单剂量口服复方氨酚烷胺胶囊在人体内的生物等效性

目的 选择18名受试者单剂量交叉po两种复方氨酚烷胺胶囊,评价其生物等效性.方法 用HPLC测定血中对乙酰氨基酚和咖啡因的药物浓度,用3p97软件计算药动学参数;用方差分析和双单侧t检验分析两种复方氨酚烷胺胶囊中对乙酰氨基酚和咖啡因的主要药动学参数.结果 对乙酰氨基酚的Tmax分别为0.99±0.47、0.88±0.39 h,Cmax分别为8.40±2.99、8.62±5.00 μg·ml-1,AUC0-24分别为35.42±9.54、33.84±10.37 mg·h·L-1;咖啡因的Tmax分别为0.94±0.24、0.90±0.19 h,Cmax分别为1.22±0.31、1.26±0.42 μg·ml-1,AUC0-24分别为8.80±2.01、8.43±2.23 mg·h·L-1.结论 两种制剂具有生物等效性.     

莫西沙星与左氧氟沙星治疗社区获得性肺炎对比研究

目的 观察莫西沙星与左氧氟沙星治疗社区获得性肺炎的临床疗效及安全性。方法将65例社区获得性肺炎患者随机分成治疗组33例和对照组32例，治疗组给予莫西沙星针剂治疗，400mg静脉滴注，每日1次；对照组给予左氧氟沙星针剂治疗，400mg静脉滴注，每日1次；疗程均为7d。结果 研究结果显示，治疗组和对照组的临床有效率分别为90．91％和87．50％；细菌清除率分别为90．91％和83．33％；不良反应发生率分别为18．18％和21．88％。两组间临床有效率、细菌清除率、不良反应发生率均无显著差异（P〉0．05）。结论 莫西沙星针剂治疗社区获得性肺炎安全有效。     

生脉注射液在气管插管后血压降低中的运用

生脉注射液具有益气养阴、复脉固脱之功效,广泛用于严重感染、血容量不足引起的血压降低.在气管插管后血压降低时,应用生脉注射液也取得了较好的临床疗效.本文对气管插管后血压降低应用生脉注射液的用法用量、注意事项等进行了归纳.     

微创经皮膀胱取石术(附22例报告)

目的 探讨微创经皮膀胱气压弹道碎石适应症、操作方法、疗效等.方法 回顾我院近两年来采取微创经皮膀胱碎石取石术治疗膀胱结石患者22例的临床资料.结果 22例患者中小儿膀胱结石5例,男性成人17例;小儿结石直径均在2.6cm以上,成人结石直径为2～5cm,多发性结石18例.均一次取尽结石,住院3～8d,平均住院4.5d,术中术后均无严重并发症.结论 微创经皮膀胱碎石取石术适应于复杂性结石的患者,具有取石成功率高,并发症少,操作方法简单、安全之优点.     

阿奇霉素迟发性过敏反应致谵妄及心房纤颤

1例62岁疑为肺部感染的女性患者,接受阿奇霉素0.5g静脉滴注后2.5h出现寒战、胸闷、憋气及高热,继之出现烦躁不安,谵妄,心电图检查示快速房颤,经抗过敏及对症治疗好转。停用阿奇霉素,改用阿莫西林,未再出现上述症状。     

艾迪注射液联合FOLFOX4化疗晚期胃癌

目的：观察艾迪注射液联合FOLFOX4化疗治疗晚期胃癌的近期疗效和毒性反应。方法：将70例晚期胃癌患者随机分两组,对照组34例,单用FOLFOX4化疗。治疗组36例,在对照组治疗的基础上加用艾迪注射液。结果：治疗组和对照组总有效率分别是41.7%、32.4%。（P〉0.05）,治疗组比对照组生存质量有明显改善（P〈0.05）。毒性反应治疗组明显少于对照组（P〈0.05）。结论：艾迪注射液联合FOLFOX4方案治疗晚期胃癌较单用FOLFOX4方案治疗疗效好,生活质量提高明显且毒性反应轻。初学研究结果提示,中药配合西药化疗的综合治疗具有临床应用的意义。     

Radiofrequency catheter ablation of tachycardia in children with and without congenital heart disease: indications and limitations

From 1993 to 1998, a total of 100 consecutive pediatric patients with tachycardia (45 male and 55 female, aged 1 year 10 months to 17 years, 11+/-4 year) who underwent electrophysiological study were reviewed. Eleven of them were younger than 5 years. Two had tachycardia-related cerebrovascular accident. Congenital heart disease was found in 12 patients. After propofol anesthesia, the clinical tachycardia could not be induced in three (two atrial tachycardia and one AV nodal re-entrant tachycardia) and became nonsustained in five (atrial tachycardia). Mechanical ablation occurred in three and two had subsequent recurrences. Among the 85 cases who received radiofrequency ablation, the overall final success rate of RF ablation for all diagnoses was 94% with a diagnosis-specific success rate ranging from 100 to 57%. Tachycardia cardiomyopathy was noted in four (three atrial tachycardia and one junctional ectopic tachycardia) and all regressed after successful ablation. Success in two patients with left posterioseptal accessory pathway could only be achieved by delivering the energy at the middle cardiac vein. Two patients with right atrial isomerism had an 'AV nodal-to-AV nodal tachycardia' which was eliminated by ablation. Total recurrence rate was 13% but final success was achieved in all during re-study except the three patients who refused re-intervention. The atrial tachycardia developed in postoperative congenital heart disease was associated with the lowest success rate (57%) and highest recurrence rate (25%). Procedure-related complications occurred in four; two with transient brachial palsy, one with first-degree AV block and one with blood loss requiring blood transfusion. In conclusion, the experience of this single center confirmed the efficacy and safety of radiofrequency catheter ablation in treating pediatric arrhythmias, but the limitations in postoperative arrhythmias and the effects of propofol on tachycardia induction (especially the atrial tachycardia) need to be improved.     

Modulation of breast cancer resistance protein (BCRP/ABCG2) by non-basic chalcone analogues

Chalcones are biosynthetic precursors of flavonoids found to possess cytotoxic and chemopreventive activities. In this study, 17 non-basic chalcone analogues were synthesized and evaluated for their ability to modulate the function of either the human wild-type (482R) or mutant (482T) breast cancer resistance protein (BCRP/ABCG2) stably expressed in breast cancer MDA-MB-231 cells. At 5muM, chalcones with 2,4-dimethoxy groups or 2,4-dihydroxyl groups on ring A were found to increase mitoxantrone accumulation to a greater extent than an established BCRP inhibitor, fumitremorgin C. At the same time, these chalcones had negligible effect on calcein accumulation in P-glycoprotein overexpressing MDCKII cells, indicating their potential as selective BCRP inhibitors. Functionally, these compounds were able to increase the sensitivity of BCRP-overexpressing cancer cells to mitoxantrone by 2-5-fold. The effect of chalcone compounds on both wild-type and mutant BCRP ATPase activity was also examined and variable effects were observed. A stimulatory effect was mostly observed with chalcones with 2,4-dimethoxy substitution on ring A which were earmarked as good BCRP inhibitors in the MX accumulation and cytotoxicity assays. These findings underscore the potential of methoxylated and hydroxylated chalcones as selective and potent inhibitors of BCRP whose mode of action may not involve the inhibition of ATPase activity.     

腹腔镜在结直肠癌根治术中的应用

目的研究腹腔镜结直肠癌根治术的可行性和手术方法。方法回顾性分析2004年2月-2006年6月腹腔镜结直肠癌根治术52例患者的临床资料。结果52例患者中有48例顺利完成腹腔镜手术，4例中转开放手术，无手术死亡病例，无术后出血、吻合口漏、吻合口狭窄发生，切口感染2例，手术平均时间200min，术中平均失血120ml，术后2—4d胃肠功能恢复，所有标本残端无癌细胞浸润或残留，清扫淋巴结数10—30个，平均（16．2±6．1）个，术后平均住院时间7d，术后电话随访至2006年10月，死亡3例，局部复发2例。结论腹腔镜结直肠癌根治术具有创伤小、康复快、美容等优点，疗效较开腹手术好。