Ionic and nonionic polymers can prevent surfactant inactivation

It is well known that treatment with exogenous surfactant works well in premature infants with lung surfactant deficiency. Effects of surfactant therapy are less dramatic when used to treat lung diseases associated with acute lung injury(ALI)and adult respiratory distress syndrome(ARDS). This less successful clinical response may be due in part to surfactant inactivation by leakage of plasma and inflammatory products into the alveoli. It is therefore important to find a way of preventing or reversing inactivation of surfac-     

Biophysical activity of pulmonary surfactant：an alternative view

Pulmonary surfactant has long been recognized as a potential factor in the development and perpetuation of the acute respiratory distress syndrome(ARDS). Attempts to use therapeutic surfactants in the treatment of ARDS, however, have been frustrated by the lack of agents that are both biophysically active and available in     

在ARDS中开放的肺部

Every year, millions of patients worldwide receive ventilator support during surgery. Mechanical ventilation has become an important therapy in the treatment of patients with impaired pulmonary function and particularly in patients suffering from adult respiratory distress syndrome (ARDS). ARDS is caused by multiple factors and is characterized by respiratory dysfunction including hypoxemia and decreased lung compliance. It is known that the decrease in lung distensibility is due to a disturbed surfactant system with an elevated surface tension. This increase in surface tension leads to an increase in forces acting at the air-liquid interface, resulting finally in endexpiratory collapse, atelectasis, an increase in right-to-left shunt and a decrease in PaO2.     

Open lung in ARDS

Every year, millions of patients worldwide receive ventilator support during surgery. Mechanical ventilation has become an important therapy in the treatment of patients with impaired pulmonary function and particularly in patients suffering from adult respiratory distress syndrome (ARDS). ARDS is caused by multiple factors and is characterized by respiratory dysfunction including hypoxemia and decreased lung compliance. It is known that the decrease in lung distensibility is due to a disturbed surfactant system with an elevated surface tension. This increase in surface tension leads to an increase in forces acting at the air-liquid interface, resulting finally in endexpiratory collapse, atelectasis, an increase in right-to-left shunt and a decrease in P_(aO_2).     

Prevention of vascular structural changes with antihypertensive therapy

<正> The primary aim of antihypertensive therapy is to reduce or normalize blood pressure of the patients, so that we can lower the incidence of morbidity and mortality which are related to cardiovascular complications due to hypertension. It is also desirable that antihypertensive treatments can prevent or reverse cardiovascular changes, so that after a certain treat ment period, it may be possible to withdraw the treat ments without the risk of hypertension. However, most studies to date have shown that withdrawal of treat ments usually resulted in rebound hypertension, with the re-establishment of hypertension within a very     

Effects of inhaled nitric oxide on de novo synthesis of phosphatidylcholine in adult rat lungs with endotoxin-induced inflammatory injury

BACKGROUND: Though inhaled nitric oxide (iNO) improved oxygenation but had no effect on mortality in randomized clinical trial for acute respiratory distress syndrome (ARDS), its efficacy in modulation of inflammation and antioxidant capability in airway and alveolar epithelial cells in mature lungs remains to be verified. As iNO is usually used in hyperoxic condition, it may alter surfactant lipid de novo synthesis in inflammatory lung. Despite the fact that NO may potentiate damage to surfactant proteins and inhibit surfactant phospholipid synthesis, iNO is still considered an alternative and encouraging therapy in intractable respiratory failure to obviate more invasive and expensive strategies. OBJECTIVE: To investigate whether hyperoxia and/or inhaled nitric oxide (iNO) may affect de novo synthesis of phosphatidylcholine (PC) in mature lungs with inflammatory injury. METHODS: Healthy adult S-D rats were first assigned into a normal control group (C) or a group with lipopolysaccharides (2 mg/kg iv)     

Pharmacological effects of saw palmetto extract in the lower urinary tract

Saw palmetto extract （SPE）, an extract from the ripe berries of the American dwarf palm, has been widely used as a therapeutic remedy for urinary dysfunction due to benign prostatic hyperplasia （BPH） in Europe. Numerous mechanisms of action have been proposed for SPE, including the inhibition of 5a-reductase. Today, al-adrenoceptor antagonists and muscarinic cholinoceptor antagonists are commonly used in the treatment of men with voiding symptoms secondary to BPH. The improvement of voiding symptoms in patients taking SPE may arise from its binding to pharmacologically relevant receptors in the lower urinary tract, such as al-adrenoceptors, muscarinic cholinoceptors, 1,4-dihyropyridine receptors and vanilloid receptors. Furthermore, oral administration of SPE has been shown to attenuate the up-regulation of α1-adrenoceptors in the rat prostate induced by testosterone. Thus, SPE at clinically relevant doses may exert a direct effect on the pharmacological receptors in the lower urinary tract, thereby improving urinary dysfunction in patients with BPH and an overactive bladder. SPE does not have interactions with co-administered drugs or serious adverse events in blood biochemical parameters, suggestive of its relative safety, even with long-term intake. Clinical trials （placebo-controlled and active-controlled trials） of SPE conducted in men with BPH were also reviewed. This review should contribute to the understanding of the pharmacological effects of SPE in the treatment of patients with BPH and associated lower urinary tract symptoms （LUTS）.     

Effect of a long-acting somatostatin analogue (octreotide) on circulating tachykinins and the pentagastrin-induced carcinoid flush

Summary Cutaneous flushing was provoked in seven patients with metastatic carcinoid tumours and the carcinoid syndrome by an intravenous injection of pentagastrin (0.6 μg·kg⁻¹ body weight). The patients were studied before and 1 h after a subcutaneous injection of the long-acting somatostatin analogue octreotide 50 μg (Sandostatin). The severity of the carcinoid flush in all the patients was reduced by administration of the analogue. The rise in facial temperature was 1.3 (0.3)° C before and 0.8 (0.2)° C after octreotide. Six patients responded to pentagastrin with a rise in the circulating neurokinin A-like immunoreactivity (NKA-LI) and five patients with a rise in circulating substance P-like immunoreactivity (SP-LI). No cutaneous flushing or rise in tachykinin concentration was observed in healthy subjects (n=6) after injection of pentagastrin. The rise in NKA-LI in the patients was decreased by 61 (14)% and the rise in SP-LI by 54 (13)% after octreotide. Although flushing still occurred, the tachykinin response in two patients was completely abolished. The data demonstrate that the release of tachykinins from carcinoid tumours during pentagastrin-induced flushing is subject to partial inhibition by octreotide. However, the occurrence of a flush in some patients in the absence of a detectable rise in circulating tachykinins indicates that the latter peptides cannot be the sole causative agent of the carcinoid flush.     

Influence of omeprazole on pharmacokinetics of domperidone given as free base and maleate salt in healthy Chinese patients

Aim： To investigate the influence of omeprazole on the pharmacokinetics of domperidone given as free base and maleate salt. Methods： An open, randomized, 2-period crossover study with a washout period of 7 d was conducted in 10 healthy Chinese, male patients. In each study period, the patients were administered a single oral dose of 10 mg domperidone as free base or maleate salt on d 1, 20 mg omeprazole twice daily on d 2 and 3, and once on d 4. A single dose of 10 mg domperidone as free base or maleate salt was taken at 4 h after administration of omeprazole on d 4. Plasma samples were collected on d 1 and 4 after the administration of domperidone, and the plasma concentrations of domperidone were determined by a sensitive liquid chromatography-tandem mass spectrometry method. Results： For free-base domperidone, pretreatment with omeprazole resulted in a 16% decrease in maximum concentration （Cmax）, compared with administration alone （P〈0.05）. However, for maleate salt, with the exception of an increase in t1/2, no pharmacokinetic parameters were significantly changed. When the free base and maleate salt were administered alone, no differences were found in any parameters between the 2 formulations. In contrast, when they were administered in the presence of omeprazole, the Cmax of domperidone given as free base was lower （25.9%） than that given as maleate salt （P〈0.05）. Conclusion： Pretreatment of omeprazole does not affect the absorption of domperidone maleate, but leads to a moderately decreased rate of absorption of the free base.     

棉酚对离体兔心的失钾作用及其可能机理

Since 1972 gossypol, a biologically active constituent of cotton seed and cotton root bark, was shown to have a potent spermatocidal effect in man. Glinical trials pointed out that occasional cases of hypokalemia and hypokalemic paralysis might happen in the course of gossypol administration. Little was known concerning the intrinsic relationship between gossypol and such hypokalemias.The authors indicated that in isolated rabbit heart brief perfusion with Lock's solution containing gossypyl 2 mg/l could induce a significant loss of the potassium content of the left ventricular myocardium, together with a drastic depression of its contractility. These actions were reversed when Mg²⁺ (2～4 me/l) had been added beforehand to the perfusion solution. It is suggested that the potassium-depleting (and negative inotropic) effect of gossypol on the isolated heart might be the consequence of its possihle inhibitory action on Na-K-ATPase (and/or other Mg-dependent enzyme systems involved in energy metabolism), thus interfering in the active potassium transport.     

子宫中隔切除术后预防粘连方法探讨

目的 探讨子宫中隔并不孕患者宫腔镜术后不同处理方法预防宫腔粘连的效果.方法 55例子宫中隔并不孕患者行腹腔镜监护下宫腔镜子宫中隔切除术(TCRS),术后针对不同患者采用不同术后处理措施,包括宫腔放置与不放IUD,是否进行人工周期治疗,部分患者术后使用GnRH-a类药物治疗术后第1、3个月行宫腔镜检查随访,宫内放置IUD的患者;于术后第3个月取环.结果 54例患者术后进行宫腔镜检查随访,其中40例分别于术后第1、3个月完成了术后2次宫腔镜检查,另14例只完成一次检查.宫腔术后放环与否对术后宫腔形态影响无差异(P>0.05),术后使用人工周期治疗患者较未使用者子宫内膜厚,此两者术后第3个月宫腔镜检查发现宫底创面均已有内膜覆盖.使用GnRH-a类药物患者术后官腔形态满意.结论 TCRS术后宫腔放置IUD无助于预防术后粘连的发生;术后人工周期治疗应更个体化并有针对性的使用GnRH-a类药物治疗.术后及时进行宫腔镜检查随访可防止术后宫底新粘连的形成.     

10例狂犬病误诊原因分析

狂犬病近年来发病率有逐年增加的趋势,近十二年来,我们共遇见狂大病２３例,其中１０例被误诊为其它疾病,现就其误诊原因进行分析如下。１临床资料１．１ 一般资料：男８例,女２例;年龄最大７８岁,最小４岁。发病季节为３月～１１月。首诊科室,儿科３例、内科３例、转院３例、急诊科１例。１．２ 临床表现：发热７例,恐风５例,恐水６例,怕光３例,流涎１０例,胸闷、气促、呼吸困难４例,烦躁不安１０例,多汗７例,恐惧６例,肢体麻木４例,抽搐４例,恶心、呕吐２例,昏厥１例。所有病例发病至死亡时间为２天～６天,死亡原因为…     

住院患者精神用药情况调查分析

目的：了解目前住院精神患者的药物使用情况。方法：采用一日法调查西安市精神卫生中心403例住院精神患者诊断和治疗情况，并与上海市精神卫生中心2004年调查结果相比较。结果：①传统精神药物使用显著减少，新型精神药物使用占据首位；②抗精神病药物使用趋向小剂量化；③本组联用丙戊酸盐类药物显著增多；④我院精神药物使用情况与上海精神卫生中心比较有显著差异。结论：近年来精神药物使用情况已发生了显著变化，与新型精神药物疗效好，副作用少，患者依从性高有关。     

复发性耳廓假性囊肿的治疗

目的 探讨不同方法对复发性假性耳廓囊肿的治疗效果.方法 对2008年5月至2012年2月在我科就诊的58例复发性假性耳廓囊肿分成2组,穿刺抽液+冷冻+加压包扎组(19例),手术切除囊肿前壁软骨+对穿缝合组(39例),随访3个月到1年,观察2组治愈率、复发率,有效率、并发症等情况.结果 对照组1次治愈后痊愈5例,复发14例,治愈率为26.3％,复发率为73.7％,有效率为78.9％,其中耳廓增厚6例,1例并发化脓性软骨膜炎.观察组治愈38例,复发1例,经过1次穿刺后治愈,治愈率为97.4％,复发率为2.6％,有效率为100.0％.所有患者无耳廓变形、增厚,无化脓性耳廓软骨膜炎的并发症.结论 囊肿前壁软骨切除+对穿缝合是治疗复发性假性耳廓囊肿的高效、首选办法,值得推广.     

欧洲药典适用性认证介绍

目的介绍欧洲药典适用性认证程序,为国内药品监管机构和原料药生产企业提供信息,促进我国原料药生产企业的国际化。方法通过查阅调研欧盟相关药品法规和与EDQM同行面对面的交流,详细了解欧洲药典适用性认证的组织机构和具体程序。结果与结论欧洲药典适用性认证程序在对原料药的质量控制有重要作用,加强了药典的监管力度,进一步保证了原料药的质量、安全性和有效性。     

不同方法治疗慢性宫颈炎的疗效分析

目的慢性宫颈炎是妇科最常见的疾病之一,可引起盆腔脏器炎症,并且与宫颈癌的发生关系密切。本文诣在探讨不同方法在慢性宫颈炎中的疗效。方法回顾性分析新乡市中心医院收治的210例宫颈炎患者,采用药物保妇康栓、聚焦超声治疗及宫腔镜下宫颈电切术的临床效果进行统计分析。结果宫颈电切术治疗有效率为97.9%,明显高于另外两组,差异有统计学意义。结论宫腔镜下宫颈电切术治愈慢性宫颈炎,并且切除宫颈移行带,减少宫颈癌发生。     

新疆维吾尔自治区基层医院平均住院日调查分析

目的 通过对新疆维吾尔自治区14个县乡级医疗机构住院患者平均住院日及影响因素进行分析,为县乡级医疗机构进一步提高医疗管理质量提供依据.方法 将2009-2010年1504例县乡级医院住院患者平均住院天数,按性别、年龄、院别、付费方式、疾病分类进行描述性统计和秩和检验分析.结果 不同性别间及院别间平均住院日差异均有统计学意义(均P＜0.05),男性平均住院日为10.39 d,女性为8.69d,乡级医院为9.27d,县级医院为9.50 d.不同年龄间平均住院日差异有统计学意义(P＜0.05),小于15岁组、15 ～24岁组、25～44岁组、45 ～65岁组、大干65岁组平均住院日分别为8.10 d、7.66d、8.83 d、10.26 d和11.33 d.自费患者平均住院日为8.39 d,新农合组为9.10 d,商业保险组10.17 d,社会基本医疗保险患者则为11.08 d.不同疾病分类间平均住院日差异明显,妊娠类平均住院日最短,为6.73 d,而肿瘤患者则为14.26 d.结论 不同性别、不同年龄段、不同疾病分类及不同付费方式间平均住院日存在差异,县级医疗机构和乡级医疗机构住院患者平均住院日也存在差异.     

药品风险管理之风险的起因分析——关于药品天然风险

药品认知水平是把握药品天然风险的决定因素，却又受到伦理需求和产业发展需求的影响。药品不良反应监测，正是常规的取法三者平衡关系的制度工具。     

The effect of temperature and of cetrimide on the rate of loss of refractility of spores of Bacillus megaterium

The rate of germination of spores of Bacillus megaterium at 30° is not significantly different from the rate at 37° but the onset of germination is delayed; outgrowth is normal. At 45° germination of some spores occurs but the rate is much slower than at 37°, and there is no lag; emergence occurs from only a proportion of the germinated spores and after 3 or 4 vegetative cells have been produced, replication ceases. A single regression equation can represent the germination rate of the spores at 37° in the presence of from 0.0005 to 0.02% w/v of cetrimide and in its absence. In 0.0005% w/v of cetrimide, germ cells emerge from some of the germinated spores but many of them become swollen and disintegrate. Concentrations of 0.00125% w/v or more progressively inhibit swelling and completely inhibit emergence.