Risk of ovarian failure and fertility preserving methods in girls and adolescents with a malignant disease

Girls and young women suffering from a malignant disease that requires treatment with chemo- and/or radiotherapy are at risk of losing fertility. The most significant risk factors are age and type of treatment given. Preserving fertility is of high priority to both the young patient and her parents. This article reviews the effect of chemo- and radiotherapy on gonadal function, and thus fertility, and offers different fertility preserving methods based on the literature. Cryopreservation of ovarian tissue is a possible way of preserving fertility in this group of patients in the future.     

Efficacy,safety and tolerance of continuous erythropoietin receptor activator intravenous administration on anemia correction in dialysis patientswith chronic renal anemia

Objective To evaluate the efficacy, safety and tolerance of continuous erythropoietin receptor activator (CERA) once every 2 weeks intravenous injection on anemia correction in dialysis patients compared to Epoetin?β (EPO?β) administration. Methods An open?label, randomized, parallel, active?control and multi?center clinical trial was performed. All the hemodialysis or peritoneal dialysis patients with chronic renal anemia who had not been treated with erythropoiesis?stimulating agents (ESAs) for at least 8 weeks before entering the treatment phase were randomized (1∶1) to receive either CERA once every 2 weeks intravenous administration (CERA group, n=132) or intravenous EPO?β three times weekly (EPO group, n=133) for 24 weeks including 16?week correction period and 8?week efficacy evaluation period. At week 25, the patients who reached the target Hb (defined as Hb≥110 g/L and increase in Hb≥10 g/L from baseline without red blood cell transfusion during the 24 weeks after the first dose) were kept on CERA or EPO?β treatment regimen for the subsequent 28 weeks to evaluate the long?term safety and tolerability. The starting dose of CERA was 0.4 μg/kg. Two primary endpoints were (1) the Hb response rate during the first 24 weeks; and (2)the mean change in Hb between the baseline and the evaluation periods (week 17 to week 24). Results Totally 232 patients (87.5%) completed the first 24?week treatment and 198 patients (74.7%) completed the whole study treatment (52 weeks). The response rate in CERA group during the first 24 weeks was 87.12%[95% CI（80.2% to 92.3%）]. Since the lower limit of the 95%CI was greater than 60% (P＜0.01), CERA once every 2 weeks intravenous administration was considered as effective in correction of renal anemia. The difference between CERA group and EPO group in mean change of Hb from evaluation periods to baseline in the per?protocol (PP) population was -4.7 g/L [95%CI (-7.38 g/L to -1.92 g/L)]. Since the lower limit of 95%CI was greater than the pre?defined non?inferiority margin -7.5 g/L (P=0.0205), CERA was considered as non?inferior to EPO in the maintenance of Hb after anemia correction. The Hb level remained stable during the subsequent 28?week extension period in both CERA and EPO groups. During the whole study period, the overall safety findings were similar in CERA and EPO groups, 50.0% and 54.6% of patients experienced at least one adverse event (AE) respectively. The findings from AEs were in accordance with the characteristics of the studied population. Conclusions Intravenous CERA once every 2 weeks is safe and effective for correcting anemia in dialysis patients. Treatment with CERA once every 2 weeks is also non?inferior to 3 times weekly EPO in maintaining the Hb level after the correction. In general, long?term intravenous administration of CERA is well tolerated by dialysis patients with chronic renal anemia.     

Differing effects of exogenous and endogenous hydrogen sulphide in carrageenan-induced knee joint synovitis in the rat

Background and purpose:

Recent findings suggest that the noxious gas H₂S is produced endogenously, and that physiological concentrations of H₂S are able to modulate pain and inflammation in rodents. This study was undertaken to evaluate the ability of endogenous and exogenous H₂S to modulate carrageenan-induced synovitis in the rat knee.

Experimental approach:

Synovitis was induced in Wistar rats by intra-articular injection of carrageenan into the knee joint. Sixty minutes prior to carrageenan injection, the rats were pretreated with indomethacin, an inhibitor of H₂S formation (dl-propargylglycine) or an H₂S donor [Lawesson''s reagent (LR)].

Key results:

Injection of carrageenan evoked knee inflammation, pain as characterized by impaired gait, secondary tactile allodynia of the ipsilateral hindpaw, joint swelling, histological changes, inflammatory cell infiltration, increased synovial myeloperoxidase, protein nitrotyrosine residues, inducible NOS (iNOS) activity and NO production. Pretreatment with LR or indomethacin significantly attenuated the pain responses, and all the inflammatory and biochemical changes, except for the increased iNOS activity, NO production and 3-NT. Propargylglycine pretreatment potentiated synovial iNOS activity (and NO production), and enhanced macrophage infiltration, but had no effect on other inflammatory parameters.

Conclusions and implications:

Whereas exogenous H₂S delivered to the knee joint can produce a significant anti-inflammatory and anti-nociceptive effect, locally produced H₂S exerts little immunomodulatory effect. These data further support the development and use of H₂S donors as potential alternatives (or complementary therapies) to the available anti-inflammatory compounds used for treatment of joint inflammation or relief of its symptoms.     

比较肾动态显像与静脉肾盂造影在泌尿系统疾病的临床价值

1 对象和方法 1.1 对象 本院住院肾脏疾病患者71(男43,女28)例,平均年龄42.8岁.其中泌尿系结石42例,输尿管狭窄10例,肾萎缩8例,肾癌、肾结核、慢性肾功能衰竭各3例,多囊肾、前列腺增生各1例,共80个患肾,其中17例行手术治疗.     

Calf hematoma mimicking thrombophlebitis: sonographic and computed tomographic appearance

Five patients with calf hematomas presented with signs and symptoms suggesting thrombophlebitis, obscuring the correct diagnosis. Venography showed no venous thrombosis; further diagnostic studies using ultrasound and/or computed tomography provided the correct diagnosis in all patients. Ultrasound showed a hypoechoic mass clearly demarcated from surrounding soft tissue, while computed tomography showed a well-defined mass whose density depended on the age of the hematoma.