Efficacy and safety of metamizol vs. acetylsalicylic acid in patients with moderate episodic tension-type headache: a randomized, double-blind, placebo- and active-controlled, multicentre study

We assessed the efficacy and safety of oral single doses of 0.5 and 1 g metamizol vs. 1 g acetylsalicylic acid (ASA) in 417 patients with moderate episodic tension-type headache included in a randomized, double-blind, placebo- and active-controlled, parallel, multicentre trial. Eligibility criteria included 18-65 years of age, history of at least two episodes of tension-type headache per month in the 3 months prior to enrollment, and successful previous pain relief with a non-opioid analgesic. Treatment arms were metamizol 0.5 g (n = 102), metamizol 1 g (n = 108), ASA 1 g (n = 102) and placebo (n = 105). The analgesic efficacy of 0.5 and 1 g metamizol vs. placebo was highly statistically significant (alpha: 0.025; one-sided) for sum of pain intensity differences, maximum pain intensity difference, number of patients with at least 50% pain reduction, time to 50% pain reduction, maximum pain relief and total pain relief. A trend towards an earlier onset of a more profound pain relief of 0.5 and 1 g metamizol over 1 g ASA was noticed. All medications including placebo were almost equally safe and well tolerated.     

Synthetic peptide vaccine against Taenia solium pig cysticercosis: successful vaccination in a controlled field trial in rural Mexico

Taenia solium cysticercosis seriously affects human health when localised in the central nervous system (CNS) and causes great economic loss in pig husbandry in rural areas of endemic countries. Increasing the resistance to the parasite in the obligatory host pig may help in curbing transmission. Three synthetic peptides based on protein sequences of the murine parasite Taenia crassiceps, which had previously been shown to induce protection in mice against homologous challenge, were tested as a vaccine against T. solium cysticercosis in pigs. Vaccinated and unvaccinated piglets (240 in all) were distributed in pairs among the peasants' households of two rural villages in Mexico in which 14% of the native pigs were cysticercotic. Ten to twelve months later, the effect of vaccination was evaluated at necropsy. Vaccination decreased the total number of T. solium cysticerci (98.7%) and reduced the prevalence (52.6%). The natural challenge conditions used in this field trial strengthen the likelihood of successful transmission control to both pig and human through a large-scale pig vaccination program. We believe this is a major contribution in anticysticercosis vaccine development as these rather simple yet protective peptides are potentially more cost-effective to produce and less variable in results than antigens that are more complex.     

No evidence of somatic activating mutations on gonadotropin receptor genes in sex cord stromal tumors

OBJECTIVE: To search for somatic activating mutations of gonadotropin receptor (FSH-R and LH/chorionic gonadotropin receptor [CG-R]) genes as a cause of sex cord stromal tumors. DESIGN: Molecular studies in human tissue. SETTING: University hospital. SPECIMEN(S): Eight granulosa cell tumors collected from paraffin-embedded tissue, eight Leydig cell tumors, and three thecomas collected from fresh-frozen or paraffin-embedded tissue. INTERVENTION(S): Tumor samples were used for DNA extraction. The entire exon 11 of the LH/CG-R gene and a hot spot for gonadotropin receptor activating mutations on exon 10 of the FSH-R gene were amplified by polymerase chain reaction. The former was analyzed by denaturing gradient gel electrophoresis and automatic direct sequencing, and the latter by automatic direct sequencing. MAIN OUTCOME MEASURE(S): Results of denaturing gradient gel electrophoresis and automatic direct sequencing. RESULT(S): No somatic activating mutation was detected in exon 11 of the LH/CG-R gene in eight Leydig cell tumors and three thecomas. In addition, no mutations were detected in eight granulosa cell tumors in the hot spot for activating mutations in exon 10 of the FSH-R gene. CONCLUSION(S): Somatic activating mutations of gonadotropin receptors seem to play no relevant role in the development of sex cord stromal tumors.     

小鼠脑缺血后的能量代谢改变和药物的作用

应用部分结扎小鼠颈总动脉(包括迷走神经)及小鼠断头法引起脑缺血后,脑组织的ATP和磷酸肌酸明显降低,乳酸明显升高。部分结扎颈动脉出现四肢无力、转圈及昏睡等症状,其严重程度与脑能量代谢改变相平行。皮下注射尼莫地平、硝苯吡啶、尼卡地平和三七皂甙对脑缺血有一定保护作用。苯巴比妥钠能改善正常和脑缺血小鼠的脑能量代谢,人参皂甙Rb₁可降低正常小鼠脑乳酸含量。     

外科术后康复护理中深化护理文化建设的探索与实践

目的 探讨在外科术后专科康复护理中深化护理文化建设的实践与效果。方法 选择符合诊断标准的乳腺癌改良根治术、脑卒中偏瘫及脊髓损伤、腰椎间盘突出患者随机分成实验组和对照组，实验组患者术后应用自制辅助卧位枕辅助维持康复体位及VCD光盘辅助指导功能锻炼，对照组采用传统方法辅助卧位及健康教育方法。结果 实验组患者疼痛减轻，舒适度及依从性优于对照组（P〈0．05）；特定知识的知晓率及功能锻炼正确率高于对照组（P〈0．05）。结论 自制系列辅助康复卧位枕及VCD光盘辅助指导功能锻炼的应用可让患者感到舒适、方便，实践了人性化护理与专科护理技术的有机结合，丰富了护理文化的内涵，值得推广。     

聚羟基丁酸己酸酯/聚碳酸亚丙酯共混材料作为血管组织工程支架的性能特征

目的：为改善生物材料聚羟基丁酸己酸酯（PHBHHx）的力学性能和聚碳酸亚丙酯（PPC）的可加工性,将两者共混,制备不同比例的共混材料,并对共混膜上血管平滑肌细胞的黏附和共混材料制成的管形支架的力学性能进行评价,以选出合适比例的共混材料作为血管组织工程支架。 方法：实验于2006-08/2007-04在清华大学生物科学与技术系生物膜与膜生物工程国家重点实验室完成。①制备5种不同比例（PHBHHx∶PPC分别为0∶10,3∶7,5∶5,7∶3,10∶0）的共混材料,利用CCK-8试剂测定兔主动脉平滑肌细胞在共混膜上培养24h后的黏附数量。②采用热致相分离和冷冻干燥法制备管形支架,通过反复浸渍和晾干,在多孔支架外层形成一层晾干的膜层。利用扫描电镜观察支架形貌、压汞仪测量孔隙率和孔径分布,利用自制装置以6.65kPa/s的加压速度测定管形支架的破裂强度,万能材料试验机测定支架的缝合强度,以羊颈动脉为对照。 结果：①兔主动脉平滑肌细胞在各种膜上培养24h后,在5∶5比例PHBHHXx/PPC共混膜和PPC膜上相对黏附量高于PHBHHXx膜（P〈0.05）。②PHBHHx和共混材料均可制备成管形支架,而单纯PPC支架在制备晾干层时溶化,无法维持原形。管形支架的孔径随PPC含量的增加而增大,孔隙率提高。③支架的破裂强度与羊颈动脉相似（P〉0.05）;缝合强度均强于羊颈动脉,以5∶5和3∶7PHBHHx/PPC共混材料制备的管形支架的缝合强度高于PHBHHx支架。 结论：①与PHBHHx相比,5∶5PHBHHx/PPC共混膜和PPC膜上兔主动脉平滑肌细胞的黏附更好。②共混材料均可以制备成管形支架,并且力学强度符合移植的要求,缝合强度以5∶5和3∶7的PHBHHx/PPC共混材料最佳。     

Pneumatic reduction of childhood intussusception. Is prediction of failure important?

Background/Purpose

Exclusion criteria for enema reduction of intussusception are still a matter of debate. The current study aimed to search for risk factors and to design and evaluate a predictive model of air enema failure.

Methods

The design was a cross-sectional study. The study was conducted at a tertiary university hospital. The participants were 164 children (mean [SD] age of 11.6 [10.7] months) with intestinal intussusception. The intervention done was pneumatic reduction only contraindicated in case of peritonitis and/or sepsis. For main outcome measures, logistic regression analysis was used to estimate the contribution of clinical parameters (age, sex, weight, clinical evolution, temperature, rectal bleeding, white blood cell count, and neutrophils) to predict the risk of enema failure. To evaluate the discriminating power of the model, a receiver operating characteristic curve was constructed, and the effectiveness at different cutoffs was calculated.

Results

Overall efficacy was 85%; manual reduction was performed in 12 (7.3%) cases, and there were 9 (6.5%) recurrences. Multivariable analysis adjusted for age and sex revealed that delayed diagnosis (evolution >24 hours) and raised neutrophils (%) were associated with failure: odds ratio of 11.52 (95% CI, 3.73-35.54) and 1.06 (95% CI, 1.02-1.11), respectively. The area under the receiver operating characteristic curve was 0.826 (95% CI, 0.740-0.912). At the best cutoff (0.15), the positive predictive value was 35% and the negative 93%. At the cutoff of 0.50, the positive predictive value was 70% and the negative 87%; the sensitivity was 29%.

Conclusions

The efficacy and safety of pneumatic reduction in childhood intussusception was confirmed. Delayed diagnosis and neutrophils significantly predict outcome. Despite consistent high negative predictive values, the model has low effectiveness in predicting enema failure and may not be clinically relevant; there is no rationale for stricter exclusion criteria.