对血浆HCMV-IgM、尿HCMV-DNA阳性患儿用更昔洛韦干预意义

目的：调查对巨细胞病毒感染婴儿用更昔洛韦治疗的必要性。方法：本研究对2007年10月～2008年10月在深圳市宝安区妇幼保健院住院的0～6个月龄婴儿2840例,以ELISA法及PCR技术对患儿血浆HCMV—IgM、患儿尿及其母乳汁HCMV—DNA进行了检测,并对结果阳性及有临床症状的患儿分治疗组及对照组。治疗组采用更昔洛韦为主的综合治疗,对照组主要采取对症治疗,并判断疗效。结果：2840例患婴中血浆HCMV—IgM阳性者184例,占6．478％,尿HCMV—DNA升高者180例,占血浆HCMV—IgM阳性者97．8％,其母乳汁HCMV—DNA升高者170例,占血浆HCMV—IgM阳性者92．4％,对血清HCMV—IgM阳性、尿及其母乳汁HCMV—DNA升高的患儿分治疗组45例及对照组125例,发现治疗组临床症状改善42例（占93．3％）,尿HCMV—DNA滴度降低30例（占66．7％）,血浆HCMV—IgM转阴22例（占48．9％）。对照组临床症状改善80例（占64％）,尿HCMV—DNA滴度降低10例（占8％1,血浆HCMV—IgM转阴2例（占1．6％）。结论：采用更昔洛韦为主的综合治疗与采取单纯对症治疗相比。差异具有统计学意义,P〈0．01。     

更昔洛韦联合氦-氖激光治疗带状疱疹神经痛疗效观察

目的 探讨更昔洛韦联合氦-氖激光治疗带状疱疹的临床疗效。方法治疗组44例,给予更昔洛韦0．25g,每日1次,静脉滴注,联合氦-氖激光治疗,每天1次,共7d。对照组32例,给予更昔洛韦0．25g,1次／d,共7d。结果治疗组治愈12例,显效29例,无效3例,总有效率93．18％;对照组治愈7例,显效17例,无效8例,总有效率75．00％。治疗组总有效率明显高于对照组（X^2=4．947,P〈0．05）。结论更昔洛韦联合氦-氖激光治疗带状疱疹神经痛的疗效迅速,病情恢复良好。     

更昔洛韦治疗小儿巨细胞病毒性肝炎的临床研究

目的：观察更昔洛韦对小儿巨细胞病毒(CMV)肝炎的疗效。方法：将50例CMV肝炎患儿随机分为两组，治疗组30例在常规护肝的基础上加用更昔洛韦5mg／kg静滴，每日2次，连续14d。对照组20例予以常规护肝治疗。结果：治疗组和对照组血清CMV-IgM及血清CMV-DNA转阴率分别为85％和17．5％，P＜0．01；治疗总有效率分别为86．7％和20％，P＜0．01，且治疗组血清胆红素(STB)复常时间及谷丙转氨酶(ALT)复常时间均较对照组明显缩短，治疗组在治疗过程中未见明显毒副作用。结论：更昔洛韦治疗小儿CMV肝炎，疗效确切，可推广应用。     

Cytomegalovirus enteritis in immunocompetent subjects: A case report and review of the literature

Cytomegalovirus (CMV) enteritis (or colitis) is generally diagnosed in immunocompromised patients in association with human immunodeficiency virus infection as well as in recipients of solid organ or hematopoietic stem cell transplant. CMV enteritis has been reported only sporadically in immunocompetent individuals. We encountered a 76-year-old woman who developed CMV enteritis without any previously identified immunocompromised states. An extensive literature review of 33 cases of CMV enteritis or colitis diagnosed in immunocompetent individuals, including the present case, revealed that the median age of the patients was 68, the accompanying symptoms were diarrhea (76%), abdominal pain (52%), and hematochezia or melena (27%), and that the outcome was generally favorable, including resolution without any treatment in 24% of the patients. CMV enteritis should be recognized more widely as a disease entity not only in immunocompromised patients but also in immunocompetent individuals, especially in elderly populations.     

丙种球蛋白联合更昔洛韦对呼吸道合胞病毒肺炎患儿肺功能影响

目的：探讨丙种球蛋白联合更昔洛韦对呼吸道合胞病毒（RSV）肺炎患儿肺功能的影响。方法：将87例RSV肺炎患儿随机分为两组,对照组43例给予更昔洛韦治疗,5mg·kg-1次-1,2次／d;观察组44例在对照组治疗基础上,加用丙种球蛋白治疗,400mg·kg-1次-1,1次／d,持续治疗14d;检测治疗前、后呼吸频率（RR）、潮气量（VT／kg）、达峰容积比（VPTEF／VE）、达峰时间比（TPTEF／TE）等肺功能指标变化。结果：观察组治疗总有效率高于对照组,差异具有统计学意义（P〈0．05）;治疗后观察组RR低于对照组,差异具有统计学意义（P〈0．05）;治疗后观察组TPTEF／TE及VPTEF／VE高于对照组,差异具有统计学意义（P〈0．05）。结论：更昔洛韦可有效抗病毒,丙种球蛋白可增强RSV肺炎患儿免疫力,促进炎症消除,两者合用可改善患儿肺功能,值得临床推广应用。     

Pharmacokinetics of ganciclovir in renal transplant children

Three cytomegalovirus (CMV)-seronegative children received renal transplants from CMV-seropositive donors and developed clinical symptoms of CMV infection between days 20 and 34 post transplantation. Ganciclovir (DHPG) was administered in a 1-h infusion, and the doses and dose intervals were adapted to the degree of renal insufficiency, according to the manufacturer's recommendations for adults. Individual pharmacokinetic parameters of DHPG were determined and were markedly altered. Plasma clearances were 0.4, 1.1 and 2.2 ml/min per kg and were related to individual creatinine clearances (20, 45 and 60 ml/min per 1.73 m²); the corresponding elimination half-lives were 23.7, 9.9 and 3.9 h. In two patients, the doses had to be further reduced in order to maintain plasma levels within the recommended values for peak and trough plasma concentrations. Therefore, monitoring of DHPG appears essential in adjusting dosage for optimal efficacy and minimal toxicity.     

Monitoring antigenemia is useful in guiding treatment of severe cytomegalovirus disease after organ transplantation

We investigated the value of monitoring CMV antigenemia during and after antiviral therapy for CMV disease. During the study period, 10 out of 214 renal transplant recipients were treated for CMV disease, receiving a total of 14 courses of treatment. Antigenemia decreased within 7 days after onset of treatment in eight of nine courses associated with a rapid clinical recovery. In three courses with a slow or absent response, antigenemia levels initially increased. Monitoring antigenemia was helpful in differentiating persisting CMV disease from other opportunistic infections and rejection. Relapses of CMV disease were preceded by rises in antigenemia. Viral isolation became negative within 3 days after initiation of ganciclovir, irrespective of the clinical response. Antigenemia is a marker of the effect of ganciclovir on CMV replication in vivo, and its monitoring may be valuable in the management of patients with severe CMV disease.     

反相高效液相色谱法考察注射用炎琥宁与注射用更昔洛韦配伍稳定性

目的 考察注射用炎琥宁与注射液用更昔洛韦在5%葡萄糖注射液中的配伍稳定性.方法 在室温[（20±1）℃]下,采用反相高效液相色谱法-二极管阵列检测器同时测定炎琥宁与更昔洛韦配伍后0～8 h内的含量变化,并观察配伍液的外观及pH值.结果 检测波长为251 mm,炎琥宁的平均回收率为99.8%,峰面积相对标准偏差（RSD）为0.84%（n=9）,更昔洛韦的平均回收率为99.7%,RSD为0.68%（n=9）.8 h内配伍液的颜色、pH值以及炎琥宁与更昔洛韦的含量均变化较大.结论 在室温条件下,注射用炎琥宁与注射液用更昔洛韦不可以在5%葡萄糖注射液中配伍使用.     

更昔洛韦阴道栓的制备及质量控制

目的:制备更昔洛韦阴道栓并建立其质量控制方法。方法:以明胶等为基质、更昔洛韦为主药制备栓剂;采用高效液相色谱法测定更昔洛韦的含量。结果:所制栓剂类白色透明鸭嘴形栓剂,软硬度合适;鉴别、检查等符合《中国药典》2005年版相应规定;更昔洛韦检测浓度线性范围为2.0～90.0 μg.mL~(-1)(r=0.999 9),平均回收率为99.28%(RSD=0.58%,n=9)。结论:更昔洛韦阴道栓制备工艺简单,含量测定方法操作简便、结果准确。     

Silk-elastinlike protein polymers for matrix-mediated cancer gene therapy

Silk-elastinlike protein polymers (SELPs) are recombinant polymers designed from silk fibroin and mammalian elastin amino acid repeats. These are versatile materials that have been examined as controlled release systems for intratumoral gene delivery. SELP hydrogels comprise monodisperse and tunable polymers that have the capability to control and localize the release and expression of plasmid DNA and viruses. This article reviews recent developments in the synthesis and characterization of SELP hydrogels and their use for matrix-mediated gene delivery.