甘草酸对肾损伤的保护作用和临床应用研究进展

动物实验研究证实甘草酸对缺血再灌注性、梗阻性、高血糖性、药物性(如马兜铃酸、庆大霉素、顺铂、阿霉素、镉等引起的)、变态反应性肾损伤都有保护作用.临床研究肯定了甘草酸在治疗肾综合征出血热中的疗效.已经有一些报道称甘草酸对慢性肾脏疾病、原发性干燥综合征并肾小管酸中毒、阿昔洛韦致急性肾衰竭和防治心脏手术引起的缺血再灌注性肾损伤也有疗效,但还需要其他研究在临床上进一步证实.     

格林-巴利综合征的治疗进展

格林－巴利综合征（GBS）是一组由脱髓鞘和急性轴突病变为的自身免疫疾病，有关其治疗包括两个方面：一是良好的加强性支支持治疗;二是通过临床试验发现血浆交换比换支持治疗更效，静脉注射免疫球蛋白与血浆交换有同等疗效，并且副作用更小。类固醇并不能改变GBS的结果，其联合运用静脉注射免疫球蛋白是否有效还有待证实。其他疗法、如脑脊液（CSF）过滤也有待证实其有效性。     

格林-巴和综合征的治疗进展

格林—巴利综合征(GBS)是一组由脱髓鞘和急性轴突病变为主的自身免疫疾病，有关其治疗包括两个方面：一是良好的加强性支持治疗；二是通过临床试验发现血浆交换比支持治疗更有效，静脉注射免疫球蛋白与血浆交换有同等疗效，并且副作用更小。类固醇并不能改变GBS的结果，其联合运用静脉注射免疫球蛋白是否有效还有待证实。其他疗法，如脑脊液(CSF)过滤也有待研究证实其有效性。     

环孢素A药物相互作用及临床应用

环孢素A作为一种强效免疫抑制剂,在1978年首次用于临床肾移植受者抗排斥反应的治疗,近年来随着研究的不断深入,环孢素A联合其他药物在神经系统疾病、溃疡性结肠炎、干眼症、再生障碍性贫血、肾病综合征、系统性红斑狼疮、银屑病等自身免疫缺陷疾病领域也有很好疗效。但环孢素A血药浓度受许多因素的影响,如年龄、性别、药物、食物、环境等。不同个体对环孢素A的吸收、代谢也存在差异。本文就近年环孢素A药物相互作用及临床应用进行综述。     

严重“干眼”，塞个栓子

干眼病,是指由于泪液的量或质异常引起的泪膜不稳定和眼球表面损害,从而引起眼部不适的一类疾病。引发干眼病的因素相当多,包括中年之后泪液分泌减少：眼部疾病如角膜疾病、眼睑炎、沙眼等;其他病症如类风湿关节炎、米库利兹综合征（淋巴细胞性泪腺及涎腺慢性肿大）、多发性关节炎、红斑狼疮、斯耶格伦综合征（多发生在中年或老年妇女,也称口眼干燥关节炎综合征）、甲状腺功能失调、糖尿病、皮肤病等;停经引起的激素失调;中风后造成的神经性麻痹;由某种药物引起,如避孕药、安眠药、镇静剂、咳嗽药、胃药等;营养不良;环境污染,如酷热、干燥、冷气、灰尘、烟雾等;长时间对着电脑屏幕工作;长期使用某种眼药水,如含防腐剂的抗菌药眼药水等诸多因素。     

旅游者腹泻用药利福昔明

利福昔明为利福霉素的衍生物,抗菌谱与利福平相似,因在胃肠道中难吸收,主要用于肠道感染和肠道疾病,已证明对于由大肠埃希菌引起的旅游者腹泻本品的疗效与环丙沙星相当,但对由空肠弯曲杆菌引起的感染无效,利福昔明也已用于其他胃肠道病症的治疗,如肝性脑病、肠内胀气及与气体相关的症状、憩室病、肠内细菌过度增殖、慢性肠炎、溃疡性结肠炎和活动期节段性回肠炎等。一些研究证明利福昔明用于治疗旅游者腹泻以及其他胃肠道疾病的疗效、药动学、适应证、不良反应、禁忌证、警告和剂量。     

＂奥美拉唑们＂的提醒

功效诚显著 1988年奥美拉唑以“洛赛克”之名问世,又一次打开了溃疡病治疗新局面,缓解症状堪称神速,抑制胃酸可谓彻底,简直是“前无古人”。随着应用推广,确认其对其他胃酸相关性疾病,如反流性食管炎、卓一艾综合征、某些胃炎、上消化道出血等疗效都不错,不但安全,副作用也小。     

肺表面活性物质的开发及临床应用

肺表面活性物质对维持正常功能起着关键作用，早产儿因肺发育未成熟，肺表面活性物质合成分泌不足，常发生新生儿呼吸窘迫综合征(RDS)，而其他一些疾病，如急性RDS、胎粪吸入性肺炎、严重感染、窒息缺氧等，也可导致继发性的肺表面活性物质缺乏。根据10多年来的临床研究，外源性肺表面活性物质对新生儿RDS有显著疗效，对急性RDS、胎粪吸入性肺炎等也有一定疗效。本文对肺表面活性物质研究的发展、药物开发、临床应用、不良反应等方面进行综述和评价。     

霉酚酸酯治疗狼疮性肾病综合征的临床观察

目前狼疮性肾病综合征在治疗上仍是一个难题,传统的激素、免疫抑制剂联合治疗,虽然有一定的疗效,但由于有较多的副作用难于长期维持,特别是老年人合并全身性疾病的患者,治疗上更棘手。霉酚酸酯的诞生为红斑狼疮性肾病的治疗开辟的一条新的途径。本文为了解霉酚酸酯治疗狼疮性肾病综合征的疗效,不良反应及安全性方面提供新的看法。     

酚妥拉明临床新用

<正> 酚妥拉明是一种咪唑啉类衍生物,属α-肾上腺素能受体阻滞剂,临床上主要用于血管痉挛性疾病如雷诺氏病、手足发绀症、感染性休克、肺水肿等疾病的治疗以及嗜铬细胞瘤的诊断试验。近年来,其临床应用范围日趋广泛,并取得较好的疗效,现将其治疗其他疾病的情况总结如下: 治疗糖尿病性周围神经病变禚雪英等报道,用酚妥拉明治疗糖尿病性周围神经病变25例的方法是:5～     

帕罗西汀的临床应用进展

帕罗西汀是一种选择性 5 羟色胺再摄取阻滞药 ,为抗抑郁新药 ,具有疗效好、不良反应少等特点 ,一些大型临床研究证实它还可用于治疗惊恐发作、广泛性焦虑症、社交焦虑症、强迫症、失眠症、经前期综合征、早泄等其他疾病     

Differential effects of topiramate in patients with traumatic brain injury and obesity—a case series

Rationale Topiramate is an antiepileptic drug known to have effects on weight. In order to use this as a tool to treat eating disorders, it is useful to examine whether these effects can be predicted in certain patients.Objectives To report the effects of topiramate, initiated for the treatment of epilepsy, on top of ongoing treatment, on eating patterns and weight of 17 patients with traumatic brain injury (TBI) with post-traumatic epilepsy and weight gain of various etiologies.Methods Patients were followed up according to their usual treatment plan. Topiramate was added on top of current and stable treatment. Dose was titrated based on the patients neurological status. Patients were asked to report side effects. No other changes were made.Results Of the 17 patients included, one patient dropped out. Six patients with binge eating disorder (BED) demonstrated the most pronounced effects, with marked attenuation of binges and normalizing body mass index. Less noticeable were the effects in patients with mood disorders. Topiramate was ineffective in patients whose overweight was a side effect of their medication. Side effects were rated as mild and included somnolence, paresthesias, mild cognitive disturbances and some gastrointestinal disturbances.Conclusions In this report of the actual effects of topiramate in a clinical setting on weight and eating habits of 17 patients with TBI and obesity of various etiologies, topiramate seemed to be a safe intervention. Topiramate appeared to be differentially effective, with particular effects on primary pathological eating patterns.     

侯春光主任中医师运用经方治疗小儿情志类疾病经验

侯春光主任中医师善于应用经方治疗小儿情志类疾病,侯老师临证强调审察病机,随证施治,方证对应,附小儿抽动障碍、精神性烦渴症、睡眠障碍、擦腿综合征4则验案,以资验证。     

Brain-derived neurotrophic factor and neuropsychiatric disorders

Brain derived neurotrophic factor (BDNF) is the most prevalent growth factor in the central nervous system (CNS). It is essential for the development of the CNS and for neuronal plasticity. Because BDNF plays a crucial role in development and plasticity of the brain, it is widely implicated in psychiatric diseases. This review provides a summary of clinical and preclinical evidence for the involvement of this ubiquitous growth factor in major depressive disorder, schizophrenia, addiction, Rett syndrome, as well as other psychiatric and neurodevelopmental diseases. In addition, the review includes a discussion of the role of BDNF in the mechanism of action of pharmacological therapies currently used to treat these diseases, such antidepressants and antipsychotics. The review also covers a critique of experimental therapies such as BDNF mimetics and discusses the value of BDNF as a target for future drug development.     

Spotlight on topiramate in epilepsy

Topiramate (Topamax) is a structurally novel broad-spectrum antiepileptic drug (AED) with established efficacy as monotherapy or adjunctive therapy in the treatment of adult and paediatric patients with generalized tonic-clonic seizures, partial seizures with or without generalized seizures, and seizures associated with Lennox-Gastaut syndrome. The incidence and severity of many adverse events, including CNS-related events, may be reduced through the use of slow titration to effective and well tolerated dosages. It is associated with few clinically significant interactions with other drugs, is effective when used with other AEDs, is not associated with drug-induced weight gain and, at lower dosages, does not interfere with the effectiveness of oral contraceptives. Therefore, topiramate is a valuable option as monotherapy or adjunctive therapy in the treatment of epilepsy in adult and paediatric patients.     

Topiramate: a review of its use in the treatment of epilepsy

Topiramate (Topamax) is a structurally novel broad-spectrum antiepileptic drug (AED) with established efficacy as monotherapy or adjunctive therapy in the treatment of adult and paediatric patients with generalised tonic-clonic seizures, partial seizures with or without generalised seizures, and seizures associated with Lennox-Gastaut syndrome. The incidence and severity of many adverse events, including CNS-related events, may be reduced through the use of slow titration to effective and well tolerated dosages. It is associated with few clinically significant interactions with other drugs, is effective when used with other AEDs, is not associated with drug-induced weight gain and, at lower dosages, does not interfere with the effectiveness of oral contraceptives. Therefore, topiramate is a valuable option as monotherapy or adjunctive therapy in the treatment of epilepsy in adult and paediatric patients.     

Topiramate and type 2 diabetes: an old wine in a new bottle

Topiramate, a marketed antiepileptic drug, has been used to treat seizures and allied neurological problems since 1999. Recently, a series of newer findings for the use of topiramate have cropped up, which include Type 2 diabetes and obesity. In a series of clinical studies, a subset of neurological patients with Type 2 diabetes mellitus (T2DM) serendipitously showed better glycaemic control when treated with topiramate. It has since been demonstrated that topiramate can act both as an insulin secretagogue and sensitiser in T2DM animal models. Pathogenesis of Type 2 diabetes involves both beta-cell dysfunction and insulin resistance. Therefore, an agent that has dual action (insulin secretagougue and sensitisation) is preferred for T2DM. Topiramate seems to act through multiple mechanisms to ameliorate diabetic symptoms, some of them unknown. Hence, it becomes imperative to discuss its probable modes of action. Topiramate raises new hope as an antidiabetic agent or a potential new chemotype with a better safety profile for the treatment of T2DM.     

Does risperidone have a place in the treatment of nonschizophrenic patients?

There is a now a substantial body of evidence that suggests the new antipsychotic agent, risperidone, may be safe and effective for treating psychotic, affective or behavioural symptoms associated with various disorders other than schizophrenia, schizophreniform disorder or schizo-affective disorder. These conditions include bipolar disorder, obsessive-compulsive disorder, Tourette's syndrome, dementia, Lewy body disease, mental retardation, Parkinson's disease, idiopathic segmental dystonia and organic catatonia. Although much of the data is anecdotal or in the form of open studies, there is now emerging a small number of well controlled investigations supporting efficacy for mania, dementia, behavioural disturbance in mental retardation and conduct disorder. Conventional antipsychotics have long been used, either in a primary capacity or as an adjunct to treat these disorders; however, they have limited benefit, pose significant risks of extrapyramidal side-effects, and may cause the potentially life-threatening neuroleptic malignant syndrome. In contrast, risperidone at the recommended low doses may be efficacious and pose reduced risk of motor side-effects. This article reviews the evidence that risperidone may be an effective new treatment for disorders other than schizophrenia.     

New therapeutical approaches for treatment of irritable bowel syndrome

Irritable bowel syndrome is a common functional disorder of the gut. The cause is not known. Symptoms can be quite variable and include abdominal pain, bloating, and sometimes bouts of diarrhea and/or constipation. It causes a great deal of discomfort and distress, but it does not permanently harm the intestine and does not lead to a serious disease, such as cancer. There are numerous treatment options in functional gastrointestinal disorders acting peripherally by influencing motility and visceral sensitivity. However, older 5-HT4 receptor agonists had limited clinical success because they were associated with changes in the cardiac function. New generation 5-HT4 receptor agonists, 5-HT, antagonists or partial antagonists are promising approaches to treat gastrointestinal dysmotility, particularly colonic diseases. A further new approach is the activation of chloride cannels within the gastrointestinal wall by the prostaglandin E metabolite lubiprostone. In patients with chronic constipation, lubiprostone produced a bowel movement, with sustained improvement in frequency as well as other constipation symptoms. Ongoing clinical trials suggest that linaclotide, a first-in-class, 14-amino acid peptide guanylate cyclase C (GC-C) receptor agonist and intestinal secretagogue is also an effective treatment for chronic constipation. The pharmacological profile suggests that orally administered linaclotide may be capable of improving the abdominal symptoms and bowel habits of patients suffering from of constipation-predominant irritable bowel syndrome and chronic constipation. Data are emerging, but the efficacy and safety profile of these agents in the treatment irritable bowel disease appears encouraging. Further randomized controlled trials are warranted.     

氟哌啶醇联合用药治疗儿童抽动障碍及精神分裂症的研究进展

氟哌啶醇为一种重要的抗精神分裂药,临床上用于治疗精神疾病引起的行为冲动和焦虑等症状,但单独使用该药物治疗的总有效率较低,与其他类型药物联合用于精神疾病的治疗往往具有更好的疗效和安全性。本文就近年来关于氟哌啶醇联合用药治疗儿童抽动障碍及精神分裂症的情况进行综述,探讨氟哌啶醇联合用药用于儿童抽动障碍及精神分裂症方面的研究进展,为临床用药提供参考依据。