Effects of graft placement site on the survival of adrenal medulla transplants into the brain and its relation with the recovery of motor function

BACKGROUND: Because of their lack of long-term viability, adrenal tissue transplants have shown limited success in alleviating the motor disturbances associated with experimental and pathologic striatal dopamine denervation. In this study, we examined how the graft placement site influences adrenal medulla transplant survival and its relation with the reduction of motor deficits in rats bearing unilateral 6-OHDA lesion. METHODS: One or 5 microL of fetal adrenal medullar tissue was grafted either inside the striatal parenchyma or into the lateral ventricle in contact with the dopamine-denervated striatum. Motor disturbances, as assessed by apomorphine-induced rotation, were correlated to the graft morphologic survival features. RESULTS: Apomorphine-induced rotation showed a marginal reduction of 11% in all groups independently of graft survival features or placement site. Intrastriatal transplants showed limited viability characterized by a substantial loss of graft initial volume as well as fewer and smaller chromaffin cells compared to ventricular grafts, which had a reduced loss of graft initial volume and more and larger chromaffin cells. CONCLUSIONS: Although the lateral ventricle may favor adrenal medulla transplant viability, their induced motor outcome is comparable to that induced by less viable intrastriatal grafts, suggesting that the implanted dopamine-producing cells may interact and influence striatal neurons better when placed in close proximity.     

肺癌肺叶袖状切除术的安全性和有效性

目的:评价肺癌肺叶袖状切除术后患者的手术安全性和远期生存状况.方法:回顾分析了1999年10月至2003年12月行肺癌根治术的94名病例,其中肺叶袖状切除术11例(Ⅰ组),全肺切除术17例(Ⅱ组),肺叶切除术66例(Ⅲ组).通过比较三组术后气管插管时间、ICU停留时间、吻合口并发症率及围手术期死亡率,评价肺叶袖状切除术的手术安全性,比较Ⅰ、Ⅱ组间的生存期和转移复发率探讨其远期有效性.组间率比较用x2检验或Fisher精确检验,均数比较用t检验,生存分析用Kaplan-Meier法,生存曲线比较用Log rank检验.显著性差异标准α=0.05.结果:Ⅰ、Ⅱ、Ⅲ组的手术死亡率为0,11.8%,3.0%,组间无显著性差异;平均气管插管时间为0.5±2.3天,2.0±7.2天,0.6±4.1天(Ⅰ、ⅢVSⅡ组,P＜0.05);吻合口并发症率为3.0%,0,5.8%,组间无显著性差异.Ⅰ组1年、3年生存率为45.5%、32.5%,Ⅱ组为58.8%、45.8%.两组生存率、远期局部复发率和转移率无显著性差异.结论:肺癌肺叶袖状切除术具有和肺叶切除术相近的手术安全性,优于全肺切除术,而其复发转移率、远期疗效与后者相近,是安全有效的手术方式.     

The importance of free hydroxyl radicals to hypoxia preconditioning

Hypoxia preconditioning states that a sublethal hypoxia period will afford neuroprotection against a second harmful event. In our experiments, we carried out a procedure for the development of hypoxia preconditioning in adult male Wistar rats using hypoxic exposure (9% O(2); 91% N(2)) for 1 h. The protection against pentylenetetrazol (PTZ)-induced seizures was studied. For this, rats were tested by a single injection of PTZ (55 mg/kg i.p.) on days 1-21 after hypoxia exposure. The hypoxia exposure significantly prevented the development of acute PTZ convulsion at different times after hypoxia. The present study was designed to determine the effect of N-t-butyl-alpha-phenylnitrone (PBN), an electron-trapping agent and free radical scavenger, on hypoxia preconditioning against PTZ seizures 7 days after hypoxia exposure. PBN abolished the protective action of hypoxia exposure. The generation of free hydroxyl radicals in the brains of animals exposed to hypoxia was determined in a second experiment. For this purpose, the rats were i. p. pretreated with 30 mg/kg PBN and NaCl, respectively, 20 min before the start of hypoxia exposure. Forty-five minutes later the rats were i.p. injected with 300 mg/kg sodium salicylate and once again exposed to hypoxia for 15 min. Immediately after that the animals were decapitated and the free hydroxyl radicals and the salicylate content were estimated in the whole brain without cerebellum. Hypoxia preconditioned animals pretreated with NaCl showed a significantly higher extent of free hydroxyl radicals in the brain compared with PBN-injected preconditioned animals and with naive and sham exposed controls. The results pointed out that the generation of free reactive oxygen species under hypoxic conditions in the brain is involved in the development of the hypoxic preconditioning phenomenon.     

CoQ10 fails to protect brain against focal and global ischemia in rats

OBJECTIVE: Release of oxygen free radicals occurs following cerebral ischemia. Studies show that oxygen free radicals mediate ischemic brain injury. CoQ10 is a potent free radical scavenger and may offset brain injury associated with reperfusion. We tested exogeneous CoQ10 as a neuroprotectant in rats following both global and focal ischemic insults. METHODS: Rats were subjected to either 4-vessel occlusion ischemia (4-VO, 10 min occlusion, 7-day survival) or middle cerebral artery occlusion (MCAO, 120 min-occlusion, 22.5 h survival). Regional cerebral blood flows (rCBF) and physiological variables such as blood pressure, pO2, pCO2, plasma glucose and hematocrit were monitored and measured in focal ischemia. The animals were randomized to receive treatments of either phosphate buffered saline (PBS) vehicle or CoQ10 following global or focal ischemia. Injection times were at the end of ischemia and 3 h later for both models of ischemia. Histological outcomes are expressed as a percentage of hippocampal CA(1) cell injury in global ischemia or percentage of cortical infarct over that of non-ischemic hemisphere in focal ischemia. RESULTS: In global ischemia, animals treated with PBS vehicle and CoQ10 had 86+/-5% (n=8) and 83+/-10% (n=8), respectively, of hippocampal CA(1) cell injury (P>0.05). The percentage of infarct volumes in animals following focal ischemia were 23+/-9% (control, n=10) and 25+/-9% (CoQ10, n=10). There were no temperature or physiological differences between the two treatment groups. CONCLUSION: Acute treatment with CoQ10 via intraperitoneal injection does not prevent neuronal injuries following global and focal ischemia.     

Long-term survival following emergency abdominal aortic aneurysm repair

Survival following emergency surgery for ruptured abdominal aortic aneurysm remains poor and is in stark contrast to that for elective repair. We have carried out a 5-year retrospective observational study to determine the long-term (5-year) survival of patients following emergency surgery for ruptured abdominal aortic aneurysm at a district general hospital in East Anglia. A total of 99 patients presented to the operating theatre for emergency repair of ruptured abdominal aortic aneurysm in this 5-year study period. In-hospital mortality was 70% and was unchanged over the 5 years. Overall long-term survival in those patients discharged from hospital was good. The ICU cost per long-term survivor was calculated to be pound sterling 36750.     

人工耳蜗植入后不同言语处理器编程方案的比较

目的　了解和认识体佩式 (SPrint)和耳背式言语处理器 (ESPrit 3G)在调试中的不同特点 ,以便更好地进行人工耳蜗调式。方法　对 9例年龄 2～ 5 4岁的全聋患者于手术后 6～ 2 4个月由使用SPrint转换使用ESPrit 3G ,比较使用不同言语处理器调试所创建的电听力图之阈值 (thresholdlevel,T -L)和舒适阈 (comfortablelevel,C -L)、以及在ESPrit 3G使用不同程序时的声场测试和问卷调查结果 ,并进行统计学分析。结果　使用由SPrint获得的程序佩戴ESPrit 3G ,4例患者 (1组 )感觉聆听效果满意 ,与以往佩戴SPrint无差异。有 5例患者 (2组 )从不同言语处理器所获得的T -L和C -L有显著差异 (P <0 .0 1) ;使用不同的编程佩戴ESPrit3G进行声场 (啭音 )听阈测试 ,结果有显著差异 (P <0 .0 1) ;问卷调查显示使用经ESPrit3G直接调试获得的程序较使用由SPrint转换而来的程序有更好的聆听效果。 1组与使用ESPrit 3G调试获得程序的 2组的声场测试结果无差异 (P >0 .0 5 )。 1组与使用由SPrint转换而来程序的 2组的声场测试结果有显著差异 (P <0 .0 1)。结论　由佩戴SPrint转为使用ESPrit3G时 ,部分患者直接使用由SPrint转化而来的程序可能存在音量感受不足的情况 ,因此为了使患者获得更好的聆听效果 ,应经ESPrit 3G重新进行     

患者接受医院免费健康教育处方状况分析

目的　了解来北京大学第一医院就诊者及其家属对《健康教育处方》的认同状况。方法　对摆放健康教育处方前来院就诊者及其陪同家属 3 98人和摆放《健康教育处方》后主动索取《健康教育处方》的 5 49人进行问卷调查。结果　《健康教育处方》摆放前 ,97 74%的人认为候诊等待时烦躁 ,92 2 1 %的人抱怨缺乏阅读材料 ,97 99%的赞成摆放《健康教育处方》 ;摆放《健康教育处方》后 ,3 7 70 %的人候诊等待时感到烦躁 ,仅 9 47%的人抱怨缺乏阅读材料 ,98 1 8%的人赞成摆放《健康教育处方》。结论　在医院发放《健康教育处方》是可行的 ,由制药厂赞助《健康教育处方》印制的方式受到大多数就诊者的认可     

Measurement of aggregate risk with copulas

Summary When aggregating financial risk on a portfolio level, the specification of the dependence structure between the risk factors plays an important role. Promising parametric models are often based on a so-called copula approach. Case studies of market crashes suggest the application of concepts allowing for extremal dependence. We present a transformed copula as a new model that both fits the data and allows for exact prediction in the tails. It turns out that the new model improves benchmark models like the t- or Clayton copula with respect to risk measures like VaR or Expected Shortfall. By performing different goodness-of-fit tests, the quality of the estimation is examined.     

新辅助化疗应用于局部晚期乳腺癌的疗效分析

目的探讨术前新辅助化疗对乳腺癌的疗效及提高患者术后生存率的作用.方法采用CMF和CAF两种化疗方案对50例Ⅲ期乳腺癌术前患者(A组)进行化疗,评价其疗效;与术后化疗(B组)进行总疗效对照比较.结果术前新辅助化疗组经化疗肿瘤全消和部分消退合计总有效率为58.0%;术后随访5 a生存率、无瘤存活率明显高于对照B组,两组无瘤存活率比较χ2＝9.07,P＜0.01.结论术前全身治疗(化疗)作为乳腺癌第一步治疗可能是首先使已存在的临床小转移灶得以控制,进而获得更多治疗成功的机会.     

多方式下延续性护理对慢性非萎缩性胃炎患者出院后健康素养、生活质量和复诊率的影响

目的研究多方式下延续性护理对慢性非萎缩性胃炎(CNAG)患者出院后健康素养、生活质量和复诊率的影响。方法选择本院2018年10月至2019年6月诊治的94例CNAG患者作为研究对象,采用信封随机法将患者均分为延续组和常规组,各47例,前者给予多方式下延续性护理,后者给予常规护理。均干预6个月.,比较两组患者健康素养、生活质量以及复诊率。结果干预后两组患者健康素养分值均较干预前显著上升.,延续组患者上升幅度较常规组更显著(P<005);延续组.患者生理功能、生理职能、活力、精神健康、躯体疼痛、总体健康评分均显著高于常.规组(P<005),而情感职能、社会功能与常规组相比差异不显著(P>005);延续组患者复诊率显著高于常规组,但再就诊率与常规组相比差异不显著(P>005)。结论多方式延续性护理可有效提高CNAG患者的健康素养和生活质量,提高复诊率。