Complications of preoperative balloon test occlusion of the internal carotid arteries: experience in 300 cases

Treatment of some tumors and aneurysms of the skull base may require internal carotid artery (ICA) sacrifice. Preoperatively to determine the dependence of the cerebral blood flow on a particular vessel, we perform a balloon test occlusion (BTO) by temporarily occluding the vessel in an awake patient. During occlusion, clinical evaluations and cerebral blood flow measurements are assessed. We have performed 300 BTOs. Eleven patients (3.7%) have had complications. Six (2%) were asymptomatic dissections. Five (1.7%) had neurologic deficits that persisted beyond the test period. Of these five, one was back to baseline in less than 24 hours, one recovered completely in a week, and one (0.33%) had a minimal but persistent dysphasia. These latter three cases are unexplained but might have resulted from unrecognized dissections or embolic events. Finally, one patient with a persistent deficit required energency surgery for reasons unrelated to the BTO and was therefore difficult to assess, and one required emergency middle cerebral artery embolectomy and repair of the dissection. The preoperative knowledge of carotid dependence in cases in which the ICA is at risk is essential, since vascular grafts or alternative surgical approaches are necessary in patients unable to tolerate carotid sacrifice. Since approximately 15 to 20% of the population falls into this category, a preoperative BTO appears justified.     

肝癌和肝硬化患者血清一氧化氮水平探讨

目的：探讨一氧化氮（NO）与肝癌及其合并症、肝硬化、肝功能分级及肝硬化并发症的关系。方法：应用化学比色法检测34例肝癌患者，45例肝硬化患者及20例正常人血清NO水平。结果：肝癌组血清NO显著高于肝硬化组及正常对照组；肝癌合并代偿期肝硬化血清NO高于合并慢性肝炎者；肝硬化组血清NO与正常对照组比较，差异有显著性；并且随肝功能Child-Pugh分级的增加而升高，A级与对照组比较无差异，B级与A级、B级与C级比较，差异有显著性。并发肝肾综合征、食管胃底静脉曲张破裂出血者较无并发症肝硬化者NO明显升高。结论：内源性NO在肝癌及肝硬化时合成增加，且与肝癌合并症、肝硬化病情严重程度及并发症的发生密切相关。血清NO测量有助于肝癌及肝硬化病情的临床评估及疗效观察。     

蚯蚓纤溶酶同工酶的分析

对4种蚯蚓(赤子爱胜蚓、栉盲环毛蚓、通俗环毛蚓、威廉环毛蚓)进行粗提，将所得样品作活性印迹试验，观察同工酶谱以及经还原后谱带的变化情况，并对这4种蚯蚓活力大小进行比较，发现威廉环毛蚓总活力最高，其经过PAGE电泳后同工酶FE2活力最高。     

Effect of aluminum adjuvants on safety and immunogenicity of Haemophilus influenzae type b-CRM197 conjugate vaccine

OBJECTIVE: The present study was carried out to evaluate the safety and immunogenicity of the Haemophilus influenzae type b-CRM197 (Hib-CRM197) conjugate vaccine in relation to the change of adjuvant from aluminum hydroxide to aluminum phosphate (AlPO4). METHODS: The present study was a clinical phase II, observer-blind, randomized, multicenter, controlled study. Subjects were healthy infants aged 6-12 weeks, eligible for expanded program of immunization (EPI) routine vaccination and admitted to Hacettepe University Department of Social Pediatrics and Gülveren Health Center, Ankara. A total of 520 healthy infants were randomized in a 2:2:1 ratio to receive at either Chiron Hib/AlPO4 vaccine or VaxemHib (aluminum hydroxide adjuvant) vaccine or HibTiter (no adjuvant). Vaccines were administered simultaneously with routine diphtheria, tetanus and pertussis (DTaP) and oral polio vaccine (OPV) vaccines at 2, 4 and 6 months of age. Blood samples for anti-plain polysaccharide (PRP) antibody measurement were collected before the first vaccination and 1 month after the last vaccination. After each vaccination parents filled out a diary for 7 days. RESULTS: Out of 520 subjects enrolled, 514 received three doses and were included for safety analysis. Local and systemic reactions occurred with low and similar frequencies in all groups. Only erythema was more common in Chiron Hib/AlPO4 vaccine (19, 10, 11% in Chiron Hib/AlPO4, VaxemHib and HibTiter, respectively, P < 0.05). Nine serious adverse events were reported in seven cases of which none were related to vaccines. A total of 504 subjects were included in the immunogenicity analysis. The three vaccines were highly immunogenic and equivalent in terms of percentage of acquisition of long-term protective levels. The anti-PRP geometric mean titers were 9.9, 8.3 and 5.14 micro g/mL, respectively (P < 0.05). CONCLUSIONS: The use of aluminum compounds adjuvants in Hib-CRM197 conjugate vaccines does not impact the safety profile, while it does increase the magnitude of anti-PRP antibody titers.     

阳离子抗菌肽研究进展

阳离子抗菌肽广泛分布于多种生物 ,越来越多的证据表明它们在机体天然免疫中有着重要的作用。广谱抗菌、抗病毒、抗肿瘤细胞及其它特性也使得其具有潜在的医药价值。对抗菌肽的研究正不断深入。该文从一般性质、作用机制、构效关系、重组表达、应用价值、存在的问题与发展方向等方面 ,对阳离子抗菌肽的最新研究进展进行综述     

甘草酸二铵治疗肝纤维化的动态观察

目的 :观察甘草酸二铵治疗肝纤维化的疗效。方法 :2 0 0例 [男性 135例 ,女性 6 5例 ,年龄 (37±s 2 1)a]慢性肝炎病人分为A组 4 5例 ,B组 15 5例。A组用门冬氨酸钾镁 2 0mL ,B组用甘草酸二铵 30 0mg ,均加入 5 %葡萄糖注射液 5 0 0mL ,ivgtt ,qd ,连用 6wk后改为口服药治疗 8wk。观察肝功能、血清透明质酸 (HA)、Ⅲ型前胶原 (PCⅢ )及肝组织学变化。结果 :治疗 6wk时 ,B组的ALT复常率为 74 .2 % ,明显优于A组 (4 6 % ) ,P <0 .0 1。治疗结束后 ,B组的肝纤维化程度明显减轻 ,与A组相比 ,HA和PCⅢ水平明显降低。结论 :甘草酸二铵不但有良好的改善肝功能作用 ,还具有抗肝纤维化作用     

正交设计法考察盐酸洛美沙星葡萄糖注射液制备工艺

目的：对盐酸洛美沙星葡萄糖注射液生产工艺过程的影响因素进行实验考察，寻求最佳生产工艺。方法：通过正交设计考察pH、加炭量、温度和加热时间4个因素对盐酸洛美沙星含量的影响，选用L16(4^5)正交表进行实验。结果：实验证明活性炭对盐酸洛美沙星有明显吸附作用，在pH值为4．8，加炭量为0．02％，温度为50℃及加热时间为10 min的优化条件下，活性炭对盐酸洛美沙星的吸附量最小。结论：生产过程中应对上述影响因素进行控制，提高产品质量。     

食管癌根治术后生存质量评价

目的评价食管癌根治术后患者生存质量.方法采用EORTC QLQ-C30以问卷形式采集食管癌根治术后患者生存质量情况,根据术后时间分组(1年组、1～3年组和3年以上组),与术前患者资料相比较.结果患者体能、社会能力于手术后出现下降,1年后明显恢复;情感能力3年后较前有提高;术后呼吸困难加重,1年后开始减轻,3年后接近术前;术后食欲丧失加重,1年后开始减轻;便秘症状术后改善.结论食管切除食管胃吻合术降低食管癌患者的生存质量,但多数生存质量评分在1年后开始恢复,3年后明显改善.     

青年人肺癌化疗加放射治疗的临床研究

目的　探讨化疗 放射治疗 (化放疗 ) <4 0岁青年人肺癌的临床病理及预后。方法　对化放疗的 70例肺癌患者 (<4 0岁 ,研究组 )进行回顾性研究 ,对照组是 82例随机选择同期患者 (≥4 0岁 )。比较两组临床病理特征和生存期。结果　研究组中位年龄 36 .5岁 ,对照组 6 2 .0岁。与对照组相比 ,研究组中女性多 (P =0 .0 39) ,中位症状持续时间长 (4个月 ,P <0 .0 0 1) ,误诊率高 (70 % ,P <0 .0 0 1)及中位误诊时间长 (4个月 ,P <0 .0 0 1) ,腺癌为主要病理类型 (6 4 .3% ,P <0 .0 0 1) ,诊断时晚期多 (90 % ,P <0 .0 0 1) ,放射治疗剂量高 (Ⅰ～Ⅲb期 ,中位剂量 6 2Gy ,P =0 .0 4 8;Ⅳ期 ,中位剂量 5 6Gy,P =0 .0 0 3) ,同期化放疗和早期放射治疗比例高 (77.1% ,P <0 .0 0 1和 5 5 .6 % ,P =0 .0 2 3) ,顺铂剂量高(90mg/m2 ,P <0 .0 0 1)以及化疗周期多 (6个周期 ,P <0 .0 0 1) ;两组在体重减轻、KPS、肿瘤家族史及吸烟史方面无差异。两个组总的中位生存时间及生存率比较差异无显著性意义 (χ2 =2 .88,P =0 .0 90 )。结论　化放疗的青年人肺癌临床病理特征明显不同于≥ 4 0岁人的肺癌 ,但生存情况一致。将青年人肺癌定义为”青年型肺癌”有一定临床实际意义。