Efficacy of short‐term oral cobalamin therapy for the treatment of cobalamin deficiencies related to food‐cobalamin malabsorption: A study of 30 patients

Background: It has been suggested that oral cobalamin (vitamin B₁₂) therapy may be an effective therapy for treating cobalamin deficiencies related to food‐cobalamin malabsorption. However, the duration of this treatment was not determined. Patients and method: In an open‐label, nonplacebo study, we studied 30 patients with established cobalamin deficiency related to food‐cobalamin malabsorption, who received between 250 and 1000 μg of oral crystalline cyanocobalamin per day for at least 1 month. Endpoints: Blood counts, serum cobalamin and homocysteine levels were determined at baseline and during the first month of treatment. Results: During the first month of treatment, 87% of the patients normalized their serum cobalamin levels; 100% increased their serum cobalamin levels (mean increase, +167 pg/dl; P < 0.001 compared with baseline); 100% had evidence of medullary regeneration; 100% corrected their initial macrocytosis; and 54% corrected their anemia. All patients had increased hemoglobin levels (mean increase, +0.6 g/dl) and reticulocyte counts (mean increase, +35 × 10⁶/l) and decreased erythrocyte cell volume (mean decrease, 3 fl; all P < 0.05). Conclusion: Our findings suggest that crystalline cyanocobalamin, 250–1000 μg /day, given orally for 1 month, may be an effective treatment for cobalamin deficiencies not related to pernicious anemia.     

永瓣藤化学成分的研究

永瓣藤化学成分的研究陈玲，谢平，戚薇，曾菊珍（药学系中药化学教研室）关键词永瓣藤，化学成分，三萜，蒜盘子甾酮永瓣藤（ＭｏｎｉｍｏｐｅｔａｌｎｍＣｈｉｎｅｎｓｅＲｅ－ｈｄ）系卫矛科永瓣藤属植物［１］，为我国特有的珍稀二类保护植物［２］，分布于江西东北部...     

Survival of Dairy Cows After Surgery to Correct Abomasal Displacement: 1. Clinical and Laboratory Parameters and Overall Survival

The objective of this study was to compare the clinical and laboratory consequences of left and right displacement of the abomasum (LDA and RDA), short‐ and long‐term survival after surgery and the findings in cows, that could not be cured by omentopexy. Data from 564 cases of displaced abomasum (466 LDA, 98 RDA) were analysed retrospectively. Clinical and laboratory findings were compared between the two manifestations of DA. Survival was assessed after 10 days and after 15 months. Necropsy was carried out on cows that died or were killed. On arrival at the clinic, left displacement of the abomasum (LDA) cows had been recognized as diseased for longer. LDA occurred earlier in lactation, and more cows with right displacement of the abomasum (RDA) were pregnant. Overall clinical symptoms were more severe in RDA than in LDA cows. Heart rate was higher, body temperature was lower, inanition, abnormal faeces and ruminal stasis were more frequent in RDA cows. Leucocyte counts were higher, and potassium and chloride levels were lower in RDA cows. Acetonuria was more frequent in LDA cows. More LDA than RDA cows were released from the clinic as cured (82.0% versus 74.5%). However, survival after the early post‐surgical period was similar for RDA and LDA cows. At necropsy, diseases of the gastrointestinal system were the predominant finding in RDA cows, while in LDA cows, diseases of the liver and other concurrent diseases were more important.     

地塞米松减轻曲马多术后镇痛时恶心呕吐的临床观察

目的 :探讨地塞米松减轻曲马多术后镇痛时恶心呕吐的临床效果。方法 :选择术后自愿硬膜外镇痛(PCEA)的病例 6 0例 ,随机分为试验组 (地塞米松 曲马多 0 .15 %布比卡因 )和对照组 (格拉司琼 曲马多 0 .15 %布比卡因 )。结果 :两组病人术后疼痛评分 (VAS法 ) ,镇静评分及恶心呕吐的发生率无明显差异 (P >0 .0 5 )。结论 :地塞米松可以减轻曲马多术后镇痛时恶心呕吐的发生 ,效果良好 ,不增加副作用 ,价格便宜     

用酶联免疫吸附术观察向附睾注射鱼肝油酸钠后抗精子抗体的变化

本研究用酶联免疫吸附术观察8只家兔在附睾注射鱼肝油酸钠后血清及精浆中的抗精子抗体。血清抗精子抗体阳性率为37.5～50.0%,最早检出率为术后2个月,6～7月达高峰。精浆抗精子抗体阳性率为25%,最早检出率为术后4个月,且此时己达高峰。与输精管结扎资料相比,发现血清抗精子抗体检出率偏低,而精浆相应抗体偏高,表明向附睾注射鱼肝油酸钠引起的免疫反应有别于结扎,以生殖道局部为主。     

Questionnaire analysis of the swallowing‐related outcomes following total laryngectomy

Objective: To determine the effects of a total laryngectomy on the swallow and subsequent quality of life in head and neck cancer patients. Design: Cross‐sectional single centre cohort study. Setting: Head and Neck Oncology Unit, Tertiary Referral Unit. Patients: Sixty‐two patients who underwent total laryngectomy at our centre participated in the study. Methods: Subjects were stratified by age, sex, tumour stage, other procedures such as myotomy and nerve re‐implantation. Pharyngectomy, glossectomy, flap reconstruction, neck dissection and previous radio‐ and chemotherapy were also assessed to see if they affected swallow and subsequent quality of life. Main outcome was measured using the MD Anderson Dysphagia Inventory questionnaire. Results: Responses were received from 46 males and 16 females (response rate of 80.5%) with a mean age of 64.7 years (SD 9.4). Median follow‐up in patients was 90 months (range 1–276). The mean MD Anderson Dysphagia Inventory total score in our series of patients was 77.7 (SD 16.6). MD Anderson Dysphagia Inventory global score was 79.4 (SD 22.6), Emotional score was 77.7 (SD 17.8), Functional score 81.3 (SD 15.9) and Physical score was 74.1(SD 18). Statistically significant differences were seen between the emotional scores of glossectomised and non‐glossectomised patients (Mann Whitney, P = 0.04). No significant correlation was seen between the subscale scores and the remaining treatment variables such as age, gender, site, tumour stage, myotomy, nerve implantation, radiotherapy, reconstruction and major complications. Conclusion: This questionnaire study is the largest of its type to assess the swallow of patients who have undergone laryngectomy at a single centre. The overall result confirmed that most patients had a subjectively good swallow. Only glossectomy and the method of PE segment closure were shown to significantly affect swallowing outcomes following surgery. We recommend further work especially prospective studies pre and post surgery using this or similarly validated instruments to fully assess swallow in the laryngectomy population.     

Evaluation of antitumor activity of 1-beta-D-arabinofuranosyl-2-amino-1,4(2H)-4-iminopyrimidine in murine tumors

1-beta-D-Arabinofuranosyl-2-amino-1,4(2H)-4-iminopyrimidine (ara-AIPy), a new deaminase-resistant analog of cytarabine, exhibited extremely potent antitumor activity against P388 leukemia [400 mg/kg on Days 1-5; increase in life span (ILS), 211%] and significant inhibition against Lewis lung carcinoma (inhibition of tumor weight, 68%) and mammary adenocarcinoma 755 (inhibition of tumor weight, 82%). Schedule-dependency studies indicate that this drug, unlike cytarabine, was effective irrespective of its treatment schedules. The drug exhibited therapeutic efficacy against established P388 tumor transplants (400 mg/kg on Days 3-7; ILS, 131%) and inhibited the tumor growth effectively even when administered as a single dose on Day 1 by both ip (2000 mg/kg; ILS, 150%) and iv (500 mg/kg; ILS, 68%) routes. Ara-AIPy was most effective when administered on Days 1, 3, 5, 7, and 9 after tumor transplantation (400 mg/kg; ILS, 210%, with 50% of animals 60-day survivors). Ara-AIPy inhibited the growth of L1210 leukemia when both the tumor transplantation and the drug treatment were administered by iv route (500 mg/kg on Days 1, 5, and 9; ILS, 181%). The routes of administration of ara-AIPy experiments showed that the drug was effective by both ip and iv routes of administration; however, better therapeutic values were obtained by ip schedules. These studies demonstrate that ara-AIPy exhibits highly significant and broad-spectrum antitumor activity against a variety of experimental animal tumor models and suggest a possible future role for this drug in the treatment of human neoplasia.     

Targeting of "T" lymphocytes against human hepatoma cells by a bispecific monoclonal antibody: role of different lymphocyte subsets.

In an attempt to construct bispecific monoclonal antibodies (bimAbs) able to target cytotoxic T lymphocytes against human hepatoma cells, an HGPRT-deficient mutant of the Hepama-6 hybridoma, which produces an antihuman-hepatoma mAb, was directly fused with splenocytes from Balb/C mice immunized by a polyclonal cytotoxic T-cell line. Hybrid hybridomas were selected in HAT medium, and their supernatants were directly screened for the ability to induce IL-2-cultured cytotoxic T lymphocytes to kill hepatoma cells in a 51Cr-release assay. The selected hybrid hybridoma, termed DQ-33, secretes a bimAb, which reacts with a CD3-associated determinant. When resting peripheral-blood lymphocytes were used as effector cells, virtually no cytolytic activity could be induced by DQ-33, whereas phytohemagglutinin-activated lymphocytes that had been expanded in vitro in IL-2-containing medium could be efficiently targeted against hepatoma cells. Targeting by DQ-33 bimAb was analyzed on different subsets of IL-2-cultured lymphocytes. It was evident that CD+4-8+ TCR alpha/beta+ and CD3+4-8-TCR gamma/delta+ lymphocytes were efficiently induced by bimAb to lyse human hepatoma cells, whereas no induction of cytolysis could be observed when CD3 + 4 + 8-TCR alpha/beta+ cells were used as effectors. DQ-33 bimAb was also able to induce lymphokine secretion (IL-2, GM-CSF and TNF-alpha) by all the different subsets of lymphocytes analyzed in the presence of target cells expressing the relevant antigen, independent of the expression of cytolytic activity.