COMPARISON OF THE CLINICAL ACTIVITY OF MESULERGINE AND PERGOLIDE IN THE TREATMENT OF HYPERPROLACTINAEMIA

The clinical activity of the new ergoline, mesulergine, was compared to pergolide in the treatment of hyperprolactinaemia. Mesulergine was given to 22 women and five men with hyperprolactinaemia. Serum prolactin was substantially lowered in 10 women; two subsequently conceived and completed normal pregnancies. Twelve women stopped treatment due to side-effects, usually nausea and vomiting, or inadequate responses. The side-effects were generally similar to those on bromocriptine; in one patient they were better and in four worse than on bromocriptine. The male patients were more tolerant of mesulergine, and substantial falls in serum prolactin were seen with evidence of tumour shrinkage. Twenty-seven women with hyperprolactinaemia received pergolide; serum prolactin was lowered or normalized in 16. Side-effects necessitating cessation of treatment were similar to those seen with bromocriptine. Nevertheless, four women tolerated pergolide better than bromocriptine and two women adequately treated with mesulergine had previously been intolerant of pergolide. We conclude that both pergolide and mesulergine may be useful and effective drugs in the treatment of hyperprolactinaemia as alternatives to bromocriptine.     

乐瓦停治疗原发性和继发性高脂血症的临床观察

本文报道乐瓦停(Lovastatin)对伴有高脂血症的陈旧性心肌梗塞(OMI)、非胰岛素依赖型糖尿病(NIDDM)及肾病综合征(NS)三组患者34例的降血脂疗效。结果显示,与治疗前比,服安慰剂4周,各组血脂均无明显变化;服乐瓦停4周,各组血脂均有明显改善,继续服药,疗效稳定。服乐瓦停12周,TC降34.1%(P<0.001),LDL-C降43.6%(P<0.001),TC/HDL-C降35.6%(P<0.001),TG降30.8%(P<0.01),OMI组及NIDDM组ApoB都明显下降(P<0.01—0.001),Apo A Ⅰ/Apo B比值都明显上升(P<0.01—0.001);三组Apo A-Ⅰ、HDL-C及NS组的Apo B及Apo A-Ⅰ/Apo B比值均未见明显变化(P>0.05)。疗程中,乐瓦停与环磷酰胺或雷公藤合用的2例SGPT均明显升高,停药后迅速回降。本文未见其它重要副作用。     

EXTRAHEPATIC PORTAL HYPERTENSION: THE CLINICAL EVALUATION,INVESTIGATION AND RESULTS OF TREATMENT OF 28 PATIENTS

The clinical picture of 28 patients with extrahepatic portal hypertension who presented before 19 years of age is described. There was a high incidence of infection in early life. Gastro-intestinal bleeding was precipitated by salicylates, fragments of bone and pregnancy. Splenoportography showed that two patients had developed spontaneous hæmodynamically significant portacaval shunts. The results of surgical treatment were satisfactory, but not good enough to make surgery the management of choice. Conservative non-operative management, with stress on the avoidance of salicylates and traumatic dietary intake, has been satisfactory for some patients. The spontaneous development of hæmodynamically significant portal-systemic shunts, not through ?sophageal varices, and the small size of the splenic vein in children provide additional reasons for avoiding surgical treatment except in emergencies to control bleeding. The choice of surgical treatment lies between spleno-renal anastomosis and interruption of the gastro-?sophageal venous anastomoses.     

头孢地嗪的临床及免疫调节作用研究

为评价头孢地嗪治疗免疫缺陷者感染的疗效、安全性及免疫调节作用，在１０７例呼吸道、尿路及其他细菌感染中，与头孢唑肟进行随机对照研究。有效率、痊愈率和细菌清除率头孢地嗪组分别为８７．３％、６１．８％和８９．３％；头孢唑肟组分别为８２．７％、５９．６％和９０．６％。不良反应发生率头孢地嗪组５．２％，头孢唑肟组７．４％。头孢地嗪组治疗后ＣＤ＋４、ＣＤ＋４／ＣＤ＋８比值升高，ＮＫ细胞活性增强，活化的淋巴细胞白细胞介素－２受体表达增多，对照药头孢唑肟则无显著作用。研究结果显示，头孢地嗪治疗免疫缺陷者感染安全有效，并具免疫调节作用。     

甲状腺血流和静态双时相显像的临床应用

对５１０例正常人和１４６４例各种甲状腺疾病患者进行了９９ｍＴｃ甲状腺血流和静态双时相显像，研究其对各种常见甲状腺疾病特别是桥本病的诊断价值。结果：甲状腺血流和静态摄取量通常可直接反应甲状腺功能高低；桥本病多数为血流明显增多，部分为轻度增多，静态摄取量则多数不增多且分布不均匀，因而能得以鉴别；亚甲炎为血流正常或轻度增多而摄取量多数为减少；冷结节内的血流多少与其囊性、实性或癌有一定相关性。提示甲状腺双时相显像比单纯静态显像明显提高了鉴别诊断价值，特别是对桥本病的诊断很有帮助     

益多酯治疗高脂血症的临床观察

106例高脂血症患者,按血脂水平随机分组。54例服非诺贝特,作对照组;52例服益多酯。与治疗前相比,益多酯治疗12周时的TC、LDL-C、TG、TC/HDL-C分别降13.8%、14.5%、32.1%及16.6%;HDL-C升16.0%(P<0.05～0.001)。益多酯对血清Apo A-Ⅰ及Apo B未见有何影响。治疗期间未见重要副作用。     

头孢哌酮—舒巴坦的体外抗菌活性及其临床应用

为了探索头孢哌酮－舒巴坦（舒普深）对医院感染菌的体外抗菌活性及其临床抗感染的有效性及安全性，对１９９５年度临床标本分离的１３７２株细菌作了包括本药在内的１７种抗生素的敏感性测定，其中革兰阴性菌１０３５株，占７５．４％，革兰阳性菌３３７株，占２４．６％；并应用舒普深治疗以呼吸系为主的细菌感染５０例次。该５０例次（４３例）细菌感染中，５８．０％发生在血液系恶性疾患和实体瘤患者，而０．２４％的患者感染处于粒细胞缺乏状态。细菌培养阳性率５６％。给药方法：每次１．０～２．０ｇ，每日２次，疗程５～１８天，其中＞７天者占５６．０％（２８／５０例次）。结果显示舒普深在体外药敏试验中对常见革兰阴性和阳性菌的敏感率高，耐药率低，优于其他第三代头孢菌素。临床应用中抗感染的有效率为８４．０％（４２／５０例次），细菌清除率为８９．３％（２５／２８例次）。除３例（６．０％）有丙氨酸转氨酶（ＡＬＴ）短暂增高外，未见其他副作用。     

THE CLINICAL SIGNIFICANCE OF PLASMA THYROID-STIMULATING ACTIVITY IN HYPERTHYROIDISM

The long-acting thyroid stimulator (LATS) measured by the method of McKenzie was detected in 36 of 60 cases of untreated hyperthyroidism—a figure comparable with that in other reported series. An association was found between LATS and several clinical features. There was a definite correlation between LATS and the occurrence of exophthalmos. The mean LATS level of 433% in 13 exophthalmic patients was significantly greater than the mean of 230% in 50 patients without exophthalmos (P<0·02. There was also a significantly higher level of LATS (P<0·05) in 34 patients who had a visible goitre (323%) than in 24 without visible goitre (184%). Sixteen patients who eventually had a recurrence of hyperthyroidism after therapy were found to have a significantly higher mean LATS level (411%) than 34 subjects who remained well (182%) (P<0·01). No correlation could be found between plasma LATS level and (a) thyroid ¹³¹I turnover, (b) the plasma level of protein-bound iodine and (c) the presence of a significant titre of antibodies to thyroglobulin in the patient's blood (Tanned red-cell titre 1/2500). The association between LATS and pretibial myx?dema was demonstrated by two patients who both had elevated plasma levels of LATS and unequivocal pretibial myx?dema when first examined. Follow-up studies over the ensuing three years demonstrated resolution of the pretibial myx?dema concurrently with disappearance of LATS from the plasma of one patient, and increasingly severe pretibial myx?dema associated with an increasing plasma level of LATS in the other. It is concluded that there is a significant relation between the plasma LATS level and various clinical features of hyperthyroidism. These data indicate the importance of LATS in relation to the pathogenesis of the disease. Recent chemical studies indicate that LATS belongs to the 7S globulins. These findings indicate that thyrotoxicosis, exophthalmos and pretibial myx?dema may result from disordered immunological mechanisms.     

溶血磷脂酰胆碱电生理研究及临床意义探讨

研究溶血磷脂酰胆碱（ＬＰＣ）的细胞电生理作用。应用膜片钳全细胞记录表明，ＬＰＣ（１０ｕｍ）作用早期对心肌细胞膜钠离子流、背景钾离子流、钙离子流均有明显的抑制作用，表现为非选择性离子通道活性的抑制，由此在ＬＰＣ（５０ｕｍ）灌注肌条时，表现静息电位（ＲＰ）、动作电位振幅和最大除极速率明显下降，异常自律性、早、晚后除极发生率增高。可见ＬＰＣ在心肌缺血早期的积聚、有助于缺血性室性心律紊乱的产生。     

头孢泊肟酯治疗细菌性感染122例临床评价

用头孢泊肟酯治疗各系统细菌性感染１２２例，结果是：总有效率为９１．８％其中耳鼻喉科有效率为９７．５％下呼吸道感染有效率为９０．０％，泌尿系感染有效率为９０．０％外科及其它感染的有效率为８６．４％。总细菌清除率为９６．６％其中革兰阳性球菌的清除率为９６．９％革兰阴性杆菌的清除率为９６４低不良反应发生率为１８．９％。     

BED REST, ACTIVITY AND THE INFLAMMATION OF RHEUMATOID ARTHRITIS

Seventy-five patients with rheumatoid arthritis have been studiedin order to assess the relative contributions of bed rest andplanned activity on the observed improvement in arthritis duringhospitalization. The benefit of bed rest was less than expected;only a third of patients showed significant improvement. A similarnumber improved during planned activity and although bed restwas superior the advantages were small. The features of thosepatients who responded to bed rest or planned activity showedsmall but important differences indicating that more carefulselection to one or other regimen may increase the number ofpatients benefiting from hospitalization KEY WORDS: Rheumatoid arthritis, Treatment, Bed rest ^*Present Address: Rheumatology Department, Rheumatism ResearchWing, The Medical School, University of Birmingham, BirminghamB15 2TJ.     

STUDIES OF THE ANATOMY,PHYSIOLOGY AND CLINICAL VARIABILITY OF CHYLURIA

Findings are reported in four cases of chyluria; in three instances this was due to filariasis. Lymphangiography was carried out on two patients whose proteinuria was investigated further. The findings are compared with those of similar studies in the nephrotic syndrome. Although orally administered lipid has been shown to enter chylous urine relatively rapidly, there is a delay in the appearance of intravenously injected labelled proteins. Results of the present studies suggest the existence of an indirect pathway for the passage of plasma proteins into abdominal lymph, and that low-density-lipoprotein synthesized in the liver, or possibly in the gut wall, does not reach the systemic circulation by way of the chyle.     

老年类风关膝关节滑膜炎关节镜下滑膜切除临床评估

目的目前对类风湿性关节炎引起的膝关节滑膜炎．大部分风湿病医师均采用关节镜下滑膜切除来治疗,但对手术后膝关节好转期能维持多久临床风湿病医师有不同的看法。方法1988～2004年12月本院对88例124膝类风湿性关节炎的患者行关节镜下膝关节滑膜切除,所有接受手术的患者年龄均〉60岁。18病例采用Pridie方法处理裸露的软骨下骨。结果手术后采用膝关节评价标准（HSS评分）来评定手术后的效果,其中85—100分64膝,70-84分41膝,60-69分14膝,60分以下5膝。Ⅲ～Ⅳ期关节的患者中,有17／19膝随访时的评分〈70分,而有86／95膝Ⅰ～Ⅱ期的膝关节手术后的好转期也仅为4～5年左右。结论关节镜下膝关节滑膜切除手术创伤小,对改善关节的炎症．遏制关节软骨溃疡的进展有一定的作用,而且对某些患者复发性的膝滑膜炎有一定的可重复性。镜下的滑膜切除对治疗类风关膝滑膜炎不失为一种简单且近期有效的手术方法。     

尿液假尿嘧啶核苷对原发性肝癌诊断价值的探讨

应用高效液相色谱法测定了４２例原发性肝癌（ＰＨＣ），６５例其它各种肝病，１１例消化道恶性肿瘤和４０例正常对照者的尿液假尿嘧啶核苷（假尿苷，Ψ）ＰＨＣ组的尿Ψ浓度（７．０±４．２ｎｍｏｌ／μｍｏｌ肌酐）明显高于正常对照组（３．２±０．７ｎｍｏｌ／μｍｏｌ肌酐）肝炎组（３．３±０．７ｎｍｏｌ／μｍｏｌ肌酐）肝硬化组（３．０±１．１ｎｍｏｌ／μｍｏｌ肌酐）及肝良性占位病变组（３．０±０．８ｎｍｏｌ／μｍ     

应用多普勒超声冷加压试验检测糖尿病患者心功能

本文应用脉冲多普勒超声心动图和冷加压试验检测43例无临床心脏病表现的糖尿病患者,发现部分患者存在潜在性左心室收缩功能减退,其原因可能是临床前期的糖尿病性心肌病和糖代谢障碍。     

VALIDITY OF ACTIVITY INDICES IN ULCERATIVE COLITIS: COMPARISON OF CLINICAL AND ENDOSCOPIC INDICES

Aim: Various different clinical indices (CI) and endoscopic indices (El) have been used to evaluate the clinical disease activity of ulcerative colitis (UC). However, no standardized CI or El of UC has been established. The aim of the present study was to determine whether or not any of the CI and/or EI for assessing the disease activity of UC could be established as a standard. Methods: The most frequently used CI and EI were identified from 100 published clinical trials dealing with UC, and representative CI and El were selected. Seventy‐four patients were enrolled in this study and their CI and El were assessed prior to treatment and at 2, 4 and 8 weeks after treatment. Furthermore, changes over time and relationships among the indices were analyzed. In this study, the clinical activity index (CAI), the disease activity index (DAI), the Lichtiger index (LI) and the Seo index were selected as the representative CI, and the Baron score and the Rachmilewitz endoscopic index (REI) were selected as the representative EI. Results: A significant decrease in all the CI and El was observed after treatment, as compared with the baseline values. Moreover, there were positive relationships among the CI and between the CI and El. Conclusion: Our results demonstrated that all the CI and El examined were almost equally useful for evaluating disease activity in UC patients. Further studies may help to determine which of the indices is the most suitable for use in UC clinical trials.