去氢骆驼蓬碱衍生物DH-330的一般药理学研究

目的:研究1-(2-氯)苯基-9-丁基-β-咔啉(DH-330)在药效学剂量或之上时对实验动物神经系统、呼吸系统和心血管系统的影响,为其进一步的开发和使用提供安全性评价数据。方法:采用灌胃给药方式观察DH-330(50,250,500 mg·kg^(-1))对小鼠自主活动、协调功能和阈下睡眠剂量戊巴比妥钠协同作用的影响;通过测定呼吸幅度、呼吸频率、动脉收缩压、动脉舒张压、动脉平均压观察DH-330对大鼠呼吸系统及心血管系统的影响。结果:DH-330剂量为药效学有效剂量的10倍时(小鼠500 mg·kg^(-1)、大鼠350 mg·kg^(-1))单次给药后会导致小鼠自主活动减少,协调能力降低,对戊巴比妥钠催眠阈下剂量的效果无协同作用,但该剂量下会使麻醉大鼠血压降低及心电图异常,其余各剂量组和各观察指标均未见异常。结论:DH-330在有效量的10倍时可能会诱发中枢神经和心血管系统毒性。DH-330在有效剂量的10倍以下时,对动物中枢神经系统、呼吸系统和心血管系统均未见有毒理学意义的影响,因此在药效学有效剂量范围内具有较高的安全性。

Management of acquired bronchobiliary fistula:A systematic literature review of 68 cases published in 30 years

AIM:To outline the appropriate diagnostic methods and therapeutic options for acquired bronchobiliary fistula(BBF).METHODS:Literature searches were performed in Medline,EMBASE,PHMC and LWW(January 1980August 2010)using the following keywords:biliobronchial fistula,bronchobiliary fistula,bronchobiliary fistula,biliarybronchial fistula,tracheobiliary fistula,hepatobronchial fistula,bronchopleural fistula,and biliptysis.Further articles were identified through crossreferencing.RESULTS:Sixtyeight cases were collected and reviewed.BBF secondary to tumors(32.3%,22/68),including primary tumors(19.1%,13/68)and hepatic metastases(13.2%,9/68),shared the largest proportion of all cases.Biliptysis was found in all patients,and other symptoms were respiratory symptoms,such as irritating cough,fever(36/68)and jaundice(20/68).Half of the patients were treated by lessinvasive methods such as endoscopic retrograde biliary drainage.Invasive approaches like surgery were used less frequently(41.7%,28/67).The outcome was good at the end of the followup period in 28 cases(range,2 wk to 72 mo),and the recovery rate was 87.7%(57/65).CONCLUSION:The clinical diagnosis of BBF can be established by sputum analysis.Careful assessment of this condition is needed before therapeutic procedure.Invasive approaches should be considered only when noninvasive methods failed.

Systematic review of health-related quality of life after esophagectomy for esophageal cancer

This study is aimed to assess the long-term healthrelated quality of life （HRQL） of patients after esophagectomy for esophageal cancer in comparison with established norms, and to evaluate changes in HRQL during the different stages of follow-up after esophageal resection. A systematic review was performed by searching medical databases （Medline, Embase and the Cochrane Library） for potentially relevant studies that appeared between January 1975 and March 2011. Studies were included if they addressed the question of HRQL after esophageal resection for esophageal cancer. Two researchers independently performed the study selection, data extraction and analysis processes. Twenty-one observational studies were included with a total of 1282 （12-355） patients. Five studies were performed with short form-36 （SF-36） and 16 with European Organization for Research and Treatment of Cancer （EORTC） QLQ c30 （14 of them also utilized the disease-specific OESI8 or its previous version OES24）.The analysis of long-term generic HRQL with SF-36 showed pooled scores for physical, role and social function after esophagectomy similar to United States norms, but lower pooled scores for physical function, vitality and general health perception. The analysis of HRQL conducted using the Global EORTC C30 global scale during a 6-mo follow-up showed that global scale and physical function were better at the baseline. The symptom scales indicated worsened fatigue, dyspnea and diarrhea 6 mo after esophagectomy. In contrast, however, emotional function had significantly improved after 6 mo. In conclusion, short- and long-term HRQL is deeply affected after esophagectomy for cancer. The impairment of physical function may be a long-term consequence of esophagectomy involving either the respiratory system or the alimentary tract. The short- and long-term improvement in the emotional function of patients who have undergone successful operations may be attributed to the impression that they have survived a near-death experience.

Intraoperative glycemic control procedures and the use of an artificial pancreas

Strict intraoperative glycemic control can significantly decrease the incidence of postoperative infection; however, anesthesiologists must carefully control blood glucose levels as well as properly manage the respiratory and cardiovascular systems. However, standard blood glucose measurement systems and insulin dosing algorithms, which are necessary for achieving strict glycemic control, have not yet been developed. An artificial pancreas (STG-22TM; Nikkiso Co., Tokyo, Japan) is considered a highly accurate blood glucose monitoring system capable of closed-loop control of blood glucose. The device has, however, many problems to be addressed since it is a large and expensive system with little versatility, and it requires a large amount of blood to be collected. Therefore, the development of less invasive and inexpensive systems with future technological progress is greatly anticipated.

The Main Causes of Calf Mortality in Dairy Farms in Poland

Calf mortality is one of important problems of calf rearing in dairy farms worldwide. Besides, several noninfectious factors, such as management around birth, colostrum management, calf housing, feeding system, hygiene and pathogens, play an important role in calf rearing. The aim of the study was to show the most common causes of mortality of calves up to 90 d of their lives. Some data are available concering calf rearing management on small and medium size dairy farm typical for Polish regions. The research was conducted in seven selected herds of Polish Holstein-Friesian cows located in South of Poland. Data on calves mortality covered the period of three years from 2004 to 2007 and were collected using medical documentation and medical inquire in the farms. All evidence was enrolled untill three months of age of calves. There were 1,800 calves tested. The influence of such factors as maintaining system （free stalls barn and stalls barns）, feeding systems and herd size on falls of calves was examined. Overall, mortality throughout the three months of study period was diarrhea, which increased the risk of death among calves younger than 90 d of age. Also, respiratory system disorders were the common cause of loss of calves. The calf mortality rate during 90 d in all herds registered in free stall barns was 61% and in stalls barns was only 29%. Effect of pneumonia in free stall barns was 18% and in stall barns was 29%. In all groups, calf mortality rates increased with increasing herd size.