慢性前列腺炎患者抑郁情绪与应对方式的相关分析

目的了解慢性前列腺炎患者抑郁情绪的发生情况,探讨抑郁情绪与应对方式之间的关系。方法以医学应对问卷、抑郁自评量表为主要工具分别对116例慢性前列腺炎患者进行问卷调查。结果抑郁发生率为46．49％,慢性前列腺炎患者中高中以上文化程度者的应对方式屈服分高于初中以下文化者,差异有统计学意义（P〈0．01）,自费治疗者的抑郁分值高于享受医疗保险者,且多采用回避的应对方式（P〈0．01）。慢性前列腺炎患者应对方式回避和屈服分值与抑郁情绪之间显著相关（r值分别为0．381、0．512,P〈0．01）。结论慢性前列腺炎患者抑郁的发生率高,且抑郁情绪与其文化程度、就医经济状况和应对方式有关。     

中西医结合治疗慢性前列腺炎

目的探讨中西医结合治疗慢性前列腺炎的疗效。方法将69例慢性前列腺炎的患者随机分成两组。对照组34例,以西药盐酸特拉唑嗪、左氧氟沙星、吲哚美辛治疗。治疗组35例,在对照组用药的基础上加服活血凉血,祛瘀散结的中药汤剂。结果治疗组的总有效率为91．4％,对照组为55．9％,两组比较,差异有统计学意义（P〈0．01）。治疗后两组患者的国际前列腺症状评分（IPSS）,生活质量评分（QOL）差异有统计学意义（P〈0．05）。结论治疗组明显优于对照组,进一步改善患者的生活质量,提高治愈率,减少复发率。     

五禽汤治疗慢性前列腺炎117例

目的探讨五禽汤治疗Ⅲa型慢性前列腺炎的临床疗效。方法采用双盲法将234例Ⅲa前列腺炎患者随机分为治疗组（五禽汤组）和对照组（可多华组），疗程为1个半月，观察治疗前后前列腺液白细胞计数（EPS-WBC）、pH值、疼痛症状评分（PS）、排尿症状评分（USS）、生活质量评分（QLS）、最大尿流率（MFR）、平均尿流率（AFR）。结果经Ridit分析，治疗组临床疗效明显优于对照组（P〈0．01），EPS-WBC，MFR，AFR的恢复情况亦明显优于对照组（P〈0．01），NIH-CPSI总评分降低幅度高于对照组（P〈0．01）。结论五禽汤治疗Ⅲa型慢性前列腺炎疗效较好且副作用小，具有临床推广价值。     

慢性肾功能衰竭血液透析前后P物质和心钠素水平比较

目的 了解慢性肾功能衰竭（CRF）患者血浆P物质（SP）、心钠素（ANP）含量变化与肾功能的关系。方法 采用放射免疫分析法检测正常对照组（50例）及CRF组（30例）血液透析（血透）前后SP、ANP，同时测定血清肌酐（Cr）。结果 血透前SP显著高于正常对照组（t=2．124，P〈0．01），血透后SP高于血透前（t=2．224，P〈0．05）；SP血透前与Cr呈正相关（r=0．6612，P〈0．05），SP血透后与Cr呈负相关（r=-0．4648，P〈0．05）；血透前ANP显著高于对照组（t=2．824，P〈0．01），血透后ANI，显著低于血透前（t=2．221，P〈0．05），ANP血透前后与Cr呈正相关（r=0．8225，P〈0．05）；血透前后SP变化值与ANP变化值呈负相关（r=-0．4811，P〈0．05）。结论 CRF患者血浆SP、ANP含量的变化与肾功能的改变有较明显的相关性。     

慢性鼻-鼻窦炎患者的鼻黏液纤毛传输功能与生活质量相关性的研究

目的探讨慢性鼻-鼻窦炎（chronic rhinosinusitis，CRS）患者鼻黏液纤毛传输功能与生活质量（quality of life，QOL）是否存在相关性。方法应用汉化SNOT-20量表，对实验组100例CRS患者和对照组60名健康体检者的生活质量评估，同时采用糖精试验测定鼻黏液纤毛传输速度。然后对两组变量进行统计学分析。结果通过汉化SNOT-估显示：QOL分值越大，患者的生活质量越差。实验组QOL低于对照组（P〈0．05）。影响健康最重要的五大问题依次为：擤鼻涕、鼻涕黏稠、头昏、注意力不集中及鼻涕向后倒流。鼻黏液纤毛传输速度（mucociliary transport rate，MTR），实验组低于对照组（P〈0．05）。实验组内，QOL：38．75±12．40，MTR：6．27±2．60，QOL与MTR间存在等级相关性。相关系数r=-0．235，P〈0．01。结论在CRS患者中，QOL与MTR间存在正相关性，临床治疗CRS时应注意改善及保护鼻黏液纤毛传输功能，着重解决鼻异常分泌物，头昏，注意力不集中问题，提高患者的生活质量。     

阻塞性睡眠呼吸暂停低通气综合征患者生活质量分析

目的通过问卷调查的方式对OSAHS患者生活质量进行分析评价,并进一步探讨疾病的严重程度和生活质量两者的相关性。方法以2009年8月至2010年8月因睡眠时打鼾、憋醒、白天嗜睡等症状来河北医科大学第二医院耳鼻咽喉科睡眠呼吸监测中心就诊的200例患者为采集对象,采用睡眠呼吸暂停生活质量指数（SAQLI）问卷,并以（PSG）得到呼吸暂停／低通气指数（AHI）等数据。结果LSaO2与SAQLI评分呈正相关（r：0．198,P〈0．05）,AHI与SAQLI评分呈负相关（r=-0．236,P〈0．05）。结论OSAHS患者的生存质量与社会支持、情绪症状及PsG指标密切相关．并需进行个体化的心理干预措施。     

血浆E-选择素和白介素-6水平与动脉粥样硬化临床病理参数关系的研究

目的观察动脉粥样硬化（As）患者血浆E-选择素（E-selectin）、白介素-6（IL-6）水平变化与疾病发展的关系。方法采用酶联免疫吸附法分别检测50例AS患者血浆E-selectin、IL-6水平,并与临床病理资料进行对比分析。结果E-selectin水平与患者冠状动脉病变支数（r=0．6965,P〈0．05）、冠状动脉病变程度（r=0．5867,P〈0．01）、左心室舒张末期内径（r=0．7368,P〈0．01）、左心室射血分数（r=0．8004,P〈0．01）之间存在相关;IL-6水平与冠状动脉病变程度（r=0．6599,P〈0．01）、左心室射血分数（r=0．8981,P〈0．01）之间存在相关;E-selectin、IL-6之间存在正相关（r=0．8874,P〈0．01）。结论检测AS患者血浆E—selectin、IL-6的变化可以评估疗效及预后。     

丧失对地震幸存者的心理影响

目的探讨四川地震丧失对幸存者的心理影响。方法对52例来河北省住院治疗的汶川地震幸存者（伤员27例、家属25例）进行心理评估。采用自编心理调查问卷,症状自评问卷SCL-90和PTSD筛查量表进行评估。结果（1）灾后38dPTSD筛查总阳性率17．1％,丧失与PTSD的发生无关。（2）财产丧失与SCL-90总分之间相关,财产丧失〈25万SCL-90总分最高（P〈0．01）,财产丧失〈15万（P〈0．05）,财产丧失与SCL-90的多项症状相关。（3）受伤程度：多变量相关分析受伤程度与抑郁（P〈O．05）和其他（P〈0．05）症状相关,与强迫临界相关（P=0．069）。单变量相关分析受伤程度与抑郁（P〈0．01）和其他（P〈0．05）症状相关,与强迫相关（P〈0．05）。（4）人员伤亡情况与SCL-90各组症状不相关。结论地震是毁灭性灾难事件,人员、财产以及健康方面的丧失会对亲历者的心理产生影响。财产方面的丧失影响最大,人员方面的丧失影响不明显,这可能与中国文化和心理动力学特点有关。     

慢性肝病患者血清白介素-6及其受体检测的临床意义

目的：观察慢性肝病患者血清白介素-6（IL-6）和可溶性IL-6受体（sIL-6R）的变化。方法：应用酶联免疫吸附试验（EIL-SA）检测慢性肝炎患者86例、肝炎后肝硬化患者18例和20例健康对照组血清中IL-6和sIL-6R水平。结果：慢性肝炎患者血清IL-6和sIL-6R含量均显著高于健康对照组（P〈0．01），其中肝炎后肝硬化组上述2参数高于慢性肝炎组；慢性肝炎组中的上述2参数显示为：重度〉中度〉轻度．各组间差异有显著性（P〈0．05或P〈0．01）：慢性肝病组血清IL-6和sIL-6R水平之间呈正相关（r=0．481，P〈0．05），IL-6和sIL-6R水平与血清总胆红素水平间亦呈正相关（r=-0．417，0．418，P〈0．01），与ALT之间无明显相关性（r=0．173，0．182，P〉0．05）。结论：血清IL-6和sIL-6R与慢性肝病的病情演变有关．对其预后有一定指导意义。     

尼美舒利治疗男性慢性盆腔疼痛综合征临床试验

目的：评价尼美舒利治疗慢性盆腔疼痛综合征（CPPS）的有效性和安全性。方法：按照NIH分类标准，采用PPMT法及EPS常规检查，将145例患者分为两组，Ⅲa型组77例，Ⅲb型组68例。两组均口服尼美舒利100mg，bid，治疗4周。根据慢性前列腺炎症状评分（CPSI）判断疗效。结果：治疗4周后，两组疼痛症状评分、生活质量评分及总CPSI评分均有明显改善（P〈0．05或P〈0．01），其中Ⅲa型组EPS中WBC计数评分较治疗前有明显减少（P〈0．05）。Ⅲa型组总有效率为84．5％，Ⅲb型组总有效率为83．3％，两组间总有效率差异无统计学竞义（P〉0．05）。两组治疗期间均无严重不良事件发生。结论：尼美舒利治疗慢性盆腔疼痛综合征是安全、有效的。     

Role of glutathione in reduction of arsenate and of gamma-glutamyltranspeptidase in disposition of arsenite in rats

Arsenate (AsV), the environmentally prevalent form of arsenic, is converted sequentially in the body to arsenite (AsIII), monomethylarsonic acid (MMAsV), monomethylarsonous acid (MMAsIII), and dimethylarsinic acid (DMAsV) and some trimethylated metabolites. Although the biliary excretion of arsenic in rats is known to be glutathione (GSH)-dependent, involving transport of arsenic-GSH conjugates, the role of GSH in the reduction of AsV to the more toxic AsIII in vivo has not been defined. Therefore, we studied how the fate of AsV is influenced by buthionine sulfoximine (BSO), which depletes GSH in tissues. Control and BSO-treated rats were given AsV (50 micromol/kg, i.v.) and arsenic metabolites in bile, urine, blood and tissues were analysed by HPLC-HG-AFS. BSO increased retention of AsV in blood and tissues and decreased appearance of AsIII in blood, bile (by 96%) and urine (by 63%). The biliary excretion of MMAsIII was also nearly abolished, the appearance of MMAsIII and MMAsV in the blood was delayed and the renal concentrations of these monomethylated arsenicals were decreased by BSO. Interestingly, appearance of DMAsV in blood and urine remained unchanged and the concentrations of this metabolite in the kidneys and muscle were even increased in response to BSO. To test the role of gamma-glutamyltranspeptidase (GGT) in arsenic disposition, the effect of the of the GGT inhibitor acivicin was investigated in rats injected with AsIII (50 micromol/kg, i.v.). Acivicin lowered the hepatic and renal GGT activities and increased the biliary as well as urinary excretion of GSH, but failed to alter the disposition (i.e. blood and tissue concentrations, biliary and urinary excretion) of AsIII and its metabolites. In conclusion, shortage of GSH decreases not only the hepatobiliary transport of arsenic, but also reduction of AsV and the formation of monomethylated arsenic, while not hindering the production of dimethylated arsenic. While GSH plays an important role in the disposition and toxicity of arsenic, GGT, which hydrolyses GSH and GSH conjugates, apparently does not influence the fate of the GSH-reactive trivalent arsenicals in rats.     

微透析取样技术在中药体内分析中的应用研究进展

本文综述了微透析取样技术在中药体内分析中的应用,介绍微透析取样技术的原理、组成、探针类型、特点,重点阐述了微透析取样技术在测定脑、血液、皮肤等组织器官中中药有效成分浓度的应用实例。表明微透析取样技术在中药药效研究中具有广阔的前景。     

应用PASS系统分析我院2010年住院医嘱

目的:了解我院2010年住院患者的合理用药情况,探讨如何利用合理用药监测系统( PASS)提高合理用药水平.方法:利用PASS对我院2010年15 966例住院患者的1 184 997条用药医嘱进行监测,以黑色警示医嘱为依据,收集不合理用药信息,并对监测结果进行统计、分析.结果:不合理用药医嘱50 261条,发生率为4.24％.绝对禁止黑色医嘱5441条,主要为药物相互作用(66.54％)、注射液体外配伍(17.86％)、用法用量(15.46％)、儿童警告(1.14％).结论:应用PASS系统能有效监测医嘱中的不合理用药情况,有利于提高临床合理用药水平,但PASS系统尚存在局限性,有待进一步完善.     

Changes in levels of dependency and predictors of mortality in elderly people in institutional care in Dunedin

The 1983 study of dependency of subjects in institutional care in Dunedin was repeated two years later. A significant increase in levels of dependency in residential homes, particularly in the Religious and Welfare sector was found. In 1983 there were 29 high dependency residents and 73 medium dependency residents in residential homes. In 1985 these numbers had increased to 55 and 86 respectively. There was no change in the number of low dependency residents. In 1983, 6 high dependency residents had been admitted to residential home care in the year prior to the study. In 1985 the number of high dependency residents recently admitted had increased to 23. There had also been a significant increase in the dependency of patients in Religious and Welfare continuing care hospitals. Of the 933 subjects in institutional care in 1983 who were able to be followed, 354 (37.9%) died in the following 2 years. Mortality rate was higher for those in hospital care (48.1%) than for those in residential home care (29.6%). Mortality rates were higher in more dependent subjects and this was evident for each measure of dependency.     

应用PASS系统对我院2008年住院医嘱的分析

目的监测分析2008年我院住院患者用药情况。方法将PASS系统嵌入医生工作站、临床药学工作站等子系统,构建合理用药计算机网络系统,对住院医嘱进行及时监测,将监测结果向医生反馈,并对其进行统计、分析。结果2008年共监测医嘱3 620 241条,不合理医嘱908条,占0.02%。不合理医嘱中,配伍禁忌(381条)占41.96%,用法用量(381条)占41.96%,药物相互作用(108条)占11.89%,儿童用药(38条)占4.19%。经与医生沟通后,更改不合理医嘱856条,占94.27%。结论PASS系统可有效监测医嘱中的不合理用药,通过与医生交流,大大减少药物不良事件的发生,值得临床推广应用,也为临床药师开展工作带来了极大的便利。但PASS系统尚存在局限性,有待进一步完善。     

Role of desacetylation in the detoxification of cephalothin in renal cells in culture

The toxicity of three cephalosporin antibiotics to rabbit kidney cells in culture was compared to their known nephrotoxic potential in vivo (cephaloridine greater than cefazolin greater than cephalothin). While cephalothin is considered to be a relatively nonnephrotoxic cephalosporin when administered to many species including humans and rabbits, in several in vitro systems involving rabbit renal tissue, cephalothin was comparatively more toxic than anticipated based on in vivo data. Cephalothin is extensively desacetylated in rabbits to a less microbiologically active metabolite, desacetylcephalothin. When a microsomal S9 fraction from rabbit kidney was added to the in vitro assay in cultured rabbit renal cells, cephalothin was desacetylated and its toxicity to kidney cells was reduced. The addition of S9 in vitro provided a toxicity ranking of the cephalosporins that correlated with their known in vivo nephrotoxic potentials (cephaloridine greater than cefazolin greater than cephalothin). The in vitro detoxification of cephalothin by S9 was blocked by the coadministration of the esterase inhibitor, aminocarb. Desacetylcephalothin was relatively nontoxic to rabbit renal tissue in vitro. These results suggest that the desacetylation of cephalothin in vivo represents a previously unrecognized mechanism of detoxification of this cephalosporin antibiotic. Furthermore, this mechanism of detoxification may be applicable to other acetylated cephalosporins.     

2009年某院住院患者抗真菌药用药调查

目的:分析讨论某院抗真菌药使用的合理性,为临床安全有效地使用抗真菌药提供参考。方法:回顾性统计分析某院2009年住院患者抗真菌药用药信息。结果:2009年某院住院患者抗真菌药DDDs排名前3名分别为:氟康唑、制霉菌素和伊曲康唑;使用金额排名前3名分别为:氟康唑、米卡芬净及卡泊芬净;更换一种抗真菌药进行治疗的患者数为176人,在全部患者中占13.4%。结论:应进一步强化用药指征的意识,提高标本送检率,同时改善某些抗真菌用药不合理更换的现象,以避免耐药性发生,从而更好更长远地体现抗真菌药的治疗价值。     

Kinetics of in vitro metabolism of methoxyphenamine in rats

1. Methoxyphenamine (MP) was metabolized in vitro by rat liver preparations to O-desmethylmethoxyphenamine (O-desmethyl-MP), N-desmethylmethoxyphenamine (N-desmethyl-MP) and 5-hydroxymethoxyphenamine (5-hydroxy-MP). These metabolic pathways were inhibited by SKF 525-A and carbon monoxide, which indicates that these reactions were mediated at least partly by an NADPH-dependent cytochrome P-450 system. 2. Strain differences in the metabolism of this drug in vitro were observed in female Lewis and Dark Agouti (DA) rats, which are proposed models for human debrisoquine phenotypes. Methoxyphenamine O-demethylase and 5-hydroxylase activity in DA rats were lower than those in Lewis rats. 3. The metabolic transformation of methoxyphenamine in vitro to O-desmethyl-MP was inhibited competitively by debrisoquine and sparteine. This indicates that the cytochrome P-450 isoenzyme mediating the metabolism of MP to O-desmethyl-MP is similar to that mediating metabolism of debrisoquine and sparteine. However, no inhibition was observed with methenytoin.     

Comparison of in vitro cell models in predicting in vivo brain entry of drugs

Although several in vitro models have been reported to predict the ability of drug candidates to cross the blood-brain barrier, their real in vivo relevance has rarely been evaluated. The present study demonstrates the in vivo relevance of simple unidirectional permeability coefficient (P(app)) determined in three in vitro cell models (BBMEC, Caco-2 and MDCKII-MDR1) for nine model drugs (alprenolol, atenolol, metoprolol, pindolol, entacapone, tolcapone, baclofen, midazolam and ondansetron) by using dual probe microdialysis in the rat brain and blood as an in vivo measure. There was a clear correlation between the P(app) and the unbound brain/blood ratios determined by in vivo microdialysis (BBMEC r=0.99, Caco-2 r=0.91 and MDCKII-MDR1 r=0.85). Despite of the substantial differences in the absolute in vitro P(app) values and regardless of the method used (side-by-side vs. filter insert system), the capability of the in vitro models to rank order drugs was similar. By this approach, thus, the additional value offered by the true endothelial cell model (BBMEC) remains obscure. The present results also highlight the need of both in vitro as well as in vivo methods in characterization of blood-brain barrier passage of new drug candidates.