急性淋巴细胞白血病最新治疗策略(下)

4分子治疗分析肿瘤细胞中的分子遗传性变异及后天变异的方法正在快速成熟起来。这些方法通常涉及基因组学、转录特征性识别及蛋白质组学,有利于更深入地了解ALL的发病机理,使用于临床评估的靶向治疗全面发展。最终,这些层出不穷的新技术将营造出一个全新的个性化分子医学时代,创造出效果更好而毒性更低的治疗方案。尽管治疗方案均显示了药物介入控制细胞周期进程、基因转录、细胞运动、凋亡及细胞代谢信号通路的可行性(图1),但针对ALL的分子治疗情况(表1)仍差强人意。我们将从众多正处于临床前期或早期临床研究的分子治疗方案中,选择出那…     

急性淋巴细胞白血病最新治疗策略(上)

利用目前的治疗手段,80%的急性淋巴细胞白血病(acute lymphoblastic leukem ia,ALL)患儿均能得到治愈,尚有部分患者需接受强化治疗,但治疗的副作用也带来了急性或远期的严重并发症。此外,成人ALL病人的生存率依然低于40%。因此,本病需要既可以提高治愈率又能改善生活质量的新治疗方案。本文讨论了新出现的可能会改善ALL病人预后的治疗方法,包括现有常规化疗药物的新剂型、新的抗代谢药和核苷衍生物、白血病相关抗原的单克隆抗体,针对白血病细胞的基因异常及相关信号通路的分子治疗。1常规化疗药物的新剂型化疗药物的脂质体剂型是将药物…     

DIABETES MELLITUS AND ADDISON'S DISEASE IN AN ADOLESCENT FEMALE

Abstract. Matsaniotis, N., Tzortzatou-Stathopoulou, F., Thomaidis, Th., Karakatsani-Kerasioti, Z., Theodoridis, Ch. and Dacou-Voutetakis, C. (First Department of Paediatrics of Athens University, "Aghia Sophia" Children's Hospital, Athens, Greece). Diabetes mellitus and Addison's disease in an adolescent female. Acta Paediatr Scand, 70: 949, 1981.-This short report describes a 16-year-old female who presented with Addison's disease 6 years after diabetes mellitus had been diagnosed. The possibility of both conditions being present should be borne in mind whenever an unexplained reduction of insulin requirements is noted, especially if this is accompanied by cutaneous pigmentation. The metabolic interrelationships of the two conditions are briefly discussed.     

急性淋巴细胞白血病(上)

急性淋巴细胞白血病是淋巴前体细胞异常引起的恶性疾病,儿童与成人均可能发生。儿童发病高峰2～5岁。有效治疗的稳步进展使本病在儿童中的治愈率80％以上,同时为新的治疗方案提供了良机,新方案将保留我们在白血病无病生存病例中获得的治疗经验,同时减轻当前强化治疗方案中的毒副作用。     

亮氨酸脑啡肽的电子结构及构效关系研究

对亮氨酸脑啡肽进行了量子化学(INDO)计算,研究其电子结构特征,讨论其活性部位、作用机理及构效关系。同吗啡和R31833进行了活性部位的电子结构与空间结构比较,推断它们的活性药效结构具有共同特点,与阿片受体相互作用时作用方式相同,作用部位有对应关系,因而具有相同的药理性质。     

体外循环术后低钾血症370例的护理

1临床资料我院1996-01/2004-12体外循环下行心内直视手术370例,其中先心病240例,冠状动脉搭桥术55例,风心病瓣膜置换术75例,年龄1.5～74.0岁.     

无环鸟苷亲脂性前体药物脂质体的制备及体外抗病毒活性(英文)

本文通过将无环鸟苷(acyclovir,简称ACV)2’位羟基分别与月桂酰氯或棕榈酰氯进行酯化反应,制得亲脂性前体药物无环鸟苷月桂酸酯和无环鸟苷棕榈酸酯(分别简称为C₁₂-ACV和C₁₆-ACV),使脂质体包封率从ACV的29.9%提高到C₁₂-ACV的95.6%和C₁₆-ACV的97.1%;漏泄实验表明在4℃透析60h后,一半以上的ACV从脂质体中漏泄,而C₁₂-ACV和C₁₆-ACV的滞留率分别为70%和80%;体外抗疱疹病毒的试验中,在最低试验浓度0.044μmol/L时,ACV不显示抗病毒活性,而C₁₆-ACV脂质体抑制细胞病变率达75%,说明前体药物通过与脂质体脂膜的结合增加了药物的进入细胞能力,从而提高了ACV的抗病毒能力。     

Management of bacterial peritonitis and exit‐site infections in continuous ambulatory peritoneal dialysis*

SUMMARY: Peritonitis and exit‐site infections remain the most important limitations to the delivery of continuous ambulatory peritoneal dialysis (CAPD). Contamination of the peritoneum, from endogenous or exogenous sources, is responsible for most peritonitis episodes. Patients usually present with a cloudy bag, although other causes should be distinguished. Clinical suspicion of peritonitis should be followed rapidly by microbiological examination and empirical treatment. Microbiological confirmation allows for subsequent treatment based on sensitivities. Other interventions such as catheter removal may be appropriate in some patients. Exit‐site infections should also be identified and treated early. Peritonitis may be further prevented by adequate exit‐site care, hygienic methods, and techniques to minimise early contamination of the exit site. Mupirocin may also have a role in preventing infections caused by Staphylococcus aureus.     

4-甲氧羰基-4-N-丙酰苯胺基哌啶1位衍生物的合成及其镇痛作用

本文报道了一系列N-[-1(2-苯乙基-4-甲氧羰基-4-哌啶基]-N-丙酰苯胺(4-甲氧羰基芬太尼)哌啶环1位取代衍生物的合成及其镇痛活性;讨论了结构与镇痛活性之间的关系。药理试验结果表明,大部分化合物具有典型的吗啡样镇痛活性,是一类作用极强的麻醉性镇痛剂。特别是哌啶环1位β-苯环被取代乙烯基替代的化合物具有相当或接近子母体化合物的镇痛活性。其代表物1321的镇痛活性(ED_(50)=0.005mg/kg ip,小鼠,热板法)略强于4-甲氧羰基芬太尼(ED_(50)=0.0063 mg/kg)。     

Bronchial artery embolization: monitoring with somatosensory evoked potentials. Work in progress

Surgery remains the treatment of choice for massive and recurrent hemoptysis. In some instances, however, immediate surgical intervention is contraindicated. In these situations, bronchial artery embolization (BAE) has proved to be a successful definitive treatment for non-surgical candidates and a palliative therapy in patients requiring hemodynamic stabilization prior to surgery. The most serious complication of BAE is spinal cord ischemia. This relates directly to the potential anastomotic connections between the bronchial circulation and the anterior spinal artery. Somatosensory evoked potentials (SSEPs) have been used in the past to monitor spinal cord ischemia during procedures that threaten the vascularity of the spinal cord. The authors report two cases in which SSEPs were employed to monitor spinal cord ischemia during bronchial artery embolization.