艾司洛尔联合胺碘酮治疗心室电风暴160例临床分析

目的：探讨和分析盐酸艾司洛尔与胺碘酮联合使用在治疗心室电风暴患者的效果。方法整群选取该院在2011年9月-2014年6月期间所收治的329例心室电风暴患者,遵照随机与知情自愿原则,分为观察组(160例)和对照组(169例)。给予药物胺碘酮治疗,对观察组患者采用盐酸艾司洛尔与胺碘酮联合治疗方案,疗程结束后,认真观察和对比两组患者所取得治疗的效果。结果观察组患者总有效率为95.0%,明显高于对照组的70.4%,该两组患者总有效率对比,差异有统计学意义(P<0.01);治疗后观察组患者收缩压与心率分别为(104.0±15.0)mmHg、(84.0±13.0)次/min全部低于对照组,该两组患者治疗后的收缩压与心率对比,差异有统计学意义(P<0.05)。结论采用盐酸艾司洛尔联合药物胺碘酮共同治疗心室电风暴患者的临床效果满意,能够提高心室风暴患者的治愈率,具有临床推广价值。     

Moonlighting Adenosine Deaminase: A Target Protein for Drug Development

Interest in adenosine deaminase (ADA) in the context of medicine has mainly focused on its enzymatic activity. This is justified by the importance of the reaction catalyzed by ADA not only for the intracellular purine metabolism, but also for the extracellular purine metabolism as well, because of its capacity as a regulator of the concentration of extracellular adenosine that is able to activate adenosine receptors (ARs). In recent years, other important roles have been described for ADA. One of these, with special relevance in immunology, is the capacity of ADA to act as a costimulator, promoting T‐cell proliferation and differentiation mainly by interacting with the differentiation cluster CD26. Another role is the ability of ADA to act as an allosteric modulator of ARs. These receptors have very general physiological implications, particularly in the neurological system where they play an important role. Thus, ADA, being a single chain protein, performs more than one function, consistent with the definition of a moonlighting protein. Although ADA has never been associated with moonlighting proteins, here we consider ADA as an example of this family of multifunctional proteins. In this review, we discuss the different roles of ADA and their pathological implications. We propose a mechanism by which some of their moonlighting functions can be coordinated. We also suggest that drugs modulating ADA properties may act as modulators of the moonlighting functions of ADA, giving them additional potential medical interest.     

Evaluation of the chronic toxicity and oncogenicity of N,N-diethyl-m- toluamide (DEET)

Chronic toxicity and/or oncogenicity studies were conducted in rats, mice, and dogs with the insect repellent DEET. DEET was mixed in the diet and administered to CD rats for two years at concentrations that corresponded to dosage levels of 10, 30 or 100 mg/kg/day for males and 30, 100, or 400 mg/kg/day for females; to CD-1 mice for 18 months at dosage levels of 250, 500, or 1000 mg/kg/day; and to dogs for one year, via gelatin capsules, at dosage levels of 30, 100, or 400 mg/kg/day. In the rodent studies, each group consisted of 60 animals of each sex, and two concurrent independent control groups, each containing 60 animals/sex were included in each study. Each group in the dog study consisted of four male and four female dogs and one control group was included in the study. Treatment-related effects were observed at the highest dose level in all three studies. For rats, the effects included decreases in body weight and food consumption and an increase in serum cholesterol in females only. In mice, the effects observed were decreases in body weight and food consumption in both sexes. The effects observed in dogs included increased incidences of emesis and ptyalism, and levels of transient reduction in hemoglobin and hematocrit, increased alkaline phosphatase (males only), decreased cholesterol, and increased potassium. One male dog in the high-dose group also exhibited ataxia, tremors, abnormal head movements, and/or convulsions on several occasions during the study. The highest no- observed-effect levels (NO-ELs) for rats, mice and dogs were determined to be 100, 500, and 100 mg/kg/day, respectively. No specific target organ toxicity or oncogenicity was observed in any of the studies.      

Quantum chemical study of the electronic and conformational characteristics of adenosine and 8-substituted derivatives: functional implications in the mechanism of reaction of adenosine deaminase

A quantum chemical study of 10 substrates of adenosine deaminase is performed. The conformational preference around the glycosidic bond of several 8-substituted derivatives of adenosine is studied using semiempirical modified neglect of diatomic overlap (MNDO) and Austin model 1 (AM1) methods. All the compounds studied show preference for the anti conformation; the syn - anti energetic differences calculated are small and in excellent agreement with experimental data. A relationship between the ab initio molecular electrostatic potential minimum energy of N3 and the syn - anti energetic difference is found. A highly significant relationship is also found between the ab initio net charge over the purine and pyrimidine rings and the logarithm of the maximum rate of deamination (log Vm) of the nucleosides by adenosine deaminase. In contrast, no significant relationship is found between the anti preference of 8-substituted derivatives of adenosine and their log Vm of deamination.     

A1 Adenosine receptors can occur manifesting two kinetic components of 8-cyclopentyl-1,3-[3H]dipropylxanthine ([3H]DPCPX) binding

The results described in this paper show, for the first time, that At adenosine receptors can have two kinetic components for the binding of the antagonist [³H]DPCPX. At low ionic strength ( 42mmo1/l), dissociation of [³H]DPCPX bound to A₁ receptors fitted better to a two kinetic components model than to a one kinetic component model. The kinetic constants were consistent with comparable Kd values for the two components of the antagonist binding, and therefore these two components cannot be distinguished by saturation isotherm analysis. Correspondence to: E.I. Canela at the above address     

Evaluation of the systematic set-up errors using electronic portal image device in the radiotherapy procedures

Objective： The aim of this work was to quantify the extent of set-up errors to conduct a quality assurance （QA） aspect of treatment delivery, verification of the treatment field＇s position on different days using electronic portal. Methods： This study was carried out on 12 patients, treated for pelvis tumor; and total of 240 images obtained by electronic portal image device （EPID） were analyzed. The EPIs acquire using EPID attached to the Siemens linear accelerator. The anatomy match- ing software （Theraview） was used and displacement in two dimensions were noted for each treatment field to study patient setup errors. Results： The percentages of mean deviations less than 5 mm in X direction were 65% ＆ 92%, from 5-10 mm were 31% ＆ 19% and more than 10 mm were 11% ＆ 9% forNP and lateral direction respectively. The percentages of mean deviations less than 5 mm in Y direction were 65% ＆ 63%, from 5-10 mm were 33% ＆ 28% and more than 10 mm were 22% ＆ 29%. The mean deviations in 2D-vector errors were 〈 5 mm in 47% and 46%, 5-10 mm in 36% and 37% and 〉 10 mm in 37% and 37% of images in the NP and lateral direction respectively. Conclusion： The results revealed that the ranges of set up errors are immobilization method to improve reproducibility. The observed variations were not within the limits..     

Nutrition education intervention for dependent patients: protocol of a randomized controlled trial

ABSTRACT: BACKGROUND: Malnutrition in dependent patients has a high prevalence and can influence the prognosis associated with diverse pathologic processes, decrease quality of life, and increase morbidity-mortality and hospital admissions. The aim of the study is to assess the effect of an educational intervention for caregivers on the nutritional status of dependent patients at risk of malnutrition. METHODS: Intervention study with control group, randomly allocated, of 200 patients of the Home Care Program carried out in 8 Primary Care Centers (Spain). These patients are dependent and at risk of malnutrition, older than 65, and have caregivers. The socioeconomic and educational characteristics of the patient and the caregiver are recorded. On a schedule of 0-6-12 months, patients are evaluated as follows: Mini Nutritional Assessment (MNA), food intake, dentures, degree of dependency (Barthel test), cognitive state (Pfeiffer test), mood status (Yesavage test), and anthropometric and serum parameters of nutritional status: albumin, prealbumin, transferrin, haemoglobin, lymphocyte count, iron, and ferritin. Prior to the intervention, the educational procedure and the design of educational material are standardized among nurses. The nurses conduct an initial session for caregivers and then monitor the education impact at home every month (4 visits) up to 6 months. The North American Nursing Diagnosis Association (NANDA) methodology will be used. The investigators will study the effect of the intervention with caregivers on the patient's nutritional status using the MNA test, diet, anthropometry, and biochemical parameters. Bivariate normal test statistics and multivariate models will be created to adjust the effect of the intervention. The SPSS/PC program will be used for statistical analysis. DISCUSSION: The nutritional status of dependent patients has been little studied. This study allows us to know nutritional risk from different points of view: diet, anthropometry and biochemistry in dependent patients at nutritional risk and to assess the effect of a nutritional education intervention. The design with random allocation, inclusion of all patients, validated methods, caregivers' education and standardization between nurses allows us to obtain valuable information about nutritional status and prevention. Trial Registration number: Clinical Trial Registration-URL: www.clinicaltrials.gov. Unique identifier: NCT01360775.     

改良尺骨鹰嘴截骨治疗肱骨髁间骨折

目的:探讨改良尺骨鹰嘴截骨治疗肱骨髁间骨折的手术方法和疗效。方法:2007年5月至2012年12月采取改良尺骨鹰嘴截骨入路治疗肱骨髁间骨折32例,男21例,女11例;年龄18~65岁,平均46.3岁;右侧19例,左侧13例。AO分型,C1型7例,C2型11例,C3型14例;开放性骨折5例(GustiloⅠ型3例,GustiloⅡ型2例)。6例合并其他处骨折,4例合并尺神经损伤,2例合并桡神经损伤。术后定期复查及X线检查,按Cassebaum评分系统评定肘关节功能。结果:32例均获随访,时间9个月~5年,平均1.9年;截骨块愈合时间6~10周,平均7.4周。未发生尺骨鹰嘴关节内骨折,无截骨块不愈合。2例肘后内固定隆起处屈肘轻度疼痛不适,1例骨折块松动,2例出现异位骨化。肘关节功能评定:优19例,良8例,可4例,差1例。结论:改良尺骨鹰嘴截骨治疗肱骨髁间骨折具有不侵袭关节、术中截骨简便、固定简单、截骨块力学稳定性好、截骨并发症发生率低等优点。     

A murine monoclonal antibody that blocks fibrinogen binding to normal platelets also inhibits fibrinogen interactions with chymotrypsin- treated platelets

We recently described a monoclonal antibody, 10E5 , that completely blocks adenosine diphosphate (ADP) induced fibrinogen binding to platelets and aggregation induced by ADP, epinephrine, and thrombin. Multiple lines of evidence indicate that 10E5 binds to platelet membrane glycoproteins IIb and/or IIIa. Because it has been reported that platelets treated with chymotrypsin aggregate when fibrinogen is added, we tested the effect of 10E5 antibody on chymotrypsin-induced fibrinogen binding and platelet aggregation. Aspirin-treated human platelets were washed in modified Tyrode's buffer (pH 7.5), incubated for 5 minutes at 22 degrees C with 300 micrograms/mL chymotrypsin, and washed again. The amount of 10E5 antibody bound to these platelets (37,232 +/- 2,928 molecules/platelet; mean +/- SEM, N=9) was similar to that bound to unstimulated control platelets (36,910 +/- 2,669) and did not differ significantly from the amount of antibody bound to ADP- treated platelets (P less than .01, N = 5). The amount of 10E5 bound to chymotrypsin-treated platelets correlated directly with the amount of fibrinogen bound to separate aliquots of the same platelet samples (r = .876, P less than .001). The 10E5 antibody caused virtually complete inhibition of both the binding of fibrinogen to chymotrypsin-treated platelets and the aggregation induced by exogenous fibrinogen. Immunoprecipitation studies of 125I-labeled chymotrypsin-treated platelets revealed that the 10E5 antibody bound proteins with molecular weights characteristic of glycoproteins IIb and IIIa. These data suggest that the fibrinogen receptor on chymotrypsin-treated platelets is identical to that on ADP-treated platelets and that this receptor is either near to, or on, the glycoprotein IIb/IIIa complex.