恩替卡韦联合双环醇治疗慢性乙肝的临床研究

目的探讨恩替卡韦联合双环醇片治疗HBeAg阳性慢性乙型肝炎的疗效。方法将300例慢性乙型病毒性肝炎患者随机分为观察组和对照组,观察组150例：双环醇片25mg／次,3次／d,口服;恩替卡韦分散片0．5mg／次,1次／d,口服,疗程48周。对照组150例：恩替卡韦分散片0．5nag／次,1次／d,疗程48周。比较两组患者治疗结束时的ALT复常率、HBV-DNA阴转率及HBeAg转阴率。结果治疗结束时观察组ALT94％保持正常,对照组为80％,差异有统计学意义（P〈0．05）。观察组HBeAg转阴率为44．67％,优于对照组的21．33％,差异有统计学意义（P〈0．05）,HBV-DNA转阴率在观察组为92％,对照组为67．33％,差异有统计学意义（P〈0．05）。结论恩替卡韦联合双环醇片治疗HBeAg阳性慢性乙型肝炎,保肝、降酶效果好,HBeAg转阴率较高,抑制病毒能力强。     

阿德福韦酯治疗HBeAg阳性慢性乙型肝炎的疗效观察

目的:探讨阿德福韦酯治疗HBeAg阳性慢性乙型肝炎患者的临床疗效及乙型肝炎病毒标记物的变化.方法:选取2005年1月～2009年10月我科病房、门诊HBeAg阳性慢性乙型肝炎患者65例,口服阿德福韦酯10 mg,每天1次,连续48周.观察血清丙氨酸转氨酶复常率、乙型肝炎病毒(HBV-DNA)阴转率、HBeAg阴转率和HBeAg血清转换率.结果:患者在治疗第四周血清丙氨酸转氨酶复常率低,HBV-DNA及HBeAg血清学没有明显变化.而在24周血清丙氮酸转氨酶复常率53.85％、HBV-DNA阴转率23.07％,HBeAg血清转换率9.23％.当治疗至48周时,血清丙氨酸转氨酸酶复常率96.92％,HBV-DNA的阴转率58.46％,HBeAg阴转率43.07％,HBeAg血清转换率41.53％.结论:阿德福韦酯治疗HBeAg阳性慢性乙型肝炎患者起效较慢,但明显改善肝脏炎症,对HBV有明显抑制作用,HBeAg血清转换率高.     

抗病毒治疗应答不佳的HBeAg阳性慢性乙型肝炎患者分别联合普通干扰素和核苷（酸）类似物治疗的疗效观察

目的观察经单一核苷（酸）类似物治疗应答不佳HBeAg阳性慢性乙型肝炎患者联合普通干扰素和联合另一种核苷（酸）类似物治疗的临床疗效及安全性。方法回顾性研究82例经核苷（酸）类似物（NUCs）初治治疗6个月疗效不佳的HBeAg阳性乙型肝炎患者,分别联合普通干扰素42例为治疗纽和联合另一种NUCs治疗40例为对照组,疗程48周。结果在治疗结束时,治疗组ALT复常率为85．7％,HBVDNA阴转率为71．4％,HBeAg转阴率为61．9％,HBeAg血清学转换率为45．2％,均显著高于对照组（分别为60．0％、45．0％、37．5％、25．0％,P〈0．05）;治疗组（干扰素联合组）发生HBsAg血清学阴转率和HBsAg血清学转换率（分别为28．6％、19．0％）,对照组无患者发生HBsAg血清学阴转和HBsAg血清学转换,联合治疗组HBsAg血清学阴转、率和HBsAg血清学转换明显高于对照组（P〈0．01）且联合组无1例发生耐药现象,而对照组有2例发生耐药。联合组联合治疗组不良反应发生率与单药治疗组比无统计学差异（P〉0．05）。结论治疗组（普通干扰素一a联合NUcs）能有效的提高ALT复常率,HBVDNA阴转率,HBeAg转阴率,HBeAg血清学转换率,能快速增加HBsAg血清学阴转率和转换率,并能降低核苷（酸）类似物（NUCs）（的耐药性,而且安全有效。故HBeAg阳性慢性乙型肝炎患者应用核苷类药物治疗应答不佳时应早期与干扰素联合治疗,从而提高疗效,缩短疗程,减少耐药性。     

复方仙芪汤联合拉米夫定治疗慢性乙型肝炎疗效观察

目的观察复方仙芪汤联合拉米夫定治疗慢性乙型肝炎（CHB）的疗效。方法将85例患者随机分为两组，治疗组45例采用复方仙芪汤联合拉米夫定治疗；对照组40例仅用拉米夫定治疗。疗程均为12个月。观察治疗前、治疗1个月、3个月、6个月、12个月及停药后6个月时乙肝病毒标记物、血清HBV—DNA定量、肝功能、肾功能等指标变化情况。结果疗程结束时．治疗组ALT复常率、HBeAg阴转率、HBeAg／HBeAb转换率分别为96％、58％与42％，高于对照组的73％、23％与18％，差异有统计学意义（P〈0．05）；H13sAg、HBV-DNA阴转率在两组间差异无统计学意义（P〉0．05）；停药后6个月，治疗组ALT复常率、H13eAg阴转率、HBeAg／HBeAb转换率、HBV-DNA阴转率分别为93％、56％、44％与89％，明显高于对照组的65％、20％、13％与63％，差异有统计学意义（P〈0．05）。复发率治疗组为5％，低于对照组的24％，差异有统计学意义（P〈0．05）。结论采用复方仙芪汤联合拉米夫定治疗CHB，在提高ALT复常、促进HBeAg阴转与HBeAg／HBeAb转换、抑制病毒复制、降低复发方面，较单用拉米夫定更有效。     

拉米夫定联合乙型肝炎疫苗和猪苓多糖治疗慢性乙型肝炎

目的：研究拉米夫定联合乙型肝炎疫苗和猪苓多糖治疗慢性乙型肝炎患者的抗病毒效果。方法：32例慢性乙型肝炎患者随机分为两组,第一阶段（0-12周）：两组均用拉米夫定治疗（100mg/d);第二阶段（13-36周）：联合用药组在继用原剂量拉米夫定基础上加用乙型肝炎疫苗5μg多点皮内注射及猪苓多糖40mg肌肉注射,每月一次。单用药组继用原剂量拉米夫定治疗。两组均定期复查症状、体征、肝功能及HBV复制指标。结果：治疗36周时,联合用药组的ALT复常率12.5%,HBV-DNA阴转率为81.25%,HBV-DNA的反跳率为12.5%;单用拉米夫定组ALT复常率为75%,HBV-DNA的阴转率为75%,HBV-DNA反跳率为12.5%。以上指标两组间P＞0.05,差异无显著性。治疗36周时联合用药组的HBeAg阴转率为50.0%,单用拉米夫定组HBeAg阴转率为12.5%,P＜0.05,差异有显著性,而HBeAg血清转换率联合用药组为18.75%,单用拉米定组为6.25%,两组均无HBsAg阴转,两组P＞0.05,差异无显著性。未发生与研究药物相关的不良反应。结论：拉米夫定联合乙型肝炎疫苗及猪苓多糖治疗慢性乙型肝炎患者较单用拉米夫定比较能提高及提早HBeAg的阴转。     

替比夫定治疗HBeAg阳性慢性乙型肝炎的临床观察

目的:观察替比夫定治疗乙肝病毒e抗原(HBeAg)阳性慢性乙型肝炎的临床疗效和安全性。方法:82例HBeAg阳性慢性乙型肝炎患者按随机数字表法分为观察组(42例)和对照组(40例)。两组患者均给予护肝治疗、免疫调节、休息等常规治疗。在此基础上,对照组患者给予阿德福韦酯片10 mg,口服,qd;观察组患者给予替比夫定600 mg,口服,qd。两组患者疗程均为12个月。观察两组患者的临床疗效,治疗前后乙型肝炎病毒DNA(HBV-DNA)水平和HBV-DNA阴转率,HBeAg血清阴转率和转换率,治疗前后丙氨酸氨基转移酶(ALT)水平和ALT复常率及不良反应发生情况。结果:治疗后观察组患者总有效率、HBV-DNA阴转率、ALT复常率显著高于对照组,两组比较差异有统计学意义(P<0.05);治疗3、6、12个月后两组患者HBV-DNA、ALT均显著低于同组治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);两组患者HBeAg血清阴转率、HBeAg血清转换率、不良反应发生率比较,差异均无统计学意义(P>0.05)。结论:替比夫定治疗HBeAg阳性慢性乙型肝炎,疗效与安全性较好。     

观察聚乙二醇干扰素α-2a治疗HBeAg阳性慢性乙型肝炎的疗效

目的观察聚乙二醇干扰素α-2a在临床治疗HBeAg阳性慢性乙型肝炎中的功效和安全性。方法在我院就诊的HBeAg阳性慢性乙型肝炎患者中随机抽取60例,每30例分为一组,治疗周期持续48周,一组称为对照组,本组患者使用普通干扰素α-2a治疗;一组称为观察组,本组患者使用聚乙二醇干扰素α-2a治疗。在第24周和第48周检测患者HBeAg、ALT和HBV-DNA指标,疗程结束后统计患者出现的不良反应。结果在第24周,观察组的HBV-DNA阴转率显著高于对照组(P<0.05),但截止本周两组的HBeAg阴转率和ALT复常率差异没有统计学意义(P>0.05);在第48周,观察组的HBeAg阴转率、HBV-DNA阴转率和ALT复常率均显著高于对照组(P<0.05),两组都存在不良反应率,但不属于严重反应且没有统计学意义。结论在临床上治疗HBeAg阳性慢性乙型肝炎时,聚乙二醇干扰素α-2a的疗效要好于普通干扰素α-2a,不良反应方面与普通干扰素差别不大。     

安福隆联合硫普罗宁治疗慢性乙型肝炎疗效观察

目的：探讨安福隆（干扰素-a2b)联合硫普罗宁（凯西莱）治疗慢性乙型肝炎的疗效。方法：选择50例慢性乙型肝炎患者，随机分为两组，A组50例应用安福隆联合硫普罗宁治疗；B组46例单用安福隆治疗。结果：治疗结束时，A组ALT复常率为88%，HBeAg阴转率为58%，HBV-DNA阴转率为68%；而B组分别为63%。37%和43%。两组间HBeAg阴转率和HBV-DNA阴转率有显著差异。结论：安福隆联合硫普罗定治疗慢性乙型肝炎疗效更佳。     

干扰素联合阿德福韦酯治疗慢性乙型肝炎38例疗效观察

目的：观察干扰素联合阿德福韦酯治疗慢性乙型肝炎的治疗效果。方法将76例慢性乙型肝炎患者随机分为观察组和对照组,每组38例。对照组患者在基础治疗的同时,干扰素500万U皮下注射,隔日一次;观察组在对照组治疗基础上加用阿德福韦酯10 mg,口服,1次/d;两组疗程均为6个月,治疗结束后,比较两组患者血清ALT水平恢复正常率、血清HBV-DNA阴转率及HBeAg阴转率。结果观察组患者ALT恢复正常率、HBV-DNA阴转率和HbeAg阴转率均显著高于对照组,差异均具有统计学意义（P〈0.05）。结论干扰素联合阿德福韦酯治疗慢性乙型肝炎的临床效果显著。     

拉米夫定治疗HBeAg阳性慢性乙型肝炎长期临床疗效观察

目的 探讨拉米夫定治疗慢性乙型肝炎的长期临床疗效,为临床更好更合理的应用拉米夫定提供依据。方法选择以拉米夫定治疗的慢性乙型肝炎患者58例,治疗后动态观察HBeAg阴转、HBeAg血清转换、HBV—DNA阴转和ALT复常情况,以及出现HBV-DNA复阳的情况。结果在整个治疗过程中（≥3年）,52例出现HBV—DNA阴转占89．66％（52／58）,HBeAg阴转率为65．52％（38／58）,HBeAg血清转换率为29．31％（17／58）。12个月时ALT复常率79．31％（46／58）。治疗过程中出现HBV-DNA复阳22例,占HBV-DNA阴转总数的42．31％（22／52）,其中13例加用阿德福韦酯后再次阴转,13例停药后随访,6例出现HBV—DNA复阳。5例患者出现HBsAg阴转。结论长期应用拉米夫定可持久抑制HBV复制和促进HBeAg阴转及血清转换,但存在耐药性和停药后的复发,选择适合的患者,可取得最佳疗效。     

磷酸阿糖腺苷与肝炎灵治疗乙型肝炎疗效比较

目的：比较磷酸阿糖腺苷与肝炎灵对乙型肝炎的疗效。方法：慢性乙型肝炎６０例，采用磷酸阿糖腺苷治疗３０例（男性２７例，女性３例，年龄３２±ｓ７ａ），ｄ１－５，１０ｍｇ／ｋｇ，ｉｍ，ｑｄ，ｄ６－２８，５ｍｇ／ｋｇ，ｉｍ，ｑｄ。对照组３０例（男性２６例，女性４例，年龄３０±８ａ），用肝炎灵４ｍＬ，ｉｍ，ｑｄ，共４ｗｋ。结果：ＨＢｅＡｇ和ＨＢＶ－ＤＮＡ阴转率、抗ＨＢｅ阳转率治疗组分别为２３％，１８％，１３％；对照组分别为３％，０，０（Ｐ＜０．０５）。结论：磷酸阿糖腺苷治疗慢性乙型肝炎，具有抑制乙型肝炎病毒（ＨＢＶ）复制的作用，疗效优于肝炎灵。不良反应轻微。     

单磷酸阿糖腺苷治疗手足口病126例疗效观察

目的观察单磷酸阿糖腺苷治疗手足口病的临床疗效。方法 252例手足口病患儿随机分为治疗组与对照组各126例。治疗组采用单磷酸阿糖腺苷治疗,5～10mg/（kg·d）加入5%葡萄糖液或10%葡萄糖液（稀释浓度0.1%）静脉滴注1次/d,治疗5～10d。对照组采用利巴韦林治疗10～15mg/（kg·d）静脉滴注1次/d,治疗5～10d,比较两组的疗效及不良反应。结果治疗组总有效率96.82%,对照组84.13%,两组比较,差异具有统计学意义（P〈0.05）,两组均未见明显不良反应。结论单磷酸阿糖腺苷治疗手足口病的临床疗效好。     

伊曲康唑注射液治疗深部真菌感染

目的:评价伊曲康唑注射液治疗深部真菌感染的有效性和安全性.方法:采用开放性临床研究,治疗深部真菌感染患者22例.确诊4例、拟诊10例、经验性治疗8例.剂量用法:d1～d2,伊曲康唑注射液200mg,iv,bid;d3～d14,200mg,iv,qd;d15～d42,改用伊曲康唑胶囊200mg,bid.结果:确诊和拟诊的14例患者真菌清除率为6/14,阴转率为6/14;综合疗效评价有效率为8/14,痊愈率为2/14.不良反应发生率为12/28.结论:伊曲康唑注射液治疗重症深部真菌感染安全有效.     

Cefetamet pivoxil in community-acquired pneumonia: an overview.

A total of 305 patients with community-acquired pneumonia have participated in comparative or non-comparative studies involving cefetamet pivoxil. Of these, 211 (55 adults and 156 children) were involved in a series of open, prospective, comparator-controlled, multi-centre studies. Adults were randomized to receive either cefetamet pivoxil 1000 mg twice daily or amoxycillin 750 mg 3-times daily for 10 days. Children received either cefetamet pivoxil 10 mg/kg twice daily, cefetamet pivoxil 20 mg/kg twice daily or cefaclor 10 mg/kg 3-times daily for 7 to 8 days. The remaining 94 patients were treated openly with cefetamet pivoxil, with most patients receiving cefetamet pivoxil 500 mg twice daily for an average of 10 days; an elderly sub-group of these patients aged 70 to 103 years received therapy for an average of 11 days. The main causative organisms isolated were Streptococcus pneumoniae and Haemophilus influenzae. In adult patients, a successful clinical outcome was achieved in 100% of assessable patients receiving cefetamet pivoxil 1000 mg twice daily, and about 90% in those receiving 500 mg twice daily. The success rate in children was 98% for both dose levels of cefetamet pivoxil and 90% for those receiving cefaclor. In elderly patients, the percentage was 78% for the 500 mg twice daily patients. Thus, the standard dose of cefetamet pivoxil (500 mg twice daily in adults, 10 mg/kg twice daily in children) was well tolerated and proved to be at least as effective as the comparator drugs which were given 3-times a day.     

青蒿琥酯联用伯氨喹治疗迁延、复燃疟疾的临床研究

目的:探讨青蒿琥酯联用伯氨喹治疗迁延、复燃疟疾的临床疗效。方法:将82例患者随机分成治疗组和对照组各41例。治疗组:给予青蒿琥酯和伯氨喹:青蒿琥酯首剂2.4 mg/kg i.v.,12 h后予1.2 mg/kg青蒿琥酯,随后6 d每日以1.2 mg/kg青蒿琥酯同法给予;同时加服伯氨喹片22.5 mg q.d.。对照组:给予quini max,首剂20 mg/kg,i.v.gtt,12 h后予10 mg/kg,随后每日12 h给予10 mg/kg,直至患者能口服,改口服quini max片10 mg/kg,q.8.h,疗程7 d。结果:7 d后治疗组、对照组治愈率分别为97.5%、95.1%;28 d治疗组、对照组治愈率分别为97.5%、90.2%,治疗组与对照组变化相近(P>0.05);两组的退热时间分别为28.0、51.6 h,血中疟原虫清除时间分别为30.4、59.5 h,治疗组较对照组均降低(P<0.01)。结论:青蒿琥酯联用伯氨喹治疗疟疾作用迅速,副作用小,低复燃率,且对耐奎宁株有效,可作为迁延、复发疟疾以及用奎宁等传统抗疟药治疗失败的首选方法。     

Tolerance to anxiolytic- and antidepressant-like effects of a partial agonist of glycineB receptors.

The present study examined effects of acute and repeated administration of 1-aminocyclopropanecarboxylic acid (ACPC), a partial agonist of glycineB receptors, in the conflict drinking test and the forced swim test in rats. Diazepam and imipramine were used, respectively, as reference drugs in those tests. In the conflict drinking test, acute administration of ACPC (200 mg/kg) increased fivefold the number of punished licks. A three- and fivefold increase in the number of punished licks was observed in rats treated repeatedly with ACPC (200 mg/kg daily; 14 days) and challenged with the same dose of the drug 24 h or 4 days later, respectively. A single injection of ACPC (400 mg/kg) reduced by 40% the immobility time in the forced swim test. In rats treated repeatedly with ACPC (400 mg/kg daily; 14 days) and challenged with the same dose 24 h or 4 days later, the drug either produced no significant effect or reduced the immobility time by 50%, respectively. On the other hand, no changes in anxiolytic- and antidepressant-like effects of chronically administered diazepam (10 mg/kg daily; 14 days) and imipramine (30 mg/kg daily; 14 days), respectively, were observed. The above results indicate that tolerance develops to the anxiolytic- and, particularly, to the antidepressant-like activity of ACPC.     

贺普丁联合抗乙肝特异性转移因子治疗慢性乙肝临床研究

目的　探讨贺普丁联合抗乙肝特异性转移因子治疗慢性乙型肝炎的临床疗效及安全性。方法　对照组常规保肝治疗的基础上 ,贺普丁 10 0 mg,每日 1次 ,连用 1年。治疗组在对照组的基础上加用抗乙肝特异性转移因子注射剂 2 mg,肌注 ,每日 1次 ,连用 3个月 ,停 3个月后继续用 3个月。治疗后 3、6、12个月时查血清肝功能、HBe Ag、HBVDNA和 CD4+ / CD8+ 。结果　对照组 /治疗组 HBe Ag阴转率 10 .5 2 %～ 42 .11% / 2 7.18%～ 6 6 .6 7% ;HBVDNA阴转率84.2 1%～ 73.6 8% / 86 .11%～ 94.44 % ;AL T复常率 6 5 .79%～ 71.0 5 % / 77.78%～ 88.89% ;CD4+ / CD8+ 1.17± 0 .10 /1.45± 0 .2 9。各项指标随时间推移明显改善。结论　贺普丁对 HBV有明显的抑制作用 ,联合抗乙肝特异性转移因子治疗 ,特异性提高机体免疫功能 ,能明显提高疗效、费用适宜 ,安全有效     

Repeated paroxetine treatment reverses anhedonia induced in rats by chronic mild stress or dexamethasone.

The present study was designed to assess the effect of dexamethasone, a synthetic glucocorticoid receptor agonist, in the sucrose preference test in rats. Rats treated acutely with dexamethasone (5-10 mg/kg) showed a significant decrease in sucrose preference (anhedonia) in comparison to vehicle treated rats, although 1 mg/kg dexamethasone did not alter the sucrose preference. Daily paroxetine treatment (10 g/kg, i.p., 14 days) reversed the anhedonic effect of acute dexamethasone (5 mg/kg), while causing no increased sucrose preference in rats that received dexamethasone vehicle. The paroxetine vehicle treated rats showed anhedonia even 14 days after acute dexamethasone administration. Paroxetine (10 mk/kg, i.p. for 28 days) also reversed anhedonia induced by chronic mild stress (8 weeks). In conclusion, acute dexamethasone induced an enduring anhedonic state that was reversed by repeated paroxetine treatment. Thus, the present study adds new data to the evidence supporting an important role for glucocorticoid in depression.     

拉米夫定治疗慢性乙型肝炎的多中心、随机双盲、安慰剂对照研究

目的：研究拉米夫定对血清乙型肝炎病毒＿脱氧核糖核酸（ＨＢＶ＿ＤＮＡ）阳性的慢性乙型肝炎病毒感染病人的疗效和安全性。方法：４２９例病人,随机分成拉米夫定治疗组（３２２例）和安慰剂对照组（１０７例）。治疗组每日口服拉米夫定１００ｍｇ,对照组服用外形相同的安慰剂每日１片,共１２ｗｋ。结果：治疗组累计９２．２％病人血清ＨＢＶ＿ＤＮＡ阴转（低于１．６ｎｇ／Ｌ）,最终持续阴转率为７８．５％。对照组ＨＢＶ＿ＤＮＡ累计阴转率为１４．１％,最终阴转率为１１％。２组疗效比较Ｐ＜０．０１。治疗前丙氨酸转氨酶（ＡＬＴ）增高的病人,１２ｗｋ时治疗组的ＡＬＴ复常率为６０．３％,对照组为２７％,Ｐ＜０．０１。２组ＨＢｅＡｇ／抗ＨＢｅ的血清转换率差别无显著意义（Ｐ＞０．０５）。２组的不良反应发生率比较,差别无显著意义（Ｐ＞０．０５）。结论：拉米夫定能明显降低血清ＨＢＶ＿ＤＮＡ水平,促使ＡＬＴ恢复正常,不良反应轻,耐受性好。     

Subacute (28-day) toxicity of furfural in Fischer 344 rats: a comparison of the oral and inhalation route.

The subacute oral and inhalation toxicity of furfural vapour was studied in Fischer 344 rats to investigate whether route-to-route extrapolation could be employed to derive the limit value for inhalation exposure from oral toxicity data. Groups of 5 rats per sex were treated by gavage daily for 28 days at dose levels of 6-192 mg/kg bw/day, or exposed by inhalation to concentrations of 20-1280 mg/m3 (6 h/day, 5 days/week) or 160-1280 mg/m3 (3 h/day, 5 days/week) for 28 days. Controls received vehicle (corn oil) or were exposed to clean air. Daily oral treatment with the highest dose of furfural (initially 192 mg/kg bw/day, later reduced to 144 mg/kg bw/day and finally to 120 mg/kg bw/day) resulted in mortality, and in increases in absolute and relative kidney and liver weight in surviving females of this group. Exposure of rats by inhalation for 6 h/day, 5 days/week for 28 days induced mortality at concentrations of 640 mg/m3 and above within 1-8 days. At 640 mg/m3 (3 h/day) and at 320 mg/m3 (3 and 6 h/day) and below, however, exposure was tolerated without serious clinical effects. In contrast, histopathological nasal changes were seen even at the lowest concentration of 20 mg/m3. With increasing exposure concentration, the nasal effects increased in incidence and severity and also expanded from the anterior part to the posterior part, including the olfactory epithelium. It was concluded that the no-observed-adverse-effect level (NOAEL) for oral toxicity was 96 mg/kg bw/day. The NOAEL for systemic inhalation toxicity was comparable, i.e. 92 mg/kg bw/day (corresponding to 320 mg/m3 (6 h/day) or 640 mg/m3 (3 h/day)) assuming 100% absorption. The presence of the histopathological nasal changes at the lowest tested concentration of 20 mg/m3 (corresponding to 6 mg/kg bw/day) proves that for locally acting substances like furfural extrapolation from the oral to the inhalation route is not valid.