苯妥英钠致过敏综合征

18岁女性胶质瘤术后患者,给予苯妥英钠100mg,3次/d预防癫痫发作。治疗16d后出现发热(38.2℃),给予对乙酰氨基酚治疗后第2天出现红斑、水疱、高热(40℃)。立即停用对乙酰氨基酚,仍见皮肤水泡,眼结膜、口腔黏膜糜烂,查WBC15.59×109/L,ALT87U/L。停用苯妥英钠,予激素抗过敏治疗及其他对症支持处理,治疗45d患者痊愈出院。     

单唾液酸四己糖神经节苷脂钠致严重过敏反应2例

2例患者静脉滴注单唾液酸四己糖神经节苷脂钠引致严重过敏反应。第1例为91岁男性帕金森病患者,静脉滴注单唾液酸四己糖神经节苷脂钠40mg,滴注10min后出现寒战、心悸、全身冷汗,BP由入院时的155/70mmHg降至130/60mmHg。第2例为84岁男性慢性肾功能衰竭合并脑缺血患者静脉滴注60mg,滴注结束后5min出现胸闷、心悸、头晕、寒战、四肢厥冷、全身冷汗、神志淡漠,BP由入院时的150/80mmHg降至90/60mmHg。2例患者经过抗过敏治疗和对症治疗后症状消失。停用该药后未再出现类似症状。     

Paradoxical effect of sodium valproate that aggravates epilepsy of MELAS in a patient with A3243G mutation of the mitochondrial DNA

Epilepsy is an associated feature of patients with the syndrome of mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS). A substitution at nucleotide position 3243 A>G of the mitochondrial DNA is the most common mutation encountered both in Caucasians and in Chinese/Taiwanese. We herein report a 38-year-old man with A3243G mutation of the mitochondrial DNA whom developed MELAS. The manifestation of his focal motor epilepsy was aggravated by use of sodium valproate (VPA). The mechanism of this paradoxical effect is proposed.     

杆状病毒介导内耳基因治疗的实验研究

目的探讨重组杆状病毒作为内耳基因治疗载体的可行性及其转染特点。方法应用Bac-to-Bac杆状病毒表达系统制备重组杆状病毒Bac-GFP,建立新生大鼠耳蜗Corti器体外模型,加入携带报告基因的病毒悬液,观察外源基因表达情况,并将其通过圆窗直接显微注射进入豚鼠内耳,观察杆状病毒在体内的转染特点。结果Bac-GFP联合丁酸钠可以高效转染毛细胞和螺旋神经节细胞,但并没有改变Corti器的正常结构。体内试验显示杆状病毒可以忠实和长效转染螺旋神经节细胞,而未被补体系统灭活。结论实验证实杆状病毒有希望成为内耳基因治疗的新型载体。     

可调钠透析在维持性血液透析中的运用

目的观察可调钠透析对透析脱水患者低血压的防治作用,以及透析前后血钠浓度的变化,评价PHD的临床效果和安全性。方法选择规律维持性血液透析患者36例,随机分成2组,每组18人,分别行普通透析与可调钠透析,观察透析后低血压的发生率,透析间期平均血压、心率,超滤量和透析后血钠浓度的变化。结果透析后可调钠透析组的低血压发生率明显低于普通透析组,而超滤量显著高于普通透析组,血钠浓度、心率等无明显差异。结论可调钠透析可明显降低透析脱水患者低血压的发生率,并且明显缓解患者的水负担,提高透析的充分性,还能改善患者心血管功能的稳定性。     

比色法测定复方阿仑膦酸钠缓释片中阿仑膦酸钠的含量

目的 测定自制的复方阿仑膦酸钠缓释片中阿仑膦酸钠的含量.方法 在碱性条件下,以水合茚三酮乙醇溶液为显色剂, 采用比色法测定,检测波长为568.0 nm.结果 阿仑膦酸钠在4.5～45.0 μg /mL浓度范围内呈良好的线性关系(r=0.9994, n= 6) ;平均回收率为99.28%(RSD =1.32%, n=6) .结论 该方法检测方便快速,结果准确可靠,能满足对制剂中含量控制和测定的要求.     

Bicarbonate Enhances Sodium Absorption from Glucose and Glycine Rehydration Solutions

ABSTRACT. Sodium, potassium and water absorption was studied over the whole length of rat jejunum and ileum by an in vivo marker perfusion technique. The composition of solutions were similar to the oral rehydration solution currently in use for the treatment of acute diarrhoeal diseases. The study shows that bicarbonate and chloride containing glucose or glycine electrolyte solutions induce a significantly greater absorption of sodium, potassium and water compared to those containing chloride only. The study also confirms that an amino acid such as glycine is as efficient as glucose in promoting the absorption of sodium, potassium and water from rat small intestine.     

Serum sodium levels and probability of recurrent febrile convulsions

In a prospective study of 69 children with febrile convulsions, serum sodium levels were often lower than normal (52% had levels <135 mmol/l). The mean level (134.4±0.4 mmol/l) was significantly lower as compared to a group of children without fever (140.6±0.4 mmol/l,n=23) and as compared to a group with fever but without convulsions (137.6±0.6 mmol/l,n=31). The probability of a repeat convulsion within the same febrile period appeared to be significantly related to the serum sodium level.Conclusion Measurement of the serum sodium is a valuable investigation in the child with a febrile convulsion. The lower the serum sodium level, the higher the probability of a repeat convulsion. This knowledge may be of practical value in deciding whether to admit the child or allow it to return home and in advising parents or carers of the risk of a repeat convulsion.     

Effect of valproate and carbamazepine on visual evoked potentials in epileptic children

The effects of carbamazepine (CBZ) and sodium valproate (SV) monotherapy on visual evoked potentials (VEP) were studied in 18 epileptic children receiving CBZ and nine epileptic children receiving SV. Pattern reversal VEP were determined before the administration of antiepileptic drugs (AED) and 1 year later during which time the patients had received AED. The VEP amplitude showed no consistent changes after 1 year of CBZ and SV therapy, but VEP P-100 latencies were significantly prolonged after 1 year of CBZ therapy. We conclude that CBZ causes a slowing down of central impulse conduction and that VEP is useful to evaluate the effects of AED within the central nervous system.     

Sweat Sodium Related to Amount of Sweat after Sweat Test in Children with and without Cystic Fibrosis

ABSTRACT. The sweat concentration of sodium was found to be inversely correlated with the amount of sweat obtained after a sweat test according to the method of Gibson & Cook in children without and with cystic fibrosis. Reference intervals for sweat sodium overlapped for the two groups but two-dimensional reference distributions for the amount of sweat (range 20-440 mg) correlated with its sodium content were completely separated. The establishment of similar distributions in centres carrying out sweat tests could serve to assess the performance of this investigation at local level.