腹腔镜手术全身麻醉中联合应用瑞芬太尼与七氟烷药效学相互作用的研究

目的探讨腹腔镜手术全身麻醉中瑞芬太尼与七氟烷的药效学相互作用。方法ASAⅠ级妇科或外科拟行择期腹腔镜手术的患者65例,每名患者预先选定七氟烷的目标浓度,并在试验过程中维持七氟烷呼出浓度恒定。采用七氟烷吸入诱导。当呼气末七氟烷浓度达到设定浓度,观察七氟烷与瑞芬太尼不同剂量组合(0、1、2、4、6和8ng/ml)时,患者对100Hz、60mA、5s的强直电刺激(electrical tetanus stimuli,ETS)的体动和循环反应。应用NONMEM软件对原始数据进行分析和浓度-效应曲线(即S形曲线)的拟合。Logistic回归模型求算七氟烷强直电刺激时的肺泡最低有效浓度(minimal alveolar concentration,MAC)。结果单独应用七氟烷,抑制ETS引起体动反应的MACETS为1.52%,抑制ETS引起循环反应的MACETS为2.24%。小剂量的瑞芬太尼即可明显降低七氟烷的MACETS。当瑞芬太尼的靶控浓度为8ng/ml时,抑制强直电刺激体动反应和循环反应的MACETS值分别下降70.0%和76.3%。结论瑞芬太尼与七氟烷在抑制强直电刺激的体动和循环反应方面存在协同作用。瑞芬太尼可以...     

Impact of traditional medicinal plant extracts on antiretroviral drug absorption

Ethopharmacological relevance

Traditional herbal medicines are often used for the treatment of different diseases in developing countries, especially in the rural areas where a lack of an efficient primary health care system is usually experienced. Many patients infected with the human immunodeficiency virus are taking traditional herbal medicines in conjunction with their modern antiretroviral medication and drug–herb interactions can occur in these cases.

Aim of the study

To investigate the effect of water extracts of two traditional medicinal plants, Hypoxis hemerocallidea and Sutherlandia frutescens as well as l-canavanine (a constituent of Sutherlandia frutescens) on the transport of nevirapine across human intestinal epithelial cells.

Materials and methods

Nevirapine transport in the apical to basolateral and basolateral to apical directions across Caco-2 cell monolayers was determined alone (normal control) and in the presence of verapamil (positive control), water extracts of Hypoxis hemerocallidea and Sutherlandia frutescens and an aqueous solution of l-canavanine. The cumulative transport and apparent permeability coefficient (P_app) values were calculated and compared.Results: Nevirapine alone was substantially effluxed in the basolateral to apical direction across the intestinal epithelial cell monolayers, which was statistically significantly (p ≤ 0.05) decreased by addition of verapamil, Hypoxis hemerocallidea extract and the l-canavinine solution. The effect of Sutherlandia frutescens on nevirapine transport was not statistically significantly different from the control.

Conclusions

Hypoxis hemerocallidea and l-canavanine interact with the efflux of nevirapine across intestinal epithelial cells and therefore can potentially increase the bioavailability of this antiretroviral drug when taken concomitantly.     

Interacting with HBsAg compromises resistance of jumping translocation breakpoint protein to ultraviolet radiation-induced apoptosis in 293FT cells

Jumping translocation breakpoint protein (JTB) is suppressed in many cancers, implying it plays a role in the neoplastic transformation of cells. In order to explore the role of JTB in the carcinogenesis of liver, we used mammalian two-hybrid, co-immunoprecipitation, GST pull-down and laser scanning confocal to verify the interaction between HBs and JTB. According to the results, HBs interacts with JTB. In addition, we further determined that S region within HBs is sufficient for binding JTB. Overexpression of JTB conferred resistance to apoptosis induced by ultraviolet radiation, whereas this effect was compromised by the co-overexpression of HBs.     

A spectroscopic study of the interaction of allylisothiocyanate with mustard 12S protein

The intraction of allylisothiocyanate (AIT) with mustard 12S protein resulted in a change in the absorption spectrum of the protein below 280nm without any shift in the ^γmax. The spectrophotometric titration of mustard 12S protein after interaction with AIT suggested the involvement of phenolic groups. Upon interaction with AIT, a new band at 250nm appeared in the near ultraviolet circular dichroism spectrum of the protein. However, no change occurred in the far ultraviolet circular dichroism spectrum. Circular dichroism measurements with amino acids suggest the possible involvement of tyrosine residues in the interaction of AIT with mustard 12S protein.     

Increased theophylline clearance in asthmatic patients due to terbutaline

Summary The pharmacokinetic mechanism of the theophylline-terbutaline interaction has been studied. Sustained release theophylline 200–400 mg b.d. was given with placebo or terbutaline 2.5 mg t.d.s. to six adult asthmatic patients.Terbutaline decreased the serum trough theophylline levels from 8.1 to 7.3 µg/ml, improved daily the clinical score from 1.51 to 1.26 and increased the peak expiratory flow rate from 316 to 370 l/min. In a single dose study following the chronic therapy, it was shown that there was no change in the peak theophylline concentration or in the timing of the peak, but the t_1/2 was reduced from 9.0 to 7.5 h, and the systemic clearance was increased from 20.2 to 24.8 ml·h^–1·kg^–1.Thus, terbutaline reduced the serum theophylline concentration by increasing its systemic clearance.     

欧美网上药店管制比较与借鉴

目的:为完善和规范我国的网上药店管制提供借鉴。方法:研究美国及欧洲各国网上药店管制特点,了解其管制模式、管制范围、管制手段,比较分析我国现存的问题。结果与结论:我国网上药店管制应解决政府管制与行业自律、国内管制与国际合作、药房管制与消费者教育等方面的问题。     

Behavioural Energetics: Some Effects of Uncertainty on the Mobilization and Distribution of Energy

Several sets of data illustrating dissociation of metabolic and muscular work rates are presented. During response acquisition, the rate of energy expenditure declines although work rates remain constant and goal achievement increases. When higher response costs are demanded for goal achievement, work rates increase whereas energy expenditure remains constant. Decreases in outcome probability also give rise to increases in motor intensity and work rate but do not influence the rate of energy expenditure. It is proposed that behaviourally-related variations in metabolic rate are influenced by environmental uncertainty (“what to do”), whereas variations in the intensity of motor output are influenced by response uncertainty (“how to do it”). The processes of response selection which provide the means by which response uncertainty is resolved, activate motor channels for the expression of energy mobilized by the prevailing state of environmental uncertainty.     

Effects on cimetidine bioavailability of metoclopramide and antacids given two hours apart

Summary Plasma cimetidine levels were determined in 9 normal subjects after a single oral dose of cimetidine 400 mg under control conditions, 2 h before metoclopramide 20 mg and 2 h after a potent antacid. The bioavailability of cimetidine was not significantly affected by metoclopramide and it was marginally reduced by the antacid.     

Vitamin D and tuberculosis

Tuberculosis is highly prevalent worldwide, accounting for nearly two million deaths annually. Vitamin D influences the immune response to tuberculosis, and vitamin D deficiency has been associated with increased tuberculosis risk in different populations. Genetic variability may influence host susceptibility to developing active tuberculosis and treatment response. Studies examining the association between genetic polymorphisms, particularly the gene coding for the vitamin D receptor (VDR), and TB susceptibility and treatment response are inconclusive. However, sufficient evidence is available to warrant larger epidemiologic studies that should aim to identify possible interactions between VDR polymorphisms and vitamin D status.     

Communication skills of nurses during interactions with simulated cancer patients

AIM: In this paper the balance of affective and instrumental communication employed by nurses during the admission interview with recently diagnosed cancer patients was investigated. RATIONALE: The balance of affective and instrumental communication employed by nurses appears to be important, especially during the admission interview with cancer patients. METHODS: For this purpose, admission interviews between 53 ward nurses and simulated cancer patients were videotaped and analysed using the Roter Interaction Analysis system, in which a distinction is made between instrumental and affective communication. RESULTS: The results reveal that more than 60% of nurses' utterances were of an instrumental nature. Affective communication occurred, but was more related to global affect ratings like giving agreements and paraphrases than to discussing and exploring actively patients feelings by showing empathy, showing concern and optimism. CONCLUSION: In future, nurses should be systematically provided with (continuing) training programmes, in which they learn how to communicate effectively in relation to patients' emotions and feelings, and how to integrate emotional care with practical and medical tasks.