The efficacy of psychotropic drugs: implications for power analysis.

The estimation of the correct sample size to successfully test a hypothesis has become critical. A common approach to this problem is for the investigating team to complete a pilot study of a few patients to establish the "active drug-placebo" difference, using this "effect size" to perform the power analysis for sample size estimation. Given the variability evident in the effect size from completed and published studies, the pilot study approach may not be entirely dependable. The authors propose a method to obtain this initial "active drug-placebo" difference, in the field of psychotropic drug research. They apply meta-analysis to statistically summarize effect sizes obtained from an exhaustive review of the literature for a specific psychotropic drug in a given clinical condition. All double-blind, random assignment studies are used to calculate the effect size; therefore, no selection bias exists. These literature-based effect sizes are then used to perform the traditional power analysis for sample size estimation. The authors propose these estimations as a convenient reference source for future clinical investigators.     

艾灸对大鼠胃溃疡模型的影响

<正> 近年来,胃粘膜的保护作用很受人们关注,这方面的研究也取得了显著的进展本文试图用醋酸烧灼胃粘膜面造成大鼠胃溃疡模型,以此为对象,研究艾灸在保护胃粘膜方面可能存在的作用。     

Decreased amniotic fluid index in term pregnancy. Clinical significance.

In a study of 331 term pregnancies a four-quadrant technique was used to obtain amniotic fluid index measurements, and the results were compared with the current widely used single-pocket measurement. In contrast to the "2-cm rule," the amniotic fluid index measurements consistently demonstrated higher sensitivity in predicting poor fetal outcome with no decrease in specificity. It was noted that pregnancies with an index of < or = 8 cm showed higher incidences of meconium staining, cesarean delivery for fetal distress, abnormal fetal heart rate monitoring and Apgar scores of < or = 7 or less at one minute.     

绝育术后盆腔痛患者血浆、腹腔液中甾体激素与前列腺素相关性研究

本文测定绝育术后盆腔痛患者44例、输卵管绝育术后行输卵管复通术11例和正常妇女15例血浆与腹腔液中的甾体激素及前列腺素水平。结果发现:血中E_2与PGF_(2α)呈明显正相关,与TXB_2呈负相关,而P则与PGF_(2α)呈明显负相关;腹腔液中E_2与PGF_(2α)、TXB_2呈负相关。盆腔痛患者,包括异位症、无明显病变盆腔痛和盆腔静脉瘀血症3组的某种PG水平高于其他组。结果表明:血与腹腔液中PGs受甾体激素的影响,绝育术后慢性盆腔痛与PGs有关。     

Copolymerization of propene with 1-alkenes using a MgCl2/TiCl4 catalyst

Copolymerization of propylene

1 System name: propene.

and 1-alkenes (1-octene, 1-decene, 1-dodecene, 1-tetradecene, 1-hexadecene) were studied with the catalyst system MgCl₂/TiCl₄-Al(i-Bu)₃. It was found that the polymerization productivity and the consumption rate of propylene are improved significantly in the presence of the comonomer. The total productivity of propylene/1-alkene copolymerizations decreases as follows: 1-octene > 1-decene > 1-dodecene > 1-hexadecene > 1-tetradecene. The reactivity ratios were estimated from the copolymerization results.     

Tunicamycin Dissociates Depolarization-induced Calcium Entry From Transmitter Release. Involvement of Glycosylated Protein(s) in the Process of Neurosecretion in PC-12 Cells

The process of regulated secretion in PC-12 cells is tightly coupled to calcium entry, which is absolutely dependent on extracellular Ca2+([Ca2+]ex). Tunicamycin treatment of the cells dissociated depolarization-triggered Ca2+ influx from depolarization (high K+)-induced transmitter release into two distinct and independent phases. Deplarization-evoked Ca2+ influx was not affected by tunicamycin treatment (1 microg/ml, 72 h), whereas depolarization-evoked transmitter release was strongly inhibited (> 60%), suggesting at least a two-step process, and the participation of glycosylated protein(s) in the actual fusion/secretion step. Similarly, bradykinin-mediated transmitter release was linearly related to and absolutely dependent on Ca2+ entry, and was inhibited by tunicamycin treatment (> 80%), whereas bradykinin-evoked Ca2+ entry was not impaired, indicating that glycosylated protein(s) are essential for bradykinin-evoked release at a step subsequent to Ca2+ influx. The heavily glycosylated alpha2 subunit of the dihydropyridine-sensitive channel, which was used to monitor tunicamycin inhibition of glycosylation, was not expressed in the tunicamycin-treated cells, as shown by Western blot analysis. This observation allowed us to conclude that the alpha1 subunit of the heteromeric dihydropyridine voltage-sensitive Ca2+ channel, which is responsible for Ca2+ entry, is also fully functional when not assembled with its corresponding alpha2 subunit. The molecular properties of the alpha2 subunit, whose role in the complex structure of the channel is not yet understood, are shown for the first time for the L-type Ca2+ channel of PC-12 cells. Similar to cardiac and skeletal muscle cells, the alpha2 subunit appears to be a glycosylated polypeptide of molecular weight 170 kD and to display a characteristic mobility shift to 140 kD under reducing conditions.     

Stereoselective inhibition of neuronal sodium channels by local anesthetics. Evidence for two sites of action?

The objective of this study was to determine if the "tonic," resting inhibition of Na+ channels by local anesthetics results from binding at a site different from that for "phasic," use-dependent inhibition. Stereoselective actions of four local anesthetics were examined in isolated frog peripheral nerve and single Na+ channels. Using the sucrose-gap method on desheathed nerves, four actions of local anesthetics were assayed: 1) tonic depression of compound action potentials at low stimulation frequency (one per minute); 2) phasic depression of the compound action potential during trains of stimulation at 5, 10, and 20 Hz; 3) competitive antagonism of the reversible Na+ channel activator veratridine assayed through the depolarization of the compound resting membrane potential; and 4) depression of the depolarization of the compound resting membrane potential initially induced by the irreversible channel activator batrachotoxin. For assays 1, 2, and 3, all local anesthetics showed a stereoselectivity, where rectus, or (+), enantiomers were more potent than sinister, or (-), enantiomers. In contrast, for the noncompetitive antagonism of veratridine's action and the depression of batrachotoxin-induced depolarization, also a noncompetitive interaction between anesthetic and activator, the (-) enantiomer was more potent than the corresponding (+) enantiomer. Blockade of single Na+ channels activated by batrachotoxin in planar lipid bilayers was also stereoselective for the (-) enantiomer. These findings, along with previously reported voltage-clamp results, can be applied to infer properties of a local anesthetic binding site in activator-free channels. Local anesthetic molecules with more sharply angled shapes have stronger stereoselectivities than less angled, more planar drugs. The inversion of the stereopotency induced by the activators can be explained by either of two mechanisms. There may be two binding sites for local anesthetics, one of high and one of low affinity and of opposite stereoselectivity; activators may change the conformation at the high affinity site, reducing its local anesthetic affinity below that of the usual low affinity site and thereby revealing the pharmacology of the weaker site. Alternatively, only a single binding site may exist and be conformationally altered by activators such that both anesthetic affinity and stereopotency are modified. In activator-free channels, however, a single, high-affinity binding site with a constant stereoselectivity can account for both tonic and phasic inhibition by local anesthetics.     

对肝外胆管梗阻时“软藤征”的再认识

本文回顾性分析了48例“软藤征”的病因,其中恶性疾病28例(占58.3％),良性疾病20例(占41.7％)。据本文资料,作者认为“软藤征”是肝管分叉部及肝外胆管急性完全(或接近完全)性梗阻时肝内胆管扩张的特征性X线表现,并非恶性梗阻特有,良性梗阻亦常见。作者指出,只要肝内胆管无或仅有轻度炎症,胆管具有良好的弹性和扩张性,不论良、恶性病变都可出现“软藤征”。那种认为当梗阻病变未显示时,仅根据“软藤征”即可作出恶性梗阻诊断的观点很值得商榷。作者认为,“软藤征”的定性及病因诊断主要应根据PTC或ERCP,或二者联合显示梗阻局部病变的形态学特征来确定。     

The effect of unilateral internal carotid arterial occlusion upon contralateral duplex study: criteria for accurate interpretation.

To determine the influence of unilateral internal carotid arterial occlusion (ICO) on Doppler frequency spectral analysis (DFSA) of the patent contralateral carotid artery, a retrospective review of 154 patients between July 1987 and December 1991 with angiographically confirmed ICO was performed, correlating duplex and arteriographic findings in a blinded fashion. Biplane arteriograms and bilateral carotid artery duplex studies that used a 5.0 MHz Doppler probe with a 1.5 mm3 sample volume at a 60 degree angle of insonation were performed on all patients. Each carotid artery was categorized by the severity of stenosis as quantified by arteriography: 1% to 15% (n = 41); 16% to 49% (n = 48), 50% to 79% (n = 21), 80% to 99% (n = 34), and bilateral occlusion (n = 10). DFSA peak systolic frequencies were commonly exaggerated in the presence of contralateral ICO and use of standard criteria for DFSA interpretation overestimated bifurcation stenoses in 43 of 89 lesions (48.3%) when determining nonhemodynamically significant lesions (less than 50% diameter reduction) with a sensitivity of only 57.3% and specificity of 96.9%. Conversely, prediction of hemodynamically significant lesions (greater than 50% diameter reduction) with standard criteria had 96.9% sensitivity but only 57.3% specificity. Modification of these criteria to account for the velocity increase or "jet effect" in the ipsilateral carotid artery system increased the sensitivity and specificity to 97.8% in predicting nonhemodynamically and hemodynamically significant stenoses respectively. A Doppler frequency spectrum with a peak systolic frequency (PSF) greater than 4.0 kHz and end-diastolic frequency (EDF) less than 5 kHz with an "open window" distinguished lesions with less than 50% diameter reduction.(ABSTRACT TRUNCATED AT 250 WORDS)     

人和兔雪旺氏细胞的体外培养及形态学观察和生物特性研究

雪旺氏细胞(Schwann cell,SC)在神经再生过程中起着重要作用。我们取人胚及兔之坐骨神经,采用“植块多次移出法”培养出纯净度达99％的人和兔的SC。对培养的SC进行了冻存和复苏处理,复苏后的细胞可保持原有的生长特性。