Effects of nandrolone decanoate on the toxicity and anti-tumour action of CCNU and FU in murine tumours.

Pre-treatment with the anabolic steroid nandrolone decanoate (ND) increases the LD50 of 1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea (CCNU) and 5-Fluorouracil (FU) in NMRI mice. Administration of ND did not affect the anti-tumour action of CCNU against a transplantable mouse adenocarcinoma of the colon (MAC 13) or the anti-tumour action of FU against MAC 26. In both tumour lines ND had no significant effect on tumour growth. These data suggest that an increase in the anti-tumour selectivity of these agents may be produced by pre-treatment with ND.     

A randomised controlled trial of standing programme on bone mineral density in non-ambulant children with cerebral palsy

Background: Severely disabled children with cerebral palsy (CP) are prone to low trauma fractures, which are associated with reduced bone mineral density. Aims: To determine whether participation in 50% longer periods of standing (in either upright or semi-prone standing frames) would lead to an increase in the vertebral and proximal tibial volumetric trabecular bone mineral density (vTBMD) of non-ambulant children with CP. Methods: A heterogeneous group of 26 pre-pubertal children with CP (14 boys, 12 girls; age 4.3–10.8 years) participated in this randomised controlled trial. Subjects were matched into pairs using baseline vertebral vTBMD standard deviation scores. Children within the pairs were randomly allocated to either intervention (50% increase in the regular standing duration) or control (no increase in the regular standing duration) groups. Pre- and post-trial vertebral and proximal tibial vTBMD was measured by quantitative computed tomography (QCT). Results: The median standing duration was 80.5% (9.5–102%) and 140.6% (108.7–152.2%) of the baseline standing duration in the control group and intervention group respectively. The mean vertebral vTBMD in the intervention group showed an increase of 8.16 mg/cm³ representing a 6% mean increase in vertebral vTBMD. No change was observed in the mean proximal tibial vTBMD. Conclusion: A longer period of standing in non-ambulant children with CP improves vertebral but not proximal tibial vTBMD. Such an intervention might reduce the risk of vertebral fractures but is unlikely to reduce the risk of lower limb fractures in children with CP.     

Tibial speed of sound in term and preterm infants

The tibial speed of sound (SOS) was measured in 91 healthy singleton infants between 31 and 42 weeks of gestation and 12 sick preterm infants. In healthy infants, the tibial SOS was associated with corrected gestational age (r = 0.40, p < 0.001) but not birth weight. The median tibial SOS in 12 sick preterm infants (2,772, range 2,566-2,934 m/s), whose corrected gestational age was between 31 and 42 weeks, was lower (p < 0.001) than that of 69 healthy gestation-matched healthy infants (3,100, range 2,870-3,381 m/s). Tibial SOS measurements may allow radiation-free assessment of metabolic bone disease of prematurity.     

UK reference data for the Hologic QDR Discovery dual-energy x ray absorptiometry scanner in healthy children and young adults aged 6-17 years.

BACKGROUND: The use and correct interpretation of bone densitometry measurements in paediatric patients relies on the availability of appropriate reference data. Ideally, such data should be matched for sex, chronological age, height, weight, pubertal development and ethnicity. AIM: To provide UK-specific reference data for the Hologic QDR Discovery dual-energy x ray absorptiometry (DXA) scanners. METHODS: Healthy, Caucasian children aged 5-18 years were recruited from local schools, colleges, general practitioner surgeries and staff from the University of Manchester, Manchester, UK. Suitable participants had DXA measurements taken of the lumbar spine, hip and total body. Sex-specific reference centile curves for bone mineral apparent density (BMAD; spine and femoral neck) are provided, using the approach suggested by M?lgaard et al. to interpret the scans. LMS (lambda, mu, varsigma) tables for calculation of individual standard deviation scores (SDSs) were produced; a weblink is provided to these tables to allow calculation of an individual child's SDSs. RESULTS: The total study population consisted of 442 participants (239 male). The total numbers of scans available for analysis were 431 of the lumbar spine, 426 of the total body and 393 of the proximal femur. Data are provided for clinical interpretation of the spine and femoral neck scans based on BMAD (g/cm3), which reduces the size dependence of DXA areal bone mineral density (g/cm2). The spine and total-body data are also presented for interpretation of results using the approach suggested by M?lgaard et al. CONCLUSIONS: This article provides the first sex-specific and ethnicity-specific reference databases for UK, which should allow the clinician to assess bone mineral density in paediatric patients, measured by the Hologic QDR Discovery DXA scanner.     

联合门静脉／肠系膜上静脉切除的胰头癌根治术

目的探讨胰头癌侵犯门静脉（portalvein，PV）和（／或）肠系膜上静脉（superior mesentericvein，SMV）时根治切除的可行性。方法回顾分析11例PV／SMV受侵的胰头癌患者临床资料，均行扩大胰十二指肠切除术。其中7例行血管壁部分切除，3例行血管节段性切除及对端吻合，1例行受侵血管切除＋人工血管移植。脾静脉与SMV端侧吻合4例，脾静脉结扎3例。消化道重建采用Child术式。结果本组PV阻断时间平均为18．1（9～32）min。全组患者术后均未发生血管栓塞、肠坏死、肝衰竭等并发症，均康复出院。11例均获随访，时间6～20个月，3例术后1年内死亡，4例术后1—2年死亡，患者平均生存时间15（7～20）个月。结论对单纯侵犯PV／SMV的胰头癌施行联合PV／SMV切除的胰头癌扩大根治术是安全可行的。     

准分子激光原位角膜磨镶术术后屈光回退及欠矫再手术32例临床分析

目的 观察准分子激光原位角膜磨镶术(LASIK)术后屈光回退及欠矫再手术的治疗效果.方法 对2004年5月～2009年8月在我院行LASIK术后发生屈光回退和欠矫的32例(46眼),在条件允许及患者自愿的前提下,原角膜瓣下再次行激光切削,随访1年,观察术后裸眼视力、屈光度变化及并发症发生情况.结果 32例(46眼)术后...     

胰管空肠连续吻合联合肠腔外引流预防胰十二指肠切除术后胰瘘

目的 对胰十二指肠切除术的胰肠吻合缝合技术和置管引流方法进行改进,以防止胰瘘的发生.方法 对2004年6月至2007年9月138例胰十二指肠切除术患者的胰肠吻合采用降落伞式胰管空肠连续吻合和吻合口下方肠腔减压外引流的临床资料进行回顾性分析.结果 降落伞式胰管空肠连续吻合时间平均11min,手术时间明显缩短,全部病例均未出现胰肠吻合口漏,术中出血平均353±61ml,平均住院日19.2d.6例患者出现肺部感染,3例上消化道出血考虑为应激性溃疡,2例患者出现胃排空障碍,均保守治疗痊愈,无手术死亡.结论 降落伞式胰管空肠连续吻合和吻合口局部肠腔减压外引流,操作简便、省时、并发症少,是胰肠吻合术的一种有效改进.     

大鼠急性肺栓塞后SMP-30表达下降及其对细胞凋亡的影响

目的：研究大鼠急性肺栓塞模型肺组织中衰老标记蛋白质30(SMP-30)的表达变化及其对Fas诱导的细胞凋亡的影响。方法:建立大鼠急性肺栓塞模型，分别在急性肺栓塞后1、8、24和48 h进行支气管肺泡灌洗，然后开胸取出肺组织。常规提取肺组织的总RNA和总蛋白，以正常组为对照，采取半定量RT-PCR的方法研究SMP-30在mRNA水平表达的变化；采用Western blotting方法进一步验证SMP-30在蛋白水平表达的变化；采用免疫组织化学方法检测大鼠肺组织中SMP-30以及肺泡巨噬细胞中IL-8在肺栓塞前后表达的变化及其组织分布情况；采用TUNEL法研究急性肺栓塞后组织细胞的凋亡情况；最后采用ELISA法检测急性肺栓塞后肺泡灌洗液中sFasL的浓度变化。结果:在大鼠急性肺栓塞后的不同时点，SMP-30的mRNA水平和蛋白水平均逐渐降低，在24和48 h下降最为明显。免疫组化研究表明SMP-30主要分布在支气管黏膜上皮细胞和肺泡上皮细胞，急性肺栓塞后SMP-30在上述细胞内的表达均明显降低。TUNEL染色发现随着SMP-30表达的降低，肺组织内出现明显的细胞凋亡现象，同时肺泡灌洗液中sFasL的浓度升高，肺泡巨噬细胞内IL-8的表达也明显升高。结论:大鼠急性肺栓塞后肺组织内SMP-30的表达明显降低，可能促进Fas－FasL细胞凋亡系统的活化。