围手术期心脏起搏临床应用探讨

报道５８例非心脏手术的围手术期心脏起搏临床应用,重点讨论围手术期心脏起搏的方法与适应症。认为经静脉右室起搏疗效恒定可靠,适应症范围广。对伴有缓慢型或快速型心律失常的心脏病或潜在心脏病患者,围手术期心脏起搏适应症可适当放宽,以确保麻醉手术顺利进行     

Cancer chemotherapy in the elderly: a series of 51 patients aged>70 years

Summary A total of 2,238 new cancer patients were treated in our institution in 1988; among the 423 (18.9%) who were>70 years old, 51 underwent chemotherapy. The median age was 75.8 years, and the Karnofsky performance status (KPS) was 70% for 40 patients. Malignancies were hematopoietic in 24 cases (47%) and digestive in 15 patients (29%), and 12 subjects (24%) had other types of cancers. The first chemotherapy course was given at the full dose to 23/51 (45.1%) patients. The drug dose was reduced for 28/51 (54.9%) patients, due in 25 cases to the subjects being>70 years old. Neither age, KPS, pretreatment assessment, nor cancer extent was correlated with the modifications made to the first cycle. An overall toxicity of grade 3+4 (WHO grading scale) was noted in 10 subjects (19.6%). Although these elderly patients were probably selected, analysis of their charts did not evidence an increase in chemotherapy toxicity, regardless of the dose they received.Presented at the EORTC Pharmacokinetics and Metabolism Group Meeting, Bordeaux, November 1990     

Intramural hematoma of the esophagus caused by minor head injury 6 hours previously

The diagnosis of extensive intramural hematoma of the esophagus due to a bicycle trauma was considerably delayed because symptoms did not develop until 6 h after the accident. This report underscores the importance of a barium meal and computed tomographic (CT) scan in cases of unexplained chest pain, even after minor trauma.     

1314例育龄妇女缺铁性贫血发病现状调查

目的 :研究育龄妇女缺铁性贫血 (IDA)的发病现状及营养状况与IDA的关系。方法 :检测青岛市城市及农村 1314例妊娠期和非妊娠期育龄妇女的外周血红蛋白浓度 (Hb)、平均红细胞体积 (MCV)、平均红细胞血红蛋白量 (MCH)、血清铁蛋白 (SF) ,并进行个人问卷调查 ,应用营养计算软件评价膳食营养。结果 :1314例育龄妇女IDA发病率为 2 0 .4 0 % ,其中非孕妇的发病率高于孕妇。农村育龄妇女的发病率明显高于城市。孕妇中孕≥ 2 8周组发病率最高 (4 0 % ) ,与其他孕周组相比差异有高度显著性 (P <0 .0 1)。营养评价结果显示非孕妇组热量、维生素A、E、B1、B2 、PP、C的缺乏率高于孕妇组(P <0 .0 0 1)。结论 :农村育龄妇女及孕 2 8周以上的孕妇为IDA高发人群。应加强对农村育龄妇女的膳食营养宣教及指导 ,对孕晚期的孕妇及时采取有针对性的干预措施。     

Benefit and risk of exercise on myocardial function in diabetes.

Regular physical activity promotes cardiorespiratory fitness and has been considered a cornerstone for non-pharmacological treatment of more than 17 million Americans with diabetes mellitus. Physical exercise has been shown to positively affect certain cardiovascular risk factors such as insulin resistance, glucose metabolism, blood pressure and body fat composition, which are closely associated with diabetes and heart disease. With the increasingly sedentary life style in our society, routine daily exercise of moderate intensity is highly recommended to reduce cardiovascular risk, the leading cause of death in diabetic patients. Exercise produces many beneficial effects to the heart function such as reduced incidence of coronary heart disease, attenuated severity of diabetic cardiomyopathy, improved cardiac performance, cardiac reserve and autonomic regulation. Nevertheless, many diabetic patients do not appear to gain much benefit from exercise or may even be at risk of performing physical exercise. This review summarizes the benefit and risk of exercise on diabetic heart function, with a special emphasis on myocardial and autonomic function.     

Use of the humanized anti-epidermal growth factor receptor monoclonal antibody h-R3 in combination with radiotherapy in the treatment of locally advanced head and neck cancer patients.

PURPOSE: To evaluate safety and preliminary efficacy of the humanized anti-epidermal growth factor receptor monoclonal antibody h-R3 in combination with radiotherapy (RT) in unresectable head and neck cancer patients. Secondary end points were the measurement of h-R3 serum levels and the assessment of the potential mechanisms of antitumor effect on patient biopsies. Anti-idiotypic response to h-R3 was assessed. To predict pharmacologic effect, a mathematical model for antibodies recognizing antigens expressed in tumors and normal tissues was built. PATIENTS AND METHODS: Twenty-four patients with advanced carcinomas of the head and neck received six once-weekly infusions of h-R3 at four dose levels in combination with RT. Pretreatment tumor biopsies were obtained to evaluate epidermal growth factor receptor expression as an enrollment criterion. Second biopsies were taken to evaluate the proliferative activity and angiogenesis in comparison with the pretreatment samples. Patient serum samples were collected to measure h-R3 levels and anti-idiotypic response. RESULTS: The combination of h-R3 and RT was well tolerated. Antibody-related adverse events consisted in infusion reactions. No skin or allergic toxicity appeared. Overall survival significantly increased after the use of the higher antibody doses. Immunohistochemistry studies of tumor specimens before and after treatment revealed that antitumor response correlated with antiproliferative and antiangiogenic effect. One patient developed antibodies to h-R3. The mathematical model predicted that the maximum difference between the area under the curve in tumors and normal tissues is reached when the antibody has intermediate affinity. CONCLUSION: h-R3 is a well-tolerated drug that may enhance radiocurability of unresectable head and neck neoplasms.     

Immunogene Therapy of Recurrent Glioblastoma Multiforme with a Liposomally Encapsulated Replication-Incompetent Semliki Forest Virus Vector Carrying the Human Interleukin-12 gene – a phase I/II Clinical Protocol

Journal of Neuro-Oncology -     

环丙氧苷诱导转导有外源HSV—tk基因的C6胶质瘤细胞的 …

目的 观察单纯疱疹病毒胸苷激酶基因（ＨＳＶ－ｔｋ）－环丙氧苷（ＧＣＶ）系统在胶质瘤基因治疗过程中,ＧＣＶ能否诱导转导有ＨＳＶ－ｔｋ基因的胶质瘤细胞凋亡。方法 采用光镜、电镜和荧光显微镜观察转导有ＨＳＶ－ｔｋ基因的大鼠Ｃ６／ｔｋ胶质瘤细胞形态学的改变,以末转导ＨＳＶ－ｔｋ基因的Ｃ６细胞作为对照,并以流式细胞术,ＤＮＡ凝胶电流分析进一步验证细胞凋亡的发生。结果 在５μｇ／ｍｌ ＧＣＶ作用７２ｈ后,Ｃ６     

喉癌组织恶性度与颈淋巴结转移关系

采用五因素评点法对４０例喉鳞癌进行组织学和临床方面的研究。结果表明，组织恶性度与Ｔ分期无相关性，浸润方式弥散及恶性度高（评分≥１１）的肿瘤发生颈淋巴结转移率显著高于有完整肿瘤边界者及恶性度低（评分≤１０）者。提示喉癌组织恶性度在预测颈淋巴结转移上有实用价值，可临导临床治疗方案的选择。     

直流电脉冲刺激豚鼠耳蜗基底膜振动研究

为了在活体上研究哺乳类动物耳蜗基底膜的电－机械特性、将一对铂－铱电极分别置于３０只豚鼠耳蜗底回的前庭阶和鼓阶。用矩形直流脉冲电刺激蜗管，用激光多普勒汛速仪测定电刺激诱发的耳蜗基底膜振动的幅度和速度。结果表明，在听敏度正常豚鼠的耳蜗，电刺激可诱发基底膜向正电极方向位移，其位移波形类似于电脉冲的矩形波。在矩形脉冲的起始沿和结束沿，由于外毛细胞的瞬态反应，可诱发与该部位特征频率一致的共振运动。据分析，这