吲达帕胺对高血压病患者降压作用的临床研究

３４例高血压病患者服国产吲达帕胺后，血压持续缓慢下降，ＴＰＲ显著下降，血浆肾素活性（ＲＡ）、血管紧张素Ⅱ（ＡＴ－Ⅱ）和醛固酮（ＡＤＳ）浓度显著增高，而心率及血儿茶酚爱（ＣＡ）水平无显著变化。治疗４周对全轿Ｃｄ，Ｐｂ，红细胞（ＲＢＣ）及血浆Ｚｎ，Ｃｕ，Ｎａ，Ｋ，Ｍｇ浓度无显著影响。其总疗效为８８．２４％，表明国产吲达帕胺是一种疗效显著而副作用低的降压药物。     

Retardation of pain development: a case of recovery from congenital insensitivity to pain

Congenital analgesia is a rare genetic disorder. We report here that a 12-year-old boy was able to recover from congenital insensitivity to pain. Neurological examinations revealed that there was a 'stocking' distribution of pain decrement on the lower extremities under the patient's knee joints. Magnetic Resonance Imaging (MRI) of his brain showed gyrus thinning with sulcus widening at both sides of the parietal lobe. Southern blot hybridization probed with cDNAs of various opioid receptors did not detect any significant abnormality. Our results suggest that this rare case may not be genetically determined.     

头皮缺损颅骨外露的修复

我科1980～1991年收治外伤性或颅面部肿瘤切除后头皮缺损颅骨外露9例,分别应用吻合血管的游离大网膜结合中厚皮片移植、游离皮瓣或轴型皮瓣转位结合皮片移植修复。讨论了修复时机、修复方法以及手术注意事项。认为双侧股前外侧游离皮瓣是修复全头皮缺损颅骨外露的可取方法,而吻合血管的游离大网膜移植修复颅骨外露的方法应尽量避免。     

应用羧化胶乳凝集试验诊断人、畜布鲁氏菌病的研究

应用以化学交联法制备的布鲁氏菌１６Ｍ抗原－羧化胶乳制剂的羧化胶乳凝集试验（ＬＡＴ）、试管凝集试验（ＳＡＴ）、虎红平板凝集试验（ＲＢＰＴ）以及酶联免疫吸附试验（ＥＬＩＳＡ）、半胱氨酸凝集试验（ＣＹＴ），对在四省布鲁氏菌病疫区收集的部分人、畜血清中布氏菌抗体进行对比检测。结果表明，ＬＡＴ较之ＲＢＰＴ具有更高的特异性；与ＳＡＴ相比，无论阳性或阴性符合率均较一致。另外，ＬＡＴ可检测血清中ＩｇＧ、ＩｇＭ两类布氏菌特异性抗体。因而本试验对人、畜布病的诊断具有特异、敏感和简便的优点，更宜在基层推广应用。     

Correlation between Cyclin A Gene Expression in Adult Patients with Acute Leukemia and Drug Resistance

Adultacuteleukemia (AL)isoneofthemostcommonmalignanttumorsofhematology .Withtherecentprogressinchemotherapyandsupportivether apy ,theremissionandsurvivalrateinALhavebeenmarkedlyimproved .However ,drugresistanceandrelapsearestillimportantfactorsaffectinglongsur vivalofthese patients .Theabnormalregulationofcellcycleisanotherfactorthatcannotbeignoredex ceptformultipledrugresistance (MDR) .WedetectcyclinA ,multidrugresistantgene (mdrl) ,topoiso meraseⅡα(TopⅡα)andbcl 2inadultpatientswithA…     

乌贼墨诱生小鼠细胞毒因子活性的检测

用乌贼墨处理小鼠后，采集血清。经体外细胞毒实验证明：乌贼墨诱生的血清对人和鼠的肿瘤细胞株均有不同程度的杀伤作用。这一结果提示：乌贼墨可能具有诱生内源性细胞毒因子产生的活性。     

Vaccination of Lewis rats with temperature-sensitive mutants of Mycoplasma pulmonis: adoptive transfer of immunity by spleen cells but not by sera.

Temperature-sensitive mutant vaccines protect rats against Mycoplasma pulmonis infection. The role of the humoral or cellular immune response in resistance to mycoplasma infection was investigated by adoptive-transfer experiments. Spleen cells from Lewis rats vaccinated but not challenged with wild-type organisms (vaccinated) and spleen cells from rats vaccinated (or not) and challenged were effective in preventing syngeneic recipients from developing respiratory disease. There was also a significant reduction in the incidence and number of challenging organisms in the respiratory system. In contrast, sera from the same donors had no detectable effect on the number of mycoplasmas recovered or on lesion development in the respiratory tract. We conclude that cellular immunity rather than humoral immunity generated in vaccinated rats confers protection against subsequent infection.     

MR-Guided percutaneous ethanol ablation of liver tissue in a .2-T open MR system: Preliminary study in porcine model

The purpose of this study was to test the feasibility of MR-guided percutaneous ethanol ablation of liver tissue on a .2-T open MR scanner. Needles were placed by MR guidance first into an ex vivo sheep liver and then into livers of three anesthetized pigs, and injection of 10 ml of 96% alcohol was performed. T1 fast low-angle shot (FLASH), T2 turbo spin echo (TSE), and T1 spin echo (SE) images were obtained after incremental volumes of injection. In one pig, simultaneous injection of saline into normal liver was also performed with subsequent pathological correlation. Ethanol-infiltrated liver was hypointense to liver on all sequences, whereas saline caused no tissue signal changes on T1 SE and either isointense or hyperintense changes on T2 TSE images. Pathological examination confirmed ethanol-induced acute liver changes as compared with the control. MR guidance of needle placement and monitoring of ethanol effects on liver tissue is feasible. This may have implications for potential MR-guided hepatic tumor ablation.     

The pharmacokinetics of lignocaine in humans during a computer-controlled infusion.

Several types of chronic pain syndromes are effectively treated with sodium channel blockers such as lignocaine. Further investigation of this therapeutic modality would be facilitated by refinement of the parameters describing lignocaine distribution and elimination. This would allow precise lignocaine infusion by a computer-controlled infusion to attain and maintain stable target lignocaine concentrations. Arterial blood samples were obtained at frequent intervals during a computer-controlled infusion of lignocaine in 12 adult human volunteers. Plasma lignocaine concentrations of 1, 2, 3, 4 and 5 microg/ml were targeted for 15 min at each concentration. A three-compartment mammillary pharmacokinetic model best described the resulting concentration vs time profile. A population pharmacokinetic analysis was performed using three different techniques; the two-stage, pooled and mixed effects modelling. There was marked overshoot of the plasma concentration above the target prior to refinement of the pharmacokinetic parameters. The best parameters of a three-compartment mammillary model fit to the measured concentration using the pooled data approach were: V(1) = 7.44, V(2) =11.5 and V(3) = 97.71; Cl(1) = 0.585, Cl(2) = 2.23 and Cl(3) =1.64 l/min. Similarly calculated parameters using NONMEM were V(1) = 6.99, V(2) =12.2 and V(3) =1341; Cl(1) = 0.703, Cl(2) =1.24 and Cl(3) =1.49 l/min. The addition of age as a covariate of the pharmacokinetic parameters improved the model in both cases. Height, lean body mass and body surface area as covariates of the pharmacokinetic parameters did not improve the predicted value of the model. Prospective testing of the pharmacokinetic parameters will be required to define whether they function well. The refinement of pharmacokinetic parameters for the computer-controlled intravenous infusion of lignocaine will facilitate further research in pain therapy. Published lignocaine pharmacokinetic values have a relatively large central volume of distribution, and hence, when implemented as a computer-controlled infusion, result in dramatic overshoot shortly after targeting a higher plasma concentration. In light of the long-lasting pain relief provided by sodium channel blockade in neuropathic pain states, overshoot of plasma concentrations must be avoided if the concentration vs effect relationship is to be defined.     

Pulmonary embolism.

Pulmonary embolism (PE) is an important health problem and often a major clinical challenge, not only because of the low specificity of its clinical manifestations but also because of the increasing number of medical circumstances that are risk factors for this illness and the importance of early identification, since prompt and appropriate treatment can decrease mortality from this disease by about 25%. In recent years research on PE has been extensive, directed mainly at trying to determine and characterize its risk factors, establish new clinical probability algorithms, develop new diagnostic methods and put existing ones into perspective, seek new therapeutic approaches (pharmacological and non-pharmacological), and above all establish protocols that can guide the clinician from the stage of clinical suspicion to measures to prevent recurrence. It was the authors' aim to review the most significant literature on this subject, in order to produce a text that reflects the state of the art concerning PE and that can be used as a guide in the clinical approach to this pathology.