喉癌及癌前病变组织中凝集素受体的观察

应用免疫组化（ABC法，技术检查喉上皮不典型增生、喉乳头状瘤、喉鳞状上皮癌中花生凝集素受体，刀豆凝集素受体，蓖麻凝集素受体，荆豆凝集素受体，双花扁豆凝集素受体的分布，提示：花生凝集素受体、荆豆凝集素受体、蓖麻凝集素受体的分布与其他化、增生和恶变有关；荆豆凝集素受体在喉上皮中随其恶性程度增加而增加；同一细胞膜表面可存在多种凝集素受体。凝集素免疫组化检查法是一种经济、方便、迅速、灵敏的方法，可以利用凝集素受体来检查喉部肿瘤的分化、增生和恶变程度，为临床诊断，鉴别诊断，治疗和预后判断提供客观指标。     

Left main coronary artery aneurysm associated with extensive coronary arterial calcification: case report and review

We present a 68-year-old male with left main coronary artery aneurysm and extensive coronary calcification involving the entire coronary arterial tree detected by coronary angiography and electron beam computerized tomography. With this article we also discussed the relationships between the pathogenesis of coronary atherosclerosis, coronary calcification, and coronary aneurysm formation.     

Neuroprotective effects of Buyang Huanwu decoction against hydrogen peroxide induced oxidative injury in Schwann cells

Ethnopharmacological relevance

Buyang Huanwu decoction (BYHWD) is a traditional Chinese medicine and can be used to promote peripheral nerve regeneration. However the regenerative mechanism of BYHWD remains unclear. The objective of this study was to investigate the protective mechanisms of BYHWD in Schwann cells damaged by hydrogen peroxide (H₂O₂).

Materials and methods

Schwann cells which were derived from neonatal sciatic nerves of rats were used in subsequent experiments. Schwann cells were injured by various concentrations of H₂O₂ (0.25, 0.5 and 1 mM final concentration). BYHWD (600 μg/ml final concentration) was added to the medium either simultaneously or 1 h later after the addition of H₂O₂. Subsequently, methyl thiazolyl tetrazolium (MTT) assay was performed. Superoxide dismutase (SOD) activity and malondialdehyde (MDA) levels were also examined after 12 h. The expression of Caspase 3 and the concentration of intercellular Ca²⁺ ([Ca²⁺]i) were also determined.

Results

Among three concentrations of H₂O₂, 0.5 mM H₂O₂ induced Schwann cells swelled and neuritis disappeared after 12 h. In the presence of BYHWD, MTT assay showed that more cells were viable in comparison with the H₂O₂ injury group. Moreover, the addition of BYHWD has also increased the SOD activity with decreased in MDA level. Furthermore, the concentration of [Ca²⁺]i and expression of Caspase 3 were decreased with the addition of BYHWD in culture.

Conclusions

Our results revealed that BYHWD protected Schwann cells from oxidative injury. The mechanism of BYHWD promoting neural regeneration possibly associated with its anti-oxidative activity.     

Treatment for unstable intertrochanteric fractures in elderly patients: internal fixation versus cone hemiarthroplasty

PURPOSE. To evaluate the effectiveness of internal fixation versus cone hemiarthroplasty for the treatment of unstable intertrochanteric fractures in elderly patients. METHODS. The choice of treatment was based on the year of admission: between 2001 and 2003, 42 patients (mean age, 73 years) underwent cone hemiarthroplasty using a cementless press fit through a posterior approach, whereas between 1999 and 2001, 45 patients (mean age, 75 years) underwent internal fixation using a dynamic hip screw through a lateral approach in a supine position. Patients with stable fractures with intact lesser trochanter, immobility before injury, age younger than 60 years, or with associated injuries (such as another fracture) were excluded. Patients were encouraged active rehabilitation in bed. Bony union was determined by clinical and radiological examinations. Patients were followed up at 6-week intervals in the first sixth months and every 3 months thereafter until bony union was achieved. In the final follow-up, 32 cone hemiarthroplasty patients and 38 internal fixation patients were available for evaluation according to Merle d'Aubigne and Postel criteria. RESULTS. There were no significant differences between the 2 groups in terms of sex, age, fracture type, Singh index, follow-up period, hospital stay, operating time, and receipt of blood transfusions. Clinical results of both groups were similar. Hemiarthroplasty patients were allowed full weight bearing significantly earlier than the internal fixation patients. CONCLUSION. Cone hemiarthroplasty can be an alternative treatment for unstable intertrochanteric fractures in elderly patients so as to achieve earlier mobilisation.     

Topotecan in platinum-resistant epithelial ovarian cancer

BACKGROUND: Topotecan has been emerged as a new promising anticancer drug for patients with ovarian cancer. METHODS: In this study, patients who were treated with topotecan were reviewed retrospectively. A total of 26 patients was included the study. All patients had received platinum-based regimens previously. Topotecan was administered a dose of 1.5 mg/m(2) intravenously 30 min daily for 5 days and repeated every 21 days. RESULTS: The response rates were 30% by CA-125 level and 29% in clinic evaluation. Median duration of response was 8 (3-15) months, median progression-free interval was 12 (4-30) months and median overall survival was 15 (4-36) months. Grade 3-4 neutropenia occurred in 58% of the patients (38% of the courses) and trombocytopenia in 29% of the patients (12% of the courses). Nonhematological toxicities were mild. There was no drug-related death. CONCLUSION: Topotecan is considered as a reasonable option for treatment of patients with platinum refractory recurrent ovarian cancer.     

外科重症监护病房术后行机械通气病人的疼痛强度评估方法研究

[目的]了解外科重症监护病房(SICU)术后机械通气清醒病人的疼痛情况及评估方法.[方法]采用方便抽样方法,应用行为疼痛量表(BPS)和数字疼痛强度量表(NRS)对北京市某三级甲等医院SICU 95 例术后行机械通气清醒病人进行疼痛强度测评.[结果]BPS分值为(5.83±1.82)分、NRS为(5.98±2.55)分.不同性别、文化程度病人BPS和NRS疼痛强度比较,差异无统计学意义(P>0.05).年龄与BPS和NRS的疼痛强度呈负相关(r值分别为-0.215和-0.302).应用和没有应用镇痛泵病人BPS及NRS疼痛分值比较差异无统计学意义.BPS评分与NRS评分存在正相关(r=0.613,P<0.001).[结论]术后病人普遍存在疼痛,BPS用于机械通气病人疼痛的评估是可靠有效的.     

Effects of Glycoprotein IIb/IIIa Inhibition on QT Dispersion in Patients with Unstable Angina and Non-Q-Wave Myocardial Infarction

Acute coronary ischemia augments inhomogeneity in ventricular repolarization, which significantly correlates with ventricular fibrillation. The effects of glycoprotein IIb/IIIa receptor inhibition on QT interval dispersion (QTd), and the effects of QTd changes on in-hospital, 30 day, and long-term cardiac events in patients with unstable angina (UA) and non-Q-wave myocardial infarction (MI) have not been investigated previously. Eighty-three patients presenting with Braunwald class IIIB UA or non-Q-wave MI were randomized to standard therapy (aspirin and unfractionated heparin, 42 patients) or tirofiban therapy: addition to standard therapy (41 patients). QT interval dispersion (QTd) and corrected QTd (QTcd) were measured prior to therapy, and 6, 24, 48, 72, and 96 hours after the initiation of the treatment. In both groups QTd and QTcd were higher than normal limits during the admission, prior to therapy. The first QTd and QTcd were not different between two groups; the remaining values were significantly lower in tirofiban group except the first and last QTd (p values for QTd at 6, 24, 48, 72, and 96 hours are 0.057, 0.045, 0.0006, 0.04, and NS, respectively, and for QTcd, they are 0.017, 0.046, 0.0004, 0.012, and 0.01, respectively). When the first QTd and QTcd compared to the following measurements in each group, the first significant decrease occurred at 6th hour (p = 0.004 for QTd, and 0.004 for QTcd) in tirofiban group, whereas in standard therapy group it was occurred at 48th hour (p = 0.02) for QTd, and 72nd hour (p = 0.019) for QTcd. While the incidence of in-hospital acute MI, recurrent refractory angina, and total major cardiac events were significantly lower in the tirofiban group (p = 0.03, 0.04, and 0.01, respectively) that early QTd recovery observed, the 30 day and long-term incidence of major cardiac events were not different between the two groups. GP IIb/IIIa receptor inhibition in addition to heparin treatment causes a faster recovery of increased QT dispersion, and the early recovery of QTd is associated with a reduction in in-hospital major cardiac events.     

Gemcitabine treatment in patients with inoperable locally advanced/metastatic pancreatic cancer and prognostic factors

Objective. Most patients with pancreatic cancer show an inoperable locally advanced/ metastatic tumour at the time of diagnosis. The present study was aimed at determining the prognostic factors in patients with advanced pancreatic carcinoma treated with gemcitabine. Material and methods. Sixty-seven unresectable or metastatic pancreatic cancer patients treated with gemcitabine were included in the study and a total of 258 cycles of treatment were applied. Results. The overall response rate was 5%. Thirty-one percent of the patients had stable disease, whereas progressive disease was seen in 49%. Clinical benefit response rate was 15%. The median duration of response was 7.3 months. Median progression-free survival was 3 months, while median overall survival was 9 months. Univariate analysis revealed that worse results were found in patients with performance status (PS)?=?2, and in patients with primary tumour location in the body or tail of the pancreas (p<0.05). Multivariate analysis of data revealed that the most important factor was PS of the patient, as the patients with PS?=?2 had worse results than the patients with PS?=?0–1 (p<0.05). Conclusions. Low PS is a negative predictive factor for the survival of patients with advanced pancreatic carcinoma treated with gemcitabine.