盐酸奥洛他定联合康复贴敷料治疗面部激素依赖性皮炎的疗效观察

目的探讨盐酸奥洛他定联合康复贴敷料治疗面部激素依赖性皮炎的临床疗效。方法将68例激素依赖性皮炎患者随机分为2组各34例。治疗组采用盐酸奥洛他定联合康复贴敷料治疗,对照组单纯采用盐酸奥洛他定治疗。治疗2、4周后,比较2组临床疗效。结果治疗2周后,2组患者总有效率比较无显著差异(P 0. 05);治疗4周后,治疗组总有效率显著高于对照组(P 0. 01)。结论盐酸奥洛他定联合康复贴敷料治疗面部激素依赖性皮炎的效果更加显著,可快速有效地缓解患者的临床症状。     

中药脱毒灵治疗海洛因依赖戒断症状42例临床观察

目的:评价中药脱毒灵对海洛因依赖戒断症状的治疗效果。方法:海洛因依赖戒断症状患者82例,分为脱毒灵组42例和洛非西定组40例,脱毒灵组口服脱毒灵7g,每日4次,治疗5日;洛非西定组口服洛非西定0.6～1.2mg/d,疗程10日。结果:治疗第5日,脱毒灵组中36例的戒断症状消失,戒断症状总分犤(0～9)0犦分,显著低于洛非西定组犤(2～144)84分犦,P<0.001,洛非西定组戒断症状降分较慢,治疗第10日戒断症状总分犤(0～76)27分犦。脱毒灵组未观察到不良反应和依赖性,洛非西定组出现血压降低、乏力等不良反应。结论:脱毒灵治疗海洛因依赖戒断症状效果显著,临床使用安全、可靠。     

大黄、白及粉联用洛塞克治疗重型颅脑损伤并上消化道出血临床观察

目的:探讨用中药大黄、白及粉联用洛塞克治疗重型颅脑损伤并发上消化道出血的疗效。方法:将75例重型颅脑损伤并发上消化道出血患者随机分成2组,对照组用洛塞克注射液治疗,治疗组在对照组治疗基础上加服大黄、白及粉。2组疗程均为7d。结果:治疗组止血有效率优于对照组(P<0.05)。结论:中药大黄、白及粉合用洛塞克治疗重型颅脑损伤并发上消化道出血较单用洛塞克疗效显著,用药方便、安全。     

更昔洛韦和中药联合治疗头面部带状疱疹的临床观察

目的：观察静脉滴注更昔洛韦和中药治疗头面部带状疱疹的疗效。方法：将90例患者随机分成两组，治疗组48例，静脉滴注更昔洛韦2.5mg／kg，一日一次，共6日，同时按照中医辩证服用汤剂；对照组42例，静脉滴注阿昔洛韦5mg～10mg／kg，一日3次，共6日，同时服用汤剂。结果：更昔洛韦组有效率明显高于对照组，差异有显著性，且起效时间、疼痛消失时问均明显比对照组短。结论：更昔洛韦配合中药治疗头面部带状疱疹，具有起效快、疗程短、治愈率高，有效地控制并发症的发生等优点，值得临床应用。     

洛伐他丁对乳腺癌细胞膜电位、MAPK活性的影响

目的:观察洛伐他丁对乳腺癌MCF-7细胞膜电位和MAPK活性的影响,探讨其抗癌作用的分子机制。方法:分别用4,8和16μmol/L终浓度的洛伐他丁处理乳腺癌MCF-7细胞24～72h后,采用激光共聚焦显微镜观察膜电位敏感的荧光阳离子分子探针diS-C3-(5)标记的细胞荧光强度的变化,同时分析洛伐他丁对ERK1和P38MAPk蛋白磷酸化水平的影响。结果:4～16μmol/L的洛伐他丁处理细胞后,能明显抑制荧光阳离子分子探针diS-C3-(5)进入胞内,该作用呈一定的剂量效应和时间依赖关系。表明洛伐他丁能明显促使MCF-7细胞膜电位负值加大,诱导细胞发生超极化。此外,实验发现洛伐他丁能显著降低ERK1和P38MAPK蛋白磷酸化水平。结论:洛伐他丁因抑制细胞内源性胆固醇合成、改变膜脂质结构而促进MCF-7细胞膜电位负值增加,诱导细胞发生超极化,同时显著降低MAPK活性。     

综合治疗复发性尖锐湿疣疗效分析

借鉴各种治疗方法的优缺点,采用静脉滴注更昔洛韦、局部干扰素封闭、CO2激光清除所有病灶的方法综合治疗尖锐湿疣(CA)20例,病情稳定后用中药黄芪煎汤当茶饮治疗。     

防水袖套在四肢外敷中药后的巧用

在四肢的跌打损伤及骨折中常外贴洛血止痛类膏药或外敷粉剂类中药,但粉类中药干燥后易脱落,掉渣,而膏药则容易移位.因而可污染衣服及被单,导致病人感官上及身体上的不适,护士也需多次更换被服,并清洗困难.     

中药内服外用治疗激素依赖性皮炎临床疗效观察

<正>随着含糖皮质激素的外用药物和化妆品的广泛应用,糖皮质激素依赖性皮炎(简称激素依赖性皮炎)发病率逐年增加。笔者于2009年1月~2012年1月应用中药内服外用治疗45例面部激素依赖性皮炎,取得良好的疗效。现报告如下:     

洛伐他丁对乳腺癌细胞膜电位、MAPK活性的影响

目的：观察洛伐他丁对乳腺癌MCF-7细胞膜电位和MAPK活性的影响，探讨其抗癌作用的分子机制。方法：分别用4，8和16μmol／L终浓度的洛伐他丁处理乳腺癌MCF-7细胞24～72h后，采用激光共聚焦显微镜观察膜电位敏感的荧光阳离子分子探针diS-C3-(5)标记的细胞荧光强度的变化，同时分析洛伐他丁对EILK1和P38^MAPK蛋白磷酸化水平的影响。结果：4～16μmol／L的洛伐他丁处理细胞后，能明显抑制荧光阳离子分子探针diS-C3-(5)进入胞内，该作用呈一定的剂量效应和时间依赖关系。表明洛伐他丁能明显促使MCF-7细胞膜电位负值加大，诱导细胞发生超极化。此外，实验发现洛伐他丁能显著降低ERK1和P38^MAPK蛋白磷酸化水平。结论：洛伐他丁因抑制细胞内源性胆固醇合成、改变膜脂质结构而促进MCF-7细胞膜电位负值增加，诱导细胞发生超极化，同时显著降低MAPK活性。     

综合疗法治疗尖锐湿疣疗效分析

目的：观察综合疗法治疗尖锐湿疣的临床疗效。方法：124例患者被随机分为两组,治疗组（68例）给予CO2激光治疗后,予更昔洛韦静脉滴注、a-2b干扰素局部注射治疗,同时皮损处予中药外洗。对照组（56例）给予CO2激光治疗后,予更昔洛韦静脉滴注,皮损处予中药外洗,随访6个月,分别观察两组的疗效。结果：治疗组和对照组的有效率分别为92.65%和78.57%,统计学处理有统计学差异（P〈0.05）。结论：综合疗法治疗尖锐湿疣临床疗效好,可降低治疗后的复发率。     

灵益胶囊用于健康人的耐受性观察

为了考察灵益胶囊在健康人体的耐受性，采用与安慰剂的随机双盲对照研究，征集３６名健康自愿受试者，随机分为６组，接受灵益胶囊和安慰剂的单剂量空胜利顿服，结果发现灵益胶囊的安全单剂量范围为１．６－６．４克，主要不良反应为口干、等大部分为轻度不良反应，少部分为中度反应，无需处理自行消失。     

中西医结合疗法治疗缓慢性心律失常

目的：观察中西医结合疗法治疗缓慢性心律失常的疗效。方法：８２例患者随机分为２组,治疗组４２例在采用阿托品及相关西药治疗基础上加用中药治疗,对照组４０例采用单纯西药治疗。结果：近期疗效治疗组显效２７例,有效１３例,总有效率９５．２％;对照组分别为１７例、１３例和７５．０％。２组近期疗效比较有显著性差异（Ｐ均＜０．０５）。治疗组在提高心率、改善心电图及血液流变性等方面优于对照组（Ｐ＜０．０５或Ｐ＜０．０１）。远期疗效显示：停药６个月后,治疗组复发率为１４．３％,对照组为４７．５％,２组远期疗效比较,治疗组明显优于对照组（Ｐ＜０．０１）。结论：中西医结合治疗缓慢性心律失常的疗效优于单纯西药治疗     

Evaluation of long-term efficacy and safety of transdermal fentanyl in the treatment of chronic noncancer pain.

The objective of this international, multicenter, open-label trial was to assess the efficacy and safety of up to 12 months of therapy with transdermal therapeutic system (TTS) fentanyl in patients (n = 532) with chronic noncancer pain. The trial was completed by 301 (57%) of the patients. The main outcome measures were pain control assessment, global treatment satisfaction, patient preference for TTS fentanyl, and quality of life. The mean dose of transdermal fentanyl (TDF) increased from 48 to 90 microg/h during a period of 12 months. During treatment, on average 67% of patients within the efficacy analysis group (n = 524) reported very good, good, or moderate pain control. Global satisfaction (very good or good) was also stable at 42%. The majority (86%) of patients reported a preference for TDF over their previous treatment (P < .001, binomial test). Short Form 36 quality-of-life scores improved from baseline for bodily pain. The most frequent treatment-related adverse events were nausea (31%), constipation (19%), and somnolence (18%). With regard to opioid-specific adverse events (respiratory depression [< 1%], adrenal insufficiency [< 1%], drug abuse/dependence [1%], and opioid withdrawal syndrome [3%]), these were extremely rare and, with the exception of opioid withdrawal syndrome, none was considered definitively related to the treatment. Long-term treatment with TDF provided a stable degree of pain control in the majority of patients with moderate to severe chronic noncancer pain. It was preferred by the majority of patients compared with their previous opioid medication. Overall, long-term treatment with TDF was generally well tolerated, particularly in view of the low incidence of potentially serious side effects such as drug abuse/dependence and respiratory depression. However, at present, it is important that patients receiving TDF should still be subject to careful assessment and monitoring.     

金莲清热胶囊治疗急性上呼吸道感染(感冒风热证)的随机双盲对照试验

目的评价金莲清热胶囊治疗急性上呼吸道感染(感冒风热证)的安全性及有效性.方法试验采用随机、双盲双模拟、多中心阳性药平行对照试验设计,共纳入226例受试者,随机分为试验组(金莲清热胶囊 金莲清热颗粒模拟剂)116例和对照组(金莲清热颗粒 金莲清热胶囊模拟剂)110例,疗程3天.结果急性上呼吸道感染疗效:试验组总显效率66.38%,总有效率95.69%;对照组总显效率60.91%,总有效率95.45%;两组比较差异无统计学意义(P>0.05),说明两组疗效相当.中医症状疗效:试验组总显效率70.69%,总有效率97.41%;对照组总显效率69.09%,总有效率93.64%;两组比较差异无统计学意义(P> 0.05),说明两组疗效相当.两组体温降低起效时间比较差异有统计学意义(P< 0.05),说明试验组体温降低起效时间优于对照组.在用药过程中,未发现该药的不良反应.结论金莲清热胶囊治疗急性上呼吸道感染(感冒风热证)安全有效.     

Oxytrex Minimizes Physical Dependence While Providing Effective Analgesia: A Randomized Controlled Trial in Low Back Pain

Physical dependence or withdrawal is an expected effect of prolonged opioid therapy. Oxytrex (oxycodone + ultralow-dose naltrexone) is an investigational drug shown here to minimize physical dependence while providing strong analgesia with twice-daily dosing. In this 719-patient, double-blind, placebo- and active-controlled Phase III clinical trial in chronic low back pain, patients were randomized to receive placebo, oxycodone qid, or oxytrex qid or bid. Each oxytrex tablet contains 1 microg naltrexone; oxytrex bid and qid treatments provide 2 and 4 microg naltrexone/day, respectively. Following a washout, patients with pain >or=5 on a 0-10 scale were dose-escalated weekly from 10 up to 80 mg/day until reaching adequate pain relief (相似文献   

Adding ultralow-dose naltrexone to oxycodone enhances and prolongs analgesia: a randomized, controlled trial of Oxytrex.

Oxytrex is a novel drug that combines oxycodone with ultralow-dose naltrexone, an opioid antagonist. Ultralow-dose opioid antagonists have been demonstrated to enhance and prolong opiate analgesia and alleviate opioid tolerance and withdrawal in rodents. This 3-week, Phase II clinical trial assessed safety and analgesic efficacy of Oxytrex in patients with moderate to severe pain from osteoarthritis. Patients with a pain score > or =5 received placebo, oxycodone 4 times a day (qid), Oxytrex qid, or Oxytrex twice a day (bid). All active treatment groups received the same total daily dose and dose escalation of oxycodone starting at 10 and ending at 40 mg/day. Importantly, the Oxytrex bid group received a lower daily dose of naltrexone than Oxytrex qid (0.002 vs 0.004 mg/day). Oxytrex bid produced a 39% reduction in pain intensity, which was significantly greater than that of placebo (P < .001), oxycodone qid (P = .006), and Oxytrex qid (P = .003). Oxytrex bid was also superior to placebo in quality of analgesia (P = .002), duration of pain control each day (P = .05), patients' global assessments (P = .04), and the Western Ontario and MacMaster Universities Osteoarthritis Index total score (P = .03). The incidence of side effects was comparable between active treatments. In this Phase II dose-ranging study, Oxytrex bid demonstrated greater pain relief with a more convenient dosing schedule compared to oxycodone qid. PERSPECTIVE: Preclinical data have shown ultralow-dose opioid antagonists to enhance and prolong opioid analgesia while reducing analgesic tolerance and physical dependence. Recent molecular pharmacology data show a mechanism of action to be the prevention of aberrant G protein coupling by opioid receptors that underlies opioid tolerance and dependence.     

Self-administration of clonidine, oxazepam, and hydromorphone by patients undergoing methadone detoxification

The extent to which hydromorphone, clonidine, and oxazepam alleviate the symptoms of opioid withdrawal and the extent and pattern of self-administration of these drugs during methadone detoxification were examined within a residential laboratory in three groups of patients dependent on methadone. Six times over the course of detoxification, acute effects of orally administered placebo and a single active drug (hydromorphone HCl, 3 mg, clonidine HCl, 0.3 mg, or oxazepam, 30 mg, all given twice daily) were tested, followed by an opportunity for subjects to self-administer the drug and dose of their choice. Hydromorphone significantly decreased opioid withdrawal symptoms and was more preferred for self-administration than the placebo. Clonidine and oxazepam did not significantly decrease withdrawal symptoms, nor was either drug self-administered significantly more than placebo. Clonidine, however, did induce side effects.     

肢体缺血预处理对大鼠肺泡巨噬细胞的抑制作用

【目的】探讨肢体短暂缺血预处理对大鼠肺泡巨噬细胞（AMs）抑制作用。【方法】按常规建立大鼠肢体短暂远隔缺血预处理（RIPC）模型。实验设空白对照组（加入未行肢体缺血预处理大鼠血清1 mL），血清实验组（加入 RIPC 大鼠血清1 mL）和纳洛酮实验组（同时加入 RIPC 大鼠血清和10μg／mL 纳洛酮各0．5 mL）。酶联免疫法检测各组 AMs 吸光度 OD 值，计算 AMs 抑制率；流式细胞仪检测 AMs 凋亡情况。【结果】与空白对照组AMs 抑制率比较，血清实验组加入血清以后其抑制率达到42．5％（ P ＜0．05），而纳洛酮实验组阻断了血清的这种效应[AMs 抑制率0％（ P ＜0．05）]。流式细胞仪显示：血清实验组 AMs 凋亡率38．2％，明显高于空白组（0．92％）和纳洛酮组（0．91％）（ P ＜0．05），而后两组组间差异无显著性（ P ＞0．05）。【结论】RIPC 大鼠血清能抑制 AMs 生长、增殖，加速其凋亡，该抑制效应可被鸦片受体阻断剂纳洛酮阻断。     

纳络酮对缺血再灌注心肌腺苷酸环化酶活性和环磷酸腺苷含量的影响

利用犬心肌缺血再灌注模型观察纳络酮对缺血再灌注心肌腺苷酸环化酶（ＡＣ）活性和环磷酸腺苷（ｃＡＭＰ）含量的影响以及纳络酮在体外对心肌ＡＣ活性的影响。结果表明：心肌缺血和缺血再灌注后，ＡＣ活性及ｃＡＭＰ含量均明显增高（Ｐ＜０．０５，Ｐ＜０．０１），缺血心肌ＡＣ活性明显高于再灌注心肌（Ｐ＜０．０５）；静脉注射纳络酮能明显降低缺血再灌注心肌ＡＣ活性和ｃＡＭＰ含量（Ｐ＜０．０５，Ｐ＜０．０１），但对生理盐水治疗的动物正常（模拟手术）、缺血和再灌注心肌匀浆ＡＣ活性无明显作用（Ｐ＞０．０５）。提示，纳络酮本身对ＡＣ活性无抑制作用，其降低缺血再灌注心肌ｃＡＭＰ含量可能涉及酶前因素。     

血清叶酸、维生素B12及铁蛋白在四种血液病演变中的意义

目的 探讨造血原料在再生障碍性贫血(AA)、阵发性睡眠性血红蛋白尿(PNH)、骨髓增生异常综合征(MDS)、急性白血病(AL)之间克隆演变的规律.方法 采用放射免疫法检测AA、PNH、MDS、AL患者治疗前后叶酸及维生素B12酶联法检测血清铁蛋白,比较每组患者治疗前后造血原料的差别,以健康志愿者为健康对照组,并比较各组患者与健康对照组之间的差别.结果 各组患者治疗前造血原料检测结果及与健康对照组比较:PNH组叶酸低于对照组(P<0.05);MDS患者维生素B12、血清铁蛋白显著高于健康对照组(P均<0.05);AL患者叶酸显著低于健康对照组(P<0.05),维生素B12、铁蛋白显著高于健康对照组(P均<0.01).与AA组治疗前比较:MDS患者维生素B12及铁蛋白均显著增高(P均<0.01);AL患者叶酸显著降低(P<0.05),维生素B12及铁蛋白均显著增高(P均<0.05).与MDS患者治疗前比较:AL患者叶酸显著降低(P<0.05),维生素B12、铁蛋白显著增高(P均<0.05).组内治疗前后比较:从患者治疗后铁蛋白增高(P<0.05);PNH患者治疗后较治疗前叶酸增高(P<0.05),维生紊B12及铁蛋白较治疗前差异无统计学意义(P均>0.05);MDS患者治疗后较治疗前叶酸差异无统计学意义(P>0.05),维生素B12及铁蛋白均显著降低(P均<0.05);AL患者治疗后较治疗前叶酸显著增高(P<0.05),维生素B12及铁蛋白均显著降低(P均<0.05).结论 血清叶酸、维生素B12及铁蛋白在AA、PNH、MDS、AL之间差异有统计学意义,对提示4种疾病之间的克隆演变、预后及治疗转归方面有一定意义.