输卵管注药绝育术副反应和并发症的近远期观察

采用多中心随机化临床试验,共接纳1705例合格受术对象,其中871例使用复方苯酚糊剂(PAP),834例使用显影苯酚胶浆(PM)。观察结果表明,术后发热率两组分别为8.0％和4.4％,组间差别有统计学意义。发热主要因药物反应所致。两组附件感染率分别为2.3‰和1.2‰。盆腔化学性腹膜炎发生率分别为1.1‰和2.4‰。未见子宫穿孔、盆腔脓肿和宫外孕。术后伴有轻度腹痛者分别占33.6％和30.8％,偶见重度者。腹痛与药物在卵管内充盈的长度和引起的组织反应范围明显有关。腰痛情况与腹痛相似。术后有症状者,多数在短时间内缓解,少数需对症治疗。术后,轻度子宫出血者两组分别为23.2％和18.0％。出血与术时取出节育器明显有关。本术对受术妇女月经无明显影响。五年随访做妇科检查和宫颈细胞学检查无阳性发现,也未查见与绝育药物主要成份有关的潜在疾患。研究表明,本术安全可靠。为进一步降低副反应和并发症的发生,研究机构应着重于现有药物配方的改进,并在保证效果的基础上,尽量减少阿的平含量。主管部门应重新估价这一技术,并加强施术管理和施术者培训,制定全国统一的操作规范,确保服务质量。本术现已得到广泛使用,有很大的发展前景,各界应予更大的关注。     

The effects of capsaicin pre-treatment on the responses of single neurones to sensory stimuli in the trigeminal nucleus caudalis of the rat: Evidence against a role for substance P as the neurotransmitter serving thermal nociception

Rats were systemically pre-treated with capsaicin either on the first day of life or at an age of 1 month. Both treatments were found to deplete substance P levels in the trigeminal nucleus caudalis (55.6% and 57.9% depletions, respectively). Extracellular single neurone recordings in the trigeminal nucleus caudalis revealed that neither type of capsaicin treatment greatly altered the proportions of neurones responding to non-noxious or noxious mechanical stimulation of the face. However, the proportion of mechanically-nociceptive neurones also responding to noxious thermal stimulation was greatly reduced in neonatally-treated, but not adult-treated rats.As both methods of capsaicin treatment caused similar depletions of substance P, it is concluded that this peptide may not be the neurotransmitter of afferent fibres to the trigeminal nucleus caudalis signalling thermal nociception.     

Immunohistochemical investigations of the influence of reserpine on the serotonin neuron system in the rat brain

A peroxidase-antiperoxidase immunohistochemical method with serotonin antiserum was employed to investigate the influence of reserpine on serotonin neurons of rats which were sacrificed at various times after injection (10 mg/kg i.p.). The disappearance of serotonin immunoreactivity induced by reserpine was detected only in the perikarya after 15 min, and then rapidly proceeded to the terminals. Between 2 and 4 h, immunoreactivity completely disappeared throughout the brain. The immunoreactivity reappeared in the perikarya after 6 h, and progressed toward the terminals gradually. However, there was an obvious difference in the rate of recovery of immunoreactivity between areas. After 7 days, the immunoreactivity returned to control levels.     

Creatine kinase isoenzyme (CK-BB) by RIA as a follow-up marker in stage D cancer of the prostate: comparison with PAP RIA

Fifty-nine patients with stage D carcinoma of the prostate under different modalities of treatment were studied for creatine phosphokinase isoenzyme BB (CK-BB) and prostatic acid phosphatase (PAP) levels in serum by radioimmunoassay (RIA) technique, in order to study the possible use of CK-BB as a follow-up marker compared to PAP. Thirty-three patients were in stable, 19 in progressive, and seven in regressive clinical state. CK-BB was above normal level in 52 (88%) out of 59 patients with no statistically significant difference between the three clinical states. On the other hand, PAP was above normal level in only 23 patients (38.98%) with statistically significant difference between the three clinical states (P less than 0.001). The PAP/CK-BB index was below 1 in stable and regressive condition, while it was above 1 in eight out of 19 patients with progressive disease. The PAP/CK-BB index may be of prognostic importance. CK-BB by RIA was abnormal in more cases than PAP. In this way CK-BB reflects the presence of the tumor and may be used for diagnosis; however, it does not reflect the clinical response as PAP does.     

Renin localization in segmental renal hypoplasia

Summary The distribuation of renin in two cases of segmental renal hypoplasia was investigated by immunofluorescence and the peroxidase anti-peroxidase (PAP) method using an anti-human renin antiserum. Renin-containing cells were found only in hypoplasic segments in the vicinity of altered glomeruli and small arteries. Well-preserved renal cortex and areas of chronic atrophic pyelonephritis failed to show any demonstrable site of renin production.Whatever is the mechanism of the disease, the characterization of large numbers of renin-containing cells in the affected kidney support a role for the renin-angiotensin system stimulation in this form of hypertension.     

Effect of dexamethasone on serum protein extravasation in experimental brain infarcts of monkey: An immunohistochemical study

Summary Experimental brain infarcts were produced in 12 adult baboons (Papio cynocephalus) by transorbital permanent clipping of the left middle cerebral artery. One group (seven monkeys) received daily injections of 1 mg/kg dexamethasone, starting 1 h after vascular occlusion and continuing till the end of the experiment. Another group (five monkeys) was not treated. One week after vascular occlusion the volume of infarcts and peri-infarct edema was estimated morphometrically on histological sections, using Masson's trichrome stain and the peroxidase-anti-peroxidase (PAP) technique for visualization of serum protein extravasation. In the untreated animals the average volume of infarct was 6.57±4.23% (mean±SD) and the volume of edema 7.83±2.93% of ipsilateral hemisphere. In the treated animals the infarct volume was not different (7.95±3.00%), but the volume of peri-infarct edema was significantly lower (2.82±3.06%,p<0.05). The results obtained indicate that dexamethasone treatment reduces the development of peri-infarct edema but does not influence the size of infarcts.     

Effects of estrogen via estrogen receptors on parvalbumin levels in cardiac myocytes of ovariectomized rats

The study investigated the effects of estrogen on parvalbumin (PV) levels in cardiac myocytes of ovariectomized rats, which is a model system for postmenopausal woman. Parvalbumin acts as a relaxing factor in cardiac myocytes. Adult female Wistar rats, 12 weeks old, were randomly divided into 5 groups of 10: sham-operated (SHAM), ovariectomized (OVX), and OVX receiving estrogen replacement of 10 μg/kg (Es10), 20 μg/kg (Es20) and 40 μg/kg (Es40). After 10 weeks, serum estrogen levels were measured and the α and β estrogen receptors in cardiac myocytes were investigated by immunohistochemistry. PV levels were examined by immunohistochemistry and Western blot analysis. Cardiac myocytes of all animals showed strong staining intensities for α immunoreactive (Es α-ir), but weak staining for β immunoreactive (Es β-ir) estrogen receptors. The Es α-ir was reduced in the cardiac myocytes of the OVX groups, but increased in the Es10, Es20 and Es40 groups. We therefore suggest that estrogen effects are mediated via Es α receptors rather than Es β receptors in female rat hearts. Estrogen and PV immunoreactive (PV-ir) levels and the intensity of the PV band observed in the OVX group were less than those of the SHAM group. In the Es10, Es20 and Es40 groups, the increased intensity of the PV-ir and PV bands correlated with the increased estrogen levels. The low PV levels in cardiac myocytes induced by low estrogen were restored by estrogen replacement therapy. Therefore a reduction of PV may lead to diastolic dysfunction in menopause.