抗角蛋白自身抗体对银屑病裸鼠皮损移植模型的影响

目的：建立银屑病裸鼠皮损移植模型,观察抗角蛋白自身抗体（AK auto Ab)对银屑病动物模型的影响。方法：将人体银屑病皮损组织块移植于裸鼠背部,移植后一组裸鼠腹腔注射纯化的人体AK auto Ab,另一组裸鼠腹腔注射生理盐水作为对照,从组织病理变化评价银屑病裸鼠皮损移植模型的可行性以及AK auto Ab对移植的银屑病皮片组织学改变的影响。结果：对照组皮损植片相当一段时间内能稳定地维持银屑病的部分重要组织学改变,而AK auto Ab注射组则可使银屑病的组织学特征的维持时间明显缩短。结论：银屑病裸鼠皮损移植模型是银屑病短期内理想的动物模型,AK auto Ab具有促进银屑皮炎恢复的作用。     

丙肝宁对动物实验性肝损伤的保护作用

目的 研究中药复方丙肝宁的保肝作用。方法 采用Ｄ－Ｇａｌ造成大鼠的急性肝损伤模型和ＣＣＩ４所致慢性肝损伤模型。结果 丙肝宁２个剂量组对Ｄ－Ｇａｌ造成大鼠的急性肝损僵模型和ＣＣＩ４所致慢性肝损伤模型的血清酶活性均具有明显的抑制作用（Ｐ〈０．０５,Ｐ〈０．０１）,病理检查结果表明,丙肝宁２个剂量组对Ｄ－Ｇａｌ造成大鼠的急性肝损伤模型和ＣＣＩ４所致慢笥肝损伤模型的肝脏病理形态的改变具有明显的改善作用。结     

不同方法制作犬腹主动脉瘤模型的比较

目的：探讨用于检验带膜记忆合金支架血管腔内搭桥治疗动脉瘤的模型。方法：分别以实验动物腹直肌后鞘、Ｄａｃｒｏｎ补片、不同口径的Ｄａｃｒｏｎ人血管及球囊导管材料,采用四种不同手术方法制作腹主动脉瘤模型。结果：１１例动物１０例模型制作成功,１例死亡,１月后造影检查发现９例的动脉瘤模型形态满意,１例动脉脉瘤扩张程度较差。结论;以腹阗甩垢鞘为材料制作动脉瘤模型具有取材方便,操作简便、不易漏血、无异物反应的优     

Treatment of femoral neck nonunions with a sliding compression screw: comparison with and without subtrochanteric valgus osteotomy

BACKGROUND: The aim of this prospective study was to investigate and compare the results of treatment of femoral neck nonunions using a sliding compression screw (SCS) with and without subtrochanteric valgus osteotomy (SVO). METHODS: Thirty-two consecutive patients with femoral neck nonunions, which sustained no osteonecrosis of the femoral head based on bone scan study, were prospectively treated with SCS with (21 patients) or without (11 patients) SVO. The indication for SCS with SVO was a femoral neck nonunion with leg shortening of more than 1.5 cm. SCS without SVO was for leg shortening of less than 1.5 cm. RESULTS: Seventeen patients with osteotomy and nine patients without osteotomy were followed for at least 2 years (range, 2-8 years). All femoral neck fractures healed, with a union period of 4.6+/-1.0 months (95% confidence interval, 4.1-5.1 months) for osteotomy cases and 4.6+/-1.1 months (95% confidence interval, 3.8-5.4 months) for nonosteotomy cases (p = 0.83). However, in the osteotomy group, two patients sustained osteonecrosis of the femoral head, and nonunion remained in 1 patient at the osteotomy site (complication rate, 18%; 3 of 17 patients). There were no complications in the nonosteotomy group (p = 0.26). The average lengthening achieved from osteotomy was 1.0 to 1.5 cm (p < 0.001). CONCLUSION: Using SCS without SVO to treat femoral neck nonunions can result in a very satisfactory outcome. It is thus preferred for indicated patients. SCS without SVO, however, cannot concomitantly correct a femoral neck shortening; furthermore, shortening may deteriorate because of a telescoping effect. For patients with evident shortening, therefore, combined SVO with SCS is more suitable.     

Total Esophagectomy versus Proximal Esophagectomy for Esophageal Cancer at the Cervicothoracic Junction

To investigate the adequate extent of esophagectomy and lymphadenectomy for an esophageal cancer localized at the cervicothoracic junction, the mortality and morbidity rates, survival rates, and patterns of recurrence were retrospectively analyzed in two groups—14 patients who underwent total esophagectomy with or without laryngectomy and 15 patients who underwent proximal esophagectomy with or without laryngectomy—at Kurume University Hospital from 1981 to 1996. Proximal esophagectomy with or without laryngectomy resulted in a lower hospital mortality rate and better overall survival for patients who underwent curative esophagectomy compared with total esophagectomy with or without laryngectomy. Multivariate analysis indicated that the extent of esophagectomy (total esophagectomy versus proximal esophagectomy) was not a prognostic factor. The incidence of recurrence was not different between the two groups. Lymph node metastasis or recurrence from such esophageal cancers was localized to the neck and upper mediastinum. For an esophageal cancer localized at the cervicothoracic junction, therefore, proximal esophagectomy with or without laryngectomy and with cervical and upper mediastinal lymphadenectomy could be better indicated for preselected patients.     

Uptake of postnatal services for mothers of newborn babies up to eight weeks of age

AIM: Significant changes have occurred in the way postnatal care is funded in New Zealand since July 1996. This study investigated three aspects of postnatal care: the uptake of the six-week check, the six-week immunisation and breast feeding rates. METHOD: A prospective prevalence survey of 504 mothers of newborn babies recruited from birthing centres in urban Auckland over the period November 1997 to February 1998. A postal questionnaire was sent at ten weeks postnatal, covering issues concerning the six-week check, six-week immunisation and breast feeding. RESULTS: Four hundred and four completed questionnaires were obtained (82%); 98% of respondents had obtained a six-week check and 90% a six-week immunisation for their infant. Infants who received their six-week check from a general practitioner were more likely to be immunised. Younger mothers (15-19 years) and older mothers (35 years plus) were less likely to have immunised children. Of reasons given for not immunising, 43% were concerns over immaturity of the baby and 27% because the child was not well. At birth, 88% of mothers were fully breast feeding and 62% at six-weeks postnatal. Of the reasons given for stopping feeding, 41% stated insufficient milk or poor weight gain and 15% stated failure to establish feeding. CONCLUSIONS: Removing the six- week check from a general practitioner check and splitting it from the immunisation, has a deleterious effect on immunisation uptake. Mothers, particularly under 20 years, but also 35 years plus, are less likely to have immunised infants. A significant number of unimmunised babies arose from concerns that the baby may be too immature. The rate of breast feeding in New Zealand is continuing to drop. Actual rates fall well below mothers' desires to breast feed. Reasons given for stopping breast feeding point to a general need for greater postnatal support. The high rate of failure to establish feeding raises concerns over lack of early postnatal support. In July 1996 significant changes in payment of the maternity services benefit were introduced in New Zealand. In particular, postnatal services previously paid on a 'fee-for-service' basis were altered to a set capped amount for the 'postnatal module'. This led to concerns that care in the postnatal period had become more limited. In particular, there were anecdotal reports of the six-week check not being given, or being given by a range of providers who did not necessarily offer the opportunity for immunisation at the time of the check. Recent concerns have also been expressed about the apparent dropping immunisation rates in New Zealand, and the dropping breast feeding rates. The present study, developed in response to these concerns investigated three aspects of postnatal care: (a) The incidence of the uptake of the six-week check and whether mothers perceived any barriers to access. (b) The incidence of the uptake of the six-week immunisation and whether mothers perceived any barriers to access. (c) The rate of breast feeding and what barriers mothers perceived to continuing to breast feed.     

Novel experimental model using free radical-induced emesis for surveying anti-emetic compounds from natural sources.

A novel experimental model of free radical-induced emesis for screening anti-emetic compounds from natural sources was established. 2,2'-Azobis(2-amidinopropane) dihydrochloride (AAPH) dissolved in liposome induced emesis in young chickens, and the emesis was prevented by antioxidants including N-(2-mercaptopropionyl)-glycine (MPG), alpha-tocopherol, and L-ascorbic acid. Tropiseton, a serotonin receptor antagonist, also prevented emesis induced by AAPH. Known anti-emetic drugs and anti-emetic principles from natural sources also showed significant retching inhibition in the experiment using this system.     

Reduced cardiotoxicity of doxorubicin given in the form ofN-(2-hydroxypropyl) methacrylamide conjugates: an experimental study in the rat

Summary A rat model was used to evaluate the general acute toxicity and the late cardiotoxicity of 4 mg/kg doxorubicin (DOX) given either as free drug or in the form of threeN-(2-hydroxypropyl)methacrylamide (HPMA) copolymer conjugates. In these HPMA copolymers, DOX was covalently bound via peptide linkages that were either non-biodegradable (Gly-Gly) or degradable by lysosomal proteinases (Gly-Phe-Leu-Gly). In addition, one biodegradable conjugate containing galactosamine was used; this residue was targeted to the liver. Over the first 3 weeks after the i.v. administration of free and polymer-bound DOX, all animals showed a transient reduction in body weight. However, the maximal reduction in body weight seen in animals that received polymer-bound DOX (4 mg/kg) was significantly lower than that observed in those that received free DOX (4 mg/kg) or a mixture of the unmodified parent HPMA copolymer and free DOX (4 mg/kg;P<0.01). Throughout the study (20 weeks), deaths related to cardiotoxicity were observed only in animals that received either free DOX or the mixture of HPMA copolymer and free DOX; in these cases, histological investigations revealed marked changes in the heart that were consistent with DOX-induced cardiotoxicity. Sequential measurements of cardiac output in surviving animals that received either free DOX or the mixture of HPMA copolymer and free DOX showed a reduction of 30% in function beginning at the 4th week after drug administration. The heart rate in these animals was 12% lower than that measured in age-matched control rats (P<0.05). Animals that were given the HPMA copolymer conjugates containing DOX exhibited no significant change in cardiac output throughout the study (P<0.05). In addition, no significant histological change was observed in the hearts of animals that received DOX in the form of HPMA copolymer conjugates and were killed at the end of the study. However, these animals had shown a significant increase in heart rate beginning at 8 weeks after drug administration (P<0.01). This study demonstrates that covalent binding of DOX to HPMA copolymer conjugates via both stable and biodegradable peptidyl linkages considerably reduces both the general acute toxicity and the late cardiotoxicity of DOX in the rat and could offer the potential for improving the therapeutic index in the clinical application of DOX.     

The protective activity of ICRF-187 against doxorubicin-induced cardiotoxicity in the rat

Summary The protective activity of the bisdioxopiperazine ICRF-187 against the cardiotoxicity of doxorubicin was evaluated in the rat using both functional and histological assays. Animals that had received a single i. v. dose of doxorubicin (4 mg/kg) alone were compared with those that had been pretreated with a single i. v. injection of saline or ICRF-187 (40 or 60 mg/kg). All rats showed a transient reduction in body weight during the first 3 weeks after drug administration. The greatest reduction (16%) was observed in animals that had received a combination of ICRF-187 (40 or 60 mg/kg) and doxorubicin. Deaths related to cardiotoxicity were observed only in rats that had received doxorubicin alone and in those treated with saline; most of the deaths occurred at between 8 and 13 weeks after drug administration. Sequential assessments of heart function showed a persistent depression of cardiac output in animals that had received doxorubicin, with or without pretreatment with ICRF-187. The reduction in cardiac output observed in rats that had been pretreated with ICRF-187 (40 or 60 mg/kg) amounted to 15% and 30% after 12 and 20 weeks, respectively, indicating that cardioprotection was only partial. Nevertheless, this represented a marked improvement as compared with the 35% reduction in cardiac output measured at 12 weeks in animals that had received doxorubicin but without pretreatment with ICRF-187. Histological examination of animals that had died during the course of the study and had received doxorubicin after pretreatment with saline revealed severe myocardial lesions typical of doxorubicin-induced damage. In contrast, animals that had been pretreated with ICRF-187 and survived for up to 20 weeks after treatment showed a marked amelioration of these lesions. The present findings may be interpreted as a true cardioprotection or a delay in the onset of the cardiotoxicity of doxorubicin resulting from pretreatment with the bisdioxopiperazine ICRF-187. Although prior and ongoing clinical trials clearly indicate that ICRF-187 protects patients well against doxorubicin-induced heart damage, further investigations are required beforehigh doses of ICRF-187 can be used as a means of increasing the protective activity of this drug against doxorubicin-induced cardiotoxicity.This work was supported by the Cancer Research Campaign