米非司酮与米索前列醇配伍引产死胎46例

目的：观察米非司酮与米索前列醇配伍引产死胎的效果。方法：对46例妊娠20～40周死胎的孕妇于第1～3日给予口服米非司酮(总量150mg)，并于用药前后进行宫颈Bishop评分，第4日晨于阴道后穹窿置米索前列醇25μg，观察引产效果。结果：服用米非司酮后宫颈成熟率达100％，引产成功率达97．82％。结论：米非司酮与米索前列醇配伍引产死胎是安全、有效的。     

小剂量米索前列醇用于晚期妊娠引产效果的临床观察

目的探讨小剂量米索前列醇在晚期妊娠引产中的效果及安全性。方法 124例妊娠38~42周、有引产指征、单胎头位、无宫缩的初产妇,随机分为两组,观察组62例患者用米索前列醇置于阴道后弯隆引产,对照组62例患者用催产素引产,观察两组患者用药前后的宫颈评分、引产效果。结果阴道后弯隆置米索前列醇后,官颈Bishop评分提高4~5分,治疗前后宫颈评分、用药后升高值和引产效果与对照组比较差异有高度统计学意义(P均<0.01),观察组均显著优于对照组。结论小剂量米索前列醇阴道给药用于晚期妊娠引产能促宫颈成熟及发动子宫收缩,是安全、有效的引产方法。     

小剂量米索前列醇片阴道后穹窿上药用于妊娠晚期促进宫颈成熟的效果研究

目的研究小剂量米索前列醇片阴道后穹窿上药用于妊娠晚期促进宫颈成熟的效果。方法选取我院收治的住院的妊娠晚期孕产妇150例,采取随机数字表法分为两组,对照组(n=75)采取常规催产素进行引产,观察组(n=75)则采取小剂量米索前列醇片行阴道后穹隆给药进行引产,比较两组宫颈Bishop评分。结果观察组引产成功率90.67%,失败率9.33%,对照组引产成功率69.33%,失败率30.67%,观察组孕产妇引产成功率高于对照组,差异有统计学意义(P0.05)。两组孕产妇用药后6h宫颈Bishop评分均高于用药前,差异有统计学意义(P0.05)。观察组孕产妇用药后6h宫颈Bishop评分均高于对照组,差异有统计学意义(P0.05)。观察组不良反应率4.00%,对照组不良反应率5.33%,两组孕产妇用药后均无严重不良反应发生,两组不良反应发生率差异无统计学意义(P0.05)。结论小剂量米索前列醇片阴道后穹窿上药用于妊娠晚期促进宫颈成熟的效果显著,可提高因此成功率,具有较高的临床价值。     

小剂量米索前列醇用于晚期妊娠引产的临床研究

目的　探讨小剂量米索前列醇用于晚期妊娠引产的有效性和安全性。方法　将 2 0 0例有引产指征的单胎头位晚期妊娠的孕妇随机分为A组 (米索前列醇组 )和B组 (静滴催产素组 )各 10 0例。A组根据宫颈Bishop评分阴道置米索前列醇 2 5 μg ,如 4～ 6h后未建立有效宫缩可重复用药 ,总量不超过 10 0 μg ,4 8h内临产为引产成功。结果　A组引产成功率 92 % ,明显高于B组 5 4 %。A组从开始用药至临产时间较B组明显缩短 (P <0 0 5 )。初产妇宫颈评分≤ 5分者 ,A组引产成功率高于B组 (P <0 .0 5 ) ,但A组有 3例仅用药一次即出现宫缩过频。两组胎儿宫内窘迫发生率、剖宫产率及产后出血发生率均无显著差异 (P <0 0 5 )。结论　小剂量重复阴道后穹窿给米索前列醇用于晚期妊娠引产 ,是安全的和有效的。     

米索前列醇用于晚期妊娠引产临床观察

目的 探讨米索前列醇用于晚期妊娠引产的安全性及效果。方法 对100例妊娠37周～43周有引产指征的初产妇，随机分成两组，即米索前列醇组，对照组。分别用米索前列醇50ug阴道后穹窿用药引产及催产素引产。结果 前者用于晚期妊娠引产有效率为94％，后者为84％，显著高于对照组。两组宫颈评分提高程度比较，差异有非常显著性意义，米索前列醇组引产时间、总产程显著短于对照组。结论 阴道后穹窿放置米索前列醇用于晚期妊娠引产能促进宫颈成熟及发动子宫收缩，是一种方便、有效、较安全的引产方法。     

米非司酮配伍米索前列醇终止10—24周妊娠临床分析

目的：米非司酮配伍米索前列醇与利凡诺终止10－24周妊娠的引产效果比较，方法：将2001－2002年来我院要求终止妊娠的患者平均分为两组，每组80例，A组为米非＋米索，米非司酮口服，50mg，每6小时一次，共3次，最后1次服药后1h予米索前列醇400－600μg置阴道后穹窿；B组为利凡诺100mg羊膜腔内注射。结果：米非司酮配伍米索前列醇组引产成功率明显高于利凡诺组，住院时间明显短于利凡诺组，出血量少于利利凡诺组。结果：米非司酮配伍米索前列醇终止10－24周妊娠是一种安全，有效，快捷的引产方法。     

米非司酮米索前列醇用于中晚期妊娠引产

目的探讨口服米非司酮配伍阴道后穹窿放置米索前列醇用于中晚期妊娠引产的有效性。方法A组50例为观察组,顿服米非司酮150mg,36h后阴道后穹窿放置米索前列醇100—400μg,可间隔12h重复用药,共计不超过5次;B组50例为对照组,顿服米非司酮150mg,36h后加服米索前列醇600μg,可间隔6h重复用药,共计不超过3次;C组50例为对照组,从腹部穿刺进入羊膜腔,注入利凡诺针100mg。结果A组引产成功49例,B、C组分别为37例、38例。A组从用药至出现规律宫缩时间、规律宫缩至胎儿娩出时间均明显短于B、C组（P〈0．005）。结论口服米非司酮配伍阴道后穹窿放置米索前列醇用于中晚期妊娠引产,成功率高、痛苦小。     

米非司酮及米索前列醇用于瘢痕子宫中期引产的临床观察

目的：探讨米非司酮配伍米索前列醇用于瘢痕子宫中期引产的安全性、可靠性。方法：第1～4天口服米非司酮,每日早6：0050mg,晚6：0025mg。第5天于阴道后穹隆置米索前列醇400μg,3h后可重复上药。结果：18例瘢痕子宫行中期引产者,完全流产率为94.44%,无产后大出血及强直宫缩,无子宫瘢痕破裂,无宫颈裂伤。结论：米非司酮是孕激素受体拮抗剂,后配伍米索前列醇阴道,用于瘢痕子宫中期妊娠可引起与足月妊娠分娩自然生理过程相似的宫颈成熟扩张变化放置,缩短有效宫缩出现时间,使宫缩缓和而协调宫缩与宫颈扩张同步进行,使产程进展加速。     

米非司酮伍米索用于晚期妊娠引产的效果观察

目的：探索米非司酮配伍米索在晚期妊娠引产中的作用及安全性。方法：将62例妊娠37^ 2-42^ 3周的正常孕妇有引产指征随机分成两组，观察组（31例）口服米非司酮200mg（8片）配合米索前列醇50μg阴道上药；对照组（31例）口服蓖麻油鸡蛋餐。结果：两组引产总有效率无显性差异, 观察组引产时间显少于对照组（P＜0．05）。服用米非司酮后宫颈缩短1－3cm,Bishop评分提高5分。与用药前比较，均有显性差异（P＜0．01）。结论：应用米非司酮配伍米索前列醇进行晚期妊娠引产，能促宫颈成熟，发动子宫收缩，并安全、有效、方便，有临床价值。     

米非司酮配伍米索前列醇在钳刮术中的应用观察

目的：探索米非司酮配伍米索前列醇应用于钳刮术中的临床效果。方法：实验组68例在钳刮术前2天口服米非司酮150mg，术前3～5小时阴道后穹窿置米索前列醇200ug。对照组52例于术前6小时宫颈管置18号导尿管。结果：两组在扩张宫颈时阻力感、手术时间、术中出血量、人流综合征等方面差异有显著性。结论：米非司酮配伍米索前列醇用于钳刮术中的临床效果明显优于传统的宫颈插管法，可以减轻病人痛苦。     

Interindividual variability in metabolic activation in humans in vivo

In assessing interindividual variability in metabolic activation, the toxic metabolite is often too unstable for conventional analysis. Possible alternatives include a stable product of the reactive metabolite e.g. cysteinyl derivatives of N-acetyl-4-benzoquinoneimine, the toxic metabolite of paracetamol, adducts with DNA or protein, and indirect measurement of the activity of the enzyme(s) producing the active metabolite. An example of the last approach is the use of furafylline, a highly specific inhibitor of human CYP1A2, to determine the extent of the metabolic activation of the cooked food mutagens PhIP and MeIQx. The extent of inhibition, determined from levels of unchanged amine in urine, is an indirect measure of the activity of the activation pathway. Further refinement of this approach, allied to improved measures of the biological process of interest should prove of value in evaluating interindividual variability and its role in the risk assessment process.     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg.kg) or i.p. (50 mg.kg) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) l.h. kg in the male rat and 10.6 (95% CI: 7.5, 15.0) l.h. kg in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p 0.001) in plasma obtained from the male (8.8 2.0%) compared with the female rat (11.7 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Theophylline kinetics in peripheral tissues in vivo in humans

Several biochemical and cellular effects have been described for methylxanthines under in vitro conditions. However, it is unknown, whether threshold concentrations required to exert these effects are attained in target tissues in vivo. We therefore employed the microdialysis technique for measuring theophylline concentrations in peripheral tissues under in vivo conditions.Following in vitro and in vivo calibration, microdialysis probes were inserted into the medial vastus muscle and into the periumbilical subcutaneous adipose layer of healthy volunteers. Following single oral dose administration of 300 mg or i.v. infusion of 240 mg theophylline, in vivo time courses of theophylline concentrations were monitored in tissues and plasma. Major pharmacokinetic parameters (c_max, t_max, AUC) were calculated for plasma and tissue time courses. The mean AUC_tissue /AUC_plasma-ratio was 0.56 (p.o.) and 0.55 (i.v.) for muscle and 0.55 (p.o.) and 0.72 (i.v.) for subcutaneous adipose tissue.We conclude that microdialysis provides important information on the distribution and the tissue pharmacokinetics of theophylline.Abbreviations FPIA Fluorescence polarisation immuno assay - AUC Area under the curve - t_max Time to peak concentration - c_max Peak concentration     

休克时血中氧自由基的变化

本实验测定10名休克患者血浆和红细胞的丙二醛(MDA)、血浆总抗的氧化活性(AOA)的含量。结果表明:休克病人红细胞膜和血浆 MDA 含量(4.298±0.722;5.348±0.834)与对照组(3.235±0.682;4.356±1.081)比较明显增高(P<0.05);血浆 AOA(39.65±7.858)与对照组(48.21±10.81)比较明显降低(P<0.01)。提示:休克时,患者机体内自由基反应增强是引起组织细胞损伤的原因之一。     

Polymorphisms in genes involved in neurotransmission in relation to smoking

Smoking behavior is influenced by both genetic and environmental factors. The genetic contribution to smoking behavior is at least as great as its contribution to alcoholism. Much progress has been achieved in genomic research related to cigarette-smoking within recent years. Linkage studies indicate that there are several loci linked to smoking, and candidate genes that are related to neurotransmission have been examined. Possible associated genes include cytochrome P450 subfamily polypeptide 6 (CYP2A6), dopamine D₁, D₂, and D₄ receptors, dopamine transporter, and serotonin transporter genes. There are other important candidate genes but studies evaluating the link with smoking have not been reported. These include genes encoding the dopamine D₃ and D₅ receptors, serotonin receptors, tyrosine hydroxylase, trytophan 2,3-dioxygenase, opioid receptors, and cannabinoid receptors. Since smoking-related factors are extremely complex, studies of diverse populations and of many aspects of smoking behavior including initiation, maintenance, cessation, relapse, and influence of environmental factors are needed to identify smoking-associated genes. We now review genetic polymorphisms reported to be involved in neurotransmission in relation to smoking.     

Tramadol concentrations in blood and in cerebrospinal fluid in a neonate

Based on blood and cerebrospinal fluid samples collected in a full-term neonate, the penetration of tramadol in the central nervous system is described. Following intravenous administration of tramadol, a lag time of about 4 h was observed until full blood–brain equilibration was achieved. This pharmacokinetic observation is in line with a recent pharmacodynamic evaluation of the central opioid effects of tramadol in adults.     

Disease control in asthmatic children seen in private practice in Switzerland

ABSTRACT

Background: Asthma is the most common chronic childhood disease in Switzerland with a prevalence of 10%. Asthma has a high economic burden accounting for high medical costs. Assessment of disease control is likely to be of help in the implementation of strategies to improve asthma. Therefore, we aimed to evaluate asthma control and therapy regimens among children in private practice.

Methods: We assessed asthma control as well as therapy regimens in 575 asthmatic children in an experience programme in Switzerland by using an abbreviated questionnaire based on the asthma control questionnaire and the child health questionnaire on Visit 1 and Visit 2.

Results: Good asthma control at Visit 1 was only present in 25.7% of asthmatic children. Occasional asthma symptoms, limitation of physical activity, nocturnal awakening and anxiety of the parent was present in 80.5%, 41.2%, 46.8% and 57% of the children, respectively. After adjustment of therapy regimens at Visit 1, mainly by adding a leukotriene receptor antagonist, asthma control was reported to be much better in 53.4% of the children at Visit 2.

Conclusions: As asthma control is inadequately achieved within a major portion of asthmatic children, it is imperative to find measures to improve asthma control and hence, to reduce the burden of disease.