硝基化合物还原、氢化的研究 Ⅳ.用Fe~(3+)催化转移氢化3,3′-二硝基-4,4′-二氨基二苯醚

以Fe~(3+)代替Pd-C和Raney Ni为催化剂、水合肼为供氢体、3,3′-二硝基-4,4′-二氨基二苯醚为受氢体、甲醇为溶剂,进行催化转移氢化反应,产物3,3′,4,4′-四氨基二苯醚(TADPO)质量好,得率可达80%。此外,还对反应温度、时间、以及水合肼、催化剂、溶剂用量,水合肼浓度、催化剂重复使用等影响因素进行了研究,获得了较佳工艺条件。本法制得的TADPO与均苯四甲酸二酐缩聚可制得性能良好的聚眯唑吡咙。     

Should all the N3 lymph nodes group metastasis be regarded as distant metastasis (M1) in curatively resected gastric cancer?

Recently, metastasis to N3 lymph nodes group was regarded as distant metastasis by the new TNM staging system due to poor overall survival. However, the 5-year overall survival rate of patients with metastasis to N3 groups was 34.5% after curative surgery. Moreover, in patients with metastasis to lymph node subgroups of #12, #13, #14, the overall 5-year survival rate increased upto 47.2% after curative resection and adjuvant chemotherapy. This was similar to that of the patients with metastasis to N1 and N2 lymph nodes groups. But in these highly tumor burden states, no survival benefit was found with the addition of immunotherapy to chemotherapy as we achieved in stage II and III. Therefore, we suggest that, at least, metastasis to #12, #13, #14 lymph nodes subgroups should not be categorized as a distant metastasis. And in these situations, active curative radical surgery with extended lymphadenectomy and adjuvant chemotherapy are recommended.     

BIOEQUIVALENCE BETWEEN rhGH FOR RECONSTITUTION AND READY-TO-USE rhGH IN TWO LIQUID FORMULATIONS

Objective To evaluate the bioequivalence between recombinant human growth hormone （rhGH） for reconstitution, and two dosages of liquid formulation of rhGH [ （151U） 5mg or （301U） lOmg per 3ml ]. Methods The study drugs were tested in a randomized, single-blind and three-period crossover studies in 24 healthy male subjects. The three drugs were administered by subcutaneous injection at a dose of O. 21U/kg body weight. A continuous somatostatin infusion was given in order to suppress the secretion of endogenous GH. The ve- nous blood samples were drawn at different time points to test the serum concentration of GH. The pharmacokinetic parameters were analyzed by statistical methods. Results 90% confidence intervals （CI） of AUC0-24h among three products were all within 80% - 125% interval （ 103. 4% - 116. 5%, 105. 7% - 119. 6% and 91.9% - 103. 7%, respectively）, and the Cls of C,~ among three products were all within 70% - 143% interval （91.9% - 114. 0%, 103. 7% -127. 2% and 81.6% -97. 4%, respectively）. There was no statisitical difference of tmax among all the three products. Conclusion These data demonstrate that there is bioequivalence between rhGH for reconstitution and two liquid formulations of rhGH.     

Prognostic role of alveolar-arterial oxygen pressure difference in acute pulmonary embolism.

BACKGROUND: This study investigated the utility of the alveolar - arterial oxygen pressure difference (AaDO (2)) in predicting the short-term prognosis of acute pulmonary embolism (PE). METHODS AND RESULTS: This study retrospectively enrolled 114 consecutive patients with acute PE, diagnosed by either spiral computed tomography or high probability ventilation - perfusion lung scans. During the first 24 h of admission, all patients had initial artery blood gas collected under room air. Patient exclusion criteria were chronic lung disease, septic emboli, and moderate and low probability lung scans. Patients were assigned to 2 groups based on either 30-day death or a 30-day composite event. Receiver operating characteristic analyses was used to determine the AaDO(2) cut-off value for predicting primary and composite endpoints. Statistical analysis demonstrated significant differences in AaDO(2) between the 30-day composite endpoint group and the 30-day composite event-free survival group (p=0.012). The AaDO(2) had a strong trend between the 30-day death group and the survival group (p=0.062). The best cut-off value for AaDO(2) was 53 mmHg and using this, the positive predictive value for 30-day death was 25% and the negative predictive value was 92%. For the 30-day composite endpoint, the positive predictive value for AaDO(2) was 35%, and the negative predictive value was 84%. In this study, thrombocytopenia was also an indicator of poor prognosis for patients with acute PE. CONCLUSION: The AaDO(2) measurement is a highly useful and simple measurement for predicting short-term prognosis in patients with acute PE. It has high negative predictive value and moderate positive predictive value for 30-day death and 30-day composite event. Aggressive thrombolytic treatment strategies should be considered for patients with an initial poor prognostic parameter (ie, AaDO(2) >or=53 mmHg).     

肺螨病的病理观察

本文报道螨类接种豚鼠气管引起的肺部病变,并对5种常见螨类的致病性进行比较。发现螨类接种后6天豚鼠肺部已形成典型的结节性病灶。结节圆锥形淡黄色,直径1～5mm之间。镜下表现为细支气管炎和细支气管周围炎,肺实质内有明显的异物肉芽肿形成,炎症在螨类接种豚鼠20天时,肺部嗜酸粒细胞浸润不明显,但30或40天时则出现明显的嗜酸细胞浸润,细支气管周围小动脉受到损害,部分小动脉内可见到螨体残骸。5种常见螨炎接种于5组豚鼠可引起大致相同的病变。从而证明豚鼠可作为动物模型以供肺螨病的研究,同时也证明5种常见贮藏螨具有相同的致病性。     

阿昔洛韦片剂和胶囊在人体的生物利用度

10名男性受试者按交叉实验设计口服阿昔洛韦片剂和胶囊各400 mg 后,用改良的 HPLC 测定血药浓度,计算表明阿昔洛韦胶囊口服后吸收快于片剂,峰浓度也较高,但吸收程度(AUC_(0-12h))相似。     

Carcinosarcoma (malignant mixed tumor) of the parotid: Report of a case with a pure rhabdomyosarcoma component

Background. Carcinosarcoma or true malignant mixed tumor of the parotid gland is extremely rare, accounting for <1% of all salivary gland malignancies. Methods. A 63-year-old woman presented with a 5-cm right parotid mass which was resected with a radical parotidectomy and infratemporal fossa dissection. Results. The tumor contained two distinctive histologic patterns, that of a poorly differentiated ductal carcinoma and a pleomorphic rhabdomyosarcoma. Additionally, a residual focus of pleomorphic adenoma was present peripherally, Immunohistochemical and electron microscopic studies confirmed the skeletal muscle differentiation. Conclusions. The pattern of combined rhabdomyosarcoma and ductal carcinoma has not been previously reported and adds further evidence to the myoepithelial derivation of these tumors. © 1994 John Wiley & Sons, Inc.     

Macrophages are activated by 17beta-estradiol: possible permission role in endometriosis.

On the basis of the common occurrence of high concentration of estrogen and activated macrophages in patients with endometriosis, we postulate that interaction between 17beta-estradiol and macrophage may be an important affair in endometriosis. So our study was focused on the effect of 17beta-estradiol on macrophage. First morphology of macrophages was examined with environmental scanning electron microscopy. Increased size, extension of more microvilli, expression of retraction fibers and elaboration of membrane ruffles were detected in 17beta-estradiol treated macrophages. Then Nitrate and nitrite level in the supernatant was measured by the method of Griess and iNOS expression was analyzed using immunohistochemical staining. It showed that 17beta-estradiol could induce NO release from peritoneal macrophages and expression of iNOS was increased. Also more TNF-alpha in supernatant that was measured by MTT via L929 cell was produced by macrophages under the inducing of 17beta-estradiol. Furthermore, [Ca2+]i, which was viewed by microscope in a laser scanning confocal unit, elevated 39.8% in peritoneal macrophages after 17beta-estradiol 100 nmol/L treated. The results above demonstrated that peritoneal macrophage had been activated in both morphology and cytokine line when interaction with 17beta-estradiol, which indicated that macrophage activated by 17beta-estradiol might play a permission role in development of endometriosis.     

颅内破裂动脉瘤手术时机的探讨(附237例分析)

目的探讨颅内破裂动脉瘤手术时机与临床预后的关系。方法回顾性分析2005年我院收治的237例颅内破裂动脉瘤，其中196例行手术治疗。按入院时Hunt—Hess分级将手术病人分为A组（Ⅰ～Ⅲ级）162例，B组（Ⅳ、Ⅴ级）34例；根据手术时间分为早期手术组（SAH3d内手术）19例，延期手术组（SAH4～10d手术）82例，晚期手术组（SAH11d之后手术）95例。比较不同手术期别动脉瘤术中破裂率、术后1个月GOS评分及术后主要并发症（脑血管痉挛、脑积水）发生率，并进行统计学分析。结果24例（10．1％）因再出血丧失治疗机会。术中动脉瘤破裂早期手术组3例（15，8％），延期手术组8例（9．8％），晚期手术组6例（613％）。术后脑血管痉挛发生率早期手术组为15，8％，延期手术组为19，5％，晚期手术组为17，9％。脑积水发生率以晚期手术组最高（14，7％）。对术后1个月GOS评分Ridit分析结果显示：A、B两组中均以早期手术组治疗效果最佳．延期手术次之．晚期手术最差。结论早期手术可规避颅内破裂动脉瘤再出血的风险，降低主要并发症发生率。对于各个级别（包括Ⅳ、Ⅴ级）的SAH病人，均应根据治疗者的手术经验与技巧和所在医院的条件，及早诊断，尽早手术。     

不同方法治疗声带良性病变的疗效观察

1999年1月～2006年12月我科应用显微支撑喉镜术、电视喉内窥镜术及间接喉镜术治疗声带良性病变108例，报道如下。