Aminotransferases During Treatment Predict Long-Term Survival in Patients With Autoimmune Hepatitis Type 1: A Landmark Analysis

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Mortality Rates and Predictors of Mortality Among Late-Middle-Aged and Older Substance Abuse Patients

This study describes mortality rates and predictors of mortality among late-middle-aged and older (55+) substance abuse inpatients ( n = 21, 139) in Department of Veterans Affairs (VA) Medical Centers in the 4 years after an index episode of care. A total of 24% of the patients died; this mortality rate was 2.64 times higher than expected. Predictors of earlier mortality included older age and nonmarried status, alcohol psychosis and organic brain disorder diagnoses, and several medical diagnoses, including neoplasms, liver cirrhosis, respiratory, endocrine and metabolic, and blood system disorders. Three proxy indicators of illness severity also predicted mortality: more prior inpatient and outpatient medical care and an index episode in an extended care unit. In contrast, more prior outpatient mental health care and remitted status predicted lower mortality. These diagnostic and treatment indicators can be used to identify patients at heightened risk for premature mortality. Moreover, they show that intensive mental health aftercare and remission of substance abuse may delay mortality, even among older patients who have longstanding substance abuse problems.     

哮喘缓解期联用乌体林斯和黄芪注射液等穴位注射控制哮喘发作的临床观察

目的　观察哮喘缓解期联用乌体林斯、黄芪注射液、鱼腥草注射液穴位注射控制哮喘发作的疗效 ,探讨其作用机理。方法　哮喘缓解期患者 5 6例 ,随机分成两组。治疗组 3 2例采用相同穴位交替选择药物 ,隔日穴位注射治疗 ;对照组 2 4例予常规治疗。并观察两组疗效及治疗前后用力肺活量 (FVC) ,1秒钟用力呼气量 (FEV1)和肺活量 (VC)的变化。结果　两组总有效率为 96.87%和 79.17% ,治疗组优于对照组 ( χ2 =10 ,P <0 .0 1)。治疗组治疗前后肺功能明显改善 ,治疗前后比较VC分别为 ( 1.79± 0 .43 )L和 ( 2 .91± 0 .64 )L ,P <0 .0 5 ;FVC分别为 ( 1.64± 0 .46)L和 ( 2 .0 9±0 .62 )L ,P <0 .0 5 ;FEV1分别为 ( 0 .92± 0 .70 )L和 ( 1.3 5± 0 .3 5 )L ,P <0 .0 5。对照组治疗前后肺功能改善不明显 (P均<0 .0 5 )。治疗组明显优于对照组。结论　在哮喘缓解期联用乌体林斯、黄芪注射液、鱼腥草注射液穴位注射控制哮喘发作的临床疗效优于常规治疗     

文拉法辛与三环类抗抑郁药治疗抑郁症痊愈率的循证医学研究

目的　比较文拉法辛与三环抗抑郁药治疗抑郁症临床痊愈率的差异。方法　应用循证医学的Me-ta分析,采用固定效应模型(fixed effects model,FEM)法对符合标准的16项对照研究文献进行评价。结果　文拉法辛与三环抗抑郁药治疗抑郁症的临床痊愈率不同,差异有显著性(χ2=4.773,df=1,P<0.05);综合的ORs=1.36,95%CI为1.04~1.78。提示文拉法辛治疗抑郁症的临床痊愈率是三环抗抑郁药的 1.36倍。结论　治疗抑郁症,文拉法辛比三环抗抑郁药有更可靠的临床痊愈率。     

国产安吖啶治疗急性白血病Ⅱ期临床试用

应用国产安吖啶对11例急性白血病进行诱导缓解化疗,初治6例,复治5例。4例达完全缓解(CR),CR率为36.4％。其中初治者为33.3％(2/6),复治者为40％(2/5)。总有效率45.5％。该药的剂量限制性毒性反应为骨髓抑制,部分病例有肝功能损害。     

On the role of additive hormone monotherapy with tamoxifen,medroxyprogesterone acetate and aminoglutethimide,in advanced breast cancer

Summary We analyzed the results of clinical studies on the therapeutic efficacy of hormone monotherapy with tamoxifen, medroxyprogesterone acetate, and aminoglutethimide in metastatic breast cancer, which were published between 1971 and 1986 and involved altogether 7000 patients. The overall response rates in patients treated with these hormonal single agents at various dose levels ranged from 31%–42%. When only estrogen receptor-positive patients were considered, the response rates lay between 41% and 54% in groups which were treated with the antiestrogenic agents tamoxifen or aminoglutethimide. The duration of remission was 12 months for tamoxifen- and aminoglutethimide-treated women, whereas medroxy-progesterone acetate effected remissions lasting from 6–16 months. The overall mean survival from start of therapy in tamoxifen- and aminoglutethimide-treated groups was 20 months, whereas information concerning this therapeutic parameter was available only in a minority of medroxyprogesterone acetate-treated groups. With respect to the response by site of metastatic lesions, all three agents caused a significantly higher degree of remissions in the soft tissue as compared to visceral disease.Abbreviations AG Aminoglutethimide - MPA Medroxyprogesterone acetate - TAM Tamoxifen     

精神分裂症恢复期患者及家属家庭干预的对照研究

目的：以康复期出院精神分裂症患者和家属为对象，定期复诊进行家庭干预并对照研究。方法：干预组68例，对照组52例，采用BPRS评定；干预组家属74人，对照组家属65人，采用SCL－90评定。结果：6个月后干预组患者BPRS和入组时对照比较均有显著性差异（P＜0．01），说明干预组患者的精神症状，不良情绪及社会功能明显好转，入组时两组家属SCL－90评定与常模对照比较，均有明显差异（P＜0．05或0．01），经干预后干预组与全国常规比较无显著性差异（P＞0．05），说明患者家属普遍存在心理障碍，经干预后家属心理状况明显改善。结论：对康复期病人及家属进行门诊家庭干预，是有效的康复方法，值得推广应用。     

Korrelation histologischer und nuklearmedizinischer Befunde der Tumorregression in behandelten bösartigen Lungentumoren

Zusammenfassung Die CT ist nach neoadjuvanter Radio-Chemo-Therapie zur Charakterisierung der Tumorregression nur begrenzt einsetzbar. Daher sollte die Wertigkeit der ¹⁸F-FDG-PET als molekulares, nichtinvasives bildgebendes Verfahren analysiert werden.Bislang 32/100 Patienten mit NSCLC Stadium IIIA/IIIB wurden in einer multizentrischen, randomisierten Therapiestudie (LUCAS-MD) untersucht. Prätherapeutisch erfolgten eine ¹⁸F-FDG-PET und eine Spiral-CT. Der neoadjuvante Therapieblock bestand aus 2–3 Zyklen Paclitaxel und Carboplatin sowie einer simultanen Radio-Chemo-Therapie. Es folgte eine zweite PET direkt vor der Operation mit Bestimmung des Glukosemetabolismus für Primärtumor und Lymphknotenmetastasen sowie eine PET-CT-Bildfusion. Der am OP-Präparat bestimmte Regressionsgrad wurde mit den PET-Befunden und dem Überleben der Patienten korreliert.In Lymphknoten von 10 Patienten mit kompletter Remission in der FDG-PET zeigte sich ein Regressionsgrad/RG III im OP-Präparat (Sensitivität 100%). Zu 94% wiesen die 16/32 Patienten mit kompletter Remission im Primärtumor RG IIb oder III auf, ein Patient RG IIa (falsch-negativ). Die Zweijahresüberlebenswahrscheinlichkeit bei kompletter Remission war nach 24 Monaten signifikant erhöht (76 vs. 20%, p=0,0079). Patienten mit RG III bzw. IIb lebten signikant länger als Patienten mit RG IIa bzw. I (63 vs. 36%, p=0,0123).Der RG korreliert mit der in der FDG-PET bestimmten metabolischen Remission. Die PET eilt metabolisch dem durch die CT bestimmten Tumoransprechen nach neoadjuvanter Behandlung deutlich voraus und ermöglicht wahrscheinlich eine prospektive Aussage über den Langzeittherapieerfolg von Patienten mit NSCLC im Stadium III.     

Clinical and radiographic results from a 2-year comparison of once-weekly versus twice-weekly administration of etanercept in biologics-naive patients with rheumatoid arthritis

Abstract

Objectives The twice-weekly administration of 25 mg of etanercept (TW) has been shown to be effective in patients with rheumatoid arthritis (RA). However, the once-weekly administration of 25 mg of etanercept (OW) was tried in order to address the economic burden of anti-rheumatic biologics. We evaluated the clinical and radiographic results from a 2-year follow-up study of patients receiving OW or TW.

Methods Sixty-three biologics-naive patients with RA were randomly assigned to receive either OW (n = 42) or TW (n = 21).

Results From baseline to year 2, rates of clinical remission, according to the Disease Activity Score of 28 joints (DAS-28) (based on C-reactive protein; CRP)–with clinical remission being regarded as a DAS-28 (CRP) score of <2.3–were significantly improved in the OW group (from 1.6 to 39.0%) and in the TW group (from 9.5 to 47.6%), but no significant between-group difference was observed at year 2. Radiographic joint damage, quantified with the modified Sharp score, was significantly progressive in the OW group in contrast to findings in the TW group. Thus, among patients receiving TW therapy, the progression of joint damage may have been inhibited or may have shown remission.

Conclusions These results suggest that, in terms of DAS-28 remission, OW therapy can efficiently substitute for TW therapy in biologics-naive patients with RA. However, TW therapy was indispensable in preventing the worsening of joint damage.