Immunosuppression in renal transplantation: Long-term clinical trial of a double versus triple therapy regimen

Summary: Sixty-nine renal allograft recipients were randomized to two immunosuppressive regimens: 35 patients received cyclosporine A and prednisolone (PC) while 34 patients received low dose cyclosporine A, prednisolone and short term azathioprine (PCA). the data of 66 patients (34 in PC and 32 in PCA groups) were analysed. the median follow-up periods were 62 months for the PC group and 60 months for the PCA group. There was no difference in graft survival between the two groups but five patients died in the PC group compared to none in the PCA group (graft survival: 88 vs 90% at 1 year and 82 vs 82% at 5 years, P = not significant at any time point; patient survival: 90 vs 100% at 1 year and 88 vs 100% at 5 years, P = 0.05 at 5 years). There was a trend for patients in the PCA group to develop earlier and more frequent rejections (not significant; P = 0.106 and P = 0.062, respectively). There were also more episodes of acute cyclosporine A nephrotoxicity and cytomegalovirus (CMV) infection in the PC group. the mean serum creatinine at 5 years was significantly higher in the PCA group when compared to the PC group (179.8 ± 76.5 μmol/L vs 154.7 ± 41.0 μmol/L; P =0.05). We found that both therapeutic regimens were effective in preventing renal allograft rejections. However, double therapy was associated with higher patient mortality secondary to infection. Patients on triple therapy, on the other hand, were more prone to develop rejections in the early post-transplant period and were associated with less favourable renal function in the long run.     

赤芝子实体中灵芝酸类成分的研究

自赤芝［Ｇａｎｏｄｅｒｍａｌｕｃｉｄｕｍ（Ｆｒ．）Ｋａｒｓｔ．］子实体的二氯甲烷提取物中分离得到一个新的四环三萜化合物，命名为灵芝酸ＤＭ（ｇａｎｏｄｅｒｉｃａｃｉｄＤＭ，Ｉ）。根据光谱（ＵＶ，ＩＲ，１ＨＮＭＲ，１３ＣＮＭＲ，ＭＳ２ＤＮＭＲ）分析，确定其结构为Ｉ式。同时还分离得到二个已知的灵芝酸类化合物，即灵芝酸Ａ（ｇａｎｏｄｅｒｉｃａｃｉｄＡ，Ｉ）和灵芝酸Ｃ（ｇａｎｏｄｅｒｉｃａｃｉｄＣ，ＩＩ）。     

肾康宁片中黄芪甲苷的薄层扫描法测定

目的:建立肾康宁片中黄芪甲甙含量测定方法。方法:双波长薄层扫描法,经水饱和正丁醇液冷浸超声提取,再上D101大树脂纯化,以氯仿-甲醇-水(65:30:10)下层液为展开剂,检测波长为520nm,参比波长为700nm。结果:平均加样回收率为97.8％(RSD=1.4％,n=6),标准曲线r=0.9996。结论:方法结果可靠、操作简单,可作为肾康宁片的质量控制标准。     

Alimentation calcique et effet de l'entraînement physique sur l'os

Physical exercise is able to influence bone structure. In the principal part of cases, physical training results in an enhanced bone density when in any case overtraining could decrease bone density. Numerous factors are involved in the effect of physical training on bone, dietary calcium supply being one. Numerous epidemiological surveys have shown that the daily calcium supply in the French population is between 500 and 1,200 mg/24 hours. Thus part of the French population is under the recommended intake of 1,000 mg. It was proposed that physical training could improve calorie intake and consequently calcium supply. The main objective of this paper is the relationship between exercise and bone structure: second, literature is used to present the role of dietary calcium on bone structure. Finally, the data of a survey in a French population are used in order to define to what extent calcium dietary supply of different sports groups agree with the dietary recommended allowance. They report that calcium supply is influenced by the type of sport, strength trained atheletes enhance calcium intake while endurance trained atheletes present lower calcium intake.     

中国羊踯躅花化学成分研究

从国产杜鹃花科植物羊踯躅(Rhododendron molle G.Don)的花中分离得到两种有药理活性的成分。经光谱(IR,MS,¹HNMR,¹³CNMR,¹H-¹H COSY,¹H-¹H NOESY,¹³C-¹H COSY)等分析证明其中一种为新的四环二萜类化合物。命名为羊踯躅素Ⅲ(rhodomollein Ⅲ)(1)。     

顺-3-甲基芬太尼的4-N-丙酰基结构类似物的合成与镇痛活性及构效关系的研究

以不同电性的基团取代顺-3-甲基芬太尼中4-N-丙酰基上的乙基,合成某些顺-3-甲基芬太尼的结构类似物。药理试验结果表明,所合成的化合物均有典型的吗啡样作用。化合物3的镇痛活性略强于顺-3-甲基芬太尼。应用半经验的INDO方法对4个代表化合物进行了量子化学计算,讨论了电子结构与镇痛活性间的关系,化合物3由于氯乙烯基的引入具有与顺-3-甲基芬太尼不同的电子结构特征,氯乙烯基可能作为电子接受体参与了与受体的作用。     

人工耳蜗植入术62例围手术期护理

1 临床资料 2000-12/2005-01进行人工耳蜗植入手术的深度双耳感音神经性耳聋患者62(男37,女25)例,年龄1.2～21.0岁;语前聋60例,语后聋2例;先天性27例(其中用药17例,患腮腺炎2 例,原因不明25例),术前常规行颞骨薄层CT,部分患者行MRI扫描;术中面神经监测,所有患者经听力学评估均行右侧人工耳蜗植入.     

导致成人与儿童患者30天脑室腹腔分流失败的原因分析（英文）

OBJECTIVE The aim of this study was to provide a comprehensive benchmark of 30-day ventriculoperitoneal(VP)shunt failure rates for a single institution over a 5-year study period for both adult and pediatric patients,to compare this with the results in previously published literature,and to establish factors associated with shunt failure.METHODS A retrospective database search was undertaken to identify all VP shunt operations performed in a single,regional neurosurgical unit during a 5-year period.Data were collected regarding patient age,sex,origin of hydrocephalus,and whether the shunt was a primary or secondary shunt.Operative notes were used to ascertain the type of valve inserted,which components of the shunt were adjusted/replaced(in revision cases),level of seniority of the most senior surgeon who participated in the operation,and number of surgeons involved in the operation.Where appropriate and where available,postoperative imaging was assessed for grade of shunt placement,using a recognized grading system.Univariate and multivariate models were used to establish factors associated with early(30-day)shunt failure.RESULTS Six hundred eighty-three VP shunt operations were performed,of which 321 were pediatric and 362 were adult.The median duration of postoperative follow-up for nonfailed shunts(excluding deaths)was 1263 days(range 525-2226 days).The pediatric 30-day shunt failure rates in the authors'institution were 8.8%for primary shunts and 23.4%for revisions.In adults,the 30-day shunt failure rates are 17.7%for primary shunts and 25.6%for revisions.In pediatric procedures,the number of surgeons involved in the operating theater was significantly associated with shunt failure rate.In adults,the origin of hydrocephalus was a statistically significant variable.Primary shunts lasted longer than revision shunts,irrespective of patient age.CONCLUSIONS A benchmark of 30-day failures is presented and is consistent with current national databases and previously published data by other groups.The number of surgeons involved in shunt operations and the origin of the patient's hydrocephalus should be described in future studies and should be controlled for in any prospective work.The choice of shunt valve was not a significant predictor of shunt failure.Most previous studies on shunts have concentrated on primary shunts,but the high rate of early shunt failure in revision cases(in both adults and children)is perhaps where future research efforts should be concentrated.