布地奈德都保短期加大剂量吸入治疗急性发作期儿童哮喘52例疗效观察

目的：观察哮喘急性发作期短期加大布地奈德都保用量与短期加用口服或静注糖皮质激素作疗效比较。方法：两组病例均应用常规剂量布地奈德都保,治疗组52例在急性发作期短期加用口服或静脉糖皮质激作比较。结果：两组病例的治疗总有效率均达100％,治疗半年后及治疗1年后的肺功能FEV1,FEF50％（呼气50％FVC时的流速）、PET经统计学处理无明显差异（P＞0．05）。结论：哮喘急性发作期短期加大布地奈德都保用量与短期加用口服或静注糖皮质激素可以取得相同效果。     

兔体内静脉输注乙酰普鲁卡因胺的药动学—药效学结合模型分析

用药动学-约效学结合模型,对ⅳ乙酰普鲁卡因胺(NAPA)后,进行了药代动力学和药效动力学分析。兔体内NAPA ⅳ后与静脉推注后的药动学参数基本一致;但效应按QT_c延长作为指标,其药效动力学的个别参数有显著性差异。输注后,NAPA的E_max,K_eo,S和EC₅₀分别为120±13.2ms,0.0182±0.007min^-1,2.26±0.93和6.31±0.71μg/ml;推注后,分别为53.6±2.5ms,0.061±0.017min^-1,2.19±0.39和6.21±1.74μg/ml。     

雷酚内酯的结构修正

雷公藤别名黄藤,系卫矛科植物雷公藤(Tripterygium wilfordii Hook.f.)。其根有舒筋活血,祛风湿,消肿止痛的功效,多用于类风湿关节炎的治疗。根皮中含有生物碱、甙、萜以及其它成分,其中多种二萜内酯成分有抗肿瘤活性和免疫     

苄普地尔与山莨菪碱合用对心肌缺血再灌注损伤的保护作用

卡普地尔与山莨菪碱合用对结扎大鼠冠脉左室支造成心肌缺血再灌注损伤的保护作用。两药同时合用可降低缺血再灌性心律失常发生率;明显提高复灌后心肌超氧物歧化酶活性及显著减轻心肌超微结构损伤。表明两药合用有协同作用,较单用苄普地尔或山莨菪碱疗效好。     

阿司匹林与埃索美拉唑合用较氯吡格雷减少高危患者再次溃疡出血的发生

问题：在有阿司匹林诱发溃疡出血史的患者中，用氯毗格雷预防溃疡出血复发，是否不次于小剂量阿司匹林加埃索美拉唑？[编者按]     

The hereditary pancreatitis gene maps to long arm of chromosome 7

Hereditary pancreatitis (HP) is an autosomal dominant disorder with incomplete penetrance characterized by recurring episodes of severe abdominal pain often presenting in childhood. Although this disorder has only been recently described, about 100 families have been documented worldwide. The pathophysiology of this disorder is unknown. Here, a large French family of 147 individuals (47 of whom were affected) from a four-generation kindred with HP has been examined and a genome segregation analysis of highly informative microsatellite markers has been performed. Linkage has been found between HP and six chromosome 7q markers. Maximal two point lod scores between HP and D7S 640, D7S 495, D7S 684, D7S 661, D7S 676 and D7S 688 were 4.00 (theta = 0.143), 5.85 (theta = 0.143), 4.91 (theta = 0.156), 8.58 (theta = 0.077), 8.28 (theta = 0.060), 4.40 (theta = 0.169), respectively. Multipoint linkage data combined with recombinant haplotype analysis indicated that the most likely order is: D7S 640-D7S 495-D7S 684-D7S 661-D7S 676-D7S 688, with the HP gene situated in the underlined region. As in all families reported in the literature, the clinical presentation of the disease is identical to the presentation of sporadic cases, one could expect that the knowledge of the HP gene could be a clue to pancreatitis in general. Based on its map position, this is the first step towards the positional cloning of the Hereditary Pancreatitis Gene (HPG).      

Anatomical study of five prenataly diagnosed sternopagus twins

Summary Among conjoined twins (1 out 50000 births), thoracopagus occurs most frequently and is generally lethal. Our anatomical study of five sets of sternopagus twins (3 female, 2 male) was performed to determine the ability of prenatal sonography to detect these anomalies. Autopsy in four cases revealed identical malformations: common sternum, single malformed heart, joined hepatic parenchyma, and a common small bowel leading to a cystic dilatation situated on the ileal segment at the end of the superior mesenteric artery. The diagnosis of conjoined twins was made in all cases by prenatal sonography at the mean time of 24.6 gestation weeks (range 19–34). The malformations detected by prenatal sonography were a single cardiac mass (all cases), joined hepatic parenchymas (3 cases), and an ileal cystic dilatation (1 case). Pregnancy was terminated in four cases. In one case cesarean delivery was performed, and the infants died 48 hours later. Prenatal sonography currently seems to be the best examination for diagnosis of sternopagus twins and the detection of lethal malformations thus allowing interruption of pregnancy.

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Etude anatomique de cinq jumeaux conjoints sternopages de diagnostic anté-natal

Résumé Les jumeaux conjoints représentent 1 pour 50000 naissances, les thoracopages sont les plus fréquents et présentent le plus souvent des malformations léthales. Une étude anatomique des malformations rencontrées chez les jumeaux conjoints sternopages a été effectuée dans le but d'évaluer l'intérêt de l'échographie anté-natale pour le diagnostic de ces malformations. Nous avons étudié anatomiquement cinq jumeaux conjoints (3 féminins, 2 masculins). Un examen nécropsique a été réalisé quatre fois, montrant dans tous les cas les mêmes malformations: sternum commun, coeur unique malformatif, union des parenchymes hépatiques, grèle commun aboutissant à une poche kystique située sur le segment iléal de l'intestin grèle, à la terminaison de l'artère mésentérique supérieure. Le diagnostic de jumeaux conjoints avait dans tous les cas été porté en anté-natal par les échographies, à un terme moyen de 26,6 semaines d'aménorrhée (extrèmes 21–26). Les malformations retrouvées par les échographies étaient: dans tous les cas une masse cardiaque unique, trois fois une union des parenchymes hépatiques, une fois une poche kystique du grèle. Le diagnostic avait conduit quatre fois à une interruption médicale précoce de la grossesse. Dans un cas une césarienne avait été pratiquée, les enfants étaient morts 48 heures après. L'échographie anté-natale nous semble actuellement le meilleur examen pour faire le diagnostic de jumeaux conjoints et rechercher des malformations léthales conduisant à une interruption de la grossesse.

     

循环胚胎干细胞定位于损伤心肌及其改善心功能的作用

目的阐明大鼠急性心肌梗死后静脉注射的胚胎干细胞(ESC)能否定位于损伤心肌和改善心功能,并探讨炎症因子TNF-α的可能作用。方法ESC体外培养并转染绿荧光蛋白(GFP);左冠前降支结扎建立大鼠心肌梗死后心功能不全模型,手术后每隔天尾静脉注射10~7 ESC共6 d,并以心肌梗死非细胞治疗组和假手术组为对照。6周后血流动力学方法测定心功能,免疫组织化学法检测心脏和其它脏器中GFP阳性区和心肌组织中GFP阳性细胞的心肌特异性蛋白肌钙蛋白Ⅰ(TnⅠ)的表达。另外,应用细胞共培养观察了TNF-α过度表达的心肌细胞对ESC迁移的影响。结果以心肌梗死后非细胞治疗组为对照,6周后ESC治疗组心功能显著改善;组织学检测发现ESC治疗组在心肌梗死区可见GFP阳性区,并相应于GFP阳性区TnⅠ染色阳性。在其他脏器中,仅在脾脏组织中可见少量的GFP阳性细胞,提示循环ESC定位于梗死损伤心肌并形成心肌组织。体外ESC迁移的研究发现TNF-α过度表达的心肌细胞可显著增加ESC的迁移。结论经静脉注射的循环ESC可定向迁移至急性心肌梗死后的损伤心肌,并进一步分化为心肌细胞而改善心功能。体外研究提示这可能与急性心肌梗死时局部释放的炎症因子如TNF-α对循环ESC的趋化作用有关。     

大豆磷脂脂质体对FeSO4／Cysteine引起培养心肌细胞损伤的保护效应

目的:观察大豆磷脂脂质体的累积对FeSO4/Cysteine体系产生羟自由基引起心肌细胞损伤的保护作用。方法:①实验于2003-10/2004-07在锦州医学院生物化学实验室完成。选用新生两三天清洁级SD大鼠的乳鼠10～15只,取心肌细胞进行原代培养48h后,随机分成3组:正常对照组、损伤组和大豆磷脂脂质体保护组。损伤组加入FeSO4/Cysteine(终浓度FeSO41×10-3mol/L Cysteine5×10-4mol/L)作用于培养的乳鼠心肌细胞12h。大豆磷脂脂质体保护组在加入损伤因素的同时加入不同质量浓度的大豆磷脂脂质体(0.2,0.4,0.8,1.6g/L)。②测定心肌细胞培养液中乳酸脱氢酶的活力,心肌细胞中丙二醛的含量和超氧化物歧化酶的活力,均参照南京建成生物工程研究所提供的试剂盒说明书进行。培养心肌细胞线粒体内琥珀酸脱氢酶的活力采用甲基四唑蓝比色测定。结果:①培养液中乳酸脱氢酶的活力:损伤组显著高于正常对照组(P<0.01)。大豆磷脂脂质体保护各组均低于损伤组(P<0.01)。②培养心肌细胞中丙二醛的含量:损伤组显著高于正常对照组(P<0.01)。大豆磷脂脂质体保护各组均低于损伤组(P<0.01)。③培养心肌细胞中超氧化物歧化酶的活力:损伤组显著低于正常对照组(P<0.01)。大豆磷脂脂质体保护各组均高于损伤组(P<0.01)。④心肌细胞线粒体内琥珀酸脱氢酶的活力:损伤组显著低于正常对照组(P<0.01)。大豆磷脂脂质体保护各组均高于损伤组(P<0.01)。⑤大豆磷脂脂质体保护作用在一定浓度范围(0.2～0.8g/L)随着浓度的升高而增强,但剂量达到一定浓度,大豆磷脂脂质体保护作用不再随着浓度的升高而增强。结论:大豆磷脂脂质体对FeSO4/Cysteine体系产生的羟自由基引起的心肌细胞损伤具有明显的保护作用,且存在大豆磷脂脂质体浓度依赖性。     

Erythropoietin stimulates a rise in intracellular-free calcium concentration in single BFU-E derived erythroblasts at specific stages of differentiation

Human cord blood progenitor-derived erythroblasts have recently been shown to respond to erythropoietin (Epo) or granulocyte-macrophage colony-stimulating factor (GM-CSF) with a transient increase in intracellular free calcium concentration [Cac]. However, the importance of [Cac] changes in mediating cell proliferation and/or differentiation is undefined. In the present study, the response of erythroid precursors at different stages of differentiation to Epo was examined. Erythroblasts were derived from adult blood erythroid progenitors (BFU- E) at day 7 or day 10 of culture. [Cac] was measured in individual Fura- 2 loaded cells with fluorescence microscopy coupled digital video imaging. The dynamic range (Rmax/Rmin) of intracellular Fura-2 was similar to that measured in free solution, suggesting insignificant amounts of intracellular Ca insensitive forms of Fura-2. Baseline [Cac] of erythroid cells calculated with an in vitro calibration method was 44 +/- 4 nmol/L and with an in vivo method was 46 +/- 4 nmol/L. Treatment of day 7 BFU-E derived erythroblasts with Epo resulted in no significant increase in [Cac]. In contrast, in more mature erythroblasts (day 10 of culture), Epo stimulated a large increase in [Cac] from 49 +/- 11 nmol/L at baseline to 279 +/- 47 nmol/L. This [Cac] increase occurred in phosphate buffered saline (PBS) containing no added calcium. The increase in [Cac] persisted for 18 minutes and was dose dependent. Day 7 and day 10 control cells treated with either insulin or media showed no significant change in [Cac] during 18 minutes of observation. Our data demonstrate that early (day 7) and late (day 10) erythroblasts display different responses to Epo, at least in terms of intracellular Ca++ fluxes. The differential [Cac] response observed in early and late erythroid precursors to growth factor stimulation suggests that [Cac] may be an important signal in cell differentiation.