消炎痛缓释系统的基础研究及新型T型铜药宫内节育器临床应用的初步研究

将消炎痛掺入SYZ-1医用加成型硅橡胶制成长21mm,直径为2.4mm含消炎痛40mg的均质型缓释药棒,通过体外消炎痛释放量测定,得出消炎痛缓释系统为非零级释放,释放时间至少持续360天,其生物安全性能评价结果全部合格,其经γ射线,环氧乙烷消毒后,无新物质产生,消炎痛释放规律不变。将该缓释系统应用于新型T型铜药宫内节育器,通过半年的临床观察有效地防止了放器后引起的月经过多,并随机选择10例放器后的妇女于分泌期吸取宫颈粘液测消炎痛含量,结果为7.44μg/ml粘液,5例妇女于分泌期吸取宫颈粘液测铜含量,结果为0.46μg/ml粘液湿重。选择15例妇女于放器前月经干净3～7天及放器1月月经干净3～7天对子宫内膜细胞后150个进行定量测定,结果示放器后1月子宫内膜细胞较放器前明显增大。     

Increased monocyte-dependent suppression of polyclonal activation of B lymphocytes from cystinotic children

In infantile cystinosis the amino acid cystine preferentially accumulates in phagocytic cells, polymorphonuclear leucocytes (PMN) and monocytes, rather than in lymphocytes. We previously described functional abnormalities in the oxidative metabolism and locomotion of cystinotic PMN and monocytes. The present study shows an abnormal lymphocyte polyclonal activation as evidenced by a decreased immunoglobulin (Ig) production and generation of Ig-containing cells (ICC) in cultures of peripheral blood mononuclear cells (PBMC) from cystinotic children upon stimultion with pokeweed mitogen andStaphylococcus aureus Cowan I. However, monocyte depletion from cystinotic PBMC fully reconstituted Ig production and ICC generation, indicating: (1) the presence of an increased monocyte-dependent suppression on lymphocyte polyclonal activation, and (2) that the intrinsic ability of cystinotic lymphocytes to respond to polyclonal stimulation was preserved. The increased cystinotic monocytedependent suppressive effect was not mediated by prostaglandin E₂ (PGE₂) since its production by cystinotic PBMC upon polyclonal activation was not different from that of controls. In addition, the sensitivity of cystinotic lymphocytes to the immunosuppressive effect of varying concentrations of exogenous PGE₂ was similar to that of controls. Finally, indomethacin and 2-mercaptoethanol, two agents able to scavenge hydroxyl (OH) radicals, restored Ig production by cystinotic PBMC, suggesting a role for reactive oxygen species in the increased cystinotic monocyte-dependent suppression.     

地肤子对小鼠胃排空的抑制作用

目的：观察地肤子及其代用品醇提物对小鼠胃排空的影响，研究地肤子抑制胃排空的有效部位及其作用机制。方法：小鼠灌胃给予酚红溶液，30min后处死，以比色法测定胃中酚红残留量，计算胃排空百分率。结果：地肤子和扫帚菜醇提物100，300mg／kg显著抑制小鼠胃排空，两者作用强度相近，藜及小藜醇提物无明显作用；地肤子的正丁醇部位及乙酸乙酯部位50mg／kg抑制小鼠胃排空，水相无明显作用。石油醚相50mg／kg则促进胃排空；乙醇、利血平及吲哚美辛预处理减弱地肤子正丁醇部位的作用，而阿托品预处理则增强其作用。结论：地肤子醇提物抑制小鼠胃排空，代用品扫帚菜的作用与其相近，地肤子的主要有效成分可能为皂苷，其作用与中枢神经系统、儿茶酚胺、内源性前列腺素及胆碱能神经系统有关。     

体重不足1500g早产儿动脉导管未闭的治疗

目的:通过对体重不足1500g的早产儿接受动脉导管早期结扎术者与仅接受消炎痛(indomethacin)治疗者的临床记录回顾性分析来寻找和确定更适当的治疗方法和方向。方法:我们把1996年7月至2003年12月治疗过的40例体重不足1500g的动脉导管未闭早产儿分为接受消炎痛的治疗者与未给予消炎痛而直接接受外科结扎者,对其结果做了比较分析。结果:消炎痛治疗者与外科手术者中的生存者与死亡者进行比较,二者在患者的体重,孕龄,伴随的心脏畸形,动脉导管的大小,消炎痛治疗并发症,机械辅助呼吸时间,ICU住院时间等均无显著性差异(P>0.05);对消炎痛治疗者与外科手术者进行比较,仅在并发症之间有显著性差异(P<0.05),即消炎痛治疗者有7例出现并发症(36.8%),而外科手术者的5例死亡也与患儿的术前状态密切相关。结论:对体重不足1500g的动脉导管未闭早产儿而言,因受消炎痛用药条件的限制、较高的并发症发生率和失败率,早期行动脉导管结扎术不失为有效的治疗手段。     

复方吲哚美辛栓与卡孕栓在人工流产术中镇痛及扩宫疗效的临床对照研究

目的:比较复方吲哚美辛栓与卡孕栓在人工流产术中止痛和扩张宫颈作用。方法:将322例早孕要求终止妊娠妇女,分为复方吲哚美辛栓组(n=140),卡孕栓组(n=182),观察两组对象术中疼痛程度、扩宫效果及副反应发生情况。结果:复方吲哚美辛栓组术中镇痛、扩张宫颈效果优于卡孕栓组(P<0·01,P<0·05),血卡孕栓组较复方吲哚美辛栓组术中、术后出血量少(P<0·05),卡孕栓组术后恶心、呕吐及腹泻例数明显多于复方吲哚美辛栓组(P<0·01),其他副反应则无明显差异(P>0·05)。结论:复方吲哚美辛栓较卡孕栓在人工流产术中具有明显的扩张宫颈、减轻疼痛的作用,且术后副反应少。     

消炎痛对白色念珠菌菌丝形成的影响

目的:探讨环氧化酶抑制剂消炎痛对白色念珠菌形态发育的影响。方法:分别用含不同浓度消炎痛的RPM I1 640加10%小牛血清的液体培养基和玉米-吐温80固体培养基培养3株白色念珠菌,观察白色念珠菌形态发育变化。结果:消炎痛对白色念珠菌芽管和菌丝形成的抑制作用与其剂量相关。在液体培养基中,消炎痛浓度为0.75 mM时可抑制50%芽管形成,浓度为2.0mM时可完全抑制芽管和菌丝形成;而在固体培养基中,消炎痛浓度为1.0mM时可抑制菌丝和厚壁孢子的形成,浓度为2.0 mM时,几乎没有菌丝形成。结论:消炎痛可以抑制白色念珠菌芽管、菌丝的形成,阴道内给予消炎痛将有助于治疗念珠菌性阴道炎。     

Potentiation of Reduced Uteroplacental Perfusion Pressure Hypertension in Pregnant Rabbits

Objective: We tested whether indomethacin (IND) potentiates the elevation of blood pressure induced by the reduction of the uteroplacental perfusion pressure (RUPP).

Methods: In pregnant rabbits on the 21st day of the 30-day gestation, the uteroplacental perfusion pressure was reduced by 68 ± 5% using a clip placed on the abdominal aorta below the renal arteries. IND suppositories (15 mg/kg each) were administered 1 and 2 days following surgery.

Results: After the second dose, MAP of IND-treated RUPP rabbits was higher (92 ± 9 mm Hg, n = 10) than in those receiving placebo (78 ± 12, n = 9, P <. 01). MAP of sham-operated pregnant rabbits with or without IND was 61 ± 9 and 58 ± 8 mm Hg, respectively (NS). Placebo-treated RUPP animals evidenced an enhanced urinary sodium excretion as compared to nor-motensive control rabbits receiving placebo (3.27 ± 0.69 mmol/kg/day vs. 1.49 ± 0.74, P <. 001). Enhanced urinary sodium excretion was blunted by IND in RUPP rabbits (1.25 ± 0.37, P <. 001).

Conclusion: (1) IND potentiates the hypertensive response induced by RUPP. (2) the reduction of urinary sodium excretion may be one of the several pharmacological effects of IND aggravating hypertension in this state.     

Tympanic Displacement Analysis in Healthy Volunteers after Indomethacin Administration

The aim of this study was to investigate whether a tympanic displacement analyser could detect decreases in cerebral blood flow and intracranial pressure after administration of indomethacin in healthy volunteers. In a double-blind crossover study involving 14 healthy volunteers all subjects first underwent a test-retest evaluation to investigate reproducibility followed by tests performed in sitting and supine positions to confirm intracranial-cochlear pressure transfer. In two further sessions tests were performed before and 90 min after subjects were blindly administered a suppository containing either 100 mg of indomethacin or placebo. It was found that tympanic membrane analysis performed 90 min after administration of such a suppository did not mirror the induced reduction in cerebral blood flow after administration of active drug. After administration of indomethacin eight of the subjects experienced discomfort and dizziness; after placebo none experienced subjective symptoms. After administration of indomethacin a statistically significant decrease in heart rate was demonstrated. The exponential form of the intracranial pressure-volume curve may explain why a decrease in intracranial pressure was not detected using the tympanic membrane displacement method, because the measurements were made in subjects with normal intracranial pressure. More significant findings may be found in patients with elevated intracranial pressure.     

Prophylactic and early targeted treatment of patent ductus arteriosus

Treatment of a haemodynamically significant patent ductus arteriosus (PDA) in the very preterm infant has been an accepted approach for several decades. However, the rationale for closure of PDA has recently been challenged due to reports of success with conservative approaches and the lack of evidence for longer-term benefits from treatment. In this article, we address an approach to assess treatment of those babies most likely to benefit.