Ostreopsis sp., a possible origin of palytoxin (PTX) in parrotfish Scarus ovifrons.

A clone of toxic dinoflagellate Ostreopsis sp. and six specimens of a parrotfish Scarus ovifrons were collected in October 1997 at Tokushima Prefecture, Japan. Ostreopsis sp. was cultured in ESM medium for 16 days, and after rearing the cell pellet (about 4.0x10(5) cells) was extracted with 50% methanol, partitioned between an aqueous layer and 1-butanol layer, and biochemically tested. Similarly, the crude toxin from S. ovifrons was extracted, and tested. The mice injected with each 1-butanol layer from Ostreopsis sp. and S. ovifrons showed the common symptoms of convulsion, drowsiness and collapse, and died within 48 h. The lethal potency of Ostreopsis sp. was calculated to be 1.0x10(-4) MU/cell. All specimens of S. ovifrons were found to be toxic, where the highest potency was determined as 2 MU/g in muscle of one specimen. After being injected with toxins, the serum creatine phosphokinase levels of mice were found to be elevated. Toxins from Ostreopsis sp. and S. ovifrons showed delayed haemolytic activity with mouse and human erythrocytes, which was inhibited by an anti-palytoxin (PTX) antibody antibody and ouabain. Toxins from Ostreopsis sp. and S. ovifrons thus resembled each other, and strongly suggested to be PTX or its akin substance. Additionally, a considerable number of adherent Ostreopsis sp. was found in the gut contents of S. ovifrons during the heavy occurrence of Ostreopsis sp. in October 1997 at Tokushima Prefecture. From the above results, it can be strongly postulated that the dinoflagellate Ostreopsis sp. is the origin of PTX which is sequestered by the parrotfish S. ovifrons through food chain.     

太溪穴临床应用举隅

太溪穴为足少阴肾经的输穴、原穴。介绍太溪穴的针灸操作方法、适应症及其治疗鼻衄、便秘、牙痛验案三则。     

外伤后迟发性颅内血肿临床分析

目的　探讨外伤后迟发性颅内血肿的发病原因、诊断、治疗和预防措施。方法　回顾分析 2 4例外伤后迟发性颅内血肿的临床资料。结果　 2 1例治愈 ,其中 15例完全康复 ,6例有不同程度的神经功能障碍 ,死亡 3例。结论　年龄因素、受伤部位、凝血功能异常、过量脱水和减压是出现外伤后迟发性颅内血肿的诱发因素 ;伤后 72h内为发病高峰 ,绝大多数发生于伤后 36h内 ;伤后早期严密观察病情变化、动态复查头颅CT是确诊关键     

Uterine myomas and factors associated with hysterectomy in premenopausal women

OBJECTIVE: Our purpose was to describe clinical characteristics in premenopausal women with uterine myomas and to identify factors associated with hysterectomy.STUDY DESIGN: Data were collected by chart abstraction in 421 premenopausal women with myomas and analyzed by univariate and multivariable regression.RESULTS: Over a median follow-up period of 29 months, 86% of women had symptoms associated with myomas and 40% had an increase in uterine size of >2 gestational weeks. By multivariable regression, bleeding symptoms at presentation and previous surgical history of cholecystectomy and adhesiolysis were significantly associated with greater odds of hysterectomy. There was a significant interaction between age and uterine size, so that as age increased, uterine size had a greater impact on the likelihood of hysterectomy.CONCLUSIONS: In this cohort of premenopausal women myomas were associated with symptoms in almost all women over the follow-up period. Hysterectomy was performed in 22% of women overall. (Am J Obstet Gynecol 1997;176:1213-9.)     

急性颅内血肿清除后继发对侧迟发性血肿

目的：急性外伤性颅内血肿清除的术中及术后，如及时发现对侧迟发性血肿并治疗可提高疗效。方法：在术中发生急性脑肿胀时应在对侧钻颅探查或术后病人恶化时行ＣＴ检查。结果：治疗３０例对侧迟发血肿病人其中１０例死亡，手术死亡率为３３．３％。结论：在清除急性外伤性颅内血肿时发生急性脑肿胀或术后病情恶化应想到对侧可能是迟发性血肿形成，宜尽早钻颅探查或复查ＣＴ，早诊早治可改善预后。     

灯盏花注射液在急性病毒性心肌炎治疗中的应用

脑伤散治疗脑外伤后综合征疗效分析甘肃省人民医院（兰州７３００００）张毅，程桂香，陈立德，刘建雄，乔栎，高俊颅脑伤后，不少患者留有某些神经方面或精神方面障碍的表现，称为脑外伤后综合征。自１９９５年９月～１９９６年１２月，我们用纯中药制剂治疗该病６０例，...     

习见蓼提取物利尿止血及镇痛作用与急性毒性研究

目的:观察黔产习见蓼水提物(AE-P)的利尿、止血、镇痛药理作用及急性毒性。方法:测定NS负荷大鼠的排尿量及尿中Na+,K+,Cl-的含量;小鼠断尾出血时间(BT)及血浆复钙时间(RT);ip醋酸致小鼠扭体反应及热板致痛的潜伏期;LD50等指标。结果:AE-P能明显增加大鼠尿量和尿中Na+,K+,Cl-含量,且ig2次/d,连续给药7d,利尿作用无耐受性产生;AE-P能明显缩短小鼠BT和RT;能明显抑制小鼠扭体反应及延长热致痛潜伏期。AE-P以5g/kg(相当于干燥原生药80.64g/kg)给小鼠24hig3次,观察10d,小鼠全部存活;ip给药,其小鼠LD50为(3.13±0.39)g/kg(相当于干燥原生药50.48g/kg)。结论:AE-P具有利尿、止血及镇痛药理作用,其利尿作用不易产生耐受性,而止血作用与影响内凝系统有关,且毒性较低。     

原发性肝癌自发性破裂出血介入动脉栓塞治疗

目的:研究原发性肝癌自发性破裂出血介入动脉栓塞治疗的方法。方法:回顾性分析对18例肝癌破裂出血患者采用急诊介入栓塞止血。结果:本组18例患者均得以有效止血。1例患者在3天后由于严重休克肝动脉栓塞治疗死于肝、肾衰竭。其余均无复发出血及急性肝功能衰竭。8例门静脉部分或完全阻塞患者经肝动脉栓塞(TAE)治疗后未出现肝功能衰竭。5例患者在栓塞术后3~7天内成功被施行肝肿瘤切除术。12例患者被明胶海绵栓塞术后,根据病情多次行介入治疗,肿瘤均有不同程度的缩小和坏死。结论:TAE是治疗肝癌破裂出血的有效方法,可达到立即止血的目的,同时可为肝癌后续血管内治疗提供途经。     

彩色多普勒超声对门静脉高压食道胃底静脉曲张破裂出血的判断

目的　探讨应用彩色多普勒超声对门静脉高压食道胃底静脉曲张破裂出血的判断价值。方法　根据门静脉高压食道胃底静脉曲张患者有无出血分为出血组 (2 5例 )、未出血组 (2 5例 )与健康对照组 (15例 )进行对比分析。结果　出血组、未出血组与健康对照组门脉充血分数分别为 :0 .12 6± 0 .0 5 6、0 .0 6 0± 0 .0 2 0、0 .0 34± 0 .0 15 ,出血组与未出血组比较有显著差异 (P <0 .0 0 1) ;胃左静脉内径分别为 :(0 .89± 0 .2 6 )cm、(0 .70± 0 .2 4 )cm、(0 .31± 0 .0 7)cm ,出血组与未出血组比较有显著差异 (P <0 .0 5 ) ;出血组与未出血组食道曲张静脉内径分别为 :(0 .4 9± 0 .12 )cm、(0 .34± 0 .11)cm ,两者比较有显著差异 (P <0 .0 1) ;食道曲张静脉内血流速度分别为 (17.9± 7.4 )cm s、(11.1± 6 .0 )cm s,两者比较有显著差异 (P <0 .0 1)。当门脉充血分数截定为 0 .0 7时 ,对出血预测敏感性 96 % ,特异性 76 %。结论　门脉充血分数、胃左静脉内径、食道曲张静脉内径及其血流速度对判断出血具有重要作用。     

宫颈阴道分泌物中IGFBF-1检测在延期妊娠引产中的临床价值

目的探讨检测胰岛素样生长因子结合蛋白-1(IGFBP-1)在延期妊娠引产中的临床价值.方法采用快速免役层析法检测202例延期妊娠孕妇宫颈阴道分泌物中的高磷酸化IGFBP-1, 并予以催产素引产.结果 IGFBP-1阳性组,3d内引产成功率91.20%;IGFBP-1阴性组,3d内引产成功率为41.80%.两结果比较差异有统计学意义(P＜0.05).结论检测宫颈阴道分泌物中胰岛素样生长结合蛋白-1 可作为预测宫颈成熟的一个客观指标.