热双蒸水联用生理盐水及右旋糖酐-40预防腹腔内肿瘤种植转移的实验研究

联合应用热双蒸水、生理盐水、右旋糖酐40 序贯腹腔冲洗的方法,行体外试验与动物试验。发现45 ℃双蒸水浸泡腹腔20 min 后能完全杀灭体外培养的B6F10 细胞;右旋糖酐40 部分抑制B16F10 细胞对胶化培养板孔壁的粘附。小鼠腹腔注入B16F10 细胞后,按上述三联合液序贯冲洗可预防70 % 的C57 BL/6j小鼠发生腹膜癌病,未见毒副作用。在此冲洗的基础上,腹腔内保留氯氨铂,疗效高达88-9 % ,但毒性也增加     

Temporary strecker stent for management of acute dissection in popliteal and crural arteries

Stent placement is a widely used bail-out treatment for dissection of peripheral arteries. Below the level of the superficial femoral artery permanent stenting is complicated by a high incidence of subacute thrombosis and restenosis. We present two cases of arterial occlusion due to acute iatrogenic dissection of the popliteal and distal fibular arteries. Successful treatment was achieved with a new bail-out procedure. Strecker stents were implanted to seal off the dissection flap. Stents were retrieved easily after 24 hr using a myocardial biopsy forceps. After stent retrieval the temporarily stented segments were patent and showed a larger lumen compared with segments treated by balloon dilatation alone. Temporary stenting is a simple and safe procedure and offers the advantage of tacking up dissection membranes and preventing recoil. Persistent presence of a metallic implant as a source of continued injury and stimulus for intimal proliferation is avoided.     

The evaluation of the use of antineoplaston AS2-1 treatment in subacute sclerosing panencephalitis

A follow-up study was carried out of 16 SSPE patients two years after completion of 6-month treatment with Antineoplaston. The study was based on an inquiry sent to the families of the patients and on control examinations at the clinic. In the period of follow-up 6 patients died, all had the downhill type of disease course and their mean survival was 18 months. Out of the remaining 10 patients 4 are in stationary condition and the remaining ones had minimal worsening. A more detailed clinical analysis showed that half the patients were in contact with and general orientation in the environment, but impairment of motor functions made difficult in most cases self-care and self-dependent functioning. All patients had evident changes in brain MRI. The survival time of the patients has been as yet from 2.5 to 5.5 years (mean 3.9 years). The results of the treatment with Antineoplaston AS2-1 + isoprinosine are comparable with those observed during isoprinosine alone treatment but significantly worse than those after administration of Propionibacterium granulosum with isoprinosine. This suggests that Antineoplaston AS2-1 fails to modify importantly the natural course of SSPE.     

Catecholamines in paraganglia associated with the hepatic branch of the vagus nerve: effects of 6-hydroxydopamine and reserpine

Paraganglia are clusters of cells containing catecholamines (CA), mainly norepinephrine (NE) and dopamine (DA). The presence of epinephrine (E), on the other hand, has only been determined by indirect methods in retroperitoneal paraganglia of newborn and aged rats. Because their location, paraganglia associated with the hepatic branch of the vagus nerve may be a possible source of CA for the liver. The main purposes of the present study were to determine CA levels and whether E can be found in the omentum minus which includes paraganglia associated with the hepatic branch of the vagus nerve, and then to study the effects of 6-hydroxydopamine and reserpine on their CA content. Twenty-four female Wistar rats were randomly ascribed to three groups receiving two intraperitoneal injections of either 6-hydroxydopamine, reserpine or saline. Twenty-four hours after the last administration the rats were anesthetized and a portion of the omentum minus was obtained. Left adrenal medulla and a liver fragment were also collected as controls. The samples were processed to be analyzed by high performance liquid chromatography and catecholamine histofluorescence. The results confirm previous reports about the presence of considerable amounts of norepinephrine and dopamine in paraganglia. Norepinephrine and dopamine in the omentum like the adrenal medulla were significantly depleted by reserpine but not by 6-hydroxydopamine treatment, suggesting that some other sources in addition to sympathetic terminals are responsible for CA in the omentum. On the contrary, both drugs reduced liver NE, consistent with the localization of this amine mainly to hepatic sympathetic terminals. Histofluorescence of the omentum revealed 2-4 paraganglia per tissue fragment. Paraganglia associated with the hepatic branch of the vagus nerve contain also E. The presence of perihepatic sources of extra-adrenal CA, and more specifically E, could be of physiological significance.     

Aluminum is a weak agonist for the calcium-sensing receptor

BACKGROUND: Aluminum (Al3+) has diverse biological effects mediated through activation of a putative extracellular cation-sensing receptor. A recently identified calcium-sensing receptor (CaSR), which has been identified in target tissues for Al3+, may transduce some of the biological effects of Al3+. METHODS: To test this possibility, we transfected human embryonic kidney 293 (HEK 293) cells with a cDNA encoding the rat CaSR and evaluated CaSR expression by Western blot analysis and function by measurement of intracellular calcium ([Ca2+]i) levels and inositol monophosphate (IP1) generation following stimulation with Al3+ and a panel of CaSR agonists. RESULTS: The CaSR protein was detected by immunoblot analysis in cells transfected with the CaSR cDNA but not in nontransfected HEK 293 cells. In addition, [Ca2+]i levels and IP1 generation were enhanced in a dose-dependent fashion by additions of the CaSR agonists calcium (Ca2+), magnesium (Mg2+), gadolinium (Gd3+), and neomycin only in cells transfected with CaSR. To determine if Al3+ activated CaSR, we stimulated cells transfected with rat CaSR with 10 microM to 1 mM concentrations of Al3+. Concentrations of Al3+ in the range of 10 microM to 100 microM had no effect on [Ca2+]i levels or IP1 generation. In contrast, 1 mM Al3+ induced small but significant increases in both parameters. Whereas Gd3+ antagonized calcium-mediated activation of CaSR, pretreatment with Al3+ failed to block subsequent activation of rat CaSR by Ca2+, suggesting a distinct mechanism of Al3+ action. CONCLUSION: Al3+ is not a potent agonist for CaSR. Because Al3+ affects a variety of target tissues at micromolar concentrations, it seems unlikely that CaSR mediates these cellular actions of Al3+.     

Antibiotic Administration in Patients Undergoing Common Surgical Procedures in a Community Teaching Hospital: The Chaos Continues

The influence of recently published guidelines by the Surgical Infection Society (SIS) on current surgical practice are not well documented. The appropriateness of antibiotic administration in a cohort of surgical patients undergoing elective and emergency surgery in a department of surgery in an urban, community-based, private, 560-bed teaching hospital was retrospectively reviewed. The following were the criteria defining administration as appropriate as modified from SIS guidelines: Prophylactic use: (1) started prior to operation; (2) spectrum appropriate to the specific operation; (3) duration ≤ 24 hours. Therapeutic use: (1) started prior to operation; (2) spectrum appropriate to pathology; (3) Duration ≤ 24 hours for contamination or “resectable” infection and ≤ 5 days for established infection in the absence of clinical evidence of persisting infection. Any switchover from an appropriate agent to another appropriate or inappropriate agent in the same patient in the absence of microbiologic or clinical indication was considered inappropriate administration. We reviewed the charts of 211 randomly selected patients who underwent elective (n= 132) or emergency (n= 79) procedures during 1996. The operations included gastrectomy (n= 22), appendectomy (n= 27), open (n= 5) or laparoscopic (n= 27) cholecystectomy, colectomy (n= 28), hysterectomy (n= 8), laparotomy for intestinal obstruction (n= 11), mastectomy (n= 26), and ventral hernia repair (n= 37). A total of 17 antibiotics were used for prophylaxis and 21 for therapy. In 156 patients (74%) the administration was considered inappropriate. Eight patients in the inappropriate group developed diarrhea (two cases of Clostridium difficile-induced colitis) compared to two cases of diarrhea in the appropriate group (nonsignificant). The average duration of administration after elective and emergency operations was 3.3 and 5.7 days, respectively. The total expense for excessive duration of administration was $18,533. Many surgeons are not familiar with the spectrum of antimicrobials and often do not distinguish between prophylactic and therapeutic administration. Antibiotic usage in current surgical practice is often inappropriate, excessive, and chaotic.     

Lipoprotein(a) and other lipoproteins in hypothyroid patients before and after thyroid replacement therapy

AIMS: To analyse the influence of thyroid hormones on serum lipoprotein(a) (Lp(a)) concentration and other lipid parameters, and hence potentially on coronary artery disease (CAD) risk. METHODS: Thirty-six patients with hypothyroidism and 165 age-matched control euthyroid subjects were evaluated in a cross- sectional study, determining thyroid function tests and fasting serum lipids and lipoproteins. In a follow-up study for those hypothyroid patients the same determinations were repeated after normalization of thyroid state by levothyroxine (L-T(4)) replacement therapy. Patients needing other treatments were excluded. At baseline, patients with hypothyroidism had significantly higher levels of Lp(a), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), apolipoprotein (apo) A-I and apo B, and a higher TC/high-density lipoprotein cholesterol (HDL-C) ratio than control subjects. RESULTS: Severity of the hypothyroid state, expressed by serum thyroid-stimulating hormone, was correlated with serum levels of Lp(a), LDL-C, and TC (r= 0.64, 0.52, 0.49, P= 0.005, P= 0.033, P= 0. 048, respectively). The pretreatment Lp(a) levels were also correlated with those of posttreatment Lp(a)(r= 0.68, P= 0.002). All patients, who presented basal Lp(a) levels higher than 30 mg/dl, showed a decrease in Lp(a) concentrations by L-T(4)therapy, and these normalized in eight cases (22.2%). Euthyroid state gave rise to a significant reduction of serum Lp(a) by 32.3%, of LDL-C by 22. 8%, of TC by 17%, of apo A-I by 9.6%, and of apo B by 9.3%. After L-T(4)therapy, CAD risk, expressed as TC/HDL-C ratio, decreased by 19.9%. CONCLUSIONS: These results show that hypothyroidism is associated not only with elevated serum levels of LDL-C but also with elevated serum Lp(a) concentrations. Lp(a) levels may be at least partially modulated by thyroid hormone-dependent mechanisms, thus increasing the risk of developing premature atherosclerosis in hypothyroid state, that might be reduced by L-T(4)therapy.     

Comparing changes in transient-evoked otoacoustic emission and pure-tone audiometry following short exposure to industrial noise

It has been suggested that otoacoustic emissions, particularly transient-evoked otoacoustic emissions (TEOAE), might be more sensitive in assessment of changes to the cochlea caused by noise than pure-tone audiometry (PTA). The aim of the study was to compare temporary threshold shifts with the changes in TEOAE following a six-hour exposure to industrial noise at the intensity of 85-97 dB (A). Thirty two male employees of a metal factory were screened. TEOAE, PTA and tympanometry were included in the hearing test battery. Both, PTA and TEOAE showed significant reduction due to noise exposure, but no correlation between temporary threshold shifts and decreases in either the overall TOAE level or the level of otoacoustic emission in the frequency bands was found. Our results confirm the high sensitivity of TEOAE to short exposure to industrial noise. This study may recommend this measurement as a method of evaluation for TTS conditions for hearing conservation programme purposes, in addition to pure-tone audiometry.