延迟小骨窗开颅手术治疗硬膜外血肿96例

1临床资料1999-08/2004-08我科采用延迟小骨窗开颅手术治疗硬膜外血肿96(男75,女21)例,年龄13～18(平均35)岁.受伤原因车祸72例,坠落伤11例,打击伤13例.均于伤后72 h内就诊并经头颅CT确诊,表现头痛96例,呕吐21例,一侧肢体无力32例,偏身麻木23例,癫痫发作1例,原发昏迷92例,59例≤30 min,33例为30～120 min,头痛进行性加重36例.就诊时GCS记分10～12分15例,13～15分81例,运动性失语2例,混合性失语3例.CT示血肿位于额顶叶12例,额叶32例,颞叶5例,顶枕叶8例,颞顶后39例(1例合并对侧脑内血肿,5例合并额颞叶脑挫裂伤).血肿量30～80mL.入院后3～15 d内先给予脱水剂、激素、止血剂、抗生素、脑活性药物、镇痛剂等对症处理保守治疗.     

可溶性抗HAV抗体Fab片段的原核表达

0　引言　甲型肝炎病毒 (HAV)是危害人类健康的致病原之一 ,目前已有多种用于接触前预防的甲肝疫苗 ;但对于接触后预防或短期到 HAV高流行区的旅游者的预防 ,则多采用免疫球蛋白作被动免疫 .在接触后 (14d内 )和潜伏期早期 ,注射免疫球蛋白预防甲肝的有效率达 85 %左右 .血源性免疫球蛋白虽然效价高 ,应用效果好 ,但可能被血源病原体污染 .因此基因工程人源抗体有望成为接触后预防的首选制剂 .我们从人源噬菌体抗体组合文库中筛选到一株甲肝特异性抗体 [1 ] ,在此基础上构建了可溶性表达载体 ,并获得可溶性表达 ,为该抗体的进一步研究打…     

Effect of ASCO/CAP Guidelines for Determining ER Status on Molecular Subtype

Background

Determination of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) status is standard for predicting prognosis and determining treatment options for patients with breast cancer. In 2010, the American Society of Clinical Oncology (ASCO) and College of American Pathologists (CAP) issued guidelines that tumors with ≥1 % positively staining cells should be considered ER positive. Here, we determined how this cutoff relates to molecular subtype.

Methods

Clinicopathological characteristics were compared between ER-negative, ER-positive, and low-ER-staining (1–10 %) tumors using chi-square analysis with P < 0.05 defining statistical significance. Gene expression data were generated for 26 low-ER-staining tumors, and their intrinsic subtype determined. Immunohistochemistry (IHC)-defined surrogate subtypes, using the threshold of positivity defined by ASCO/CAP guidelines, were compared with molecular subtypes.

Results

Low-ER-staining tumors were clinicopathologically more similar to ER-negative than to ER-positive tumors; 88 % of low-staining tumors were basal like or HER2 enriched. Only those tumors expressing 10 % ER-positive cells were classified as luminal A subtype.

Conclusions

Under ASCO/CAP guidelines, tumors with 1–10 % ER staining would be classified as ER positive, yet most are basal like or HER2 enriched and have pathological features similar to ER-negative tumors. Clinical trials seeking to treat tumors of ER-negative basal-like and/or HER2-enriched subtypes should thus not preclude enrollment based solely on results of ER immunohistochemistry. As ER status is a critical element in the choice of treatments for patients with breast cancer, it is imperative that the most effective method for classifying tumors be developed.     

STUDY ON INHIBITION OF PANCREATIC EXOCRINE SECRETION BY SOMATOSTATIN IN RATS

We used a potent and specific monocional antibody to somatostatin to test the physiologoic inhibitory role of the tetradecapeptide somatostation on pancreatic secretion, Somatostatlncreased both the total amylase and vofume of pancreatic sectetion. C.hoIecystokirfin-A receptor antagom smabolished the stimulatory ellect of somatostatin Jmmunoneutralization, We conclude that somatotation tccli-tally inhiblts pancreatic secretion in fasted rats via inhibition of the release or action of cholecystokinin.,Furthermore, the source of these paptides is likely islet delta cells and intrapancxeatie neurons, respectively.     

Control of dumping symptoms by somatostatin analogue in patients after gastric surgery

Octreotide acetate is a long-acting analogue of the naturally occurring inhibitory gastrointestinal peptide, somatostatin. We tested the efficacy of octreotide in controlling the symptoms of dumping syndrome in response to a provocative meal in a randomized, double-blinded, crossover trial in nine severely affected patients. Pretreatment with octreotide acetate (100 micrograms injected subcutaneously) reduced postprandial dumping symptoms from a mean +/- SEM score of 15.7 +/- 1.6 (placebo treatment day) to 4.6 +/- 1.7. With placebo treatment, all nine patients became symptomatic in response to the meal, whereas with octreotide treatment, symptoms occurred in only two of nine patients. Similarly, all placebo-treated patients showed a postprandial increase in pulse rate to a mean +/- SEM of 105 +/- 6 beats per minute, whereas only one of nine octreotide-treated patients showed an increase in pulse rate (mean +/- SEM, 80 +/- 3 beats per minute). These differences were also statistically significant. While no significant changes were observed in postprandial hematocrit values or osmolality between placebo and octreotide treatments, octreotide prevented hypoglycemia in four affected patients and significantly inhibited insulin release. We conclude that octreotide is a useful tool in the treatment of patients with severe, refractory dumping syndrome.