Treatment of singultus following craniocerebral injury★ Intranasal cavity drip infusion versus intramuscular injection of aminazine

BACKGROUND: Craniocerebral injury always accompanies with singultus, while frequent singultus may cause increased intracranial pressure. Simultaneously, respiratory alkalosis and cerebral hypoxia induced by respiratory disorder may aggravate craniocerebral injury. OBJECTIVE: To observe the therapeutic effects of intranasal cavity drip infusion of aminazine and intramuscular injection on singultus following craniocerebral injury. DESIGN: Contrast observation. SETTING: Department of Neurosurgery, Xi'an Aerospace General Hospital. PARTICIPANTS: A total of 102 patients with singultus following craniocerebral injury were selected from the Department of Neurosurgery, Xi'an Aerospace General Hospital from June 2001 to June 2006. Patients with craniocerebral injury were diagnosed with CT examination and randomly divided into nasal cavity medication group (n =62) and intramuscular injection group (n =40). There were 44 males and 18 females in the nasal cavity medication group and their mean age was (33±4) years; while, there were 26 males and 14 females in the intramuscular injection group and their mean age was (29±4) years. All patients and their relatives provided the confirmed consent. METHODS: Patients in the nasal cavity medication group were slowly dripped aminazine solution into bilateral nasal cavity with the dosage of 12.5 mg (0.5 mL). Patients who had no obvious effect or had mild improvement received the treatment once every 6 hours. The treatment was stopped if symptoms were also observed after the fifth medication. In addition, patients in the intramuscular injection group received intramuscular injection of 50 mg aminazine. Patients who had no obvious effect or had mild improvement received the treatment once every 6 hours. The treatment was changed if symptoms were also observed after the fifth medication. MAIN OUTCOME MEASURES: Therapeutic effects of different medications in the two groups. RESULTS: All 102 patients were involved in the final analysis. Effective rate in the nasal cavity medication group was higher than that in the intramuscular injection group, and there was significant difference (χ2= 11.882, P < 0.01). At 6 hours after onset of singultus, effective rate in the nasal cavity medication group was higher than that in the intramuscular injection group, and there was significant difference (χ2 =8.188, P < 0.01). CONCLUSION: Therapeutic effects of intranasal cavity drip infusion of aminazine on singultus following craniocerebral injury are superior to those of intramuscular injection.     

大鼠体外循环模型的建立与应用

由于操作简便、节省人力物力，大鼠体外循环模型的应用愈加广泛。大鼠在小型呼吸机辅助下，应用颈静脉插管入右心房引流血液至贮血瓶，在蠕动移液泵作用下，经膜式氧合器氧合、变温器变温，通过股动脉或尾动脉插管注入动脉系统，建立体外循环回路。有血预充、减少总预充量和维持足够的转流流量是建立大鼠体外循环模型的关键。     

高分辨MRI对颈动脉粥样硬化斑块成分显示的病理对照研究

目的分析和评价高分辨MRI对颈动脉粥样硬化斑块不同成分的显示效果,为颈动脉内膜切除术术前判断斑块稳定性提供参考。方法对26例行颈动脉内膜切除术的颈动脉粥样硬化性狭窄患者术前高分辨MRI 4种不同序列的影像(T1WI、T2WI、PDWI和3D TOF)与斑块标本病理进行逐层对照,分析斑块内不同成分的MRI影像特点。结果获得斑块28块,切为238段,主要分布于颈总动脉和颈内动脉,以复杂斑块为特征的Ⅳ～Ⅴ型58段(24.37%)和Ⅵ型79段(33.19%)为主;斑块内纤维帽主要表现为TOF序列的带状低信号,钙化和纤维化组织分别表现为在各序列影像上的不规则低信号和不特定信号,脂质池和坏死核呈T1WI、PDWI和3D TOF序列的等至稍高信号,近期出血表现为T1WI、T2WI和PDWI序列的明显高信号。结论高分辨MRI不仅可以清晰显示动脉粥样硬化斑块,进行动脉管腔狭窄程度的测定,通过多序列影像联合分析还可以分辨斑块内部不同成分,有助于术前对斑块稳定性的判断。     

撬拨复位植骨椎弓根螺钉固定治疗胸腰椎爆裂性骨折

[目的]椎体撬拨植骨成形加椎弓根螺钉固定治疗早期胸腰椎爆裂性骨折,预防术后形成“空心椎”引起的钉松动、断钉及伤椎再塌陷、后凸畸形等并发症。[方法及结果]收治胸腰椎爆裂性骨折患者28例,行椎弓根螺钉内固定后,用神经根探子撬拨压缩下陷的伤椎上终板和前中柱,使之复位,经伤椎通过椎弓根植骨成形。术后随访6~18个月,全部获得骨性愈合(100%)。脊柱后凸Cobb's角度术前平均23.6°(n=23)矫正至术后平均4.4°(n=23),随访角度5.3°;椎体前缘高度压缩比由术前平均45%恢复至术后97%,随访时95%;伤椎椎管内矢状径术前平均7.6 mm,术后17.5 mm,随访矢状径17.1 mm,无明显狭窄。无内固定松动、断裂或弯曲。[结论]椎体撬拨植骨成形加椎弓根螺钉固定治疗胸腰椎压缩性骨折,手术安全性高,经植骨均获得骨性愈合,恢复了伤椎的强度和刚度,减少了内固定的应力,防止后凸畸形,降低并发症出现。     

Loss of cables, a novel gene on chromosome 18q, in ovarian cancer.

Cables, a cyclin-dependent kinase (cdk) interacting protein, has recently been identified and mapped to human chromosome 18q11. Cables appears to be primarily involved in cell cycle regulation and cell proliferation. Overexpression of Cables in Hela and other cell lines inhibits cell proliferation and tumor formation. We hypothesize that loss of Cables expression is associated with ovarian cancer. To test our hypothesis, we examined Cables expression in the four most common subtypes of ovarian carcinomas: serous, endometrioid, mucinous, and clear cell. In addition, mucinous and serous borderline tumors were also included. Loss of Cables expression was observed at high frequency in ovarian serous (11 of 14 cases, 79%) and endometrioid (5 of 10 cases, 50%) carcinomas. In contrast, strong Cables staining was detected in all clear cell carcinomas (10 cases) and mucinous tumors (5 carcinomas and 5 borderline tumors). The majority of serous borderline tumors (11 of 14 cases, 79%) showed positive Cables staining, with the rest showing focal loss of Cables expression. Furthermore, RT-PCR revealed the lack of Cables mRNA in a human ovarian cancer xenograft. No correlation was noted between loss of Cables and histologic grade, tumor stage, and survival. In conclusion, our results indicate that loss of Cables is common in ovarian serous and endometrioid carcinomas and imply that Cables may be involved in the pathogenesis of these two types of ovarian carcinomas.     

颞叶癫痫大鼠海马CA1区Sema3C、Np1的表达变化研究

目的探讨颞叶癫痫的发病机制。方法取健康雄性SD大鼠制成颞叶癫痫模型，用免疫组织化学和原位杂交技术对匹罗卡品致痫后不同时间点CA1区的Sema3C mRNA、Np1 mRNA和蛋白表达进行分析。结果在匹罗卡品致痫后7d，实验组CA1区Sema3C、Np1的表达明显低于对照组（P〈0．01）。结论CA1区Sema3C、Np1的表达下凋可能参与了海马CA1区内的轴突出芽机制。     

川崎病并冠状动脉损害研究进展

川崎病(KD)是一种主要发生于儿童的急性血管炎综合征,目前在欧美一些发达国家,该病发病率已超过风湿热成为儿童期后天性心脏病的首位病因。冠状动脉损害是其严重并发症,可进一步导致心肌梗死、猝死及缺血性心脏病等后遗症。本文主要从KD冠状动脉损害的病理、诊断、检测、治疗等方面总结一下新的进展。     

Objective responses in patients with malignant melanoma or renal cell cancer in early clinical studies do not predict regulatory approval.

PURPOSE: Tumor responses in early-phase trials are used to determine whether new agents warrant further study. Given that spontaneous regressions are observed in melanoma and renal cell carcinoma, this study assessed whether tumor responses, particularly in these two tumor types, predict for future regulatory drug approval. EXPERIMENTAL DESIGN: The literature was reviewed to assess tumor response rates to cytotoxic agents in phase I and II trials in the following solid tumors: melanoma, renal cell carcinoma, non-small-cell lung cancer, breast cancer, ovarian cancer, colorectal cancer, and other solid tumors. Response rates were categorized and the relationship of these categories to the end point of regulatory drug approval was determined. RESULTS: Fifty-eight drugs were assessed in 100 phase I trials, and 46 of these drugs were also studied in 499 phase II trials. Higher overall response rates in both phase I trials (P = 0.03) and phase II trials (P < 0.0001) were predictive of regulatory approval. However, response in melanoma or renal cell carcinoma was not predictive for either phase I or phase II studies. CONCLUSIONS: For cytotoxic agents, although overall objective response rates reliably predict subsequent marketing approval, isolated responses in melanoma and renal cell carcinoma are not predictive.     

老年糖尿病患者髋关节置换手术围手术期处理

目的探讨老年糖尿病患者髋关节置换手术围手术期血糖的控制方法和对手术的影响。方法回顾性分析32例老年糖尿病髋关节置换手术治疗围手术期血糖调控情况。结果32例患者入院时空腹血糖(12.8±1.7)mmol/L,经术前用胰岛素控制空腹血糖至(7.1±1.2)mmol/L后,分别接受全髋关节置换、股骨头置换手术,术中及术后继续使用胰岛素控制血糖至基本正常水平。本组术中血糖为(8.9±1.1)mmol/L。32例中,仅1例(3.2%)伤口愈合不良,未发生感染等其他明显并发症。结论老年糖尿病患者经正确的围手术期处理,将血糖控制至基本正常水平,可耐受髋关节置换手术。