芒种养生重细节

我国古人把每年太阳到达黄经75度时定为芒种节气,时值公历6月5日或6日,意即有芒的作物（主要指麦类）开始成熟收割,也是夏播作物播种时节,如晚谷、黍、稷等。此时已进入真正的夏季,最大的特点就是气温升高、空气潮湿,此时又恰是蚊虫繁殖滋生之时,因此生活上更要注意一些细节,才能适应天气的变化。[第一段]     

Long term complications following renal transplantation

The long term complications of renal transplantation were assessed in 36 patients who had lived for 10 or more years with a functioning renal transplant. Thirty-three patients were alive with a mean plasma creatinine of 0.13 mmol/L (SD 0.07). A 62 year old women died from a myocardial infarction 11 years after transplantation and two women developed chronic rejection and returned to dialysis after 17 years. Nineteen patients have required antihypertensive therapy, five have suffered ischaemic heart disease and two a cerebrovascular event. Malignancy has developed in 13 patients, with four having two or more organs involved. Skin cancers (9 squamous cell, 4 basal cell) were present in all 13 patients and recurred in six. The other malignancies included carcinoma of cervix (2), cervix and bladder (1) and thyroid (1). Three patients have required parathyroidectomy for autonomous hyperparathyroidism, two splenectomy for hypersplenism, and one bilateral hip replacement for avascular necrosis of the femoral heads. The development of hypertension, vascular disease and malignancy are the most important long term complications after renal transplantation. Strategies must be formulated to reduce the morbidity and mortality from these causes.     

热咳停颗粒长期毒性研究

目的:研究热咳停颗粒的长期毒性。方法:实验分为4组,即对照(生理盐水)及热咳停颗粒高、中、低剂量(188、94、18g.kg-1)组,灌胃给药,连续3月。给药后检测大鼠血常规、尿常规与血液生化指标,并尸检各主要脏器;停药2周后再次检查上述指标,以观察是否存在异常。结果:灌胃3月后,大鼠体质量逐渐增长,生长发育良好。热咳停颗粒高剂量组除大鼠血液中谷丙氨酸氨基转移酶(GPT)、尿素氮(BUN)有所增高,少数的肝、肾有轻度损害外,外周血象、尿常规及血液生化指标的检测均在常值范围之内。停药2周后检测上述各项指标和尸检各脏器未见异常。结论:热咳停颗粒给药期间对大鼠肝、肾有轻微损伤,但停药后其又能恢复正常。     

Tolerability of long term clozapine treatment

Tolerability of long term clozapine treatment (7–8 years) was investigated in 27 female patients (age 34–77 years). Diagnosis according to ICD 9 was schizophrenia in 21 patients, severe psychomotor agitation with mental deficiency in 4 patients and an endogenous depression in 2 patients. All patients had previously been treated with different neuroleptics but with inadequate response or distressing side effects. The duration of the disorder was 10–36 years, duration of hospitalisation 10–36 years. At the day of investigation the total dose of clozapine ranged from 52–826 g, the average total dose being 385 g. The daily dose of clozapine ranged from 75 to 600 mg, the average daily dose being 225 mg. Only 2 patients were treated exclusively with clozapine, the other 25 patients were also receiving other neuroleptics. Seventy eight per cent of the investigated patients complained about hypersalivation and 63% showed overweight. In 37% of the patients the EEG demonstrated abnormalities. Mild parkinsonism was reported in 15% and akathisia in 11% of the patients, all these patients being on combined treatment. Clozapine did not induced tardive dysakinesia (TD) in any of the patients within a treatment period of 7–8 years. It is concluded that a potential benefit of clozapine includes a low incidence of neurological side effects even after long term administration.     

Stability of liposomes on long term storage

The effect of the lipid composition of liposomes on their storage for up to one year under different environmental conditions has been examined using 5,6-carboxyfluorescein as a model drug. When cholesterol and/or alpha-tocopherol were included in the liposomes, a significantly greater amount of dye was retained. The presence of alpha-tocopherol decreased the breakdown of phosphatidylcholine to lysophosphatidylcholine and also reduced the level of peroxidation. Carboxyfluorescein retention was further enhanced when liposomes were stored at 4 degrees C or at room temperature (20 degrees C) in an O2-free atmosphere. Lysophosphatidylcholine formation also slowed when the liposomes were kept at 4 degrees C, or in an O2-free atmosphere. It is concluded that egg yolk lecithin liposomes may be stored for long periods at low temperature in an O2-free atmosphere or with added stabilizers such as cholesterol and alpha-tocopherol.     

Optimising drug utilisation in long term care

Providing quality long term care for the elderly while containing costs is presenting major challenges for governments and policy makers. Although international variability exists with respect to the number of medications and other factors influencing suboptimal pharmacotherapy, suboptimal pharmacotherapy among elderly persons is common. This international problem requires a creative and multifaceted approach to improve and rationalise prescribing. We outline the non-regulatory efforts and regulatory means to approaching this problem. The recent introduction of a prospective payment system for long-term care in the US has underscored the importance of a regulatory approach to counter-balance the cost containment efforts which bundle the cost of medications into a prospectively set per diem rate. An examination of how US regulatory bodies are considering improving prescribing is provided. Considering the case of coronary heart disease, we provide data regarding the performance of a quality indicator aimed at stimulating quality prescribing for this medical condition. Although the use of regulatory approaches can improve prescribing, it is also recognised that a more holistic approach involving multidisciplinary teams and greater focus on the patient is the ultimate aspiration. This is particularly the case with the elderly in whom appropriate drug therapy can have a major impact on outcomes. A major cultural shift in the way society views and treats the elderly may be required in order to produce dramatic improvements in long term care for older people.     

比较米索前列醇与缩宫素足月引产的疗效

目的：比较阴道给米索前列醇与静脉滴注缩宫素对足月引产的有效性及安全性。方法：５０例产妇（初产妇４９例、经产妇１例）年龄２０～４０ａ，妊娠３７．６～４２．４ｗｋ，随机分为２组，各２５例。Ａ组用米索前列醇１片（５０μｇ／片）阴道给药，４～６ｈ重复直至临产。Ｂ组用静脉滴注缩宫素２．５～５ＩＵ。结果：用药后６ｈＡ组比Ｂ组宫颈Ｂｉｓｈｏｐ评分改善更明显（Ｐ＜０．０５）；从给药引产到阴道分娩的时间短，但无统计学差异（１１±５ｈｖｓ１５±７ｈ，Ｐ＞０．０５）；引产成功率高（８８％ｖｓ４４％，Ｐ＜０．０１）；２组均未发现明显副作用。结论：阴道给米索前列醇较静脉滴注缩宫素足月引产的成功率高。