前列腺特异抗原研究进展与挑战(摘要)

前列腺特异抗原(ＰＳＡ)发现四分之一世纪以来,已成为诊断前列腺癌最有价值的肿瘤标志物。前列腺癌在男性癌症发病中占首位。自从80年代中期第一代检测ＰＳＡ的方法问世以来,前列腺癌的发病率有了显著改变。这部分归功于ＰＳＡ检测的增加,从而使前列腺癌得到早期诊断,这有利于将癌症控制在发病早期,增加治愈的可能性。虽然ＰＳＡ是一个有效的肿瘤标志物,并具有器官特异性,但其癌症特异性不高。ＰＳＡ升高也可见于其他良性前列腺疾病,尤其当ＰＳＡ浓度在4～10μｇ/Ｌ时。这个浓度范围被称为“诊断灰色区域”。对ＰＳＡ分子结构的研究主要集中…     

乙稀雌酚肌注致心房纤颤1例

1　病例报告　男 ,71岁 ,因排尿困难于 1999- 0 9- 0 4入院 .B超确诊前列腺增生 5 a,既往无高血压、心脏病及心率失常史 .查体 :Bp17/ 10 k Pa,心界不大 ,心率 6 2次· min- 1 ,心律齐 .下腹部可触及涨大的膀胱 ,约耻骨上 4指 .入院时 ECG正常 .肝肾功能无异常 ,确诊前列腺增生伴急性尿潴留 .首先予导尿 ,导出尿液约 90 0 m L,之后 im乙稀雌酚 1mg,2 h后患者突发心慌、胸闷、气短、心前区疼痛 .发现患者大汗BP12 /6 k Pa,P110次· min- 1 ,R2 8次· min- 1 ,心率绝对不齐 ,脉搏明显短促 ,两肺底可闻及湿性罗音及哮鸣音 ,ECG示房颤 ,心…     

Prevalence of cluster headache in the Republic of Georgia: results of a population-based study and methodological considerations

We present a study of the general-population prevalence of cluster headache in the Republic of Georgia and discuss the advantages and challenges of different methodological approaches. In a community-based survey, specially trained medical residents visited 500 adjacent households in the capital city, Tbilisi, and 300 households in the eastern rural area of Kakheti. They interviewed all ( n  = 1145) biologically unrelated adult occupants using a previously validated questionnaire. The household responses rates were 92% in Tbilisi and 100% in Kakheti. The survey identified 32 persons with possible cluster headache, who were then personally interviewed by one of two headache-experienced neurologists. Cluster headache was confirmed in one subject. The prevalence of cluster headache was therefore estimated to be 87/100 000 (95% confidence interval < 258/100 000). We used a conservative approach, which has an obvious advantage of high-quality data collection, but is very demanding of manpower and time.     

Endovascular suture occlusion of the middle cerebral artery in rats: Effect of suture insertion distance on cerebral blood flow,infarct distribution and infarct volume

Abstract

Sprague-Dawley rats anesthetized with isoflurane, underwent MCA occlusion by intraluminal 3-0 suture insertionl either 22 mm (n =8) or 18 mm (n =6) beyond the CCA bifurcation or were sham-operated as controls (n =3) for autoradiographic analysis of cerebral blood flow. Infarct volume was measured 24 hours after the onset of ischemia (22 mm, n =11; 18 mm, n =10); neurological examinations were performed at 6 and 24 hours. Cerebral blood flow in the MCA distribution was significantly lower in the 22 mm suture insertion group than in the 18 mm group (p < 0.05). The total infarct volume was significantly larger (197± 15 versus 135± 19 mm³, p < 0.05) and the coefficient of variance was significantly smaller (23.8% versus 43.9%, p < 0.05) in the 22 mm group. Border zone regions of medial caudoputamen and dorsolateral cortex were often spared in the 18 mm group but never in the 22 mm group. The neurological deficit was more severe in the 22 mm group at 24 hours (p < 0.05), but not at 6 hours. The greater blood flow reduction and the less variable histological damage in dorsolateral cortex of watershed area between the middle and anterior cerebral arteries) and the greater histological damage in medial caudate in the 22 mm group further characterizes this focal ischemia model for two potential applications: 22 mm insertion for studies requiring extensive and reproducible infarcts; 18 mm insertion for studies requiring less severe and more variable lesions after permanent MCA occlusion. [Neural Res 1997; 19: 409-416]     

Is phenytoin contraindicated in patients receiving cranial irradiation ?

Three recent publications have reported the development of erythema multiforme and Stevens-Johnson syndrome in patients receiving cranial irradiation and sodium phenytoin. Some authors have recommended that patients receiving whole brain radiation therapy and who have had seizures should not be prescribed phenytoin but an alternative anticonvulsant. This article reviews the current literature pertaining to the development of this potentially lethal complication in patients receiving whole brain radiation and phenytoin, with reference to the single recorded case of Stevens-Johnson syndrome in a patient receiving cranial irradiation and phenytoin in Auckland, New Zealand. While the clinical picture in the 16 patients reported in the literature and the current case report differed from the classical form of erythema multiforme, a similar pattern of presentation and outcome appeared in all patients reviewed, suggesting that the combination of phenytoin, cranial irradiation and the gradual reduction of concomitant steroids seem to lead to the development of erythema multiforme and/or Stevens-Johnson syndrome. The data presented, although sparse, suggest that phenytoin should not be prescribed in patients receiving cranial irradiation.     

氨溴索治疗小儿毛细支气管炎77例

1临床资料2002-01／2004-02收治临床症状典型且无并发症毛细支气管炎患儿116例，发病年龄3-24(平均8．4)mo，男61例，女55例，按就诊时间顺序分为氨溴索雾化吸入组(观察组)、氨溴索静脉点滴组(对照Ⅰ组)和常规治疗组(对照Ⅱ组)，分别为38，39，39例．常规治疗组给予头孢噻肟钠50mg／kg，2／d及穿琥宁80-120mg／d分别静脉滴注及对症治疗(如吸氧、镇静、退热等处理)；观察组在常规治疗的基础上加用氨溴索4mg加生理盐水10mL超声雾化吸入10～15min，2／d；     

1型糖尿病患儿的课堂注意力：稳定血糖的效果

目的:观察评估通过使用胰岛素泵以稳定血糖,是否可以改善1型糖尿病患儿的课堂注意力。试验设计:对4例患有1型糖尿病且血糖水平不稳定的患儿在课堂中的表现进行为期10d的观察。在放置胰岛素泵,控制血糖后再观察10d。利用改良多基线设计血糖控制水平是否与患儿专注于功课和走神行     

孤立性乳晕顶泌腺色汗症

作介绍了1例孤立性乳晕顶泌腺色汗症的11岁女童，这是在Medline（医学献分析与检索系统）中引证的最年轻病例，本回顾性章的目的是增加初级保健提供对顶泌腺色汗症的认识并对治疗进行讨论。0．025％的辣椒碱乳膏是一个已被证实的治疗方法，它可减少患所遇到的潜在心理影响和窘迫。     

Airway and body surface sensors for triggering in neonatal ventilation

Failure of neonatal patient triggered ventilation may reflect a delay in delivery of flow relative to the inspiratory effort of the infant. Transmission of diaphragmatic contraction to the sensor site (patient delay) and further transmission to and within the sensing device (device delay) both contribute to the delay in triggering. Patient and device delays were studied for different sensing systems in 36 infants, 24 of whom were intubated. Device delay was long (<40 ms) with a conventional apnoea monitor compared with sensors placed at the airway opening (2 ms), the inspiratory (12 ms) and expiratory (3 ms) pressure transducers of the ventilator, the Graseby capsule (8 ms), strain gauges (3 ms) and oesophageal pressure (6 ms). In near normal infants, the sum of patient and device delays for the latter sensors was less than 20 ms and a minor component of the total delay. However, in severe lung disease the total delay may be more than 100ms even for airway sensors.