Modulation of 5-fluorouracil with methotrexate and low-dose N-(phosphon-acetyl)-L-aspartate (PALA) is inactive in advanced pancreatic carcinoma

Purpose: To evaluate the effect of biochemical modulation by PALA and methotrexate on the therapeutic activity of 5-fluorouracil (5-FU) in patients with advanced pancreatic adenocarcinoma.Patients and methods: The treatment protocol consisted of phosphonacetyl-L-aspartate (PALA) 250 mg/m² i.v. 15-minute infusion followed by methotrexate 200 mg/m² i.v. 30-minute infusion on day 1 and 5-FU 600 mg/m² i.v. push on day 2. Folinic acid was given at 15 mg/m² p.o. every six hours for eight doses, starting 24 hours after methotrexate infusion. Cycles were repeated every two weeks.Results: Thirty patients with advanced chemotherapy-naive pancreatic cancer were included; 26 had measurable disease. Median age 56 years (27–72); median PS 1 (0–2). One PR (3.9%) was achieved; nine patients had stable disease. Median time to progression was 91 days. Median survival was 177 days and one year survival was 13.3% (4 of 30 patients). Treatment was well tolerated; diarrhea WHO grade 2 or 3 occurred in six patients; stomatitis WHO grade 2 and 3 in nine patients.Conclusions: Modulation of 5-FU by PALA and MTX given in this dose and schedule appears to be ineffective in patients with advanced pancreatic adenocarcinoma.     

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.     

Heat-Induced Hyperactivation

Purpose: The objectives of this study were (1) to determine the sperm hyperactivation and related kinematic parameters at 40°C after using four sperm wash procedures and (2) to correlate the heat-induced hyperactivation data with cases of clinical pregnancies from either artificial insemination or standard in vitro fertilization (IVF). Methods: Semen samples (n = 51) were collected by ejaculation, and semen analyses were carried out to determine the pretreatment data. Sperm kinematic measurements were performed using the Hamilton Thorn HTM-C computer-aided sperm analyzer. Hyperactivation was determined using the sort module on the HTM-C. Membrane integrity was assessed using the hypoosmotic sperm swelling procedure. Sperm morphology and acrosomal status were also determined using the Spermac stain. Each semen specimen was divided and processed through either the swim-up wash, the 1-h test-yolk buffer (TYB) wash, the 1 mg/ml pentoxifylline stimulant procedure, or the two-layer 90:47% gradient colloidal solution procedure. The washed sperm were incubated at 25 or at 40° C for 4 hr. After incubation, kinematic parameters were assessed for the posttreatment data. Semen specimens were obtained on different occasions for artificial insemination or standard IVF. Data from intracytoplasmic sperm injection cases were not included to avoid confounding factors. Live births and/or pregnancies with fetal heartbeat examined by ultrasound were considered clinical pregnancies. Results: Heat-induced hyperactive motility was significantly higher in sperm of the male partner of pregnant (n = 7) patients compared with nonpregnant (n = 44) patients (mean ± SE, 10.0 ± 3.3 versus 5.5 ± 0.8%) after TYB processing fallowed by 4 hr of incubation at 40°C. This was also observed after colloid (Percoll) processing (11.6 ± 4.6 versus 5.8 ± 0.8%). There were no differences in hyperactivation after 4 hr at 23°C between pregnant and nonpregnant cases. Parameters such as count, volume, motility, viability, and acrosomal status were not different for the groups. However, the percentage of sperm with normal morphology (WHO classification) was twice as high in the pregnant group versus the nonpregnant group. Conclusions: Heat-induced hyperactivation was associated with fertile sperm and was predictive of pregnancy obtained after artificial insemination or IVF. The association was evident only after TYB or Percoll sperm processing. The study could not confirm the finding of significant decreases in motility after heat treatment of sperm derived from infertile males. The mechanism for heat-induced hyperactivation did not involve membrane integrity or the sperm acrosome, although an involvement of heat shock proteins was postulated. Interestingly, there were no pregnancies when sperm did not exhibit heat-induced hyperactivation.     

慢性乙肝患者血清转氨酶变化与肝组织学炎症程度相关性的研究

目的探讨慢性乙肝患者肝功能变化与肝组织学炎症活动程度分级（G）的相关性及临床价值。方法对60例生化指标（AST、ALT）明显异常的慢性活动性乙肝患者进行肝组织活检，观察肝组织炎症程度与肝功能生化指标的相关性。结果在所观察60例慢性乙肝患者肝功能血清生化指标异常时，肝组织均有不同程度的炎症（G），但所检测的AST、ALT并不随着炎症的增加而升高（P〉0．05）。结论肝功能血清生化指标能提示慢性乙肝患者肝组织有不同程度的炎症，但肝组织炎症程度与ALT和AST的异常程度不相关。     

便携式全自动气压止血带的研制

介绍了便携式全自动气压止血带的原理、特点及应用前景.     

Total versus tube-related additional work of breathing in ventilator-dependent patients

BACKGROUND: In tracheally intubated or tracheostomized spontaneously breathing patients, tube resistance can highly increase the patient's work of breathing. In this study we focused upon the relationship between total (WOBtot) and tube-related additional inspiratory work of breathing (WOBadd) and compared different ventilatory modalities for proper tube compensation. METHODS: In ten tracheostomized spontaneously breathing patients we measured WOBtot and WOBadd in the continuous positive airway pressure (CPAP) mode, under inspiratory pressure support of 5, 10, and 15 cmH2O in the pressure support ventilation (PSV) mode, and under flow-adjusted pressure support in the automatic tube compensation (ATC) mode. WOBadd and WOBtot were calculated on the basis of measured tracheal pressure and esophageal pressure, respectively. Inspiratory peak tracheal pressure above PEEP was taken as an estimate of pressure support beyond mere tube compensation (i.e., overcompensation). RESULTS: The percentage of the tube-related WOBadd on WOBtot in the CPAP mode was 52%. It decreased with increasing pressure support in the PSV mode from 32% (PSV 5 cmH2O) to 17% (PSV 15 cmH2O). WOBadd was only 15% of WOBtot in the ATC mode. In contrast to the other ventilatory modes, reduction of WOBadd in the ATC mode was achieved with the smallest amount of overcompensation, i.e. with minimal pressure assist beyond mere tube compensation. CONCLUSION: In tracheally intubated or tracheostomized spontaneously breathing patients, adequate compensation of tube resistance (i.e. with minimal overcompensation and minimal undercompensation) is best done by the ATC mode.     

血细胞分析仪的工作原理及其近期发展

本文简要介绍了血细胞分析仪的主要工作原理，各主要厂家在血细胞分析仪上采用的白细胞分类技术及业界的技术进展。     

不同血细胞分析系统间检测结果的偏差评估及应用

目的 分析同一临床实验室不同型号的血细胞分析仪的性能特点，并对其检测结果进行评估，对有偏差的项目进行调整，使同一实验室不同型号的血细胞分析仪的检测结果具有可比性。方法 对本实验室所使用的Sysmex KX-21、Sysmex SE-9500和Beckman Coulter Ac．T 5diff三台血细胞分析仪的准确度、精密度、线性度分别进行评价，选定其中一台指标最优的仪器作为比对仪器，将另外两台仪器的血细胞参数进行调整。结果 因Sysmex KX-21的WBC、RBC、HGB及PLT四项指标的准确度、精密度、线性度均较理想，故选为比对仪器。Sysmex SE-6500和Beckman Coulter Ac．T 5diff有部分指标的部分评价项目与Svsmex KX-21有偏差。对有偏差的项目进行调整后，三台仪器的四项指标的相关系数的平方均不低于0．95。结论 同一实验室在使用不同型号的血细胞分析仪时，应对其进行相互校准。校准后，保证三台仪器的检测结果具有可比性。     

亚热带气候环境下西藏小型猪部分血液生理生化指标的比较

目的比较研究西藏小型猪在亚热带气候环境下的部分血液生理生化指标。方法常规方法测定原代和F1代西藏小型猪血液的9项生理和9项生化指标,比较两代之间以及雌、雄之间的不同,并与其他实验动物及人类的同类指标进行对比分析。结果在生化指标中,原代雌雄之间AST差异显著;F1代雌雄之间TG、ALB有差异,BUN、CHOL有显著性差异。在生理指标中,原代雌、雄间无差异,F1代雌雄间MONO有显著性差异。结论西藏小型猪已经基本适应亚热带地区的环境。与其他实验动物相比西藏小型猪许多生理生化指标更接近人类,非常适合替代犬、猴用于生物医学研究。     

基于单片机的输液监控系统设计

研制一种智能输液速度测控系统,以解决临床静脉输液方式之不便,提高输液安全性和效率。利用光电技术和调制解调技术实现对静脉输液液滴信号的可靠检测;利用单片机技术实现输液量计数、显示与监控。