中国急性心肌梗塞的疾病经济负担

主要通过对急性心肌梗塞疾病经济负担的研究，总体描述进行二线预防的重要性。资料主要来源于中文文献检索、政府统计报表。主要利用直接医疗费用来计算疾病经济负担，而未考虑直接非医疗费用和间接费用。中日急性心肌梗塞的发病率约为45／10万。55／10万。城市高于农村，男性高于女性。在2000年，急性心肌梗塞的死亡率在城市为32．39／10万，农村为17．99／10万，其死亡率随年龄增长而相应增长。与发病率一样，城市高于农村，男性高于女性。25岁以上人群因急性心肌梗塞而损失的DALY在2000年为3．57DALYs／千人口。怎性心肌梗塞的直接医疗费用在国家卫生部部属医院为28257元／例，省级医院为8663元／例，县级医院为5447无／例。测算2000年急性心肌梗塞的疾病经济负担为13亿元。19亿元。但由于只有10．6％的急性心肌梗塞病人得到临床床治疗，因此，本测算结果可能低估了在中国实际发生的疾病经济负担。     

我国医学高校筹资、成本和效率评价--基本框架和概述

“中国高等医学院校筹资、成本分析和经济效益评价研究”是国家教育部高教司和卫生部科教司立项课题，共产出5篇论文。主要分析研究课题的基本框架，重点介绍研究背景、研究思路、研究目的、资料来源与调查方法，以及产生出的几篇论文的安排。     

全雄激素阻断治疗晚期前列腺癌

为了评价全雄激素阻断治疗晚期前列腺癌的疗效，采用双侧睾丸切除、Ｆｌｕｔａｍｉｄｅ和Ｆｉｎａｓｔｅｒｉｄ联合治疗Ｄ２期前列腺癌病人５例。随访１５～２０个月，结果ＰＳＡ均正常，前列腺体积缩小６１．２％～６９．３％，有显著性差异（Ｐ＜０．０１），骨转移灶缩小、部分消失，积水肾脏完全恢复正常，所有病人治疗后全部有效。表明全雄激素阻断对晚期前列腺癌有良好的治疗效果。提出在三个层次上阻断雄激素治疗晚期前列腺癌的策略。     

Facilitation of ethanol consumption by intracerebroventricular infusions of corticosterone

Male Wistar rats bearing intracerebroventricular (ICV) cannulae and with simultaneous access to 6% ethanol and water were subjected to adrenalectomy (ADX) or sham surgery. ADX decreased ethanol intake. Starting a few days later, the animals received ICV infusions with 100 μg corticosterone acetate (CORT) with 2-to 3-day intervals for 2 weeks. ICV CORT, but not SC CORT at the same dose, restored ethanol consumption in ADX rats to preoperative levels, whereas vehicle infusions (propylene, glycol) did not. Adrenally intact animals, which normally consumed moderate amounts of ethanol (≈0.5 g/kg per day), also showed a robust effect of ICV infusions of CORT, whereas this facilitatory effect was not observed in high consumers (≈3.0 g/kg per day). The suppressive effect of ADX on ethanol intake was not reproduced by concurrent and repeated ICV infusions of intracellular mineralocorticoid (RU 28318) and glucocorticoid (mifepristone) receptor blockers. It is concluded that CORT stimulates alcohol consumption by acting in the brain, probably by way of neuronal membrane mechanisms.     

呋苄青霉素药代动力学及组织分布的研究

呋苄青霉素是由我国开发成功的一个酰脲类青霉素。本项研究采用微生物法,以狗和正常人为受试对象,以氧哌嗪青霉素和羧苄青霉素为对照进行药代动力学研究,结果表明,3个药的药—时曲线符合二室开放式模型,呋苄青霉素较其它对照药具较高的即刻血浓度和较低的肾清除率。用微生物法和放射自显影法测定的呋苄青霉素在小鼠体内组织分布汪明,呋苄青霉素广泛分布于体内各组织,尤其在肺、肝、肠中的浓度明显高于羧苄青霉素。     

How adverse drug reactions can play a role in innovative drug research

We describe how adverse drug reactions (ADRs) can play an important role in pharmaceutical research and drug development. Not only do ADRs represent the risks and drawbacks associated with drugs but they can also be related to other knowledge available in pharmaceutical and medical research. We offer a model that can be used to systematically map the pathways through which ADRs can lead to innovative research. These pathways include chemical, therapeutic or pathophysiological steps that can be taken to arrive at new knowledge based on ADRs. We used the development of angiotensin-converting enzyme inhibitors, especially captopril, as a case study. The similarity between the ADR profiles of captopril and penicillamine was a starting point for further innovation. Historical analysis shows that in several instances research in the field of angiotensin-converting enzyme inhibitors has been triggered by ADRs. The model presented here might be applicable to other areas of innovative drug research.     

泌尿生殖道患者沙眼衣原体和支原体检测及支原体药敏分析

目的　检测皮肤性病门诊泌尿生殖道患者沙眼衣原体 (CT)和支原体感染情况及支原体培养加药敏分析。方法　对5 0 95例泌尿生殖道感染者用金标法检测沙眼衣原体抗原 ,用微量肉汤稀释法检测解脲支原体 (Uu)和人型支原体 (Mh)并进行 8种抗生素的药敏试验。结果　 5 0 95例泌尿生殖道感染者中衣原体阳性 417例 ,总阳性率为 8 2 % ,女性患者阳性率 ( 11 2 % )明显高于男性患者阳性率 ( 6 2 % ) ,有显著性差异 ( χ2 =40 1,P <0 0 1) ;检出支原体 172 8例 ,总阳性率为 3 3 9% ,女性患者阳性率 ( 4 3 0 % )明显高于男性患者阳性率 ( 2 8 0 % ) ,有显著性差异 ( χ2 =114 8,P <0 0 1) ;其中Uu感染 ( 12 5 1例 ,2 4 6% )明显高于Mh感染 ( 71例 ,1 4% )和Uu +Mh混合感染 ( 4 0 6例 ,8 0 % )。Uu对红霉素、罗红霉素、交沙霉素、阿奇霉素、强力霉素、美满霉素、氧氟沙星、环丙沙星的高度敏感率分别为 60 3 %、67 5 %、73 2 %、85 3 %、5 5 7%、40 1%、2 5 6%、2 7%。Uu +Mh混合感染对 8种抗生素均出现不同程度的耐药菌株。结论　湖南地区泌尿生殖道感染患者中 ,衣原体、支原体感染处于国内较高水平。支原体对不同种类抗生素有较高的耐药性 ,特别是Uu +Mh混合感染 ;临床上做支原体培养加药敏试验 ,对指导     

口服Sumatriptan治疗偏头痛的临床评价

本文报告口服Sumatriptan 100mg对偏头痛急性发作119例次的治疗结果。治疗后4h内显效91例次(76.5％),好转16例次(13.4％),无效12例次(10.1％),总有效率为89.9％。对偏头痛伴随症状恶心、呕吐和畏光、畏声的缓解率分别为94.2％、96％和94.3％。     

Effects of food deprivation on cocaine base smoking in rhesus monkeys

Studies have shown that both food deprivation and response cost have important influences on the magnitude of self-administration of a wide variety of psychoactive drugs. In an attempt to extend these findings to the smoked route of drug self-administration, the effects of food allotment and fixed-ratio (FR) value were evaluated in four male rhesus monkeys trained to smoke cocaine base. In the first phase of the experiment, monkeys were trained to self-administer smoked cocaine base under a chained progressive-ratio (PR), fixed-ratio (FR) schedule during daily experimental sessions. Monkeys were required to make 20 lever-press responses and then five inhalations on a smoking spout to obtain the first smoke delivery. The lever ratio then increased to 60, 140, 300, 620, 1260, 2540, and 4940 for each successive smoke delivery. The initial lever ratio value was reset to 20 at the beginning of each daily session. The body weights of three monkeys were determined under free-feeding conditions. Monkeys were then restricted to 100 g food and, when body weights had stabilized, the daily food allotment was increased to 150 g, approximately 210 g, or greater than 400 g (satiation). As the daily food allotment and body weight increased, the mean number of smoke deliveries decreased in two of three monkeys. In the second phase of the experiment, three monkeys were maintained under either food-satiated or food-restricted conditions. Body weights were maintained at approximately 90% of their free-feeding weights under food-restricted conditions. The cost of the drug (lever FR value) was constant within each experimental session, but was increased after 3 consecutive days of stable responding. Fixed-ratio values were increased from 128 to 256, 512, 1024, and 2048. Monkeys were required to complete the lever FR value and then to make five inhalations on the smoking spout to gain access to 1.0 mg/kg per delivery cocaine base. The mean number of smoke deliveries increased at FR 256, 512, and 1024 when monkeys were food-restricted as opposed to food-satiated. Correspondingly, the mean number of responses increased under food-restricted conditions. Responding continued to increase over a wider range of FR values, and the peak number of responses was higher under food-restricted, as opposed to food-satiated conditions. These results, using the smoking route of administration, are consistent with the hypothesis that food deprivation increases the self-administration of reinforcing drugs.