Epidural steroid injection for sciatica: An analysis of 526 consecutive cases with measurements and the whistle test

The effects of epidural injections of triamcinolone acetonide and bupivacaine in the treatment of sciatica were analyzed in a retrospective series of 526 consecutive cases with measurements. A new test (the whistle test) is described. There is a paucity of measureable parameters in reports on the subject in the literature, and many are not specific or symptom-oriented to sciatica. The procedure was performed by the same operator and reviewed one week post-operatively with measurements. 491 patients (93.35%) achieved excellent to good pain relief, backed by appropriate increases of straight-leg-raise measurements. But 17 patients (3.46%) of this group required surgery later. It is concluded that epidural steroid injection is a simple, cost-effective and minimally invasive treatment for sciatica, especially in the acute. It also serves as a method for crisis intervention and as a prognosticator.     

Effects on growth of single short courses of fluoroquinolones

The aim of the study was to document the effects of short courses of fluoroquinolones given during an outbreak of multidrug resistant typhoid fever in southern Viet Nam on the growth of children over a period of two years. In a prospective cohort study, 326 Vietnamese children aged between 1 and 14 years were followed up for two years after receiving either ciprofloxacin (70 mg/kg given over 7 d) (n = 173) or ofloxacin (45-50 mg/kg given over 3-5 d) (n = 153) for suspected typhoid fever. Growth velocity and weight for height were compared with an age matched control group of children from the same locality (n = 223) who had not contracted typhoid or received any fluoroquinolones. In the ofloxacin and ciprofloxacin treated patients there was no evidence of acute joint toxicity, nor of any joint symptoms attributable to either of the fluoroquinolones. There was no difference in expected weight for height measurements between the three groups of children over the two year period. During the first year, height velocity in ciprofloxacin treated children was greater than in either ofloxacin treated children or untreated controls. Height velocity in the latter two groups was not significantly different. After two years height velocity was similar in the three groups. The results support the use of short course fluoroquinolone treatment in childhood typhoid, especially when caused by strains resistant to other antibiotics.     

Energy and macronutrient intakes in preschool children in urban areas of Ho Chi Minh City,Vietnam

Background  

An increasing prevalence of overweight and obesity has been documented in preschool children in Ho Chi Minh City (HCMC), Vietnam. However, little is known about what preschool children in HCMC eat or how well their nutrient intake meets nutrient recommendations. This study aims to describe the energy and macronutrient intake and compare these nutrient intakes with the recommendations for Vietnamese children aged four to five years.     

向量图参数分析心力衰竭患者心肌复极离散指标及预后

目的:心电图QT间期离散度对心血管事件的预测价值仍有争议,实验从向量图的角度探讨QT间期离散度的应用及其对心力衰竭患者预后的预测价值。方法:①临床资料:2003-05/2005-07在桂林医学院附属医院住院的充血性心力衰竭患者229例为充血性心力衰竭组,年龄60～83岁;同期住院的急性冠脉综合征患者26例为急性冠脉综合征组;30例年龄匹配的正常人为正常对照组。所有受试者对实验均知情同意,实验符合伦理学标准。②检测方法:使用北京美高仪软件技术有限公司提供的Q/CPCGY 001-2000型心电综合分析系统检测向量图;同时检测与向量图同步记录的12导联心电图;应用上海群天医疗器械有限公司生产的Q/NYOZ-02-2001型动态心电图仪检测室性心律失常的发生情况;对充血性心力衰竭患者电话随访2年,只询问健在还是死亡。③观察指标:向量图各指标与QT间期离散度的关系、二者与心律失常事件和死亡率的关系。结果:285例受试者的资料均进入结果分析。①向量图指标:充血性心力衰竭组及急性冠脉综合征组额面及横面的QRS/T夹角均大于正常对照组(P<0.05);死亡组额面及横面的QRS/T夹角均显著大于生存组(P<0.05);室性早搏≥LOWNⅢ级者的额面及横面QRS/T夹角的平均角度均显著大于<Ⅲ级者(P<0.05～0.01)。②心电图指标:充血性心力衰竭组及急性冠脉综合征组QTc、间期离散度均大于正常对照组(P<0.05);死亡者的QTc显著大于生存者(P<0.01);室性早搏≥LOWNⅢ级QT者的QTc显著大于<Ⅲ级者(P<0.05)。③相关性分析:额面及横面的QRS/T环的夹角与QT间期离散度呈显著正相关(P<0.05)。结论:向量图的QRS/T夹角、心电图的QTc是反映心肌电不稳定、预测充血性心力衰竭患者心律失常事件、死亡率、以及长期预后不良的有用指标,QT间期离散度无预测作用。     

PRAVASTATIN IN ACUTE ISCHAEMIC SYNDROMES: RESULTS OF A RANDOMISED PLACEBO-CONTROLLED TRIAL

Therapy with individual 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) has been shown conclusively to diminish coronary event rates and mortality in both primary and secondary prevention. To date, scant attention has been paid to whether initiation of such regimens in the hospital phase of acute coronary syndromes might confer cardioprotective benefits. The purpose of this study was to determine the safety and tolerability of early initiation of statin therapy in patients with acute coronary syndromes. In this randomised, double-blind, three-month, pilot study, 100 patients with acute myocardial infarction or unstable angina and low-density lipoprotein cholesterol >3.5 mmol/l were randomly assigned to pravastatin 40 mg daily or placebo initiated within 48 hours of hospital admission. Pravastatin proved safe and well tolerated in these patients, who were well matched at baseline. No statistically significant differences in death, MI and drug-related adverse events were observed in the pravastatin group compared with control subjects. This pilot study shows that therapy with pravastatin early after an acute coronary event is safe and well tolerated. Larger, long-term studies are needed to confirm these findings.     

老年心力衰竭患者血浆脑钠肽前体质量浓度与QTc间期关系及对预后的预测

目的:分析老年充血性心力衰竭患者血浆脑钠肽前体与QTc间期的关系、以及二者对充血性心力衰竭预后的判断价值。方法:选择2003-05/2005-07在桂林医学院附属医院心内科住院的充血性心力衰竭患者208例[年龄(66.1±13.5)岁]。①使用罗氏2010全自动分析仪测定其脑钠肽前体质量浓度,根据测定值把患者分为<2000ng/L组,2000-3999ng/L组,4000-5999ng/L组和≥6000ng/L组4组。②12导同步心电图自动测算QTc间期,同时人工测量QT间期离散度,比较4组间的差异。③对患者随访2年,比较死亡和生存者QTc间期和QT间期离散度的差异。④采用直线相关回归分析法分析脑钠肽前体质量浓度与心脏各腔室直径、左室射血分数值、QTc间期和QT间期离散度的关系。结果:①随着脑钠肽前体质量浓度的增加,QTc也随之增宽,<2000ng/L组QTc间期比其他3组窄(P<0.01);QTd的改变只显示≥6000ng/L组宽于<2000ng/L组(P<0.05)。②随访期间的死亡率为15.4%(32/208),死亡者的平均QTc间期大于生存者[(430.80±39.16),(423.01±29.42)ms,P<0.01],但间期离散度差别不显著[(52.72±10.09),(53.38±18.89)ms,P>0.05]。③相关回归分析示脑钠肽前体质量浓度,左心房及左心室直径与QTc间期呈直线正相关(P<0.05-0.01),QTc间期与QT间期离散度呈直线正相关(P<0.014)。结论:①充血性心力衰竭患者患者血浆脑钠肽前体质量浓度与QTc间期有很好的相关性。②二者联合应用有助于充血性心力衰竭患者危险程度的分层,同时增高示预后不良。     

Preferred CDRH3 lengths for antibodies with defined specificities [In Process Citation]

The third complementarity determining regions of heavy chain variable regions (CDRH3) confer the fine specificities of antibodies. The CDRH3 length distribution of all human or all mouse antibodies appears to be more or less random, with the human distribution having a wider spread. Since the Kabat database of aligned amino and nucleotide sequences of proteins of immunological interest has grown at least 4 times during the past 7 years, we attempt to study CDRH3 length distributions of human and mouse antibodies with defined specificities, where enough complete and distinct CDRH3 sequences are available. For mouse antibodies against small haptens or carbohydrates, a preferred length usually dominates for a given specificity. There are not enough human sequences of small hapten or carbohydrate antibodies for a similar study. Both human and mouse anti-protein antibodies have wider ranges of CDRH3 length distributions, probably due to the presence of different antigenic epitopes on the protein molecules, and thus many different antibodies. For anti-DNA antibodies, both humans and mice exhibit even wider length distributions, since DNA can be double stranded, single stranded, supercoiled, etc.