复方苦参结肠溶胶囊治疗溃疡性结肠炎11例

[目的]观察复方苦参结肠溶胶囊对溃疡性结肠炎(UC)的治疗作用。[方法]将18例UC患者随机、单盲、阳性平行对照分为复方苦参结肠溶胶囊组(治疗组,11例)和柳氮磺吡啶组(对照组,7例),服药时间均为8周。对比观察2组患者服药前后的症状、体征、大便常规、结肠镜和病理检查,并监测肝肾功能、血尿常规、心电图等变化。[结果]治疗组症状、体征、大便常规、结肠镜和病理检查结果评分均优于对照组(P<0.05)。[结论]复方苦参结肠溶胶囊对UC有较好的治疗作用,且无明显的不良反应,值得临床推广运用。     

新生儿和小婴儿危重先天性心脏病急诊手术

目的探讨新生儿和小婴儿危重先天性心脏病急诊手术的必要性及提高手术疗效的措施。方法收集新生儿和小婴儿危重先天性心脏病55例的急诊手术资料，男性35例，女性20例。患儿术前有反复肺炎心衰史或持续缺氧发作，其中动脉导管未闭（PDA）合并肺动脉高压（PH）3例、室间隔缺损（VSD）伴肺动脉高压34例、室间隔缺损（VSD）合并房间隔缺损（ASD）8例、室间隔缺损合并动脉导管未闭4例、严重肺动脉狭窄（PS）合并房间隔缺损4例、法洛四联症（TOF）2例，均行急诊手术治疗。结果术后并发气胸3例、呼吸机相关性肺炎2例、拔管后再插管3例、低心排2例、术后早期严重心功能不全合并有毛细血管渗漏综合征3例，常规治疗下仍少尿或无尿，持续3-5h，肺内渗出增多，中心静脉压进行性上升，均行腹膜透析治疗。全组病例51例痊愈出院，死亡4例。结论新生儿和小婴儿危重先天性心脏病急诊手术效果较好。合理的围手术期管理、合适的体外循环方法及手术方案是提高手术成功率的关键。     

The association between insulin-like growth factor-I and cardiac repolarization

ObjectivePrevious studies reported associations between insulin-like growth factor I (IGF-I) serum concentration and cardiac morbidity and mortality, but the association between IGF-I serum concentration and cardiac repolarization has not been investigated in a population-based study so far. Therefore, we analyzed the impact of IGF-I concentrations on QTc, QT and RR intervals in two population based studies, The Study of Health in Pomerania (SHIP) and the Rotterdam Study.Design457 individuals from SHIP and 155 individuals from the Rotterdam Study older than 55 years and without cardiovascular diseases and a left ventricular hypertrophy were investigated. IGF-I was determined by automated two-site chemiluminescence immunoassays and electrocardiograms were recorded by an ACTA electrocardiograph at a sampling frequency of 500 Hz. The association of IGF-I with QTc, QT and RR intervals was investigated by multivariable linear regression analyses adjusted for age, gender, diabetes mellitus, myocardial infarction, hypertension, body mass index, serum potassium and calcium in both studies separately and in pooled analysis.ResultsThere were no significant associations between log-transformed IGF-I and QTc interval in the single populations, whereas a significant inverse association was detectable in the pooled population (β, ? 15.6; 95%-confidence interval, ? 25.7, ? 5.5). The QTc interval was significantly higher in the first tertile of IGF-I compared to the third tertile (β, 5.4; 95%-confidence interval, 9.5–1.3) in the pooled analysis.ConclusionThe inverse association between IGF-I serum concentrations and QTc interval in our study is suggestive of a higher risk for cardiac arrhythmias and thus might provide additional evidence for increased cardiovascular mortality in subjects with low IGF-I secretion.     

Effective therapy of insulinoma by using long-acting somatostatin analogue. A case report and literature review

We are reporting a case of 68-year-old woman with insulinoma, after a non-successful tumor surgery and a long-term diazoxide treatment. She had a lot of hypoglycemia cases, and a weight gain of 50?kg. An abdominal CT scan demonstrated a tumor 28?mm in the diameter, in the head of the pancreas. The patient did not agree for the repeated insulinoma surgery. Furthermore, we found a lesion in the left adrenal gland (14?mm in the diameter) and in the right lung (8?mm in the diameter). Pheochromocytoma was diagnosed on the basis of hypertension, elevated levels of normetanephrine in the 24-h urine collection, and an elevated level of norepinephrine in a plasma sample. After the left adrenal gland removal we observed lower blood pressure. Since we had revealed the presence of somatostatin receptors by the somatostatin receptors scintigraphy, we decided to control hypoglycemia by a monthly subcutaneous administration of the long-acting lanreotide. Because of higher glucose levels (300-400?mg/dl) we started an intense insulin therapy. Nowadays, the patient feels better, she has lost 20?kg of her body weight, and we have observed normal blood glucose levels during the long-term lanreotide treatment. We have noticed neither side effects nor hypoglycemic episodes and we have reduced the dose of insulin. The presented case can be an evidence of the effective treatment of the pancreatic neuroendocrine tumor of insulinoma type, with somatostatin analogue.