不同剂量辛伐他汀对肾病综合征高脂血症的近期疗效

目的 :观察辛伐地他汀 -舒降之对肾病综合征高脂血症的近期疗效及安全性 ,比较不同剂量辛伐他汀的降脂作用。方法 :72例均系肾综合并高脂血症的患者 ,随机分治疗组 (5 6例 )和对照组 (16例 ) ,在积极治疗原发病的同时 ,治疗组给予服辛伐他汀每晚 5～ 2 0mg ,14例混合性高脂血症患者同时服用非诺贝特 ;对照组未用降脂药。观察治疗前及治疗后 1周、2周血脂全套 (TC ,TG ,LDL和HDL)、肝功能 (AST ,ALT ,TP和ALB)、肾功能 (BUN ,Scr)、及尿蛋白定量的变化。结果 :辛伐他汀每晚 2 0mg服用 1周可使 6 3%的患者总胆固醇 (TC)下降 33% ,服用 2周可使 84%的患者血TC降至正常 ;单用辛伐他汀在降低TC的同时 ,可使甘油三酯 (TC)下降 43.16 % ,若与非诺贝特合用可使TG下降达 6 4.2 2 % ,未见不良反应发生 ;辛伐他汀的降脂作用与剂量及用药时间密切相关 ,2 0mg >10mg >5mg ,每晚服用 5mg共 2周仅能使 6 0 %的患者TC下降 12 .5 %。结论 :辛伐他汀 (每晚 2 0mg)能安全、快速有效降低肾病综合征患者的高脂血症 ,而对减少尿蛋白、改善肾功能近期无作用     

胆碱酯酶重活化剂PAM类构型、构象问题

本文参考X-衍射数据,采用MNDO程序计算了不同构型、构象PAM类的生成热,结合核磁共振数据讨论了PAM类构象等问题.结果表明,PAM类在水溶液中:顺式体肟基可以自由旋转,任何一种构象都可能成为药效构象;反式体肟基本不可能存在稳定的平面构象,其药效构象只能是优势构象.用MNDO程序中反应途径的计算法,还计算了顺、反式肟基构型相互转变的势垒,为探讨PAM类重活化机理提供了一定的参考.     

The Lewis blood group--a new genetic marker of ischaemic heart disease.

In a cohort of 3383 men aged 53 to 74 in the Copenhagen Male Study we investigated the association between ischaemic heart disease (IHD) and the Lewis blood group, assigned to chromosome 19. Among men with the Le(a-b-) phenotype, 8% had a history of non-fatal myocardial infarction, among others the frequency was 4%. The corresponding odds ratio was (95% confidence interval: CI) 1.9 (1.2-3.0) P < 0.01, men with Le(a-b-) had a risk-factor profile and pattern of disease resembling that of Reaven's syndrome X. In a subsequent prospective study 343 men with arteriosclerotic stigmas were excluded. The men had their morbidity and mortality recorded over the next 4 years. One-hundred-and-one men suffered IHD; 26 dying from IHD. In total 162 men died. Men with Le(a-b-) had an increased risk of death from IHD compared with others. Adjusted for age, relative risk (RR) (95% CI) was: 4.4 (1.9-10.3), P < 0.001, and for all causes of mortality: RR = 1.6 (1.0-2.6), P < 0.05. Men with the Le(a-b-) phenotype had an increased risk of an IHD event compared to men with other phenotypes (RR = 1.6 (0.9-2.8), P = 0.10) and a significantly higher IHD case fatality rate (RR = 2.8 (1.5-5.2), P = 0.01). The finding that the Le(a-b-) phenotype is a genetic marker of IHD risk may have implications in terms of prevention. The Le(a-b-) phenotype may also contribute to providing an explanation for the substantial ethnic differences found in the incidence of IHD. The similar risk-factor profile and pattern of disease found between Le(a-b-) men and individuals with Reaven's syndrome X is hypothesized to be due to a close genetic relationship on chromosome 19.     

彩色多普勒在心脏起搏器综合征诊断中的应用价值

目的 :探讨运用彩色多普勒血流显像 (CDFI)并结合心电图 (ECG)诊断起搏器综合征 (PMS)的临床价值。方法 :对具有详实临床及ECG资料的心室按需 (VVI)起搏器安置患者 6 0例及对照组 4 8例进行CDEI检查 ,观察起搏组与对照组的三尖瓣返流 (TR)的发生率、返流程度 ,并分析二者之间的相关性。结果 :起搏组出现逆传P波 (即PMS阳性 )者 15例 ,CDFI检测出现TR者 2 0例 ,明显高于对照组 ,且PMS阳性者TR发生率明显高于PMS阴性者 ,表明安置VVI起搏器后出现逆传P波与TR的发生相关性良好。结论 :CDFI对PMS的诊断具有重要意义 ,尤其将ECG与CDFI结合应用有助于诊断率的提高。     

EMPACT syndrome

Background: Seizure prophylaxis with phenytoin is a common measure in oncologic patients with brain metastases. In these patients, generalized severe adverse drug reactions such as erythema multiforme (EEM) may occur. However, in a subgroup of patients with brain radiation therapy, EEM‐like lesions develop particularly in the radiation field. Most recently, the acronym EMPACT ( E rythema M ultiforme associated with P henytoin A nd C ranial radiation T herapy) was proposed to specifically describe this syndrome. Patient/Method: Here, we report on EMPACT syndrome in a 46‐year‐old woman. Therapeutic measures included seizure prophylaxis with phenytoin and total brain radiation therapy of brain metastases from bronchial carcinoma. Three weeks after introduction of phenytoin, the patient presented with EEM‐like skin lesions restricted to the original radiation field and facial mucocutaneous involvement. After a few days, the rash spread to the upper part of the body. She was also in poor general condition. Results: The immediate cessation of phenytoin therapy, combined with administration of systemic corticosteroids and high dose immunoglobulins along with intensive local treatment and pain medications, resulted in complete resolution of the skin eruption. Patch testing to phenytoin was positive after 72 hours. Conclusion: EMPACT should be classified as an specific entity among the EEM‐like drug reactions as it only appears after radiotherapy and seizure prophylaxis with the anticonvulsant phenytoin. We propose including specific type IV‐sensitization to phenytoin into the definition of EMPACT.     

Clinical Observation on the Efficacy of Babaodan Combined with Interventional Therapy for Primary Hepatocellular Carcinoma

Objective To observe the clinical effect of Babaodan combined with transcatheter arterial chemoembolization （TACE） therapy for primary hepatocellular carcinoma. Methods Selected patients were randomly assigned to two groups. One group accepted TACE only and the other group accepted TACE and took 2 Babaodan capsules orally 3 times a day for 8 weeks. Results After 8 weeks＇ treatment, the size of the tumors and the alpha foetal protein （AFP） concentration in all the patients in the two groups diminished and was not significantly different between the two groups （P〉0.05）. The ratio of stability and improvement in the traditional Chinese medicine （TCM） syndrome was higher in the Babaodan plus TACE group than it was in the TACE only group （P〈0.05）. There were more complications in the TACE only group than in the Babaodan plus TACE group. The one-year survival rate in the Babaodan plus TACE group was higher than in the TACE group （P〈0.05）. Conclusion Babaodan can improve TCM syndrome, reduce complications and prolong survival of patients with primary hepatocellular carcinoma.     

16例茎突综合征误诊原因分析

目的吸取误诊教训，提高对茎突综合征诊断水平。方法回顾性分析3例茎突综合征误诊的临床资料。结果找出误诊原因，并借助文献进行分析、讨论。结论要熟悉茎突综合征的病因，临床特点和并发症，提高警惕性，发现可茎突综合征病人，及时做医学影像检查和咽部触诊。     

A Management of Early CRPS I Caused by Ankle Sprain: A Case Report

Abstract:   We present a case of a 13-year-old boy who developed signs and symptoms of neuropathic pain/early Complex Regional Pain Syndrome (CRPS) Type I, formerly known as Reflex Sympathetic Dystrophy (RSD), after spraining his ankle while wrestling. Aggressive pain control, using medications and sympatholytic blocks, with physical therapy and rehabilitation, led to the resolution of his painful condition. This prevented the disease from possibly progressing to a full-blown case of CRPS I (RSD) that is very challenging to treat.     

热休克对小麦未成熟种子萌发、生物发光和抗氧化酶活性的影响

以小麦（Triticum aestivum L.）品种石4185为材料,研究了45 ℃处理0～120 min对小麦未成熟籽粒谷甘胱肽转移酶（GST）、谷胱甘肽还原酶（GR）、过氧化氢酶（CAT）和过氧化物酶（POD）活性, 超微弱发光,种子萌发和愈伤组织诱导的影响.结果表明,热休克处理使未成熟籽粒萌发率、愈伤组织诱导率和GST活性明显增加,且其作用随处理时间的延长而增大;在处理过程中, CAT活性先减少后增加,热休克对GR活性无明显影响.GST的活性与蛋白质质量分数呈显著正相关.     

La dimension de contact et les troubles esthéticophysiognomiques

Dimension of contact is the very moment when meeting with someone. The limits can be precisely defined as an aesthetic moment, i.e. the very moment when someone appears. That is an experience of one's expressivity. One can usually go through this ephemeral moment to reach simple self-continuity. Pathologies of contact may be described at different levels: neurosis, pathological personalities and psychosis.