谷康泰灵治疗原发性骨质疏松症的疗效观察

为观察谷康泰灵注射液治疗女性原发性骨质疏松症的疗效 ,将 75例患者按身高、体重、年龄、绝经后时间及治疗前骨密度值等条件相近分为 3组 ,对照组服用钙制剂 ,谷康泰灵肌肉注射组服用钙制剂同时给谷康泰灵注射液 4ml肌肉注射 ,谷康泰灵静脉滴注组服用钙制剂同时给谷康泰灵注射液 4ml加入生理盐水中静脉滴注 ,治疗期半年。测量治疗前后患者的骨密度及血清Ca、P、BGP、ALP及TRAP。结果谷康泰灵注射液肌肉注射组和静脉滴注组患者骨密度及骨代谢指标较治疗前和对照组变化显著 ,骨密度和血清ALP、BGP明显升高 ,血清TRAP活性显著下降 ,并有效的缓解了疼痛症状 ,且谷康泰灵静脉滴注组效果好于肌肉注射组。表明谷康泰灵注射液可促进成骨、抑制破骨细胞的骨吸收 ,增加骨量 ,改善骨质疏松。     

耻骨后前列腺药物注射结合局部理疗治疗慢性前列腺炎197例疗效观察

目的:观察耻骨后药物注射结合局部理疗治疗慢性前列腺炎的疗效。方法:回顾性总结根据美国国立卫生研究院(NIH)标准诊断为Ⅱ型及Ⅲ型经口服药物治疗效果欠佳的慢性前列腺炎患者197例,年龄17～61岁,美国国立卫生研究院慢性前列腺炎症状评分(NIH-CPSI)>19分,用庆大霉素8万U、1%利多卡因2ml注射至耻骨后间隙前列腺外周,每2～3天1次,共6～9次,注射后次日开始40℃～42℃热水坐浴15～20min,每日2次,也可经直肠射频或微波治疗,隔日1次。治疗期间禁烟酒及辛辣饮食,忌久坐、少骑车。采用NIH-CPSI评分的改变判定疗效。结果:观察4～8周,治愈69例(35%),显效92例(47%),有效19例(10%),无效17例(9%),总有效率91%。1例出现排尿轻微疼痛,持续1d,未经治疗而自行消失。结论:耻骨后前列腺穿刺注射结合局部理疗治疗慢性前列腺炎方便、安全、有效。     

冰片对激光烧伤创面的镇痛及抗炎作用

 为探讨冰片的镇痛及抗炎效应，我们将豚鼠用激先造成烧伤动物模型，分别给冰片、京万红和生理盐水，观察给药前后痛阈及炎症反应。对3组正常左右后足跖痛阈值进行方差检验，P<0.05。对正常右后足跖3组间两两痛阈对比，P>0.05，说明3组间基础痛阈绝对值虽有差异，但无统计学意义。正常左右后足跖激光烧伤前后3组间痛阈对照，结果冰片组P<0.01；京万红和生理盐水组P均>0.05，说明冰片有较强的镇痛作用。对组织形态学的变化采用光镜读片及CMIAS-真彩色医学图象分析系统进行扫描。结果炎症的严重程度京万红组>盐水组>冰片组。临床上可根据伤口情况，选用冰片，发挥清热止痛、消炎消肿、防腐生肌之功效。     

Bipolar disorder and substance abuse.

Substance use disorders are overrepresented in individuals with bipolar and bipolar spectrum disorders. Although awareness of this phenomenon has increased over the past 20 years, few empirically based treatment strategies have been developed for this challenging patient population. This review examines the relationship between bipolar and substance use disorders and treatment options that have been studied in this patient population. First, we examine the high prevalence rates of substance use disorders in individuals diagnosed with bipolar disorder, the common problems associated with establishing a bipolar disorder diagnosis in individuals who abuse substances, the possible explanations for the frequent coexistence of bipolar and substance use disorders, and the negative effect of substance abuse on the course of and treatment outcomes for bipolar disorder. The review then focuses on treatment approaches for this patient population, including integrated group therapy for co-occurring bipolar and substance use disorders and pharmacotherapies that target both disorders. Finally, we present suggestions for medications that might be tested for their efficacy in treating both disorders in specific subgroups of patients with bipolar and substance use disorders.     

An exploration of emotional response to erotic stimulation in men with premature ejaculation: effects of treatment with clomipramine

Emotions presumably play an important role in sexual response and dysfunction in men. Yet, few studies have investigated differences in affect between sexually dysfunctional and functional men or changes in dysfunctional men resulting from successful treatment. We compared men having premature ejaculation (PE) with sexually functional counterparts on positive and negative affects, and examined changes in their affective response to pharmacotherapeutic treatment with clomipramine, an ejaculation-retarding agent. Results indicated higher levels of specific negative affects in PE men than controls. Positive affect also differed among groups, and showed variation in response to erotic stimulation and drug treatment. When specific positive affects were analyzed, they diverged in their response to stimulus and drug manipulations. For example, all groups exhibited a decrease in arousal/sensual during clomipramine treatment, but only PE men who responded positively to pharmacological treatment exhibited significant elevation in their enjoyment of the sexual experience. The fact that alleviation of the dysfunction improved positive affect in PE men responsive to clomipramine argues for the efficacy of pharmacotherapy in promoting positive emotional experiences associated with sexual response. But the failure of negative affects to approximate the low levels typical of sexually functional men also suggests the need to consider nonpharmacological methods to ensure complete reinstatement of healthy sexual response.     

Responsiveness of human varicose saphenous veins to vasoactive agents

AIMS: To test in vitro the constrictor and relaxation responsiveness of variously diseased segments of human saphenous vein from patients with varicose vein disease. METHODS: The vein segments were derived (i) from the inguinal saphenous vein (valvularly incompetent and slightly dilated; tissue A); (ii) from the distal end of the lower leg just above the medial ankle (competent; tissue B); (iii) from a tributary to the long saphenous vein just below the knee (dilated, incompetent and overtly varicose; tissue C). The contractile responses were tested with phenylephrine (an alpha-adrenergic receptor agonist) and aescin, a clinically used phlebotonic drug derived from horse chestnut extract. Relaxant responses were tested with acetylcholine and sodium nitroprusside. RESULTS: Both contractile agents contracted vein segments from the inguinal and ankle area with similar potency and efficacy, but were virtually without effect in the overtly varicose segments from the calf. EC50 values (molar concentration of the agonist that produces 50% of the maximum effect) in tissues A and B were 2.9 +/- 0.3 and 2.5 +/- 0.5 micromol l(-1) (phenylephrine) and 9.4 +/- 1.0 and 15.9 +/- 2.5 micromol l(-1) (aescin); the corresponding maximum effects (maximum effect, percent of KCl-induced contraction) were 76 +/- 3 and 70 +/- 4% (phenylephrine) and 70 +/- 2 and 71 +/- 3% (aescin) (P = NS in both cases for A vs B). In tissue C, the maximum effects were 5 +/- 5% (phenylephrine) and 10 +/- 7% (aescin) of KCl-induced contraction (not significantly different from zero). Acetylcholine-induced relaxation was similar for vein segments from locations A and B, whereas sodium nitroprusside was more effective in tissue B than A. CONCLUSIONS: These findings support the notion that abnormalities within the venous wall affect venous smooth muscle contractility. Since competent and incompetent clinically normal vessels show normal contractile responses, whereas varicose vessels are not responsive to vasoactive drugs, it is likely that pharmacological treatment regimens are effective in early, but not in late stages of the disease.     

Pharmacological elements in clinical application of synthetic peptides

The research carried out on the biological properties of synthetic peptides and the possibility of obtaining them in adequate amounts through the recombinant DNA technology allows their use as therapeutical agents. Procedures following the synthesis of peptides must be performed in order to verify their structure, conformation, immunogenicity and biological activity and to make them suitable for clinical applications. The size of synthetic peptides together with some modifications such as amidation, acetylation and sulfatation must be taken into consideration as they may have a significant impact on half-life, stability and biological activity. Endothelial, epithelial and enzymatic interference which may hinder the absorption of drugs must be evaluated in order to choose the most appropriate route of administration. The considerable bioavailability related to the intravenous route, the effectiveness of the circulation of the intramuscular route and the possibility of reaching specific targets by the intra-arterial route must also be taken into consideration. There is the possibility of applying transdermal therapeutic systems and transdermal iontophoresis only for peptides of low molecular weight. Among synthetic peptides provided with antianaemic activity, erythropoietin, growth factors and interleukin 3 must be mentioned because of their effectiveness both in optimal stimulation of melopoiesis after chemotherapy or bone-marrow transplantation and in the treatment of anaemia occurring during chronic renal failure. Furthermore, interferon alpha was shown to be one of the most used synthetic peptides provided with antiviral and antineoplastic activity. Remarkable results have been obtained in the treatment of chronic hepatitis C, haematological malignancies and some solid tumours. More recently, interleukin 2 has been tested in the treatment of melanoma and renal cancer, inducing a reasonable proportion of overall response rate. Finally, the antagonist of gonadotropin-releasing-hormone may be regarded as effective agent both in the treatment of prostate cancer and in the inhibition of luteinizing-hormone surges during controlled ovarian stimulation. Toxic side effects can be related to the administered dose as well as to metabolites derived from bacteria in which peptides have been synthesized.     

Use of sibutramine and other noradrenergic and serotonergic drugs in the management of obesity

Drugs that act through noradrenergic and serotonergic mechanisms have historically served as the mainstays of pharmacologic treatments for obesity. This review addresses the following three topics: a brief discussion of older weight loss medications approved for short-term use (benzphetamine, phendimetrazine, diethylpropion, mazindol, and phentermine), as well as over-the-counter adrenergic drugs (phenylpro-panolamine and ephedrine); recent clinical studies documenting the safety and efficacy of a new medication for obesity treatment, sibutramine, recently approved by the Food and Drug Administration for long-term use; and recent studies characterizing the valvulopathy associated with fenfluramine and dexfenfluramine, serotonergic medications for obesity which have been removed from the markets.     

从肝论治胸痹探要

从肝与心的生理联系、病因病机论述从肝论治胸痹。治宜疏肝与柔肝,疏之以刚克柔,柔之以柔克刚。用辛以助其条达之性,起到疏肝作用;用酸以抑其上逆之性,起到了柔肝的作用。