五酯胶囊对茚地那韦在比格犬体内药代动力学的影响

目的:研究五酯胶囊对茚地那韦(IDV)药代动力学影响.方法:实验动物为比格犬,本实验采用自身对照法,6只比格犬按单给硫酸茚地那韦片和连续给五酯胶囊后再给硫酸茚地那韦片分为单用茚地那韦组和五酯胶囊组.给药(硫酸茚地那韦片)前禁食不禁水12 h,给药前及给药后按设定时间点于比格犬前肢静脉采血800 μl,分离出血浆,血浆经乙酸乙酯萃取2次,合并上清,氮气吹干,复溶,使用LC/MS/MS法检测比格犬血浆中茚地那韦浓度.结果:IDV在比格犬血浆中的药物浓度线性范围为20～10 000 μg/L,线性关系良好(r>0.99),最低定量限为20 μg/L.比较单用硫酸茚地那韦片和连续给药五酯胶囊后给药硫酸茚地那韦片的药代动力学参数,连续给药五酯胶囊7 d后给药茚地那韦片时茚地那韦的AUC0-t及Cmax均有显著性提高.结论:本方法灵敏度高,特异性好,适用于血浆样品检测.结果显示五酯胶囊会影响茚地那韦在比格犬体内药代动力学过程.     

环孢菌素A血药浓度的影响因素及其临床监测注意事项

目的 总结肾移植术后使用环孢菌素A需注意的问题，为临床应用提供依据。方法 调研了近年来临床应用CsA的资料，进行总结和评价。结果 该药目前在移植术后的抗排异中，仍起着主要的作用。结论 从监测方法、标本的采集、药物相互作用、机体状况、服用方法等方面，都有许多影响CsA血药浓度的因素，因此，提醒用药时要多方位的加以考虑。     

新癀片治疗癌症疼痛的临床评价

目的 观察和评价新癀片治疗癌症疼痛的作用特点及其在三阶梯止痛中的意义和地位。方法 运用10分制数字分级划线法观察患服药前后不同时段的疼痛程度，判断该药的止痛效果、有效剂量、起效时间、持续时间、有效剂量维持时间及其副作用，从而了解该药的止痛作用特点。结果 该药在3片以上有肯定的止痛效果，完全缓解和明显缓解率占79．7％，总有效率达84．4％，与10mg／12h美施康定相比，疗效略低(P＜0．05)，但对轻疼痛可达同样的止痛效果；新癀片止痛起效时间不一，持续时间不等，有效剂量维持时间多在1周之内，部分病例加量后仍可获得一定的止痛效果，但5片以上时腹泻、腹痛等副作用出现机率增加；同时该药还常引起多汗，并有退热作用。结论 该药有肯定的止痛效果，其量效关系、时效关系及副作用方面的结果表明，可将其作为第一阶梯用药，并尤其适用于伴有发热或因服用阿片类药物而出现便秘。     

多抗甲素的超微药理学

多抗甲素是我国首创的新型免疫增强剂,化学结构为α-甘露聚糖肽。本文报告了多抗甲素的超微药理学研究成果。采用电镜技术,研究了该药对脾脏、胸腺、肝脏和造血干细胞的超微结构影响。结果表明该药对免疫器官有明显活化作用,对造血干细胞有增殖作用,对肝细胞有保护作用。从超微结构水平阐述了多抗甲素的药理学,为临床用药提供了依据。通过本项研究,提出了“趟微筠理学”的新概念。     

茚达特罗对COPD患者日常活动影响的研究

目的 研究茚达特罗对慢性阻塞性肺疾病(COPD)患者的治疗效果及日常活动的影响。方法 采取随机对照方法,将129例中度COPD患者分为3组,每组43例,分别每日单次吸入150μg茚达特罗(茚达特组)、安慰剂(空白对照组)、18μg噻托溴铵(噻托溴铵组),疗程均为3 w。治疗3 w后,采用身体体积描记法及肺活量检测评估肺功能,多感官臂带记录评估患者活动量的改变。结果 治疗3 w后,茚达特罗组最大吸气量为2.69 L,显著大于噻托溴铵组及空白对照组(P<0.05);与安慰剂相比,茚达特罗和噻托溴铵均能显著改善肺功能相关指标(P<0.05);对每日步行数、每日步行时间、平均活动水平进行比较,茚达特罗组均优于噻托溴铵组及空白对照组(P<0.05);3组间不良反应无统计学差异(P>0.05)。结论 每日单次吸入150μg茚达特罗能够缓解中度COPD患者肺的过度充气(肺气肿),对患者日常活动能力的改善也有积极作用。     

高渗甘露醇在脑肿瘤动脉化疗中的应用价值

本文回顾和总结了高渗甘露醇在动脉介入化疗治疗脑肿瘤中的应用价值和意义。目前该药的应用仍存在争论。本文还综述了甘露醇开放血脑屏障的原理、应用方法，剂量，毒副作用等，以期对临床应用提供依据和指导作用。     

高原低氧对大鼠脏器超微结构的影响及红景天素的保护作用

本文应用透射电镜对平原大鼠急进高原后其主要脏器超微结构的变化,以及红景素的保护作用进行了观察,结果表明:在特高海拔地区,由于受严重低氧环境的影响,大鼠脏器超微结构均发生不同程度的弥漫性损伤,突出地表现为细胞线粒体变性肿胀,甚至呈髓鞘样改变,细胞间质水肿、核异染色体边聚、肌浆网明呈扩张、糖原颗粒减少、毛细血管基膜增厚不均匀等。红景天素可明显减轻细胞超微结构缺氧性损伤,提示该药具有较好的保护作用。本文还对其可能的作用机理进行了探讨。     

可减少老年痴呆症的药物

吡乙酰胺(吡拉西坦、脑复康) 该药具有激活、保护并修复大脑神经细胞，提高学习能力，推迟记忆障碍发生的功效。但该药单用的有效率仅为58．8％，而与安定、去甲羟安定等药合用可将有效率提高到65．3％，其中半数人的症状在用药1～2周后得到改善。该药对轻、中度老年痴呆症的疗效较好，而对重症病例无效。     

鼻泰对大鼠肥大细胞保护作用的实验研究

鼻泰滴鼻剂由辛夷、桂枝、细辛等组成，试用于治疗变应性鼻炎，能迅速缓解鼻塞、抑制流鼻涕，并有较好的远期疗效，为了探索其作用机制，笔者就该药对肥大细胞的保护作用迸行了观察。     

青海冬虫夏草及有效成分对免疫调节作用的研究进展

冬虫夏草是我国特有的名贵中药,由于自然和人为因素,其资源保护显得日益重要.本文在查阅了大量文献的基础上,从冬虫夏草在青海的生态状况、有效成分及冬虫夏草的免疫调节作用等方面总结了近年来冬虫夏草的研究进展.     

The role of interventional radiology in trauma

Introduction Interventional Radiology has evolved into a specialty having enormous input into the care of the traumatized patient.In all hospitals,regardless of size,the Interventional Radiologist must consider their relationships with the trauma service in order to     

Carbohydrate Supplementation during Exercise: Does It Help? How Much is Too Much?

KEY POINTS· Carbohydrate intake during exercise can delay the onset of fatigue and improve performance of prolonged exercise as well as exercise of shorter duration and greater intensity (e.g., continuous exercise lasting about 1h and intermittent high-intensity exercise), but the mechanisms by which performance is improved are different.     

Diagnóstico ecográfico del neumotórax

The ultrasonographic diagnosis of pneumothorax is based on the analysis of artifacts. It is possible to confirm or rule out pneumothorax by combining the following signs: lung sliding, the A and B lines, and the lung point. One fundamental advantage of lung ultrasonography is its easy access in any critical situation, especially in patients in the intensive care unit. For this reason, chest ultrasonography can be used as an alternative to plain-film X-rays and computed tomography in critical patients and in patients with normal plain films in whom pneumothorax is strongly suspected, as well as to evaluate the extent of the pneumothorax and monitor its evolution.     

磁共振DWI和动态增强鉴别颅底脊索瘤和侵袭性垂体瘤的应用

目的 探讨磁共振扩散加权成像(DWI)和动态增强在颅底脊索瘤和侵袭性垂体瘤(IPA)鉴别诊断中的应用价值.方法 搜集经手术病理证实且影像学有鞍区破坏的颅底脊索瘤患者15例、向鼻咽部侵犯的IPA患者20例.测量二者的表观扩散系数(ADC)值,绘制受试者工作特征曲线(ROC),分析动态增强曲线的类型,统计达峰时间(TTP)、增强峰值(EP)和最大对比增强率(MCER),分析各个参数在鉴别诊断中的价值.结果 颅底脊索瘤的ADC值为(1.274±0.07)×10-3mm2/s,高于IPA ADC值(0.672±0.03) ×10-3 mm2/s(P ＜0.001),ADC阈值为0.964×10-3mm2/s时,ROC曲线下面积为0.997,敏感度为93.3％,特异度为100％.颅底脊索瘤时间-信号强度曲线(TIC)Ⅰ型14例,TICⅢ型1例,此例TICⅢ型者TTP约40 s;IPA TIC Ⅰ型7例,TICⅢ型13例.颅底脊索瘤和IPA的EP、MCER差异均有统计学意义(P ＜0.001).结论 ADC值和TIC的类型及其相关参数(EP,MCER)有助于颅底脊索瘤和IPA之间的鉴别.     

Treatment of intrahepatic arteriovenous fistula in hepatocellular carcinoma with N-butyl-2-cyanoacrylate

Primary hepatocellular carcinoma (HCC) continues to be one of the most common malignancies with an incidence of approximately one million cases per year and a dismal prognosis; some authors have reported a median survival of 1 ～ 2 months after diagnosis. Although surgery remains the only hope for cure, few patients are candidates[1,2].     

U50,488H对正常及缺氧心肌细胞L型钙电流的作用

目的 探讨心脏阿片受体和β-受体相互作用的机制。方法 采用全细胞膜片钳技术，观察U50，488H(β-阿片受体选择性激动剂)对正常和缺氧心肌细胞L型钙电流的作用。结果 U50，488H剂量依赖性(0．1～100μmol／L)抑制正常心肌细胞的L型钙电流及异丙肾上腺素(0．1μmol／L)激动的钙电流，而细胞缺氧后，这一抑制作用减弱；U50，488H对Forskolin(10μmol／L)激动的L型钙电流无明显影响。结论 β-阿片受体对β-受体信号的负性调节作用在细胞缺氧后减弱，其作用位点可能发生于β-受体与腺苷酸环化酶环节之间。     

Overtraining syndrome : la piste de la suractivité ?

Introduction

Overtraining is clearly a multifactorial disturbance. We aimed at evaluating the relative importance of overactivity and nutritional imbalances.

Methods

A comparison of 17 footballers with seven subjects with a diagnosis of overtraining evidenced that the two groups differ by energy expenditure resulting from physical activity (1573 ± 378.6 kcal/d from 804.7 ± 184.7 kcal/d) while food intake does not exhibit significant differences.

Conclusion

In this sample of subjects, inadequate food intake is found in both groups, so that overtraining appears rather characterized by a higher level of physical activity. Therefore, a relative energy deficit resulting from overactivity rather than dietary mistakes appears to explain the syndrome in these athletes, who are thus truly “overtrained”.     

Prenatal detection of brain anomalies with ultrasonography

Ultrasound is the first-line imaging study of the fetal brain performed at 12, 22 and 32 weeks of gestation. The very structured evaluation of biometric and morphological data, facilitated by the use of a checklist, ensures a high quality examination. All patients where an anomaly of any key element is suspected should be referred to a center dedicated to prenatal diagnosis for confirmation irrespective of the gestational age. Prenatal diagnosis plays a significant role in France since medical interruption of pregnancy until term is authorized.     

Sexual homicide: Brief review of the literature and case report involving rape,genital mutilation and human arson

The objective of the current paper is to report a new case of sexual murder involving human arson and summarize the literature on the phenomenon of sexual homicide. The present case study is unprecedented in Greece and a rarity in international literature due to the fact that the victim suffered genital mutilation and incineration while still alive. The evaluation consisted of 176 articles; 53 were reviewed by the authors. The results revealed sparse, but significant, research findings. The authors discuss the limitations regarding research, incidence of the phenomenon, crime-scene patterns, offender characteristics (killing methods, motive inferences, sociodemographic data, classifications, psychopathology, modus operandi), and victim selection. The incidence of the phenomenon is unclear (1–4%) due to non-standardized criteria. It is an expression of displaced anger or sexual sadism and/or a way to elude detection (ancillary benefit). Most offenders (in their first kill) and victims were in their late 20s to early 30s and belong to Caucasian populations. Personal weapons were commonly used against women, strangulation is the prevalent killing method against children, and firearms against men. Most of the sexual homicide perpetrators are non-psychotic at the time of the attack, but experience personality pathology, primitive defenses, pathological object relations, and withdrawal into fantasy in order to deal with social isolation.