Impact of different doses of ethinyl oestradiol on reduction of final height in constitutionally tall girls

Fifty-two tall girls were treated for constitutionally tall stature with different ethinyl oestradiol (EE) dosages. They were divided into three different treatment groups: group B (100 g EE/day;n=11); group C (300 g;n=25) and group D (500 g;n=16) and compared with an untreated group A (n=21) matched for age, height, bone age (BA) and height prediction. Using the height prediction method TW II, EE treatment reduced final height compared with the untreated girls in a weak dose-dependent manner, 2.3 cm (100 g/day), 3.0 cm (300 g/day), and 3.8 cm (500 g/day). Such a dose dependency was not found on applying the Bayley-Pineau height prediction method (100 g/day: 4.1 cm; 300 g/day: 4.2 cm; 500 g/day: 4.5 cm). However, there was a striking inverse correlation of the BA at the onset of treatment with the height reduction achieved using the TW II method (r: –0.43;P<0.001). Importantly, girls with a BA below 12 years at the onset of treatment experienced a height reduction of more than 6 cm.The EE dose used in the range of 100–500 g/day is not crucial for the amount of height reduction in tall girls. In general high dose EE treatment should be given restrictively, and especially so in girls with a BA (TW2 RUS-ZH) above 12.0 years.     

Peri-operative elastase-α-1 proteinase inhibitor in patients with postoperative intervertebral discitis

Summary In a prospective study of 251 patients operated upon for lumbar disc herniation it has been investigated whether the preoperative and early postoperative values of Elastase--1 Proteinase Inhibitor (EPI) — an indicator of inflammatory processes — and C-reactive Protein (CRP) — a well known predictor of some postoperative complications — were correlated to the later development of discitis. Postoperatively discitis developed in 14 patients. A randomly choosen group of 15 complication-free patients out of the total of 251 cases was used as control group.Elevated EPI plasma values, especially in the pre-operative and first postoperative days, turned out to be significantly related to the likelyhood of later discitis development, but no such relation for the CRP plasma values could be established. Thus and early prediction of patients at risk for this complication seems to be possible by pre- and postoperative measurement of EPI. It could be justified —but its usefulness has yet to be proven — to give antibiotics prophylactically and other anti-inflammatory medication in patients with elevated pre- and postoperative EPI values.     

Prediction of survival and recurrence in bladder carcinoma

Summary We have followed a large population of patients receiving radiation treatment for bladder carcinoma with respect to survival and recurrence-free survival. Bivariate and multivariate life table analyses have been performed using a set of independent variables. The most important were T class, grade (G), urinary carcinoembryonic antigen (U-CEA) taken before treatment and cytological analysis 4 months after treatment. We compared the usual way of classifying a patient (T+G) with the combination of U-CEA and cytology since the latter two variables seemed to have great prognostic importance. The analyses show that T+G gives the best significance for survival (P=0.0003) while U-CEA and cytology is better for recurrence-free survival (=0.0002). 0.0002).     

血管抑素联合顺铂治疗Lewis肺癌

目的探讨血管抑素联合顺铂对内皮细胞增殖和Lewis肺癌生长抑制作用.方法将内皮细胞接种到96孔板中,加入不同试药72 h后,作MTT检测每孔中的细胞数.将Lewis肺癌细胞接种到C57小鼠右腋下,随机分为4组,分别用不同试药处理.每2日测量瘤体积,20天后处死动物,称取瘤重,常规病理和免疫组织化学染色检查,观察微血管密度和血管内皮细胞生长因子表达情况.结果顺铂与血管抑素在抑制血管内皮细胞增殖方面具有协同作用.顺铂组和顺铂 血管抑素组瘤体积、瘤重和血管密度均明显＜对照组.其中以顺铂与血管抑素在同时应用时瘤体积与瘤重又明显低于顺铂组.结论血管抑素与顺铂同时使用对lewis肺癌生长的抑制作用优于先后使用.     

国产长春瑞滨联合顺铂治疗转移性乳腺癌的临床观察

目的：观察国产长春瑞滨(盖诺)联合顺铂方案治疗转移性乳腺癌的临床疗效。方法：运用盖诺(25mg／m^2 IV dl，d8)加顺铂(DDP80mg／m^32 IV d1)治疗转移性乳腺癌26例。结果：取得CR3例(11．5％)，PR12例(46．1％)，总有效率RR(CR PR)达57．6％。主要毒副作用为骨髓抑制，胃肠道反应和静脉炎。白细胞减少的发生率100％，其中Ⅲ-Ⅳ度达57．7％。恶心、呕吐的发生率92．3％，Ⅲ-Ⅳ度达11．5％。静脉炎的发生率15．4％。结论：国产长春瑞滨联合顺铂对转移性乳腺癌疗效确切，且毒性可以耐受，可以作为对蒽环类药物治疗后复发，转移乳腺癌患者的二线治疗方案。     

抗菌药物联用对耐甲氧西林金黄色葡萄球菌体外抗菌活性研究

目的了解万古霉素与头孢哌酮/舒巴坦、亚胺培南、左氧氟沙星联用对MRSA的体外抗菌活性,指导临床合理用药。方法常规方法培养分离细菌,用VITEK微生物自动分析仪或API系统鉴定到种。MRSA鉴定应用乳胶凝集试剂盒,药敏试验采用肉汤倍比稀释法和琼脂平板稀释法。结果万古霉素对40株MRSA的MIC90为4mg/L,而与头孢哌酮/舒巴坦、亚胺培南、左氧氟沙星联用MIC90降为0.25～1mg/L。结论万古霉素与上述三种药物联用以协同作用为主,抗菌活性提高4倍以上。临床上治疗由MRSA引起的重症感染应根据药敏试验结果采用万古霉素与亚胺培南或头孢哌酮/舒巴坦或其它抗菌药物联合应用。     

中西医结合治疗急性白血病存活十年以上5例

中西医结合是提高急性白血病长期存活的有效途径。笔者采用中药与化疗相结合的方法治疗３００余例急性白血病患者中，５例存活长达１０年以上，最长１例已存活２０年，至今皆高质量健康生存。现代药理学研究表明部分中药具有良好的抗白血病作用。     

Validation of outcome prediction in elderly patients

We recently described an equation for predicting the 1-year survival of critically ill patients aged over 70 years. The aim of this study was to check the performance of this equation in a validation group of 555 patients. The required demographic details (age, diagnosis, acute physiology score) of all elderly patients admitted between 1/4/95 and 31/9/96 were recorded and patients were followed for 1 year. One hundred and six patients died on the intensive care unit (19% mortality) and a further 134 died within 1 year (43% total 1-year mortality). The performance of the predictive equation was modest; the goodness-of-fit p-value was 0.04 and the area under the receiver operating characteristic curve was 0.75. For both groups, the combined 1-year survival of all critically ill elderly patients was 55% but the outcome of patients aged over 85 years remains poor (37%).     

广州军区部队人群病毒性肝炎的预测

目的 :本研究试图将灰色模型应用于南方部队人群病毒性肝炎的预测。方法 :应用灰色模型和 EXCEL 将灰色模型在计算机上编程 ,对广州军区 1992年～ 2 0 0 1年病毒性肝炎的发病率资料进行预测值与实测值的比较 ,从而 ,判断灰色模型在影响因素较稳定的传染病预测中的价值。结果 :应用灰色模型对广州军区病毒性肝炎的发病率资料作预测 ,实测值与预测值的误差较小为 0 .2 ,是实际值均数的 14 .3% ,预测结果的精度属合格。结论 :灰色模型可应用于部队人群病毒性肝炎的预测 ,且这一预测方法在病毒性肝炎的预测中是有价值的     

拉米夫定联合α干扰素治疗HBeAg阳性慢性乙型肝炎

目的 :观察拉米夫定和干扰素联合治疗HBeAg阳性慢性乙型肝炎的疗效及其影响因素。方法 :64例HBeAg阳性的慢性乙型肝炎患者随机分成治疗组和对照组。治疗组32例 ,同时使用α干扰素及拉米夫定9个月 ,随后单用拉米夫定15个月,对照组32例 ,单用拉米夫定24个月 ,定期检测丙氨酸转氨酶 (ALT)、HBeAg、抗 -HBe、HBVDNA ,并作YMDD变异检测 ,两组在治疗结束时进行疗效评价。结果 :治疗组ALT复常率为90.6 % (29/32) ,对照组ALT复常率为87.5 % (28/32) ,两组差异无显著性 (P>0.05),治疗组HBeAg阴转率为68.8 % (22/32) ,对照组HBeAg阴转率为37.5 % (12/32) ,两组比较差异有显著性 (P<0.05) ,治疗组HBeAg/抗 -HBe血清转换率为53.1 % (17/32) ,对照组HBeAg/抗 -HBe血清转换率为25 % (8/32) ,两组比较差异有显著性 (P<0.05),治疗组HBVDNA阴转率为78.1 % (25/32) ,对照组HBVDNA阴转率为59.4 % (19/32) ,两组比较差异无显著性 (P>0.05) ,治疗组YMDD变异率为21.9 % (7/32) ,对照组YMDD变异率为40.6 % (13/32) ,两组比较差异无显著性 (P>0.05) ,同时治疗组ALT复常率、HBeAg转换率、HBVDNA阴转率与治疗前ALT及HBVDNA基线水平有关。结论 :α干扰素联合拉米夫定治疗HBeAg阳性的慢性乙型肝炎对于ALT中度升高、HBVDNA高水平复制