激素性股骨头坏死介入治疗的临床疗效分析

股骨头缺血性坏死（ANFH）又称为无菌性股骨头坏死,是一种髋关节病变,发病率和致残率较高。激素已明确为引起股骨头无菌性坏死的病因之一,逐渐引起人们的重视。我科自2006年2月～2010年7月共收集整理有明确大量使用激素病史的股骨头无菌性坏死病例10例,并对其进行介入治疗,经过临床观察,取得满意疗效。     

活血养骨汤治疗股骨头无菌性坏死临床观察

股骨头骨骺无菌性坏死，又称股骨头骨骺软骨病，或扁平髋。是一种以关节病变为主，致残率很高的慢性、顽固性、难治的疾病，对本病的治疗时间长，见效慢。近年来，我院在临床实践中用活血养骨汤为主方治疗股骨头无菌性坏死26例，疗效满意，现报告如下。     

股骨头缺血坏死的介入疗效评价

成人股骨头缺血性坏死(avascular necrosis of the femoral head,ANTH)又称为无菌性坏死、骨软骨病等,发病率和致残率较高。由于其发病原因复杂,病变可累及整个髋关节,导致关节软骨破坏、股骨头坏死、塌陷性改变,从而引起髋关节功能障碍甚至功能丧失。本文探讨成人股骨头缺血坏死的影像诊断、临床治疗时机、治疗方法的有效性等。     

高压氧治疗无菌性股骨头坏死患者的疗效观察

目的探讨无菌性股骨头坏死患者高压氧治疗的临床疗效。方法将同期住院的无菌性股骨头坏死患者60例,在常规治疗的基础上加用高压氧治疗,治疗压力0.1mPa,吸纯氧60min？次,10次一疗程。结果患者的临床效果有明显提高。结论无菌性股骨头坏死患者经高压氧治疗的疗效有明显的提高。     

中医中药治疗股骨头无菌性坏死27例临床观察

股骨头无菌性坏死已逐渐成为近年来临床骨科领域的一种常见病、多发病,它对人们的工作生活造成较为严重的负面影响。现就笔者在临床上利用中医中药治疗股骨头无菌性坏死的心得体会加以总结。1 一般资料 本组27例患者,男8例,女19例;年龄最大78岁,最小39岁;病程最长3年,最短半年;外伤性21例,特发性6例;双侧股骨头发病1例;合并强直性脊椎炎1     

间充质干细胞移植治疗股骨头坏死研究进展

股骨头坏死(osteonecrosis of the femoral head,ONFH)又称为股骨头无菌性坏死或股骨头缺血性坏死,多见于35～55岁青壮年,发病率和致残率高,是骨科临床常见难治症之一[1]。ONFH是源于不同病因引发的股骨头供血不足,致软骨下骨细胞和骨髓坏死,最终导致骨小梁吸收、股骨头塌陷、关节功能障碍的疾病。对于晚期(Ⅲ期及以后)股骨头塌陷并伴严重骨性关节炎患者,只能选择     

介入配合中药治疗股骨头无菌性坏死54例初步报告

股骨头无菌性坏死（ANFH）是指股骨头骨组织因失去血运而发生坏死，同时有骨栓塞、骨无菌性坏死等。ANFH 50％-70％经保守治疗无效，需行外科股骨头置换术，此手术创伤大，病人痛苦多。随着介入技术在临床上的广泛应用，我院自2002年1月-2007年8月共对54例ANFH进行介入及中药结合治疗，现将效果报告如下。     

介入治疗对不同分期股骨头无菌坏死临床疗效观察

股骨头无菌坏死是一种常见病，其原因复杂，治疗方法较多，疗效不一。近年来开展了股骨头无菌坏死溶栓介入治疗技术，初步证明了介入治疗技术的可行性，但对不同分期股骨头无菌坏死临床疗效观察较少报道。本文根据本院收治的不同分期股骨头无菌坏死患者对介入治疗疗效观察分析，初步探讨了不同分期股骨头无菌坏死对介入治疗敏感性，同时进一步探讨了不同分期股骨头无菌坏死的治疗方案。     

股骨头无菌性坏死48例临床X线分析

股骨头无菌性坏死４８例临床Ｘ线分析福州市公费医疗第一门诊部张碧环，郑诚光福州市公费医疗第二门诊部陈容芳股骨头无菌性坏死为常见的骨关节病，近年来激素的广泛应用，使激囊性股骨头坏死的发病率增高。本文收集１９８４～１９９４年接诊的股骨头缺血性坏死４８例，结...     

经动脉介入联合生骨胶囊治疗股骨头无菌坏死的临床研究

股骨头缺血性坏死症是临床常见病,也是一种疑难病。股骨头无菌性缺血坏死的介入治疗是指在影像设备的监视下,通过导管将具有溶栓、活血化瘀、扩张血管、改善微循环等作用的药物直接送至股骨头供血动脉内,结合中药治疗达到改善股骨头的血液供应,恢复其正常的血液循环、骨质重建,重塑股骨头等治疗目标的综合方法。通过对本组56例股骨头无菌性缺血坏死病例的介入治疗,肯定了其效果。介绍如下。     

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.