Tetralogy of Fallot with Anomalous Origin of the Right Pulmonary Artery from the Ascending Aorta and Hypoplastic Left Pulmonary Artery

A case of tetralogy of Fallot associated with anomalous origin of the right pulmonary artery from the ascending aorta and hypoplastic left pulmonary artery was successfully repaired. Following the simultaneous procedure with banding of the right pulmonary artery and replacement of modified Blalock-Taussig shunt to the left pulmonary artery at 34 days of age, the intracardiac repair was performed successfully at 1 year and 10 months of age. The patient was well 6 months postoperatively, without unilateral pulmonary hypertension.     

Hearing rehabilitation with osseointegrated hearing implant in bilateral congenital external auditory canal atresia

Introduction and objectivesCongenital atresia of the external auditory canal (EAC) is a congenital defect present in one in every 10,000–20,000 births. It causes conductive hearing loss, with an air-bone gap of 50–60 dB. Early amplification is essential in bilateral cases to ensure normal language development. The aim of this study is to present the osseointegrated hearing implant as a treatment for bilateral EAC atresia, reviewing the audiometric results and the rate of complications.Material and methodsRetrospective analysis of patients diagnosed with bilateral congenital EAC atresia under follow-up in the pediatric ENT clinic of the ENT and Head and Neck Surgery department of a Portuguese Tertiary Hospital, between 2003 and 2019. We reviewed the medical records and collected information on the assessment of the initial audiometric status. In the cases submitted for implantation with an osseointegrated hearing implant, we analyzed the details of follow-up, including immediate and long-term post-operative complications, as well as the audiometric results.ResultsWe present 8 pediatric patients, 6 girls and 2 boys, with a diagnosis of bilateral congenital EAC atresia. The audiometric assessment revealed moderate to severe bilateral conductive hearing loss with a mean speech recognition threshold (SRT) of 51 dB. Six patients underwent osseointegrated hearing implantation. All 6 patients showed good audiometric results, with an average SRT of 20 dB and closure of the air-bone gap.ConclusionsThe osseointegrated hearing implant was an effective treatment option in these patients, without significant morbidity or complications. Osseointegrated hearing implantation should be considered first line treatment for children with bilateral congenital EAC atresia, as it presents good functional results and a high level of patient satisfaction.     

Factors affecting the family support system of patients with schizophrenia: a survey in the remote island of Tsushima

Possible support for home-cared schizophrenic patients and their families was investigated on Tsushima, one of the many isolated islands in Japan. The psychopathologic symptoms of the patients were evaluated using the Brief Psychiatric Rating Scales (BPRS), their social adjustment using the Psychiatric Disability Assessment Schedule (DAS), mental states of the families using the General Health Questionnaire (GHQ), and the quality of life (QOL) using the Life Satisfaction Rating Scales (LSR). The family support systems for the patients were evaluated with regard to: (i) family support for the patient's daily life (FS), (ii) hardships of family life caused by living with the patient (HF), and (iii) empathic attitude of the family toward the patient (EA). Psychotic symptoms of schizophrenic patients were closely related to the mental state and QOL of their families. Family support was significantly correlated with HF and EA. Moreover, the family support system was shown to be related both to the psychotic symptoms of the patient and the mental state of the family. These results suggest that an approach to improve the family support system for the patient may exert positive effects on the patient's psychotic symptoms and his/her social adjustment. We also consider that intervention by a public organization is necessary to improve the family support system on islands.     

滴注过程中应注意避光的药品

综述了对光敏感、易光化降解、易氧化的临床常用注射剂的光稳定性研究进展。除硝普钠、对氨基水杨酸钠、两性霉素B等注射液需避光滴注外,吡啶类、噻嗪类、酚类、部分维生素类、喹诺酮类及抗肿瘤化疗药物在临床使用时,也应当采用避光滴注的措施,以保证临床用药的安全性和有效性。     

董廷瑶教授从脾胃论治儿科病证

董廷瑶教授在调补脾胃方面注重从脾胃升降机理着手，和胃运脾；肺脾同病时，除调肺之标外，采用培土生金法杜绝生痰之源；在小儿疳证方面，也同样注重调理脾胃，消补兼施，灵活运用。     

地龙降压蛋白对自发性高血压大鼠降压作用及其机制的影响

目的:初步探讨地龙降压蛋白对自发性高血压大鼠(spontaneously hypertension rat,SHR)的降压作用及机制。方法:选择16周龄雄性SHR 24只随机分为3组:模型组、地龙降压蛋白低剂量组、地龙降压蛋白高剂量组,另纳入8只同龄雄性Wistar大鼠为正常对照组,干预持续28d。采用无创尾动脉套袖法观察地龙降压蛋白对SHR的降压作用;放射免疫分析法测定SHR血浆、肾脏局部醛固酮(aldosterone,Ald)、6-酮-前列腺素-F1α(6-Keto-PGF1α)含量。结果:地龙降压蛋白低、高剂量组均可明显降低SHR的血压,与模型组比较有显著性差异(P<0.05),可明显降低SHR血浆、肾脏Ald的水平(P<0.05);同时显著升高血浆、肾脏局部6-Keto-PGF1α的含量(P<0.05)。结论:地龙降压蛋白对SHR有降压作用,其降压机制可能与降低SHR血浆、肾脏Ald的水平,升高血浆、肾脏局部6-Keto-PGF1α的含量有关。     

竹叶提取物大鼠代谢试验研究

目的:研究竹叶提取物在SD大鼠体内的生物转运,为其应用提供安全性毒理学评价依据。方法:选用为4.0 g/kg体重剂量进行代谢试验研究。结果:竹叶提取物灌胃后各个时相血浆、肝脏、肾脏、脑、肌肉组织及尿液中4种碳苷黄酮原形物均无检出;灌胃给予竹叶提取物,只有在12~24 h时段从粪便中检出的原形物占摄入量的27.6%。竹叶提取物中一种羟基香豆素类化合物灌胃后各个时相在大鼠肝脏、脑、肌肉组织及粪便中均无检出,在血液及肾脏中有检出,24 h后该组分在在尿液中检出1.9%。结论:4种碳苷黄酮在大鼠胃肠道内均无直接吸收,其中一部分被直接排出体外,另一部分在胃肠道逐渐分解成小分子而被吸收入血液。其中的一种羟基香豆素类化合物主要经胃肠道直接吸收入血液,在肾脏中代谢后从尿液排出体外。     

五色灵芝提取液与LAK细胞协同抑瘤作用的研究

目的探讨五色灵芝提取液与LAK细胞合用对小鼠移植性动物肿瘤的抑制作用。方法按药物体内抑瘤作用常规筛选方法进行,试验动物用NIH小鼠。瘤株为小鼠肉瘤细胞(sarcoma-180)。小鼠随机分成五组,每组10只。阴性对照组以生理盐水20ml/kg.d灌胃。阳性对照组以环磷酰胺(CTX)20mg/kg.d灌胃。第一实验组:灵芝液组20g/kg.d灌胃。第二实验组:LAK细胞1×107/只/隔天 IL-25000U/天腹腔注射。第三实验组:灵芝液20g/kg.d灌胃 LAK细胞1×107/只/隔天 IL-25000U/天腹腔注射。各组均于接种后24小时开始灌胃给药,连续10天。均于末次给药后24小时处死,计算抑瘤率。结果各组抑瘤率分别是:第一实验组为46.41%～60.42%,第二实验组为44.85%～51.29%,第三实验组为71.41%～75.42%。各实验组的抑瘤作用与阴性对照组相比较,差异均有显著性意义(P<0.001)。灵芝液与LAK细胞联合组与单用灵芝液组或单用LAK细胞组比较,差异均有显著性意义(P<0.05)。结论五色灵芝提取液与LAK细胞联合使用具有协同抑瘤作用。     

Prosopo-Thoracopagus Conjoined Twins and Other Cephalopagus-Thoracopagus Intermediates: Case Report and Review of the Literature

Prosopo-thoracopagus twins are united from the face down to the umbilicus, none with union in the brain but all with visceral anomalies intermediate between those of cephalopagus and thoracopagus. In a review of over 1200 cases of conjoined twins reported during the past 100 years, there were 14 that illustrate the continuum between cephalopagus and thoracopagus, including three that were united only from the cervical region to the umbilicus. Classic cephalopagus twins are joined from the top of the head to the umbilicus, sharing a single foregut as well as two relatively normal hearts, the “posterior” one often diminished. Typical thoracopagus, however, are conjoined only from the upper thorax to the umbilicus, each twin with a normal foregut but both sharing a single complex multiventricular heart. The intermediate cases shared either a single very abnormal heart or two hearts united by double aortic arches, and all except one had a single foregut. It is these cases intermediate between cephalopagus and thoracopagus which are the subject of this report. Received September 11, 1996; accepted December 16, 1996     

The fate of embryos transferred into the uterus

Purpose The purpose of this study is to elucidate the fate of embryos transferred into the uterus.Methods Implantation rates were compared between synchronous and asynchronous intrauterine embryo transfers in mice. Then transferred embryos were recovered from the uterus and examined morphologically 24 hr after transfer. Moreover, the same transfer-recovery experiments were performed after ligation of the uterus two-thirds from the uterotubal junction immediately before transfer.Results The implantation rate was high (58.4% per embryo, 87.5% per recipient) when blastocysts were transferred into the uteri of recipients of pseudopregnant Day 4, but it was very low (0–2.4% per embryo, 0–8.3% per recipient) when blastocysts were transferred to recipients of pseudopregnant Day 2, or two-cell embryos into recipients of pseudopregnant Days 2 and 4. When transferred embryos were recovered from the uterus 24 hr after transfer, few embryos (1.4%) were recovered in asynchronous transfers, while 66.3% of the embryos were recovered in synchronous transfers. However, from recipients in which the lower portions of uteri were ligated, embryos at more advanced stages were recovered even in asynchronous transfers.Conclusions These results suggest that discharge from the uterus is one of the major causes of the low implantation rate for asynchronous transfer.