Mitomycin-C induced hemolytic uremic syndrome: a case report and literature review

Hemolytic uremic syndrome spontaneously arises in a few patients with advanced cancer, but it is more commonly related to the use of certain chemotherapeutic agents. Mitomycin-C is, etiologically, the most common causative agent inducing hemolytic uremic syndrome, in a dose dependent manner. We report this syndrome, attributable to mitomycin-C at a cumulative dose of 40 mg/m2, in a gastric cancer patient. A 42-year-old female with stage III gastric cancer underwent radical gastrectomy and was given mitomycin-C at 10 mg/m2 intravenously every four weeks as adjuvant therapy. Hemolytic uremic syndrome was diagnosed three months after the last dose of mitomycin-C administration. The most prominent symptoms included pallor, hypertension and anasarca, with laboratory evidence of microangiopathic hemolytic anemia, azotemia and hyperkalemia. Her disease was progressive, but fortunately stabilized after staphylococcus column A dialysis. Her disease remained in remission for 24 months from the time of diagnosis, and then relapsed in the form of peritoneal carcinomatosis with partial intestinal obstruction.      

Prevalence and aetiology of neurological impairment in extremely low birthweight infants

Objective : To determine the prevalence and perinatal predictors of cerebral palsy, intellectual impairment, visual impairment and deafness in a cohort of extremely low birthweight (ELBW) infants at two years of age.
Methodology : The study population comprised 199 of the 224 (89%) ELBW infants managed at the Mater's Mothers Hospital, Brisbane, between July 1977 and February 1990 and who survived to two years. The prevalence of cerebral palsy, intellectual impairment, blindness and deafness was measured by clinical, psychometric and audiological assessment and the association with 24 risk factors examined.
Results : Cerebral palsy occurred in 20 children (10%). Risk of cerebral palsy was associated with ventricular dilatation, intraventricular haemorrhage, necrotizing enterocolitis and multiple birth, though only ventricular dilatation (OR 4.41; 95% Cl 1.32-14.8) remained significant in the adjusted analysis. Intellectual impairment occurred in 20 children (10%) and was independently associated with ventricular dilatation (OR 15.0; 95% Cl 2.2-102.8), ventilation F _iO₂ >80% (OR 3.4; 95% Cl 1.01-11.5), vaginal delivery (OR 3.5; 95% Cl 1.09-11.4) and male sex (OR 6.1; 95% Cl 1.67-22.3). No perinatal predictor was statistically associated with risk of deafness. Retinopathy of prematurity (OR 36.9; 95% Cl 2.8-495.5) was associated with risk of later visual impairment.
Conclusions : Intellectual impairment was associated with a broad range of perinatal variables. Cerebral palsy was associated with fewer variables, all of which were also associated with intellectual impairment. Neurologic injury was associated with male sex and multiple birth, which are not biological insults themselves, but may be markers of susceptibility to injury.     

乌头碱对大鼠心肌细胞钙通道阻滞作用的单通道分析

用膜片钳法,在培养的Wistar大鼠心室肌细胞上记录了L型钙通道的单通道活动。乌头碱50μg·ml^-1能显著阻断L型钙通道的活动,使其开放时间缩短、关闭时间延长、开放概率下降。与对照组比较,有显著性统计学差异(P<0.01)。而对通过L型钙通道的钡离于流幅值无明显影响。     

论卫生船舶在登陆作战中的配置

在大规模登陆作战中需要大量的卫生船舶实施各种保障,因此必须对卫生船舶进行合理的配置,保证其既能有效地完成保障任务,又能避免重叠配置造成浪费．卫生船舶的配置应与指挥关系、保障任务战时分类相适应,具体配置时按医院船、卫生运输船、卫生救护艇的保障要求配置,并可根据保障任务的变化进行相应的调整．     

2636例医院感染调查分析

目的 了解医院感染情况,为预防与控制医院感染提供依据.方法 采用前瞻性和回顾性相结合的调查方法,对2010-2012年64431例住院患者进行医院感染调查分析.结果 3年共发生医院感染2636例,医院感染率为4.09％（2 636/64 431）;感染部位以上、下呼吸道感染为主;综合ICU、肾内科、神经内科、内分泌科为感染高发科室;革兰阴性菌仍是医院感染的主要细菌,占52.48％（689/1 313）.结论 加强医院感染管理和医务人员培训、规范消毒隔离、严格无菌操作、减少侵入性操作及合理应用抗菌药物是降低医院感染的有效措施.     

利用化学鉴别反应对药品真伪进行初步判断

利用化学鉴别反应对药品真伪进行初步判断。掌握药品分子结构非常关键。根据药品分子结构，利用化学试剂，借鉴一些专属和常用的鉴别方法，对药品真伪进行初步判断。     

藏药紫金标抗HSV-1的作用机理研究

目的 :探讨紫金标抗单纯疱疹Ⅰ型病毒 (HSV-1)的作用及机理 ,为进一步开发该药提供理论依据。方法 :采用不同剂量的紫金标作用于适量HSV-1感染的Vero细胞 ,以 50%组织细胞感染量 (TCID₅₀ ) ,细胞病变效应(CPE) ,MTT法和核酸分子杂交作为评价指标。结果 :MTT法测得紫金标的 50 %抑制浓度 (IC₅₀ )为 29.46mg·L^-1,50%中毒浓度 (TC₅₀ )为 1 077mg·L^-1,治疗指数 (TI)为 36.56 ,结果表明紫金标有明显抑制HSV-1的作用 ,其作用强度和有效时间与药物浓度成正比。紫金标无直接灭活HSV-1的作用 ,也不能影响病毒的释放 ;但可干扰HSV -1对宿主细胞的吸附。不同浓度的紫金标能明显抑制HSV-1gD基因复制和mRNA表达。结论 :紫金标具有显著的抗HSV-1的作用 ,能抑制HSV-1对宿主细胞的吸附以及抑制HSV-1gD基因复制与转录。     

消痔片质量标准研究

目的:建立了消痔片的质量标准(马勃、薯莨、山豆根、牡砺等).方法:采用TLC法对处方中薯莨、山豆根进行鉴别;用HPLC法测定苦参碱含量.结果:在TLC色谱中均能检出薯莨、山豆根;苦参碱在0.204～2.040μg范围内呈良好线性关系(r=0.9999),平均回收率为97 64%,RSD为1.49%.结论:本方法简便可行,重现性好,为消痔片的质量控制提供了方法.     

c-met癌基因与乳腺癌血管生成的相关性研究

目的探讨原癌基因c-met在乳腺癌血管生成中的作用及其临床意义,为寻求抗人乳腺癌血管生成药物提供依据。方法应用SP免疫组化和计算机图像分析技术,对80例乳腺癌、20例乳腺纤维腺瘤的微血管密度和c-met蛋白表达进行定量测定。结果乳腺癌组织微血管计数、c-met阳性表达与组织学分级、淋巴结转移、肿瘤分期显著相关(P<0．01)。高微血管计数与c-net阳性表达显著相关(P<0．01)。结论原癌基因c-met激活参与调控乳腺癌的肿瘤血管生成,是一重要的预后因素。     

Detailed per-oral small bowel examination vs. enteroclysis. Part II: Radiographic accuracy

Accuracy of the detailed per-oral small bowel series and enteroclysis was compared in 134 patients known to have (or not have) disease of the small bowel. Overall sensitivity of the per-oral examination was 92% and specificity 94%, compared to 94% and 89%, respectively, for enteroclysis. There was no difference between the two in Crohn disease, adhesions, and metastatic disease; however, enteroclysis was thought to be more effective in delineating peritoneal adhesions in patients with obstruction. The authors conclude that while the per-oral study and enteroclysis are equally valid methods of examining the small bowel, the per-oral study is preferable as a screening examination because it requires less time, has fewer side effects, and involves a lower radiation exposure.