Local analgesic and vascular effects of intradermal ropivacaine and bupivacaine in various concentrations with and without addition of adrenaline in man

Ropivacaine, a new long–acting amino–amide local anaesthetic agent, and bupivacaine, in various concentrations with or without addition of adrenaline, were tested in a randomized, double–blind study using intradermal wheals. Ten non–smoking, healthy, young male volunteers participated. In series I plain solutions of ropivacaine (0.25%, 0.5%, 0.75% and 1%) and bupivacaine (0.25%, 0.5% and 0.75%) were injected intradermally and in series II the same concentrations, with the addition of adrenaline 5 ug ml^-1 ( 1 :200 000), were used. The same volunteers took part in both series, with an interval of at least three weeks between the experiments. Saline was included as control in both series. Pin–pricking was used to assess the dermal analgesia. Plain solutions of ropivacaine produced significantly longer durations of dermal analgesia than did plain solutions of bupivacaine, in all tested concentrations. A significant increase in duration was seen for both local anaesthetics when adding adrenaline. Local vascular effects at the injected areas were determined by visual inspection (nil, pink, pale). Local blanching (pale) was significantly more frequent for plain solutions of ropivacaine, in all tested concentrations. Local redness (pink) was significantly more frequent with plain bupivacaine, in a dose–dependent relation. An initial redness was frequently observed for both local anaesthetics containing adrenaline, followed by blanching at most sites.     

Modulation of infection-induced inflammation and locomotive deficit and longevity in senescence-accelerated mice-prone (SAMP8) model by the oligomerized polyphenol Oligonol.

Oligonol is produced from the oligomerization of polyphenols (typically proanthocyanidin from a variety of fruits such as lychees, grapes, apples, persimmons, etc.) and contains catechin-type monomers and oligomers of proanthocyanidins. The ability of Oligonol to affect infection-dependent eye inflammation, locomotion and longevity in senescence-accelerated prone mice (SAMP8) (a model of senescence acceleration and geriatric disorders with increased oxidative stress and neuronal deficit) was investigated. Oligonol (60mg/kg) significantly modulated the extent of inflammation scores in the eye of SAMP8 mice. Examination of the mice indicated infection with mouse hepatitis virus and pinworm (Syphacia obvelata) in both males and females and with the intestinal protozoa (trichomonad) in males. A comparison of the two groups (using log-rank test) and the difference in the mean life span between groups (using Student's t-test) indicated significant differences in survival (p=0.043) and the mean life span (p=0.033) in male SAMP8 mice. Oligonol increased the mean life span and this was statistically significant. In the open-field locomotive test, the 7-week-old SAMP8 mice crossed more than 40 partitioned lines in 1min. At 48-week-old control untreated male SAMP8 crossed 2 lines. The Oligonol-treated 48-week-old male SAMP8 mice crossed 17 lines however. The improved locomotive activity was statistically significant even after 36weeks in the Oligonol-treated male SAMP8 but this was not the case throughout the time course of the study in the Oligonol-treated female SAMP8. Thus Oligonol treatment to SAMP8 mice modulated the severity of infection-dependent inflammation, prolonged life-span and significantly improved locomotive activity indicating potential benefit to aging-associated diseases such as Alzheimer's or Parkinson's diseases. This presents potential for further research to define infection-dependent inflammation associated with degenerative conditions and the molecular mechanism of dietary antioxidant protection.     

THE PHARMACOLOGICAL ROLE OF P-GLYCOPROTEIN IN THE INTESTINAL EPITHELIUM

P-glycoprotein, a membrane-associated transport protein, has recently been recognised as an important element of the intestinal epithelium. This paper summarises thein vivodata on the pharmacological role of intestinal P-glycoprotein. These data show that P-glycoprotein contributes to the elimination of many drugs by mediating their direct secretion from the blood into the intestinal lumen. In addition, there is also evidence that this protein can limit oral drug absorption. Hence, inhibition of intestinal P-glycoprotein, e.g. by a reversal agent like cyclosporin A, may be a promising strategy for improving the oral bioavailability of P-glycoprotein substrate drugs. Indeed, several preclinical and clinical studies have shown that coadministration of drugs with a reversal agent can substantially increase oral drug absorption.     

肾移植患者的多药耐药基因外显子26基因型与术后他克莫司用量的关系

目的研究肾移植患者的多药耐药基因(MDR1)外显子26(exon26)的基因型与术后他克莫司(FK506)用量的关系。方法回顾106例肾移植术后常规使用FK506患者的临床资料。肾移植患者MDR1 exon26基因分型的方法为:提取患者的DNA,采用聚合酶链反应(PCR)扩增MDR1基因,检测限制性内切酶片段的多态性(RFLP)。根据MDR1 exon26基因分型将患者分为CC、CT和TT 3组。检测各组患者肾移植后第3、6和12个月的FK506血药浓度,比较各组患者FK506血药浓度／FK506用量(μg·L-1／mg·kg-1·d-1)的比值及术后1个月内的急性排斥反应发生率。结果受者经MDR1 exon26基因分型示:CC型32例(30．2％),TT型30例(28．3％),CT型44例(41．5％)。CC型患者FK506血药浓度／FK506用量的比值明显低于CT型和TT型(P<0．01),而CT型患者又低于TT型(P<0．05)。CC型患者的排斥反应发生率明显高于CT和TT型(P<0．05),CT与TT型比较,差异无统计学意义(P>0．05)。结论MDR1 exon26 CC型的患者与CT或TT型比较,需服用更高剂量的FK506才能取得与CT或TT型相似的血药浓度。因此,了解患者的MDR1 exon26基因型有利于指导患者肾移植术后个体化用药。     

部分创面外用抗菌药物与成纤维细胞生长因子2、表皮生长因子、重组人生长激素对成纤维细胞生物学特性影响的实验研究

目的观察部分创面外用抗菌药物与成纤维细胞生长因子(FGF)2、表皮生长因子 (EGF)、重组人生长激素(rhGH)对成纤维细胞生物学特性的影响。方法体外培养成纤维细胞, 按所加药物不同分为对照组(常规培养)、丁胺卡那霉素(0．021、0．210、2．100 mg/L)组、庆大霉素(5、 50、500 mg/L)组、氯霉素(0．01、0．10、1．00 mg/L)组、磺胺米隆(5、10 g/L)组、FGF2(2 400 U/ml)组、 EGF(2 000 U/ml)组及rhGH(0．016、0．160、1．600 g/L)组。用噻唑蓝(MTT)法测定各组成纤维细胞增殖活性[吸光度(A)值],用流式细胞仪检测细胞周期,并于显微镜下观察细胞形态的变化。结果 (1)MTT法检测:与对照组A值0．455 3±0．021 7比较,各种剂量丁胺卡那霉素组、庆大霉素组、氯霉素组、磺胺米隆组成纤维细胞A值均明显降低(P<0．05或0．01),其中磺胺米隆(5、10 g/L)组降低最明显,分别为0．101 3±0．001 1、0．095 0±0．004 1(P<0．01)。FGF2组及0．016 g/L rhGH 组细胞A值明显高于对照组(P<0．05),而EGF组及0.160、1．600 g/L rhGH组A值与对照组接近 (P>0．05)。(2)细胞周期检测:对照组细胞增殖指数(PI)为(9．63±0．45)％,与之比较,0．210 mg/L丁胺卡那霉素组细胞PI值无明显变化(P>0．05),FGF2组、EGF组及0．016 g/L rhGH组PI值均明显升高,分别为(46．76±2．33)％、(42．30±1．41)％、(13．29±0．47)％(P<0．05或0．01)。 (3)形态学观察:对照组、EGF组及0．160、1．600 g/L rhGH组成纤维细胞数目较多,呈长条形或梭形, 轮廓不清,透明度高;丁胺卡那霉素组、庆大霉素组、氯霉素组、磺胺米隆组细胞数目较少,形态不规则,轮廓清晰,透明度低,细胞内多有颗粒样物质及空泡;FGF2组、0．016 g/L rhGH组细胞分布均匀、密集,呈长条形或梭形,核分裂相多见,轮廓不清,透明度高。结论不同创面外用药物对成纤维细胞生物学特性的影响各异,在创面修复过程中应选择合适的创面外用药物,以促进愈合并抑制瘢痕增生。     

医院感染常见细菌分布与耐药性分析

目的了解细菌分布及常见细菌的耐药性。方法回顾性分析某院2000—2004年临床标本分离的细菌及其耐药性监测结果。结果1439株细菌中，革兰阳性菌456株（31．69％），以凝固酶阴性表皮葡萄球菌为多，达206株（45．18％），其次为金黄色葡萄球菌92株（20．18％）；两种葡萄球菌的耐药率相似，对万古霉素耐药率均为0。革兰阴性菌983株，前5位依次为肠杆菌属346株（35．20％），克雷伯菌属164株（16，68％），铜绿假单胞菌155株（15．77％），埃希菌属101株（10．27％），变形杆菌属94株（9．56％）；前5位革兰阴性菌对常用抗菌药物的耐药性以半合成青霉索较明显，铜绿假单胞菌的耐药性较突出。结论应高度重视细菌变迁和耐药性监测，提高抗菌药物合理应用水平。     

慢性乙型肝炎患者抗病毒治疗后生存质量评估

目的了解慢性乙型肝炎（CHB）患者生存质量（QOL）状况,并通过抗病毒治疗对其QOL进行干预.方法采用横断面调查,选择2003年至2004年期间武汉大学人民医院感染科212例慢性乙型肝炎患者及健康人群185例,分别以健康状况问卷（SF-36）、医学应对问卷以及肝病特质问卷进行调查.结果与健康对照组比较,CHB患者除情感职能（RE）外,其他维度得分均明显低于健康对照者（P＜0.05）.CHB患者QOL与年龄、肝病特质问卷得分以及医学应对问卷中的屈服、面对因子分显著负相关（P＜0.01）.虽然不同抗病毒治疗方案对CHB患者QOL的影响差异无统计学意义,但完全应答组与无应答组比较,两组除社会功能（SF）（P＜0.05）以外其他维度的得分差异均有统计学意义（P＜0.01）;部分应答组与无应答组比较,仅RE、躯体疼痛（BP）及一般健康状况（GH）维度的得分差异有统计学意义（P＜0.05）.结论CHB患者QOL多个纬度均有受损.有效的抗病毒治疗能提高患者的QOL.     

住院患者精神药品使用情况调查分析

目的:了解我院住院患者应用精神药品的现状及趋势,为临床合理用药提供参考。方法:对我院住院患者2001年~2005年精神药物的销售金额、用药频度(DDDs)、药品限定日费用等进行统计分析。结果:精神药品销售金额和用药频度逐年增加,年增长率分别为25.76%、37.58%、87.03%、145.61%,药品限定日费用逐年上升。结论:应用精神药物人数增加较快,销售金额增加明显,对现有的精神药品应加强不良反应监测。