博莱霉素与博莱霉素A5诱导小鼠肺组织损伤的差异

目的探讨静脉注射博莱霉素(BLM)和博莱霉素A5(BLM-A5)对小鼠肺组织损伤的不同作用。方法8周龄雌性C57BL/6小鼠49只,随机分为BLM组19只、BLM-A5组20只和对照组10只,分别经尾静脉一次性注射BLM 150 mg/kg、BLM-A5 150 mg/kg和生理盐水。观察每组小鼠体重、生存率,肺组织病理改变及肺组织羟脯胺酸的含量。结果①BLM组和BLM-A5组小鼠最低体重分别为静脉注射处置前的65.46%和66.87%,均较对照组明显降低(P值均小于0.001)。②BLM组、BLM-A5组和对照组小鼠的生存率分别为:43%、55%和100%。③BLM组小鼠注射处置后28 d,在胸膜下及血管周围形成广泛、稳定的间质纤维化病理改变,而BLM-A5组无明显纤维化形成。BLM组与BLM-A5组、正常组比较,肺纤维化病理评分均明显增高(P值均小于0.001)。④BLM-A5组和对照组注射处置后28 d,右肺羟脯氨酸含量分别为471.6±49.4 nmol和405.0±74.6 nmol,两组间无统计学差异。BLM组为978.4±106.1 nmol,与BLM-A5组、对照组比较分别存在显著性差异(P值均小于0.01)。结论静脉注射BLM与BLM-A5,对小鼠肺组织损伤的作用存在着明显的差异,BLM可导致肺间质形成广泛的纤维化,而BLM-A5仅引起轻微的肺组织损伤,不形成明显的间质纤维化。     

Sufficient prophylactic efficacy with minor adverse effects by intravesical instillation of low-dose bacillus Calmette-Guérin for superficial bladder cancer recurrence

BACKGROUND: Intravesical instillation of bacillus Calmette-Guérin (BCG) is the most efficient strategy for prophylaxis of superficial bladder cancer recurrence. Adverse effects of BCG are major obstacles, but the reduction of BCG dose could minimize these effects. The efficacy and adverse effects of half-dose (40 mg) BCG, Tokyo 172 strain, were prospectively evaluated. METHODS: A total of 93 patients with superficial bladder cancer (pTa or pT1) were sequentially assigned to receive either 40 or 80 mg of BCG after transurethral resection. BCG was administered weekly for 6 weeks postoperatively. Eighty patients observed longer than 12 months after BCG therapy (41, 40 mg group; 39, 80 mg group) were analyzed. RESULTS: BCG therapy course was completed in 71 patients. Tumor recurrence was recognized in 11 of 40 patients in the 40 mg group and in 5 of 31 patients in the 80 mg group. There was no significant difference in tumor recurrence rate between the two groups (P = 0.547). BCG therapy was withdrawn in 1 patient in the 40 mg group and in 8 patients in the 80 mg-group because of BCG-related adverse effects. The morbidity of BCG-related toxicity was significantly higher in the 80 mg group. CONCLUSION: Half-dose of BCG Tokyo 172 strain had a similar efficacy and its toxicity was significantly lower compared to the standard dose. Thus, half-dose of this strain might be suitable, at least for initial BCG therapy, for the prophylaxis of bladder cancer recurrence. Further study would be necessary to clarify the efficacy of low-dose instillation in high-risk patients.     

Urinary arginine vasopressin (AVP) measurement in children: Water deprivation test incorporating urinary AVP

The value of a water deprivation test incorporating urinary arginine vasopressin (AVP) measurement was investigated in 13 patients with polydipsia and/or polyuria (complete central diabetes insipidus [CCDI] in four; incomplete central diabetes insipidus [ICDI] in five; secondary nephrogenic diabetes insipidus [NDI] in three; compulsive water drinking [CWD] in one) and a group of 25 control subjects (C). Urine samples were collected after water deprivation during sleep and the urinary osmolalities and AVP concentrations were measured. Analysis of the results of 104 urine samples from the 25 control subjects demonstrated a close correlation between urinary osmolality and AVP (r = 0.89, P < 0.001). After water deprivation during sleep, the respective mean maximal urinary osmolalities and AVP concentrations were: 127.4±34.4 mOsm/kgand 1.1±0.5 pg/mL in the patients with CCDI (14 samples, four children); 410.3±101.8 and 6.1±3.5 in those with ICDI (16 samples, five children); 348.7±71.2 and 100 + 45.1 in those with NDI (nine samples, three children); 541.5±143.5 and 43.6±33.2 in the patient with CWD (two samples, one child) and 898.8±186.3 and 97.4±50.4 in group C (54 samples, 18 children). Furthermore, the urinary AVP level relative to the osmolality in each patient varied depending on the AVP secretion status and renal concentrating ability. Each patient, except the one with CWD, could be discriminated from the normal subjects using this test. It seems that this test is easy to perform and useful for diagnosis and follow-up of patients with partial/complete posterior pituitary function defects and those with renal concentration impairment.     

Efficacy and morbidity of transrectal ultrasound-guided 12-core biopsy for detection of prostate cancer in Japanese men

BACKGROUND: The objectives of the present study were to determine whether an extensive biopsy scheme contributes to enhanced detection of prostate cancer in Japanese men and to assess the associated pain and morbidity. METHODS: A total of 147 patients were included in this analysis, with 12 biopsy cores being obtained from each patient. Standard systematic sextant biopsy at the apex, mid-prostate and base of the prostate gland was carried out under local anesthesia and this was followed by the acquisition of additional sextant cores at the same levels from the far lateral peripheral zone. Each patient answered a self-administered questionnaire on pain and morbidity during the 5 days following biopsy. RESULTS: Overall, 39 patients (26.5%) received a diagnosis of prostate cancer. Nine patients (23.1%) were positive only at the standard sextant sites, three patients (7.7%) were positive exclusively at the far lateral sites and the remaining 27 patients (69.2%) were positive at both sites. Cancer was found most frequently in cores obtained from the apex (P = 0.009), with this trend being more evident in patients with abnormal rectal findings, positive sonographic findings, gland volume < 40 cm(3) and prostate-specific antigen density > 0.15 ng/mL/cm(3) (P < 0.03). These findings were also true for those with a prostate-specific antigen range from 4.1 to 20.0 ng/mL. A gradual decrease in incidence and grade of pain, hematuria and rectal bleeding was observed during the first 5 days after biopsy (P < 0.0001). CONCLUSIONS: Using this 12-core biopsy scheme, we found cancer most frequently in cores taken at the level of the apex. While the extensive procedure only marginally enhanced overall detection of prostate cancer, it was well tolerated with gradually decreasing pain and morbidity over a brief postbiopsy period. Further efforts to optimize biopsy schemes are warranted.     

Listener and context dependency in the perception of emotional aspects of infant voice

Developmental aspects of an infant's ability to express emotions through vocalizations were studied based on perceptual rating experiments against 12 vocalization- and emotion-related reference words. Three groups of listeners, students, mothers with infants, and nursery governesses, rated 28 voice samples recorded from a male infant at 6, 9, 12 and 17 months of age, under a positive or negative context. Among three factors extracted by a factor analysis, one representing the emotional contrast of frightened/angry versus happy was found to be independent of listener group, infant age and context. The other two, one representing contrast between pleased/happy versus demanding/sad and the other seeking affection and rejecting/angry were dependent on infant age and context. These results may indicate that infants even at 6 months of age can express the emotional contrast of ‘pleasure’ versus ‘discomfort’ through vocalization, which listeners perceive independently in context.     

Combined Non-Surgical Treatment with Transileocolic Obliteration and Endoscopic Injection Sclerotherapy for Esophageal and Gastric Varices

Abstract: Clinical results associated with the combined treatment of endoscopic injection sclerotherapy (EIS) followed by transileocolic obliteration (TIO) for esophageal of gastric varices were evaluated in 31 patients. Twenty patients underwent emergency treatment, and 11 underwent non-ememgency treatment. No fatal complications developed after this combined treatment.     

NF-κB反义寡核苷酸对博莱霉素致小鼠急性肺损伤的保护作用

目的研究转录因子NF-κB在博莱霉素(BLM)致小鼠急性肺损伤病理过程中的重要作用,及其反义寡核苷酸对肺损伤的防治作用。方法小鼠随机分为5组,于0d经小鼠尾静脉分别注射150mg/kg或300mg/kgBLM,在注射前6h和注射后第5d,150组和300组分别注射生理盐水(NS);anti150组和anti300组分别注射p65的硫甙反义寡核苷酸(900μg/只);同时设立正常对照组,分别在3个时间点(注射前6h、0d、第5d),经尾静脉注射NS,观察各组小鼠体质量变化、死亡情况和肺组织病理改变。结果(1)150组和anti150组死亡率分别为53%和0%(P<0.05);而300组和anti300组死亡率分别为100%和60%(P<0.05)。p65反义寡核苷酸抑制了BLM所致小鼠死亡;(2)150组和anti150组小鼠的最低体质量分别减轻至原来的(65.5±7.8)%和(82.1±3.4)%(P<0.01)。p65反义寡核苷酸改善了BLM所致小鼠体质量减轻;(3)肺组织HE染色显示,BLM致死的150组小鼠,可见肺组织血管结构丧失,出血性水肿,肺泡腔内大量炎性渗出;非BLM致死小鼠注射BLM后14d,可见肺组织大片实变,肺泡结构丧失。而anti150组14d明显减轻了BLM导致的肺组织损伤。结论NF-κB可能在BLM致小鼠急性肺损伤过程中具有重要作用。NF-κB反义寡核苷酸对BLM所致小鼠急性肺损伤具有保护作用。