类固醇激素依赖型溃疡性结肠炎的临床药物治疗

1类固醇激素（CS）依赖机制 口服大剂量CS（强的松40—60mg或相当剂量的其他类固醇激素）治疗30d内临床改善；或静脉注射大剂量CS治疗7．10d内临床改善，称之为CS治疗有效。反之，在上述限定时间内，患者对CS治疗无反应即被定义为类固醇激素抵抗（Steroid—refractoriness SR）。如果患者最初对CS有反应，但后来在减药期间或在CS停用后很快复发，并且需要重复CS治疗，以控制症状，缓解病情，这种情况被定义为类固醇激素依赖（Steroid—dependent or SD）。     

胃乐新颗粒治疗溃疡性结肠炎80例疗效观察

目的胃乐新颗粒（成分：猴头菌浸膏）对溃疡性结肠炎的治疗效果进行评估。方法将在本院就诊的溃疡性结肠炎患者80例分为2组，治疗组和对照组各40例，治疗组轻中度患者口服胃乐新颗粒5g／次、3次／d，重度患者加服强的松40mg／d，SASP4g／a、4次／d；对照组轻中度患者口服SASP4g／a、4次／d，重度患者加服强的松40mg／d。均以6周为一疗程，比较2组疗效。结果分别从症状和内镜下对两组治疗效果进行比较，治疗组均明显优于对照组（P〈0．05）。结论胃乐新颗粒治疗溃疡性结肠炎疗效明显。     

复方甘草酸苷治疗激素依赖性皮炎临床分析

目的观察复方甘草酸苷治疗激素依赖性皮炎的疗效及安全性。方法对照组口服氯雷他啶片10mg，1次／d，外用维生素E尿素霜，连续21d；治疗组在对照组的基础上，加用复方甘草酸苷注射液40mg，1次／d，5d后改为复方甘草酸苷片50mg，3次／d，共21d。结果治疗组和对照组治疗后的TSS分别为（4．5±1．7）和（10．4±2．3），差异有显著性（P〈0．01）；治疗组有效率为84．14％，对照组为41．67％，两组疗效比较差异有显著性（P〈0．05）。治疗组86例中虽有4例出现一定的不良反应，经相应处理后很快恢复。结论复方甘草酸苷治疗激素依赖性皮炎安全、有效。     

甲基泼尼松龙治疗感染性休克的研究

目的：采用建立感染性休克兔动物模型,给予甲基泼尼松龙（MP）治疗,评价其疗效。方法：选择健康家兔30只,随机分为A、B、c和对照组,分别予甲基泼尼松龙1ms／（ks·d）、甲基泼尼松龙3ms／（kg·d）、休克发生后延迟给甲基泼尼松龙3mg／（kg·d）和对症常规治疗,监测各组血压回升时间、循环改善时间及病情稳定时间。结果：大剂量甲基泼尼松龙治疗组血压回升时间明显缩短,总有效率与对照组比较,差异有统计学意义（P〈0．05）。结论：实验中大剂量甲基泼尼松龙治疗感染性休克安全有效,可根据进一步实验与临床研究推广到临床应用。     

激素依赖型溃疡性结肠炎的治疗进展

溃疡性结肠炎是属于慢性炎症性肠病中的一种,具有反复发作的临床特征,一般情况下为了患者的临床病症,会对其进行激素治疗,溃疡性结肠炎患者在使用激素进行治疗的短时间内可以对病情进行控制,但是在激素量减少或停止后就会反复性发作,这种情况称之为激素依赖型溃疡性结肠炎。本文对我院2014年3月至2015年3月收治的激素依赖型溃疡性结肠炎患者110例进行了治疗,并对其治疗效果及进展进行了分析。     

醋酸泼尼松龙不同给药途径治疗慢性阻塞性肺疾病加重期的对照观察

目的比较口服或静脉给予泼尼松龙治疗慢性阻塞性肺疾病（COPD）加重期的临床效果。方法COPD加重期住院患者345例,应用计算机最小化程序随机分为静脉滴注组（172例）和口服组（173例）,静脉滴注组应用醋酸泼尼松龙注射液60mg／d,静脉滴注;口服组应用醋酸泼尼松龙片20mg／次,3次／d,2组患者共用7d。7d后,所有患者改为口服醋酸泼尼松龙片17．5mg／次,3次／d,此后每天减量5mg,直到人院前的维持量或停药。主要结局包括治疗失败、死亡、转入ICU、强化药物治疗等。结果静脉滴注组和口服组于研究期间的总治疗失败率分别为61．7％（106／172）和56．1％（97／173）,于2周内的治疗失败率分别为18．0％（31／172）和17．3％（30／173）,于2周～3个月的治疗失败率分别为43．6％（75／172）和38．7％（67／173）,组间差异均无统计学意义（P〉0．05）。结论COPD加重期患者应用泼尼松龙治疗后90d,口服组效果并不比静脉组差,因此应优先采用口服泼尼松龙治疗。     

葡萄籽原花青素治疗大鼠溃疡性结肠炎作用机理研究

目的：观察葡萄籽原花青素（GSPE）对三硝基苯磺酸（TNBS）／25％乙醇溶液诱导的大鼠溃疡性结肠炎（uC）的治疗作用，并初步探讨其作用机理。方法：用TNBS／25％乙醇采用二次致炎的方法复制大鼠溃疡性结肠炎模型，将Wistar大鼠随机分为正常对照组、模型对照组、柳氮磺吡啶（SASP）组和GSPE低、中、高剂量组（100、200、400mg／kg），     

钙拮抗剂治疗儿童激素依赖性肾病综合征的疗效

目的观察和评价钙拮抗剂对儿童激素依赖性肾病综合征（SDNS）的疗效及安全性。方法选取SDNS住院患儿45例。男25例，女20例；平均发病年龄（5．0±1．8）岁，其中治疗组23例，对照组22例。治疗组采用恬尔心1mg／（kg·d），2次／d，联合糖皮质激素、免疫抑制剂治疗，维持3个月停药，同时服用泼尼松1．5～2．5mg／（kg·d），隔日1次，平均2．0mg／（kg·d），隔日1次，霉酚酸酯（mycophenolate mofetil，MMF）15～30mg／（kg·d），2次／d，根据病情定期减量。定期复查尿、血常规、24h尿蛋白定量、血清肌酐和尿素氮、肝功能，对照组采用泼尼松联合霉酚酸酯治疗。治疗3个月后进行疗效及安全性评价。结果治疗组中完全缓解率明显大于对照组（P〈0．01）。两组中均有2例分别出现胃肠道症状和一过性白细胞减少。结论恬尔心是治疗儿童SDNS的一种有效、安全的辅助制剂。     

新型抗溃疡性结肠炎药物巴柳氮的进展

溃疡性肠炎是最常见的炎性肠疾病，其发病率为5～10／10万，流行区域可高达100／10万。美国的年发病率为7．3／10万，目前美国有50～100万溃疡性肠炎患者。英国约有8～10万例溃疡性结肠炎患者。2004年国内有人估计，我国溃疡性结肠炎的发病率为40／10万。溃疡性肠炎是难根治的，需反复治疗或维持治疗，慢性溃疡性肠炎增加了癌变的可能性．10年以上病程癌变率为5～10％，     

黄芪降白汤治疗难治性肾病36例

难治性肾病综合征,是指原发性肾病综合征经过强地松标准疗法（成人1mg／kg／d连续治疗8周）无效者,或经过强地松标准疗法治疗缓解,但一年内复发3次或半年内复发两次以上者,病情复杂,治愈率低。临床针对顽固性肾病临床疗效的研究,是目前肾脏学科的研究重点。我院自2003年-2007年采用中西医结合疗法治疗难治性肾病36例,取得较好疗效,现报告如下。     

Application of the "filter model" to a risk assessment for vinyl chloride

The filter model was used to estimate thresholds for the induction of cancer from many dose-response sets for inhalation and ingestion exposure to vinyl chloride for rat and inhalation exposure for mouse. Estimates for a variety of end-point combinations were log-normally distributed over about 2 decades from about 1 to 100 ppm for inhalation exposure to rat and 0.1 to 30 ppm for mouse. When the data is transformed to "dose" (milligrams per kilogram body weight per day), the estimates for inhalation and ingestion exposure and also for rat and mouse are similar. Estimates for different experiments carried out for different durations of time (single exposure to 1 yr) are comparable. Since the threshold is an intrinsic property of the biological system, the estimate, even from a protocol for short exposure and less than lifetime observation, can be used directly in a risk assessment as the maximum safe dose.     

Inhalation toxicity in mice exposed to sarin (GB) for 20-720 min

Most of the historical data for the toxicity of sarin (GB) was collected for exposure times of <10 min in attempts to establish the utility of and defence against this agent in offensive military use. However, information concerning the toxicity of GB (and other nerve agents) from longer exposures of 1-12 h is critical for all personnel who must work in or close to low-level concentrations of chemical for extended periods and for all personnel, dressed in Individual Protective Equipment, who need to know when, and if, it is safe to take off these cumbersome garments.The data presented for the toxicity of GB to mice for whole-body exposures of 20 min to 12 h are intended to form part of an ongoing, multi-species effort aimed at establishing toxicity estimates for humans for these longer exposure times: LCT50 values of 430, 540, 900, 1210 and 2210 mg.min m(-3) or LC50 values of 21.5, 9.0, 5.0, 3.4 and 3.1 mg m(-3) were obtained for mice for 20-, 60-, 180-, 360- and 720-min exposures to GB, respectively. The data for longer exposures do not follow Haber's rule (LCT50=CT). The 20- and 60-min data fit the 'toxic load model' involving CnT that was established previously from historical data for 0.17-30 min GB exposures to mice. The LCT(50) and LC50 values for 3, 6 and 12 h are progressively higher (toxicity lower) than predicted by either Haber's rule or the toxic load model.     

The use of technetium-99m radiolabeled human antimicrobial peptides for infection specific imaging

Bacterial resistance to conventional antibiotics poses a challenge medicine to search for alternatives. Cationic antimicrobial peptides (AMPs) are promising for the development of a new class of antibiotics. This review focuses on the use of technetium-99m labeled synthetic AMPs, derived from human natural cationic AMPs, for target-delivery to and in vivo detection of infection sites caused by (drug-resistant) micro-organisms. The scintigraphic approach has proven to be a reliable method for evaluating AMPs in pharmacological studies and for optimizing target-delivery of radiolabeled AMPs to pathological sites in animals and humans. In addition, the effect of alterations in amphipathicity, amino acid substitution, and dimerization on the biological performance of AMPs is reported. Radiolabeled AMPs offer good perspectives for diagnosis of infections, for monitoring therapy, and, most importantly, for the ability to discriminate between infections and sterile inflammatory processes.     

Immunoassay and GC-MS procedures for the analysis of drugs of abuse in meconium.

The analysis of meconium specimens for metabolites of substances of abuse is a relatively accurate method for the detection of fetal exposure to drugs. Most of the methods reported in the literature before the early 1990s relied on radioimmunoassays. The purpose of this study was to develop and validate methods for meconium sample preparation for the screening and gas chromatography-mass spectrometry (GC-MS) confirmation of meconium extracts for cannabinoids, cocaine, opiates, amphetamines, and phencyclidine. EMIT and TDx immunoassays were evaluated as screening methods. The sample preparation method developed for screening included extraction and purification prior to analysis. Cutoff levels were administratively set at 20 ng/g for 11-nor-delta9-THC-9-COOH (THCCOOH) and phencyclidine and at 200 ng/g for benzoylecgonine, morphine, and amphetamines, although lower levels could be detected in meconium using the EMIT-ETS system. Ninety-five meconium specimens were subjected to the screening procedure with GC-MS confirmation of presumptive positives. In addition, 30 (40 for cocaine) meconium specimens were subjected to GC-MS analysis for all analytes regardless of the screening results to determine the false-negative rate, if any, of the immunoassay. Although there were no false negatives detected, the GC-MS confirmation rate for the immunoassay-positive specimens was generally low, ranging from 0% for amphetamines to 75% for opiates. The lowest rate of confirmed positives was found with the cannabinoids, suggesting that tetrahydrocannabinol (THC) metabolites other than free 11-nor-9-carboxy-delta9-THC may be major contributors to the immunoassay response in meconium.     

Ethnicity/race and the diagnosis of depression and use of antidepressants by adults in the United States

The objective of this study is to discern ethnic/race-specific (black, Hispanic, white) population-adjusted rates of US office-based visits documenting a diagnosis of depression, and the extent of the use of antidepressant pharmacotherapy for its treatment. Data from the National Ambulatory Medical Care Survey for the time-frames 1992-1997, and 2003-2004, were partitioned into four, 2-year time intervals for trend analysis among patients aged 20-79 years. From 1992-1993 to 2003-2004, the annualized rate of visits documenting a diagnosis of depression increased from 10.9 to 15.4 per 100 US population for whites, from 4.2 to 7.6 for blacks, and from 4.8 to 7.0 for Hispanics. A concomitant diagnosis of depression and antidepressant use increased from 6.5 to 11.4 per 100 for whites, from 2.6 to 5.2 for blacks, and from 3.0 to 5.6 for Hispanics. It can be concluded that by 2003-2004, diagnostic and treatment rates were comparable among blacks and Hispanic, but were less than half the observed rates for whites.     

网络环境下研究型医科大学教师信息素养的调查与分析

目的对网络环境下研究型医科大学教师信息素养进行调查与分析,对改进教师队伍建设提供参考。方法采用问卷调查方法,对某研究型医科大学教师进行问卷调查。结果网络环境下,教师主动获取网络医学信息为62.1%;获取信息的目的主要是知识更新占69.9%,跟踪学科最新进展占63.1%,完成教学任务、科研课题占59.9%;获取信息主要途径：查询数据库占59.9%,查询Internet占59.9%,阅读图书、期刊占39.7%;教师＂完全能够＂构建高级检索式的人数只占14.9%,＂不会＂构建检索式的人数占29.8%。信息获取的主要影响因素：缺乏检索知识占46.5%,不了解数据库资源内容占33.3%,缺乏计算机网络知识占26.6%,外文水平占23.0%。教师信息需求高,信息检索和信息利用能力等方面存在明显差异,整体水平有待提高。结论研究型医科大学教师的信息素养存在差异,应对教师队伍进行信息素养培训并动态更新,才能保持教师队伍的素质,保证研究型医科大学教育的先进性。     

Precision from drug stability studies. Investigation of reliable repeatability and intermediate precision of HPLC assay procedures

A multi-company investigation is presented to obtain and compare precision results for LC assay procedures. Forty-four drug substances and drug products of various types subjected to 156 stability studies, with 2915 assay values in total, were included. This provides an excellent source of real long-term precision estimates, as the same analytical procedure was applied during the whole stability study, extending from 12 to 60 months. Intermediate precision was calculated either using the residual standard deviation of the regression line or applying an analysis of variances, depending on whether there was a significant degradation of the analyte or not. The results show impressively the large intervals where the individually calculated parameters scatter. Distribution ranges and averages for repeatability, intermediate precision, and the ratio between the two precision levels are mainly dependent on the type of drug product. Repeatabilities were found up to 0.8% for solutions, 1.6% for drug substances, 1.9% for tablets, 2.3% for creams, and 3.4% for a bath. For intermediate precision, which includes additional variability factors due to the reference standard, operator, equipment, reagents, etc., a similar dependency was obtained with a slightly changed order: up to 1.1% for drug substances, 2.2% for solutions, 2.3% for tablets, 3.1% for creams, and 3.2% for a bath. The ratio between the precision levels is up to 2.5 and similar for all investigated drug product types, apart from solutions with up to 5.3. These differences for the types of drug product may be explained by the influence of the sample and/or the sample preparation: the more complex, the higher the variability contribution. For the investigated examples, the impact of the analyte and of the concentration (dosage) seems to be of less importance. Therefore, a classification of drug product types for orientation on acceptable precision (ranges) for LC assay seems to be possible.     

Simultaneous determination of grepafloxacin, ciprofloxacin, and theophylline in human plasma and urine by HPLC.

A specific and sensitive reversed-phase high-performance liquid chromatographic (HPLC) method has been developed and validated for the simultaneous determination of grepafloxacin, ciprofloxacin, and theophylline in human plasma and urine. This assay allows these drugs to elute and be resolved in a single chromatogram at 280 nm, using a linear gradient. The procedure involves liquid-liquid extraction. Separation was achieved on a C18 reversed-phase column. The quantification limits were 0.05 mg/L in plasma and 0.5 mg/L in urine for grepafloxacin and ciprofloxacin and 0.5 mg/L in plasma and urine for theophylline. Standard curves were linear (correlation coefficients >0.999) over the ranges 0.05 to 5 mg/L for grepafloxacin and ciprofloxacin in plasma, from 0.5 to 20 mg/L for theophylline in plasma, and from 0.5 to 500 mg/L for the three drugs in urine. The coefficients of variation for the three drugs were less than 10% for within- and between-day analyses. The recoveries averaged 94.5% for theophylline, 93% for ciprofloxacin, 93.7% for grepafloxacin, and 95.1% for the internal standard (IS). The assay can be used for pharmacokinetic studies of these drugs, to investigate the interaction of grepafloxacin and ciprofloxacin with theophylline, or for routine simultaneous monitoring of theophylline, grepafloxacin, and ciprofloxacin.     

Recent developments in antibacterial drug discovery: microbe-derived natural products--from collection to the clinic

The pharmaceutical industry has historically relied on nature to provide compounds for antibacterial drug discovery. In recent years, several pharmaceutical companies have scaled back their efforts in natural product research. Nevertheless, the screening of natural products for antibacterial activity continues to provide excellent sources of biologically and chemically informative leads for new drugs. New technologies in high-throughput cultivation, genetic approaches to biodiversity and discovery of relatively untapped sources of natural products are expanding the ability to find novel, potent and highly selective antibacterial structures. Advances in purification, dereplication and structure elucidation, combined with the ability to chemically or biologically derivatise hits, aim to make the timeline for natural product-derived drug discovery similar or shorter than that expected for small synthetic molecules. This review addresses the strengths and shortcomings of technologies focused on microbe-derived natural products for antibacterial drug discovery and stresses the need for commitment to these approaches in order to achieve the goal of delivering safe, efficacious and high-quality medicines in the long run.     

Recent developments in antibacterial drug discovery: microbe-derived natural products – from collection to the clinic

The pharmaceutical industry has historically relied on nature to provide compounds for antibacterial drug discovery. In recent years, several pharmaceutical companies have scaled back their efforts in natural product research. Nevertheless, the screening of natural products for antibacterial activity continues to provide excellent sources of biologically and chemically informative leads for new drugs. New technologies in high-throughput cultivation, genetic approaches to biodiversity and discovery of relatively untapped sources of natural products are expanding the ability to find novel, potent and highly selective antibacterial structures. Advances in purification, dereplication and structure elucidation, combined with the ability to chemically or biologically derivatise hits, aim to make the timeline for natural product-derived drug discovery similar or shorter than that expected for small synthetic molecules. This review addresses the strengths and shortcomings of technologies focused on microbe-derived natural products for antibacterial drug discovery and stresses the need for commitment to these approaches in order to achieve the goal of delivering safe, efficacious and high-quality medicines in the long run.