阿片类联合激素及抗惊厥药治疗晚期癌痛的临床观察

目的　探讨晚期癌痛应用阿片类药物的合理用药方案。方法　选择伴有中、重度疼痛的晚期肿瘤患者,分３组,第一组３６例,采用盐酸羟考酮控释片（奥施康定）单药治疗;第二组１９例,用奥施康定和甲强龙联合治疗;第三组２５例,用奥施康定联合加巴喷丁。观察３组患者治疗后的疼痛缓解情况和生活质量。结果　单用奥施康定组完全缓解率为６３.９％,奥施康定联合甲强龙组为６８.４％,奥施康定和加巴喷丁联用组为４８.０％。主要毒副反应为便秘,其次为恶心、呕吐。第二组毒副反应最轻,第三组部分患者出现头晕和嗜睡。结论　阿片类药物奥施康定治疗晚期癌痛具有较好的疗效,其中奥施康定联合甲强龙尤其适合肺癌伴脑转移或骨转移患者,且安全性高,值得临床推广。     

Bioassay chamber for angiogenesis with perfused explanted arteries and electrospun scaffolding

OBJECTIVE: The purpose of this study was to test the hypothesis that explanted perfused arteries can serve as the initial endothelial cell culture source to evaluate the onset of angiogenesis in a cellulose acetate electrospun scaffold. METHODS: Electrospun scaffolds with fiber diameters roughly controlled in three broad ranges: 0.01 to 0.2, 0.2 to 1, and 1 to 5 microm (Nanomed Nanotechnol Biol Med 2:37-41, 2006), were used in cell culture to determine which provides the best culture topology. This scaffold was then tested in a bioassay chamber whose cellular source was an explanted abdominal aorta from donated euthanized mice. Scaffolds were draped over a cannulated vessel perfused for 24 h. Cell viability, density, and morphology were quantified. RESULTS: The largest fiber diameter group provided the best culture topology for human umbilical vein endothelial cells, showing high cell viability and density, and enhanced elongated cell morphology. Addition of single-walled carbon nanotubes decreased cell density significantly but chitosan heightened cell density and promoted spontaneous capillary tube like structure. Viability of endothelial cells increased with higher flow in the bioassay chamber. CONCLUSIONS: Endothelial cells showed a growth preference towards larger diameter fibers. Addition of chitosan improved culture conditions. Thus, this study provides a proof of principle for the possibility of co-culturing tissue engineered vascular networks from a perfused explant.     

Anorectal pressure in patients with symptomatic hemorrhoids

This study was carried out on 30 patients with symptomatic internal hemorrhoids and 20 normal controls. The anal sphincter pressure was studied before and after surgery. A significantly high anal pressure was found in all patients with symptomatic internal hemorrhoids, when compared with normal controls, and there was no relation between this increase and the degree of hemorrhoids. One week following surgery, this high pressure was reduced significantly and was not affected by the type of operation. Thus, this increase in resting anal pressure is due to an overactivity of the internal hemorrhoids, which is secondary to the presence of the hemorrhoidal mass.     

巴氯芬对腰椎间盘突出症急性发作期抗痉挛作用的临床观察

OBJECTIVETo study the anti-spastic effect of "baclofen "on acute paroxysm of lumbar intervertebral disc herniation.METHODSThe observation group adopt physical therapy and the drug : (1) physical therapy: lumbar intervertebral traction and computer interme     

Primary hyperaldosteronism causing posttransplantation hypertension: localization by adrenal vein sampling

A 58 year-old man with end-stage renal disease who had received a cadaveric renal transplant presented with persistent hypertension and hypokalemia. Allograft renal artery stenosis, rejection, and cyclosporine effects were excluded. Hypokalemia persisted despite potassium supplementation and antihypertensive medications with hyperkalemic effects. The biochemical findings of primary hyperaldosteronism with a normal adrenal anatomy imaged by magnetic resonance imaging (MRI) necessitated adrenal vein sampling to lateralize a left adrenal adenoma. His hypokalemia was cured by the removal of the adenoma, and his blood pressure (BP) control was easily achieved with a less complex regimen of antihypertensives. We suggest that the concomitant existence of resistant hypokalemia and posttransplantation hypertension, especially in the cyclosporine era, should stimulate a search for hyperaldosteronism; once transplant renal artery stenosis has been excluded, the patient should be investigated for primary hyperaldosteronism. When imaging studies fail to show adrenal pathology, adrenal vein sampling will likely do so.     

Acute radiation effects on cutaneous microvasculature: evaluation with a laser Doppler perfusion monitor

Laser Doppler perfusion monitoring is a noninvasive technique for measuring blood flow in epidermal microvasculature that makes use of the frequency shift of light reflected from red blood cells. Measurements in patients undergoing radiation therapy show increases in blood flow of ten to 25 times baseline at doses above 50 Gy, and increases are observed with doses as low as 2 Gy. Follow-up measurements show rapid decreases in flow levels after completion of therapy, but levels remain elevated even at 1 year.