颅痛定对动物软脑膜微循环及脑组织血流量的影响

颅痛定对高分子右旋糖酐和５－ＨＴ所致血瘀大鼠软脑膜微循环障碍，有明显改善作用，可增大微血管管径，加快流速，改善流态；小鼠灌胃给药，可明显增加其脑组织血流量。     

Tumor cell-specific loss of p53 protein in a unique in vitro model of human breast tumor progression

Mutations of the p53 gene are the most frequent genetic lesionin breast cancer. Here, we examined p53 expression in a uniquein vitro model of tumor progression derived from a single breastcancer patient (21T series). While the normal mammary epithelial,fibroblast and mesothelial cells derived from this patient expressedeasily detectable functional p53 protein, the primary as wellas metastatic tumor cell lines demonstrated a lack of p53 proteinsynthesis. 21T tumor cells failed to exhibit G₁ cell cycle arrestupon exposure to     

Acute appendicitis in the elderly

A prospective study was done on 104 patients more than 60 years old with appendicitis. The clinical features are by and large, similar to that of the younger patient. However, four patients presented atypically with abdominal distension with little or no pain. A statistically significant increase in appendiceal perforation is found in patients more than 70 years old and in patients with prolonged delay in operation. However, delay on the part of the surgeon contributed only slightly to the high appendiceal perforation as 85.6 per cent of patients who were operated upon within 24 hours of admission. Appendicitis in the elderly patient appeared to progress to perforation faster and perforation occurred in about 40 per cent of patients within 24 hours of onset of symptoms. Five patients died and 29 postoperative complications occurred in 24 more patients. An associated medical disease is linked to a statistically significant increase in mortality. Appendiceal perforation and a total delay of more than 37 hours are associated with a statistically significant increase in morbidity.     

Colorimetric indicators of microbial contamination in corneal preservation medium

PURPOSE: To compare acid-base and oxidation-reduction indicators and to investigate the effect of buffer and temperature on the colorimetric detection of microbial growth in corneal preservation media. METHODS: Corneal preservation media containing gentamicin, without or with HEPES buffer, were prepared with either phenol red or AlamarBlue indicators (AccuMed International, Westlake, OH, U.S.A.). Both media were inoculated with Staphylococcus aureus, Streptococcus sanguis, Pseudomonas aeruginosa, Serratia marcescens, or Candida albicans and then incubated at 4 degrees C, 22 degrees C, or 35 degrees C. The pH or percent reduction were determined hourly for eight hours, then daily for one week. RESULTS: The length of time before a confirmed change in pH or reduction occurred varied by microorganism, storage temperature, and buffering capacity. At 4 degrees C, none of the microorganisms caused a detectable pH change in buffered medium within one day after inoculation, although two bacterial species reduced AlamarBlue within four hours. At 22 degrees C and 35 degrees C, all bacteria except P. aeruginosa produced a pH shift within a few hours, and all tested bacterial species reduced AlamarBlue. For bacteria producing detectable pH changes, HEPES-buffered medium took longer to change than medium without HEPES. C. albicans was not detectable in HEPES-buffered medium at any temperature by phenol red and was only detectable by AlamarBlue after 2-3 days at 22 degrees C and 35 degrees C. CONCLUSION: Acidic shifts in refrigerated corneal preservation medium do not occur during contamination by several microorganisms. AlamarBlue, a redox indicator, is more sensitive than phenol red in detecting some bacteria. C. albicans is not reliably detected by pH or redox indicators.     

Anterior epitympanic cholesteatoma with facial paralysis: a characteristic growth pattern

Epitympanic cholesteatoma may involve the facial nerve at several anatomic locations resulting in functional impairment. The most common site of nerve compression is the middle-ear segment where the nerve is frequently devoid of bony covering. In five patients with facial palsy due to epitympanic cholesteatoma, a characteristic pattern of growth was recognized in which the cholesteatoma traversed the anterior epitympanum rather than taking the more common posterior route. Extension anteromedial to the head of the malleus leads to compression of the facial nerve in the region of the geniculate ganglion at the level of the middle cranial fossa floor. The most probable pathogenesis of this lesion is extension of disease along the embryologic course of either the saccus anticus or the anterior saccule of the saccus medius. Management of these lesions is surgical and may require, in addition to mastoidectomy with anterior and/or posterior atticotomy, middle fossa craniotomy and/or partial removal of the labyrinth for complete excision.     

Pulmonary edema and acute upper airway obstruction

Pulmonary edema following the relief of acute upper airway obstruction is unusual and unpredictable. The cause is usually attributed to pulmonary and hemodynamic changes resulting from high negative intrathoracic pressures during obstructed respiration. The incidence of this problem is not known. Why pulmonary edema develops in only certain patients is also unclear. We reviewed the records of 27 consecutive adult patients admitted and treated for acute upper airway obstruction. Three of 27 (11%) developed pulmonary edema. Age, sex, diagnosis, duration of obstruction, history of cardiopulmonary disease, and perioperative fluid administration were evaluated. No differences were noted between those who did and those who did not develop pulmonary edema. Pulmonary edema following acute upper airway obstruction appears to be more common than is generally appreciated, however, no specific factors seem related to its occurrence.     

子午流注计法治疗偏头痛的临床研究

本文采用子午流注针法治疗３５例偏头痛患者，同时设立普通针刺法治疗３０例作为对照组，观察了治疗组部分患者（１８例）治疗前后血液中５－羟色胺（５－ＨＴ）及５－羟吲哚乙酸（５－ＨＩＡＡ）含量的变化情况。治疗结果表明两组患者治疗后临床症状得分均有明显下降（Ｐ＜０．０１）。而子午流注组的下降幅度明显优于普通针刺组（Ｐ＜０．０５）。提示子午流注针法对偏头痛患者的疗效优于普通针刺组。     

Development of the gastrointestinal mucosal barrier: changes in phospholipid head groups and fatty acid composition of intestinal microvillus membranes from newborn and adult rats

Phospholipids in microvillus membrane (MVM) prepared from the proximal small intestine of newborn (less than 24 h of age) and adult rats were characterized to determine if differences in composition existed. Our hypothesis is that developmental differences in composition of the MVM may account for mucosal barrier differences to microorganisms and antigens during the perinatal period. Lipid analysis showed that both cholesterol and total phospholipids, per mg of membrane protein, were much higher in the newborn MVM than the adult, but the molar ratio of these two lipid classes remained unchanged. Increased phosphatidylcholine and decreased phosphatidylinositol levels were found in the newborn MVM compared to the adult. In addition, the major difference in fatty acid composition of total lipid extracts and three major membrane phospholipids, phosphatidylcholine, phosphatidylethanolamine, and phosphatidylinositol appeared to be an increased ratio of palmitate (16:0) to stearate (18:0) and of oleate (18:1) to linoleate (18:2) in the newborn. These data suggest that changes in the proportion of phospholipid polar head groups and fatty acyl groups as well as changes in the amount of total phospholipids and cholesterol exist in the newborn MVM. These observations are consistent with differences in MVM fluidity previously noted and may help explain the increased uptake of antigens and other mucosal barrier defects in the newborn intestine.