放射治疗兔耳增生性瘢痕的实验研究

目的:研究经过医用高能电子线照射兔耳增生性瘢痕实验模型后,观察伤口愈合的情况、瘢痕愈合后的病理改变及肌动蛋白(ACTIN)和血管生长因子(VEGF)表达变化情况。方法:选用日本大耳白兔18只,在每只兔耳腹侧面制作直径6mm的圆形全层皮肤缺损创面10个。将总计360个缺损创面模型随机分为6组,第1组为空白对照组(3只),其余5组为照射组(各3只)。将照射组每只兔耳随机用200cGy、400cGy、600cGy、800cGy、1000cGy的6Mev电子线照射兔耳缺损创面,照射野周围用铅板防护,观察兔耳缺损创面的愈合情况变化及创面愈合后瘢痕组织进展情况。并于致伤一个月后对实验模型取材,进行光镜、电镜及组织学观察。结果:兔耳腹侧面圆形创面缺损,能产生与人类增生性瘢痕类似的增生块。各照射组,缺损创面愈合延迟。总照射剂量相近的情况下,单次不同照射剂量对增生性瘢痕形成的影响有显著性差异。结论:日本大耳白兔可以形成类似人的增生性瘢痕病理改变,可以用作增生性瘢痕研究的实验动物模型。动物实验证明,医用6Mev高能电子线照射治疗是一种有效的治疗增生性瘫痕的方法,总照射剂量相近的情况下,分5次照射、单次剂量400cGy,为最佳照射剂量。     

社区获得性肺炎患儿体液免疫检测与分析

目的:探讨社区获得性肺炎患儿体液免疫水平及规律,为临床儿科医师提供理论依据.方法:对对2011年1月至2012年6月我院儿科病房儿童社区获得性肺炎住院187例患儿的体液免疫在治疗前进行检测,包括免疫球蛋白A(IgA),免疫球蛋白G(IgG)、免疫球蛋白M(IgM)、补体C3(C3)、补体C4(C4)共5项观察指标.根据年龄分成5组,分别为:1组(1～3月),2组(3～6月),3组(6～12月),4组(1岁～3岁),5组(3岁以上),对5组检测结果进行统计学对比分析.结果:5组患儿体液免疫指标的统计学差异有非常显著意义(P＜0.01),其中以小婴儿、婴幼儿为低.结论:用具体数据证实小婴儿、婴幼儿体液免疫较大龄儿童为低,为临床医师充实了实验理论依据,有利于儿科医师设计临床治疗方案.在解释病情和医患沟通,构建和谐医患关系方面有积极意义.     

Management of bronchiolitis without antibiotics: a multicentre randomized control trial in Bangladesh

Objective: To ascertain that antibiotics have no role in the management of bronchiolitis. Design: Multicentre randomized control trial (RCT). Setting: Five purposively selected teaching hospitals in Bangladesh. Patient: Children under 24 months old with bronchiolitis. Interventions: Children were randomized into three groups of therapeutic interventions: parenteral ampicillin (P‐Ab), oral erythromycin (O‐Ab) and no antibiotic (N‐Ab) in adjunct to supportive measures. Main outcome measures: Clinical improvement was assessed using 18 symptoms/signs which were graded on a two‐point recovery scale of ‘rapid’ and ‘gradual’, indicating improvement within ‘four days’ and ‘beyond four days’, respectively. Results: Each intervention group consisted of 98 ± 1 children having comparable clinico‐epidemiological characteristics at the baseline. The trial revealed that most chesty features (features appearing to arise from chest, i.e. cough, breathing difficulty, wheeze, chest indrawing, tachypnoea, tachycardia, rhonchi and crepitation) demonstrated a gradual recovery, beyond 4th admission day and, not differing among the three intervention groups (p > 0.23, p < 0.62, p = 0.54, p < 0.27, p = 0.75, p = 0.76, p = 0.81, p > 0.98, respectively). Most non‐chesty features (features appearing to arise away from chest, i.e. feeding/sleeping difficulties, social smile, restlessness, inconsolable crying, nasal flaring, fever and hypoxaemia) demonstrated a rapid recovery, within 4 days, remaining comparable among the three intervention groups (p < 0.07, p = 0.65, p = 0.24, p < 0.61, p = 0.22, p = 0.84, p = 0.29 and p = 0.96, respectively). However, nasal symptoms (runny nose and nasal blockage) also showed no difference among groups (p = 0.36 and p = 0.66, respectively). Thus, the dynamics of clinical outcome obviates that children not receiving antibiotics had similar clinical outcome than those who did. Conclusion: In hospital settings, managing bronchiolitis with only supportive measures but without antibiotics remains preferable.     

龙芩草喷雾剂的解热作用及对肿瘤坏死因子的影响

目的:观察龙芩草喷雾剂的解热作用及其对肿瘤坏死因子-α(TNF-α)功能的影响,探讨其药理作用的相关机制和"异病同治"的物质基础.方法:耳缘静脉注射脂多糖造成家兔发热模型,并用脂多糖造成肺泡Ⅱ型上皮细胞损伤模型.观察使用药物前后家兔体温和细胞培养上清液中TNF-α含量的变化.结果:龙芩草喷雾剂能够拮抗脂多糖导致的体温上升,缓解发热反应,抑制脂多糖引起的TNF-α含量增多.结论:龙芩草喷雾剂具有显著的解热作用,可能与其抑制TNF-α分泌的异常增加有关.     

抚触后沐浴对促进婴儿生长发育的研究

目的:探讨抚触后沐浴对婴儿生长发育的影响。方法:对42天门诊的100例沐浴后抚触和抚触后沐浴的婴儿进行体重、身长、睡眠时间及抬头、翻身等体格及行为发育的比较,同时对两组的生长发育和行为发育进行t检验和χ2检验。结果:抚触后沐浴的婴儿体重、身长增长速度较快,睡眠时间长,抬头及翻身等行为发育优于沐浴后抚触的婴儿。结论:抚触后沐浴的效果优于沐浴后抚触,值得推广。     

Glycemic status in hyperthyroid subjects

This was an observational case-control study carried out in the Department of Biochemistry, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka jointly with the 'Thyroid and Endocrine Clinic' of the same institution during the period of January 2002 to December 2002. Sixty-five (65) newly diagnosed hyperthyroid patients between 20-60 years of age were studied, where forty-five (45) were Graves' disease and twenty (20) were TMNG (Toxic multinodular goiter) patients. Thyrotoxicosis was diagnosed by history, clinical examination and biochemical investigations- FT4, TSH, and Radioactive iodine uptake (RAIU) test. Thirty (30) age and sex matched healthy subjects were taken as control. The mean age was 33.02+/-9.24 years in Graves' disease and 37.55+/-9.49 years in TMNG. Female predominance observed in both the diseases. Glucose intolerance was found in 72.3% of thyrotoxic patients, which is much higher than European population. Our study showed Diabetes mellitus (DM) in 11% of Graves' disease patients. The incidence of DM in Graves' disease was slightly higher in our population. Incidence of DM in TMNG in our study was much lower (5%) than that of Graves' disease (11%) but the incidence of IGT (Impaired glucose tolerance) in TMNG was more (85%) in relation to Graves' disease (54%). Percentage of RAIU was more marked in Graves' disease than TMNG. There is a significant positive correlation (p<0.05) between plasma glucose and FT4 in Graves' disease. Glucose intolerance is frequently found in Thyrotoxic patients.     

Spot morning urine protein creatinine ratio and 24 hour urinary total protein excretion rate

Proteinuria helps to establish the diagnosis of most renal diseases and also to predict the outcome of such diseases. Proteinuria is biochemically represented by measuring the protein concentration in timed collection of 24 hour urine. But, 24-hour timed urine collection is time consuming, cumbersome and often unreliable due to collection errors and also results in undue delay on diagnostic process. An alternate approach avoiding arduous and inaccurate timed urine collection can be the measurement of protein creatinine ratio in spot morning urine. This study was aimed to evaluate whether the spot morning urine protein creatinine ratio can be a reliable alternative to 24-hour urinary total protein (UTP) estimation. The study was carried out in the department of Biochemistry, Bangabandhu Sheikh Mujib Medical University, Dhaka on 50 (fifty) non-diabetic Chronic Renal Disease (CRD) patients with an age ranging from 18 -70 years. The study subjects were grouped into mild, moderate and severe CRD on the basis of GFR. Urinary protein and creatinine concentrations were measured in spot morning urine samples and their ratios were calculated. Urinary protein measured in 24-hour timed collected urine samples gave the 24-hour UTP excretion rate. In our study, spot morning urine protein creatinine ratio significantly correlated with 24-hour UTP excretion rate in all CRD patients. Severe CRD patients gave significant positive correlation (p<0.05), whereas mild and moderate CRD patients gave very highly significant positive correlation (p<0.001). Therefore, it may be suggested that protein creatinine ratio in spot morning urine can be accepted as a reliable and alternative to 24-hour UTP excretion rate in non-diabetic chronic renal disease patients. This simple and inexpensive procedure will thus simplify the way of establishing the severity of renal disease along with its prognosis.     

槐定碱的生理药动学模型

建立了槐定碱在动物体内生理药动学模型，预报其在大鼠血浆，组织和器官中的浓度一时间过程。微机拟合结果表明：大鼠ｉｖ２０ｍｇ·ｋｇ－１槐定碱，组织器官药物浓度理论值和实验值趋向一致。将此模型放大到２．５ｋｇ兔体内，发现在ｉｖ１０和２０ｍｇ·ｋｇ－１槐定碱两种剂量上，血药浓度预报伍与文献报道吻合。