Serum Levels of Free Insulin-Like Growth Factor (IGF)-I in Normal Children

Serum levels of free insulin-like growth factor (IGF)-I were measured by immunoradiometric assay (IRMA) in fasting sera of 137 normal boys and 120 normal girls aged from 8 to 15 yr to study relationships between free IGF-I levels and ages, total IGF-I, IGF binding protein (IGFBP)-1, IGFBP-3, and acid-labile subunit (ALS) levels. In both sexes, serum free IGF-I levels and the ratios of free IGF-I to total IGF-I were significantly higher in the pubertal age groups than in the prepubertal age groups. Serum levels of free IGF-I showed a significant positive correlation with those of total IGF-I, IGFBP-3 and ALS, while they showed a significant negative correlation with those of IGFBP-1. These observations suggest that increase in serum free IGF-I levels during puberty is caused by a dramatic increase in total IGF-I, rather than IGFBP-3, and a decrease in IGFBP-1. Also, high free IGF-I levels may play an important role in pubertal growth spurt.     

低位前外侧入路微创全髋置换术

目的:评价低位前外侧入路微创全髋关节置换术的可行性和早期临床效果.方法:17位患者18例髋关节进行前外侧入路微创全髋关节置换术,仰卧位,自大转子上2 cm为顶向前下切口,纵行切开髂胫束和臀中肌前部着点,由髋关节囊前方分离至髋臼前外缘.不脱位,经股骨颈截骨和取头,处理髋臼植入假体.患髋内收外旋股骨颈基底脱出切口外,股骨扩髓后植入假体.结果:手术切口平均长(10.5±2.1)cm.切口长短与体重正相关,髋臼病理改变和翻修者更长.手术时间平均为(101.7±14.6)min,术中出血量110～600ml,平均(302.2±77.3)ml;双侧髋关节置换1例.术后2～5 d患髋均可负重行走.随访7～22个月,Harris评分平均:术前44;术后6个月85.假体位置理想.无并发症.结论:经低位的前外侧入路行微创全髋关节置换术,需要特殊的髋关节拉钩和牵开技术.有创伤小、不损伤臀上神经、假体位置理想、术中可以处理较复杂病理改变、准确测量两侧下肢体长度、术后外展肌有力、早期康复等优点.     

Prophylactic laparoscopic-assisted total gastrectomy for hereditary diffuse gastric cancer.

BACKGROUND: Ten percent of gastric cancer (GC) cases are familial, with one third resulting from a mutation in the tumor suppressor gene CDH1. Loss of this important structure can result in hereditary diffuse gastric cancer (HDGC), which carries a high mortality if early diagnosis is not made. Despite its clear genetic origin, optimal management of HDGC family members is controversial, as the utility and efficacy of current cancer screening programs for mutation carriers are unproven. METHODS: A 53-year-old Caucasian woman was initially seen for genetic screening because multiple family members had mutations of the CDH1 gene. Her pedigree analysis demonstrated 4 generations of gastric cancer, and 2 of the generations carried the CDH1 germline mutation, consistent with HDGC. At endoscopy, the patient's gastric mucosa was normal and random biopsies were also normal. The patient underwent a laparoscopic total gastrectomy. RESULTS: The gross examination of her stomach appeared normal. On histologic examination, however, the stomach was found to have diffuse (signet ring cell) adenocarcinoma in-situ with 11 microscopic foci of invasive adenocarcinoma limited to the lamina propria. CONCLUSION: Our case is the first reported prophylactic total gastrectomy utilizing a laparoscopic approach, and it highlights the importance of taking a thorough family history and obtaining a pedigree analysis. Endoscopic screening in HDGC cannot rule out diffuse GC, because the stomach and biopsies can be normal despite the presence of adenocarcinoma. Therefore, our case supports the recommendation for prophylactic gastrectomy in HDGC.     

CLINICAL SIGNIFICANCE OF THE DETECTION OF MINIMAL RESIDUAL DISEASE IN CHILDHOOD B-ALL BY FLOW CYTOMETRY

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高脂血症对血浆t-PA和PAI-1活性的影响

目的 探讨高脂血症患者的纤溶系统的变化。方法 选取正常人及高脂血症者，测定其血脂、血浆t—PA和PAI-1活性。结果 高脂血症组比正常人血浆t—PA活性下降，而PAI-1的活性有升高；在TG及LDL-C升高者，其血浆t—PA活性比正常人血浆t—PA活性降低，而血浆PAI-1活性比正常人升高；单纯TC升高者血浆PAI-1活性接近正常人组，而血浆t—PA活性比正常人组明显降低。结论 高脂血症对纤溶系统有一定的影响，其中甘油三酯和LDL-C对纤溶系统的影响更明显，而胆固醇对纤溶系统也有一定的影响。     

舒芬太尼用于全凭静脉麻醉40例研究

目的：探讨舒芬太尼全凭静脉复合麻醉时对听觉诱发电位指数、血流动力学和术后复苏的影响.方法：40例美国标准协会（ASA）Ⅰ～Ⅱ级病人择期行胆囊切除手术,随机分为Ⅰ组（舒芬太尼组）和Ⅱ组（芬太尼组）,记录两组病人麻醉期间各时间点的听觉诱发电位指数（AEPI）值、收缩压、舒张压、心率和SpO2.结果：Ⅱ组插管后1 min、2 min的收缩压较Ⅰ组升高,而插管后1 min的心率较Ⅰ组降低（P＜0.05）;Ⅰ组插管后1 min、2 min和3 min时的AEPI值低于Ⅱ组（P＜0.05）;Ⅰ组拔管后至定向力恢复的时间较Ⅱ组长（P＜0.05）;Ⅰ组丙泊酚的用量较Ⅱ组少（P＜0.05）.结论：等效剂量的舒芬太尼较芬太尼的全凭静脉复合麻醉可以使病人达到更为合适的麻醉深度,并能使血流动力学更加稳定,同时可减少丙泊酚用量.     

Heat and moisture exchangers as a treatment option in the post-operative rehabilitation of laryngectomized patients

A multi-institutional, prospective clinical study was undertaken to investigate whether the use of a heat and moisture exchanger (HME) in the period following total laryngectomy could prevent the development or reduce the severity of respiratory symptoms. Fifty-nine patients from three hospitals were provided with HMEs, either immediately post-surgery or, in the case of post-surgical radiotherapy, upon completion of the radiotherapy. For the total sample (n= 59) statistically significant improvements over time (between 3 and 6 months) could be found in forced expectoration (P < 0.05), in the perceived voice quality (P < 0.001), social anxiety (P < 0.001), social interactions (P < 0.001) and in feelings of anxiety and depression (P < 0.05). Repeated measures analysis of variance indicated statistically significant group differences over time in forced expectoration and stoma cleaning (P < 0.05). No statistically significant differences over time were noted between the regular and non(regular) HME user groups in voice quality or in various aspects of daily living.     

白芍总甙促干扰素诱生及抗病毒作用的研究

研究白芍总甙的促干扰素诱生及抗病毒作用,结果表明;白芍总甙10 mg·L~(-1)在试管内无直接诱生干扰素(JFN)作用.可促进鸡新城疫互I系弱毒冻干疫苗诱生αIFN,其最适浓度为10 mg·L~(-1)可促进ConA诱生γIFN.当ConA为亚适剂量时,最适浓度为l～10 mg·L~(-1)当ConA为最适剂量时,其最适浓度为0.1 ～1mg·L~(-1),皆可提高IFN效价l～2倍。具有直接抗病毒作用,白芍总甙250 mg·L~(-1)能使水泡性口炎病毒效价下降2.22个对数值。