狂犬病诊治进展

人类的狂犬病是一种中枢神经系统病毒感染性疾病,常由患狂犬病动物的唾液污染伤口而传染;一旦出现症状,病人基本上100%死亡,从狂犬病后康复的病例极为罕见,仅有3例报道。临床表现为特有的恐水怕风、咽肌痉挛、进行性瘫痪等。狂犬病在87个国家有流行,主要流行于东南亚、非洲及拉     

布洛芬对乙酰氨基酚退热疗效对比

长期以来,发热是儿科关注的问题,发热程度有助于判断病情,儿童多因与病情不成比例,轻微疾病即可出现发烧,父母常常不了解这一现象而引起不必要的恐慌,随意应用退热药即成为儿科普遍的现象[1].采用安全有效的退热药物值得临床探讨.     

Establishment of a mouse model of cancer cachexia with spleen deficiency syndrome and the effects of atractylenolide I

Cancer cachexia is a multifactorial metabolic syndrome that affects～50%–80%of cancer patients,and no effective therapy for cancer cachexia is presently available.In traditional Chinese medicine,a large portion of patients with cancer cachexia was diagnosed as spleen deficiency syndrome and treated with tonifying TCMs that produce clinic benefits.In this study we established a new animal model of spleen deficiency and cancer cachexia in mice and evaluated the therapeutic effects of atractylenolide I,an active component of tonifying TCM BaiZhu,in the mouse model.Cancer cachexia was induced in male BALB/c mice by inoculation of mouse C26 colon adenocarcinoma cells,whereas spleen deficiency syndrome was induced by treating the mice with spleen deficiency-inducing factors,including limited feeding,fatigue,and purging.The mouse model was characterized by both cachexia and spleen deficiency characteristics,including significant body weight loss,cancer growth,muscle atrophy,fat lipolysis,spleen,and thymus atrophy as compared with healthy control mice,cancer cachexia mice,and spleen deficiency mice.Oral administration of atractylenolide I(20 mg·kg?1per day,for 30 days)significantly ameliorated the reduction in body weight and atrophy of muscle,fat,spleen,and thymus in mice with spleen deficiency and cachexia.The established model of spleen deficiency and cancer cachexia might be useful in the future for screening possible anticachexia TCMs and clarifying their mechanisms.     

精于颐养走过百年——许德珩的长寿要诀

许德珩一生精于摄生颐养,享年100岁.他的养生要诀主要有如下几条: 重视饮食条理 许老的饮食以清淡为主,定时定量,不饱食,不偏食,不挑食.早餐一般是一碗稀饭,一个小馒头,少许咸菜;午餐以蔬菜为主,加上少许牛肉(晚年不食猪肉),主食100克;晚餐则以素为主.一日三餐既不随意增减,更不暴饮暴食.饮酒微量,只喝一点果酒,不饮白酒等烈性酒.爱吃新鲜水果,不吃甜食.     

浅谈如何加强医疗器械的管理

医疗器械的应用在疾病的诊断、治疗及预防等各个环节都发挥着不可替代的作用,其质量的好坏直接关系到人民群众的身体健康和生命安危.2000年国务院颁布了第一部医疗器械监管法规-<医疗器械监督管理条例>,标志着我国医疗器械监管正式走上了法制化轨道,但是由于种种原因,目前我国在医疗器械的生产、经营以及使用等各个环节都存在着较为普遍和严重的问题,其监管已显得相对滞后,成为食品药品部门监管中的一个"软肋",以至于频频出现像钢板等植入性器械断裂现象和发生举国震惊的"眼球事件".本文就我县医疗器械的经营、使用现状和如何加强对医疗器械的监管作以下分析和探讨.     

黑米:滋肾补胃益气血

黑米因外皮乌黑而得名,又称补血糯米、贡米、黑珍珠,是一种具有诸多保健功效的珍贵稻米.黑米含有淀粉、蛋白质、脂肪、多种维生素,又含钙、磷、镁、铁、锌、钼、硒等多种矿物质和微量元素.黑米所含蛋白质不但比普通大米高37%,而且其中氨基酸的含量亦比白米高25.4%,人体所需的赖氨酸、精氨酸、氮氨酸、色氨酸等,黑米中也都具有,营养价值很高.     

捕捉蛛丝马迹,让恶性肿瘤早现身——常见恶性肿瘤发病的早期信号(二)

痣 痣可发生在皮肤的任何部位,如面部、手掌、脚底、腰部、前胸、后背和阴囊等处.痣如出现下述现象,可能是癌变信号:反复发生感染;突然有痒感,不由自主地用手搔抓,甚至抓破出血;表面潮湿或有结痂形成;原为棕色,逐渐颜色变深变黑;有出血倾向,稍微触碰即发生出血;周围有炎性红晕,触之有痛感;痣上原有毛发突然自行脱落;痣的中央部出现硬结或自发性出血、溃疡形成和周围出现散在的呈卫星状小黑痣.     

克隆病并穿孔1例

1病例介绍病人,女,35岁,因突发下腹部疼痛半小时就诊,病史诉说欠清,(家属补充,腹痛时间约4～5年),查体:脉搏96次/分,血压84/60 mmHg,表情淡漠、四肢湿冷。全腹压痛呈板状腹,叩诊移动浊音可疑,以脐下压痛明显,B超提示腹腔内有少许积液,右侧卵巢囊肿,约44 cm大小。实验室检查白细胞16×109/L,中性0.80。考虑腹腔脏器穿孔,在全麻下行剖腹探查,取下腹正中切口进腹,腹腔内有臭味溢出,吸出浑浊性液体约250 ml,有食物残渣,距回盲部约50 cm处,向上见约45 cm长的回肠充血水肿     

刺五加注射液致过敏反应2例报告

例1:患者男性,51岁,因患冠心病人院治疗.给予刺五加注射液60mL加5%葡萄糖250mL中静脉注射.输人约50mL时,患者面色潮红,瘙痒感,开始发现前臂有散在的米粒大小的红色小点,继而遍及颈、四肢部以及全身出现点状红色皮疹,甚痒.立即停药,给予扑尔敏、Vc、葡萄糖酸钙口服无效.改为肌注盐酸肾上腺素、静滴地塞米松,1天后上述症状逐渐减轻.     

小便带血,源于结石

市运动会就要开幕了,体校的学生都在紧张地"备战",准备在运动会上崭露头角.小董一直是学校的"尖子生",这段时间练得更加刻苦.可是,最近每次锻炼小董都会感到小腹疼痛难忍,而且小便常常带血,他又怕去医院会耽误比赛,一直不敢告诉老师和家人.后来,还是同宿舍的小张告诉了老师.老师得知这种情况后,马上带着小董到了医院.医生做了X线摄片检查,才知道小董是患了尿路结石.     

Comparative activity of cetirizine and mizolastine on histamine-induced skin wheal and flare responses at 24 h

AIMS: The aim of our study was to compare the activity of cetirizine 10 mg with that of mizolastine 10 mg vs placebo at 24 h after intake in healthy volunteers. METHODS: This was a double-blind, randomized, placebo controlled, three-way cross-over study with a wash-out period of 7 +/- 2 days between each period. The study included 36 healthy volunteers (18--50 years, mean age = 32 years; 9 males). The objective measurement was the cutaneous reactivity to increasing concentrations of histamine (0, 5, 10, 20, 40, 80, 160 mg ml(-1)) administered by prick tests. The reactivity was evaluated by the wheal and flare areas (mm2). The AUC (area under curves) values of the wheal and flare areas as a function of the log2 transformed histamine concentration were calculated for each subject and treatment, and compared. RESULTS: A highly significant treatment effect was evidenced both for wheal and flare responses (P = 0.0001). This indicates the good activity of both cetirizine 10 mg and mizolastine 10 mg in inhibiting skin wheal and flare reactions to histamine. In addition, the mean AUC values significantly differed between cetirizine and mizolastine (64.8 and 117.8 log2 (mg ml(-1)) x mm2 for wheal, and 939.4 and 2340.8 for flare, respectively; P = 0.0001), with a superior activity of cetirizine than mizolastine at 24 h after intake both on wheal and flare responses. The tolerance of cetirizine and mizolastine was good. The severity of the adverse events was never more than 'moderate', 'fatigue' being the most frequent reported symptom [cetirizine (6 subjects), placebo (3), mizolastine (5)], followed by 'somnolence' [cetirizine (0), placebo (1), mizolastine (3)]. There was no serious adverse event. CONCLUSIONS: This study shows that cetirizine (10 mg) suppresses skin reactivity to histamine more effectively than mizolastine (10 mg) 24 h after intake in healthy volunteers.     

咪唑斯汀与西替利嗪治疗慢性荨麻疹的药物经济学分析

目的 比较咪唑斯汀与西替利嗪治疗慢性荨麻疹的成本-效果(C/E).方法 96例慢性荨麻疹患者随机分为A组和B组,分别口服咪唑斯汀和西替利嗪14 d,1次/d,10 mg/次,比较2组临床疗效以及运用药物经济学方法进行C/E分析.结果 A、B2组的总有效率分别为66.67％(32例)和64.58％(31例),差异无统计学意义(P＞0.05);B组的C/E(0.22)明显低于A组(0.85),差异有统计学意义(P＜0.05).结论 西替利嗪治疗荨麻疹的C/E较低,较咪唑斯汀更适宜临床推广使用.     

Lack of interaction between two antihistamines,mizolastine and cetirizine,and ethanol in psychomotor and driving performance in healthy subjects

The pharmacodynamic interaction between mizolastine, a new H₁ antihistamine, and ethanol was assessed in a randomized, double-blind, three-way crossover, placebo-controlled study. Eighteen healthy young male volunteers received mizolastine 10 mg, or cetirizine 10 mg or placebo once daily for 7 days with a 1-week wash-out interval. An oral dose of ethanol or ethanol placebo, given 2 h after dosing on days 5 or 7 of each treatment period, was administered to achieve a peak blood alcohol concentration (BAC) of 0.7 g/l, then maintained for 1 h by two further doses of ethanol. Driving ability and psychomotor performance were evaluated using actual and simulated driving tests, critical flicker fusion threshold (CFF), adaptive tracking and divided attention (DAT) tasks. Ethanol produced a significant decrement in all tasks up to 5.5 h after administration: an increase in steering movements of 4.6, in lateral deviation of 0.45 m, in braking reaction time of 80 ms, in driving test and DAT performance of +3.2; and a decrease in CFF and in tracking speed of 2.6 m·s^–1. Neither mizolastine nor cetirizine significantly impaired driving ability or arousal (CFF) compared with the placebo. However, both drugs significantly impaired DAT performance 6:00 h post-dose (increase of +2.1 for mizolastine and +2.4 for cetirizine). The tracking speed was significantly decreased 7:50 h after mizolastine administration (-1.3 m·s^–1) and more consistently from 1:30 to 7:50 h after cetirizine administration (-1.4 m·s^–1). No significant adverse interaction, i.e potentiation, occurred between ethanol and either antihistamine. No pharmacokinetic interaction occurred in BAC. In conclusion, treatment with a therapeutic dose of mizolastine or cetirizine has minimal or no effect on human performance, does not impair driving task performance and does not interact with ethanol at concentrations of 0.7 g·^–1.     

治疗慢性特发性荨麻疹用药方案的成本-效果分析

目的:对3种慢性特发性荨麻疹治疗方案进行成本-效果分析。方法:根据文献资料,选择96例慢性特发性荨麻疹病人,随机分为咪唑斯汀组、西替利嗪组和氯雷他定组,运用药物经济学方法对3个治疗组进行最小成本、成本-效果比及增加成本-增效比的比较分析。结果:3组疗效差异无显著性(P>0.05),西替利嗪组费用成本最低,为3组方案中最优选方案。结论:通过药物经济学方法对用药方案进行成本-效果分析,为临床治疗方案的选择提供参考。     

某院2008-2015年H1受体阻断剂的不良反应报告分析

目的：了解2008-2015年H₁受体阻断剂的不良反应的发生情况,促进临床合理安全用药。方法：回顾性分析2008-2015年上报的45例H₁受体阻断剂的不良反应,从患者的一般情况、药品种类、不良反应类型等方面进行统计分析。结果：45例H₁受体阻断剂的不良反应中,女性多于男性,以31~40岁患者居多,大多数患者ADR史不详,发生ADR例数较多的药物有地氯雷他定、左西替利嗪及咪唑斯汀,主要累及神经系统、皮肤及其附件和消化系统等。结论：嗜睡、头晕、心悸、过敏等是新型H₁受体阻断剂主要不良反应,对这类药仍需加强患者用药指导与监测。     

Comparative wheal and flare study of mizolastine vs terfenadine, cetirizine, loratadine and placebo in healthy volunteers.

1. Mizolastine, a new benzimidazole derivative with potent selective, non-sedative H1-histamine antagonist activity was compared with terfenadine, cetirizine and loratadine using the histamine-induced wheal and flare model in healthy volunteers. 2. Study design was a five way double-blind crossover design using a single dose of mizolastine 10 mg, terfenadine 120 mg, cetirizine 10 mg, loratadine 10 mg and placebo. 3. Histamine tests were performed on 10 occasions up to +24 h after dosing using an intradermal injection of histamine 2 micrograms with concommittant contralateral injection of a saline control. 4. Mizolastine, terfenadine, cetirizine and loratadine significantly (P < 0.001 vs placebo) inhibited the wheal and flare formation starting 1 to 2 h after dosing up to 24 h after dosing. 5. Mizolastine was significantly more active than loratadine on the wheal (P < 0.01) and flare (P < 0.05) inhibition from 3 up to 6 and 8 h respectively, as active as terfenadine on both parameters and as active as cetirizine on wheal inhibition while less active (P < 0.01) than cetirizine on flare inhibition at 2 and 12 h post-dosing.     

昆明山海棠联合咪唑斯汀治疗慢性荨麻疹的疗效观察及安全性分析

目的：旨在采用昆明山海棠联合咪唑斯汀对慢性荨麻疹患者进行治疗,观察其疗效。方法：慢性荨麻疹患者分为2组,观察组60例,采用昆明山海棠联合咪唑斯汀治疗;对照组60例,采用咪唑斯叮治疗。治疗2月后观察其疗效及安全性。结果：治疗2月后观察组的有效率优于对照组,痊愈率也优于对照组。观察组未出现明显副作用。结论：采用昆明山海棠联合咪唑斯汀治疗慢性荨麻疹疗效优于单用咪唑斯汀组,无明显副作用,值得推广。     

咪唑斯汀和依巴斯汀治疗慢性荨麻疹的药物经济学分析

目的 讨论咪唑斯汀和依巴斯汀抗组胺药物治疗慢性荨麻疹所产生的经济成本进行药物经济学分析.方法 108例慢性荨麻疹患者随机分为治疗组与对照组,分别给予咪唑斯汀、依巴斯汀治疗28d,观察疗效并进行成本-效果分析.结果 治疗组与对照组的有效率分别为88.0%、85.2%(P0.5)成本-效果比分别为1.18和0.94,对照...     

缓释茶碱与盐酸西替利嗪治疗小儿咳嗽变异性哮喘疗效观察

目的：观察缓释茶碱与盐酸西替利索治疗小儿咳嗽变异性哮喘(CVA)的临床疗效。方法：治疗组30例给予茶碱缓释胶囊和盐酸西替利嗪，对照组给予酮替芬和阿莫西林，疗程均为二周。结果：治疗组有效率明显高于对照组，x^2＝11．12，P＜0．01，有极显著性差异。结论：茶碱缓释胶囊与盐酸西替利嗪治疗小儿CVA依从性好，服药方便，药效作用时间长，无明显副作用。     

咪唑斯汀与氯雷他定抗炎作用对比

目的探讨咪唑斯汀与氯雷他定在治疗皮肤疾病时抗炎作用的比较。方法选取炎性反应明显的志愿参加此研究的78名患者,给予咪唑斯汀或者氯雷他定服用,分别于服用药物后1d,3d,7d记录炎性反应最明显的一块红斑面积和风团面积。咪唑斯汀为试验验组,氯雷他定为对照组。结果服用药物1d后,服用咪唑斯汀组红斑面积及风团面积变化显著优于氯雷他定组(P<0.05);服用药物3d,7d后,服用咪唑斯汀组风团面积减退情况显著优于氯雷他定组(P<0.05)。结论咪唑斯汀能明显治疗皮肤炎性反应。