血管瘤不同治疗方法的疗效评价

目的　评价四种不同方法治疗血管瘤远期疗效。方法　取 1992～ 1998年共七年间我院门诊及住院分别患有毛细血管瘤、海绵状血管瘤、蔓状血管瘤病人 2 33例 ,分别采取血管瘤营养血管结扎 平阳霉素注射、5 %鱼肝油酸钠注射、平阳霉素 强的松龙注射、平阳霉素 5 %鱼肝油酸钠注射 4种治疗方法 ,并对上述 4种方法血管瘤注射后进行随访及疗效评定。结果　血管瘤营养血管结扎 平阳霉素注射组总有效率及显效率均较其余 3组高 ,而单纯应用鱼肝油酸钠血管瘤注射组较其余 3组无论是总有效率或显效率均低。结论　联合用药较单一用药治疗血管瘤效果好 ,而血管瘤远期疗效与药物在瘤体内存留时间长短有关 ,停留时间愈长 ,其有效率愈高 ,而缝扎血管瘤营养血管后无疑为药物在血管瘤内长时间停留提供条件。     

治疗型乙肝疫苗治疗慢性病毒性乙型肝炎的疗效观察

目的 评价治疗型乙肝疫苗在慢性乙型肝炎治疗中的应用价值。方法 应用ＥＬＩＳＡ方法和聚合酶链反应方法检查６０例ＨＢｓＡｇ、ＨＢｅＡｇ、抗ＨＢｃ阳性且ＨＢＶＤＮＡ阳必的慢惭肝患者隧后血清中上述指标及临床变化。结果 用治疗型忆疫苗Ⅰ、Ⅱ、Ⅲ型治疗后,ＨＢｅＡｇ、ＨＢＶＤＮＡ 阴转率分别是２３．３３％、１６．６７％,抗ＨＢｅ总的阳转率为１６．６７％;肝组织炎改变（Ｇ）有不同程度的减轻,纤维化程度（Ｓ）无明     

短程糖皮质激素治疗流行性乙型脑炎76例

目的：探讨糖皮质激素治疗流行性乙型脑炎的疗效。方法：采用地塞米松针剂加入液体静脉滴注,并配合物理降温、镇静止痉、脱水、给氧、扩容、纠酸、防治感染,加强护理等常规综合治疗。结果：治愈６９例（９０８％）,好转３例（３９％）,死亡４例（５３％）。结论：在常规综合治疗基础上应用激素治疗乙型脑炎疗效显著提高。     

不同治疗方法对转移性脑肿瘤疗效的对比分析

目的：研究不同治疗方法对改善转移性脑肿瘤临床症状及其预后的疗效,探讨转移性脑肿瘤合理有效的治疗方案。方法：对1995年1月～1997年12月收治的218例转移性脑肿瘤患者进行前瞻性研究,分析评价不同治疗方法对缓解临床症状、改善预后以及延长生存时间的作用和疗效。结果:伽玛刀治疗组病灶完全消失率为34.2％,明显高于其它各组。伽玛刀组、介入化疗组,放疗组的临床症状好转或消失率分别为71.1％、85．7％、64．1％,一年生存率分别为20％、76％、63％。介入化疗组的病灶局部控制率达100％。影像学检查显示颅内转移灶获得良好局部控制的患者临床症状大多好转或消失。结论:伽玛刀能使颅内转移瘤迅速缩小或消失,术后予以全脑放疗或介入化疗能有效地预防转移瘤的复发,缓解临床症状,延长患者的生存时间。     

A molecular scheme for the reaction between γ-aminobutyric acid and the most abundant chloride channel on crayfish deep extensor abdominal muscle

Single-channel measurements were performed with the aim of constructing a detailed molecular scheme for the reaction between -aminobutyric acid (GABA) and a chloride channel of crayfish deep extensor abdominal muscle (DEAM). GABA was applied in pulses to outside-out patches of muscle membrane, and, based on the dose-response of the peak currents and of their rise times, a linear model with five binding steps has been proposed. Evaluation of the single-channel kinetics indicated at least three open states. Two of them originate most probably from the fully liganded receptor state and are grouped in mixed bursts due to their different life times. The third one appears independently, outside the bursts, and originates from a lower liganded receptor state. Simulations of the dose-responses and the open time distributions with this model led to a set of rate constants which generated relatively optimal fits.     

A prospective randomised trial on the effect of monitoring plasma anticonvulsant levels in epilepsy

Summary To evaluate whether knowledge of plasma levels of anti-epileptic drugs has an effect on therapeutic outcome, 127 epileptic outpatients were randomly assigned to two groups (A and B). Plasma levels of group A were reported to the treating physician who attempted to keep the plasma levels within the therapeutic range. The treating physician was not informed of the results of plasma lavel determinations of group B. Data from 105 patients were available for assessment at the end of the study year. Therapeutic results of groups A and B were not significantly different. The reduction in seizure frequency was associated with an increase in plasma concentrations of the anti-epileptic drugs. Thus, under the conditions of the study, knowledge of plasma levels of anti-epileptic drugs did not further improve therapeutic results.

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Zusammenfassung Um festzustellen, ob die Kenntnis des Plasmaspiegels der Antiepileptika das Therapieergebnis verbessern kann, wurden 127 ambulant behandelte Patienten mit Epilepsie in randomisierter Reihenfolge in zwei Gruppen eingeteilt (A und B). Die Plasmaspiegel der Antiepileptika in Gruppe A wurden dem behandelnden Arzt mitgeteilt, der versuchen sollte, die Plasmaspiegel in den Therapeutischen Bereich zu bringen. Die Ergebnisse der Plasmaspiegelbestimmung in Gruppe B (Kontrollgruppe) wurden dem behandelnden Arzt nicht mitgeteilt. Am Ende des Untersuchungsjahres konnten die Daten von 105 Patienten ausgewertet werden. Das Behandlungsergebnis von Gruppe A und von Gruppe B war am Ende des Beobachtungsjahres nicht signifikant verschieden. Die Abnahme der Anfallshäufigkeit ging mit einem Anstieg der Plasmakonzentration der Antiepileptika einher. Somit konnte unter den Bedingungen dieser Studie das Therapieergebnis durch die Kenntnis der Plasmaspiegel der Antiepileptika nicht weiter verbessert werden.

     

Biphasic effect of tricyclic antidepressants on the release of norepinephrine from the adrenergic nerves of the rabbit heart

The release of norepinephrine (NE) from the right atrium of the rabbit heart was used as a model to investigate biphasic effects due to tricyclic antidepressants, similar to those clinically observed in the treatment of depression and known as therapeutic window. Strips of the atrium were loaded with³H-NE, and then superfused by Krebs solution. The basal release and the electrical stimulation evoked release of³H-NE were measured in the presence and absence of four clinically used tricyclic antidepressants: imipramine, amitriptyline, desipramine and nortriptyline. In addition, guanethidine, an adrenergic neuron blocker, was also studied. At lower concentrations (0.5–10 µM) tricyclic antidepressants increased, whereas higher concentrations (50–100 µM), inhibited the evoked release of NE. This inhibition was not prevented by the alpha₂ adrenoceptor antagonist yohimbine, excluding the possibility of alpha₂ adrenoceptormediated inhibition of NE release. In higher concentrations the tricyclic antidepressants increased the basal release of NE in a Ca-independent way. Secondary amine derivatives were more potent inhibitors of the evoked release, and enhance the resting basal release of NE to a greater extent than the tertiary ones. Similarly, guanethidine (1–50 µM) also decreased the evoked release and increased the basal release of NE in a concentration dependent manner. Yohimbine failed to counteract the inhibition caused by guanethidine and the increment of the basal release was Ca-independent. It is concluded that the effect of tricyclic antidepressants in potentiating the release of NE is masked by their adrenergic neuron blocking properties, i.e. they inhibit the release of NE. Our findings are consistent with paradoxical clinical observations that some tricyclic antidepressants have therapeutic value only in lower plasma concentrations and they become ineffective at higher concentrations.     

中西医综合治疗痴呆的临床研究

目的　探索中西医综合治疗痴呆的方法。方法　随机将 10 3例痴呆患者分为 A、B两组 ,A组采用头针、体针、耳针、病灶相对应头皮区穴位药物封闭、中药和功能训练综合治疗方法 ;B组采用常规药物、功能训练、液体疗法 ;常用药物选脑血管扩张剂 :维脑路通、西比灵 ;改善脑代谢类 :脑复康、γ-氨基丁酸 ;胆碱能类 :毒扁豆碱、卵磷脂 ;抗氧化类 :维生素 C、维生素 E;抗炎类 :消炎痛。结果　两组疗效对比 ,其总有效率 A组为 83% ,B组为 5 9% ,A组明显优于 B组。结论　中西医综合治疗方法的疗效明显优于常规药物治疗     

苯巴比妥在患儿血清样品中的稳定性

目的:探讨患儿苯巴比妥(PB)血清样品在冷处储存的稳定性.方法:荧光偏振免疫法(FPIA)测定30例患儿应用PB治疗时的血药浓度,比较其血清样品当天测定浓度(C1)与其在冷处储存7 d后测定浓度(C7).结果:PB血药浓度C1与C7呈正相关(P＜0.01),其回归方程:C7＝1.054 5C1－1.275 8,r＝0.983 1.平均Re(C7/C1,相当于PB在患儿血清中的平均回收率)为(100.4±4.8)%,RSD为4.70%(n＝30),且两者的各组偏差［(C7－C1)/C1］均小于10%.结论:患儿血清样品在冷处储存7 d,其PB能保持稳定,有利于常规治疗药物监测(TDM)时的样品储存.     

951例心功能不全患者地高辛血清浓度的监测分析

目的: 了解地高辛血清浓度的监测情况.方法:调查深圳市人民医院1998～2000年3 a完成的951例心功能不全患者地高辛血清浓度监测数据,并分析年龄对地高辛血清浓度的影响.结果:地高辛血清浓度在有效范围内比例逐年上升,低于治疗范围的比例较高,高出治疗范围的比例较低;高于治疗范围的患者中毒率为53.6%(52/97),有效浓度内患者中毒率为1.3%(6/470);70岁以上组血清浓度明显高于其他年龄组,年龄与血清浓度超出正常范围的比例间无明显相关性;中毒的临床表现以心律失常(54.2%)和消化道反应(34.7%)为主;中毒原因有血肌酐增高、高血钾、低血钾及伴发感染等.结论:地高辛血清浓度监测能较好地反映地高辛临床疗效,地高辛浓度正常不能排除药物中毒的可能性,老年患者是临床监测的重点.