急性淋巴细胞白血病(下)

5 风险评估对病人的复发风险进行评估以确保只有高危病例才被施予极强治疗.研究表明采用成人方案治疗的青少年病人,其效果要显著差于使用儿童方案治疗的同年龄组.     

Effect of oral zinc supplementation on the growth of preterm infants

Objective  

To compare the effect of oral zinc supplementation on growth of preterm infants.     

Expression of ATP-binding cassette membrane transporters in rodent and human sertoli cells: relevance to the permeability of antiretroviral therapy at the blood-testis barrier

The blood-testis barrier (BTB), composed primarily of Sertoli cells, is responsible for protecting developing germ cells from xenobiotic exposure. ATP-binding cassette (ABC) membrane-associated drug efflux transporters, P-glycoprotein (P-gp), breast cancer resistance protein (BCRP), and the multidrug resistance-associated proteins (Mrps), have been shown to restrict antiretroviral drug permeability at blood-tissue barriers such as the blood-brain barrier. However, it remains unclear whether these transporters are functional at the level of Sertoli cells and can regulate anti-HIV drug permeability at the BTB. This study investigated the functional expression of ABC transporters in a mouse Sertoli cell line system (TM4) and in primary cultures of human Sertoli cells (HSECs). Expression of multidrug resistance Mdr1a/1b/MDR1/P-gp, Mrp1/MRP1, and Mrp4/MRP4 is confirmed by quantitative polymerase chain reaction and immunoblotting analysis in TM4 cells and HSECs. Immunofluorescence studies revealed plasma membrane localization of P-gp, Mrp1/MRP1, and Mrp4/MRP4 in both cell systems. However, Bcrp expression and localization was only detected in rodent cells. Accumulation of 1) rhodamine-6G (R-6G), a fluorescent P-gp substrate, 2) [3H]atazanavir, a HIV protease inhibitor and known P-gp substrate, 3) 2'7'-bis-(2-carboxyethyl)-5-(and-6)carboxyfluorescein (BCECF), a fluorescent Mrp substrate, and 4) [3H]mitoxantrone, a BCRP substrate, by TM4 monolayer cells in the presence of established inhibitors demonstrates that these transporters are functional. In addition, several anti-HIV drugs significantly enhance the accumulation of R-6G, [3H]atazanavir, BCECF, and [3H]mitoxantrone by TM4 cells. This study provides the first evidence of ABC transporter expression and activity in Sertoli cells and suggests that these transporters could play an important role in restricting antiretroviral drug permeability at the BTB.     

Blood conservation strategies for reducing peri-operative blood loss in open heart surgery

Defects in hemostasis are frequently seen in open heart surgery. Strategies should be reviewed about the peri-operative blood loss and conservation of blood here. In this study, comparison among three agents (Aprotinin, Tranaexaemic Acid & Epsilon Amino Caproic Acid) is done to reduce the peri-operative blood loss in open-heart surgery. Ninety male and female patients within 20-60 years of age were selected who underwent conventional cardiac surgery and anesthesia with Cardio-pulmonary-bypass for common open heart surgeries (ASD, VSD, AVR, etc) and randomly divided into three groups 30 patients in each. Group A, B, C was administered Inj. Aprotinin, Tranaexaemic acid & EACA respectively. Perioperative hemodynamic parameters and blood loss in suction bottle & drainage tube were noted until the 3rd POD. Requirement of blood transfusion, heparin, protamine and blood derived products were also noted. Activated clotting time was documented in the perioperative period. Clinically relevant outcome like re-exploration, mechanical ventilation, morbidities, mortality etc were also verified. Data were analyzed and results were calculated with student's T test & ANOVA. The groups were matched regarding recorded peri-operative variables. Peri-operative blood loss is significantly reduced (p<0.05) both in the Aprotinin and Tranexamic acid groups. Renal dysfunction was reported in 20% of aprotinin patients, 14.29% of tranexaemic acid patients and 18.51% of EACA patients. A conclusion was drawn from the study that Tranexamic acid can significantly reduce the peri-operative blood loss in open heart surgery cases and that it can be preferred as an agent of choice in blood conservation strategy in these cases.     

Indoor air pollution and health of children in biomass fuel-using households of Bangladesh: comparison between urban and rural areas

Objectives  

Indoor air pollutants from biomass combustion pose a risk for respiratory diseases in children. It is plausible that distinct differences in the indoor air quality (IAQ) exist between urban and rural areas in developing countries since the living environment between these two areas are quite different. We have investigated possible differences in IAQ in urban and rural Dhaka, Bangladesh and the association of such differences with the incidence of respiratory and some non-respiratory symptoms in children of families using biomass fuel.