嗜铬细胞瘤手术治疗(附120例报告)

９７３年９月至１９９５年６月手术治疗嗜铬细胞瘤１２０例，其中良性１１３例（９４０％），恶性７例（５９％）。Ｂ超、ＣＴ对肾上腺嗜铬细胞瘤的诊断率分别为８９０％、９７０％。强调充分的术前准备，严密的术中及术后监测是手术治疗的三个重要环节。本组无症状嗜铬细胞瘤占７５％。恶性嗜铬细胞瘤的治疗仍以手术治疗为主。     

Lacosamide as treatment of epileptic seizures – cost utility results for Sweden

Bolin K, Berggren F, Forsgren L. Lacosamide as treatment of epileptic seizures – cost utility results for Sweden.
Acta Neurol Scand: 2010: 121: 406–412.
© 2010 The Authors Journal compilation © 2010 Blackwell Munksgaard. Objectives – To calculate cost per additional quality‐adjusted life‐year (QALY) for lacosamide as adjunctive treatment for patients with uncontrolled partial‐onset seizures as compared to no adjunctive treatment. Materials and methods – A decision‐tree simulation model was constructed to calculate the number of seizures and health‐care utilization for treated and untreated with lacosamide, respectively. Prices from 2007 were used for all costs. Results – All results were calculated for a 24‐, 18‐, 12‐ and 6‐months follow‐up. The cost per additional QALY was estimated to € 27,641 (24 months). Using a willingness‐to‐pay threshold for a QALY of € 50,000 the net marginal value of using lacosamide was estimated to about € 850,000 per 1000 patients. Conclusions – The estimated cost per QALY gained falls within the range of reported estimates of the willingness‐to‐pay for an additional QALY. The results imply that lacosamide is cost‐effective in the treatment of uncontrolled partial‐onset seizures (1 € ≈ 9.6 SEK).     

Internalization of Libby amphibole asbestos and induction of oxidative stress in murine macrophages.

The community members of Libby, MT, have experienced significant asbestos exposure and developed numerous asbestos-related diseases including fibrosis and lung cancer due to an asbestos-contaminated vermiculite mine near the community. The form of asbestos in the contaminated vermiculite has been characterized in the amphibole family of fibers. However, the pathogenic effects of these fibers have not been previously characterized. The purpose of this study is to determine the cellular consequences of Libby amphibole exposure in macrophages compared to another well-characterized amphibole fiber; crocidolite asbestos. Our results indicate that Libby asbestos fibers are internalized by macrophages and localize to the cytoplasm and cytoplasmic vacuoles similar to crocidolite fibers. Libby asbestos fiber internalization generates a significant increase in intracellular reactive oxygen species (ROS) as determined by dichlorofluorescein diacetate and dihydroethidine fluorescence indicating that the superoxide anion is the major contributing ROS generated by Libby asbestos. Elevated superoxide levels in macrophages exposed to Libby asbestos coincide with a significant suppression of total superoxide dismutase activity. Both Libby and crocidolite asbestos generate oxidative stress in exposed macrophages by decreasing intracellular glutathione levels. Interestingly crocidolite asbestos, but not Libby asbestos, induces significant DNA damage in macrophages. This study provides evidence that the difference in the level of DNA damage observed between Libby and crocidolite asbestos may be a combined consequence of the distinct chemical compositions of each fiber as well as the activation of separate cellular pathways during asbestos exposure.     

二阶导数光谱法测定海仙灵口服液中甲硝唑含量

目的:建立二阶导数光谱法测定海仙灵口服液中甲硝唑含量的方法。方法:用二阶导数光谱法直接测定海仙灵口服液中甲硝唑含量,276.8nm波长处测定振幅D值。结果:甲硝唑在5.15～25.75μg·ml~(-1)范围呈良好线性关系;其回归方程为D=0.835×10~(-4)C-1.1×10~(-4)(r=0.9970),平均回收率99.71%、RSD=2.39%(n=5)。结论:本方法操作简单、准确,可用于测定海仙灵口服液中甲硝唑含量。     

电化学法研究抗癌药物与DNA的作用

目的研究抗癌药物(Schiff碱配合物)与DNA的作用情况,探讨其与DNA的作用机制,为抗癌药物的筛选提供依据。方法用循环伏安法、交流阻抗法、微分脉冲法三种电化学研究方法研究自合成的schiff配合物的电化学性质及其与DNA的作用机制。结果此Schiff碱配合物在0.4和-0.8V分别出现一个灵敏的氧化峰和还原峰。当加入一定量的DNA时,配合物的氧化还原峰电流明显降低,扩散系数减小,电化学反应电阻增大。结论该配合物与DNA的作用较强,作用模式可能为部分插入作用。     

Evaluation of the rice breath hydrogen test for small intestinal bacterial overgrowth

OBJECTIVES: The aims of this study were 1) to document the sensitivity, specificity, and predictive values of the rice breath hydrogen test for small intestinal bacterial overgrowth; 2) to determine the possible influence of concurrent gastric bacterial overgrowth and gastroduodenal pH on the efficacy of this test; and 3) to investigate whether reliability is limited by an inability of small intestinal luminal flora to ferment rice or its product of hydrolysis, maltose. METHODS: Twenty adult subjects were investigated with microbiological culture of proximal small intestinal aspirate and a 3-g/kg rice breath hydrogen test. Gastroduodenal pH, the presence or absence of gastric bacterial overgrowth, and the in vitro capability of small intestinal luminal flora to ferment rice and maltose, its product of hydrolysis, were determined. RESULTS: Sensitivity of the rice breath hydrogen test for small intestinal bacterial overgrowth was 33% and remained low even when subjects with small intestinal overgrowth with oropharyngeal-type (38%) and colonic-type flora (20%) and those with concurrent small intestinal and gastric bacterial overgrowth (40%) were considered separately. Sensitivity remained suboptimal despite favorable gastroduodenal luminal pH and documented ability of bacterial isolates to ferment rice and maltose in vitro. Specificity of the rice breath hydrogen test for small intestinal bacterial overgrowth was 91%. Positive predictive value, negative predictive value, and predictive accuracy were 75%, 63%, and 65%, respectively. CONCLUSIONS: Clinical value of the rice breath hydrogen test for detecting small intestinal bacterial overgrowth is limited. The rice breath hydrogen test is not a suitable alternative to small intestinal intubation and culture of secretions for the detection of small intestinal bacterial overgrowth.     

煮沸对自来水有机浓集物致突变性的影响

本文通过Ames试验观察了以地面水为源水的H市自来水,经煮沸后其致突变性的变化情况。结果见到,自来水有机浓集物的致突变活性,随着沸腾持续时间的延长而上升。经色/质谱仪分析,亦见有新的化合物生成。     

蛇葡萄根化学成分的研究

从蛇葡萄Ampelopsissinica根中分得6个成分,经光谱分析鉴定为羽扇豆醇,β-谷甾醇,胡萝卜甙,儿茶素,蔗糖,棕榈酸。羽扇豆醇系首次从该属发现。     

子宫动脉栓塞术治疗子宫肌瘤的疗效观察

目的探讨子宫动脉栓塞术治疗子宫肌瘤的临床效果。方法采用超选择性子宫动脉栓塞术治疗8例子宫肌瘤患者。用Seldinger技术穿刺股动脉，将导管选择性插至双侧子宫动脉，经导管注入PVA颗粒或真丝线段，阻断肿瘤血供。结果经血管造影发现，子宫肌瘤瘤体血供丰富，均由双侧子宫动脉供血，栓塞双侧子宫动脉后，肿瘤血供完全阻断。治疗后随访3-6mo，临床症状明显缓解，月经量及月经周期恢复正常，肌瘤和子宫体积明显缩小。结论子宫动脉栓塞术治疗子宫肌瘤简便易行，创伤小，临床效果肯定，值得大力推广。     

子宫颈癌介入治疗的价值初探

目的探讨经导管子宫动脉灌注化疗并栓塞治疗子宫颈癌的临床价值。方法研究对象为40例Ib2-Ⅲa期子宫颈癌患者，化疗药物为DDP30mg、5-Fu0．75g、ADM30mg。采用Seldinger技术穿刺右股动脉，作超选择性子宫动脉灌注化疗并栓塞。结果总有效率为87．5％。28例患者在治疗后进行了子宫根治术＋盆腔淋巴结清扫术。术中出血减少，手术时间缩短。结论经导管子宫动脉灌注化疗并栓塞治疗可为巨块型子宫颈癌及邻近有浸润的不能手术的大部分子宫颈癌患者行子宫根治术创造条件，并降低手术难度。