Juvenile polyposis in a tropical country

The clinical profile, malignant potential, and management of 17 children with juvenile polyposis (more than five juvenile polyps) were evaluated clinically and endoscopically. Colonoscopy and polypectomy were done three weekly until colonic clearance was achieved, and thereafter two yearly. All polyps were subjected to histological examination. Mean age was 7.7 years, with a male preponderance (3:1). Presentation was with rectal bleeding (94%), pallor (65%), stunted growth (53%), and oedema (47%), and the mean (SD) duration of symptoms was 33 (27) months. None had a positive family history or any congenital anomaly. Two children had six polyps up to the transverse colon; the rest had numerous polyps all over the colon. All children had juvenile polyps on histology and 10 (59%) had adenomatous changes (dysplasia). Total colectomy was done in six for intractable symptoms. Colon clearance was achieved in eight after an average 3.4 polypectomy sessions, and three were still on the polypectomy programme. In conclusion, juvenile polyposis is commonly associated with low grade dysplasia. Serial colonoscopic polypectomy is effective but colectomy is required for intractable symptoms and when clearance of the colon is not possible.     

Cardiovascular effects of carbon dioxide in ventilated preterm infants

Sick preterm infants may, under certain conditions, demonstrate blood pressure passive cerebral blood flow in response to changes in arterial carbon dioxide tension. Blood pressure in turn depends on cardiac output and peripheral resistance. A Doppler technique for assessing cardiac output compared favourably in terms of reproducibility to a thermodilution technique in a group of infants undergoing cardiac catheterization for congenital heart disease. Doppler was subsequently used to monitor changes in cardiac output following an increase in arterial carbon dioxide tension of 1 kPa in 25 ventilated preterm infants. Blood pressure increased significantly (p = 0.006). However, heart rate did not change significantly (p = 0.16) and, in addition, both stroke and minute volume decreased (p = 0.023, p = 0.02, respectively). This suggests that accompanying changes in components of peripheral resistance exert important effects on blood pressure in the preterm neonate in response to changes in arterial carbon dioxide tension.     

2.26胃食管反流病(GERD)和功能性消化不良患者中射频消融对胃节律失常和胃排空的作用

目的明确在合并GERD和消化不良的患者(GERD+)中进行食管下段括约肌/贲门区的射频消融术(RFA)治疗对胃肌电活动及胃容量的影响. 方法于因GI疾病就诊的人群中选出45名难治性GERD患者(32名女性,13名男性,年龄:19-78岁),在进行RFA(Stretta procedure)之前,接受内镜及胃电图(EGG)-水负荷(WLT)试验:内镜显示为1级食管炎或正常黏膜;EGG-WLT采用标准方法检测,并且根据EGG节律带基线和计算机分析做出诊断(胃动过缓、胃动过速、混合型节律失常或正常).     

End-of-Life Medical Costs of Medicaid Cancer Patients

ObjectivesTo quantify end-of-life (EOL) medical costs for adult Medicaid beneficiaries diagnosed with cancer.ConclusionsMedicaid cancer patients incur substantially higher EOL costs than noncancer patients. This increased cost may reflect the cost of palliative care. Future studies should assess the types and timing of services provided to Medicaid cancer patients at the EOL.     

环磷酰胺对大鼠早期胚胎发育里程的影响

目的：为探索烷化剂对哺乳动物早期胚胎发育里程的影响及其可能的机制。方法：孕大鼠第３ 天ｉｐ 环磷酰胺（Ｃｙｃ １０ 、２０ 、４０ｍｇ／ｋｇ） ,孕第４ 天评价胚胎的胚胎化作用,胚胎发育时相,及蜕变胚胎率;同时显微外科分离胚胎内细胞团及滋养层细胞,评价两群细胞受损情况。结果：在Ｃｙｃ １０ｍｇ／ｋｇ 时,胚胎的胚泡化作用,胚胎发育时相均未受明显影响;４０ｍｇ／ｋｇ 时,蜕变胚胎率明显提高。胚泡化率及胚胎细胞数呈剂量依赖性减少,其中内细胞团细胞减少尤甚。结论：Ｃｙｃ 在未引起早期胚胎蜕变率显著增加时,可影响细胞周期,但不影响发育里程;高剂量时,显著影响发育里程并伴蜕变率显著增加     

从D-葡萄糖合成(3S,4S,5R)-4-O-苄基-3-表莽草酸甲酯

本文报道用D-葡萄糖为原料,经九步反应,对映选择地合成了标题化合物(10),从而为制备新抗生素二(口恶)霉素及类似物提供了对映选择合成的途径。     

新型头孢菌素的合成和抑菌试验

从7-氨基头孢烷酸(7 ACA)和7-氨基-3-去乙酰氧基头孢烷酸(7 ADCA)合成了六个7-取代连氮基头孢菌素和六个7α-甲氧基-7β-取代腙基头孢菌素,体外抑菌试验表明大部分化合物的抑菌活性较弱。