抗癌药物对心脏毒性反应(附五例报告)

本文报道五例肿瘤患者在用抗癌药的治疗过程中,出现对心脏不同程度的毒性反应,并就有关几种抗癌药物的毒性作用机理及防治进行了讨论。     

拜新同及艾克地平对高血压患者血压变异性的影响

目的　观察拜新同 (长效 )及艾克地平 (中效 )两种钙拮抗剂对高血压患者血压变异性的影响。方法　 79例原发性高血压分为 3组 :未用药组 ;拜新同组 (30mg每日 1次口服 ) ;艾克地平组 (2 0mg每日 2次口服 )。用药的第7d做动态血压监测 ,观察血压变异性。结果　与未用药组比较 :艾克地平组血压变异性改变不显著 (P >0 .0 5 ) ;拜新同组的收缩压变异性下降 (P <0 .0 5 ) ,舒张压变异性改变不明显 (P >0 .0 5 )。结论　拜新同可降低原发性高血压患者的收缩压变异性 ,艾克地平不改变血压变异性。     

某化工厂1987～2000年164例工伤事故调查分析

目的调查分析某化工厂工伤事故的分布规律及其危险因素,以便采取相应的预防干预措施。方法对1987～2000年该化工厂发生的工伤事故进行回顾性调查分析,建立数据库,并统计分析。结果 ①事故以轻伤为主,约占80.0％。②事故类别主要是灼烫烧伤和机械伤害,分别为工伤事故总数的35.8％、28.5％。③工伤伤害性质以骨折多见,约为总数的56.1％。④受伤工人的年龄分布以30～40岁段为主,约为总数的31.1％。⑤工伤事故原因中注意力不集中和违反操作规程分别为总数的43.0％,38.3％。结论12根据上述流行病学特点,采取相应的措施来减少工伤事故的发生。     

Uroscopy in the 21st century: high-field NMR spectroscopy

From the experiments described, it can be seen that there are different research approaches that can be taken and these are summarized in Table 1. Whereas much scientific research is principally hypothesis led, there remains, nevertheless, an important place for exploratory research. High resolution NMR can measure, directly and simultaneously, a wide range of endogenous metabolites in biological fluids and has the unique capability of providing structural information on the metabolites detected. It has proved to be a powerful research tool with which to study inherited metabolic diseases, renal disease, drug metabolism, and toxicity, and can be used to monitor the effects of drug therapy. For instance, by using a library of experimental toxins one can map the metabolic profile of site-specific nephron injury. With this approach in man one could eventually take an unknown disease such as Balkan nephropathy and predict the initial site of tubular injury, the mode of injury and therefore the kind of toxin capable of producing that injury. NMR spectroscopic techniques are still advancing rapidly, with ever increasing sensitivity and sophistication of NMR pulse sequences to enhance structural elucidation in complex mixtures. Given the advances in directly coupled HPLC-NMR and even HPLC-NMR-mass spectroscopy it is likely that these technologies in conjunction with pattern recognition will make major contribution to our understanding of renal processes and provide new diagnostic insights in the 21st century.      

Activation of guinea pig eosinophil respiratory burst by leukotriene B4: role of protein kinase C

Leukotriene B4 (LTB4) and the protein kinase C activator, 4-beta-phorbol dibutyrate (PDBu), both induced a pronounced and concentration-dependent stimulation of hydrogen peroxide (H2O2) generation by purified guinea pig peritoneal eosinophils in the concentration range 1 nM-1 microM. The LTB4 response was inhibited competitively by the specific LTB4 receptor antagonist, U-75302, with a KB of 25 nM, while the concentration-response curves for both stimuli were shifted rightwards (3.8-fold and 2.8-fold for LTB4 and PDBu, respectively) by the competitive protein kinase C inhibitor, 1-O-hexadecyl-2-O-methylglycerol at a concentration of 300 microM. LTB4 appears, therefore, to induce respiratory burst in eosinophils via a receptor-mediated mechanism involving protein kinase C.     

The effects of radiofrequency catheter ablation on the metabolic enzymes and Ca++-ATPase of myocytes

Summary Using histochemical technique, the effects of radiofrequency catheter ablation (RFCA) on the activities of LDH, SDH, CCO, and Ca⁺⁺-ATPase of guinea-pig ventricular myocytes were examined. The histological changes were observed for comparison. Radiofrequency energy (500 kHz) delivered was 20 WX 10 s. The results were as follows: RFCA resulted in significant impairments in all the four kinds of enzymes but without statistical differences in the areas involved in this energy level. No statistically significant difference was found between the ranges of enzymatic damages and areas of pathological lesions. These findings showed a consistency in areas of the histological and histochemical lesions resulted from RFCA.     

医疗纠纷处理应重视的几个问题

通过对医疗纠纷产生的原因进行分类,提出一套有针对性的处理医疗纠纷的方法,依照客观公正的原则及时处理,并建议医院成立一支处理医疗纠纷的的专门队伍和机构。     

扶正化瘀胶囊干预慢性乙型肝炎肝纤维化作用的多中心临床研究

目的　研究扶正化瘀胶囊治疗慢性乙型肝炎肝纤维化的临床疗效及其安全性。方法　多中心、随机、双盲、平行对照的方法 ,入选年龄 18～ 65岁的慢性乙型肝炎肝纤维化患者。试验药 (扶正化瘀胶囊 )和对照药 (和络舒肝胶囊 ) ,均为每次 5粒 ,3次 /d口服 ;疗程 2 4周。疗程结束后进行 12周的随访。观测指标 :(1)于治疗第 0、2 4周观察肝组织病理学、HBV标志物 ,第 0、12、2 4周检测肝纤维化血清指标 (HA、LN、P Ⅲ P、Ⅳ C)、B超肝脾检查 ,第 0、6、12、18、2 4周观察肝功能 (随访期评价肝功能、血清肝纤维化指标 )。 (2 )安全性指标 :治疗前、后检测血、尿常规 ,肾功能 ,心电图。结果　 (1)受试者入组情况及人口学资料 :试验组 110例 ,对照组 10 6例 ,两组病例人口学特征、生命体征、病程、药物过敏史、既往治疗史、肝功能、纤维化血清学指标、肝组织病理学 (试验组 99例 ,对照组 96例 )、HBV标志物、肾功能等各项指标比较 ,无显著差异。 (2 )肝组织病理学 :治疗前后作活检肝组织学观察 93例 ,试验组 50例和对照组 43例治疗前纤维化分期 (S)均值分别为 2 .3 3和 2 .11。试验组治疗后S均值为 1.80 ,较治疗前显著下降。对照组治疗后S均值为 2 .14 ,与治疗前比较无显著改善。试验组活检肝组织纤维化分期判断     

重症急性胰腺炎大鼠血清高迁移率族蛋白-1水平的时相变化及意义

目的 观察重症急性胰腺炎(SAP)大鼠血清肿瘤坏死因子α(TNF-α)、白细胞介素19(IL-19)和高迁移率族蛋白-1(HMGBl)水平的时相变化，探讨HMGBl在SAP病程中的意义。方法采用胰管逆行灌注5％牛磺胆酸钠的方法复制大鼠SAP模型。随机分为正常对照组(N组，n=8)、假手术组(Sham组，n=8)和重症急性胰腺炎组(SAP组，n=80)。用酶联免疫吸附试验(ELISA)检测各组动物血清TNF-α、IL-1β。用Westernblot法检测血清HMGBl水平。结果 SAP组大鼠血清TNF-α和IL-1β在建模后迅速升高，约在4～6h达高峰，之后迅速下降，在建模12h即降至接近正常水平，一直维持至24和48h。SAP组大鼠血清HMGB1水平在建模后12h开始有明显升高，至24和48h仍维持在较高水平。结论 HMGB1可能作为晚期炎症因子参与了SAP的全身炎症反应。     

不同用途的心室肌细胞的分离

目的 :建立适合于不同用途的心室肌细胞的酶解分离方法。方法 :恒流 Langendorff灌流 ,I型胶原酶酶解分离 ,应用膜片箝技术记录离子电流、双波长显微荧光光度术检测细胞内游离钙离子浓度及视频跟踪系统测定心肌单细胞收缩。结果 :采用不同分离技术参数获得的心肌细胞能满足上述三种实验条件下的要求。酶解分离的单个心室肌细胞静息电位为 (- 74 .0 6± 4 .5 4 ) m V,记录到心室肌细胞典型的钾、钠、钙离子电流和稳定的心室肌细胞内游离钙比值 ,心室肌单细胞收缩特性稳定。结论 :通过调整分离技术参数获得的心室肌细胞性能稳定 ,具有正常的电 -机械生理特性和耐钙性。