Unusual Delayed Manifestation of a Penetrating Chest Trauma

Abstract Pericardial tamponade remains a diagnostic challenge to the clinician especially when the patient is well compensated hemodynamically. We report an unusual case who sought medical help 1 month after having been stabbed in his chest. An investigation revealed a perforation of the myocardium and a pericardial tamponade. The patient survived thanks to a large organized clot that plugged the perforation. The patient was exposed to increased risk due to delayed onset, recognition, and therapy of the tamponade. Most reports on this subject deal with acute pericardial tamponade. Only few cases of delayed pericardial tamponade have been reported. A review of the relevant literature and the therapeutic approaches are discussed.     

Value of serum progesterone for ectopic pregnancy in therapeutic effect monitoring]

OBJECTIVE: To study the value of serum progesterone in selecting the candidate patients with ectopic pregnancy (EP) for methotrexate (MTX) treatment and in monitoring the effect of the treatment. METHODS: Thirty-seven EP patients who were given single-dose intramuscular injection with 50 mg/m2 MTX were divided into success and failure groups according to the effect of the treatment. The serum progesterone concentrations in these patients were measured and compared between the 2 groups, and the receiver-operator curves (ROC) were used to determine the critical serum progesterone levels for assessing the effect of MTX treatment. The time consumed respectively by serum progesterone and beta-human chorionic gonadotrophin (beta-hCG) decreasing to below normal level was also compared. RESULTS: The serum progesterone concentrations of the success group (7.93+/-2.02 ng/ml) were significantly lower than those of the failure group (14.53+/-1.72 ng/ml, P<0.05). The recommended critical level for assessing the effect of MTX treatment for EP patients was 11 ng/ml according to the ROC, and the time for serum progesterone decreasing to below normal level was significantly less than that for beta-hCG. CONCLUSION: Serum progesterone can be used as an index for selecting candidate EP patients for MTX treatment, and also as a good indicator for assessing the therapeutic effect after treatment.     

大鼠脑内儿茶酚胺类递质及其代谢物的同时提取及反向高效液相测定法

目的建立一种操作简便、高效的测定脑组织中去甲肾上腺素(NA)、肾上腺素(AD)、多巴胺(DA)、3,4二羟基苯乙酸(DOPAC)及高香草酸(HVA)的方法,为有关药物作用机理的研究提供实验手段.方法以有机溶剂提取,高效液相色谱--电化学检测器(HPLC-EC)测定大鼠纹状体、皮质、下丘脑NA、AD、DA、DOPAC及HVA的含量.结果测得NA、AD、DA、DOPAC及HVA的绝对回收率依次分别为:80.3%±12.4%,86.5%±14.3%,90.3%±12.1%,89.5%±17.2%、87.6%±[13].2%.线性范围0.2～20ng,批内与批间变异系数分别小于8%及10%.结论该方法具有简便、迅速、回收率较高的特点,便于实验室应用.     

神经生长因子基因转染联合强化铁营养防治豚鼠爆震性聋的实验研究

Objective To study the protective effects of adenovirus-mediated human beta-nerve growth factor gene (hNGFβ) transfer combined with iron fortified nutrition on blast hearing damage in guinea pigs. Methods Deafness was induced by blast (172dB SPL) in 35 healthy guinea pigs. Seven days after noise exposure, 10 guinea pigs were inoculated with adenovirus-mediated hNGFβ (Ad-hNGFβ) into the perilymphatic space (the gene group), another 10 guinea pigs were given hNGFβ combined with iron fortified nutritional diet (the combination group), still another 10 guinea pigs were inoculated with artificial perilymphatic fluid (APF), and 5 guinea pigs served as control, given neither medicine nor noise exposure. Auditory brainstem response (ABR) threshold shifts were monitored in the guinea pigs before blast exposure and after gene transfer. Changes in cochlear morphology were examined with immunohistochemical and HE staining. Results One week after successful inoculation of hNGFβ, it was noted that Ad-hNGFβ protein was expressed in each turn of the cochlea, and its intensity was almost equal. After gene transfer in the combination group and the gene group, ABR threshold shifts at week 1 and 4 were significantly smaller than those of the APF group. HE staining showed that the number of the spiral ganglion cells in the combination group and the Ad-hNGFβ group was significantly higher than that of the control group after 4 weeks (P<0.01). Conclusions Ad-hNGFβ combined with iron fortified nutritional diet was effective in the prevention and treatment of blast hearing damage of cochlear hair cells.     

Closed to reason: time for accountability for the International Narcotic Control Board

For more than two decades, the International Narcotic Control Board (INCB) has tried to stop harm reduction and its HIV prevention programs. This posture is based on a fundamental misunderstanding of their responsibilities and of drug addiction itself – i.e. as a public health and clinical care matter made criminal by decree. A recent focal point for the Board's action has been rejecting the use of supervised injection facilities to reduce morbidity and mortality of drug injectors. They single out individual countries and attempt to bully them into rejecting such programs under the banner of the United Nations (falsely) and in the name of international treaties. Their unrelenting and unjustified badgering of signatories to the international treaties that established the INCB is not only unjustified; it is an affront to one of the core purposes of the Board itself: to ensure adequate medical supplies and safe use of controlled substances. The INCB's ill-conceived obsession with intravenousaddiction as a crime flies in the face of the medical view and policies of the World Health Organization and the universally endorsed principles of the General Assembly of the United Nations.     

简单灵敏的免疫复合物抗原特异性固相酶联检测法

本文将聚乙二醇(PEG)比浊法和固相酶联免疫法(ELISA)结合,建立了—较灵敏的免疫复合物(IC)直接固相吸附抗原特异性检测法。利用牛清蛋白(BSA)为已知抗原组份的IC模型,分别对IC直接固相吸附的条件和影响因素、方法的灵敏度、重复性等进行了研究。结果发现IC在解离状态下直接固相吸附后的抗原特异性检测灵敏度明显高于未解离者。该法具有简单易行,灵敏度较高、适于临床测定大量血清样品等优点。     

肾动脉狭窄支架植入术的临床疗效观察

目的探讨肾动脉狭窄支架植入术的临床疗效.方法1997年1月～2004年12月,我院行支架介入治疗肾动脉狭窄27例.对27例术前、术后及随访期内血压、肾功能以及生活质量进行评估,并与同期单纯药物治疗肾动脉狭窄27例进行比较.结果介入组27例植入支架40枚,手术成功24例(88.9%,24/27),失败3例(11.1%,3/27),手术并发症5例(18.5%,5/27).术后在血压下降(包括收缩压舒张压)肌酐下降,肾小球滤过率增加方面,介入组获益率明显优于药物组,两组比较差异均有显著性,术后随访6个月～8年6个月,中位数为1年9个月,介入组有19例能比较健康的生活和工作,药物组仅12例能维持生活和工作.结论支架介入治疗较单纯药物治疗肾动脉狭窄疗效显著.     

Similar motion of a hand-held object may trigger nonsimilar grip force adjustments.

The tight coupling between load (L) and grip (G) forces during voluntary manipulation of a hand-held object is well established. The current study is to examine grip-load force coupling when motion of the hand with an object was either self-generated (voluntary) or externally generated. Subjects performed similar cyclic movements of different loads at various frequencies with three types of manipulations: 1) voluntary oscillation, 2) oscillating the right arm via the pulley system by the left leg (self-driven oscillation), and 3) oscillating the arm via the pulley system by another person (other-driven oscillation). During the self-generated movements: 1) the grip forces were larger and 2) grip-load force modulation was more pronounced than in the externally generated movements. The G-L adjustments are not completely determined by the mechanics of object motion; nonmechanical factors related to movement performance, for instance perceptual factors, may affect the G-L coupling.