护士配制表柔比星致自身变态反应1例

表柔比星为半合成的第2代蒽环类抗生素，为多柔比星的同分异构体，4-位置上的羟基由顺式变为逆式。这种立体结构上的细微变化提高了抗肿瘤的治疗指数，且降低了骨髓和心脏的毒性。因此，该药目前临床上广泛用于抗肿瘤的治疗。但我院1名护士在配制表柔比星时出现变态反应，现介绍如下。     

Health status,work limitations,and return-to-work trajectories in injured workers with musculoskeletal disorders

BACKGROUND: The purpose of this study was to describe the health status and work limitations in injured workers with musculoskeletal disorders at 1 month post-injury, stratified by return-to-work status, and to document their return-to-work trajectories 6 months post-injury. METHODS: A sample of 632 workers with a back or upper extremity musculoskeletal disorder, who filed a Workplace Safety and Insurance Board lost-time claim injury, participated in this prospective study. Participants were assessed at baseline (1 month post-injury) and at 6 months follow-up. RESULTS: One month post-injury, poor physical health, high levels of depressive symptoms and high work limitations are prevalent in workers, including in those with a sustained first return to work. Workers with a sustained first return to work report a better health status and fewer work limitations than those who experienced a recurrence of work absence or who never returned to work. Six months post-injury, the rate of recurrence of work absence in the trajectories of injured workers who have made at least one return to work attempt is high (38%), including the rate for workers with an initial sustained first return to work (27%). CONCLUSIONS: There are return-to-work status specific health outcomes in injured workers. A sustained first return to work is not equivalent to a complete recovery from musculoskeletal disorders.     

Synthesis of 14C‐labeled piperidines and application to synthesis of [14C]SCH 351125, a CCR5 receptor antagonist

1‐Benzyl‐4‐hydroxy[2‐¹⁴C]piperidine, a useful intermediate in labeled compound synthesis, was prepared from [¹⁴C]formaldehyde in high yield. The distribution pattern of ¹⁴C in the product is consistent with a mechanism involving reversible iminium ion formation and rapid equilibration of the iminium ion through a cationic aza‐Cope rearrangement. These steps precede the rate‐determining intramolecular cyclization step. SCH 351125 is a potent, selective CCR5 receptor antagonist with potential as a treatment for HIV infection. [¹⁴C]SCH 351125, required for metabolism studies, was prepared from 1‐benzyl‐4‐hydroxy[2‐¹⁴C]piperidine in six steps. [¹⁴C]SCH 351125 is a mixture of four atropisomers. Preparation of [¹⁴C]SCH 351125 besylate salt of the desired atropisomer pair is also described. Copyright © 2007 John Wiley & Sons, Ltd.     

FM sonography in diffuse liver disease: prospective assessment and blinded analysis

FM sonography - a signal-processing technique that uses frequency and phase information as well as amplitude data - shows promise in evaluation of patients with diffuse liver disease. In a prospective blinded review of 37 patients with biopsy-proved liver disease and 42 healthy volunteers, FM sonography was clearly superior to traditional amplitude-based (AM) sonography in distinguishing healthy from diseased subjects. Statistically significant differences were seen in accuracy (FM, 98.7%; AM, 84.8%), sensitivity (FM, 97.3%; AM, 70.3%), and negative predictive value (FM, 97.7%; AM, 78.8%). Our data also suggest that current FM sonographic techniques cannot differentiate among histologic findings associated with different hepatic parenchymal abnormalities. It is unclear, therefore, whether FM imaging can reduce the numbers of patients who require biopsy for diagnosis or the frequency of biopsy procedures in patients with known disease.     

Lack of spontaneous activity of cutaneous spinal dorsal horn neurons in awake, drug-free, spinally transected cats

Extracellular single-unit activity was recorded from neurons with cutaneous input in the dorsal horn of the spinal cord (L4-L6) of awake, drug-free cats before (for several weeks) and after (day 1 through day 7) cord transection (T12). The spontaneous activity of the neurons was minimal or nonexistent in both recording conditions. The lack of spontaneous activity following spinal cord transection contrasts sharply with activity recorded in acute spinal-cord transected preparations in which high rates of spontaneous activity have been reported. This discrepancy may reflect an important difference between the chronic, awake, drug-free and acute preparations.     

扩张型心肌病与β1 受体自身抗体关系初探

目的 探讨抗β1受体自身抗体与扩张型心肌病（DCM）之间的关系。方法 以人心脏β1受体细胞外第二环表位肽段作为抗原，应用酶联免疫吸附测定（ELISA）技术，检测28例DCM患者和32例正常人血清中β1受体的自身抗体。结果 DCM患者血清中有13例（46％）抗β1受体自身抗体阳性，正常人血清中有2例（6％），两组阳性率差异有显著性（P＜0．01）；DCM组自身抗体平均几何滴度为1：92，显著高于正常对照组1：20（P＜0．01）；DCM患者中自身抗体阳性者的抗体滴度在不同心功能间的分布差异有显著性（P＜0．001）。结论 DCM患者存在着β1受体自身抗体且其滴度也明显高于正常对照组。     

血清TPS浓度在消化道肿瘤中价值的研究

共选择３０例消化道肿瘤病人，其中食管癌，胃癌，大肠癌各１０例，设健康献血者３０例，对两组血清特异型组织多肽抗原浓度进行了检测，结果肿瘤组血清ＴＰＳ浓度明显高于健康人。消化道肿瘤阳性检出经达７０％，其中食管癌８０％，胃癌６０％，大肠癌７０％。消化道肿瘤合并淋巴转移阳性检出率达７６．９％，其中食管癌１００％，胃癌６６．７％，大肠癌７０．０％。随着病程发展，血清ＴＰＳ浓度呈现升高趋势。     

血康口服液与他莫昔芬联合治疗免疫性血小板减少性紫癜疗效观察

联合应用血康口服液和他莫昔芬治疗成人免疫性血小板减少性紫癜(ITP)20例。疗程超过2月。15例患者的血小板(BPC)计数明显上升,有效率为75％(15/20),对于激素治疗无效者,仍有良效。对月经过多者和不适合应用激素者尤为适应。两药合用无明显副作用。治疗起效时间较快,平均13天。疗效持续时间较长,长者已达一年以上。