. Both patients had acquired chromosome 21 anomalies in their leukemic blasts. The first patient, constitutionally normal, had an i(21q) in his leukemic blasts; the patient with constitutional trisomy 21 had tetrasomy 21 and additional chromosomal changes. The clinical symptoms and the results of morphologic, immunologic, and cytogenetic studies are discussed.     

北方汉族人群维生素D受体基因Bsm I位点多态性与前列腺癌易感性的相关性分析

目的 :研究低发病的中国汉族人群维生素D受体基因 (VDRG)BsmⅠ 位点单核苷酸多态性 (SNP)与前列腺癌的关系 ,探讨不同种族前列腺癌发病的基因差异。　方法 :收集中国北方地区汉族人群 10 3例前列腺癌病人及10 6例健康对照者外周血标本 ,应用变性高效液相色谱 (DHPLC)检测VDRG第 8内含子BsmⅠ多态位点 ,并对该位点SNP分布进行分析。　结果 :BsmⅠ 多态位点bb、Bb、BB基因型和等位基因在北方地区汉族前列腺癌病人及对照者中的分布频率差异无显著性 (P >0 .0 5 ) ,基因型分布频率分别为 92 .2 3%、7.77%、0和 94.34 %、5 .6 6 %、0 ;等位基因B、b分别为 3.88%、96 .12 %和 2 .91%、97.0 9%,而与高发病人群的分布相比有显著不同。　结论 :VDRGBsmⅠ多态性在低发病的中国汉族人群与前列腺癌无相关 ,其分布与高发病人群有明显差异 ,提示VDRGBsmⅠ多态性可能是前列腺癌发病种族差异的原因之一。     

The Boston AIDS Survival Score (BASS): a multidimensional AIDS severity instrument.

OBJECTIVES: This study developed a new acquired immunodeficiency syndrome (AIDS) severity system by including diagnostic, physiological, functional, and sociodemographic factors predictive of survival. METHODS: Three-hundred five persons with AIDS in Boston were interviewed; their medical records were reviewed and vital status ascertained. RESULTS: Overall median (+/- SD) survival for the cohort from the first interview until death was 560 +/- 14.4 days. The best model for predicting survival, the Boston AIDS Survival Score, included the Justice score (stage 2 relative hazard [RH] = 1.25, 95% confidence interval [CI] = 0.80, 1.96; stage 3 RH = 1.76, 95% CI = 1.15, 2.70), a newly developed opportunistic disease score (Boston Opportunistic Disease Survival Score; stage 2 RH = 1.35, 95% CI = 0.90, 2.02; stage 3 RH = 2.10, 95% CI = 1.38, 3.18), and measures of activities of daily living (any intermediate limitations, RH = 1.84, 95% CI = 1.05, 3.21; any basic limitations, RH = 2.60, 95% CI = 1.44, 4.69). This model had substantially greater predictive power (R2 = .17, C statistic = .68) than the Justice score alone (R2 = .09, C statistic = .61). CONCLUSIONS: Incorporating data on clinically important events and functional status into a physiologically based system can improve the prediction of survival with AIDS.