多巴酚丁胺负荷试验核素心室造影诊断冠心病的价值

本文对７０例ＣＡＤ患者和３０例正常人进行了ＤＳＴ－ＥＲＮＡ分析。ＣＡＤ组负荷前ＬＶＥＦ的敏感性，特异性与准确率为６５．７％、９６．７％、７５．０％，ＲＥＦ为７４．３％、８６．７％、７８．０％，ＲＷＭ为７４．３％、９Ｏ．０％、７９．Ｏ％，ＰＦＲ为６４．３％、１００％、７５．０％；负荷后ＬＶＥＦ为８８．６％、９０．０％、８９，０％，ＲＥＦ为９２．８％、９３．３％、９３．３％，ＲＷＭ为９２．８％、９３．３％、９３．３％，ＰＦＲ为８８．６％、９０．０％、８９．Ｏ％。ＤＳＴ－ＥＲＮＡ用于诊断ＣＡＤ具有与ＳＥＥＴ同样的敏感性与特异性，且弥补了ＳＥＥＴ方法的不足。ＲＥＦ、ＲＷＭ、ＰＦＲ异常早发于ＬＶＦＦ异常和ＥＣＧＳＴ－Ｔ改变，是诊断ＣＡＤ的敏感指标     

G-CSF支持大剂量化症治疗晚期恶性肿瘤的临床观察(附23例分析)

23例晚期肿瘤病人接受G-CSF支持的大剂量化疗，剂量强度达2．0～2．5，总有效率达91．3％，CR率达56．5％，其中非何杰金淋巴瘤CR为83．3％，睾九肿瘤CR率为100％，乳腺癌CR率为40％，肺癌CR为28．6％，滑膜肉瘤CR率为100％，食管癌CR率为50％。骨髓抑制达Ⅲ～N度，感染发生率17．4％，GPT、BUN、Cr升高均为-过性。     

儿童先天性畸形267例病理分析

1553例儿童尸检中发现各种先天性畸形267例，检出率为17．19％，其中围产儿尸检495例，畸形122例，检出率为24．65％，男165例，女102例，男女之比为1．6：1。按病种以骨骼肌肉系统为最多（20．47％），按系及部位数，以消化系统为最多（20．11％）。单一畸形133例（49．81％），多发畸形134例（50．19％），二者基本相等。多数畸形发生于体内（65．92％），其次为体表（22．47％），二者并存者较少（11．61％）。根据畸形对健康的影响程度，分为0、＋、＋＋、＋＋＋四类，分别占15．36％、13．11％、34．83％及36．70％。本文还对尸检在畸形检查中的重要性，进行了讨论。     

普通内科门诊76例急性腹痛的诊治观察

目的：分析急性腹痛诊治情况，腹痛原因、特点与治疗方法。方法：选取我院普内科收治的76例急性腹痛患者为研究对象，采用回顾性方式分析患者临床症状，总结病因和治疗方法。结果：本组患者中有16名为急慢性胃炎，占21．05％，11例为消化性溃疡，占14．47％，9例为急性胃肠炎，占11．84％，8例为急性阑尾炎，占10．53％，9例为急性胆囊炎、胆结石，占11．84％，6例为泌尿系结石，占7．89％，5例为胃肠痉挛，占6．58％，2例为尿路感染，占2．63％，急性胰腺炎4例，占5．26％，3例为急性肠梗阻，占3．95％，3例为急性盆腔炎，占3．95％。结论：掌握急性腹痛的原因、特征，及时采取有效的措施对于患者的治疗、帮助患儿恢复健康有着积极作用。     

尿SDS-PAGE在肾脏病中的诊断意义

探讨尿ＳＤＳ—ＰＡＧＥ的临床意义，检测正常人１９０例，肾病综合征（ＮＳ）１２４例，慢性紧炎１３２例，急性肾炎２６例，肾盂肾炎４１例。结果显示，正常人７９．４７％为生理型，２０．５３％为小分子型，ＮＳ２９．０３％为混合型，４８．３９％为大分子型，２２．５８％为中分子型。慢性肾炎４３．９４％混合型，１５．１５％大分子型，３６．３６％小分子型，４．５４％中分子型。急性肾炎３４．６２％大分子型，５７．６９％中分子型，７．７０％混合型。肾盂肾炎７８．０５％小分子型，２１．９５％中分子型。１３例肾小球肾炎患者病理检查结果：５例混合型，６例大分子型病理损害均在２～４级，２例中低分子型病理损害均在１～２级，提示尿ＳＤＳ—ＰＡＧＥ检测结果与病理损害程度结果基本相符，此法可作为初步判断肾脏损害程度的参考依据     

老年人血脂异常调查分析

目的 了解老年人血脂异常的现况。方法 通过对2004年862位50～80岁的老年人体检化验血脂各组分结果进行回顾分析。结果 体检老年人的血脂各组分中，总胆固醇（TC）、甘油三脂（TG）、低密度脂蛋白胆固醇（LDL-C），男性均高于女性（P〈0．01）。血脂异常的总患病率为57．78％（男性为68．22％，女性52．25％，P〈0．01）；最常见的是高TC血症为37．52％（男性为43．64％，女性为34．2。7％，P〈0．05）。单种血脂异常率为21．0％（男性为22．0％，女性为19．1％）；合并2种血脂异常率为26．4％（男性为33．5％，女性为22．6％）；合并3种血脂异常率为9．7％（男性为7．1％，女性为14．6％）；合并4种血脂异常率为0．4％（男性为1．1％，女性为0．6％）。结论 老年人2种以上脂质成分异常较为常见；老年男性的血脂异常率明显高于女性。     

复方呋喃西林滴鼻凝胶剂的制备

目的：制备复方呋喃西林滴鼻凝胶并对其含量进行测定。方法：以卡波姆-40为乳化剂，三乙醇胺调节pH，制备水溶性透明凝胶。用紫外分光光度法和旋光度法分别测定凝胶剂中呋喃西林和盐酸麻黄碱的含量。结果：制备的凝胶均匀细腻，稠度适宜。呋喃西林的平均含量为98．56％，RSD为1．24％。平均回收率为99．36％，RSD为0．83％，盐酸麻黄碱的平均含量为97．93％，RSD为1．32％。平均回收率为100．36％，RSD为0．67％。结论：该制剂性质稳定，容易吸收，无刺激性，使用方便，测定方法简单易行，快速准确。     

药物治疗甲真菌病的临床应用分析

目的：综述药物治疗甲真菌病的临床应用分析。方法：检索1995年-2005年3月MEDLINE网站收入的药物治疗甲真菌病的Meta分析，系统综述10个Meta分析4种口服药物（灰黄霉素、伊曲康唑、特比萘芬、氟康唑）和一种外用药物（环吡酮）治疗甲真菌病的临床证据。结果：灰黄霉素、伊曲康唑、特比萘芬、氟康唑、环吡酮真菌学治愈率分别为24．5％～68％，56．5％～93％，74％～96．5％，48％～65．6％，29％～85．7％；临床治愈率为33．7％～41oA．70％，70％，45％～66．5％，52％；复发率为40％．10．4％～21％，15％，4．4％，20．7％；治疗总费用（美元）为569．00～1470．70，713．00～1783．00，422．00～1106．00，1005．24，361．12～682．00；费用／真菌学治愈率为837．00～3578．40，767．00～2215．60，454．00～1233．90，1532．40，686．50。结论：特比萘芬是一种较经济有效的治疗甲真菌病口服药物，环吡酮甲涂剂是一种较好的外用药物，伊曲康唑冲击疗法明显降低了治疗成本。     

芦氟沙星与洛美沙星随机对照治疗急性细菌性感染

通过芦氟沙星与洛美沙星随机对照治疗急性细菌性感染，评价前者的安全性、有效性。芦氟沙星治疗呼吸道、泌尿道及皮肤软组织感染４６例，洛美沙星治疗相应系统感染４９例。结果显示芦氟沙星组与洛美沙星组不同病种的临床痊愈率为７６．０９％与６７．３５％，有效率为９３．４８％与９０．００％；两组的细菌清除率为９２．６８％与９７．６２％；不同细菌所致感染的临床痊愈率为７８．０５％与７８．５７％，有效率为９２．６８％与９５．２４％；所分离细菌的纸片敏试高敏率为８３．１３％与９１．５７％；不良反应发生率分别为１３．０４％与１２．２４％，两组各对应指标经统计学处理，Ｐ＞０．０５，差异无显著性。表明芦氟沙星作为一种长效氟喹诺酮类抗生素，使用方便，不良反应少，可有效治疗轻中度呼吸系统、泌尿系统及皮肤软组织感染。     

国产盐酸洛美沙星治疗124例泌尿系感染

由二个试验中心采用均衡顺序随机开放方法使用国产盐酸洛美沙星片剂与胶囊，以诺氟沙星片剂对照，治疗１２４例泌尿系感染患者。治愈率和有效率：洛美沙星片剂为８０．５％和９２．７％；洛美沙星胶囊为７６．７％和９３％；诺氟沙星为６５％和８２．５％。片剂和胶囊分别与诺氟沙星比较，治愈率和有效率均无显著性差异。细菌阴转率和清除率：洛美沙星片剂为８５％和８５％，胶囊为７９．１％和７７．３％；带氟沙星为７１．８％和７０．７％。三者比较均无显著性差异。不良反应：洛美沙星发生率为２．３％，诺氟沙星为２．５％，两药均未出现肝、肾功能损害及造血系统功能异常。     

赛庚啶和西咪替丁联合治疗慢性荨麻疹的双盲观察43例

针对人体皮肤血管处存在H_1和H_2受体,联合采用H_1和H_2受体阻滞剂即赛庚啶2mg和西咪替丁400 mg tid睡前加服1次,疗程1mo治疗慢性荨麻疹43例,治愈率为51％,总有效率达95％,与安慰剂进行双盲对照有非常显著差异。作者认为联合用药比单用任何一种更为有效、安全。     

Brivaracetam in the treatment of focal and idiopathic generalized epilepsies and of status epilepticus

Brivaracetam is the latest approved antiepileptic drug in focal epilepsy and exhibits high affinity as SV2A-ligand. More than two thousand patients have received brivaracetam within randomized placebo-controlled trials. Significant median seizure reduction rates of 30.5% to 53.1% for 50 mg/d, 32.5% to 37.2% for 100 mg/d and 35.6% for 200 mg/d were reported. Likewise, 50% responder rates were 32.7% to 55.8% for 50 mg/d, 36% to 38.9% for 100 mg/d and 37.8% for 200 mg/d. Overall, brivaracetam is well tolerated. The main adverse events are fatigue, dizziness, and somnolence. Immediate switch from levetiracetam to brivaracetam at a conversion ratio between 10:1 to 15:1 is feasible, and might alleviate the behavioral side effects associated with levetiracetam. Brivaracetam has the potential to perform as an important, possibly broad-spectrum AED, initially in patients with drug-refractory epilepsies. Its intravenous formulation may be a new and desirable alternative for status epilepticus, but there is so far no experience in these patients.     

Treatment of overactive bladder with once-daily extended-release tolterodine or oxybutynin: the antimuscarinic clinical effectiveness trial (ACET)

Treatment with the antimuscarinic agents tolterodine and oxybutynin is the mainstay of therapy for overactive bladder, a chronic and debilitating condition characterized by urinary urgency with or without urge incontinence, usually in combination with urinary frequency and nocturia. This study consisted of two trials; in one, patients with overactive bladder were randomized to 8 weeks of open-label treatment with either 2 mg or 4 mg of once-daily extended-release tolterodine (TER), and in the other to 5 mg or 10 mg of extended-release oxybutynin (OER). The study protocol and design were identical for the two trials and site selection ensured that there was no bias in either trial for the tendency of investigators to prescribe one drug rather than the other, or for geographical location. A total of 1289 patients were enrolled, 669 in the tolterodine trial (TER 2 mg, n = 333; TER 4 mg, n = 336) and 620 in the oxybutynin trial (OER 5 mg, n = 313; OER 10 mg, n = 307). Fewer patients prematurely withdrew from the trial in the TER 4 mg group (12%) than either the OER 5 mg (19%; p = 0.01) or OER 10 mg groups (21%; p = 0.002). More patients in the OER 10 mg group than the TER 4 mg group withdrew because of poor tolerability (13% vs 6%; p = 0.001). After 8 weeks, 70% of patients in the TER 4 mg group perceived an improved bladder condition, compared with 60% in the TER 2 mg group, 59% in the OER 5 mg group and 60% in the OER 10 mg group (all p < 0.01 vs TER 4 mg). Response to therapy was greater in a subgroup of patients whose perception of bladder condition was moderate to severe at baseline (TER 4 mg 77% vs OER 10 mg 65%; p < 0.01). Dry mouth was dose-dependent with both agents, although differences between doses only reached statistical significance in the oxybutynin trial (OER 5 mg vs OER 10 mg; p = 0.05). Patients treated with TER 4 mg reported a significantly lower severity of dry mouth compared with OER 10 mg. In conclusion, the greater efficacy and tolerability of tolterodine ER 4 mg suggests improved clinical effectiveness compared with oxybutynin ER 10 mg.     

Efficacy and safety of cerivastatin, 0.2 mg and 0.4 mg, in patients with primary hypercholesterolaemia: a multinational, randomised, double-blind study. Cerivastatin Study Group

Elevated serum cholesterol level is a key risk factor for cardiovascular morbidity and mortality. Cerivastatin is a highly effective lipid-lowering agent currently licensed at doses of 0.1, 0.2, 0.3 and 0.4 mg. This was a multicentre, randomised, double-blind, parallel-group study comparing the efficacy and safety of cerivastatin 0.4 mg/day with that of cerivastatin 0.2 mg/day in patients with primary hypercholesterolaemia. There was a six-week placebo run-in phase followed by a 24-week active treatment phase. A total of 494 patients were randomised to receive cerivastatin 0.4 mg (n = 332) or 0.2 mg (n = 162). Per-protocol (PP) analysis revealed that mean low-density lipoprotein cholesterol (LDL-C) level decreased by 38.4 +/- 0.7% from baseline in the 0.4 mg group, compared with a decrease of 31.5 +/- 0.9% in the 0.2 mg group (p < 0.0001). There was a significant gender difference in the 0.4 mg group: LDL-C decreased by 44.4 +/- 8.9% in women, compared with a decrease of 37.0 +/- 0.9% in men (p < 0.046). In the PP group as a whole, total cholesterol decreased by 26.0 +/- 0.5% from baseline in the 0.4 mg group, compared with a decrease of 21.6 +/- 0.7% in the 0.2 mg group (p < 0.0001). Both doses were well tolerated; only eight (2.4%) patients in the 0.4 mg group and five (3.1%) patients in the 0.2 mg group withdrew owing to adverse events. Cerivastatin 0.2 mg/day and 0.4 mg/day was found to lower low-density lipoprotein cholesterol and total cholesterol levels in a dose-dependent manner, with both doses exhibiting a good safety profile.     

Comparison of 1 mg/body and 3 mg/body of intravenous granisetron for the prevention of chemotherapy-induced nausea and vomiting and adverse events in hematological malignancy patients

Granisetron is a selective 5-hydroxy tryptamine3 receptor antagonist and widely used for chemotherapy-induced nausea and vomiting (CINV). Recommended dose of intravenous granisetron in the USA and Europe has been set at 0.01 mg/kg (1 mg/body) in the antiemetic treatment guidelines established by the American Society of Clinical Oncology and National Comprehension Cancer Network. In contrast, the approved dose in Japan is 0.04 mg/kg (3 mg/body). Randomized controlled trials (RCTs) which compared 1 mg/body with 3 mg/body of intravenous granisetron for CINV had been reported in Japan. In these RCTs, however, hematological malignancy patients were excluded. We performed observational retrospective study to compare 1 mg/body with 3 mg/body of intravenous granisetron for the prevention of CINV and adverse events in hematological malignancy patients. Number of the patients and chemotherapy courses were 15 and 30 in the 1 mg/body group, and 15 and 27 in the 3 mg/body group, respectively. No nausea rates in the 1 and 3 mg/body group were 83% and 89% of courses, respectively. No vomiting rates in the 1 and 3 mg/body group were 97% and 100% of courses, respectively. The incidences of constipation in the 1 and 3 mg/body group were 34% and 45% of courses, respectively. Anaphylaxis and headache did not occur in both groups. Our findings suggested that 1 mg/body of intravenous granisetron can prevent from CINV in hematological malignancy patients, as well as 3 mg/body.     

Perampanel in the treatment of focal and idiopathic generalized epilepsies and of status epilepticus

Perampanel is the latest approved antiepileptic drug in focal and generalized epilepsies and has a distinct and selective mode of action on AMPA-receptors. Several thousand patients have received perampanel within randomized placebo-controlled trials, open-label extension trials and post-marketing observational studies. Significant median partial-onset seizure reduction rates of 23% for 4 mg/day, 26–31% for 8 mg/day and 18–35% for 12 mg/day were reported. Likewise 50 percent responder rates were 29% for 4 mg/day, 33–38% for 8 mg/day and 34–36% for 12 mg/day. Primary generalized tonic–clonic seizures were reduced by 76.5% (8 mg) vs 38.4% (placebo) in a recent controlled trial. Overall, perampanel is well tolerated and the main adverse events are dizziness, somnolence and fatigue. There are also anecdotal reports on use in progressive myoclonic epilepsies and status epilepticus. Perampanel will likely remain an important, possibly broad-spectrum AED with a significant market share, especially in patients with drug-refractory epilepsies.     

白鹃梅嫩叶及花序中营养成分分析

目的对白鹃梅嫩叶及花序的主要营养成分进行分析,为白鹃梅嫩叶及花序的进一步开发利用提供参考。方法运用食品卫生检验国家标准中的相关方法测定白鹃梅嫩叶及花序中主要营养成分的含量。结果测得直接晒干的白鹃梅嫩叶及花序中氨基酸的总含量为22.48%,且含有已测的17种氨基酸,还原糖总量为10.10%,锌、铁、镁、钾、钙、铬、硒的含量分别为24.00mg/kg、160.35mg/kg、2841.14mg/kg、9111.32mg/kg、5799.56mg/kg、0.22mg/kg、0.08mg/kg。测得煮后晒干的白鹃梅嫩叶及花序中氨基酸的总含量为22.35%,且含有已测的17种氨基酸,还原糖总量为8.83%,锌、铁、镁、钾、钙、铬、硒的含量分别为19.50mg/kg、197.38mg/kg、2834.71mg/kg、7798.41mg/kg、5482.84mg/kg、1.06mg/kg、0.04mg/kg。结论从测得的白鹃梅嫩叶及花序中主要营养成分的含量可知,白鹃梅嫩叶及花序营养丰富、口感细腻,具有较高的食用价值。     

Lansoprazole versus omeprazole: influence on meal-stimulated gastric acid secretion

Aims: To investigate, by means of meal-stimulated acid secretion, the extent to which differences in plasma half-life, bioavailability and the recommended therapeutic dose can influence the antisecretory potency of lansoprazole and omeprazole.
Methods: In this double-blind, placebo-controlled, crossover study, 10 healthy male volunteers received 15 mg or 30 mg lansoprazole, 20 mg or 40 mg omeprazole or placebo for 5 days, in a randomized order. Meal-stimulated acid secretion was determined by means of a homogenized test meal and intragastric titration.
Results: On day 1, meal-stimulated acid secretion was decreased by 35% and 45% after administration of 15 mg or 30 mg lansoprazole, and by 16% and 42% after 20 mg or 40 mg omeprazole. After 3 and 5 days of dosing the decreases were 53% and 48% with 15 mg lansoprazole, 82% and 82% with 30 mg lansoprazole, 43% and 39% with 20 mg omeprazole, and 76% and 83% with 40 mg omeprazole. At all measuring points during the 5-day dosing periods, lansoprazole 15 mg and 30 mg proved superior to 20 mg omeprazole in inhibiting meal-stimulated gastric acid secretion, but the differences were only statistically significant for the lansoprazole 30 mg dose. 30 mg lansoprazole and 40 mg omeprazole proved equipotent. On day 1 only 30 mg lansoprazole was significantly better than placebo.
Conclusion: This study demonstrated the following order of antisecretory potency: 30 mg lansoprazole=40 mg omeprazole>15 mg lansoprazole≈20 mg omeprazole.     

Meta-Analyses of Cisapride, Omeprazole and Ranitidine in the Treatment of GORD: Implications for Treating Patient Subgroups

OBJECTIVE: Meta-analyses of efficacy results reported in trials of the pharmacological treatment of gastro-oesophageal reflux disease (GORD) with cisapride, omeprazole or ranitidine were performed using randomised, double-blind studies identified by a Medline search covering the years 1984 to 1995. RESULTS: The overall order of efficacy following 12 weeks of acute treatment was omeprazole 40 mg/day (95% cured) > ranitidine 600 mg/day (81% cured) > cisapride 40 mg/day or ranitidine 300 mg/day (approximately 60% cured). However, important differences emerged regarding efficacy in mild versus severe GORD, and in the frequency of relapse. In mild GORD, the cure rate with cisapride 40 mg/day was greater than the cure rate with ranitidine 300 mg/day (56 vs 38%, respectively), and the cure rate with cisapride 80 mg/day was similar to the cure rate with omeprazole 20 mg/day (82 vs 75%, respectively). In severe GORD, the cure rate with cisapride 80 mg/day was half that of omeprazole 20 mg/day (43 vs 87%, respectively) and comparable with that of ranitidine 300 mg/day (50%). Among patients treated acutely with omeprazole, 6-month relapse rates were 17% with omeprazole 20 mg/day maintenance therapy, but 76 to 80% without maintenance therapy. Among patients treated acutely with cisapride, 6-month relapse rates were 33% with 20 mg/day maintenance therapy and only 40% without maintenance therapy, which compare favourably with those following 6 months' maintenance therapy with ranitidine 300 mg/day (49%). CONCLUSION: These results indicate that omeprazole is clearly the treatment of choice for severe GORD, suggest that cisapride may be the treatment of choice for mild GORD, and indicate that either of these two treatments is superior to ranitidine for the prevention of relapse. Further comparative clinical studies are needed, designed specifically to delineate the most appropriate drug therapy for various subgroups of GORD patients.     

A comparison of the carcinogenicity of N-nitrosodiethylamine and N-nitrosodimethylamine after intratracheal instillation into Syrian golden hamsters

N-Nitrosodiethylamine (NDEA) and N-nitrosodimethylamine (NDMA) were instilled intratracheally into male Syrian golden hamsters once a week for 15 wk. The total dosages were 1.5 mg and 7.5 mg of NDEA and 0.75 mg and 1.5 mg of NDMA. A control group simultaneously received phosphate buffer vehicle. Tumours related to instillation appeared principally in the respiratory tract and the liver. Over the entire lifespan of the animals tumour incidence rates in the respiratory tract were 100% in both the NDEA groups, 6% in both NDMA groups and 8% in the control group. The total incidences of liver tumours were 6% in the 0.75 mg NDMA group, 19% in the 1.5 mg NDMA group, zero in the NDEA groups, and 4% in the control group. These results indicate that, when administered by this route, NDEA is a much more potent carcinogen in the respiratory tract than is NDMA but NDMA alone seems to be carcinogenic to the liver, at a total dosage of 1.5 mg.