动力髋螺钉内固定与Gamma钉内固定治疗老年股骨粗隆骨折的比较

目的：比较动力髋螺钉（DHS）内固定与Gamma钉内固定治疗老年股骨粗隆间骨折的疗效,分析并发症发生原因及预防措施。方法：随机抽出老年股骨粗隆问骨折行DHS内固定60例（A组）,Gamma钉63例（B组）,通过病例分析获得年龄、性别、骨折类型、手术时间、术中出血、术后下床时间、功能恢复及并发症发生等指标,按手术方式分组,对手术时间、术中出血、术后下床时间、功能恢复情况和并发症发生情况进行比较。结果：DHS内固定组与Gamma钉内固定组比较手术时间明显延长、术中出血增多：但并发症发生、功能恢复优良率、术后下床时间相似。结论：Gamma钉内固定与DHS内固定临床疗效相似．但Gamma钉内固定在缩短手术时间及减少术中出血上有优势,较DHS内固定更能满足各种不同类型和年龄的股骨粗隆间骨折。     

Modulation of DNA repair capacity and mRNA expression levels of XRCC1, hOGG1 and XPC genes in styrene-exposed workers

Decreased levels of single-strand breaks in DNA (SSBs), reflecting DNA damage, have previously been observed with increased styrene exposure in contrast to a dose-dependent increase in the base-excision repair capacity. To clarify further the above aspects, we have investigated the associations between SSBs, micronuclei, DNA repair capacity and mRNA expression in XRCC1, hOGG1 and XPC genes on 71 styrene-exposed and 51 control individuals. Styrene concentrations at workplace and in blood characterized occupational exposure. The workers were divided into low (below 50 mg/m³) and high (above 50 mg/m³) styrene exposure groups. DNA damage and DNA repair capacity were analyzed in peripheral blood lymphocytes by Comet assay. The mRNA expression levels were determined by qPCR. A significant negative correlation was observed between SSBs and styrene concentration at workplace (R = − 0.38, p = 0.001); SSBs were also significantly higher in men (p = 0.001). The capacity to repair irradiation-induced DNA damage was the highest in the low exposure group (1.34 ± 1.00 SSB/10⁹ Da), followed by high exposure group (0.72 ± 0.81 SSB/10⁹ Da) and controls (0.65 ± 0.82 SSB/10⁹ Da). The mRNA expression levels of XRCC1, hOGG1 and XPC negatively correlated with styrene concentrations in blood and at workplace (p < 0.001) and positively with SSBs (p < 0.001). Micronuclei were not affected by styrene exposure, but were higher in older persons and in women (p < 0.001). In this study, we did not confirm previous findings on an increased DNA repair response to styrene-induced genotoxicity. However, negative correlations of SSBs and mRNA expression levels of XRCC1, hOGG1 and XPC with styrene exposure warrant further highly-targeted study.     

放射线诱导的K562细胞增殖抑制的初步研究

 目的　研究60Coγ射线诱导K562细胞增殖抑制的剂量效应关系以及受照过程中的K562细胞形态学变化和Egr-1基因表达的变化。方法　通过3H-TdR竞争性地掺入K562细胞的DNA合成,使用低本底液体闪烁计数器测定掺入细胞的放射性活度,分析K562细胞在受到60Coγ射线照射后的增殖抑制情况。采用吉姆萨染色法在显微镜下观察K562细胞的形态学改变。采用反转录PCR方法分析K562细胞在受照射后发生增殖抑制的过程中Egr-1基因的表达变化。结果 　细胞增殖抑制表现出明显的剂量依赖性;照射前后K562细胞的形态和染色特点发生了明显的变化,具备了某些较高分化程度的红细胞才有的特点;在接受照射后的早期,与细胞分化、凋亡密切相关的基因Egr-1有一过性的表达上调,表现为在照射后的0.5 h和 1 h ,早期生长反应基因Egr-1的转录水平迅速升至最高,此后迅速下降,到8 h下降到低于正常水平。结论　K562细胞的增殖抑制表现显著的剂量依赖性;受照后的K562细胞在形态学上向更成熟的阶段分化。Egr-1基因在受60Coγ射线照射后可被一过性激活表达。     

Impact of preexisting tumor necrosis on the efficacy of stereotactic radiosurgery in the treatment of brain metastases in women with breast cancer

BACKGROUND:

Breast cancer is the second most common source of brain metastasis. Stereotactic radiosurgery (SRS) can be an effective treatment for some patients with brain metastasis (BM). Necrosis is a common feature of many brain tumors, including BM; however, the influence of tumor necrosis on treatment efficacy of SRS in women with breast cancer metastatic to the brain is unknown.

METHODS:

A cohort of 147 women with breast cancer and BM treated consecutively with SRS over 10 years were studied. Of these, 80 (54.4%) had necrosis identified on pretreatment magnetic resonance images and 67 (46.4%) did not. Survival times were computed using the Kaplan‐Meier method. Log‐rank tests were used to compare groups with respect to survival times, Cox proportional hazards regression models were used to perform univariate and multivariate analyses, and chi‐square and Fisher exact tests were used to compare clinicopathologic covariates.

RESULTS:

Neurological survival (NS) and survival after SRS were decreased in BM patients with necrosis at the time of SRS compared with patients without necrosis by 32% and 27%, respectively (NS median survival, 25 vs 17 months [log‐rank test, P = .006]; SRS median survival, 15 vs 11 months [log‐rank test, P = .045]). On multivariate analysis, HER2 amplification status and necrosis influenced NS and SRS after adjusting for standard clinical features, including BM number, size, and volume as well as Karnofsky performance status.

CONCLUSION:

Neuroimaging evidence of necrosis at the time of SRS significantly diminished the efficacy of therapy and was a potent prognostic marker. Cancer 2012. © 2011 American Cancer Society.     

Epilepsy in the Renaissance: A survey of remedies from 16th and 17th century German herbals

Ethnopharmacological relevance

Before modern anticonvulsive drugs were developed people in central Europe used herbal remedies to treat epilepsy. Hundreds of different plants for this indication can be found in German herbals of the 16th and 17th centuries. Here we compile these plants and discuss their use from a pharmacological perspective.

Materials and methods

Nine of the most important European herbals of the 16th and 17th century including Bock (1577), Fuchs (1543), Mattioli (1590), 103 and 104, Brunfels (1532), Zwinger (1696), and Tabernaemontanus (1591, 1678) were searched for terms related to epilepsy, and plants and recipes described for its treatment were documented. We then searched scientific literature for pharmacological evidence of their effectiveness. Additionally the overlapping of these remedies with those in De Materia Medica by the Greek physician Dioscorides was studied.

Results

Two hundred twenty one plants were identified in the herbals to be used in the context of epilepsy. In vitro and/or in vivo pharmacological data somehow related to the indication epilepsy was found for less than 5% of these plants. Less than 7% of epilepsy remedies are in common with De Materia Medica.

Conclusions

Numerous plants were used to treat epilepsy in the 16th and 17th centuries. However, few of these plants have been investigated with respect to pharmacological activity on epilepsy related targets.     

伴有精神病性症状的抑郁症患者的甲状腺功能和体液免疫特征

目的探讨伴有精神病性症状的抑郁症患者的甲状腺功能和体液免疫功能。方法采用放射免疫分析法检测伴有精神病性症状的抑郁症患者48例、不伴精神病性症状的抑郁症患者48例的血清三碘甲状腺素原氨酸(T3)、甲状腺素(T4)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)的水平,采用免疫透射比浊法检测2组患者的血清免疫球蛋白G(IgG)、免疫球蛋白A(IgA)、免疫球蛋白M(IgM)、补体3(C3)、补体4(C4)的水平。结果两组甲状腺功能无统计学差异(P>0.05),伴有精神病性症状组血清C3水平低于不伴精神病性症状组(t=-2.290,P=0.028)。结论伴与不伴精神病性症状的抑郁症患者的血清补体3有一定差异。     

抗胸腺细胞球蛋白致患儿急性肝损害

1例17个月男性患儿,因1型糖尿病行自体造血干细胞移植入院。入院后皮下注射非格司亭5.0μg/kg行造血干细胞动员,给予环孢素25mg,2次/d口服,第12天肝功能正常。停用环孢素,改用抗胸腺细胞球蛋白（ATG）静脉滴注。第1天应用ATG8mg,第2天应用12mg,随后血生化检查：ALT1041U/L,AST209.3U/L,ALP296.4U/L,LDH695.1U/L,TBil19.3μmol/L,DBil11.7μmol/L。立即停用ATG,给予保肝治疗,肝功能逐渐好转。20d后行造血干细胞回输,无不适出院。随访半年肝功能正常。     

静脉滴注丙种球蛋白治疗重症毛细支气管炎免疫球蛋白变化及临床观察

目的 观察并分析丙种球蛋白(intravenous immune globulin,IVIG)治疗重症毛细支气管炎的疗效.方法 将78例重症毛细支气管炎(Lowell评分≥10分)患儿分为治疗组40例,对照组38例,对照组给予常规综合治疗,治疗组在常规治疗的基础上给予IVIG(400 mg·kg-1·d-1)静脉滴注,每天1次,连用3 d,观察两组咳嗽、喘憋、气促、哮鸣音好转、住院时间和疗效.结果 咳嗽、喘憋、气促、哮鸣音好转,住院时间,治疗组较对照组明显缩短,差异均具有统计学意义(P值均<0.05),两组临床疗效比较差异有统计学意义(U=2.475,P<0.01).结论 IVIG治疗重症毛细支气管炎疗效明显.