超低出生体重儿红细胞输注的临床分析

探讨超低出生体重(ELBW)儿减少红细胞输注的可能性。方法对1989～1997年9年间256 例超低出生体重儿的红细胞输注进行临床分析。在此期间红细胞输注指征进行了3次制订,对检验样本的采 血量进行了严格的控制,部分病例应用了重组人促红细胞生成素治疗。结果1994年以后有1/4的ELBW儿 不需要输注红细胞,1989～1997年平均输血次数由7次降至2.7次(P＜0.01)。按出生体重累计红细胞输注 量由163.5mL/kg降至69.2mL/kg(P＜0.01),接受供血者人数由6.3人降至1.5人(P＜0.01)。红细胞输注 前的平均红细胞压积比,机械通气者由0.43降至0.34、自主呼吸者由0.41降至0.31。ELBW儿更加不成熟,平 均胎龄由27.4周减至26.0周,平均出生体重由833g降至741g。存活率仍达78％,住院时间没有延长,严重并 发症如视网膜病、动脉导管未闭、脑室出血的发生率没有增加。结论制订严格的红细胞输注指征有助于减少 输血次数和接受供血者人数,且患儿临床耐受良好。     

脑康泰胶囊对阿尔茨海默氏病大鼠学习记忆作用的影响

目的：观察脑康泰胶囊对阿尔茨海默氏病模型大鼠学习记忆作用的影响。方法：采用脑立体定向颅内注射啉酸所致阿尔第默氏病（Alzheimers disease.AD)大鼠模型的方法。结果：脑康泰胶囊可显著增加强AD大鼠被动学习和主动学习的能力。调节脑组织中单胺类递质含量及血清中相关激素水平,并显著改善AD模型大鼠的脑电图。结论：脑康泰胶囊显著改善AD大鼠学习记忆能力的作用,其机制与其调节中枢递质及激素水平等相关。     

A quality assessment tool to evaluate tocolytic studies

Over the past 15 years, the use of β-agonists has declined worldwide. Following the Royal College of Obstetricians and Gynaecologists guidelines in 2002, clinicians in the UK and beyond were faced with the dilemma of continuing to use β-agonists, desist from using tocolytic therapy completely or choosing to change to atosiban or calcium channel blockers (CCBs). While grade A level 1 evidence exists to show that atosiban is significantly more efficacious than placebo and significantly safer than β-agonists for the treatment of spontaneous preterm labour, the evidence for CCBs, such as nifedipine, is much less robust and no placebo-controlled trials have been performed. Published studies on nifedipine are largely investigator-led studies of small sample size, which lack sufficient power. As a result, most of the evidence has been based on meta-analyses of these studies, which look retrospectively at pooled data and are only as good as the quality of the studies included. In light of this, a tool was developed to produce a systematic review of studies on tocolytic effectiveness, which can and should be applied to all tocolytics and which considered both method- and topic-specific markers of quality. In the process of applying this tool to nifedipine, an extensive literature search identified 31 studies for a systematic review of the quality of nifedipine studies assessed by eight paired reviewers with wide experience in the subject of spontaneous preterm labour and preterm birth. Forty topic- and method-specific items of quality were assessed. The paucity of good quality studies of nifedipine used for the treatment of spontaneous preterm labour should be highlighted in meta-analyses or systematic reviews, which measure efficacy and should limit and influence the degree to which recommendations and guidelines are made on the basis of such studies.     

华蟾蜍毒素对离体豚鼠输精管的作用

华蟾蜍毒素(华蟾素)使离体豚鼠输精管产生剂量依赖性收缩反应,利血平化豚鼠输精管及冷藏输精管对华蟾素反应减弱。给酚妥拉明、维拉帕米后,输精管对华蟾素反应均受抑制,溴苄胺可使反应潜伏期缩短。结果提示华蟾素收缩输精管反应可能与其促进肾上腺素能神经末稍NA释放有关。     

Clinical relevance of genomic aberrations in homogeneously treated high-risk stage II/III breast cancer patients

Little is known about the prognostic impact of chromosome aberrations in breast cancer. The aim of our study was to determine whether genomic aberrations of prognostic relevance can be identified in the context of a clinical study using molecular cytogenetics. Paraffin-embedded tumor samples of 44 patients with high-risk stage II/III breast cancer were analyzed by comparative genomic hybridization. All patients received identical therapy including dose-escalated chemotherapy followed by peripheral blood stem cell transplantation. The most frequent chromosomal aberrations were gains on chromosome arms 17q (24 cases), 1q (21 cases), 8q (17 cases), 20q (13 cases), 6p (9 cases) as well as losses on chromosome arms 13q (25 cases), 11q (20 cases), 5q (11 cases), 6q (11 cases), 9p (10 cases), 18q (10 cases), 8p (9 cases) and 16q (9 cases). In univariate analysis, the correlation with the clinical outcome revealed a higher risk for patients with tumors exhibiting 13q losses and a reduced risk for tumors exhibiting 16q losses (p = 0.020), 6q losses (p = 0.041) and estrogen-receptor positivity (0.051). In multivariate analysis using the Cox model, only the loss of 16q exhibited borderline significance (p = 0.065). These data show that comparative genomic hybridization can be performed in the context of a clinical trial. In our subgroup of high-risk breast cancer patients, chromosomal aberrations were valuable prognostic parameters.     

Seasonal evaluation of reproductive status and exposure to environmental estrogens in hornyhead turbot at the municipal wastewater outfall of Orange County, CA

Seasonal changes in developmental stages, condition factor (CF), gonadosomatic index, and plasma vitellogenin (Vtg) concentrations in male and female hornyhead turbot were examined at the wastewater outfall (T1) of the Orange County Sanitation District, and two farfield sites T11 (7.7 km northwest of the outfall) and Dana Point (35 km south of the outfall) between February 2005 and May 2006. Fish collected from the three sites exhibited male-oriented sex ratios. With few exceptions, developmental stages, CF, and GSI of both genders and plasma Vtg concentrations of females were not significantly different in samples collected from different sites at the same sampling period. More advanced gonad developmental stages and higher plasma Vtg concentrations in females were observed in August, indicating the seasonality of the reproductive cycle for this species. Plasma Vtg concentrations in males were observed in all of the sampling sites with the highest prevalence at T11 relative to T1 and Dana Point. The Vtg expression in males from the three sampling sites indicated widespread exposure to estrogenic compounds in waters of coastal California. However, the histopathological and reproductive relevance of the responses appeared to be insignificant and may not affect the population in these locations.     

Comparison of cytogenetic and molecular cytogenetic detection of chromosome abnormalities in 240 consecutive adult patients with acute myeloid leukemia.

PURPOSE: To prospectively compare cytogenetic and molecular cytogenetic analysis for the detection of the most relevant chromosome abnormalities in a large series of patients with acute myeloid leukemia (AML). PATIENTS AND METHODS: Two hundred forty consecutive adult patients with AML entered onto the multicenter treatment trial AML HD93 were studied. Chromosome banding and fluorescence in situ hybridization (FISH) applying a comprehensive set of genomic DNA probes were performed in a single reference laboratory. RESULTS: Two cases of inv(16), three cases of t(11q23), and three cases of t(8;21)var were only detected by molecular cytogenetics. By FISH, aberrations were identified in three cases with normal karyotypes: inv(16), -Y (in a patient with low metaphase yield on chromosome banding) and a 12p microdeletion. Additional aneuploidies, in particular +8q and +11q, were diagnosed by FISH; however, virtually all these aberrations occurred in patients with complex karyotypes or as an additional abnormality in leukemias with an AML-specific translocation. Finally, aberrations were detected by FISH in eight of 14 patients with no assessable metaphases. CONCLUSION: In most cases of AML, conventional cytogenetic study reliably detects chromosomal abnormalities, and this method should not be replaced by FISH. FISH should be used as a complementary method for the detection of more subtle abnormalities, such as inv(16) and t(11q23), in all patients with newly diagnosed AML and for suspected t(8;21)var. Furthermore, molecular cytogenetics using this comprehensive set of DNA probes provides a valuable diagnostic tool for patients with poor chromosome morphology, low or no yields of metaphase cells, or both.