Oocyte and embryo quality as well as pregnancy rate in intracytoplasmic sperm injection are not affected by high follicular phase serum progesterone

The effect of elevated serum progesterone concentrations (>1ng/1) on or before the day of human chorionic gonadotrophin(HCG) injection on the outcome of women receiving gonadotrophin-releasinghormone analogue (GnRHa)/ human menopausal gonadotrophin (HMG)for ovarian stimulation prior to intracytoplasmic sperm injection(ICSI) was evaluated. A total of 1275 ICSI cycles were analysedretrospectively. In 53 cycles (4.5%), serum progesterone concentrationswere > 1 ng/ml. Patients in the high progesterone group hadsignificantly higher oestradiol and luteinizing hormone concentrationson the day of HCG injection. The characteristics of the cumulus-coronacell complexes and the nuclear maturity of the oocytes weresimilar in the groups of patients with high and low serum progesteronelevels. Fertilization and cleavage rates as well as embryo qualitywere not different in the two groups. No difference in implantationor clinical pregnancy rates was observed between the high progesteroneand low progesterone groups. Moreover, the cumulative exposureto progesterone during the follicular phase, as expressed bythe area under the curve (AUC), and the duration of exposureto high serum progesterone levels (>1 ng/ml) were not significantlydifferent between pregnant and non-pregnant women in the highprogesterone group. We conclude that in ICSI cycles pretreatedwith GnRHa, increased serum progesterone concentrations on orbefore the day of HCG injection do not affect ICSI outcome.     

Desensitization to substance P following intrathecal injection

Summary The intrathecal injection of substance P (SP) (2.5–15 g) has been shown to produce hyperalgesia in the rat tail flick test. Repeated injection of SP (7.5 or 15 g) or pretreatment with two of these doses produces desensitization to this hyperalgesic response. Desensitization is doserelated with respect to degree and duration. This phenomenon is relatively specific because the hyperalgesic response to methysergide, a serotonin receptor antagonist, is unaffected, while that produced by phentolamine, an adrenergic receptor antagonist, is much less affected than that of SP. Pretreatment with a desensitizing regimen of SP potentiates the antinociceptive effect of morphine and baclofen when they are tested immediately after the regimen but if a 30 min delay is permitted, an inhibition of their effects is observed. These results support the notion that the spinal antinociceptive effect of morphine and baclofen is due to an interaction with SP mechanisms in the spinal cord, the nature of which may be more complex than is presently understood. Desensitization produces no change in baseline responsiveness in the tail flick test. This suggests that the hyperalgesic response to SP is due either to an action at a site other than the primary afferent synapse, or if it is at this site either compensatory mechanisms occur or SP is not the primary determinant of tail flick latency but may play a modulatory role.     

雷尼替丁与复方丹参联合治疗急性胰腺炎35例疗效分析

目的：观察雷尼替丁与复方丹参联合治疗急性胰腺炎的疗效。方法：对确诊急性胰腺炎65例随机分成治疗组35例,对照组30例,分别用常规治疗,常规治疗加雷尼替丁与复方丹参静滴,连用4－7天,评价其疗效。结果：治疗组与对照组显效率分别为85.71%、43.3%,两组差异显著,P＜0.05。结论：两药联合应用不仅可减轻本病的炎症病变,且可改善心肌细胞营养状况。     

四妙勇安汤加味合血塞通治疗小儿钩端螺旋体脑动脉炎疗效分析

目的：探讨四妙勇安汤加味合血塞通注射液对钩端螺旋体脑动脉炎的临床疗效。方法：从入院先后随机分组对照,治疗组口服四妙勇安汤加味,静滴血塞通;对照组肌注青霉素,静滴维脑路通加脑细胞激活剂。结果：治疗组治愈率65.22％,总有效率95.65％;对照组治愈率37.5%,总有效率84.37％。两组治愈率、总有效率比较有显著性差异（P＜0.05）,治疗组治疗后血液流变学各项指标明显下降,而对照组仅有部分改善。结论：四妙勇安汤加味联用血塞通注射液治疗钩端螺旋体脑动脉炎临床效果显著,优于常规西医治疗。     

板兰根冲剂致药疹1例

1　病例介绍患者冯某,男,18岁,入院前4天因自觉咽喉疼痛,遂自服“板兰根冲剂(北京同仁堂制药二厂生产)2包。因药后症状未缓解,也未再服用。入院前1日在腹部出现红色细小斑丘疹,微痒,未予重视。夜间皮疹逐渐增多,泛发全身,尤以面部、胸腹部为多,自觉瘙痒,伴见口苦咽痛,便干尿黄,纳差,眠差,舌质红苔黄,脉弦数。于1998年9月26日入院。查体:神差懒言,咽部充血(),心肺无异常。T:37.7℃,R:17次/分。皮肤科检查:全身泛发鲜红色斑丘疹,针尖至米粒大小,密集成片,皮疹尤以面部、胸腹部为多,皮温高。血常规检查示:白细胞15.4×109/L,中性36%,淋巴64%…     

视神经萎缩的治疗临床研究

目的 探讨视神经萎缩的有效治疗方法。方法 对324例526例眼视神经萎缩患,用胞二磷胆碱、肌苷做球后注射。结果 临床治愈88例,显效261例,进步106眼,有效率86．9％,收到了较满意的效果。结论 胞二磷胆碱、肌苷可通过卵磷脂的合成改善视神经周围的血液循环,刺激和促进视神经纤维的生物修补,从而导致视神经功能的改善和恢复。     

紫外光谱法测定利巴韦利葡萄糖注射液中利巴韦林的含量

目的建立利巴韦林葡萄糖注射液中利巴韦林的快速测定方法.方法用紫外分光光度法直接测定利巴韦林葡萄糖注射液中利巴韦林的含量.结果在207 nm处,以水为溶媒,利巴韦林葡萄糖注射液中利巴韦林浓度在3～15μg/ml,与其相应的吸收度呈良好的线性关系(n=5;r=0.999 9),样品平均回收率为101.4%±0.53%.结论该法简便快速、准确可靠,适合药房快速分析.     

Utility and Prognostic Ability of a Diagnostic Injection Before Revision Total Knee Arthroplasty

BackgroundDiagnostic injections are commonly utilized in the workup of painful total knee arthroplasties (TKA), particularly when the diagnosis remains unclear. However, current literature provides limited evidence regarding the utility and prognostic capability of anesthetic injections in this scenario. This study sought to establish the role of diagnostic injections in predicting successful revision TKA.MethodsA retrospective review was conducted on 144 consecutive aseptic revision TKAs receiving diagnostic anesthetic injections. Instability (57.6%) and aseptic loosening (33.3%) comprised most revision etiologies. Patient-reported percentage pain relief after the injection was statistically correlated with KOOS JR, Knee Society Score, UCLA Activity Level, and satisfaction scores.ResultsAbout 74.3% (107/144) of revision TKAs reported >50% pain relief after injection. There were no differences in pain relief based on revision indication (P = .841). Improvement from preoperative activity level was greater in the >50% pain relief group (P = .024). Four-month patient satisfaction did not differ between patients who reported >50% and ≤50% pain relief (67% vs. 66%, P = .130). About 64% of patients who reported >50% pain relief were satisfied at minimum 1-year follow-up, compared with only 47% of those who reported ≤50% pain relief after diagnostic injection (P < .001).ConclusionStudy results show that patients reporting >50% pain relief after diagnostic injection have improvements in activity level and maintain greater satisfaction at minimum 1-year than those reporting ≤50% pain relief. Expectations for improvement after revision TKA should be tempered if diagnostic anesthetic injection yields minimal subjective pain relief.     

Small animal jet injection technique results in enhanced immunogenicity of hantavirus DNA vaccines

DNA vaccine evaluation in small animals is hampered by low immunogenicity when the vaccines are delivered using a needle and syringe. To overcome this technical hurdle we tested the possibility that a device developed for human intradermal medicine delivery might be adapted to successfully deliver a DNA vaccine to small animals. Disposable syringe jet injection (DSJI) does not currently exist for small animals. However, a commercialized, human intradermal device used to to administer medicines to the human dermis in a 0.1 mL volume was evaluated in Syrian hamsters. Here, we found that hantavirus DNA vaccines administered to hamsters using DSJI were substantially more immunogenic than the same vaccines delivered by needle/syringe or particle mediated epidermal delivery (gene gun) vaccination. By adjusting how the device was used we could deliver vaccine to either subcutaneous tissues, or through the skin into the muscle. RNA and/or antigen expression was detected in epidermal, subepidermal and fibroblast cells. We directly compared six optimized and non-optimized hantavirus DNA vaccines in hamsters. Optimization, including codon-usage and mRNA stability, did not necessarily result in increased immunogenicity for all vaccines tested; however, optimization of the Andes virus (ANDV) DNA vaccine protected vaccinated hamsters from lethal disease. This is the first time active vaccination with an ANDV DNA vaccine has shown protective efficacy in the hamster model. The adaptation of a human intradermal jet injection device for use as a method of subcutaneous and intramuscular jet injection of DNA vaccines will advance the development of nucleic acid based medical countermeasures for diseases modeled in hamsters.