抹、擦、梳、滚、揉、按 降压六字经

高血压患者在坚持服用降压药物的同时进行按摩,可帮助巩固降压疗效。这里推荐"抹、擦、梳、滚、揉、按"六字按摩法。抹就是用食指或中指抹前额。擦就是用双手手掌摩擦头部的左右两侧。摩擦时用力不宜过大,以自觉舒适为好。梳就是双手手指微屈,十指好似虎爪般,先从前额发     

慢性咳嗽、呼吸困难、心律失常、猝死、

病历摘要患者张××,男性,60岁,金属冶炼厂拌粉工人,住院号2205900。咳嗽四年余,咳嗽气急加剧伴下肢浮肿10多天,于1979年5月14日入院。患者自1975年起有轻咳,白色泡沫痰,经某医院摄胸片,诊断为肺结核,用链霉素90克,内服异烟肼,来见好转,活动后气急,遂于1977年8月摄胸片复查,病灶未见好转,继续抗结核治疗。入院前十几天咳嗽、气急加剧,不能平卧,伴尿量减少下肢浮肿,胃纳差,经急诊胸透诊断为肺结核收入肺科病房。既往身体健     

多种微量元素注射液中铁、锌、锰、铜、硒、铬、钼的测定

目的：建立多种微量元素注射液中铁、锌、锰、铜、硒、铬、钼的含量测定方法。方法：采用火焰原子吸收法测定多种微量元素注射液中铁、锌、锰、铜含量,石墨炉原子吸收法测定其硒、铬和钼含量。结果：铁、锌、锰、铜、硒、铬、钼的线性范围分别为0．053～0．385μg／mL、0．25～2．50μg／mL、0．25～3．50μg／mL、0．5～8．0μg／mL、10．0～100．0ng／mL、10．0～100．0ng／mL、5．0～50．0ng／mL,平均回收率分别为99．2％、99．3％、99．0％、99．9％、98．4％、100．5％、99．0％。结论：本法可以准确测定多种微量元素注射液中铁、锌、锰、铜、硒、铬、钼的含量,该法简便、快速、准确可靠。     

尿频、尿急、尿痛、呕吐、消瘦

病历摘要患者男,22岁,住院号:18243。未婚,黑龙江人,1977年5月10日因尿频、尿急、尿痛反复发作2年,呕吐,逐渐消瘦20余天急诊入院。患者2年前无明显诱因出现尿频、尿急、尿痛,经当地诊断为肾盂肾炎,用青霉素、链霉素治疗,症状好转后断续服用消炎药,未进行系统治疗。平素尚能做一般工作,但每遇过劳即感乏力,周身不适,胃纳欠佳。20天前症状加重,频繁呕吐,为咖啡色胃内容物,尿少,去卫生院诊断为尿毒症而住院治疗月余无明显好转,不能进食,消瘦,转来我院。过去史:否认结核病史,无胃病出血史,无血液病史。个人史:无特殊。家族史:父母健在,家中无同样病史。     

云南汉族、白族、纳西族儿童锌、铜、铁、钙、镁水平现状调查

目的了解云南省三个不同民族地区儿童血清必需微量元素锌（Zn）、铜（Cu）、铁（Fe）及宏量元素钙（Ca）、镁（Mg）水平现状，探讨其影响因素。方法调查昆明市区汉族儿童、大理地区剑川县白族儿童、丽江地区纳西族3～9岁儿童共1104人。测定儿童血清Zn^2＋、Cu^2＋、Fe^2＋及Ca^2＋、Mg^2＋，对所得结果进行年龄组间、地区间比较。结果建立了昆明市区、丽江县、剑川县汉族、白族、纳西族儿童元素Zn^2＋、Cu^2＋、Fe^2＋、Ca^2＋、Mg^2＋水平参考范围。昆明市区汉族学龄前儿童Zn^2＋、Ca^2＋低于学龄儿童，Cu^2＋高于学龄儿童，Fe^2＋、Mg^2＋水平无统计学差异；剑川县白族儿童Zn^2＋低于学龄儿童，Cu^2＋、Fe^2＋、Mg^2＋高于学龄儿童，Ca^2＋水平无统计学差异；丽江县纳西族儿童Zn^2＋、Fe^2＋、Mg^2＋低于学龄儿童，Cu^2＋高于学龄儿童，Ca^2＋水平无统计学差异。结果表明同一地区儿童年龄组间血清元素水平存在明显统计学差异（P〈0．01）。三个地区儿童血清Zn^2＋、Cu^2＋、Fe^2＋、Ca^2＋、Mg^2＋水平比较：各年龄组儿童Zn^2＋、Cu^2＋丽江高于剑川、昆明；学龄前儿童Ca^2＋、Mg^2＋、Fe^2＋剑川高于昆明、丽江；学龄儿童Fe^2＋、Mg^2＋昆明低于丽江、剑川。Ca^2＋丽江高于剑川、昆明。各地区间差异有统计学意义（P〈0．01）。结论云南省汉族、白族、纳西族儿童Zn^2＋、Cu^2＋、Fe^2＋，Ca^2＋、Mg^2＋水平存在年龄组间、地区间差异，应高度重视儿童血清必需元素水平现状。     

网络、资本、人

2010年过去了。这一年,新医改政策继续推进,基本药物招标、补贴政令频出,药品降价持续施压,药品零售业感受到黑云压城,却还没经受风刀霜剑的真正摧折;     

尿频、尿急、尿痛

泌尿科的医生总爱戏称自己是＂水管工＂,这话虽说有调侃的意味,但比喻还是相当恰当的。其实人的泌尿系统也正如水管一样,从藏在肾脏里细微的肾小管,到排尿的输尿管,再到储存尿液的＂蓄水池＂（膀胱）,犹如一个复杂的城市排水系统。     

养神、养性、养气

中老年人应该注意生态情志养生,以培养出快乐的情绪、坚强的意志、和谐的人际关系,从而达到保持健康,延年益寿的目的。随着经济的不断发展,人们对健康的需求也发生了很大的变化,大家越来越关注健康,重视养生。那么,到底该从什么角度阐述养生的理论和实践呢?笔者认为,生态     

勤学、修身、自律

雨果说过“书籍是改造灵魂的工具,是滋补光明的养料。”我赞同这一说法。作为年轻人,多学习,可以培养宁静的心态,陶冶健康的生活情趣。因为年轻人,特别是年轻干部,缺少经验,甚至许多东西都是处于不懂、不知的状态。多学习,无论是向书本学、向他人学,或有机会参加培训、学习、讲座等,都可以增长我们的业务知识或社会知识,才能明白什么事可做、什么事不可做、如何做,才能明白勤学、修身、自律、敬业之间的内在联系。     

Susceptibility to erythromycin of anaerobes of the genera Bacteroides, Fusobacterium, Sphaerophorus, Veillonella, Clostridium, Corynebacterium, Peptococcus, Peptostreptococcus

The minimal inhibitory concentrations (MIC) of erythromycin were determined by broth dilution tests for 313 anaerobic strains, most of which were clinical isolates. All the gram-positive anaerobes tested (84 Peptococcaceae, including 21 Peptostreptococcus anaerobius and 15 Peptococcus variabilis; 65 Corynebacterium acnes and 29 Clostridium strains, including 13 C. perfringens) were sensitive (MIC values 0.012 through 3.12 microgram erythromycin/ml); so were 111 cultures of gram-negative anaerobes (52 Bacteroides fragilis, 12 B. thetaiotaomicron, 7 B. vulgatus, 13 B. oralis, 4 B. melaninogenicus, 10 Sphaerophorus necrophorus, 2 Veillonella sp., 11 members of other species). Erythromycin at concentrations of 6.25 through 200.0 microgram/ml was active against 24 strains (1 B. fragilis, 4 Fusobacterium fusiforme, 9 Sph. freundi, 10 Sph. varius). The present results are compared to the limited number of reports existing with regard to the susceptibility of anaerobes to erythromycin.     

Safety assessment of poloxamers 101, 105, 108, 122, 123, 124, 181, 182, 183, 184, 185, 188, 212, 215, 217, 231, 234, 235, 237, 238, 282, 284, 288, 331, 333, 334, 335, 338, 401, 402, 403, and 407, poloxamer 105 benzoate, and poloxamer 182 dibenzoate as used in cosmetics

Poloxamers are polyoxyethlyene, polyoxypropylene block polymers. The impurities of commercial grade Poloxamer 188, as an example, include low-molecular-weight substances (aldehydes and both formic and acetic acids), as well as 1,4-dioxane and residual ethylene oxide and propylene oxide. Most Poloxamers function in cosmetics as surfactants, emulsifying agents, cleansing agents, and/or solubilizing agents, and are used in 141 cosmetic products at concentrations from 0.005% to 20%. Poloxamers injected intravenously in animals are rapidly excreted in the urine, with some accumulation in lung, liver, brain, and kidney tissue. In humans, the plasma concentration of Poloxamer 188 (given intravenously) reached a maximum at 1 h, then reached a steady state. Poloxamers generally were ineffective in wound healing, but were effective in reducing postsurgical adhesions in several test systems. Poloxamers can cause hypercholesterolemia and hypertriglyceridemia in animals, but overall, they are relatively nontoxic to animals, with LD(50) values reported from 5 to 34.6 g/kg. Short-term intravenous doses up to 4 g/kg of Poloxamer 108 produced no change in body weights, but did result in diffuse hepatocellular vacuolization, renal tubular dilation in kidneys, and dose-dependent vacuolization of epithelial cells in the proximal convoluted tubules. A short-term inhalation toxicity study of Poloxamer 101 at 97 mg/m(3) identified slight alveolitis after 2 weeks of exposure, which subsided in the 2-week postexposure observation period. A short-term dermal toxicity study of Poloxamer 184 in rabbits at doses up to 1000 mg/kg produced slight erythema and slight intradermal inflammatory response on histological examination, but no dose-dependent body weight, hematology, blood chemistry, or organ weight changes. A 6-month feeding study in rats and dogs of Poloxamer 188 at exposures up to 5% in the diet produced no adverse effects. Likewise, Poloxamer 331 (tested up to 0.5 g/kg day(-1)), Poloxamer 235 (tested up to 1.0 g/kg day(-1)), and Poloxamer 338 (at 0.2 or 1.0 g/kg day(-1)) produced no adverse effects in dogs. Poloxamer 338 (at 5.0 g/kg day(-1)) produced slight transient diarrhea in dogs. Poloxamer 188 at levels up to 7.5% in diet given to rats in a 2-year feeding study produced diarrhea at 5% and 7.5% levels, a small decrease in growth at the 7.5% level, but no change in survival. Doses up to 0.5 mg/kg day(-1) for 2 years using rats produced yellow discoloration of the serum, high serum alkaline phosphatase activity, and elevated serum glutamicpyruvic transaminase and glutamic-oxalacetic transaminase activities. Poloxamers are minimal ocular irritants, but are not dermal irritants or sensitizers in animals. Data on reproductive and developmental toxicity of Poloxamers were not found. An Ames test did not identify any mutagenic activity of Poloxamer 407, with or without metabolic activation. Several studies have suggested anticarcinogenic effects of Poloxamers. Poloxamers appear to increase the sensitivity to anticancer drugs of multidrug-resistant cancer cells. In clinical testing, Poloxamer 188 increased the hydration of feces when used in combination with a bulk laxative treatment. Compared to controls, one study of angioplasty patients receiving Poloxamer 188 found a reduced myocardial infarct size and a reduced incidence of reinfarction, with no evidence of toxicity, but two other studies found no effect. Poloxamer 188 given to patients suffering from sickle cell disease had decreased pain and decreased hospitilization, compared to controls. Clinical tests of dermal irritation and sensitization were uniformly negative. The Cosmetic Ingredient Review (CIR) Expert Panel stressed that the cosmetic industry should continue to use the necessary purification procedures to keep the levels below established limits for ethylene oxide, propylene oxide, and 1,4-dioxane. The Panel did note the absence of reproductive and developmental toxicity data, but, based on molecular weight and solubility, there should be little skin penetration and any penetration of the skin should be slow. Also, the available data demonstrate that Poloxamers that are introduced into the body via routes other than dermal exposure have a rapid clearance from the body, suggesting that there would be no risk of reproductive and/or developmental toxicity. Overall, the available data do not suggest any concern about carcinogenesis. Although there are gaps in knowledge about product use, the overall information available on the types of products in which these ingredients are used, and at what concentration, indicates a pattern of use. Based on these safety test data and the information that the manufacturing process can be controlled to limit unwanted impurities, the Panel concluded that these Poloxamers are safe as used.     

HPLC法测定抗妇炎胶囊中木兰花碱、黄柏碱、药根碱、巴马汀、小檗碱、槐果碱、苦参碱、氧化槐果碱、槐定碱和氧化苦参碱

目的 采用高效液相色谱（HPLC）法同时测定抗妇炎胶囊中木兰花碱、黄柏碱、药根碱、巴马汀、小檗碱、槐果碱、苦参碱、氧化槐果碱、槐定碱和氧化苦参碱10种活性成分。方法 采用InerSustain AQ-C₁₈色谱柱（250 mm×4.6 mm,5 μm）,流动相A：乙腈–无水乙醇（80∶20）,流动相B：0.1%磷酸溶液,梯度洗脱,检测波长220 nm,体积流量1.0 mL/min,柱温30℃,进样量10 μL。结果 木兰花碱、黄柏碱、药根碱、巴马汀、小檗碱、槐果碱、苦参碱、氧化槐果碱、槐定碱和氧化苦参碱分别在2.69～134.50、1.95～97.50、0.63～31.50、0.86～43.00、11.95～597.50、0.59～29.50、6.08～304.00、4.85～242.50、1.66～83.00、19.79～989.50 μg/mL线性关系良好（r≥0.999 3）;平均回收率分别为99.11%、98.23%、96.95%、97.78%、100.02%、97.21%、99.66%、99.52%、98.81%、100.08%,RSD值分别为1.04%、1.23%、1.37%、1.65%、0.70%、1.28%、0.65%、0.81%、1.11%、0.63%。结论 建立的HPLC法可用于抗妇炎胶囊中10种活性成分的测定,作为抗妇炎胶囊质量控制方法。     

Simultaneous measurement of bupivacaine, etidocaine, lidocaine, meperidine, mepivacaine, and methadone

A gas-liquid chromatographic method for the simultaneous measurement of bupivacaine, etidocaine, lidocaine, meperidine, mepivacaine, and methadone in serum is described. The drugs and the internal standard, prilocaine, are extracted from 1 ml of serum. The procedure involves a two-step extraction and injection of the extract into a gas chromatograph equipped with a 10-ft OV-11 glass column and a nitrogen-phosphorus detector. The temperature gradient program results in a run time of 16 min and retention times for meperidine, prilocaine (internal standard), lidocaine, etidocaine, mepivacaine, methadone, and bupivacaine of 3.8, 5.4, 6.0, 8.7, 11.0, 11.7, and 14.8 min, respectively. Standard curves for all drugs were linear over the 80 to 2,000-ng/ml range and recovery of all components averaged 97 +/- 2% with the lowest detection limit of 10 ng/ml for all drugs except meperidine and methadone, which were 20 ng/ml. The within-day coefficients of variation ranged from 12 to 8% at 500 ng/ml. The day-to-day coefficients of variation of the slope and intercept values ranged from 2 to 0% and 130 to 3%, respectively. Response factors of the nitrogen-specific collector varied with the drug analyzed and resulted in peak area variation at constant offset and attenuation of 30%. This method is intended and adequate for therapeutic monitoring of chronically treated pain patients who are being given various combinations of local anesthetic and/or narcotic agents.     

Strength of drug habits: For heroin,morphine, methadone,alcohol, barbiturates,pentobarbital, benzedrine,cocaine, and marijuana

The drug habits for 78 confirmed opiate addicts were studied on eight scales from the Process Association Test of Addiction (PATA) for many drug names. Through cluster analysis eight stages of addiction were defined: “to be clean”, “to learn about drugs”, “to hustle”, “to chip” (also “to be high”), to be psychologically dependent or “to need a shot”, “to be hooked”, “to kick a habit” and “to be in treatment”. Associations stimulated by the words heroin and morphine were very similar over the eight stages of addiction in opiate addicts. The subjects were especially inclined to associate morphine and heroin with the most severe level of addiction, “to be hooked”. Associations to both methadone and cocaine were elevated at the “hooked” stage, but in other respects associations to these drugs were opposite. Thus, associations to cocaine were focused on the stage of psychological dependence and the lower intermediate stage of addiction, “to chip” and “to be high”, whereas associations to methadone suggested a turning away from addiction as indicated by avoidance associations (“to come down” and “to kick a habit”) as well as associations to “treatment” and “to be clean”. Marijuana, Benzedrine, “goofball” (barbiturates) and alcohol habits were prominent at an intermediate stage of addiction (“to chip” and “to be high”). Avoidance associations were common for Benzedrine and “goofballs” (also pentobarbital) but not for marijuana or alcohol. “Hustling” associations were frequent for marijuana but not for alcohol.     

Disposition of fluvastatin, an inhibitor of HMG-COA reductase, in mouse, rat, dog, and monkey

The physiological disposition of fluvastatin, a potent inhibitor of hydroxymethylglutaryl-CoA reductase and thus cholesterol synthesis, has been studied in the mouse, rat, dog, and monkey using 14C- or 3H-labeled drug. Oral doses of fluvastatin were absorbed at a moderate to rapid rate. The extent of absorption was dose-independent and was essentially complete in all four species studied. However, the drug was subject to extensive presystemic hepatic extraction followed by direct excretion via the bile, thus minimizing the systemic burden and yielding high liver/peripheral tissue concentration gradients for fluvastatin and its metabolites. Only at high doses far exceeding the intended human daily dose of ca 0.6 mg kg-1 did fluvastatin bioavailability approach unity, apparently due to saturation of the first-pass effect. Dose-normalized blood levels of fluvastatin and total radioactivity were higher in the dog than in the other species, suggesting a smaller distribution volume in the former. Fluvastatin was partially metabolized before excretion, the extent of metabolism being smallest in the dog and greatest in the mouse. The half-life of intact fluvastatin ranged from 1-2h in the monkey to 4-7h in the dog. Regardless of the dose or dose route, the administered radioactivity was recovered predominantly in feces, with the renal route accounting for less than 8 per cent of the dose. No tissue retention of radioactivity was observed, and material balance was essentially achieved within 96h after dosing.     

New antiretroviral drugs: a review of the efficacy,safety, pharmacokinetics,and resistance profile of tipranavir,darunavir, etravirine,rilpivirine, maraviroc,and raltegravir

Background: The introduction and approval of new antiretroviral agents in the US and Canada bring new opportunities and new challenges. Arguably, for the first time ever, clinicians have the drugs necessary to achieve the goal of suppressing HIV RNA to levels less than 50 copies/mL in even the most treatment-experienced patients and in those with extensive drug-limiting resistance mutations. However, the use of these new agents is complicated by many drug–drug interactions and – to some extent – pre-existing mutations. To derive maximum durability from the use of these newer drugs, a thorough understanding of their indications and limitations is critical. Objective: To thoroughly review the six most recently approved or soon-to-be-approved antiretroviral drugs in the US and Canada: tipranavir, darunavir, etravirine, rilpivirine, maraviroc, and raltegravir. Methods: Discussion of the indications for, and pharmacokinetics, resistance profile, activity, toxicity, and clinical trials results of, the six new agents. Results/conclusions: These six new agents have resulted in marked progress towards the goal of being able to provide HIV-infected individuals with the drugs necessary to achieve decades of durable suppression of HIV without substantial toxicity.