光固化流体树脂与可见光固化窝沟封闭剂防治儿童龋病的疗效对比

目的 探讨光固化流体树脂与可见光固化窝沟封闭剂对儿童龋病的疗效.方法 将我院龋齿防治的120例儿童随机分为两组.试验组60例进行光固化流体树脂治疗.对照组60例可见光固化窝沟封闭剂治疗.观察两组患龋率及封闭剂维持率.结果 试验组龋齿率为7.9％,稍低于对照组的8.8％,无统计学差异（P ＞0.05）;试验组1年封闭剂维持率为96.2％,高于对照组的84.2％,有统计学差异（P＜0.05）;试验组2年封闭剂维持率为90.0％,高于对照组的75.8％,有统计学差异（P＜0.05）.结论 光固化流体树脂较可见光固化剂疗效显著,其患儿封闭剂维持率比较高,同时患儿患龋率也较低,值得临床选择.     

尼妥珠单抗在晚期胰腺癌综合治疗中的疗效分析

目的：观察尼妥珠单抗在晚期胰腺癌综合治疗中的临床疗效。方法回顾性分析19例经泰欣生初治（10例）或者复治（9例）的晚期胰腺癌患者的临床资料,所有患者在治疗过程中应用尼妥珠单抗（200mg/周）靶向治疗至少3周,且疗效可以评价。结果近期疗效：患者中无CR,PR1例,疾病控制率（DCR）为52.6%（10/19）。疾病相关症状有较好改善,包括疼痛程度减轻、KPS评分提高等。19例患者均可获得PFS结果,中位PFS为3.57个月。2例患者仍存活,17例患者可获得总生存（OS）结果,最短3.0个月,最长31.7个月（患者系复治,应用尼妥珠单抗综合治疗后生存时间为24个月）,中位OS 11.75个月。结论尼妥珠单抗在晚期胰腺癌的综合治疗中疗效及安全性值得肯定,并能较好地改善此类疾病的相关症状,可能是会成为晚期胰腺癌患者的有效选择之一,其疗效有待进一步的大样本量的临床研究确认。     

172例人血清蛋白临床应用合理性调查与分析

目的 评价人血清蛋白的临床应用情况,并为临床合理用药提供实证。方法 利用美康合理用药临床药学工作站,从该院2010年应用人血清蛋白的住院患者中,随机抽取172例,对所选病例进行回顾性分析,获取有关临床应用信息,包括患者的年龄、性别、科室、诊断、疗程、用药原因、用药前白蛋白浓度等指标,将以上数据进行整理统计。结果 肝胆外科应用最多(26.1%);用量较大的主要是危重患者;在个人用量分布方面,以使用10~20 g的患者最多;用药原因以低蛋白血症所占比例最大(38.9%);使用人血清蛋白前患者血清清蛋白浓度分布主要集中在20~30 g/L范围内。结论 该院人血清蛋白的使用还存在一些问题,应遵循安全、有效、经济的用药原则,严格执行人血清蛋白的适应证,以获得最佳的效果。     

丹红注射液用于高血压性脑出血微创术围手术期58例

目的探讨高血压性脑出血微创术围手术期应用丹红注射液治疗的临床疗效。方法将116例行微创手术治疗的高血压性脑出血患者随机分为两组,各58例。对照组采用甘露醇常规治疗,观察组在对照组基础上加用丹红注射液。结果治疗2周后,观察组患者血肿吸收情况明显优于对照组（P〈0.05）;总有效率观察组为50.00%,明显高于对照组的37.93%（P〈0.05）;两组患者不良反应发生率比较,差异无统计学意义（P〉0.05）。结论高血压性脑出血微创术围手术期应用丹红注射液的临床疗效确切,且安全性好。     

2379株肺炎克雷伯菌的临床分布与耐药性分析

目的分析医院2009年至2011年肺炎克雷伯菌(KPN)的临床分布及耐药性变化,为临床合理使用抗菌药物提供依据。方法收集临床分离的菌株,采用Vitek-2 Compact全自动微生物分析仪进行细菌鉴定及药物敏感性试验,应用Whonet 5.3软件统计数据。结果痰标本为肺炎克雷伯菌的主要标本来源,占65.04%~79.34%;儿科和脑外科为肺炎克雷伯菌主要分布的病区,分别占30.69%,15.81%;肺炎克雷伯菌对头孢类抗生素药物的耐药率较高,但耐药率逐年下降,对亚胺培南、美洛培南、奈替米星、庆大霉素、环丙沙星、哌拉西林他唑巴坦、左旋氧氟沙星的耐药率为3.03%~28.8%。结论该院肺炎克雷伯菌耐药率虽有所下降,但仍形势严峻,临床应继续根据药物敏感性试验结果合理使用抗菌药物。     

妈咪爱治疗儿童功能性便秘50例

目的观察妈咪爱治疗儿童功能性便秘的疗效。方法采用回顾性分析方法,将100例功能性便秘的患儿随机分为两组,各50例,对照组采用多饮水、多食蔬菜、水果等富含粗纤维素食物及进行排便习惯锻练等综合性常规治疗,治疗组在常规治疗基础上,加服妈咪爱,疗程均为1个月。比较两组治疗效果。结果治疗组总有效率为90.00%,明显高于对照组的70.00%(P<0.05)。结论妈咪爱治疗儿童功能性便秘可显著提高临床有效率,值得临床推广。     

Individual patterns of alcohol use

Aims

We present methodology to identify statistically distinct patterns of daily alcohol use and classify them into categories that could be further used in monitoring of transitions between patterns such as transitions from regular to problem use.

Data

The study analyzed individual patterns of adult alcohol consumption from two datasets containing short (< 6 month) and long (up to 2 years) daily records of drinking. These data were collected over the period between 1999 and 2003.

Results

By using a non-parametric (Kolmogorov–Smirnov) test we have identified distinct drinking patterns and classified them into 8 types according to their means, percentages of non-drinking days and variances of consumed amount during drinking days. For each studied individual we calculated a transition chart that characterizes transitions between the types.

Conclusions

Individual daily consumption patterns can be identified, and classified into distinct patterns. Changes between the patterns could be related to life events or environmental trends, and thus provide insights into pathways towards either heavier use or recovery.     

C-reactive protein promotes atherosclerosis by increasing LDL transcytosis across endothelial cells

Background and Purpose

The retention of plasma low-density lipoprotein (LDL) particles in subendothelial space following transcytosis across the endothelium is the initial step of atherosclerosis. Whether or not C-reactive protein (CRP) can directly affect the transcytosis of LDL is not clear. Here we have examined the effect of CRP on transcytosis of LDL across endothelial cells and have explored the underlying mechanisms.

Experimental Approach

Effects of CRP on transcytosis of FITC-labelled LDL were examined with human umbilical vein endothelial cells and venous rings in vitro and, in vivo, ApoE^-/- mice. Laser scanning confocal microscopy, immunohistochemistry and Oil Red O staining were used to assay LDL.

Key Results

CRP increased transcytosis of LDL. An NADPH oxidase inhibitor, diphenylene iodonium, and the reducing agent, dithiothreitol partly or completely blocked CRP-stimulated increase of LDL transcytosis. The PKC inhibitor, bisindolylmaleimide I and the Src kinase inhibitor, PP2, blocked the trafficking of the molecules responsible for transcytosis. Confocal imaging analysis revealed that CRP stimulated LDL uptake by endothelial cells and vessel walls. In ApoE^-/- mice, CRP significantly promoted early changes of atherosclerosis, which were blocked by inhibitors of transcytosis.

Conclusions and Implications

CRP promoted atherosclerosis by directly increasing the transcytosis of LDL across endothelial cells and increasing LDL retention in vascular walls. These actions of CRP were associated with generation of reactive oxygen species, activation of PKC and Src, and translocation of caveolar or soluble forms of the N-ethylmaleimide-sensitive factor attachment protein.     

Efficacy and safety of canagliflozin in subjects with type 2 diabetes: systematic review and meta-analysis

Purpose

To assess the efficacy and safety of the novel sodium glucose co-transporter 2 (SGLT2) inhibitor—canagliflozin for type 2 diabetes (T2DM).

Methods

A search of Medline (1946–January 2014), Embase (1950–January 2014), and The Cochrane Library for randomized controlled trials of canagliflozin compared to placebo or active comparator in T2DM was performed. Clinical Trials website and unpublished U.S. Food and Drug Administration data were also searched.

Results

Ten trials including 6,701 patients were analyzed. Compared with placebo, canagliflozin produced absolute reductions in glycated hemoglobin A_1c levels when used as monotherapy (weighted mean difference (WMD) ?1.08 %, 95 % confidence interval (CI) [?1.25 to ?0.90], p?p?HbA1c by ?0.21 % (WMD, 95 %CI [?0.33 to ?0.08], p?=?0.001). Canagliflozin led to greater body weight loss (vs. placebo, WMD ?2.81 kg, 95 %CI [?3.26 to ?2.37]; vs. active comparators, WMD ?3.49 kg, 95 %CI [?4.86 to ?2.12]). Hypoglycemia with canagliflozin was similar to placebo or sitagliptin, and was lower than glimepiride (risk ratio (RR) 0.15, 95 %CI [0.10 to 0.22]). Genital tract infections were more common with canagliflozin (vs. placebo, RR 3.76, 95 %CI [2.23 to 6.35]; vs. active comparators, RR 4.95, 95 %CI [3.25 to 7.52]). Similar incidences of urinary tract infections were noted with canagliflozin compared with control groups.

Conclusion

Canagliflozin led to improvements in reducing glycated hemoglobin A_1c levels and body weight with low risk of hypoglycemia in patients with T2DM. Common adverse effects including genital tract infections and osmotic diuresis-related AEs were identified and reviewed. Risks of cardiovascular events are even less certain, and more data on long-term effects are needed.     

宫腔镜电切术联合米非司酮治疗围绝经期功能失调性子宫出血 92 例简

目的 探讨宫腔镜电切术联合米非司酮治疗围绝经期功能失调性子宫出血的临床疗效.方法 将2010年6月至2012年6月收治的198例围绝经期功能失调性子宫出血患者分为对照组和观察组,对照组给予宫腔镜子宫内膜电切术治疗,观察组给予宫腔镜子宫内膜电切术联合口服小剂量米非司酮治疗.分别对两组手术情况、疗效、贫血状况、激素水平和不良反应进行评定.结果 两组患者术中出血量、手术时间、膨宫液用量和住院时间比较,差异无统计学意义（P＞0.05）;观察组治疗有效率明显高于对照组（P＜0.05）,治疗后贫血症状较对照组明显改善（P＜0.05）;治疗前后血清卵泡雌激素（FSH）、黄体生成素（LH）、雌二醇（E2）和孕酮（P）等激素水平对照组患者无明显变化（P＞0.05）,观察组患者治疗后较治疗前有所下降,但差异无统计学意义（P＞0.05）;两组并发症发生率比较无统计学意义（P＞0.05）.结论 宫腔镜子宫内膜电切术联合米非司酮治疗围绝经期功能失调性子宫出血疗效显著、安全,值得临床推广.