重型活动性狼疮性肾炎治疗体会

目的 结合临床资料总结出重型狼疮性肾炎(LN)两种较好的治疗方法.方法 甲基强的松龙(MP)联合环磷酰胺(CTX)的"双冲"方案及足量激素口服或甲基强的松龙冲击联合霉酚酸酯(MMF)的冲击联合方案.结论 作者认为重型LN必须遵循个体化原则,根据病理类型的不同、病情的急缓选择合适的治疗方法.     

在Suzuki反应中，催化剂循环使用和产物回收的简便方法

在钯催化的Suzuki交叉偶联反应中，以聚环氧乙烷-甲醇为混合溶剂，反应结束后用正庚烷提取，产物进入非极性相，收率〉90％。催化剂留在极性相，可循环使用多次。     

聚凝胺法辅助鉴定ABO血型2例

某些疾病可能引起暂时性抗原减弱，血清抗体下降而导致血型鉴定困难。聚凝胺技术具有敏感性高、反应快速等优点，对ABO血型的鉴定有辅助作用。我们采用聚凝胺法辅助鉴定ABO血型2例，现报告如下。     

异维A酸联合白花蛇舌草注射液治疗重度痤疮36例

痤疮是青年人群中最常见的一种皮肤病，重度痤疮常因面部出现较多炎性皮疹、囊肿、结节而使容貌受损，极大地影响患者身心健康。本病治疗方法较多，但疗效不满意。2000年以来，笔者应用口服异维A酸联合白花蛇舌草针肌肉注射治疗本病，取得较好效果，现报道如下。     

托尼萘酸治疗老年戊型肝炎

目的：观察托尼萘酸治疗老年戊型肝炎的安全性及临床疗效。方法：56例老年戊型肝炎病人分为治疗组和对照组，2组病人均给予常规护肝、支持、对症治疗。治疗组36例，男性28例，女性8例：年龄（67&;#177;s11）a。加用托尼萘酸，2片，po，tid。对照组20例，男性16例，女性4例：年龄（66＋12）a，仅给予基础治疗。治疗后4，8wk时比较2组病人的临床指标改变。     

福州出台十一条措施加强对医院监管

目的 观察甲基强的松龙治疗毛细支气管炎的疗效。方法 将毛细支气管炎患儿72例随机分为两组，治疗组35例，应用小剂量甲基强的松龙静滴；对照组37例常规治疗。结果两组在喘憋消失、肺部喘鸣音消失、咳嗽消失、住院天数方面比较，差异有显著性（P〈0．05，P〈0001）。结论 小剂量强的松龙治疗毛细支气管炎疗效确切，安全有效，值得临床推广应用。     

^1H-magnetic resonance spectroscopy screening for animals with acute cerebral infraction suitable forthrombolytic therapy

BACKGROUND: As a non-invasive technique which can provide comprehensive biological information, 1H-magnetic resonance spectroscopy (1H-MRS) may provide valuable reference data for irreversible recovery or reversible changes in ischemic tissue after stroke. OBJECTIVE: To monitor and evaluate the effect of the urokinase thrombolytic therapy after experimental acute cerebral ischemia by 1H-MRS technology and investigate its adaptability. DESIGN: Randomly controlled animal study. SETTINGS: Shenzhen Hospital of Peking University and National Key Laboratory of Pattern and Atom & Molecular Physics, Wuhan Physics and Mathematics Institute, Chinese Academy of Science. MATERIALS: Eleven healthy adult Sprague-Dawley (SD) rats, weighing 260–300 g and of both genders, were supplied by Experimental Animal Center of Tongji Medical Collage, Huazhong University of Science and Technology [SCXK (e) 2004-007]. 4.7T superconducting nuclear magnetic resonance meter was provided by Brucker Company. METHODS: The experiment was carried out in Shenzhen Hospital of Peking University and National Key Laboratory of Pattern and Atom & Molecular Physics, Wuhan Physics and Mathematics Institute, Chinese Academy of Science from August 2003 to December 2005. ① The rats were randomly divided into 30-minute self-thrombo-embolism group (n =6) and 60-minute self-thrombo-embolism group (n =5). Six rats in 30-minute self-thrombo-embolism group were occluded with clot embolus for 30 minutes and 5 rats in 60-minute self-thrombo-embolism group were occluded for 60 minutes. 10 000 U/kg urokinase was dissolved in 2 mL saline and the operation lasted for 5 minutes. ② 1H-MRS was performed before thrombolysis and at 3 hours and 24 hours after successful embolization. The metabolic changes of N-acetyl-L-aspartic acid (NAA)/phosphocreatine (PCr) + creatine (Cr), choline phosphate (Cho)/PCr+Cr and lactic acid (Lac)/PCr+Cr in the region of interests were analyzed. ③ The T2W image was conducted 24 hours after the thrombolytic therapy with TR=500 ms and TE=25 ms. ④ The subjects were sacrificed immediately after 1H-MRS and the brain tissues were cut into pieces and stained with HE method; in addition, pathological changes were observed under optic microscope. MAIN OUTCOME MEASURES: ① Metabolic changes of NAA/PCr+Cr, Cho/PCr+Cr and Lac/PCr+Cr in the region of interests; ② T2W image at 24 hours after the thrombolysis; ③ pathological observation of brain tissue. RESULTS: Eleven rats were all involved in the final analysis. ① Metabolic changes in the region of interests : In 30-minute self-thrombo-embolism group, the Lac peak emerged immediately after the embolism, but the ischemic zone decreased 3 hours after the thrombolytic therapy (0.252±0.01, 0.603±0.01, P < 0.01). Lac/(PCr+Cr) ratio was 0.290±0.01 at 24 hours after thrombolysis, which was higher than that at 3 hours after thrombolysis (P < 0.01). The NAA/ (PCr+Cr) ratio decreased significantly at 3 hours after the thrombolysis as compared with that before thrombolysis (0.922±0.16, 1.196±0.01, P < 0.05). In 60-minute self-thrombo-embolism group, the Lac/(PCr+Cr) ratio was higher at 3 hours after thrombolysis than that before thrombolysis (0.846±0.12, 0.601±0.11, P < 0.05) and the NAA/(PCr+Cr) decreased at 3 hours after the embolism. Fluctuation of NAA/ (PCr+Cr) ranged from 0.68 to 0.75 before thrombolysis and from 0.71 to 0.75 at 3 hours after thrombolysis. ② T2W image: T2W image showed that 2 subjects in 30-minute self-thrombo-embolism group whose Lac/NAA was higher than 0.7 suffered from intracranial hemorrhage. This meant that the subjects with Lac/NAA > 0.7 were more likely to suffer from intracranial hemorrhage. ③ Histological and morphological examinations: Optic microscope demonstrated that interspace surrounding nerve cells was widened at ischemic center; neurons were swelling; nucleus was stained lightly; pyknosis and mesenchymal edema were mainly observed in lateral cortex of brow and vertex and in lateral part of corpus striatum. CONCLUSION: ①Compound parameters in ischemic area before thrombolysis should be regarded as an important predicting marker for thrombolytic therapy, effect evaluation and termination. ② 1H-MRS combining with other imaging technique is a detecting way for screening cases who are suitable for thrombolytic therapy.     

不同产地鱼腥草质量评价

目的比较不同产地鱼腥草的质量。方法采用GC法测定不同产地甲基正壬酮含量。结果不同产地鱼腥草的甲基正生酮含量差异显著。结论不同产地的鱼腥草药材中甲基正壬酮的含量以陕南地区较高。     

抗菌药物临床应用指导原则（3）各类抗菌药物的适应证和注意事项

1 青霉素类抗生素。本类药物可分为：(1)主要作用于革兰阳性细菌的药物，如青霉素(G)、普鲁卡因青霉素、苄星青霉素、青霉素V(苯氧甲基青霉素)。(2)耐青霉素酶青霉素，如甲氧西林(现仅用于药敏试验)、苯唑西林、氯唑西林等。(3)广谱青霉素．抗菌谱除革兰阳性菌外，还包括：①对部分肠杆菌科细菌有抗菌活性者，如氨苄西林、阿莫西林；②对多数革兰阴性杆菌包括铜绿假单胞菌具抗菌活性者，如哌拉西林、阿洛西林、美洛西林。