Long-term observation of chronic subsutaneous administration of lisuride in the treatment of motor fluctuations in parkinson's disease

Summary Twenty-nine patients with advanced Parkinson's disease were treated with subcutaneous lisuride infusion in addition to a basic therapy consisting of levodopa + PDI in all, and deprenyl in some patients. At the time of the report, 13 patients are still receiving lisuride infusion after 5–36 months, while 16 have dropped out after 0.5–30 months one because of psychosis, three because of insufficient efficacy, three due to death unrelated to treatment, three because of difficulties in handling the pump as outpatients, and six for other reasons. Off-periods and parkinsonian disability in off and in on were reduced significantly. These improvements remained constant throughout the observation period. Once the optimal dose regimen is established, only minor adjustments of the doses of lisuride and levodopa are required in the individual case.     

胃癌术后镇痛对肠功能恢复的观察与护理

目的　探讨胃癌手术后硬膜外持续镇痛对患者肠功能的影响。方法　对 6 0例胃癌术后病人进行随机分组 ,PCEA(pa tientcontrolledEpiduralanalgesia)组 :采用硬膜外持续镇痛 (30例 ) ;对照组 :采用间断注射镇痛剂 (30例 ) ,观察肠蠕动、肛门排气时间及不良反应。结果　肠蠕动恢复时间PCEA组 (5 2 1± 4 3)h ,对照组 (5 1 5± 4 4 )h。肛门排气时间PCEA组 (6 5 4±7 5 )h ,对照组 (5 6 1± 9 3)h。PCEA组不良反应明显少于对照组。结论　术后镇痛不影响胃癌术后肠蠕动恢复 ,但应加强术后早期活动的指导     

腹腔灌注联合射频透热治疗28例晚期卵巢癌

[目的]探讨晚期卵巢癌腹腔转移的治疗方法。[方法]以顺铂 卡铂 依托泊甙为主的联合方案行腹腔持续热灌注化疗并腹腔射频透热治疗28例晚期卵巢上皮癌，观察其疗效及毒副反应。[结果]完全缓解(CR)5例，部分缓解(PR)16例，稳定（NC）5例，进展（PD）2例，总有效率75.0%。主要毒副反应为骨髓抑制。[结论]双铂联合依托泊甙腹腔热灌注并射频透热治疗对中晚期卵巢癌疗效较好，毒副反应少。     

Phase II study of continuous-infusion high-dose ifosfamide in advanced and/or metastatic pretreated soft tissue sarcomas

Background: Ifosfamide has important activity in pretreated soft tissue sarcomas (STS), and recent data support a clinically significant dose-response relationship for this agent. Administration by continuous infusion and hematopoietic support have rendered dose intensification regimens possible by reducing both hematologic and non-hematologic toxicities. The optimal dose and schedule of ifosfamide when given at high doses remain to be defined. In a previous phase I study, we demonstrated the feasibility of a continuous infusion (c.i.) high-dose ifosfamide (HDI) regimen in the ambulatory setting for patients with advanced solid tumors. The objective of the present phase II study was to assess the antitumor activity and toxicity of such a schedule in patients with advanced pretreated STS.Patients and methods: Thirty-eight patients with advanced and/or metastatic STS, all pretreated with an anthracycline with or without standard-dose ifosfamide, were treated. Ifosfamide was given by c.i. at a dose of 3.5 g/m²/day over four consecutive days, with equidose mesna uroprotection over five days. G-CSF was added at a dose of 200 µg/m²/day subcutaneously from day 6 to day 12. Cycles were repeated every three weeks in the outpatient setting.Results: A total of 159 cycles of therapy were given (median 4 per patient, range 3–6). Treatment compliance was generally satisfactory. The major toxicity was hematologic, with six febrile neutropenic episodes requiring hospitalisation and parenteral antibiotics. Acute renal failure occurred in one patient after three cycles of therapy; central nervous system toxicity was mild. An overall response rate of 39% was observed (95% confidence interval, 26% to 55%), with one complete and 14 partial remissions. All but one of the responder patients had previously received standard-dose ifosfamide. The median response duration was nine months (range 5–21+ months), and the overall median survival ranged from 6–30+ months (median 13 months).Conclusions: High-dose ifosfamide is an active regimen in anthracycline- pretreated STS. Future clinical trials should be aimed at evaluating the impact of different administration schedules on clinical response and outcome. The potential role of HDI as front-line chemotherapy as well as in the adjuvant treatment of STS needs to be investigated in randomized trials.     

Randomized trial comparing monthly low-dose leucovorin and fluorouracil bolus with weekly high-dose 48-hour continuous-infusion fluorouracil for advanced colorectal cancer: A Spanish Cooperative Group for Gastrointestinal Tumor Therapy (TTD) study

Purpose: The objective of this multicenter study was to compare the efficacy and toxicity profiles of a combination of 5-fluorouracil (5-FU) given by bolus injection together with intravenous leucovorin (LV) versus high-dose 5-FU in continuous infusion (CI) in the treatment of advanced colorectal cancer.Patients and methods: A total of 306 patients were randomized to receive either 5-FU 425 mg/m² given by bolus injection on days 1–5 plus intravenous (i.v.) LV 20 mg/m² every four to five weeks or 5-FU 3.5 g/m²/week in a 48-hour CI. Therapy was continued until disease progression. Second-line chemotherapy was allowed in both arms.Results: The response rates in 306 patients with measurable lesions were 19.2% (modulated arm) and 30.3% (CI arm, P < 0.05). The median progression-free survival times were 23.5 weeks (modulated arm) and 25 weeks (CI arm, P = NS). Median survival times were 42.5 weeks (modulated arm) and 48 weeks (CI arm, P = NS). There were no significant differences in grade 3–4 toxicity profiles but if we consider all grades we observed more mucositis in the modulated arm and more hand-foot syndrome in the CI arm.Conclusions: In terms of response rate, the continuous infusion regimen was more effective than the modulated regimen. There was no significant difference in survival and time to progression, and none in grade 3–4 toxicity.     

鼻塞持续气道正压通气治疗新生儿呼吸衰竭临床观察

目的观察经鼻塞持续气道正压通气(N-CPAP)治疗新生儿呼吸衰竭的效果。方法应用STEPHANN-CPAP小儿呼吸机对30例危重新生儿进行经鼻塞持续气道正压通气呼吸支持治疗,观察治疗前后临床症状和血气变化。结果治疗有效25例,无效5例。治疗有效患儿使用N-CPAP时间12~96h,平均(32±4)h。并发症为鼻黏膜损伤,共12例。全部病例均治愈出院。结论N-CPAP治疗新生儿肺炎并呼吸衰竭及早产儿原发性呼吸暂停效果显著,是新生儿科一种简便易行、无创安全、疗效显著的呼吸支持设备。     

A catheter technique in ophthalmic regional anaesthesia. Cadaver experiments

BACKGROUND: Regional anaesthesia for ophthalmic surgery is generally accomplished by peri- or retrobulbar techniques. Depending on the duration of ophthalmic surgery, reblock might become necessary. Our goal was to invent a catheter technique for ophthalmic regional anaesthesia that enables the user to administer local anaesthetics intraoperatively into the peri- or retrobulbar space continuously. METHODS: Twenty-five adult cadaver orbits of normal size and anatomy were used for the experiments. A flexible catheter was introduced transcutaneously or transconjunctivally into the extra- or intraconal space. Methylene blue solution was injected through the catheter. RESULTS: Using the same transcutaneous retro- and peribulbar technique, it was possible to introduce flexible catheters into a proper position of the cadaver orbits. The injected dye was found intra- or extraconally. CONCLUSION: Examining the spread of the dye in the orbit, we concluded that it is possible to provide ophthalmic anaesthesia for surgery through an indwelling catheter. We proved that continuous or intermittent administration of a local anaesthetic agent into the extra- or inraconal space can be achieved and this technique may allow us to maintain anaesthesia as long as it is necessary.     

先天性白内障手术中预防后发障的方法

目的　探讨小儿先天性白内障手术中预防后发障的方法。方法　对 46例 ( 4 6眼 )先天性白内障 ,以白内障超声乳化仪的注吸I/A系统吸净晶状体植入人工晶状体后 ,进行后囊连续环形撕囊及前段玻璃体切除联合手术 (A组 ) ,同期施行的3 2例 ( 3 2眼 )先天性白内障 ,以同样的方法行白内障摘出人工晶状体植入后 ,进行单纯后囊连续环形撕囊术 ,不做前段玻璃体切除 ,作为对照组 (B组 )。术后随访 2年以上。结果　后发障发生的情况 ,A组 2眼 ( 4 4% ) ,B组 7眼 ( 2 1 9% ) ,两组对比差异具有显著性意义 (P <0 0 5 )。两组均未发现眼底并发症。结论　先天性白内障术中行后囊连续环形撕囊联合前段玻璃体切除术 ,是预防后发性白内障的有效方法。     

连续环形撕囊的大小对后囊浑浊的影响

目的　分析不同口径连续环形撕囊对后囊浑浊的影响。方法　回顾 10 1眼分别以囊口直径 4 5～ 5 0mm和 6 0～7 0mm连续环形撕囊 ,行白内障超声乳化联合后房人工晶状体植入术 ,观察术后后囊浑浊的情况。结果　随访 1年 ,A组采用小口径连续环形撕囊 68眼中 1年发生后囊浑浊 2 5眼 ( 3 6 8% ) ,其中 2级 2 1眼 ( 3 0 9% ) ,3级 4眼 ( 5 9% ) ;B组采用大口径连续环形撕囊 3 3眼中 1年发生后囊浑浊 2 6眼 ( 78 8% ) ,其中 2级 18眼 ( 5 4 5 % ) ,3级 8眼 ( 2 4 2 % )。 2组间发生后囊浑浊 2级、3级 ( χ2 =4 2 976,P <0 0 5 ;χ2 =5 5 0 73 ,P <0 0 5 )差异均具有显著意义。结论　小口径截囊者后囊浑浊发生率低于大口径截囊者。     

不同截囊方式所致晶状体后囊破裂的比较

目的　比较开罐式截囊与连续环形撕囊术中后囊破裂的原因和发生率。方法　将作者 4年来手术的 13 3眼白内障按时间顺序分为A组和B组。A组行开罐式截囊 ;B组行连续环形撕囊 ,其它步骤相同。分别统计后囊破裂的例数和原因。结果　后囊破裂共 14眼 ,其中A组 10眼 ,发生率 10 75 % ;B组 4眼 ,发生率 10 0 0 %。两组发生率的差异无显著意义 ( χ2=0 0 16,P >0 5 0 )。结论　后囊破裂与截囊方式无关。