CO2激光加局注干扰素治疗15例尖锐湿疣

近几年对尖锐湿疣 (ＣＡ )的治疗方法虽有很多报道 ,但此方法治疗鲜见报道。现将本人治疗的１５例结果报告如下。１资料与方法１ １一般资料 :治疗组与对照组病例均来源于我科１９９９年９月～２０００年８月份门诊患者。治疗者均选择无心脏病、高血压及麻药过敏史 ,女性为无孕者。治疗组１５例 :其中男９例 ,女６例 ,年龄２０～５８岁之间 ,平均３５例。病程１０天～４月。１５例中有３例以往曾在外地做过ＣＯ２ 激光及药物治疗疗效不显著 ,近期皮疹增多。对照组１４例 :其中男８例 ,女６例 ,年龄２２～５４岁之间 ,平均３１岁 ,病程１周～…     

低分子肝素治疗冠心病无症状心肌缺血的疗效观察

低分子肝素(ＬＭＷＨ)是用普通肝素进行亚硝酸分解纯化而获得。近年来已有较多报道用于治疗心绞痛和脑血栓形成［１，３］。在国内对冠心病无症状心肌缺血的治疗极少报道,为此我科用ＬＭＷＨ治疗冠心病无症状心肌缺血,报道如下。１病例与方法１．１病例选择５８例冠心病患者的诊断均符合１９７９年ＷＨＯ《缺血性心脏病的命名及诊断》。随机分为治疗组和对照组。治疗组(ＬＭＷＨ组)３１例,男１９例,女１２例,年龄４５～７８岁,平均５９±１１岁,病程１～１８年,对照组(阿斯匹林组)２７例,男１７例,女１０例,年龄４０～７４岁,平均５５±８岁…     

光量子血疗法治疗生殖器疱疹58例分析

我院于１９９９年８月～２０００年８月采用光量子血疗法治疗生殖器疱疹５８例,取得满意疗效,现报告如下：１ 临床资料 患者均为门诊病人,临床症状典型,分为治疗组和对照组,治疗组５８例,其中男３３例,女２５例,年龄２０～６５岁,平均３８．５岁,病程１０天～１年,平均３月左右。对照组３０例,具有典型症状和体征,其中男１９例,女１１例,年龄１８—７０岁,平均３５．１岁,病程５天～１年,平均４月左右。２ 治疗方法２．１ 治疗组：患者取卧位,常规消毒后加用有构椽酸钠抗凝剂的血袋采集患者静脉血２００ｍｌ,在无菌条件…     

思密达西米替丁治疗饮酒致急性胃粘膜损伤出血

我院急诊科应用思密达联合西米替丁治疗饮酒导致急性胃粘膜损伤出血３０例,取得满意效果,现报告如下：１ 资料及方法１．１ 资料：我科于１９９９年２月～２０００年７月间收治确诊为饮酒导致急性胃粘膜出血共６０例,随机分为两组,治疗组３０例,其中男２４例,女６例,年龄２０～４９岁,平均３３岁。对照组３０例,其中男２３例,女７例,年龄１８～５１岁,平均３５岁。两组年龄、性别、饮酒量、出血量经统计学处理具有可比性。１．２ 治疗方法：两组病例均给予急性酒精中毒常规治疗,再根据分组用药。对照组用西米替丁、云南白药治…     

西咪替丁与速尿治疗秋季腹泻40例疗效观察

我科从１９９７年９～１２月，采用西咪替丁加速尿治疗秋季腹泻４０例，与病毒唑加乳酸菌素治疗４０例对照比较，收到了较好的效果，现报告如下。１临床资料１１一般资料男４５例，女３５例；年龄最小３５ｄ，最大１８１２岁；＜１岁６２例，＞１岁１８例；呕吐３１例，...     

降纤酶治疗急性缺血性脑血管病31例临床观察

我科自１９９９年４月至２０００年８月,用降纤酶治疗急性缺血性脑血管病（脑梗塞）患者引例,并与对照组进行比较,效果满意,报告如下：１ 临床资料１．１ 病例选择：６２例脑梗塞患者随机分为治疗组和对照组各３１例。治疗组男２４例,女７例;年龄５２—８６岁,平均６６．７岁。对照组男２３例,女８例;年龄５６～８１岁,平均６４．４岁。患者均系发病后６～２４小时就诊,且经头颅ＣＴ确诊。两组病例颈内动脉脑梗塞４６例,椎一基底动脉脑梗塞１６例。伴发疾病有原发性高血压、单纯动脉硬化、冠心病、脑动脉硬化。两组病人性别、年…     

独参汤治疗扩张型心肌病20例疗效观察

在常规治疗基础上，采用独参汤治疗扩张型心肌病２０例，取得较好效果，报道如下。１资料与方法本组系住院病人，均符合１９９２年２月卫生部制定的扩张型心肌病的诊断标准。男２５例，女１７例，年龄３５～６２岁。心功能Ⅰ级２例，Ⅱ级１６例，Ⅲ级１４例，Ⅳ级１０例（ＮＹＨＡ分级）。入院合并室早１８例，完全性左束支传导阻滞８例，左前分支阻滞５例，完全性房室传导阻滞１例，Ⅱ°Ⅰ型房室传导阻滞２例，心房纤维颤动４例。随机分为２组，治疗组２０例，男１２例，女８例，年龄３５～６２岁；对照组２２例，男１３例，女９例，年龄３…     

克拉瑞啶治疗动脉硬化性脑梗塞38例

我院自１９９５年１１月用克拉瑞啶治疗动脉硬化性脑梗塞３８例，并随机选择用传统方法（７０代血浆、维脑路通与丹参）治疗的３８例作对照，现将结果报道如下。１ 临床资料１．１ 一般资料：７６例动脉硬化性脑梗塞病人均符合全国神经精神科学术会议拟定的诊断标准。治疗组３８例，男２２例，女１６例。年龄３５～８５岁，平均（５９±１７）岁。重型１７例，中型１５例，轻型６例。对照组３８例，男２６例，女１２例，年龄３４～８２岁，平均年龄５８±１８岁。重型１６例，中型１８例，轻型４例。１．２ 治疗方法：治疗组；克拉瑞陡１６…     

前列腺素E1治疗脑梗死35例观察

我院于１９９９年１月～１２月采用哈尔滨制药三厂生产的前列腺素Ｅ１(ＰＧＥ１)治疗脑梗死 ,取得了满意效果 ,现报道如下 :１临床资料１ １一般资料 :脑梗死７０例均为我院住院患者 ,随机分为两组。治疗组３５例 ,男２９例 ,女６例。年龄４６～７４岁 ,平均年龄５７岁 ,发病均在７２小时以内的首发脑梗死患者。本组病例均经头颅ＣＴ检查确诊。言语障碍 ,肌力Ⅲ级１６例 ,意识障碍５例 ,伴高血压１８例 ,糖尿病４例 ,冠心病８例。对照组３５例 ,男２８例 ,女７例 ,年龄４８～７０岁 ,平均年龄５６岁 ,发病时间、症状体征大致同治疗组。１ ２…     

9例外伤性胃管破裂的诊疗体会

笔者自１９９８年５月～２００１年３月 ,用钙拮抗药硝苯地平预防静滴红霉素引起的胃肠道反应 ,现报道如下。１资料和方法１ .１对象 :８６例均为本院门诊和住院患者 ,随机分为２组。治疗组４７例 ,男３１例 ,女１６例 ,年龄１５～７２岁 ,平均４１ ８岁。对照组３９例 ,男２５例 ,女１４例 ,年龄１７～６９岁 ,平均４２ .３岁。２组患者的年龄、性别经统计学处理 ,差异无显著性。８６例均为感染性呼吸道疾病患者 ,所患疾病分别为慢性支气管炎并发急性感染、支气管哮喘继发感染、急性扁桃体炎、急性咽 (喉 )炎、肺部炎症。１ .２治疗方法 :…     

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.