Lymph node metastases and prognosis in penile cancer

Lymph node status is a key prognostic factor in penile squamous cell carcinoma. Recently, growing evidence indicates a multimodality approach consisting of neoadjuvant chemotherapy followed by consolidation surgery improves the outcome of locally advanced penile cancer. Thus, accurate estimation of survival probability in node‐positive penile cancer is critical for treatment decision making, counseling of patients and follow‐up scheduling. This article reviewed evolving developments in assessing the risk for cancer progression based on lymph node related variables, such as the number of metastatic lymph nodes, bilateral lymph node metastases, the ratio of positive lymph nodes, extracapsular extension of metastatic lymph nodes, pelvic lymph node metastases, metastatic deposit in sentinel lymph nodes and N stage in TNM classification. Controversial issues surrounding the prognostic value of these nodal related predictors were also discussed.     

临床药师参与外科术后耐药菌感染药物治疗的病例分析

摘 要 目的：通过参与外科术后耐药菌感染会诊的案例分析,探讨临床药师在外科抗感染药物治疗中的作用。方法: 临床药师根据指南及掌握的抗菌药物抗菌谱与药动学特点,协助临床医师参与患者术后抗感染方案的制定,开展药学监护。结果: 临床药师参与外科术后耐药菌感染会诊后,3例术后感染患者均获痊愈。结论: 临床药师在外科治疗团队中的药学监护作用不可忽视。     

大黄联合血液净化治疗鱼胆中毒并发多脏器功能障碍综合征

摘 要 目的:评价大黄联合血液净化治疗鱼胆中毒并发多脏器功能障碍综合征的临床疗效和安全性。方法: 采用回顾性分析方法,37例血液净化治疗鱼胆中毒患者为对照组,32例大黄联合血液净化治疗鱼胆中毒患者为治疗组,比较2组受损脏器恢复情况、治愈率、病死率及药品不良反应等。结果:2组患者治疗后21 d血尿素氮、血肌酐、N-乙酰β-D氨基葡萄糖苷酶、尿量恢复率、ALT、AST、总胆红素、直接胆红素,少尿期恢复时间、消化系统损伤恢复例数,凝血酶原时间、血小板（第7天）,痊愈时间、治愈率等指标比较,差异均有统计学意义（P＜0.05）。结论:大黄联合血液净化治疗鱼胆中毒并发多脏器功能障碍综合征疗效优于单纯血液净化治疗。     

东革阿里不同提取物抗高尿酸血症的实验研究

摘 要 目的：考察东革阿里不同提取物对高尿酸血症大鼠尿酸排泄以及肾脏功能的影响。方法: 将60只雄性Wistar大鼠均分为空白组、模型组、阳性对照组、氯仿组、乙酸乙酯组和正丁醇组,灌胃大鼠酵母膏、腺嘌呤和氧嗪酸钾制作大鼠高尿酸血症模型。造模成功后,除空白组以外的其他组继续给予造模剂,除模型组外的其他组在给予造模剂1h后分别给予相应的药液,给药14 d,检测大鼠血清和尿液中的尿酸（UA）、尿素氮（UN）及肌酐（Cr）水平、肝脏及血清中的黄嘌呤氧化酶（XOD）活性等指标。结果:与模型组相比,氯仿组和正丁醇组血清尿酸、肌酐水平显著降低（P<0.05）,尿液尿酸、肌酐水平显著升高（P<0.05）,XOD活性显著降低（P<0.01）。与阳性对照组相比,氯仿组、乙酸乙酯组、正丁醇组血清和尿UA、Cr、UN水平以及血清和肝脏XOD活性等指标均无显著性差异（P＞0.05）。氯仿组、乙酸乙酯组、正丁醇组血清和尿UA、Cr、UN水平以及血清和肝脏XOD活性等指标均无显著性差异（P＞0.05）。结论:东革阿里氯仿萃取物、正丁醇萃取物能降低腺嘌呤、酵母膏和氧嗪酸钾引起的高尿酸血症大鼠血尿酸水平,可能是通过抑制黄嘌呤氧化酶活性来发挥降尿酸作用。     

Regulation of aromatase activity of rat granulosa cells: induction of synthesis of NADPH-cytochrome P-450 reductase by FSH and dibutyryl cyclic AMP

Aromatase is an enzyme complex that is composed of a specific form of cytochrome P-450 and a flavoprotein, NADPH-cytochrome P-450 reductase. Aromatase activity of granulosa cells is increased markedly by follicle-stimulating hormone (FSH) and by analogs of cyclic AMP. It was the objective of the present study to investigate the effects of FSH and dibutyryl cyclic AMP (Bt₂cAMP) on the synthesis of NADPH-cytochrome P-450 reductase in rat granulosa cells maintained in vitro. Granulosa cells were obtained from the ovaries of diethylstilbestrol (DES)-treated immature rats and were incubated in the presence of DES (10⁻⁷ M), DES + FSH (250 ng/ml), or DES + Bt₂cAMP (1 mM) for up to 72 h. After 72 h of incubation, aromatase activity of cells incubated with DES alone was 5 pmoles estrogen formed 2 h⁻¹ mg⁻¹ protein and was increased > 60-fold in cells incubated with FSH or Bt₂cAMP. NADPH-cytochrome P-450 reductase was immunoisolated from [³⁵S]methionine-labeled lysates of granulosa cells incubated for 72 h in the absence or presence of stimulatory factors. The rate of synthesis of reductase was found to be increased about 3-fold in cells incubated with DES + FSH or DES + Bt₂cAMP as compared to cells incubated with DES alone. By immunoblot analysis we found that the cellular content of reductase was increased about 2-fold by FSH and Bt₂cAMP treatment. Reductase specific activity was 10 nmoles min⁻¹ mg⁻¹ protein in membrane fractions of DES-treated cells and was increased 1.6-fold by FSH treatment. These findings are indicative that FSH increases the rate of synthesis, cellular content and specific activity of NADPH-cytochrome P-450 reductase in rat granulosa cells in vitro. The finding that Bt₂cAMP causes a similar induction of reductase synthesis is suggestive that the stimulatory effect of FSH on this component of the aromatase enzyme complex is mediated by an increase in cyclic AMP formation.     

Aflatoxin metabolism in humans: detection of metabolites and nucleic acid adducts in urine by affinity chromatography.

A high-affinity IgM monoclonal antibody specific for aflatoxins was covalently bound to Sepharose 4B and used as a preparative column to isolate aflatoxin derivatives from the urine of people and experimental animals who had been exposed to the carcinogen environmentally or under laboratory conditions. Aflatoxin levels were quantified by radioimmunoassay and high-performance liquid chromatography after elution from the affinity column. In studies on rats injected with [14C]aflatoxin B1, we identified the major aflatoxin-DNA adduct, 2,3-dihydro-2-(N7-guanyl)-3-hydroxy-aflatoxin B1 (AFB1-N7-Gua), and the oxidative metabolites M1 and P1 as the major aflatoxin species present in the urine. When this methodology was applied to human urine samples obtained from people from the Guangxi Province of China exposed to aflatoxin B1 through dietary contamination, the aflatoxin metabolites detected were also AFB1-N7-Gua and aflatoxins M1 and P1. Therefore, affinity chromatography using a monoclonal antibody represents a useful and rapid technique with which to isolate this carcinogen and its metabolites in biochemical epidemiology and for subsequent quantitative measurements, providing exposure information that can be used for risk assessment.     

高温及游泳对腹腔巨噬细胞的影响

我们采用电子显微镜等技术研究了高温及游泳对SD大鼠腹腔巨噬细胞超微结构和功能的影响。结果表明外界高温(40℃)能使大鼠体温急剧升高(Y=0.05074+37.92),游泳时间明显缩短(P<0.01),显著抑制巨噬细胞变形、游走及吞噬能力,促进巨噬细胞出现空泡变性,游泳能加重上述变化。在受热后24h,巨噬细胞吞噬能力基本恢复,而空泡变性无明显改变。     

儿童脱髓鞘病变CT形态学改变在诊断中的意义（附九例分析）

笔者报道了经ＣＴ检查的９例脱髓鞘病变。这些病例中脱髓鞘病变的ＣＴ形态学分布有一定的特异性，有利于进一步定性。其中肾上腺脑白质营养不良（ＡＬＤ）６例；ＡＬＤ－Ｉ型３例，伴病变区钙化１例；ＡＬＤ－Ｉ型和ＩＩ型兼有者２例；单纯侧脑室三角区周围钙化者１例。Ａｌｅｘａｎｄｅｒ病２例：临床伴巨脑，ＣＴ表现为以额部为主的脑白质病变。Ｃｏｃｋａｙｎｅ综合征１例：有特殊的临床表现，这是诊断该病的依据；ＣＴ表现为颅内多发弥漫对称性钙化伴脑白质数量减少。本文还对病理改变与ＣＴ表现之间的关系以及若干脱髓鞘病变的鉴别作了讨论。     

小剂量γ线照射及合并噪声暴露对豚鼠外周血NK细胞活性的影响

实验研究了小剂量γ线照射及合并噪声暴露对脉鼠外周血ＮＫ细胞活性的影响。结果表明，单纯γ线照射和单纯噪声暴露组动物外周血ＮＫ细胞活性较对照组部有一定程度的增高，其中尤以后者为明显。但噪声暴露对γ线照射引起的ＮＫ细胞活性无明显影响；而γ线照射对噪声暴露引起的ＮＫ细胞活性却表现有一定的拮抗作用，其机理有待探讨。     

门脉高压静脉曲张的CT诊断

本文分析了３０例门脉高压症的ＣＴ表现，包括食管静脉、食管周围静脉，奇静脉及奇静脉，小网膜静脉曲张，脐周静脉，脾静脉扩张，以及肝硬化门脉高压症的其他伴随异常，ＣＴ尽管不是诊断食管静脉曲张有首选方法，但在它判定门脉高压和食管周围静脉曲张以及奇静脉，半奇静脉系统，小网膜及后腹膜静脉曲张在存在和范围方面明显优于食管钡餐检查，因此，ＣＴ是诊断门脉高压静脉曲张的一种重要补充方法。