心肌钙蛋白I在溶栓治疗中的临床观察

目的　观察急性心肌梗塞 (AMI)溶栓后血管再通和未通者与未溶栓者血清肌钙蛋白的动态变化。方法　定量测定 94例AMI患者的心肌肌钙蛋白I(cTnI) ,以 >10 0ng/L作为阳性判定值。 结果　溶栓再通者cTnI峰值较未通组与未溶组显著增高 (P <0 .0 5 ) ,且峰值增大 ,峰值时间提前 8小时 ,再通组cTnI恢复正常时间平均为 (130± 38)小时 ,较未通者提前 6 0小时。结论　溶栓后动态测定血清cTnI浓度、峰值时间 ,可作为判断溶栓成功的指标之一     

急性心肌梗塞溶栓治疗相关动脉再灌注对QT离散度的影响

目的　探讨急性心肌梗塞 (AMI)患者溶栓治疗相关动脉再灌注对 QT离散度 (QTd)的影响。方法　 6 2例 AMI患者分为溶栓再通组、未通组及非溶栓组 ,测量溶栓前后 QTd,并进行比较。结果　 AMI溶栓前溶栓组 (6 5 .6± 13.9) ms与非溶栓组 (6 3.2± 18.2 ) m s QTd 差异无显著性 (P>0 .0 5 ) ,溶栓治疗再通后 ,QTd明显减小。溶栓未通组及非溶栓组 (4 6 .7± 11.6 ) ms、(4 7.5± 13.2 ) ms,显著高于溶栓再通组 (31.4± 9.4) ms,(P<0 .0 1)。伴心室颤动者 QTd(70 .6± 16 .2 ) ms明显高于不伴心室颤动者 (4 7.9± 13.5 ) ms,(P<0 .0 1)。结论　急性心肌梗塞溶栓治疗相关动脉再灌注后 QTd 明显减小 ,心室颤动的发生率降低。     

老年COPD患者血浆内皮素和降钙素基因相关肽水平测定

目的研究血浆内皮素 (ET 1)和降钙素基因相关肽 (CGRP)对慢性阻塞性肺病 (COPD)的影响 ,以探讨其改变在COPD病理生理过程中的作用。方法测定 4 8例老年COPD患者及健康对照组 30例ET 1及CGRP水平 ,并将COPD组分为急性发作期 (A组 ) 34例及临床缓解期 (B组 ) 14例 ,测定A组治疗前后血浆ET 1、CGRP水平 ,以及PoO2 、SaO2 浓度。结果老年COPD组血浆ET 1(41 2 5±2 1.4 3ng L)明显高于对照组 (2 7.2 1± 12 .73ng L)老年COPD组血浆CGRP(6 7 2 6± 31.6 0ng L)明显高于对照组 (39 75± 7.85ng L) ,二者与对照组相比较 ,差异均有显著意义 (P <0 0 1)。COPDA组治疗前后血浆ET 1、CGRP比较 ,治疗后ET 1水平 (35 11± 13.0 6ng L)较治疗前降低 (6 3 4 7± 2 9.12ng L) ,差异有显著意义 ,CGRP治疗后水平 (112 4 2± 71.87ng L)较治疗前升高 (84 12± 36 .0 9ng L) ,差异有显著意义。并且ET 1水平与动脉血氧分压 (PaO2 )及血氧饱和度 (SaO2 )呈负相关 ,CGRP水平与PaO2 、SaO2 呈正相关。结论缺氧状态下的ET 1、CGRP的失衡是影响COPD的重要病理生理改变     

心肌钙蛋白Ⅰ在溶栓治疗中的临床观察

目的观察急性心肌梗塞(AMI)溶栓后血管再通和未通者与未溶栓者血清肌钙蛋白的动态变化.方法定量测定94例AMI患者的心肌肌钙蛋白I(cTnI),以＞100ng/L作为阳性判定值.结果溶栓再通者cTnI峰值较未通组与未溶组显著增高(P＜0.05),且峰值增大,峰值时间提前8小时,再通组cTnI恢复正常时间平均为(130±38)小时,较未通者提前60小时.结论溶栓后动态测定血清cTnI浓度、峰值时间,可作为判断溶栓成功的指标之一.     

内皮素和降钙素基因相关肽与扩张型心肌病的相关性

为探讨血浆内皮素 (ET)和降钙素基因相关肽 (GGRP)与扩张型心肌病 (DCM )的相关性 ,应用放射免疫分析法测定DCM治疗前后的ET和CGRP水平。结果 ,DCM组ET治疗前 ( 91 .2±2 2 .52 )ng/L ,治疗后为 ( 71 .2 1± 2 4 .64)ng/L均显著高于对照组 ( P <0 .0 1 .P <0 .0 5) ,CGRP水平治疗前为 ( 1 36.82± 2 1 .36)ng/L ,高于对照组的 ( 1 0 8.2 6± 1 3.2 8)ng/L(P <0 .0 1 ) ,治疗后为 ( 1 1 4 .54±1 7.2 6)ng/L ,差异不显著 ( P >0 .0 5)。结果提示 ,ET及CGRP水平与DCM病情相关 ,检测DCM患者ET及CGRP水平有助于判断病情。     

急性心肌梗死静脉溶栓的临床观察

目的 观察静脉溶栓治疗对急性心肌梗死(AMI)患者的预后的影响.方法 将144例AMI患者分为尿激酶静脉溶栓再通组42例,未通组24例和对照组78例.比较分析溶栓再通与未通及非溶栓治疗的AMI患者住院期间的临床疗效.结果 显示溶栓再通组在住院期间2～3周内死亡率明显低于非溶栓组及未通组(P＜0.05),且心绞痛、心力衰竭及严重的心律失常的发生率,溶栓再通组低于未通组及非溶栓组.临床判断梗死相关血管再通率为64%(42/66),0～6 h梗死相关血管溶栓再通率为67%(37/56),6～12 h为50%(5/10).溶栓组无1例过敏反应.结论 用尿激酶静脉溶栓治疗急性心肌梗死是一种安全有效的方法,溶栓治疗能显著改善AMI患者急性期预后,即使临床间接指征判断未通者,其部分指标优于对照组.     

甲状腺功能亢进症患者血浆内皮素一氧化氮水平的变化及其临床意义

目的 :探讨甲状腺功能亢进症患者血浆内皮素 (ET)、一氧化氮 (NO)水平变化。方法 :应用放射免疫法及分光比色法测定了 5 0例甲亢患者及 30例正常对照者血浆 ET、NO浓度。结果 :甲亢患者血浆 ET(15 8.4 7± 4 1.4 3) ng/ L 较正常对照组(4 9.36± 9.6 8) ng/ L 明显升高 (P <0 .0 1)。甲亢患者血浆 NO(1.96± 0 .5 7μmol/ L)较正常对照组 (0 .87± 0 .38) μm ol/ L 明显升高 (P <0 .0 1)。结论 :血浆 ET、NO浓度变化在甲亢的病理生理过程起一定作用。     

95例急性冠脉综合征患者血浆同型半胱氨酸、内皮素和肌钙蛋白水平的分析

目的　探讨急性冠脉综合征 (ACS)患者血浆同型半胱氨酸 (Hcy)、内皮素 (ET- 1)水平变化以及与肌钙蛋白 (c INI)的关系。方法　采用荧光衍生后高效液相色谱法、放免法、免疫荧光法分别测定 4 5例不稳定型心绞痛 (UA)、 4 0例急性心肌梗塞 (AMI)和 4 0例正常人血浆 Hcy、ET- 1和 c INI水平。结果　 U A组和 AMI组的Hcy水平分别为 12 .4 978± 3.4 5 0 7mol/L 和 18.8175± 4 .6 988μmol/L;ET- 1水平分别为 6 8.6 4 6 7± 2 0 .8886 ng/L和 89.7332± 2 7.384 2 ng/L ;c IN I水平分别为 1.2 16 8± 0 .80 11ng/m l和 2 8.5 380± 2 1.10 2 9ng/m l;均明显高于正常对照组的 5 .892 5± 1.6 32 0 μm ol/L、 5 7.70 0 0± 2 0 .0 6 6 9ng/L、 0 .0 2 7± 0 .0 2 1ng/ml,有非常显著差异 (P<0 .0 0 1或 P<0 .0 5 )。而 AMI组又明显高于 UA组 ,差异有显著性 (P<0 .0 0 1)。结论　监测 Hcy、ET- 1和 c IN I,对 ACS防治有指导作用 ,可减少心脏事件的发生和判断预后。     

肝硬化患者血中NO、ox-LDL及ET-1的水平

目的　探讨NO、ox LDL及ET 1在肝硬化时的变化及其与肝功能的关系。方法　采用分光光度法和酶联免疫吸附法以及放射免疫分析法分别测定了 5 4例肝硬化患者血中的NO、ox LDL和ET 1水平 ,并与 6 8名正常人进行了对比分析。结果　表明肝硬化组NO、ox LDL、ET 1分别为 (1.34±0 .2 5 ) μmol/L、(0 .48± 0 .0 8)mg/L、(17.5 1± 3.5 6 )ng/L均显著高于正常人组的 (0 .6 6± 0 .18) μmol/L、(0 .32± 0 .0 7)mg/L、(6 .0 7± 1.45 )ng/L(P <0 .0 5 )。且NO、ox LDL及ET 1的含量与肝功能分级相平行。结论　提示NO、ox LDL和ET 1水平的变化可作为评估肝硬化患者病情轻重的指标。     

急性心肌梗死溶栓再通对左室重构及左室功能的影响

目前 ,溶栓治疗已广泛应用于急性心肌梗死的患者 ,溶栓再通 ,能缩小梗死面积 ,挽救濒死心肌。本文通过观察再通组心室容积及心功能的变化 ,并与溶栓未通组及未溶栓组进行对比 ,来探讨溶栓再通对左室重构及功能的影响。1　资料与方法1.1　临床资料 :我院 1997年 1月至 1999年 12月急性心肌梗死患者 86例 ,溶栓的条件给药方法及再通的判定参照国内 1996年 7月修订的急性心肌梗死溶栓疗法参考方案 [1 ] 。其中符合条件 6 1例。给予尿激酶 15 0万 U于 0 .5 h内静脉滴入。再通 46例 ,未通 15例。再通组男 43例 ,女 3例 ,平均年龄 (6 2± 10 )岁…     

Affective and Anxiety Disorders and Alcohol and Drug Dependence:

Depression and anxiety frequently coexist in patients with substance use disorders. This clinically-oriented article examiens the relationship between these conditions and emphasizes data showing that substances of abuse can cause signs and symptoms of both depression and anxiety. These substance-related syndromes appear to have a different course and prognosis than uncomplicated, independent anxiety and major depressive disorders, and clinicians should consider the role of alcohol and other drugs in all patients presenting with these complaints. The authors will also outline an approach for diagnosing and managing patients with the combination of a substance use and depressive or anxiety disorder.     

Synthesis and anti-nociceptive and anti-inflammatory effects of gaultherin and its analogs

The synthesis of gaultherin (1) and its analogs was carried out to provide 11 glycosides under phase-transfer catalytic conditions. The activities of all synthesized compounds were evaluated by nitric oxide production inhibitory assay in vitro. Methyl 2-O-(4-O-β-d-galactopyranosyl)-β-d-glucopyranosylbenzoate (5f) showed significantly anti-nociceptive and anti-inflammatory effects by the evaluation in vivo. Structure–activity relationships within these compounds were discussed.     

Modelling and simulation of variability and uncertainty in toxicokinetics and pharmacokinetics

Two important methodological issues within the framework of the variability and uncertainty analysis of toxicokinetic and pharmacokinetic systems are discussed: (i) modelling and simulation of the existing physiologic variability in a population; and (ii) modelling and simulation of variability and uncertainty when there is insufficient or not well defined (e.g. small sample, semiquantitative, qualitative and vague) information available. Physiologically based pharmacokinetic models are especially suited for separating and characterising the physiologic variability from the overall variability and uncertainty in the system. Monte Carlo sampling should draw from multivariate distributions, which reflect all levels of existing dependencies in the intact organism. The population characteristics should be taken into account. A fuzzy simulation approach is proposed to model variability and uncertainty when there is semiquantitative, qualitative and vague information about the model parameters and their statistical distributions cannot be defined reliably.     

成骨细胞的功能与损伤和骨质疏松的防治

骨质疏松是一种全身性骨骼疾病,导致骨折风险增加。成人的骨量通过破骨细胞的骨吸收和成骨细胞的骨形成作用来维持动态平衡,治疗骨质疏松症的理想策略是抑制破骨细胞的骨吸收和/或增强成骨细胞的骨形成功能。目前针对保护成骨细胞及增强其功能的骨质疏松疗法相对较少。因此,本文针对成骨细胞相关功能蛋白、各种细胞损伤机制（内质网应激、氧化应激、机械过载、微小RNA和长链非编码RNA的影响等）及骨质疏松的治疗与预防作一综述,以期为针对增强成骨细胞功能的骨质疏松治疗策略提供新思路。     

Self-stimulation and amphetamine: Tolerance to d and l isomers and cross tolerance to cocaine and methylphenidate

The effects of the d and l isomers of amphetamine on self-stimulation responding were tested following acute and chronic administration. Tolerance and post-drug depression of responding occurred in tests with both isomers, indicating no role for p-hydroxynorephedrine (PHN) which is one of the metabolites of d-amphetamine. In the second experiment, d-amphetamine, methylphenidate and cocaine all produced quantitatively and qualitatively similar effects on self-stimulation responding following acute administration. Following chronic administration of d-amphetamine, animals showed tolerance to all three drugs, indicating cross-tolerance among them. These data are consistent with an hypothesis that tolerance and post-drug depression following chronic amphetamine treatment are the result of decreases in postsynaptic receptor sensitivity, which would lead to a decreased effectiveness of all three drugs, regardless of their pre-synaptic mechanisms.     

益生菌与肿瘤防治

益生菌广泛存在于自然界中,通过维持宿主体内菌群平衡、影响肠屏障功能和调节免疫应答等作用,提高宿主健康水平,被公认为"肠道健康卫士".一些益生菌可以增强机体的免疫功能,抑制致癌物质,影响肿瘤细胞的基因表达,对肿瘤具有拮抗作用.大量研究表明,益生菌在未来的肿瘤防治中有很好的应用和发展前景.     

Acamprosate and naltrexone treatment effects on ethanol and sucrose seeking and intake in ethanol-dependent and nondependent rats

Rationale  Two pharmacotherapies are approved for treating alcohol craving (acamprosate and naltrexone), but both have shown mixed findings in animals and humans. Objectives  The present experiments utilized a “reinforcer blocking” approach (i.e., rats were able to consume ethanol during treatment) to better understand the efficacy of these treatments for ethanol seeking and drinking using ethanol-dependent and nondependent rats. Materials and methods  In “nondependent” experiments, drugs (acamprosate 50, 100, and 200 mg/kg; naltrexone 0.1, 0.3, and 1.0 mg/kg) were administered over 3-week periods prior to operant sessions with a low response requirement to gain access to reinforcers for 20 min. For “dependent” experiments, rats were made dependent in vapor/inhalation chambers. Results  Acamprosate and naltrexone had similar effects on intake in nondependent and dependent rats; neither drug was selective for ethanol over sucrose drinking. In nondependent animals, naltrexone was more efficacious at more doses than acamprosate, and acamprosate’s effects were limited to a dose that also had adverse effects on body weight. Both pharmacotherapies showed more selectivity when examining reinforcer seeking. In nondependent rats, acamprosate and naltrexone had response-attenuating effects in ethanol, but not sucrose, groups. In dependent animals, acamprosate had selective effects limited to a decrease in sucrose seeking. Naltrexone, however, selectively decreased ethanol-seeking in nondependent rats. Conclusions  The naltrexone-induced decreases in seeking suggested a change in incentive motivation which was selective for ethanol in nondependent rats. The “nondependent” paradigm may model early stages of “problem drinking” in humans, and the findings suggest that naltrexone could be a good intervention for this level of alcohol abuse and relapse prevention.     

Antiinfective and encrustation-inhibiting materials--myth and facts

Catheters, urethral and ureteral stents and other urological implants are frequently affected by encrustration and infection due to their permanent contact with urine. Indwelling urinary catheters provide a haven for microorganisms and thus require extensive monitoring. Several surface modification techniques have been proposed to improve the performance of devices including the immobilization of biomolecules, the incorporation of hydrophilic grafts to reduce protein adsorption, the creation of hydrophobic surfaces, the creation of microdomains to regulate cellular and protein adhesion, new polymers and antimicrobial coatings. Physico-chemical explanation to elucidate the mechanism of such encrustation or infection inhibiting materials is still not available. Our series of experiments showed a marked decrease of silver-activity in biological fluids which corresponds with the controversial clinical results obtained with silver coated urinary catheters. Rifampicin/minocycline coated catheters had very low activity against Gram-negative rods, enterococci and Candida spp., the main causing organisms of urinary catheter infection. Surface engineered materials and antimicrobial drug delivery systems will be the next generation of sophisticated urinary catheters and stents, if both efficacy as well as efficiency has been proved clinically.     

Alprazolam and lorazepam single and multiple-dose effects on psychomotor skills and sleep

Summary The effects of alprazolam 0.5 mg and lorazepam 2 mg on cognitive and psychomotor skills were assessed in twelve normal volunteer subjects in a randomised, double-blind, crossover design. Single and multiple dose effects were monitored using a battery of tests comprising critical flicker fusion threshold (CFFT), choice reaction time (CRT), simulated car tracking, and subjective ratings of perceived sedation (LARS) and of sleep behaviour (LSEQ). Compared with placebo baseline scores, treatment with lorazepam 2 mg (both single and multiple doses) resulted in a widespread impairment of CRT, tracking accuracy, and CFFT. Single doses of alprazolam 0.5 mg reduced CFFT with respect to the placebo baseline. Single and multiple dose treatment with both drugs resulted in subjective reports of sedation, a reduction of sleep onset latency, and improved sleep quality. Only lorazepam 2 mg significantly disrupted the integrity of behaviour on waking from sleep. These results suggest important pharmacodynamic differences between the two drugs in the doses used.