Initial results of laser angioplasty under angioscopic guidance for salvage of an ischemic lower limb: preliminary report

From March to July 1989, nine patients at risk for peripheral artery disease underwent intraoperative Nd:YAG laser angioplasty using angioscopy at the Veterans General Hospital (Taipei, Taiwan, Republic of China). Following the laser angioplasty, balloon dilatation was performed in all cases. Eight men and one woman at an average age of 68 were included in the study (range: 58 to 78 years old). Ischemic symptoms included five patients with disabling claudication, four with pain at rest and one with gangrene on the toes. Eight of the nine patients had complete occlusions ranging from 2 to 19 cm in length. Two patients had high degree multiple segmental stenosis of the superficial femoral artery from 1 to 2 cm in length. Initial clinical success (indicated by relief of symptoms and increase in Doppler ankle pressure and index) and improvement in the angiographic luminal diameter was noted in 9 of 10 occluded vessels (90%) that underwent Nd:YAG laser treatment which was delivered at 10 to 12 watts through laser probes. Prelaser intraluminal diameter increased from 0.05 +/- 0.07 to 0.53 +/- 0.07 mm, Doppler ankle pressure index rose from 0.51 +/- 0.12 to 0.81 +/- 0.12, Doppler ankle pressure increased from 62.44 +/- 16.10 to 104 +/- 21.21 mmHg and the amplitude of pulse volume recorder at ankle level rose from 5.77 +/- 2.80 to 12.11 +/- 2.77 mm as compared with prelaser therapy (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)     

药事管理学科科研问题及对策浅析

分析当前我国药事管理学科科研中存在的问题和原因。提出发展科研的思路与方法。     

电针治疗对老年性痴呆大鼠血清β淀粉样蛋白及生长因子水平的影响

目的:观察电针对老年性痴呆(AD)模型大鼠β-淀粉样蛋白及转化生长因子(TGF-α)的影响,揭示针灸治疗的作用机理和针灸治疗AD的免疫基础。方法:建立AD大鼠模型,随机分为电针组、喜得镇组、模型自然恢复组、假手术组,观察血清β-AP和TGF-α水平。结果:电针组和喜得镇组大鼠血清β-AP水平明显下降(P<0.05),但仍明显高于假手术组。结论:电针能降低AD模型大鼠血清中β淀粉样蛋白及TGF-α。     

GAD-Ab、ICA和IAA联合检测对成人隐匿性自身免疫性糖尿病的诊断价值（附138例分析）

目的 评价血清谷氨酸脱羧酶抗体(GAD—Ab)、胰岛细胞抗体(ICA)和胰岛素自身抗体(IAA)联合测定对成人隐匿性自身免疫性糖尿病(LADA)的诊断价值。方法 利用ELISA法测定138例临床诊断为2型糖尿病患者及46例健康者的血清GAD—Ab、ICA和IAA，并比较抗体阳性和阴性患者的临床特征。结果 临床诊断为2型糖尿病患者GAD-Ab和ICA的阳性率分别为20．3％和11．6％，与对照组比较差异有显著性(X^2=8．528，P=0．003；X^2=5．841，P=0．016)；IAA的阳性率8．0％。与对照组比较无显著性差异(X^2=1．902，P=0．168)。抗体阳性患者血清C肽水平较低。结论 胰岛自身抗体联合检测可提高LADA患者的检出率；LADA患者胰岛储备功能较差。     

麻黄离体培养研究进展

麻黄的出口量和使用量在逐年增加，麻黄碱的提取一直以野生资源为原料，使麻黄野生资源将近枯竭，土地沙化日趋严重，生态环境受到严重破坏。为了保护野生资源，国务院颁发了有关禁止滥挖干草和麻黄的通知，鼓励人工种植麻黄，从根本上解决麻黄资源紧缺的问题。目前人工种植麻黄的种源主要依靠采集野生种子育苗，由于野生麻黄的种源是一混杂的群体，因此栽培的麻黄在形态、生长发育及其有效成分上都存在差异，影响麻黄的产量和质量，从而制约了我国麻黄企业的发展。因此利用生物技术进行麻黄快速繁殖及种质保存、细胞离体培养产生代谢药用产物的研究具有广阔的应用前景。本文综述了国内外麻黄组织培养、细胞悬浮培养等研究状况，为麻黄资源可持续利用提供了一个新的有效途径。     

过氧化氢对豚鼠耳蜗功能及形态的影响

目的 在体观察过氧化氢(H2O2)对豚鼠耳蜗功能及形态的影响。方法 实验动物分为4组，分别灌流人工外淋巴液(artificial perilymph,APL)，50μMH2O2，100μMH2O2和200μMH2O2(H2O2均溶于APL中)，并用Pl和H033342双染色方法观察H2O2引起的内耳细胞损伤情况。结果 所有H2O2灌流组复合动作电位((CAP)阈移和耳蜗微音电位(CM)幅度变化与人工外淋巴液组比较差异有显著性，且各H2O2组的变化呈现出浓度依赖性；Pl和H033342双染色方法发现外毛细胞是H2O2攻击的主要靶细胞，而Hensen细胞未见任何损伤痕迹。结论 H2O2可导致耳蜗功能下降及耳蜗毛细胞损伤：Hensen细胞较毛细胞可能具有更强的抗氧化能力。     

Bladder Cancer and Arsenic Exposure： Differences in the Two Populations Enrolled in A Study in Southwest Taiwan

Objective Analyses of bladder cancer mortality in the Black Foot Disease (BFD) endemic area of southwest Taiwan conducted by Morales et al. showed a discontinuity in risk at 400 μg/L arsenic in the drinking water in a stratified analysis and no discontinuity in a continuous analysis.     

Phase II study of neoadjuvant carboplatin and paclitaxel followed by radiotherapy and concurrent cisplatin in patients with locoregionally advanced nasopharyngeal carcinoma: therapeutic monitoring with plasma Epstein-Barr virus DNA.

PURPOSE: To assess the efficacy of neoadjuvant paclitaxel and carboplatin (TC) followed by concurrent cisplatin and radiotherapy (RT) in patients with locoregionally advanced nasopharyngeal carcinoma (NPC) and to monitor treatment response with plasma Epstein-Barr virus (EBV) DNA. PATIENTS AND METHODS: Thirty-one patients with International Union Against Cancer stages III and IV undifferentiated NPC had two cycles of paclitaxel (70 mg/m2 on days 1, 8, and 15) and carboplatin (area under the curve 6 mg/mL/min on day 1) on a 3-weekly cycle, followed by 6 to 8 weeks of cisplatin (40 mg/m2 weekly) and RT at 66 Gy in 2-Gy fractions. Plasma EBV DNA was measured serially using the real-time quantitative polymerase chain reaction method. Results All patients completed planned treatment. Response to neoadjuvant TC was as follows: 12 patients (39%) achieved partial response (PR) and 18 achieved (58%) complete response (CR) in regional nodes; five patients (16%) achieved PR and no patients achieved CR in nasopharynx. At 6 weeks after RT, one patient (3%) achieved PR and 30 patients (97%) achieved CR in regional nodes, and 31 patients (100%) achieved CR in nasopharynx; 29 patients (93%) had EBV DNA level of less than 500 copies/mL. Neoadjuvant TC was well tolerated, and the most common acute toxicity of cisplatin plus RT was grade 3 mucositis (55%). At median follow-up of 33.7 months (range, 7 to 39.3 months), six distant and three locoregional failures occurred. Plasma EBV DNA level increased significantly in eight of nine patients who experienced treatment failure but did not increase in those who did not. The 2-year overall and progression-free survival rates were 91.8% and 78.5%, respectively. CONCLUSION This strategy was feasible and resulted in excellent local tumor control. Serial plasma EBV DNA provides a noninvasive method of monitoring response in NPC.     

Clinical evaluation of HER-2/neu protein in malignant pleural effusion-associated lung adenocarcinoma and as a tumor marker in pleural effusion diagnosis.

PURPOSE: Lung adenocarcinoma presenting as malignant pleural effusion (MPE) is common in Taiwan. Microscopically, the involved pleurae are infiltrated by numerous tumor foci, which suggests that the cancer cells are highly invasive. Overexpression of HER-2/neu has been related to proliferation, antiapoptosis, and the high invasiveness of various cancer cells. We therefore were interested in studying the role of HER-2/neu in MPE-associated adenocarcinoma cell lung cancer (ADCLC). Experimental Design: The expression of HER-2/neu in pleural effusion was measured by ELISA. The HER-2/neu protein expression on tumor cells was evaluated by immunohistochemical (IHC) staining, and gene amplification was assayed by fluorescence in situ hybridization. RESULTS: The mean value of HER-2/neu in pleural effusions of patients with ADCLC and other nonmalignant lung diseases was 9.9 and 2.7 ng/ml, respectively. The difference is statistically significant (P < 0.001). Compared with cytokeratin 19 fragment CYFRA 21-1, the performance of HER-2/neu as a tumor marker in pleural effusion diagnosis was better. Overexpression of HER-2/neu in tumor tissues was found in 70% (23 of 32) of patients with MPE-associated ADCLC, 30% (13 of 43) with stage I/II non-small cell lung cancer (NSCLC), and 44% (14 of 32) with stage III NSCLC. The incidence of HER-2/neu overexpression in tumor tissues of patients with MPE-associated ADCLC was significantly higher than that of patients with stage I-III NSCLC without MPE. HER-2/neu gene amplification was uncommon (1.9%). The correlation between the IHC H-score in tumor samples and the pleural effusion level of HER-2/neu was significant (P < 0.01). A higher incidence of HER-2/neu expression beyond the cutoff point (5.5 ng/ml) in pleural effusions was also found in patients whose IHC H-scores were >50. CONCLUSIONS: These findings indicate that HER-2/neu is important in the pathogenesis of MPE-associated ADCLC and is a potential tumor marker for a diagnosis of pleural effusion.     

中药饮片质量规范研究概论

我国即将实行中药饮片批准文号制度,而目前饮片质量参差的重要原因之一是饮片质量标准未能全面概括饮片质量要素。本文系统地概述了中药饮片质量规范研究的内容和研究步骤,重点叙述了中药饮片质量标准的研究内容。