5 Gy全身照射对大鼠伤口巨噬细胞的抑制效应及W11-a12的促愈作用

目的 研究大鼠全身5Gy照射对伤口巨噬细胞（MΦ）功能的影响及W11－a12的促愈作用。方法 采用^60Coγ射线身身照射复合皮肤创伤模型,观察了MΦ酵母－补体复合物玫瑰花环形成试验、吞噬功能和分泌纤维粘连蛋白（FN）、转化生长因子β1（TGFβ1）、碱性成纤维细胞生长因子（bFGF）的功能。结果 大鼠5Gy全身照射复合皮肤创伤后第3、5天伤口内巨噬细胞C3b受体表达、吞噬功能,合成与分泌FN、TGFβ、bFGF的功能均显著受到抑制,但抑制效应的程度不同,MΦ的吞噬功能的抑制重于其分泌功能,分泌TGFβ1功能的抑制重于分泌bFGF的功能,W11-a12能显著逆转辐射对MΦ功能的抑制效应。结论 伤口MΦ功能受抑是合并放射损伤后伤口难愈的主要原因,增强MΦ功能是W11－a12促愈作用的一个途径。     

避免鼻内窥镜手术并发症的临床解剖

目的：为避免鼻内窥镜手术并发症提供解剖学基础。方法：在３０侧成人头部正中矢状剖面标本上,观察了泪囊的毗邻、在鼻腔外侧壁上的投影及筛窦的毗邻。结果：泪囊与中鼻道前房相邻,其在鼻腔外侧壁上投影的前界为“骨梭”,后界为钩突基部,上界为中鼻甲附着处前部的下缘,下界为下鼻甲附着处前部的上缘。筛顶壁为一前窄后宽的骨板,筛前、后动脉在筛窦内均靠筛顶下方并与筛板同水平走行。结论：鼻内窥镜手术者若熟悉手术区的解剖可减少或避免并发症。     

Successful chemotherapeutic treatment of diencephalic syndrome with continued tumor presence

A 7-month-old infant with typical features of diencephalic syndrome (DES) associated with a hypothalamic mass, most probably a glioma, was treated with chemotherapy. The tumor showed clear shrinkage, but after more than 2 years regrowth was noted. During the treatment period the child regained normal growth and became free of symptoms. As radiation therapy, especially at a young age, has significant adverse effects and a neurosurgical approach to the diencephalic region also has the potential to cause significant sequelae, a chemolherapeulic option, when it exists, is preferred. Thus, in an infant in whom a glioma is suspected to be the cause of the DES, based on the clinical picture and the neuroimaging appearance, chemotherapy should be considered the primary therapeutic modality. Even if its effect is temporary, its use is well justified. The most appropriate treatment protocol still needs to be determined.     

Metabolic base production and mucosal vulnerability during acid inhibition in a mammalian stomachin vitro

Acid inhibition increases gastric mucosal susceptibility to damage by luminal acid. This might be due to reduced metabolic CO₂ and bicarbonate whereas, during normal acid, secretion cytoprotective CO₂/HCO₃- production parallels acid production. Metabolic activity and mucosal damage caused by luminal acid perfusion was determined in anin vitro mouse stomach, with and without acid inhibition, and at 0%, 1%, or 5% serosal CO₂ supply. Without acid inhibition there was no mucosal damage at any level of serosal CO₂/HCO₃- supply. Acid inhibition reduced metabolic CO₂ production by 29% (P<0.004) and resulted in microscopic damage to 55% of the mucosal area and perforation in four of five stomachs (P<0.05). Although, 1% CO₂ supply completely replaced the reduction in metabolic CO₂, it did not protect against mucosal damage. Overreplacement by 5% serosal CO₂/HCO₃- was required to prevent damage. There was no correlation between luminal CO₂/HCO₃- output and mucosal damage. The protection by endogenous or exogenous CO₂/HCO₃- appears to act intracellularly rather than by intragastric or intercellular neutralization.This study was supported by Swiss National Foundation grants 32-26369.89 and 32-33626.92. The morphometry equipment was supported by a grant from the Osterreichische Nationalbank.     

Radiation doses of yttrium-90 citrate and yttrium-90 EDTMP as determined via analogous yttrium-86 complexes and positron emission tomography

Yttrium-90 is used for palliative therapy for the treatment of skeletal metastases, but because it is a pure - emitter, data on the pharmacokinetics and radiation doses to metastases and unaffected organs are lacking. To obtain such data, the present study employed yttrium-86 as a substitute for⁹⁰Y, with detection by positron emission tomography (PET). The study compared the properties of two different⁸⁶Y complexes —⁸⁶y-citrate and⁸⁶Y -ethylene diamine tetramethylene phosphonate (EDTMP) — in ten patients with prostatic cancer who had developed multiple bone metastases (the ten patients being divided into two groups of five). Early dynamics were measured up to 1 h post injection (p.i.) over the liver region, followed by subsequent whole-body PET scans up to 3 days p.i. Absolute uptake data were determined for normal bone, bone metastases, liver and kidney. Radiation doses were calculated according to the MIRD recommendations. Based on the pharmacokinetic measurements of the distribution of the⁸⁶Y complexes, it was possible to calculate radiation doses for the bone metastases and the red bone marrow delivered by complexes containing⁹⁰Y. In 1 cm³ of bone metastasis, doses of 26±11 mGy/MBq and 18±2 mGy/MBq were determined per MBq of injected⁹⁰Y- citrate and⁹⁰Y- EDTMP, respectively. The doses to the bone marrow were 2.5±0.4 mGy/MBq for⁹⁰Y- citrate and 1.8±0.6 mGy/MBq for⁹⁰Y-EDTMP.⁸⁶Y and PET provide quantitative information applicable to the clinical use of⁹⁰Y. This method may also be useful for the design of other⁹⁰Y radiopharmaceuticals and for planning radiotherapy dosages.     

Transitional cell carcinoma of the renal pelvis and ureter: Outcome and patterns of relapse in patients treated with postoperative radiation

We assessed the records of 101 patients with locally advanced transitional cell carcinoma (TCC) of the renal pelvis and ureter treated with postoperative radiation therapy to determine outcome and patterns of failure. Locally advanced disease (i.e., T3–4N0 or N+ disease) was identified in 65 patients. Postoperative radiation was used to treat 86 patients, with a median dose of 35 Gy in 20 fractions over 4 weeks to the tumor bed and regional lymph nodes. There were 15 patients with no residual disease who were offered no further therapy. No patient received postoperative chemotherapy. Prognostic factors were examined using univariate and multivariate analysis, and the patterns of failure were identified after postoperative irradiation. Median follow-up was 9.3 years, during which 76 deaths occurred. The 5-year overall survival was 43% and 10-year survival was 23%. A multivariate analysis identified T3 category, lymph node involvement, and age at diagnosis as significant prognostic factors for survival. Tumor grade was a significant prognostic factor on univariate analysis but not on multivariate analysis. Failure analysis showed that only 36% of patients with locally advanced disease remained relapse free. For this group of patients, distant metastases developed in 53%, and locoregional failured occurred in 35% despite postoperative irradiation. Locoregional failure occurred in 95% of patients with nodal involvement who received postoperative radiation, and 77% of those developed distant relapse. This leads us to conclude that patients with resected locally advanced (T3, T4N0, N+) TCC of the upper urinary tracts have a high risk of relapse and death from disease despite postoperative radiotherapy. Because the main feature of the disease is early distant failure, post-operative chemotherapy is required to improve the outcome for this group of patients.     

Intraoperative retinal light damage reflected in electrophysiologic data

In a series of 30 unilaterally pseudophakic patients, electroretinograms and electrooculograms were recorded 6 months postoperatively. The unoperated on fellow eyes served as controls High intraoperative retinal light exposure (3.4–7.3 mW/cm², Zeiss OPMI 6 operating microscope) caused a substantial reduction of electrophysiologic potentials. Light protection prevented deterioration of electroretinogram and electro-oculogram potentials; reducing the bulb voltage, tilting the axis of illumination, filtering short wavelengths and the use of light shields resulted in 4-log-unit lower intensities (0.8–3.7 W/cm²).Abbreviations ACL anterior chamber lens - ECCE extracapsular cataract extraction - ICCE intracapsular cataract extraction - PCL posterior chamber lens     

药品行政保护品种介绍:神经和精神系统药物(一)(待续)

文拉法辛缓释胶囊　通用名 :文拉法辛 (venla faxine)缓释胶囊。商品名 :怡诺思 (Efexor)缓释胶囊。化学名 :(R/S) 1 [2 (二甲胺 ) 1 (4 甲氧苯基 )乙基 ]环己醇盐酸盐。结构式见图 1。图 1　文拉法辛结构式　　　Fig 1　Structureofvenlafaxine　　申请日 :1999年 4月 16日。申请人 :荷兰AHP制药有限公司。申请号 :A NL 990 4 16 10。授权号 :B NL 9912 2 32 1。授权日 :1999年 12月 2 3日。法定行政保护期 :从授权之日起 7.5a ,到 2 0 0 7年 6月2 3日止。专利介绍 :欧洲专利第 0 12 2 6 6 9号。商标注册 :在我国注册的商标为怡诺…