胸腺肽联合比阿培南治疗革兰阴性杆菌重症下呼吸道感染疗效观察

目的 探讨胸腺肽联合比阿培南治疗革兰阴性杆菌重症下呼吸道感染的疗效和安全性.方法 将54例革兰阴性杆菌重症下呼吸道感染患者随机分为胸腺肽联合比阿培南治疗组26例(A组)和比阿培南治疗组28例(B组),疗程均为7～14d.比较两组临床疗效、比阿培南使用时间、细菌清除率及不良反应情况.结果 A、B两组的临床有效率分别为84.6％、82.1％,差异无统计学意义(P＞0.05);A组治疗时间(8.2±3.4)d,优于B组的(13.2±3.6)d(P＜0.05);A、B两组细菌清除率86.7％、80.7％ (P ＞0.05).结论 胸腺肽联合比阿培南治疗革兰阴性杆菌重症下呼吸道感染比阿培南单用治疗时间短,且安全,有效,值得临床推广.     

头孢丙烯治疗细菌性感染31例

目的:评价头孢丙烯的疗效及安全性.方法:以头孢丙烯和头孢克洛随机对照治疗急性轻、中度呼吸道及皮肤软组织感染,31例患者接受头孢丙烯(250～500 mg,2次/d)、35例患者接受头孢克洛(250～500 mg,3次/d)治疗,疗程7～14 d.结果:治疗组和对照组的痊愈率和总有效率分别为77.4%,80.0%(P＞0.05)与96.8%,94.3%(P＞0.05);细菌阳性率、清除率分别为87.1%,88.6%(P＞0.05)和96.3%,93.5%(P＞0.05);不良反应发生率分别为4.7%和4.3%(P＞0.05).结论:头孢丙烯治疗轻、中度细菌感染安全、有效.     

加替沙星序贯治疗呼吸道细菌感染的疗效分析

目的 观察加替沙星序贯治疗呼吸道细菌感染的疗效及安全性.方法 将我院2006年8月～2007年8月确诊为下呼吸道细菌感染的住院110例患者分成两组,A组56例,用加替沙星注射液0.4g,iv qd×3～5d后改用加替沙星胶囊0.4g,poqd,总疗程7～14d的序贯治疗;B组54例,用左氧氟沙星序贯治疗.结果 A、B组的总有效率分别为94.6%、96.3%,差异无统计学意义(P＞0.05);细菌清除率分别为96.0%、85.4%,差异有统计学意义(P＜0.05);不良反应发生率分别为17.9%、7.4%,差异有统计学意义(P＜0.05),不良反应轻微,患者可耐受,不影响治疗.结论 加替沙星序贯治疗下呼吸道细茵感染的疗效确切,安全性好.     

莫西沙星治疗慢性支气管炎急性发作的前瞻性研究

目的:研究莫西沙星对慢性支气管炎急性发作(AECB)的疗效.方法:对AECB患者随机分成二组,一组口服莫西沙星400mg,gd×6d,另一组口服克拉霉素500mg,bid×6d,观察临床疗效和细菌清除状况以及不良反应.结果:莫西沙星治疗组和克拉霉素治疗组病人的临床总有效率分别为93.1%和87.9%,差异无显著性(P＞0.05);支气管周围炎症吸收率分别为84.7%和71.2%,差异有显著性(P＜0.05);痰中致病菌清除率分别为88.9%和72.1%,差异有显著性(P＜0.05);不良反应发生率分别为1.4%和13.6%,差异有显著性(P＜0.05).结论:在治疗AECB时,莫西沙星与克拉霉素比较,两者的临床疗效基本相似,但其支气管周围炎症吸收状况前者优于后者,痰中致病菌清除率更高,更具依从性和耐受性.     

注射用头孢唑肟钠国产品与进口品随机对照单盲治疗急性细菌性感染临床评价

目的评价注射用头孢唑肟钠国产品治疗中、重度呼吸道细菌性感染的有效性和安全性。方法本临床试验选用两组药物，采用随机对照方法。试验药（注射用头孢唑肟钠国产品）和对照药（注射用头孢唑肟钠进口品）的剂量均为每次2g，Bid，疗程均为7～14d。结果头孢唑肟钠国产品组与进口品组疗效评价例数分别为20例和21例，临床有效率分别为90．0％和90．5％，细菌清除率分别为94．4％和88．9％。药物不良反应发生率分别为0和4．8％。以上结果经统计学处理差异无显著性。结论注射用头孢唑肟钠国产品与进口品在临床疗效、细菌学疗效、药物不良反应等方面无明显差异，且对敏菌引起的中重度感染疗效确切，药物不良反应少而轻微。     

阿奇霉素联合左氧氟沙星治疗社区获得性肺炎疗效分析

目的探讨阿奇霉素联合左氧氟沙星治疗社区获得性肺炎的疗效,为临床用药提供参考。方法将120例社区获得性肺炎随机分为3组,A组应用阿奇霉素治疗,B组应用左氧氟沙星治疗,C组联合应用阿奇霉素及左氧氟沙星治疗,疗程均为7～14d。观察3组患者临床疗效、病情变化、细菌清除率和不良反应。结果 C组有效率为92.5%,与A组(62.5%)、B(67.5%)差异有统计学意义(P<0.05);C组发热、啰音消退时间和血?妗⒎尾?X线恢复时间与A、B组差异有统计学意义(P<0.05);C组细菌清除率为92.5%与A组(67.5%)、B组(65.0%)差异有统计学意义(P<0.05);3组不良反应发生率差异无统计学意义(P>0.05);A组与B组的临床疗效、病情变化、细菌清除率比较差异无统计学意义(P>0.05)。结论阿奇霉素联合左氧氟沙星治疗CAP患者,疗效高,病程短,副作用少,是基层医疗机构CAP患者较为适宜的临床用药方案。     

加替沙星与左氧氟沙星治疗急性细菌感染的疗效比较

目的 比较加替沙星与左氧氟沙星治疗急性细菌感染的疗效,评价加替沙星治疗急性细菌感染的有效性和安全性.方法 将呼吸系统和泌尿系统感染的患者228例根据数字表法随机分为A组和B组,每组114例.A组给予加替沙星200 mg加入5％葡萄糖注射液100 ml静脉滴注;B组给予左氧氟沙星200 mg加入5％葡萄糖注射液100 ml静脉滴注.两组均予2次/d,疗程均为7～14 d.观察两组疗效和细菌清除率以及不良反应.结果 A组痊愈率、总有效率分别为68.4％、93.0％,B组分别为66.7％、90.3％,差异均无统计学意义(x2=0.184、0.213,均P＞0.05).A组细菌清除率、细菌药物敏感试验敏感率分别为89.4％、78.8％,B组分别为77.2％、70.3％,差异均有统计学意义(x2=4.812、4.236,均P＜0.05).A组不良反应发生率为7.0％,B组为6.1％,差异无统计学意义(x2=0.672,P＞0.05).结论 加替沙星治疗急性细菌引起的呼吸系统、泌尿系统感染疗效显著,不良反应较低,治疗效果与左氧氟沙星无明显差异,值得临床推广应用.     

探讨持续泵入美罗培南对脓毒血症多重耐药菌患者的研究

目的:探究美罗培南持续泵入对脓毒血症多重耐药菌患者的临床疗效研究。方法:2019年9月～2020年12月期间在某院选取符合条件的脓毒血症多重耐药菌患者60例为研究对象,采用随机数字表法随机分为A组和B组各30例。A组采用持续泵入美罗培南治疗,B组给予静脉滴注美罗培南治疗,对比两组患者的临床疗效和两组患者的细菌总清除率。结果:A组治疗前PCT约为(16.25±1.64)ng·ml~(-1),CRP约为(74.13±22.12)mg·ml~(-1);A组治疗后PCT约为(0.35±0.11)ng·ml~(-1),CRP约为(15.25±1.25)mg·ml~(-1);B组治疗前PCT约为(16.33±1.78)ng·ml~(-1),CRP约为(73.24±22.36)mg·ml~(-1),B组治疗后PCT约为(1.17±0.55)ng·ml~(-1),CRP约为(23.25±11.37)mg·ml~(-1)。由此可见,A组指标比B组降低更多;A组总清除率为93.33%,高于B组66.66%(P0.05),具有统计学意义;A组患者住院时间为(11.21±1.23)d, B组患者住院时间为(18.56±1.24)d,组间比较,差异具有统计学意义(P0.05);A组的总体有效率为90.00%,高于B组66.66%(P0.05),具有统计学意义。结论:对脓毒血症多重耐药菌患者给予持续泵入美罗培南治疗,既可以取得显著的临床效果,提高细菌清除率,又可以减少患者住院时间,对于临床治疗有着重要意义,值得应用和推荐。     

头孢吡肟治疗慢性阻塞性肺疾病急性加重期并呼吸衰竭的疗效观察

目的:观察国产头孢吡肟治疗慢性阻塞性肺疾病急性加重期(AECOPD)并呼吸衰竭的疗效及安全性。方法:96例AE-COPD并呼吸衰竭患者随机分成A组(n=48)与B组(n=48),分别给予头孢吡肟、头孢哌酮钠/他唑巴坦钠治疗。2组给药剂量均为2.0g,静脉滴注,bid,疗程7～14d。结果:A组与B组总有效率分别为82%、62%(P<0.01);A组与B组痰菌清除率分别为79.1%、45.8%(P<0.05);A组与B组不良反应发生率分别为8.3%、10.4%(P>0.05)。结论:头孢吡肟治疗AECOPD并呼吸衰竭疗效优于头孢哌酮钠/他唑巴坦钠,两者均有较好的安全性。     

雷贝拉唑与兰索拉唑治疗幽门螺杆菌阳性十二指肠溃疡的对比

目的:比较雷贝拉唑与兰索拉唑联用抗菌药物治疗幽门螺杆菌(helicobacter pylori,Hp)阳性十二指肠溃疡的疗效.方法:将经内镜证实的89例Hp阳性十二指肠溃疡患者随机分为两组,分别给予口服雷贝拉唑和兰索拉唑(均联用抗菌药物)治疗,于停药后4周复查内窥镜及Hp检测.结果:治疗组与对照组的疼痛消失时间分别为(1.38±0.66)d和(2.39±1.07)d(P＜0.05);1周末的症状消失率分别为93.48%和88.37%(P＞0.05);2周末的症状消失率分别为97.83%和95.35%(P＞0.05);溃疡愈合率分别为93.48%和90.70%(P＞0.05);Hp根除率分别为91.30%和90.70%(P＞0.05).结论:用雷贝拉唑治疗有较高的溃疡愈合率和Hp根除率,止痛效应较快,是一种有应用前景的质子泵抑制剂.     

Affective and Anxiety Disorders and Alcohol and Drug Dependence:

Depression and anxiety frequently coexist in patients with substance use disorders. This clinically-oriented article examiens the relationship between these conditions and emphasizes data showing that substances of abuse can cause signs and symptoms of both depression and anxiety. These substance-related syndromes appear to have a different course and prognosis than uncomplicated, independent anxiety and major depressive disorders, and clinicians should consider the role of alcohol and other drugs in all patients presenting with these complaints. The authors will also outline an approach for diagnosing and managing patients with the combination of a substance use and depressive or anxiety disorder.     

Synthesis and anti-nociceptive and anti-inflammatory effects of gaultherin and its analogs

The synthesis of gaultherin (1) and its analogs was carried out to provide 11 glycosides under phase-transfer catalytic conditions. The activities of all synthesized compounds were evaluated by nitric oxide production inhibitory assay in vitro. Methyl 2-O-(4-O-β-d-galactopyranosyl)-β-d-glucopyranosylbenzoate (5f) showed significantly anti-nociceptive and anti-inflammatory effects by the evaluation in vivo. Structure–activity relationships within these compounds were discussed.     

Modelling and simulation of variability and uncertainty in toxicokinetics and pharmacokinetics

Two important methodological issues within the framework of the variability and uncertainty analysis of toxicokinetic and pharmacokinetic systems are discussed: (i) modelling and simulation of the existing physiologic variability in a population; and (ii) modelling and simulation of variability and uncertainty when there is insufficient or not well defined (e.g. small sample, semiquantitative, qualitative and vague) information available. Physiologically based pharmacokinetic models are especially suited for separating and characterising the physiologic variability from the overall variability and uncertainty in the system. Monte Carlo sampling should draw from multivariate distributions, which reflect all levels of existing dependencies in the intact organism. The population characteristics should be taken into account. A fuzzy simulation approach is proposed to model variability and uncertainty when there is semiquantitative, qualitative and vague information about the model parameters and their statistical distributions cannot be defined reliably.     

成骨细胞的功能与损伤和骨质疏松的防治

骨质疏松是一种全身性骨骼疾病,导致骨折风险增加。成人的骨量通过破骨细胞的骨吸收和成骨细胞的骨形成作用来维持动态平衡,治疗骨质疏松症的理想策略是抑制破骨细胞的骨吸收和/或增强成骨细胞的骨形成功能。目前针对保护成骨细胞及增强其功能的骨质疏松疗法相对较少。因此,本文针对成骨细胞相关功能蛋白、各种细胞损伤机制（内质网应激、氧化应激、机械过载、微小RNA和长链非编码RNA的影响等）及骨质疏松的治疗与预防作一综述,以期为针对增强成骨细胞功能的骨质疏松治疗策略提供新思路。     

Self-stimulation and amphetamine: Tolerance to d and l isomers and cross tolerance to cocaine and methylphenidate

The effects of the d and l isomers of amphetamine on self-stimulation responding were tested following acute and chronic administration. Tolerance and post-drug depression of responding occurred in tests with both isomers, indicating no role for p-hydroxynorephedrine (PHN) which is one of the metabolites of d-amphetamine. In the second experiment, d-amphetamine, methylphenidate and cocaine all produced quantitatively and qualitatively similar effects on self-stimulation responding following acute administration. Following chronic administration of d-amphetamine, animals showed tolerance to all three drugs, indicating cross-tolerance among them. These data are consistent with an hypothesis that tolerance and post-drug depression following chronic amphetamine treatment are the result of decreases in postsynaptic receptor sensitivity, which would lead to a decreased effectiveness of all three drugs, regardless of their pre-synaptic mechanisms.     

益生菌与肿瘤防治

益生菌广泛存在于自然界中,通过维持宿主体内菌群平衡、影响肠屏障功能和调节免疫应答等作用,提高宿主健康水平,被公认为"肠道健康卫士".一些益生菌可以增强机体的免疫功能,抑制致癌物质,影响肿瘤细胞的基因表达,对肿瘤具有拮抗作用.大量研究表明,益生菌在未来的肿瘤防治中有很好的应用和发展前景.     

Acamprosate and naltrexone treatment effects on ethanol and sucrose seeking and intake in ethanol-dependent and nondependent rats

Rationale  Two pharmacotherapies are approved for treating alcohol craving (acamprosate and naltrexone), but both have shown mixed findings in animals and humans. Objectives  The present experiments utilized a “reinforcer blocking” approach (i.e., rats were able to consume ethanol during treatment) to better understand the efficacy of these treatments for ethanol seeking and drinking using ethanol-dependent and nondependent rats. Materials and methods  In “nondependent” experiments, drugs (acamprosate 50, 100, and 200 mg/kg; naltrexone 0.1, 0.3, and 1.0 mg/kg) were administered over 3-week periods prior to operant sessions with a low response requirement to gain access to reinforcers for 20 min. For “dependent” experiments, rats were made dependent in vapor/inhalation chambers. Results  Acamprosate and naltrexone had similar effects on intake in nondependent and dependent rats; neither drug was selective for ethanol over sucrose drinking. In nondependent animals, naltrexone was more efficacious at more doses than acamprosate, and acamprosate’s effects were limited to a dose that also had adverse effects on body weight. Both pharmacotherapies showed more selectivity when examining reinforcer seeking. In nondependent rats, acamprosate and naltrexone had response-attenuating effects in ethanol, but not sucrose, groups. In dependent animals, acamprosate had selective effects limited to a decrease in sucrose seeking. Naltrexone, however, selectively decreased ethanol-seeking in nondependent rats. Conclusions  The naltrexone-induced decreases in seeking suggested a change in incentive motivation which was selective for ethanol in nondependent rats. The “nondependent” paradigm may model early stages of “problem drinking” in humans, and the findings suggest that naltrexone could be a good intervention for this level of alcohol abuse and relapse prevention.     

Antiinfective and encrustation-inhibiting materials--myth and facts

Catheters, urethral and ureteral stents and other urological implants are frequently affected by encrustration and infection due to their permanent contact with urine. Indwelling urinary catheters provide a haven for microorganisms and thus require extensive monitoring. Several surface modification techniques have been proposed to improve the performance of devices including the immobilization of biomolecules, the incorporation of hydrophilic grafts to reduce protein adsorption, the creation of hydrophobic surfaces, the creation of microdomains to regulate cellular and protein adhesion, new polymers and antimicrobial coatings. Physico-chemical explanation to elucidate the mechanism of such encrustation or infection inhibiting materials is still not available. Our series of experiments showed a marked decrease of silver-activity in biological fluids which corresponds with the controversial clinical results obtained with silver coated urinary catheters. Rifampicin/minocycline coated catheters had very low activity against Gram-negative rods, enterococci and Candida spp., the main causing organisms of urinary catheter infection. Surface engineered materials and antimicrobial drug delivery systems will be the next generation of sophisticated urinary catheters and stents, if both efficacy as well as efficiency has been proved clinically.     

Alprazolam and lorazepam single and multiple-dose effects on psychomotor skills and sleep

Summary The effects of alprazolam 0.5 mg and lorazepam 2 mg on cognitive and psychomotor skills were assessed in twelve normal volunteer subjects in a randomised, double-blind, crossover design. Single and multiple dose effects were monitored using a battery of tests comprising critical flicker fusion threshold (CFFT), choice reaction time (CRT), simulated car tracking, and subjective ratings of perceived sedation (LARS) and of sleep behaviour (LSEQ). Compared with placebo baseline scores, treatment with lorazepam 2 mg (both single and multiple doses) resulted in a widespread impairment of CRT, tracking accuracy, and CFFT. Single doses of alprazolam 0.5 mg reduced CFFT with respect to the placebo baseline. Single and multiple dose treatment with both drugs resulted in subjective reports of sedation, a reduction of sleep onset latency, and improved sleep quality. Only lorazepam 2 mg significantly disrupted the integrity of behaviour on waking from sleep. These results suggest important pharmacodynamic differences between the two drugs in the doses used.