三种血管舒张剂对慢性缺氧性肺动脉高压大鼠肺动脉收缩反应的比较

观察了米力农(Mil), lemakalim (Lem)和维拉帕米(Ver)三种血管舒张剂对前列腺素F_2α (PGF_2α)所致缺氧2和4 wk大鼠肺动脉和主动脉环收缩反应的影响. Lem (0.01～1.0 μmol·L^-1), Mil和Ver(均为0.1～10.0 μmol·L^-1)对主动脉和肺动脉都有明显的抑制作用, 使PGF_2α引起的血管收缩反应曲线压低, EC₅₀显著增高(P<0.001), 呈剂量相关关系. 其抑制强度为Lem>Mil>Ver, 缺氧前后顺序不变. 无论缺氧前后, Lem和Ver对主动脉和肺动脉的抑制强度都较接近, Mil则在缺氧条件?下, 对肺动脉的抑制作用选择性地增强.     

Antenatal cardiotocogram quality and interpretation using computers.

OBJECTIVE: To test the application in practice of computerized fetal heart rate (FHR) analysis in pregnancy. DESIGN: Randomized distribution of subjects with computerized analysis automatically revealed or concealed. SETTING: A district general hospital and a teaching hospital outside London. SUBJECTS: 2869 pregnant women studied within a year. OUTCOME MEASURES: Quality and duration of the cardiotocogram; quantitative measurement of FHR variation; number of stillbirths. RESULTS: With interactive advice to the operator, records were of improved quality (up to 28% without signal loss) with potentially much reduced recording time. The short-term FHR variation measured in the last records before intervention is reported for the first time. CONCLUSION: The benefits of using the computers include improvement in record quality and saving of time. In addition, where interpretation depended on estimation of FHR variation there was prima facie evidence of observer misinterpretation; visual analysis was unreliable. A larger trial is now required with more rigorous constraints on intervention.     

Combination therapy for rheumatoid arthritis and drug-induced systemic lupus erythematosus

Summary Development of drug-induced systemic lupus erythematosus (SLE) is an uncommon complication of the use of D-penicillamine and sulphasalazine. We report two cases of patients with rheumatoid arthritis (RA) who developed symptoms and signs of SLE and suggest that increasing use of these two agents as combination therapy in RA may cause an additive risk to the occurrence of this complication.     

Abdominal wall tenderness: a useful sign in chronic abdominal pain.

The outcome in 72 patients with obscure abdominal pain and a positive Carnett's (abdominal wall tenderness) test, seen in one firm's surgical outpatient clinic between 1975 and 1983, was sought by a combination of hospital note retrieval and general practitioner questionnaire. Full follow-up data to date or death were available for 58 (81 per cent) patients and partial follow-up for 14 patients. The study showed that the patients generated a good deal of investigation and a number of surgical procedures but that seldom were their symptoms attributable to serious pathology. Familiarity with the test, taken in the context of a proper history and examination, has been found helpful in assessing such patients and saves the inconvenience, expense and occasional hazard of investigation, and even surgery.     

Emotional Responses of Athletes to Injury and Treatment

The primary purpose of this study was to identify athletes' emotional responses to injuries measured before physiotherapy appointments. In addition, other key variables thought to affect this response were assessed. The subjects were 52 patients (42 male, 10 female, mean age ± SD = 25.33 ± 9.63 years) who had sustained a sports injury, and attended one of five clinics participating in the study within 12 weeks of that injury. They completed a psychological questionnaire before each treatment, while the treating physiotherapist completed an experienced practitioner severity of injury form after treatment.A mean of the values assigned to each emotional response by all subjects over a maximum of five treatments was calculated using a one-way ANOVA. Both positive and negative emotional responses were recorded, with a temporary reversal of subjects' improving emotional state trend between the second and third treatments. The mean value of injury severity as perceived by patients (5.162 ± 0.2442) was higher than that perceived by physiotherapists (4.777 ± 0.2174) although not significantly (p = 0.233). It is proposed that physiotherapists be especially vigilant at what appears to be a crucial stage in the treatment of patients and a series of suggestions are made.     

Factors related to change in global health after group physical therapy in ankylosing spondylitis

Summary The purpose of this study was to evaluate how improvements in global health in patients with ankylosing spondylitis (AS), who had received group physical therapy, were associated with changes in physical functioning and other outcome measures.Sixty-seven AS patients from 2 outpatient departments (modified New York criteria) received group physical therapy weekly. After 9 months we studied the following variables to explain changes in global health: disease duration, spinal mobility, fitness, functional status (SIP, HAQ and Functional Index), pain, stiffness, and articular and enthesis indices. Change scores were calculated as baseline values minus scores at 9-month follow-up. Personality traits (neuroticism, social inadequacy, self-esteem and health locus of control) and loneliness were also included as possibly explanatory variables. Patient's assessment of change in global health after 9 months of group physical therapy was self-reported on a 10 cm visual analogue scale (–5=maximum worsening, 0=no change, +5=maximum improvement). Correlations were calculated between change in global health and all candidate explanatory variables. In this pre/post test design multiple and stepwise regression analyses were performed to study the relations between changes in global health and all explanatory variables.Pearson correlation coefficients between improved global health and the explanatory variables were significant for lower self-esteem (0.27) and improvements in chest expansion (0.31), fitness (0.32), HAQ-S (0.29), and stiffness (0.33). Regression analysis revealed 2 significantly explanatory steps: changes in fitness explained 16% of total variance of changes in global health, and changes in stiffness contributed an additional 11%.In AS, the beneficial effects of group therapy on global health are partly mediated by increased fitness and relief of stiffness. Group physical therapy in patients with AS may be expected to improve global health status and to bring relief of characteristic disability symptoms of disease such as stiffness.     

氨甲喋呤-α-肽的固相合成

用固相肽合成法合成了氨甲喋呤(MTX)与MTX-α-苯丙氨酸及精氨酸衍生物,产物不经进一步分离纯化即可达到HPLC单峰,质谱分析其分子量符合理论值。MTX-α-苯丙氨酸经羧肽酶-A处理后,可完全降解为MTX。体外细胞毒性试验,两者活性差异在100倍以上,提示MTX-α-苯丙氨酸是一理想的前体药物。     

Migraine association and linkage analyses of the human 5-hydroxytryptamine (5HT2A) receptor gene

5-Hydroxytryptamine (5HT), commonly known as serotonin, which predominantly serves as an inhibitory neurotransmitter in the brain, has long been implicated in migraine pathophysiology. This study tested an Mspl polymorphism in the human 5HT_2A receptor gene ( HTR2A ) and a closely linked microsatellite marker (D13S126), for linkage and association with common migraine. In the association analyses, no significant differences were found between the migraine and control populations for both the Mspl polymorphism and the D13S126 microsatellite marker. The linkage studies involving three families comprising 36 affected members were analysed using both parametric (FASTLINK) and non-parametric (MFLINK and APM) techniques. Significant close linkage was indicated between the Mspl polymorphism and the D13S126 microsatellite marker at a recombination fraction (θ) of zero (lod score=7.15). Linkage results for the Mspl polymorphism were not very informative in the three families, producing maximum and minimum lod scores of only 0.35 and 0.39 at recombination fractions (θ) of 0.2 and 0.00, respectively. However, linkage analysis between the D13S126 marker and migraine indicated significant non-linkage (lod2) up to a recombination fraction (θ) of 0.028. Results from this study exclude the HTR2A gene, which has been localized to chromosome 13q14-q21, for involvement with common migraine.