雷公藤多甙与棉酚合用对雄大鼠生育力的影响

本研究探讨雷公藤多甙(GTW)与棉酚合用对雄大鼠生育力的影响。SD雄大鼠用棉酚及GTW各6 mg/kg/d,灌胃给药,每周6日,共11周。10只用药动物全部不育,附睾精子密度和活率也明显下降,而体重增长如常,性行为存在。睾丸光镜下结构绝大多数无明显异常,血清睾酮水平正常,副性腺重量无明显变化。停药6周后生育力恢复。在相同剂量下,单用GTW或棉酚均无抗生育效果。表明两药合用有相加作用,为减少棉酚和GTW副作用提供一条可能途径。     

Low-dose inhaled nitric oxide for neonates with pulmonary hypertension

Objective : Inhaled nitric oxide (iNO) has been shown to cause selective pulmonary vasodilatation and improve ventilation-perfusion matching and may be an important therapeutic option for the treatment of persistent pulmonary hypertension of the newborn (PPHN). We report our experience on the use of iNO in neonates with severe PPHN.
Methodology : Inhaled NO was administered to 10 infants with PPHN and persistent hypoxaemia (meconium aspiration syndrome, n = 9; pneumonia, n = 1) after failure of conventional therapy to improve oxygenation. With the exception of one infant, iNO was commenced at 10 ppm.
Results : After 30 min exposure to iNO, the arterial oxygen tension (PaO₂) rose from a median of 49 mmHg (6.5 kPa) [range 12-82 mmHg (1.6-10.9 kPa)] to 75 mmHg (10 kPa) [range 17-450 mmHg (2.3-60 kPa)] ( P = 0.005), while the median oxygenation index fell (pre-iNO of 37 vs post-iNO 20) ( P = 0.005) and median systemic arterial pressure rose (pre-iNO 46.5 mmHg (6.2 kPa) [range 32-63 mmHg (4.3 to 8.4 kPa vs post-iNO 54.5 mmHg (7.3 kPa) [range 36-74 kPa]) P = 0.005). All infants subsequently continued to receive iNO with the duration of exposure to iNO ranging from 12 to 168 h (median duration 100 h). Three infants died despite showing an initial beneficial response to iNO. The mean duration of intubation for survivors was 11.9 ± 2.6 days. Methaemoglobinaemia and toxic levels of nitrogen dioxide were not seen during iNO administration. Of the seven survivors, 12 month follow up in two infants and 4 month follow up in four infants showed age-appropriate neurodevelopmental skills, with one infant having very mild hearing loss.
Conclusions : Inhaled NO reduces the oxygenation index by improving the PaO₂ and decreasing ventilation pressures, and appears to be clinically useful in severely hypoxaemic infants with PPHN refractory to conventional treatment.     

Inhaled nitric oxide during emergency neonatal transportation

ABSTRACT Inhaled nitric oxide is currently being investigated as a selective pulmonary vasodilator for neonates with persistent pulmonary hypertension. The use of continuous inhaled nitric oxide during emergency transportation of three critically ill neonates with meconium aspiration and pulmonary hypertension is described. The successful application of this technique may allow safer transportation of neonates who require high level intensive care including ongoing nitric oxide, high frequency ventilation and/or extracorporeal life support. Regionally based nitric oxide-equipped retrieval teams may relieve the pressure on smaller neonatal intensive care units to provide inhaled nitric oxide therapy and allow centralization of nitric oxide resources, thus facilitating development of expertise and the completion of meaningful research programs with substantial recruitment.     

Progress towards the elimination of leprosy in Nigeria: a review of the role of policy implementation and operational factors

The annual reports of the national leprosy control programme in Nigeria were reviewed to study the trends of the indices of leprosy control from 1992 to 2003 and determine the influence of operational and policy factors. By 2003, both national prevalence and case detection rates had reached below 0.5 per 10,000. Sub-nationally, all except three contiguous States in the Southeast, had prevalence rates below one case per 10,000. Over the 12 years, the prevalence rate decreased by 94-1%, from 7.14 to 0.42 per 10,000, with two periods of rapid decline: 1992-1994 and 1998. Remarkable surges of discharges from multi-drug therapy (MDT) occurred in these same periods. The period 1992-1994 corresponds to the years of introduction of MDT, case reviews, and clean-up of leprosy registers nationwide, while 1998 corresponds to the year the programme adopted the shortened 12-month MDT regime for multibacillary (MB) leprosy. The overall trend of case detection since 1992 was relatively stable, but had three significant periods of initial increase (1992-1994), stability (1994-1999) and recent decline (1999-2003), apparently related to the changing levels of activeness of the national programme. The pattern of new cases detected revealed increasing MB classification and lower disability, but a relatively stable child rate since 1992. The trend of MB proportion was also related to the years of MDT introduction and the adoption of a new leprosy case definition and classification policies. Thus, Nigeria has attained a low leprosy endemic status-mainly through operational and policy influences. The challenges that remain include reducing the relatively high leprosy burden in the Southeastern States and evolving effective case detection interventions that will make an observable impact on the incidence of leprosy.     

Nontransferrin-bound iron in plasma from hemochromatosis patients: effect of phlebotomy therapy

Plasma from patients with iron overload resulting from idiopathic hemochromatosis contains nontransferrin-bound iron, measurable by the bleomycin, assay. During venesection therapy, the concentration of bleomycin iron declines in a way highly correlated with plasma ferritin concentrations. Even when patients had been venesected to give very low total plasma iron concentrations and high transferrin iron-binding capacity, bleomycin-detectable iron was still present at low concentrations. Bleomycin-detectable iron can stimulate damaging free radical reactions, and its persistence in plasma even after prolonged venesection might contribute to the tissue damage that results from iron overload.     

What would make your life better? A needs analysis of leprosy settlements in the middle belt region of Nigeria

A needs analysis using rural appraisal and matrix ranking techniques was done in six leprosy communities in the middle belt region of Nigeria. Asked 'what would make their life better?' whole village groups were made to list, prioritize and rank their expressed needs by voting in a matrix table drawn on the ground. Out of a total of 504 votes, 31% was for health care or drugs for their general ailments, 23.6% for money and less than 10% for other needs that ranged from water, trade and housing to love and, least, mobility aids. Health care was prioritized in all communities but got the highest votes in three communities, money got the highest in the only two communities where it was prioritized and water in one. The need ranked the highest in each settlement seemed to be a reflection of its peculiar socio-economic situation. Apart from the similar priorities of health care and money, men's differing priorities were water, housing, clothes and assistance with farming, and women's, school fees for children, family, trade and food. These reflect their different traditional roles. Considering the variety of needs we think that there is no one solution to rehabilitation in the Nigerian context, but the situation and context of individual settlements should be considered, looking at general health care, income generation or loans schemes, schooling and water supply.     

Correlation of acetylcholinesterase activity in the brain and blood of wistar rats acutely infected with Trypanosoma congolense

ObjectiveTo investigate the neurotransmitter enzyme Acetylcholinesterase (AChE) activity in the brain and blood of rats infected with Trypanosoma congolense (T. congo).MethodsPresence and degree of parasitemia was determined daily for each rat by the rapid matching method. AChE activity was determined by preparing a reaction mixture of brain homogenate and whole blood with 5, 5-dithiobisnitrobenzioc acid (DTNB or Ellman's reagent) and Acetylthiocholine (ATC). The increase in absorbance was recorded at 436 nm over 10 min at 2 min intervals. Trypanosome species identification (before inoculation and on day 10 post infection) was done by Polymerase chain reaction using specific primers.ResultsThe AChE activity in the brain and blood decreased significantly as compared with the uninfected control. The AChE activity dropped to 0.32 from 2.20 μmol ACTC min^?1mg protein^?1 in the brain and 4.57 to 0.76 μmol ACTC min-1mg protein^?1 in the blood. The animals treated with Diminaveto at 3.5 mg/kg/d were observed to have recovered significantly from parasitemia and were able to regain AChE activity in the blood but not in the brain as compared to the control groups. We also observed, that progressive parasitemia resulted to alterations in PCV, Hb, RBC, WBC, neurophils, total protein, lymphocytes, monocytes and eosinophil in acute infections of T. congo. Polymerase chain reaction (PCR) of infected blood before inoculation and on day 10 post infection revealed 600 bp on agarose gel electrophoresis.ConclusionsThis finding suggest that decrease in AChE activity increases acetylcholine concentration in the synaptic cleft resulting to neurological failures in impulse transfer in T. congo infection rats.     

The effect of tooth clenching on the sensory and pain perception in the oro-facial region of symptom-free men and women

Summary  The aim of this study was (i) to examine the effect of light tooth contact as in diurnal tooth clenching on the tactile detection threshold (TDT), the filament-prick pain detection threshold (FPT) and the pressure pain threshold (PPT) in the oro-facial region and (ii) to examine the possible gender difference in this effect on the tactile and pain perception. Twenty healthy volunteers participated. The TDT and the FPT were measured by means of Semmes-Weinstein monofilaments, on the cheek skin (CS) overlying the masseter muscles (MM) and on the skin overlying the palm side of the thenar skin (TS). The PPT was measured at the central part of the MM using a pressure algometer. Each parameter was measured before and after keeping light tooth contact for 5 min (session 1) and after keeping the jaw relaxed for 5 min (session 2) as a control. Although there were no significant session effects on any of the parameters, there were significant effects of experimental condition on the TDT in both men and women ( P  <   0·001). Men had a significant higher FPT of the left CS ( P  <   0·05) and TS ( P  <   0·01) and a significant higher PPT of the MM than women ( P  <   0·001). These results illustrate that sensitivity to pain (FPT, PPT) was higher in women than in men. Although there were no significant gender differences in habituation of sensory perception, the increase of TDT after clenching/no clenching was larger in women, which warrants further study.