Recalcitrant trametinib‐induced paronychia treated successfully with topical timolol in a pediatric patient

Paronychia has been described as a side effect in patients undergoing treatment with MEK (mitogen activated protein kinase enzyme) inhibitors. It is usually a recurrent condition that can have a significant impact in the quality of life. Topical beta blocker treatment has been described as an effective therapy in antineoplastic‐induced pyogenic granulomas and in antineoplastic‐induced paronychia. We describe the first case treated with topical timolol for a trametinib‐induced paronychia in a pediatric patient that allowed to continue the third line antineoplastic therapy for his glioma.     

Glycine transporter (GlyT1) inhibitors with reduced residence time increase prepulse inhibition without inducing hyperlocomotion in DBA/2 mice

Inhibition of the glycine transporter type 1 (GlyT1) leading to potentiation of the glycine site (GlyB) on the N-methyl-d-aspartate (NMDA) receptor has been proposed as a novel therapeutic approach for schizophrenia. However, sarcosine-based GlyT1 inhibitors produce undesirable side effects including compulsive walking and respiratory distress. The influence of specific biochemical properties of GlyT1 inhibitors, such as mode of inhibition and residence time, on adverse effects is unknown. Two GlyT1 inhibitors that contain a sarcosine moiety, sarcosine and ALX-5407, and two compounds that do not contain a sarcosine moiety, Roche-7 and Merck (S)-13h, were evaluated for their potency, mode of inhibition, and target residence times in vitro, and modulation of prepulse inhibition (PPI) and locomotor activity in vivo. (S)-13h and sarcosine were competitive inhibitors while ALX-5407 and Roche-7 demonstrated mixed noncompetitive inhibition. Potency of GlyT1 inhibition (ALX-5407 > (S)-13h > Roche-7 ? sarcosine) did not correlate with residence time on GlyT1 (sarcosine = Roche-7 ? (S)-13h < ALX-5407). ALX-5407 and (S)-13h induced compulsive walking, termed obstinate progression (OP), at doses that increased PPI in DBA/2 mice, demonstrating that OP was not a function of mode of inhibition or inhibitor chemotype. Sarcosine and Roche-7 increased PPI without inducing OP, suggesting that compounds with decreased GlyT1 residence time were efficacious without adverse effects. Direct activation of the GlyB site by d-serine did not produce OP. However, OP induced by (S)-13h was blocked by strychnine, a glycine receptor (GlyA) antagonist, suggesting that OP induced by GlyT1 inhibition was mediated by GlyA. Thus, GlyT1 inhibitors with short residence times demonstrated efficacy without mechanism-based adverse effects.     

利培酮联合低频重复经颅刺激改善老年精神分裂症患者顽固性幻听和认知功能的研究

目的：探讨低频重复经颅刺激对于改善老年精神分裂症患者顽固性幻听和认知功能的临床应用价值。方法按就诊顺序编号将100例老年精神分裂症患者分为对照组和观察组,每组50例。对照组给予利培酮治疗;观察组联用利培酮与低频重复经颅刺激治疗。于治疗前后采用听幻觉量表（ AHRS）及副反应量表（ TESS）对患者进行测评,同时评估患者的词语流.性及连线实验表现。结果经8周治疗后,观察组的幻听评分明显低于对照组,组间比较差异具有统计学意义（P＜0.05）。观察组词语流.性明显优于治疗前（P＜0.05）。对照组词语流.性治疗前后比较差异无统计学意义（ P＞0.05）。连线实验结果显示,两组患者治疗前后比较差异均无统计学意义（ P＞0.05）。结论低频重复经颅刺激可有效改善老年精神分裂症患者顽固性幻听,对改善其认知功能具有一定效果,值得临床借鉴和推广。     

治疗慢性阻塞性肺病并发顽固性气胸的一种新方法

对21例慢性阻塞性肺病并发持续漏气的气胸患者，采用放置双管，闭式引流加间断负压吸引，并经高位微管注入高聚金葡素的治疗方法。结果：20例患者患侧肺完全复张，治愈出院，结果说明对于慢性阻塞性肺病并发顽固性气胸，采用该种疗效，效果确切，简单易行。     

培哚普利加黄芪注射液治疗难治性心力衰竭疗效观察

目的观察培哚普利(Perindoprol)加黄芪注射液(Milkvetch Injection,MI)治疗充血性心力衰竭(CHF)的疗效。方法器质性心脏病并发CHF心功能IV级(NYHA分级标准)。经2周足量的强心甙、利尿剂、β-受体阻滞剂治疗后心功能无明显改善者64例。随机分成治疗组32例,在常规治疗基础上加培哚普利加MI静脉滴注2周;对照组32例用米力农静脉滴注2周,治疗前后作心肌酶谱、血浆肌钙蛋白I(cTnI)测定,彩色超声心动图测定心功能。结果两组与治疗前比较心功能均有显著改善(P<0.01),两组疗效差异无显著性(P>0.05);治疗后血磷酸肌酸激酶同工酶(CK-MB)及cTnI浓度均有改善,但以治疗组为显著(P<0.01),对照组不明显(P>0.05)。在治疗过程中两组均未见明显不良反应。结论在难治性心力衰竭患者中培哚普利加MI有助于心功能的改善。     

数字化排粪造影在顽固性便秘患者中的临床应用

目的 探讨数字化排粪造影在顽固性便秘患者的临床应用.方法 回顾性分析60例顽固性便秘患者进行的数字化排粪造影检查资料,通过测量肛直角、肛上距、乙耻距和小耻距、肛管长度、肛直间距、骶骨及骶尾曲率等指标,得出相关疾病的诊断.结果 25例次(41.7%)为会阴下降,16例次(26.7%)为直肠前壁黏膜脱垂,37例次(61.7%)为直肠内套叠,12例次(20%)为直肠外脱垂,47例次(78.3%)为直肠膨出或称直肠前突,13例次(21.6%)为盆底痉挛综合征,39例次(65%)为耻骨直肠肌肥厚症,11例次(18.3%)为盆底疝,12例次(20%)为骶直分离,10例次(16.7%)为内括约肌失迟缓症.结论 数字化排粪造影对顽固性便秘患者相关疾病的阳性检出率达10种之多,可为临床提供有价值的诊断参考.     

关于裂脑人神经心理学实验结果的分析

本文对顽固性癫痫病人裂脑手术治疗前后心理功能变化进行研究。通过对10例裂脑人的wechsler的成人记忆测验(WMS),wechsler成人智力测验(WAIS)及Halstead-Reitan神经心理成套测验(HR)等三项心理学检查,认为胼胝体切断术(裂脑)治疗癫痫效果肯定;对病人的智力、记忆力等神经心理功能无不良影响。从裂脑人出现的左右功能的转移与倒置,发现了人类大脑左、右半球的言语和操作等各自功能的优劣及其胼胝体的整合作用。进一步验证了“每一个半球分别具有高级智慧机能”的新观点。     

颈总动脉注射莨菪类药物治疗153例顽固性癫痫疗效分析

颈总动脉注射莨菪类药物治疗153例顽固性癫痫,完全控制74例,显效43例,有效13例,总有效率达84.9％。毒、副作用小。     

葛根黑苏汤联合通元针法对顽固性薄型子宫内膜患者黄体中期子宫内膜容受性与子宫血流动力学的影响

目的:探讨葛根黑苏汤联合通元针法对顽固性薄型子宫内膜患者黄体中期子宫内膜容受性(ER)与子宫血流动力学的影响。方法:选择顽固性薄型子宫内膜患者84例为研究对象,随机分为两组。对照组接受阿司匹林治疗,观察组在对照组基础上给予葛根黑苏汤联合通元针法治疗,两组疗程均为3个月经周期。记录两组治疗前后中医症侯积分的变化,在阴道超声下观察黄体中期的子宫内膜厚度、容积与血流情况,并比较两组治疗前后子宫内膜分型与子宫内膜血流分型、子宫动脉血流参数。比较两组临床疗效,治疗后的经期行经时间、妊娠成功率和妊娠患者受孕时间。结果:与治疗前比较,两组治疗后各个单项中医证候积分与总积分均明显降低(P<0.05),且观察组治疗后的上述积分均低于对照组(P<0.05)。两组治疗后子宫内膜厚度、容积均增大,子宫内膜血流收缩期峰值流速/舒张末期流速(S/D)降低,且观察组治疗后的上述指标均优于对照组(P<0.05)。两组治疗后子宫内膜分型与血流分型均有明显改善,且观察者改善情况优于对照组(P<0.05)。两组治疗后平均子宫动脉血流搏动指数(mPI)、阻力指数(mRI)和平均血流收缩期峰值流速/舒张末期流速(mS/D)均明显降低,且观察组上述指标均低于对照组(P<0.05)。观察组治疗总有效率为81.0%,明显高于对照组的61.9%(P<0.05)。观察组治疗后的经期行经时间、受孕时间短于对照组,而妊娠率高于对照组(P<0.05)。结论:葛根黑苏汤联合通元针法能够显著减轻顽固性薄型子宫内膜患者临床症状,改善子宫内膜厚度、容积与形态,并提高子宫血流灌注,从而有利于改善ER及子宫血流动力学,提高妊娠率。