大鼠静脉注射3种铂制剂后铂的肾排泄与肾分布比较研究

目的:探讨铂类抗癌药的肾毒性机制。方法:12只大鼠均分为3组,分别按铂元素10mg·kg-1剂量静脉注射顺铂、卡铂和双环铂,采用原子吸收法测定并计算4h尿药累积排泄率及肾组织中浓度。结果:4h累积排泄率顺铂、卡铂、双环铂分别平均为(33.7±5.7)%、(89.1±8.5)%、(70.1±9.8)%,肾组织中铂的浓度分别为(70.6±31.6)、(217.7±97.6)、(278.8±112.0)μg.g-1。结论:与顺铂相比,双环铂与卡铂肾排泄较快,肾组织中的铂浓度相对较高;肾组织中铂浓度高低与肾毒性大小之间可能无直接关系。     

Use of sodium nitroprusside in neonates: efficacy and safety

Sodium nitroprusside was administered to 58 neonates, including 11 with severe respiratory distress syndrome, 15 with persistent pulmonary hypertension of the newborn, 28 with clinical shock, three with systemic hypertension, and two with pulmonary hypoplasia, all refractory to conventional intensive therapy. Nitroprusside was infused at 0.2 to 6.0 micrograms/kg/min for periods of 10 minutes to 126 hours. Infants with severe respiratory distress syndrome had increased PaO2 and decreased PaCO2 or peak inspiratory pressure, and nearly all (82%) survived. Infants with persistent pulmonary hypertension of the newborn had variable responses; improvement did not correlate with survival, but survival (47%) was identical to that in an earlier series of infants given tolazoline. Infants in shock had improved perfusion, urine output, and serum bicarbonate levels, and these responses were significantly related to survival. Hypertension was controlled in all three hypertensive infants. Adverse effects were very uncommon. Toxic effects were not observed. Sodium nitroprusside is effective and can be used safely in circulatory disorders in the neonate.     

腹水浓缩回输治疗顽固性腹水的临床分析

目的探讨体外腹水浓缩回输治疗顽固性腹水的临床意义。方法选择顽固性腹水的患者，予以腹穿使腹水经过体外浓缩再回输入腹腔。观察体重、腹围、血液生化，利尿剂使用量的变化。结果与治疗前相比，腹水浓缩回输后，体重、腹围明显下降，利尿剂使用量减少，血浆白蛋白升高，胆红素、INR、电解质、肾功能无明显变化。结论腹水浓缩回输腹腔治疗顽固性腹水，效果可靠，操作简单，并发症少，有利于提高患者的生活质量。     

放置TCu220c宫内节育器15年左右子宫内膜形态学的研究

目的：探讨国产TCu220c宫内节育器（IUD）放置15年左右（13－17年）子宫内膜的形态学改变及其安全性，并为临床放置年限提供科学依据。方法：采用光镜、透射电镜，从组织病理学和超微结构病理学角度，对24例放置国产TCu220cIUD15年左右妇女的子宫内膜进行形态学研究。结果：TCu220cIUD放置15年左右，铜离子的作用在逐渐减弱，对子宫内膜的影响也在逐渐减轻，但TCu220cIUD仍然具有抗生育作用。子宫内 膜没有癌变倾向。对进入更年期的妇女，放置TCu220cIUD15年左右，子宫内膜仍无间变和癌变。结论：TCu220cIUD放置15年左右是较为安全的。     

Blunted Sensitivity to Sucrose in Autoimmune MRL-lpr Mice: A Curve-Shift Study

Lupus-prone MRL-lpr mice show an autoimmunity-associated behavioral syndrome that has many features similar to the effects of chronic stress. The present study evaluated whether autoimmune MRL-lpr mice show reduced responsiveness to sucrose, as observed in normal animals exposed to chronic mild stress. Sixteen-week old MRL-lpr mice and their age-matched congenic MRL +/+ controls were given 0%, 0.5%, 1%, 2%, 4%, 8%, or 16% sucrose solution to drink every 48 h in a one-bottle test. The MRL-lpr mice drank less than controls at all concentrations, except at 16%. The amount of sucrose consumed vs. solution concentration followed a saturation curve. Estimates were obtained for the concentration yielding the half-maximum response (X₅₀) and the response at saturating concentration of sucrose (R_max). The X₅₀ was significantly higher in MRL-lpr than in MRL +/+ mice, indicating a shift to the right of the concentration-intake curve. The R_max did not differ significantly between substrains, suggesting that the autoimmune process did not affect performance capacity. Pretreatment with the immunosuppressant cyclophosphamide diminished the substrain difference in X₅₀, suggesting that reduced sensitivity to sucrose is related to autoimmune/inflammatory factors. These results support the similarity between autoimmunity-associated behavioral syndrome and behavioral changes produced by chronic stress, and suggest common neuroendocrine mechanisms. Because reduced sensitivity to palatable stimulus may reflect blunted hedonic responsiveness (“anhedonia”), it is hypothesized that an autoimmune/inflammatory factor(s) produces the depression found in human lupus, and some cases of affective disorder. Copyright © 1996 Elsevier Science Inc.     

Functional heterogeneity of the descending limbs of Henle's loop

By using the in vitro microperfusion technique, were examined functions of the descending limbs of Henle's loop obtained from either the short-loop nephron (SDL) or the upper portion of the long-loop nephron of hamsters (LDLu). Morphological distinctions between these segments were confirmed by light and electron microscopic observations. Both segments were highly permeable to water. The LDLu was highly permeable to sodium and to chloride: efflux coefficients (10^–7 cm²·s^–1) for²²Na and³⁶Cl were 41.0±5.4 and 3.8±0.6, respectively. The SDL were less permeable to sodium and to chloride: efflux coefficient for²²Na and³⁶Cl were 2.9±1.4 and 0.9±0.2, respectively. In contrast, the SDL was more permeable to urea as compared to the LDL, efflux coefficients for urea being 5.1±1.4 vs 1.4±0.3, respectively. When composition of the perfusate was identical to that of the bathing fluid, no transepithelial voltage was demonstrated. The volume flux was very small or undetectable. From these observations, we propose that the internephron heterogencity must be taken into consideration for constructing a model of countercurrent system in the renal medulla.     

A double-blind randomized study comparing imipramine with fluvoxamine in depressed inpatients

Objective To compare the efficacy of imipramine and fluvoxamine in inpatients from two centers suffering from a depressive disorder according to DSM IV criteria.Methods The study included 141 patients with a depressive disorder according to DSM IV criteria. After a drug-free and placebo run-in period of 1 week, patients were randomized to imipramine or fluvoxamine; doses of both drugs were adjusted to a predefined target blood level. Efficacy was evaluated 4 weeks after attaining predefined adequate plasma level.Results The mean age of the study group (47 males, 94 females) was 51.8 (range 19–65) years. Of these 141 patients, 56 had episode duration longer than 1 year, 48 had mood congruent psychotic features, and 138 patients received medication. Seven patients did not complete the medication trial. The total number of patients using concurrent medication was 12/138 (8.6%). On the primary outcome criteria patients on imipramine improved significantly better on the change of illness severity score of the CGI (² exact trend test=4.089, df=1, P=0.048). There was no significant difference in 50% or more reduction on the HRSD, the other primary outcome criterion. On the secondary outcome criteria the mean reduction of the HRSD scores was significantly larger in the imipramine group than in the fluvoxamine group (mean difference=3.1, standard error (SE)=1.4, t=2.15, df=136, P=0.033). There was no significant difference in the number of patients with an HRSD 7 at the final evaluation.Conclusions In depressed inpatients imipramine is more efficacious than fluvoxamine. Both drugs were well tolerated by all patients.     

Postnatal urinary conductance measurement in preterm infants

The aim of this study was to determine whether serial urinary conductance measurements can be used to estimate reliably the end of the transition period of negative sodium balance in preterm infants. The relationship between urine conductance, measured by a conductance meter, and urine sodium concentration was determined in 109 pooled samples of urine obtained from 14 preterm infants during the transitional period of fluid balance. It was shown by linear regression analysis that urine sodium concentration (mmol l -1 ) = 0.78 ×urine conductance -1.25. Urine sodium concentrations derived from the above formula were concordant with urine sodium measured directly when used to calculate daily sodium balance in all 14 infants.

Conclusion: Urine conductance can be accurately measured at the cotside by neonatal nurses and used to identify the timing of the postnatal transition from negative to positive sodium balance in preterm infants. These findings can help in making decisions on the introduction of postnatal sodium administration to preterm infants.     

RP-HPLC法测定人血清中水杨酸的浓度

目的:建立测定人血清中水杨酸浓度的方法。方法:采用反相高效液相色谱法,HYPERSILODS(200×4.6mm,5μl)色谱柱;流动相:甲醇∶1%乙酸(45∶55);流速:0.9ml/min;检测波长:299nm;柱温:35℃。结果:水杨酸在0.51～32.64μg/ml范围内有良好的线性关系,r=0.9999,血清中药物最低检测浓度为0.1μg/ml(S/N=3),提取回收率为90%,血清中三种浓度回收率分别为103.92%、99.68%、99.51%,日内、日间RSD分别为3.9%、1.6%、1.0%及5.9%、3.2%、1.9%。结论:本法操作简单、快捷,方法灵敏度和准确度较高,适用于血药浓度及生物利用度的测定。