平原人进驻高原后红细胞生成素的变化

目的　探讨红细胞生成素在高原低氧适应机制中的作用。方法　对平原进驻海拔 3 70 0m和气 5 3 80m第 7天及半年的健康青年进行血液促红细胞生成素 (EPO)、血红蛋白 (Hb)及血氧饱和度 (SaO2 )检测 ,并与平原健康青年作对照。结果　进驻高原低氧环境EPO、Hb较平原增高显著 (P <0 .0 5或 0 .0 1 ) ,SaO2 降低非常显著 (P <0 .0 1 )。进驻高原第 7天和半年 ,3 70 0m较 5 3 80mEPO ,Hb降低非常显著 ,SaO2 增高非常显著 (P <0 .0 1 )。进驻 3 70 0m ,第 7天较半年EPO无统计学意义 (P >0 .0 5 ) ,Hb ,SaO2 差异显著 (P <0 .0 5或 0 .0 1 ) ;进驻 5 3 80m ,第 7天较半年EPO ,Hb,SaO2 均有显著性差异 (P <0 .0 5或P <0 .0 1 )。结论　在高原缺氧环境下 ,红细胞生成素调节机制紊乱 ,是导致继发性红细胞增多的一个重要环节。     

Percutaneous suprapubic cystolithotripsy for pediatric bladder stones in a developing country

OBJECTIVE: To evaluate our experience with percutaneous suprapubic cystolithotripsy (PCCL) in Yemeni children with endemic urinary bladder stones. PATIENTS AND METHODS: Between January 1993 and December 1998, 117 children underwent percutaneous suprapubic lithotripsy in Arabia Felix Modern Hospital, Sana'a Republic of Yemen. The patients' ages ranged from 8 months to 14 years (average 3.7 years). Ninety patients (77%) were under 5 years old; 20 patients (16%) were between 6 and 10 years old, and 7 patients (6%) were between 11 and 14 years old. There were 116 boys and 1 girl. The stone size ranged from 0.7 to 4 (average 2.3) cm. Five patients had coexisting urinary bilharziasis and another 5 patients had coexisting renal stone. In 10 patients, the stone was in the urethra. The procedure was done under general anesthesia. Dilation of the tract was made under fluoroscopy. The instrument was an adult 26-french nephroscope, the same as that used for percutaneous nephrolithotripsy. Ultrasound disintegration was needed for stones of > 1 cm. A suprapubic catheter was left for 24 h, and a urethral catheter was kept for 48 h. RESULTS: All patients became stone free. The average operating time was 15 (5-50) min. The average hospital stay was 2.7 (2-5) days. No severe intra- or postoperative complication was observed. The nucleus and/or the main component of the stones were ammonium acid urate in 109 patients (93%). CONCLUSION: Based on our experience we can conclude that percutaneous suprapubic lithotripsy is a safe and effective method for the treatment of bladder stones in children. It reduces morbidity and hospital stay and thus the cost of treatment. Our series proves the nutritional etiology of endemic pediatric bladder stones. To our knowledge, this is the largest series reported on percutaneous suprapubic management of endemic bladder stones in children.     

The incidence of prostate cancer in a screening population with a serum prostate specific antigen between 2.5 and 4.0 ng/ml: relation to biopsy strategy

PURPOSE: It has recently been suggested that the diagnostic threshold for the prostate specific antigen (PSA) assay be lowered to enhance prostate cancer detection. A 22% incidence of prostate cancer has been reported in men with PSA between 2.5 and 4.0 ng/ml. We designed a study to confirm this observation. MATERIALS AND METHODS: Men who participated in our free early detection program and who had serum PSA between 2.5 and 4.0 ng/ml were asked to undergo prostate biopsy. Of 268 eligible men 151 (56%) agreed to participate in this free trial. All men underwent biopsy using an 11-core multisite directed biopsy scheme. All biopsy cores were color coded for location specificity and examined by 1 pathologist. RESULTS: Cancer was identified in 24.5% (37 of 151) of the men biopsied. The median age of men with cancer was 62 years (range 43 to 74). Conventional systematic sextant biopsies, which accounted for 6 of the 11 cores, detected 73.0% (27 of 37) of the cancers and the alternate site biopsies identified the remaining 10. Gleason score was 6 in 25 men, 3 + 4 in 5, 4 + 3 in 4 and 8 or greater in 3 (median Gleason score 6). There were 14 men who had 1 core positive for cancer, 9 had 2 and 14 had more than 2 (median number of positive cores 2). Of the 14 men with 1 positive core 11 had a less than 3 mm focus of cancer and 8 had only a positive alternate site biopsy. There were 11 cases of abnormal results on digital rectal examination, 5 of which were cancer, and 31 cases of abnormal results on ultrasonography, 13 of which were cancer. Median biological variability in PSA was +/-15% (range 0.4% to 440.0%). CONCLUSIONS: We found a significant incidence of cancer (24.5%, 37 of 51) in men with serum PSA between 2.5 and 4.0 ng/ml. In our study 67.6% of the detected cancers were significant based on the biopsy data. If the PSA threshold is lowered the conventional systematic sextant technique may be preferable to an extended strategy.     

Pulmonary metastatectomy for soft tissue sarcomas: is it valuable?

BACKGROUND: A retrospective study and analysis was performed to determine the value and benefit of pulmonary metastatectomy for soft tissue sarcomas, and which factors predict prognosis following resection. METHODS: Twenty-three patients underwent resections for pulmonary metastases from a soft tissue sarcoma (STS) at King Faisal Specialist Hospital and Research Center (KFSH&RC), between January 1985 and December 1998. There were 11 male and 12 female patients. Thirteen of 23 patients (57%) had one to three metastases, and 10 (43%) had four or more metastases. A total of 41 thoracic explorations was performed for the 23 evaluable patients. Median sternotomy was used only for three patients and lateral thoracotomy was used for 20 patients as an initial surgical approach. Pulmonary resections performed included one or more wedge resections (n=16), segmentectomy (n=5), and lobectomy (n=2). No one in this series underwent pneumonectomy. The number of resected metastatic nodules ranged from one-six with average three. Eight patients (35%) received various kinds of postoperative adjuvant chemotherapy. RESULTS: The overall and disease-free survival rate post-metastatectomy at five years was 24% and 21%, respectively. Various prognostic indicators were examined to evaluate their association with improved survival. Age, sex localization of the primary site and histologic type, tumor grade, size of the resected nodules, laterality (unilateral or bilateral), types of resection, adjuvant chemotherapy, and local recurrence did not significantly affect survival. However, patient with disease free interval >6 months, and those with three or fewer metastases showed a trend toward a higher five-year overall survival (p=0.06, 0.07, respectively). CONCLUSIONS: Surgical excision of lung metastases from soft tissue sarcomas is well accepted and should be considered as a first line of treatment if preoperative evaluation indicated that complete resection of the metastases is possible. Further investigation is needed before chemotherapy can be recommended as additional therapy.     

下腔静脉滤器置入与下肢深静脉血栓形成复发的相关性分析

目的探讨下腔静脉滤器(ICVF)置入与下肢深静脉血栓形成(DVT)治疗后复发的关系。方法回顾性分析2002年1月至2009年3月我院的确诊为DVT且符合入选标准的261例患者的临床资料。按照随访结果将患者分为复发组和未复发组,分别对可能引起复发的相关因素,如年龄、性别、分型、是否放置ICVF等11项因素进行对比分析。结果多因素logistic回归法分析放置ICVF,未完成抗凝治疗,分型及未行压力循环袜治疗是下肢DVT治疗后复发的独立危险因素(P0.05),而其他7项因素与DVT复发无统计学意义(P0.05)。结论 ICVF置入是DVT治疗后复发的重要危险因素,使用压力循环袜治疗和规范的抗凝治疗对预防DVT治疗后复发有重要的临床意义。     

大鼠注射重组腺病毒Ad-HGF后血清中抗腺病毒抗体的检测

目的观察大鼠重复给与携带肝细胞生长因子基因的重组腺病毒（recombinant adenovirus carrying hepatocyte growth factor gene，Ad-HGF）后，血清中抗腺病毒抗体的出现时间及消失规律。方法大鼠给与不同剂量的Ad-HGF共14次，利用病毒中和反应（细胞病变效应及绿色荧光方法）观察血清中抗腺病毒抗体。结果手术及正常对照组和实验组动物给药7次前血清处理的细胞均出现明显细胞病变效应及强荧光。之后各剂量组动物血清均对腺病毒有不同程度的中和作用，停药后13周到14周抗体水平很低或已不存在。同时观察到动物性别及给药剂量大小无差异。结论大鼠肌注Ad-HGF7次后，动物血清中可检测到抗腺病毒抗体，停药后13周或14周抗体基本消失，此结果对Ad-HGF的实际应用具有指导意义。     

早期帕金森病99Tcm-TRODAT-1多巴胺转运蛋白SPECT脑显像

目的　应用99Tcm TRODAT 1进行多巴胺转运蛋白 (DAT)SPECT脑显像 ,探讨其在早期诊断帕金森病中的应用价值。方法　对Hoehn Yahr分级为Ⅰ级的 7例偏侧帕金森病患者和 7例年龄匹配的健康志愿者进行99Tcm TRODAT 1SPECT脑显像。应用计算机感兴趣区 (ROI)技术半定量计算纹状体 /小脑、尾核 /小脑和壳核 /小脑放射性计数比值 ,分别代表纹状体、尾核和壳核的DAT功能水平 ,对帕金森病患者纹状体及其组成部分的DAT功能与健康志愿者的相应区域DAT功能进行比较 ,并对帕金森病患者患侧肢体对侧和同侧纹状体、尾核和壳核的DAT功能分别进行比较。结果　早期帕金森病患者双侧纹状体DAT功能均低于健康志愿者 (1.5 5± 0 .16,1.46± 0 .14 ,1.80± 0 .0 4,P <0 .0 5 ,P <0 .0 1) ,并以患侧肢体对侧纹状体功能降低明显 (P <0 .0 1) ;与健康志愿者相比 ,双侧尾核DAT功能降低 (2 .2 0± 0 .0 5 ,1.88± 0 .3 8,1.62± 0 .2 2 ,P <0 .0 5 ,P <0 .0 0 1) ;与健康志愿者相比 ,双侧壳核DAT功能降低 (1.92± 0 .10 ,1.61± 0 .15 ,1.43± 0 .2 0 ,P <0 .0 1,P <0 .0 0 1) ,且以患侧肢体对侧壳核DAT功能降低明显 (P <0 .0 5 )。所有受检者在显像过程中及显像后均无不良反应发生。结论　99Tcm TRODAT 1SPECT脑显像有助于临床早期诊     

鹰嘴豆豆芽降血糖功效成分纯化研究

目的研究分离纯化鹰嘴豆豆芽降血糖功效成分的工艺。方法采用聚酰胺-大孔树脂联用技术,考察了HPD100、HPD300、HPD450、HPD600、D101、D141、SA-3、FL-3等8种大孔树脂对鹰嘴豆豆芽降糖活性成分纯化的研究。结果聚酰胺与FL-3大孔树脂联用富集鹰嘴豆豆芽降糖活性成分效果最好,药材与聚酰胺比为5∶1,药材与大孔树脂比为3∶1,树脂径高比为1∶6,以4倍体积的40%乙醇洗除杂,再以70%乙醇洗脱,收集5倍体积洗脱液。富集物降糖活性成分纯度可达52%。结论聚酰胺与FL-3大孔树脂联用富集鹰嘴豆豆芽降血糖功效成分效果最佳,是理想的分离纯化介质。     

前列爽颗粒的药效学研究

目的:从抗炎、镇痛、抗凝、活血化瘀4个方面进行前列爽颗粒治疗慢性前列腺炎的药效学研究,为其临床应用提供依据.方法:实验分模型组、前列回春胶囊组、前列爽颗粒1.13,2.25,4.50 g·kg-1组,采用二甲苯致小鼠耳廓肿胀法、醋酸致小鼠腹腔毛细血管通透性增高法、角叉菜胶致大鼠足跖肿胀法、小鼠醋酸扭体法建模,小鼠以剪尾法测定出血时间(BT),玻片法测定凝血时间(CT),ELISA法测凝血酶原时间(PT),BM-15A型显微镜观察小鼠耳廓毛细血管口径和毛细血管网交点数,来评价前列爽颗粒的抗炎、镇痛、抗凝、活血化瘀作用.结果:前列爽颗粒1.13,2.25,4.50 g·kg-1组能明显抑制二甲苯所致的小鼠耳廓肿胀(P＜0.01),2.25,4.50 g·kg-1组降低醋酸致小鼠毛细血管通透性(P＜0.01),0.79,1.58,3.15 g·kg-1组能抑制角叉菜胶所致的大鼠足跖肿胀(P＜0.01),显著减少醋酸所致的小鼠扭体反应(P＜0.01),2.25,4.50 g·kg-1组能延长PT,BT,CT(P ＜0.01),毛细血管口径和毛细血管网交点数明显增加(P＜0.01).结论:前列爽颗粒具有抗炎、镇痛、抗凝、活血化瘀的作用.