血浆置换治疗慢性重型肝炎的疗效观察

目的观察血浆置换（PE）治疗慢性重型肝炎的临床疗效。方法102例慢性重型肝炎的患者随机分为2组：治疗组53例，对照组49例，2组患者内科基础治疗相同，治疗组加用血浆置换治疗，共186例次。观察2组患者在症状、体征、有效率及肝功能等方面的改变并进行比较。结果治疗组患者的临床症状明显改善，肝功能有所恢复，有效率明显高于对照组（73．58％对比46．94％，P〈0．01）。结论血浆置换是治疗慢性重型肝炎的有效方法。     

加用还原型谷胱甘肽综合治疗重型肝炎的疗效观察

目的：观察还原型谷胱甘肽（GSH）针剂治疗重型肝炎的疗效。方法：70例重型肝炎分为两组．治疗组35例在综合疗法基础上加用GSH 1200mg加10％葡萄糖250ml静脉滴入，日1次；对照组35例不加用GSH，其余治疗两组相同。结果：治疗组存活27例（77．1％），死亡8例（22．9％）；对照组存活17例（48．6％），死亡18例（51．4％），P〈0．05。结论：加用GSH综合治疗重型肝炎能够提高重型肝炎患者的存活率。     

丁咯地尔、706代血浆、灯盏花素治疗脑供血不足临床观察

目的观察丁咯地尔、706代血浆、灯盏花素治疗脑供血不足临床效果。方法随机将76例脑供血不足患者分为治疗组41例，对照组35例。对照组采用倍他司汀500ml、川芎嗪120mg、维生素B6，静脉滴注，1次／d；治疗组则改为生理盐水250ml、丁咯地尔200mg静脉滴注，同时使用706代血浆300ml、灯盏花素20mg静点，1次／d。两组均同时使用20％甘露醇125ml，2次／d静点，使用3d。两组治疗后7d观察效果。结果治疗组治愈率、显效率分别为51％、39％，明显高于对照组的34％、31％（P〈0．05），且经颅多普勒（TCD）检查经治疗后脑动脉流速改善优于对照组。结论观察丁咯地尔、706代血浆、灯盏花素治疗脑供血不足临床效果良好。     

酚妥拉明联合谷胱苷肽治疗慢性重型肝炎疗效观察

目的 应用酚妥拉明联合还原型谷胱甘肽（GsH）辅助治疗慢性重型肝炎32例，以评价疗效。方法 选择慢性重型肝炎64例，根据治疗方法的不同平均分为两组，对照组给常规综合治疗，治疗组在常规综合治疗基础上加用酚妥拉明10mg加入甘利欣一组水中静滴，GSHl．2g溶于5％的GS250ml静脉滴注，每日1次，持续1个月。结果 治疗组与对照组比较存活率明显提高（P〈0．05），肝功能显著改善（P〈0．01）。结论 早期、足量应用GSH联合酚妥拉明能改善慢性重型肝炎患者的肝功能．提高生存率，其效果明显优于对照组，且安全有效，有较高的性价比，值得临床推广应用。     

血浆置换治疗慢性重型肝炎的疗效研究

目的探讨血浆置换（PE）治疗慢性重型肝炎的疗效。方法将70例慢性重型肝炎住院患者随机分为PE组和对照组,PE组在内科综合治疗基础上联合PE,对照组仅给予内科综合治疗,疗程为1个月。结果PE组在TBil、ALT、CHO、CHE、PTA、BUN及Cr方面改善明显优于对照组（P〈0．05）;PE组总有效率为62．86％,对照组为31．43％,PE组明显高于对照组（P〈0．05）;住院期间内PE组死亡率为11．42％,而对照组高达31．42％,两者比较差异有统计学意义（P〈0．05）。结论PE联合内科综合治疗可以明显提高慢性重型肝炎的治疗效果,是一种安全可靠的治疗方法。     

马来酸桂哌齐特联用依达拉奉治疗急性脑梗死临床疗效观察

目的观察马来酸桂哌齐特联用依达拉奉治疗急性脑梗死的临床疗效、血脂及红细胞压积等指标改变。方法将86例脑梗死患者随机分为治疗组40例和对照组46例。治疗组应用马来酸桂哌齐特320mg＋生理盐水500ml静脉滴注，每天1次；依达拉奉30mg＋生理盐水100ml静脉滴注，每天2次，连用2厨。对照组予血栓通0．45g＋生理盐水250ml加胞磷胆碱0．5g＋生理盐水100m静脉滴注，每天1次，连用2周。记录治疗前后2组血脂及红细胞压积等指标，并进行疗效评定。治疗前及治疗后28d进行神经功能缺损（ESS）评分。结果2组治疗后总胆固醇、三酰甘油、低密度脂蛋白、红细胞压积、纤维蛋白原均低于治疗前，但仅治疗组治疗前后差异有统计学意义（P〈0．05），且治疗后各项指标均低于对照组，差异均有统计学意义（P〈0．05）；治疗组总有效率为90．0％高于对照组的71．7％，差异有统计学意义（P〈0．05），治疗组治疗后ESS评分高于治疗前和对照组，差异均有统计学意义（P〈0．05）。结论马来酸桂哌齐特联用依达拉奉治疗急性脑梗死疗效确切，安全可靠。     

依达拉奉治疗急性脑梗死40例近期疗效观察

目的观察依达拉奉治疗急性脑梗死的近期疗效。方法将80例急性脑梗死患者随机分为治疗组和对照组各40例，对照组给予血塞通针0．45g加入生理盐水250ml静脉滴注，每天1次，并口服阿司匹林肠溶胶囊0．1g，每晚1次，连用14d；治疗组则在此基础上加用依达拉奉30mg加入生理盐水100ml静脉滴注，每天2次，连用10—14d。2组治疗前后均进行神经功能缺损程度评分（NDS）及临床疗效评定。结果治疗组总有效率为90％（36／40），明显高于对照组67．5％（27／40），差异有显著性（P〈0．05）。2组治疗后NDS评分较治疗前下降，治疗组优于对照组，差异有统计学意义（P〈0．05）。结论依达拉奉是一种治疗急性脑梗死的有效而安全的药物。     

丁咯地尔加血塞通治疗急性脑梗死临床分析

目的 观察丁咯地尔加血塞通治疗急性脑梗死的疗效。方法 采用随机分组对照试验方法，将62例急性脑梗死患者随机分为观察组与对照组，其中观察组32例，丁咯地尔100mg加入5％葡萄糖或生理盐水250ml静脉滴注。每日1次；血塞通500mg加入5％葡萄糖或生理盐水250ml静脉滴注，每日1次，联用14d；其他治疗措施同对照组。对照组30例，给予胞二磷胆碱静脉滴注，口服肠溶阿斯匹林100mg，每日1次等常规治疗。结果 观察组与对照组显效率分别为81．3％（26／32）及50．0％（15／30）（P〈0．01），2组治疗后神经功能缺损评分比较，差异有显著性（P〈0．05）。结论 丁咯地尔加血塞通治疗急性脑梗死有明显神经功能改善作用。     

血浆置换治疗重型肝炎临床分析

目的：探讨血浆置换（PE）治疗重症肝炎的临床疗效。方法：对32例重型肝炎患者在内科治疗基础上采用PE治疗,选择同期没有进行PE治疗的重型肝炎33例为对照组。结果：PE治疗组患者及临床症状,实验室检查指标及成活率均获得改善,其改善程度普遍优于对照组（P〈0．05或P〈0．01）。结论：PE治疗重型肝炎是一种安全、有效的方法。     

前列地尔治疗慢性重型肝炎65例临床疗效观察

目的探讨前列地尔对重型肝炎的疗效。方法107例慢性重型肝炎患者随机分为治疗组65例,对照组42例。对照组予常规内科综合治疗（应用甘草酸制剂、门冬氨酸钾镁、还原型谷胱甘肽、促肝细胞生长素、白蛋白、血浆等）,治疗组在综合治疗基础上加用前列地尔10～20ug,溶于5％葡萄糖注射液100ml中静脉滴注,1次／d,疗程为4周。结果治疗组对重型肝炎的有效率为70．76％,对照组有效率为35．71％,差异有统计学意义（P〈0．001）;治疗组疗程结束后TBIL、r-GT下降和PTA升高的幅度等改变与对照组比较差异有统计学意义（P〈0．005）。结论前列地尔临床应用安全性高,及早给药对慢性重型肝炎有较好疗效,尤其在降低血清胆红素和改善凝血酶原活动度方面,可作为内科综合疗法的主要药物之一。     

Therapy with macrolides in patients with cystic fibrosis

Cystic fibrosis affects 1/2500 individuals and is the most common lethal autosomal recessive disease in people of northern European descent. It is characterized by chronic infections with mucoid Pseudomonas aeruginosa and progressive deterioration of respiratory function. Much research has focused on the inflammatory component of the disease. Macrolide antibiotics are postulated to suppress inflammatory mediators and interfere with biofilm formation produced by P. aeruginosa. In vitro studies show promising results, and a limited number of human studies reported improvements in respiratory function with the drugs. Macrolide antibiotics are generally safe and well tolerated and may prove to be effective in patients with cystic fibrosis.     

Oxazepam pharmacokinetics in patients with epilepsy treated long-term with phenytoin alone or in combination with phenobarbitone

The pharmacokinetics and serum protein binding of oxazepam, a drug mainly eliminated by a single step glucuronidation reaction, were studied in nine epileptic patients treated long-term with phenytoin or phenytoin with phenobarbitone, and in nine healthy control subjects. Oxazepam elimination half-life was shorter and apparent oral clearance higher in treated patients than in age and sex matched control subjects. Serum bilirubin concentration was lower in treated patients. There was no significant correlation between serum bilirubin concentrations and oxazepam elimination. Serum alpha 1-acid glycoprotein concentration was higher in the treated patients than in the control group. Oxazepam was more than 93% bound to serum proteins, but the extent of binding was not significantly different between the two groups. These results show that oxazepam glucuronyl transferase activity is increased by treatment with phenytoin alone or in combination with phenobarbitone in epileptic patients.     

Tenoxicam compared with diclofenac in patients with ankylosing spondylitis

A randomized study was performed on 24 patients with ankylosing spondylitis to compare the efficacy and tolerability of 20 mg tenoxicam daily with 50 mg diclofenac twice daily. There were 6 withdrawals from the group taking tenoxicam and 4 from the diclofenac group. Depression in 1 patient taking tenoxicam was the only significant adverse event. Both drugs were otherwise well tolerated. Tenoxicam and diclofenac were rated as good or excellent by 27% and 55% of patients, respectively. Global assessment, pain and duration of morning stiffness were improved with both drugs but this improvement was not statistically significant and there was no statistically significant difference between the two groups. This study confirms that tenoxicam is effective and well tolerated but larger numbers would be required to detect a small difference between groups.     

Controlled-release naproxen compared with isoxicam in patients with osteoarthritis

The therapeutic efficacy and tolerability of a new controlled-release 1000 mg tablet of naproxen (naproxen CR) were compared with 200 mg isoxicam in 100 out-patients with osteoarthritis. Medications were administered once daily for 4 weeks in a controlled, randomized, double-blind, parallel trial. Patients were assessed for duration of stiffness, global pain, pain in the worst affected joint, night pain, pain on full passive movement, and pain on selected activity. No statistically significant differences were found between naproxen CR and isoxicam for any of the efficacy variables. Only 3 patients (2 with naproxen CR, 1 with isoxicam) reported adverse events, all mild to moderate; no patient withdrew from the study. At the conclusion of the study, patients and physician evaluated therapeutic response independently; both drugs provided steady improvement as judged by patients and physician. Both physician and patients evaluated naproxen CR as very good or good for 36 (72%) patients, and isoxicam as good or very good for 35 (73%) patients. Naproxen CR and isoxicam proved equally effective and well-tolerated for the treatment of osteoarthritis in this study.     

Satisfaction with information and its relationship with adherence in patients with chronic pain

□ Due to the nature of chronic pain it would be expected that patients are highly adherent to their pain medication. However, results from this study have shown that 23 per cent of patients often or always avoid using their pain medication, 13.4 per cent often or always alter dosages, and 10.3 per cent often or always stop taking their medication for a while. This suggests intentional non‐adherence to pain medication □ Less than 50 per cent of respondents were satisfied with information provided on side effects, what to do if side effects occur, and possible interactions with other medication □ Patients' satisfaction with information about their medication was related to self‐reported adherence; greater satisfaction was associated with higher self‐reported adherence     

Genomic profiling associated with recurrence in patients with rectal cancer treated with chemoradiation

PURPOSE: Stage II and III adenocarcinoma of the rectum has an overall 5-year survival rate of approximately 50%, and tumor recurrence remains a major problem despite an improvement in local control through chemotherapy and radiation. The efficacy of chemoradiation therapy may be significantly compromised as a result of interindividual variations in clinical response and host toxicity. Therefore, it is imperative to identify those patients who will benefit from chemoradiation therapy and those who will develop recurrent disease. In this study, we tested whether a specific pattern of 21 polymorphisms in 18 genes involved in the critical pathways of cancer progression (i.e., drug metabolism, tumor microenvironment, cell cycle regulation, and DNA repair) will predict the risk of tumor recurrence in rectal cancer patients treated with chemoradiation. PATIENTS AND METHODS: A total of 90 patients with Stage II or III rectal cancer treated with chemoradiation were genotyped using polymerase chain reaction (PCR)-based techniques for 21 polymorphisms. RESULTS: A polymorphism in interleukin (IL)-8 was individually associated with risk of recurrence. Classification and regression tree analysis of all polymorphisms and clinical variables developed a risk tree including the following variables: node status, IL-8, intracellular adhesion molecule-1, transforming growth factor-beta, and fibroblast growth factor receptor 4. CONCLUSION: Genomic profiling may help to identify patients who are at high risk for developing tumor recurrence, and those who are more likely to benefit from chemoradiation therapy. A larger prospective study is needed to validate these preliminary data using germline polymorphisms on tumor recurrences in rectal cancer patients treated with chemoradiation.     

Treatment with ketoconazole in diabetic patients with vaginal candidiasis

Thirty-two diabetic patients with vaginal candidiasis were treated orally with 400 mg ketoconazole once daily for five days. At the end of the treatment period symptoms had disappeared and cultures for Candida were negative in 18 patients; a total of 28 reported improved symptoms. One month later 15 patients were still negative for Candida and 24 showed improved symptoms. The remaining 8 repeated the course of treatment; 6 became negative while 2 cases remained refractory to treatment. It was concluded that these encouraging results and low relapse rates indicate ketoconazole as a drug of first choice for candidiasis in patients with predisposing conditions such as diabetes.