Imiquimod 5% cream is an acceptable treatment option for external anogenital warts in uncircumcised males

OBJECTIVES: To determine the safety and efficacy of imiquimod (Aldara) 5% cream in the treatment of prepuce-associated warts in uncircumcised males. METHODS: An open-label study in six UK medical centres with 35 uncircumcised males with prepuce-associated warts treated with imiquimod 5% cream three times per week for up to 16 weeks. Other anogenital warts were also treated. RESULTS: Three times weekly application of imiquimod was found to be safe, with erythema as the most commonly reported local skin reaction. Forty per cent of patients had complete clearance of anogenital warts within 16 weeks. CONCLUSIONS: Imiquimod cream at a dosing regimen of three times per week, is effective and has an acceptable safety profile in the treatment of prepuce associated warts and other external anogenital warts in uncircumcised males.     

Effect of carnitine supplementation on cardiac function in hemodialyzed children

Thirteen carnitine-deficient children (mean age, 16.1 ±2.56 years) on a three-times-weekly hemodialysis program for at least 1 year, and 11 healthy age matched children were involved in the study. All the patients had stable blood pressure and hemoglobin (Hb) levels with a maintenance dose of erythropoetin and none were digitalized. The total carnitine (TC) and free carnitine (FC) plasma levels were sampled prior to hemodialysis (HD) before and after 3 months of carnitine supplementation. A free carnitine (FC) to acylcarnitine (AC) ratio less than 4 was defined as carnitine deficiency. Intravenous L-carnitine was injected at a dose of 20–4.0 mg/kg three times weekly at the end of each dialysis session for a 3-month period. Echocardiographic examination was performed the day following HD, before and after carnitine treatment. Systolic and diastolic functions of the left ventricle, including the ejection fraction, were measured. Almost all the parameters were significantly different in controls and hemodiaiyzed patients. In carnitine-deficient hemodiaiyzed patients. 3 months of L-carnitine supplementation resulted in a significant increase in blood carnitine levels and the FC/AC ratio, but this was not associated with any significant improvement of cardiac function. Furthermore no significant changes were observed in plasma triglycerides, total cholesterol or other lipoprotein parameters before or after carnitine supplementation. Although there was a moderate increase in mean hematocrit (Hct) and Hb levels, these also did not reach statistically significant levels. These results suggest that the 3 months of carnitine supplementation is not sufficient to ameliorate cardiac function or increase Hb levels in children.     

The effect of indomethacin tocolysis in preterm labour on perinatal outcome: a randomised placebo-controlled trial

Objective To determine whether indomethacin tocolysis in preterm labour is associated with a better perinatal outcome than placebo.
Design A randomised placebo-controlled trial.
Setting Two university teaching hospitals with level three neonatal intensive care units.
Population Women in preterm labour with intact membranes between 23 and 30 weeks of gestation.
Methods Random allocation to tocolysis with indomethacin (50 mg followed by 25 mg 6 hourly for 48 hours) or placebo in a double-blind fashion.
Main outcome measures The primary outcome, perinatal mortality or severe neonatal morbidity, was defined as perinatal death, necrotising enterocolitis, bronchopulmonary dysplasia, intraventricular haemorrhage or pen-ventricular leucomalacia. Data were analysed using odds ratios (OR) and 95% confidence intervals (95% CI).
Results Between March 1995 and February 1996, 34 women (39 babies) were recruited. The baseline characteristics of the two groups were similar. No patient was lost to follow up. In the indomethacin group, gestation was prolonged by > 48 hours in 13/16 (81%) of women vs 10/18 (56%) in the placebo group. The incidence of perinatal mortality or severe neonatal morbidity was not significantly different between the groups, but occurred in twice as many babies in the indomethacin group as in the placebo group d/l9 (32%) vs 3/20 (15%) OR (95% CI) 2.62 (0.44–18.8). There was one perinatal death, of a baby delivered at 24 weeks of gestation. This occurred in the indomethacin group.
Conclusion There is no evidence that indomethacin tocolysis is beneficial, and further trials are needed to assess the impact of indomethacin tocolysis in preterm labour.     

抗肿瘤药物研究Ⅰ:去甲斑蝥素氨基酸衍生物的合成与抗癌活性

In order to search for new compounds with higher anti-cancer activities and lower toxicities, 19 amino acid derivatives of norcantharidin, of which 16 are unknown compounds, were designed and synthesized. Preliminary screening results revealed that 2-(syn-exo-7-oxabicyclo [2. 2. 1] heptane-2, 3-dicarboxylic imido)-N-phenyl glutaramic acid exhibited a fairly apparent inhibitory activity against human-hepatoma cells in vitro (inhibitory rate 39.4% at 0.025 μtmol/ml).     

Computed tomography for cervical spine trauma. The impact of MDCT on fracture detection and dose deposition

A multidetector computed tomography (MDCT) was installed in our department. Referral rates, examination protocols and detection rates of abnormal findings in CT examinations for cervical spine trauma 6 months before and 6 months after MDCT installation were compared to look for changes in practice. Retrospective analysis of all CT cervical spine examinations in patients with multiple trauma over two contiguous 6-month periods: from July 2003 to December 2003 (helical CT) and from January 2004 to June 2004 (MDCT). Variables recorded were number of CT examinations performed, scan plane coverage and traumatic abnormalities detected. Phantom dosimetry measurements for cervical spine examination in both helical CT and MDCT were compared. One hundred and fifty four patients underwent cervical spine CT during these periods. Helical CT period: of 91 patients undergoing CT cervical spine examination for trauma, 65 (71%) were complete cervical examinations and 26 (29%) were level-specific examinations. Eight patients (9%) had cervical spine fracture, six of which were apparent on radiographs. Dose estimations for thyroid, lens and breast were 24.76, 1.86 and 0.21 mGy, respectively, for complete cervical spine examinations. MDCT period: of 63 patients who underwent CT cervical spine examination for trauma, 61 (97%) were complete examinations and 2 (3%) were level-specific examinations. Six patients (11%) had cervical spine fracture, three of which were apparent on radiographs. Dose estimations for thyroid, lens and breast were 75.8, 9.7 and 0.7 mGy, respectively, for complete cervical spine examinations, which were notably higher than those for helical CT. After installation of MDCT, clinical requests for complete examination of the cervical spine following trauma increased. This changing trend resulted in a significantly higher radiation dose to thyroid, lens and breast.     

Abortifacient Potential of Aqueous Extract of Senna alata Leaves in Rats

Objective To study the abortifacient activity of aqueous extract of Senna alata leaves in female Wistar rats.Methods Pregnant rats weighing 143.65 ± 13.11 g were completely randomized into 5 groups（A-E）.Rats in group A（negative control） were orally administered,once daily with 0.5 ml of distilled water on days 10-18 post-coitum while those in groups B,C,D,and E were treated exactly like the negative control except they received the same volume containing 2.85 mg/kg body weight of mifepristone（group B,reference drug）,250,500 and 1 000 mg/kg body weight of the extract respectively（groups C-E）.Results Phytochemical screening of the extract showed positive results for saponins（1.22%）,flavonoids（1.06%）,cardiac glycosides（0.20%）,cardenolides and dienolides（0.18%）,phenolics（0.44%） and alkaloids（0.52%）.Respiratory distress,salivation,diarrhoea,changes in the appearance of hair as well as maternal mortality were not observed at any time during the exposure period except in the mifepristone-treated animals where there was episode of diarrhoea and tiredness.The extract significantly reduced（P〈0.05） the number of life foetus,weight and survival ratio of the foetus,numbers of implantations and Corpora lutea,implantation index,progesterone,prolactin,estradiol,follicle stimulating and luteinizing hormones whereas the number of dead foetus,number and percentage of rats that aborted,percentage vaginal opening,resorption index,pre-and post-implantation losses increased significantly.In addition,mifepristone-treated animals produced resorption index that compared well with the distilled water control.There was also no dead or life foetus and serum progesterone concentration was increased in the animals treated with mifepristone.All cases of abortion were accompanied with vaginal bleeding.Although,the final weight of the rats increased significantly,the feed and water intake were not significantly altered in all the treatment groups.The weight of the uterus,uterine-body weight ratio,length of the right uterus horn and uterine cholesterol decreased significantly in all the treatment groups.The uterine alkaline phosphatase activity and glucose concentration increased in only the extract-treated animals whereas mifepristone decreased the uterine alkaline phosphatase activity and glucose content of the animals.Conclusion This study has provided evidence to the age-long claim of S.alata leaves in ＂washing the uterus＂.The abortifacient properties were most pronounced at 500 and 1 000 mg/kg body weight of the extract and were similar to the animals treated with 2.85 mg/kg body weight of mifepristone.Hormonal influence,changes in implantation site,estrogenicity and uterogenicity are suggested as possible mechanism of abortifacient activity of aqueous extract of S.alata leaves.Overall,the extract may be used as an abortifacient especially at 500 and 1 000 mg/kg body weight and therefore not safe for consumption as oral remedy during pregnancy.