Intra-operative quick insulin assay to confirm complete resection of insulinomas guided by selective arterial calcium injection (SACI)

Background and aims Insulinomas are rare endocrine disorders. Pre-operatively, conventional imaging techniques often fail to localise the tumor. In addition, due to the lack of quick insulin assays, intra-operative confirmation of complete resection was impossible until recently. Materials and methods Six patients with biochemical evidence of an insulinoma underwent pre-operative localisation studies and selective arterial calcium injection (SACI). In addition, insulin was measured before surgery and every 10–15 min after resection of the tumor using a quick insulin assay. Results Pre-operative localisation studies identified the tumor correctly as follows: endosonography: three of four, magnetic resonance imaging: two of four and SACI: six of six. Tumors in the head and body were enucleated while those in the tail were resected (n = 2, each). Those three patients, in whom magnetic resonance imaging and/or endosonography could localise the tumors pre-operatively, underwent laparoscopic surgery while the remaining three patients underwent open surgery. Intra-operatively, insulin dropped to normal levels within 20 min in all cases. After a follow-up of 0.8–3 years, all patients remained biochemically cured. Conclusions Pre-operatively, SACI appears to be a very sensitive localisation technique and may be most helpful in guiding the surgeon if conventional imaging techniques fail to localise the tumor. Complete removal of an insulinoma can be reliably predicted using a quick insulin assay. This paper was presented at the 2nd Biennial Meeting of the European Society of Endocrine Surgeons (ESES), May 18–20, 2006, Krakow, Poland.     

小鼠背根神经节中三个不同的钙激活氯离子通道基因家族的表达(英文)

目的在背根神经节(dorsal root ganglion,DRG)中等大小感觉神经元中可以观察到钙激活氯离子流(I_(Cl(Ca)))。在坐骨神经损伤模型中,在大多数大中神经元上诱导出类似的氯离子流。本文旨在探讨引起这个离子流的分子基础。方法使用常规的定量RT-PCR方法检测在DRG中三个基因家族的表达,这三个基因家族都具有诱导I_(Cl(Ca))的特点。结果在成年小鼠的DRG中,分别显示了在正常状态和坐骨神经损伤3天后CLCA,Bestrophin和Tweety基因家族成员的转录产物。结论mBestl和Tweety2可能在损伤诱导的DRG神经元I_(Cl(Ca))中发挥作用。     

异搏定区域动脉灌注在阻止急性胰腺炎重症化治疗中的作用

目的探讨钙拮抗剂异搏定区域动脉灌注在阻止急性胰腺炎重症化治疗中的作用。方法45例轻型急性胰腺炎患者被随机分为3组常规治疗组、静脉治疗组及动脉灌注组。入院后,常规治疗组采取常规保守治疗;静脉治疗组行合理液体治疗,静脉注射异搏定;动脉灌注组液体补充同时采用持续动脉灌注异搏定1~2周。测定治疗后1、4及7d血清肿瘤坏死因子-α(TNF-α)、白介素-1β(IL-1β)、黏附分子-1(ICAM-1)及P-选择素(P-selectin)水平。结果治疗后4、7d,血清TNF-α和P-selectin水平动脉灌注组较静脉治疗组及常规治疗组明显降低(P<0.05);血清IL-1β水平动脉灌注组和静脉治疗组均较常规治疗组明显降低(P<0.05);血清ICAM-1水平动脉灌注组明显低于常规治疗组(P<0.05)。结论持续区域动脉灌注异搏定可能通过减少细胞因子的产生,抑制黏附分子P-selectin和ICAM-1的上调,阻止急性胰腺炎重症化发展。     

Functional outcome and general health status in patients after arthroscopic release in adhesive capsulitis

Frozen shoulder is said to be a self-limiting entity but full recovery often takes more than 2 years. For that, most patients are unwilling to tolerate painful restriction while awaiting resolution. We prospectively investigated 30 patients (16 women, 14 men) for the outcome of arthroscopic capsular release in idiopathic frozen shoulder. Results were determined by the assessment of subjective and objective parameters to estimate both shoulder function and general health status. Symptoms persisted without improvement for a minimum of 6 months of conservative treatment. Preoperative average American shoulder and elbow surgeons score (ASES) was 35, visual analog scale (VAS) to measure pain was 7, and simple shoulder test (SST) was 4. Mean scores of the physical component of SF-36 were considerably reduced. Mean forward elevation was 85°, average abduction was 70°, mean internal rotation was 15°, and mean external rotation was 10°. Patients were followed-up at 6 weeks, 3, 6, 12 months and by a mean of 36 months. Range of motion for all planes improved (P < 0.05). Median VAS reduced to 2, average ASES increased to 91, and SST enhanced to a mean of 10 (P < 0.05). We stated improvement of the physical components in the SF-36 questionnaire in particular bodily pain and the role-physical score. There were no significant differences between the measurements in the early postoperative phase compared to the mid-term follow-up (P > 0.05). Our results demonstrate that arthroscopic release of refractory idiopathic frozen shoulder combined with a gentle manipulation provides reliable expectations for improvement in both clinical and general health status for most patients. We recommend the use of a limb-specific and a general-health-status questionnaire to conclude the benefit of the surgical intervention and contribute the optimization of a therapy concept more effectively.     

手术及综合康复治疗膝关节僵直

目的 探讨膝关节纤维性僵直手术及围手术期、术后综合康复治疗的方法和意义.方法 26例膝关节纤维性僵直患者,采用髌骨外上方小切口,辅助关节镜下行关节内粘连松解,并结合徒手推拿松解.术前进行心理宣教,术后第2天开始经止痛泵维持在CPM机上行慢速全范围关节活动度功能锻炼,并行主被动伸屈膝功能锻炼、髌骨内推训练.结果 术后平均随访19个月(8～32个月),膝关节活动度从术前平均32°增至113°,平均提高81°.无皮肤坏死、创口裂开、肌腱断裂、骨折等并发症发生.结论 关节镜辅助下小切口松解治疗膝关节纤维性僵直的手术操作简单,创伤小,康复快.膝关节僵直围手术期及术后综合康复治疗,对膝关节功能恢复有重要意义.     

孕妇血清钙及白蛋白测定的临床意义

目的 :了解测定血清钙、白蛋白的变化对孕妇影响的临床意义。方法 :采用邻甲酚酞络合酮、离子选择性电极法、溴甲酚绿法测定。结果 :孕妇组血清总钙、离子钙、白蛋白的含量明显低于非孕妇组 ,差异有非常显著性 (P<0 .0 1) ,中孕妇组与晚孕妇组比较血清总钙、离子钙没有差异 (P>0 .0 5 )。白蛋白含量晚孕妇组明显低于中孕妇组 ,差异有显著性 (P<0 .0 1)。结论 :血清总钙、离子钙、白蛋白对孕妇尤为重要。动态监测 ,及时补充可提高孕妇及胎儿的健康     

The expression of somatostatin receptors 1 and 2 in benign,pre‐malignant and malignant laryngeal lesions

The expression of somatostatin receptors 1 and 2 in benign, pre‐malignant and malignant laryngeal lesions The role of chemotherapy in squamous cell carcinoma of the larynx has not been clearly defined. Whilst toxic chemotherapy regimes may confer a marginal improvement in survival, surgery and radiotherapy remain the mainstay of treatment. Somatostatin is a naturally occurring peptide, which exerts antiproliferative and antiangiogenic effects via five membrane‐bound receptor subtypes. The expression of somatostatin receptor subtypes (SSTRs) 1 and 2 was studied in benign, pre‐malignant and malignant laryngeal specimens. Epithelial expression of SSTR1 was detected in 4/6 (67%) Reinke's oedema, 5/6 (83%) pre‐malignant and 8/12 (67%) malignant specimens, with virtually no stromal or vascular expression. High levels of epithelial SSTR2 expression were noted in all Reinke's oedema specimens, compared with low‐to‐moderate levels in only 2/6 (33%) pre‐malignant and 3/12 (25%) malignant specimens (P < 0.01). This ‘loss’ of epithelial SSTR2 expression may provide a growth advantage in pre‐malignant and malignant laryngeal lesions. Vascular expression of SSTR2 was ubiquitous in all groups, with scant stromal expression. Overall, most (>80%) pre‐malignant and malignant laryngeal specimens expressed at least one of the two SSTR subtypes studied. Somatostatin analogues may have a therapeutic role in squamous cell carcinoma of the larynx.     

精密过滤介质在泛酸钙生产中的应用

在泛酸钙生产过程中，采用精密微孔过滤机代替离心机与快开式平板过滤器的生产工艺，提高了产品产量和质量，减少了溶剂的损失。     

Inhibition of the amorphous calcium phosphate phase transformation reaction by polyphosphates and metal ions

Summary The induction time for amorphous calcium phosphate (ACP) phase transformation was monitored at pH 7.4 and T=25°C with [Ca²⁺]₀=[PO₄]₀=4.0×10⁻³ M, as a function of added crystal growth inhibitors Mg²⁺, Sr²⁺, Zn²⁺, pyrophosphate (PP), and tripolyphosphate (TPP). Metal ions increase the induction time for the initiation of the phase change reaction in the order Zn²⁺<Sr²⁺<Mg²⁺. For polyphosphates it was observed that both PP and TPP are potent inhibitors with TPP more effective than PP as expected. The combination of Mg²⁺ or Sr²⁺ and PP or TPP leads to a synergistic delay in the onset of the phase conversion. The greatest inhibition was observed for Mg²⁺ and TPP. Reaction solutions containing 2.0×10⁻⁴ M Mg²⁺ and 4.0×10⁻⁵ M TPP resulted in a 90% increase in the induction time over what would be anticipated from an additive effect from these species.     

Transforming growth factor alpha treatment alters intracellular calcium levels in hair cells and protects them from ototoxic damage in vitro

To determine if transforming growth factor alpha (TGFα) pretreatment protects hair cells from aminoglycoside induced injury by modifying their intracellular calcium concentration, we assayed hair cell calcium levels in organ of Corti explants both before and after aminoglycoside (i.e. neomycin, 10⁻³M) exposure either with or without growth factor pretreatment. After TGFα (500ng/ml) treatment, the intracellular calcium level of hair cells showed a five-fold increase as compared to the levels observed in the hair cells of control cultures. After ototoxin exposure, calcium levels in hair cells of control explants showed an increase relative to their baseline levels, while in the presence of growth factors pretreatment, hair cells showed a relative reduction in calcium levels. Pretreatment of organ of Corti explants afforded significant protection of hair cell stereocilia bundle morphology from ototoxic damage when compared to explants exposed to ototoxin alone. This study correlates a rise in hair cell calcium levels with the otoprotection of hair cells by TGFα in organ of Corti explants.