Effects of comicronised fenofibrate on lipid and insulin sensitivity in patients with polymetabolic syndrome X

BACKGROUND: This study investigated the effects of comicronised fenofibrate in patients with dyslipidemia and polymetabolic syndrome X. DESIGN: After a 6-week dietary run-in phase, 37 male patients eligible on lipid criteria entered a 12-week treatment phase consisting of diet plus one capsule daily containing 200 mg of comicronised fenofibrate (Lipanthyl(R)). RESULTS: A significant reduction in plasma concentrations of total cholesterol, LDL cholesterol and triglyceride was observed after 4, 8 and 12 weeks of treatment with fenofibrate. The improvement in the atherogenic index LDL/HDL cholesterol from a pretreatment 3.8 to 3.0 after treatment was highly statistically significant and may be judged as satisfactory. Significant changes were also observed in haemostatic factors (fibrinogen reduced by 19%, factor VII activity reduced by 18%). Fasting serum insulin levels and insulin response (area under the curve) after oral glucose load were significantly reduced by 26.8% and 18.7%, respectively, indicating an improvement of insulin sensitivity. Systolic and diastolic blood pressure were significantly reduced. Uric acid was significantly reduced by 21.6%. CONCLUSION: These favourable effects of comicronised fenofibrate both on lipid and non lipid parameters, including insulin sensitivity, may confer to this product a particular interest in the treatment of patients with polymetabolic syndrome X.     

Therapy with gentamicin-PMMA beads,gentamicin-collagen sponge,and cefazolin for experimental osteomyelitis due to<Emphasis Type="Italic"> Staphylococcus aureus</Emphasis> in rats

Introduction In spite of new surgical techniques and recently developed antibiotics, there is no satisfactory solution for the treatment of chronic posttraumatic osteomyelitis. The introduction of local antibiotic treatment with gentamicin-PMMA beads according to Klemm has provided new stimuli for the treatment of chronic osteomyelitis. With the development of collagen as an absorbable carrier substance, the disadvantages of the rigid carrier system became evident. Due to the varying surgical techniques and different forms of adjuvant therapy, it is difficult to assess therapeutic methods and compare different studies. Therefore, it seemed appropriate to study the effect of local treatment with different antibiotic carriers in the setting of an animal study.Materials and methods The proven rat model for Staphylococcus aureus-induced osteomyelitis was used to compare the results of monotherapy with cefazolin, gentamicin-PMMA beads, or gentamicin-containing collagen sponge with the combination of local and systemic antibiotic treatment.Results Single-agent therapy with parenterally administered cefazolin reduced the CFU from 3.7×10⁶ to 2.9×10⁴ g^-1 of tibial bone. The effect on osteomyelitis was more pronounced with the local application of antibiotics. The best results were achieved with the gentamicin-containing collagen sponge which reduced the bacterial colony count to 1.4×10² CFU/g compared with 9.8×10² CFU/g achieved with gentamicin-PMMA beads. The effect was most marked using a 4-week combination therapy with local application of the gentamicin-containing collagen sponge and systemic administration of cefazolin. In 9 of 11 animals, no bacteria could be detected in the bone.Conclusion Each of the treatment modalities resulted in a significant therapeutic effect. Due to its ability to quickly release large amounts of gentamicin, the flexible gentamicin-containing collagen sponge proved to be superior to the rigid PMMA system. Although the gentamicin-containing collagen sponge provided high antibiotic concentration at the site of implantation, an additive effect was attained when combined with systemic antibiotic treatment.     

南海海绵Axinyssa sp．的化学成分

目的：对采自中国南海的海绵Axinyssa sp．进行化学成分研究，从中寻找具有生物活性的次生代谢产物。方法：用硅胶和凝胶LH-20柱层析对海绵Axinyssa sp．的乙醚提取物进行分离纯化，并结合现代波谱技术对得到的化合物进行结构鉴定。结果：分离得到了4个化合物，其结构分别鉴定为theonellin isothiocyanate（1），theonellin formamide（2），7-isothiocyanato-7，8-dihydro-α-bisabolene（3）和axinysterol（4）。结论：化合物1-3均为首次从海绵Axinyssa sp．中分离得到，同时也是首次从中国海域的海洋生物中分离得到。     

补气活血化瘀止血方对经皮冠状动脉介入治疗术后主要不良心血管事件及出血的影响

目的 探究补气活血化瘀止血配方对经皮冠状动脉介入治疗(PCI)术后主要不良心血管事件(MACE)及出血的影响.方法 以2019年1月至2020年1月在成都市第五人民医院行PCI的冠心病病人124例为研究对象,病人的中医症候表现为气虚血瘀证.采用随机数表法将病人随机分为两组,每组62例.观察组给予补气活血化瘀止血配方和泮托拉唑钠肠溶胶囊安慰剂,对照组给予补气活血化瘀止血配方安慰剂和泮托拉唑钠肠溶胶囊.观察两组MACE、术后出血及PCI术后第7天、第30天腺苷二磷酸(ADP)抑制率、花生四烯酸(AA)抑制率、ADP诱导的血凝块强度(MAADP).结果 观察组MACE发生率(3.2％)与对照组(9.7％)比较,差异无统计学意义(P>0.05).观察组出血事件发生率(29.0％)、出血类型、出血部位与对照组出血事件发生率(24.2％)、出血类型、出血部位比较,差异无统计学意义(P>0.05).观察组PCI术后30 d MAADP、ADP抑制率、AA抑制率与PCI术后7 d比较,差异无统计学意义(P>0.05).对照组PCI术后30 d MAADP与PCI术后7 d比较显著升高,PCI术后30 d ADP抑制率与PCI术后7 d比较显著降低(P<0.05).结论 补气活血化瘀止血配方预防PCI术后出血的效果与泮托拉唑钠肠溶胶囊相似.此外,由于潜在的CYP450酶依赖性机制,补气活血化瘀止血配方对氯吡格雷的干扰作用较泮托拉唑钠肠溶胶囊小.     

髓质海绵肾的影像学诊断（附13例报告）

目的研究髓质海绵肾（MSK）的影像学表现，并提高其诊断准确性。方法临床疑诊MSK的13例患者中，起先8例经X线平片检查，11例经超声检查，7例经CT平扫，其中，3例又经CT增强扫描，随后，11例经静脉肾盂造影（IVP）证实，2例经手术病理证实。对所有患者的影像表现进行了回顾性分析。结果IVP显示集合管呈线状、囊状扩张。X线平片显示肾乳头、髓质区簇状排列的圆形、椭圆形致密影。超声显示围绕肾髓质放射状分布的小回声区和强回声光点。CT平扫示环绕肾小盏分布的点状或簇状结石影，髓质区饱满、明显增大，呈低密度影，增强后，结石影周围的集合管内造影剂蓄积，造成结石影增大的假象。结论IVP是诊断本病例的金标准，但它属于有创性检查，X线平片可作为本病的首选检查方法，而CT能清楚显示肾内结石的形态、大小及分布状况，尤其是髓质增大且呈低密度是本病一新的重要征象之一。     

南海海绵Clathria fasciculate化学成分的研究(Ⅱ)

从中国南海海绵Clathria fasciculate的乙酸乙酯相分离鉴定出4个有机化合物，经GC-MS，FAB，IR，^1HNMR,^13CNMR和COSY等波谱技术确定它们分别是：胆甾-4-烯-3-酮（Ⅰ）；豆甾-4-烯-3-酮（Ⅱ）；（Z）-17-二十四碳烯-1-醇（Ⅲ）和1-（17Z-二十四碳烯基）-甘油醚（Ⅳ），为首次有关该种属海绵化学成分研究系列的第二次报道。     

An unusual association of contralateral congenital small kidney, reduced renal function and hyperparathyroidism in sponge kidney patients: on the track of the molecular basis.

Of unknown pathogenesis, sponge kidney (SK) is variably associated with nephrocalcinosis, stones, nephronic tubule dysfunctions and precalyceal duct cysts. Amongst 72 unrelated renal SK patients with renal stone disease, we detected one with unilateral bifid renal pelvis and six with unilateral small kidneys (longitudinal diameter difference >15%). Secondary causes of small kidney were excluded. Of the seven cases, four had reduced renal function (67 vs 7% in the entire cohort), and three developed hyperparathyroidism during follow-up (43 vs 4%). The pathogenesis of SK ought to explain why anatomical structures of different embryological origin are involved (the precalyceal and collecting ducts and the nephron) and why there is frequent association with hyperparathyroidism. In embryogenesis, the metanephric blastema synthesizes the chemotactic glial-derived neurotrophic factor (GDNF) to prompt the ureteric bud to branch off from Wolff's mesonephric duct, and to approach and invade the blastema. The bud's tip expresses the GDNF receptor (RET). RET-GDNF binding is crucial not only for the correct formation of ureters and collecting ducts (both of Wolffian origin), but also for nephrogenesis. We advance the hypothesis that SK results from a disruption in the ureteric bud-metanephric blastema interface, possibly due to one or more mutations or polymorphisms of RET or GDNF genes. This would explain: the concurrent alterations in precalyceal ducts and the functional defects in the nephron, the occasional association with size and the functional asymmetry between the two kidneys, some degree of renal dysplasia causing the reduction in the glomerular filtration rate and (given the role of RET in parathyroid cell proliferation) the association with hyperparathyroidism.     

Disseminated intravascular coagulation in lupus erythematosus responding to prednisone therapy

A 48-year-old man with systemic lupus erythematosus (SLE) developed disseminated intravascular coagulation (DIC) with clinical bleeding. Since no other cause for DIC could be demonstrated, he was treated with prednisone, which rapidly corrected his DIC. This case demonstrates the need for a complete hematological investigation of patients with SLE who present with hemostatic abnormalities.     

INFECTION AFTER RETINAL DETACHMENT SURGERY

In 250 consecutive retinal detachment operations performed by the author, there were 14 cases (56%) of infection of the scleral buckle The commonest infecting organism was Staphylococcus aureus.
The surgery in these infected cases took longer than average, and utilized more than the usual amount of silicone sponge, a higher proportion were reoperations After an average follow-up of 22 months, only six of the 14 had vision of 6/36 or better and of these, two had persisting inferior traction detachments.
On the basis of this study and others, the preferred management of infected scleral buckles is to remove the sponge as soon as the diagnosis is made The risk of redetachment is a lesser evil than the sequelae of prolonged inflammation which include traction retinal detachment, massive perirebnal proliferabon, and premacular fibrosis.