狂犬病诊治进展

人类的狂犬病是一种中枢神经系统病毒感染性疾病,常由患狂犬病动物的唾液污染伤口而传染;一旦出现症状,病人基本上100%死亡,从狂犬病后康复的病例极为罕见,仅有3例报道。临床表现为特有的恐水怕风、咽肌痉挛、进行性瘫痪等。狂犬病在87个国家有流行,主要流行于东南亚、非洲及拉     

布洛芬对乙酰氨基酚退热疗效对比

长期以来,发热是儿科关注的问题,发热程度有助于判断病情,儿童多因与病情不成比例,轻微疾病即可出现发烧,父母常常不了解这一现象而引起不必要的恐慌,随意应用退热药即成为儿科普遍的现象[1].采用安全有效的退热药物值得临床探讨.     

Establishment of a mouse model of cancer cachexia with spleen deficiency syndrome and the effects of atractylenolide I

Cancer cachexia is a multifactorial metabolic syndrome that affects～50%–80%of cancer patients,and no effective therapy for cancer cachexia is presently available.In traditional Chinese medicine,a large portion of patients with cancer cachexia was diagnosed as spleen deficiency syndrome and treated with tonifying TCMs that produce clinic benefits.In this study we established a new animal model of spleen deficiency and cancer cachexia in mice and evaluated the therapeutic effects of atractylenolide I,an active component of tonifying TCM BaiZhu,in the mouse model.Cancer cachexia was induced in male BALB/c mice by inoculation of mouse C26 colon adenocarcinoma cells,whereas spleen deficiency syndrome was induced by treating the mice with spleen deficiency-inducing factors,including limited feeding,fatigue,and purging.The mouse model was characterized by both cachexia and spleen deficiency characteristics,including significant body weight loss,cancer growth,muscle atrophy,fat lipolysis,spleen,and thymus atrophy as compared with healthy control mice,cancer cachexia mice,and spleen deficiency mice.Oral administration of atractylenolide I(20 mg·kg?1per day,for 30 days)significantly ameliorated the reduction in body weight and atrophy of muscle,fat,spleen,and thymus in mice with spleen deficiency and cachexia.The established model of spleen deficiency and cancer cachexia might be useful in the future for screening possible anticachexia TCMs and clarifying their mechanisms.     

精于颐养走过百年——许德珩的长寿要诀

许德珩一生精于摄生颐养,享年100岁.他的养生要诀主要有如下几条: 重视饮食条理 许老的饮食以清淡为主,定时定量,不饱食,不偏食,不挑食.早餐一般是一碗稀饭,一个小馒头,少许咸菜;午餐以蔬菜为主,加上少许牛肉(晚年不食猪肉),主食100克;晚餐则以素为主.一日三餐既不随意增减,更不暴饮暴食.饮酒微量,只喝一点果酒,不饮白酒等烈性酒.爱吃新鲜水果,不吃甜食.     

浅谈如何加强医疗器械的管理

医疗器械的应用在疾病的诊断、治疗及预防等各个环节都发挥着不可替代的作用,其质量的好坏直接关系到人民群众的身体健康和生命安危.2000年国务院颁布了第一部医疗器械监管法规-<医疗器械监督管理条例>,标志着我国医疗器械监管正式走上了法制化轨道,但是由于种种原因,目前我国在医疗器械的生产、经营以及使用等各个环节都存在着较为普遍和严重的问题,其监管已显得相对滞后,成为食品药品部门监管中的一个"软肋",以至于频频出现像钢板等植入性器械断裂现象和发生举国震惊的"眼球事件".本文就我县医疗器械的经营、使用现状和如何加强对医疗器械的监管作以下分析和探讨.     

黑米:滋肾补胃益气血

黑米因外皮乌黑而得名,又称补血糯米、贡米、黑珍珠,是一种具有诸多保健功效的珍贵稻米.黑米含有淀粉、蛋白质、脂肪、多种维生素,又含钙、磷、镁、铁、锌、钼、硒等多种矿物质和微量元素.黑米所含蛋白质不但比普通大米高37%,而且其中氨基酸的含量亦比白米高25.4%,人体所需的赖氨酸、精氨酸、氮氨酸、色氨酸等,黑米中也都具有,营养价值很高.     

捕捉蛛丝马迹,让恶性肿瘤早现身——常见恶性肿瘤发病的早期信号(二)

痣 痣可发生在皮肤的任何部位,如面部、手掌、脚底、腰部、前胸、后背和阴囊等处.痣如出现下述现象,可能是癌变信号:反复发生感染;突然有痒感,不由自主地用手搔抓,甚至抓破出血;表面潮湿或有结痂形成;原为棕色,逐渐颜色变深变黑;有出血倾向,稍微触碰即发生出血;周围有炎性红晕,触之有痛感;痣上原有毛发突然自行脱落;痣的中央部出现硬结或自发性出血、溃疡形成和周围出现散在的呈卫星状小黑痣.     

克隆病并穿孔1例

1病例介绍病人,女,35岁,因突发下腹部疼痛半小时就诊,病史诉说欠清,(家属补充,腹痛时间约4～5年),查体:脉搏96次/分,血压84/60 mmHg,表情淡漠、四肢湿冷。全腹压痛呈板状腹,叩诊移动浊音可疑,以脐下压痛明显,B超提示腹腔内有少许积液,右侧卵巢囊肿,约44 cm大小。实验室检查白细胞16×109/L,中性0.80。考虑腹腔脏器穿孔,在全麻下行剖腹探查,取下腹正中切口进腹,腹腔内有臭味溢出,吸出浑浊性液体约250 ml,有食物残渣,距回盲部约50 cm处,向上见约45 cm长的回肠充血水肿     

刺五加注射液致过敏反应2例报告

例1:患者男性,51岁,因患冠心病人院治疗.给予刺五加注射液60mL加5%葡萄糖250mL中静脉注射.输人约50mL时,患者面色潮红,瘙痒感,开始发现前臂有散在的米粒大小的红色小点,继而遍及颈、四肢部以及全身出现点状红色皮疹,甚痒.立即停药,给予扑尔敏、Vc、葡萄糖酸钙口服无效.改为肌注盐酸肾上腺素、静滴地塞米松,1天后上述症状逐渐减轻.     

小便带血,源于结石

市运动会就要开幕了,体校的学生都在紧张地"备战",准备在运动会上崭露头角.小董一直是学校的"尖子生",这段时间练得更加刻苦.可是,最近每次锻炼小董都会感到小腹疼痛难忍,而且小便常常带血,他又怕去医院会耽误比赛,一直不敢告诉老师和家人.后来,还是同宿舍的小张告诉了老师.老师得知这种情况后,马上带着小董到了医院.医生做了X线摄片检查,才知道小董是患了尿路结石.     

MHD应用于治疗尿毒症的效果及对Hcy水平的影响

目的 观察维持性血液透析(MHD)对尿毒症的治疗效果,及对同型半胱氨酸(Hcy)水平的影响.方法以2014年3月至2015年10月接受治疗的尿毒症患者为观察对象.根据其治疗方式分为腹膜透析组(n=48)和维持性血液透析组(n=52).比较2组患者透析前后血生化指标、炎性细胞因子和Hcy水平以及生活质量的差异.结果2组患者治疗前的BUN、SCr和GFR水平无明显差别,治疗后,2组患者的BUN、SCr水平较治疗前降低,GFR水平较治疗前升高,且维持性血液透析组变化更明显(P<0.05);2组患者治疗前的IL-18、IL-6、hs-CRP和Hcy水平无明显差别,治疗后,2组患者上述指标水平均较治疗前降低,且维持性血液透析组降低更明显(P<0.05);2组患者治疗前生活质量得分无明显差别,治疗后,2组患者生活质量均较治疗前增高,且维持性血液透析组增高更明显(P<0.05).结论维持性血液透析对尿毒症有较好的治疗效果,可明显改善患者血生化指标,提高患者的生活质量.     

The effects of age on carbamazepine pharmacokinetics and adverse effects.

The pharmacokinetics and effect of single oral doses of carbamazepine (400 mg) were compared in a group of six young volunteers aged between 20 and 25 years, and a second group of five elderly volunteers aged between 66 and 84 years. No age related changes in salivary or plasma pharmacokinetics or in psychomotor function were detected.     

Time-course effects of oral guanethidine administration on cardiovascular and autonomic effects on dogs.

The time-course effects of guanethidine (2.5 mb/kg/day, p.o.) administered for 2 days, 7 days and 7-8 months were investigated in dogs. Guanethidine treatment for 2 days failed to produce any significant alterations in sympathetic neuronal activity to the myocardium, resting neurogenic tone in the perfused hind limb vasculature and lumbar sympathetic neuronal transmission. Following guanethidine administration for a peroid of 7 days both cardiac and lumbar sympathetic neuronal activity was markedly and significantly depressed with concomitant reduction in heart rate and resting neurogenic tone to the hind limb. However, continued treatment with guanethidine for a period of 7-8 months resulted in complete restoration of cardiac as well as lumbar sympathetic neuronal activity. Both heart rate and resting neurogenic tone were also returned to placebo levels. The development of tolerance of these sympathetic nerves to guanethidine treatment was not associated with any alterations in the activity of adrenergic receptors. Further, there was a significant and time-dependent increase in cholinergic vasocilator activity in the lumbar sympathetic chain which could account for the exertional hypotension noted in the patients receiving guanethidine treatment.     

不同剂量米非司酮对子宫肌瘤患者临床疗效及血清学影响分析

目的 研究不同剂量米非司酮对子宫肌瘤患者临床疗效及血清学影响并作出相关的分析.方法 选择2014年5月1日至2015年9月1日收治的92例子宫肌瘤患者进行研究分析,并将所有患者随机分为观察组和对照组各46例.检测2组患者治疗前和治疗后2个月子宫和子宫肌瘤的大小、血清中黄体生成素、孕激素、雌二醇和卵泡刺激素平水变化,并统计治疗后患者临床疗效和不良反应例数.结果 治疗前2组患者的子宫及子宫肌瘤大小相比差异无统计学意义(P＞0.05).治疗后,2组患者较治疗前均有减小,差异有统计学意义(P＜0.05)且观察组治疗后子宫大小、子宫肌瘤大小与照组相比较小,差异有统计学意义(P＜0.05).治疗前2组患者血清中的各激素水平比较差异无统计学意义(P＞0.05).治疗后2组患者血清中的黄体生成素、孕激素、雌二醇和卵泡刺激素水平和治疗前相比降低,差异有统计学意义(P＜0.05).治疗后,观察组患者血清中黄体生成素、孕激素、雌二醇和卵泡刺激素水平均明显低于对照组患者,差异有统计学意义(P＜0.05).观察组和对照组临床疗效相比差异无统计学意义(P＞0.05).观察组不良反应率明显低于对照组,差异有统计学意义(P＜0.05).结论 小剂量的米非司酮对于治疗子宫肌瘤患者的临床效果更佳,能够更有效地降低患者血清中相关的激素水平,降低不良反应的发生率,更具安全性.     

大黄素对血管生成的抑制作用

目的研究大黄素对血管生成的抑制作用及相关作用机制。方法用鸡胚观察药物对血管生成的影响;用培养的内皮细胞检测大黄素抑制细胞增殖和诱导细胞凋亡作用。结果大黄素150和300 μg/egg对鸡胚的血管生成的抑制率分别为37.6%和63.2%。大黄素抑制内皮细胞增殖，在有bFGF、无bFGF、有VEGF的条件下，其IC₅₀值分别为5.56，8.40和6.91 mg·L^-1。大黄素可诱导内皮细胞凋亡，并可干扰内皮细胞周期，出现G₂/M期阻滞；可导致Cyclin B1,P34^cdc2和Bcl-2等蛋白的表达下调，但对Bax的表达无影响。结论大黄素有抑制血管生成作用，有可能应用于肿瘤治疗。     

Selective inhibitory effects of nifedipine and verapamil on oxidative metabolism: effects on theophylline.

Nine healthy male volunteers were studied to assess the possibility of an interaction between theophylline and nifedipine or verapamil using a randomised, crossover design. Subjects received theophylline 125 mg 8 hourly with and without nifedipine 20 mg 12 hourly and verapamil 80 mg 8 hourly. Nifedipine treatment reduced mean total theophylline clearance by 9%, due to decreased clearances via 1- and 3-demethylation. Verapamil treatment reduced mean total theophylline clearance by 14%, due to decreased clearances via 1- and 3-demethylation and 8-hydroxylation. Verapamil and nifedipine at usual clinical doses are unlikely to cause clinically significant changes in theophylline disposition.     

Adverse effects of atypical antipsychotic agents and their effects on quality of life

STUDY OBJECTIVES: To determine how axis III metabolic disturbances associated with atypical antipsychotic agents (weight gain, diabetes mellitus, and hyperlipidemia) affect patients' quality of life by comparing perceived quality of life of patients taking these agents who developed the disorders with those who did not develop them. A secondary objective was to compare patients' assessments of their quality of life with assessments made of the same patients by their treating psychiatrists. DESIGN: Analysis of questionnaire results. PATIENTS: Thirty three patients hospitalized at a Missouri Department of Mental Health long-term care psychiatric facility after January 1, 1990. MEASUREMENTS AND MAIN RESULTS: Participating patients independently completed the "long" form of the Quality of Life Enjoyment and Satisfaction Questionnaire. The psychiatrists who treated these patients completed the Physical Health-Activities section of the same questionnaire, based on their assessments of their patients' quality of life. Fifteen patients had a diagnosed axis III metabolic disturbance. For the group with these comorbid illnesses, the mean score on overall life satisfaction and contentment was 3.6 (fair to good). The corresponding value for the group without these comorbid diseases was 4.538 (good to very good). Psychiatrists' assessments of their patients' quality of life were less positive than the patients' own assessments, regardless of the existence of comorbid disease. CONCLUSION: Patients receiving atypical antipsychotic drugs had a perceived high quality of life and were satisfied with a variety of aspects of their lives. However, metabolic disturbances had a significant, detrimental effect on patients' perceived quality of life.     

不同剂量的甲泼尼龙琥珀钠对重症哮喘患者的疗效及毒副作用观察

目的 观察不同剂量的甲泼尼龙对重症哮喘患者的疗效及其毒副作用.方法 选取2014年5月至2016年5月就诊的重症哮喘患者64例,随机分为对照组、观察组A、观察组B、观察组C,每组16例.对照组采用地塞米松(0.3~0.5 mg·kg-1·d-1治疗,观察组A、观察组B、观察组C分别采用甲泼尼龙(1~1.5 mg·kg-1·d-1)、甲泼尼龙(2~4 mg·kg-1·d-1)、甲泼尼龙(6~8 mg·kg-1·d-1)治疗,观察并比较不同剂量甲泼尼龙对重症哮喘患者的治疗总有效率、治疗前后PaO2及PaCO2、症状和体征改善时间、毒副作用.结果 观察组A、观察组B、观察组C治疗重症哮喘的总有效率显著高于对照组(P<0.05),观察组B、观察组C 治疗重症哮喘的总有效率显著高于观察组A(P<0.05);观察组A、观察组B、观察组C的PaO2显著高于对照组(P<0.05),PaCO2显著低于对照组(P<0.05);观察组B的PaO2显著高于观察组A(P<0.05),观察组C的PaO2显著高于观察组B(P<0.05);观察组A、观察组B、观察组C症状和体征改善时间显著低于对照组(P<0.05);观察组B体征控制时间显著低于观察组A(P<0.05),观察组C体征控制时间显著低于观察组B(P<0.05);观察组A、观察组B、观察组C的上消化道出血率、血糖、血压显著高于对照组(P<0.05);观察组C的血糖、血压显著高于观察组A、观察组B(P<0.05).结论 采用2~4 mg·kg-1·d-1剂量的甲泼尼龙治疗重症哮喘患者效果好,不良反应低,值得推广应用.     

齐拉西酮、利培酮治疗精神分裂症的效果及对性激素的影响分析

目的探讨分析齐拉西酮、利培酮治疗精神分裂症的效果及对性激素的影响。方法将2017年11月～2018年11月的156例精神分裂症患者应用随机数字表法分为实验组与对照组,并分别采用药物齐拉西酮和利培酮进行治疗,比较治疗效果。结果实验组治疗后患者的阳性与阴性症状量表(PANSS量表)评分情况显著优于对照组,且实验组患者的血清睾酮、雌二醇及催乳素的性激素情况显著优于对照组,差异有统计学意义(P <0.05)。结论采用齐拉西酮对患者进行治疗,能够提升治疗效果,且不会对患者的代谢情况和激素水平产生较大的影响,治疗效果显著。     

Dissociation of cycloheximide's effects on activity from its effects on memory

Two doses of cycloheximide (CYC) were used to dissociate the effect of this drug on locomotor activity from its effect on memory. Results indicated significant short-term (30′–40′) and long-term (24 hr) increases in locomotor activity occur at both CYC doses, whereas significant short- and long-term decreases in step-out latencies in a passive-avoidance task occur primarily at the higher CYC dose. Pargyline, a monoamine oxidase inhibitor, significantly increases locomotor activity but does not decrease step-out latencies in the passive-avoidance task. It is concluded that the decreases in step-out latencies shown by CYC-treated animals in the passive avoidance task are the result of an amnesic effect of CYC rather than its effect on locomotor activity.