美罗培南与头孢哌酮/舒巴坦治疗老年重度医院感染肺炎的临床评价

目的 评价美罗培南与头孢哌酮／舒巴坦治疗老年重度医院感染肺炎（HAP）的有效性和安全性。方法 美罗培南为治疗组，头孢哌酮／舒巴坦为对照组，随机对照观察两组药物治疗老年重度HAP的疗效和安全性。结果 人选81例病例，治疗组41例，对照组40例，美罗培南与头孢哌酮／舒巴坦治疗老年重度HAP的总有效率分别为90．2％和87．5％，痊愈率为39．0％和35．0％，不良反应发生率为12．1％和10．0％，实验室异常发生率为9．7％和7．5％（P〉0．05）。两组共分离细菌102株，细菌清除率分别为98．1％和62．5％，对铜绿假单胞菌的清除率分别为94．7％和36．3％（P〈0．05）。结论 美罗培南与头孢哌酮／舒巴坦治疗老年重度HAP疗效确切且安全，美罗培南抗菌活性比头孢哌酮／舒巴坦更强，尤其对铜绿假单胞菌。     

比阿培南与亚胺培南／西司他丁治疗下呼吸道感染疗效对比

目的比较比阿培南与亚胺培南／西司他丁治疗下呼吸道感染的临床效果。方法将80例下呼吸道感染患者随机分成两组,对照组给予亚胺培南／西司他丁静滴,治疗组给予比阿培南静滴,疗程7～14d。比较两组的临床疗效和细菌学疗效,记录治疗过程中的不良事件。结果对照组和治疗组的临床有效率分别为82．50％和87．50％,细菌学疗效分别为77．50％和82．50％,两组比较均无统计学差异（P均〉0．05）。两组不良反应发生率分别为10．0％和7．5％,两组比较无统计学差异（P〉0．05）。结论比阿培南与亚胺培南／西司他丁对下呼吸道感染的临床疗效相当,不良反应少,安全可靠。     

泌尿系感染：加替沙星联合万古霉素治疗肠球菌性泌尿系感染24例

48例随机分为对照组和治疗组各24例，对照组给予万古霉素2．0g／d，静滴：治疗组给予加替沙星400mg／d,万古霉素1．0g／,静滴。疗程均14d。结果：对照组和治疗组临床治疗有效率分别为91．7％和87．5％（P〉0．05）。两组分离出48株肠球菌，对万古霉素敏感率为100．0％，粪肠球菌对加替沙星的敏感率为72．7％；     

头孢哌酮／舒巴坦治疗医院内获得性肺炎临床分析

目的评价头孢哌酮／舒巴坦治疗HAP的疗效。方法87例HAP患者随机分为头孢哌酮／舒巴垣治疗组和头孢他啶对照组，治疗前后行痰培养。结果治疗组与对照组总有效率、细菌清除率分别为93．19％和90．48％、72．09％和61．91％，差异有统计学意义。结论头孢哌酮／舒巴坦可以作为HAP的经验治疗用药。     

莫西沙星短程疗法对65岁以上AECOPD的近、远期疗效及安全性评价

目的评价莫西沙星短程疗法对65岁以上AECOPD的疗效和安全性。方法60例AECOPD（年龄≥65岁）随机分为两组，试验组（30例）给予莫西沙星0．4静滴，1次／d，疗程5d，对照组（30例）给予头孢哌酮舒巴坦3．0静滴，2次／d，和阿齐霉素0．5静滴，1次／d，疗程10天。结果治疗结束时试验组和对照组的临床有效率分别为93．33％和70．00％（P〈0．05），细菌学清除率分别为90．91％和75．00％（P〉0．05）；试验组和对照组不良反应发生率分别为10．00％和6．67％（P〉0．05）。结论莫西沙星短程疗法治疗AECOPD不仅起效快，近期疗效好，而且可以延长至下次急性发作时间的间期，减少1年内急性发作次数和使用其他抗生素的频率，可以作为AECOPD的一线治疗方案，在老年病人可安全使用。     

舒巴坦钠/头孢哌酮与头孢曲松钠,头孢噻肟钠治疗肺心病急性发作

目的：比较舒巴坦钠／头孢哌酮与头孢曲松钠，头孢噻肟钠治疗肺心病急性发作期的疗效。方法：选取我院住院的肺心病急性发作期病例120例，随机分成3组，分别给予舒巴坦钠／头孢哌酮，头孢曲松钠，头孢噻肟钠，均为4g／d静滴，疗程7～14日。结果：舒巴坦钠／头孢哌酮，头孢曲松钠，头孢噻肟钠的临床总有效率为93．0％、73．2％、61．1％，细菌清除率分别为94．2％、72．2％、57．7％。3组比较有显性差异。结论：在治疗肺心病急性发作期感染时，舒巴坦钠／头孢哌酮优于其它第三代头孢菌素。     

头孢他啶联合奈替米星或左氧氟沙星治疗老年医院获得性肺炎的对照观察

目的 观察头孢他啶联合奈替米星治疗老年医院获得性肺炎（Hospital acquired pneumonia）的疗效。方法 将42例病人随机分为两组，治疗组22例，予头孢他啶2．0g静滴，每日2次；同时予奈替米星0．2～0．3g静滴，每日11次。对照组20例予头孢他啶2．0g静滴，每日2次；同时予左氧氟沙星0．5g静滴，每日1次。疗程均为7-14d。结果 治疗组与对照纽的有效率分别为81．8％和80％；两组的细菌清除率分别为84．6％和83．3％；药物不良反应发生率分别为13、6％和10％，两组比较均无统计学意义（P〉0．05）。结论 头孢他啶联合奈替米星治疗老年医院获得性肺炎安全、有效。     

莫西沙星序贯治疗老年急性下呼吸道感染的疗效观察

目的观察莫西沙星序贯治疗老年急性下呼吸道感染的疗效。方法选取60例老年中重度急性下呼吸道感染的老年患者,随机分组后,分别给予莫西沙星序贯治疗、莫西沙星静脉治疗及头孢呋辛序贯治疗,比较其临床疗效、细菌清除率及不良反应。结果莫西沙星序贯治疗组与莫西沙星静脉治疗组相比,总有效率（85％与90％）、治愈率（75％与75％）及细菌清除率（88．23％与87．5％）无显著差异（P〉0．05）,但显著优于头孢呋辛序贯治疗组（65％、50％和68．8％,P〈0．05）。3组不良反应发生率均较低,无显著性差异（P〉0．05）。结论莫西沙星序贯治疗临床抗感染疗效确切,不良反应轻微,是治疗老年人急性下呼吸道感染较为理想的治疗方法。     

舒巴坦／头孢哌酮治疗老年人下呼吸道感染疗效的临床评价

目的 评价舒巴坦／头孢哌酮治疗65例老年人下呼吸道感染的疗效。方法 对1995年6月-1997年1月我院老年病房65例患，以舒巴坦／头孢哌酮2克 生理盐水20ml静注，每12小时给药一次，平均疗程12±4天。根据临床症状改善的程度，痰菌转阴率及X线胸片进行临床疗效分析。结果 临床有效率84．6％，细菌清除率78．2％。临床分离的各种革兰阴性杆菌的体外药敏试验．显示67％对本品呈高度敏感。本品不良反应少．无明显肝肾功能损害。结论 舒巴坦／头孢哌酮对治疗老年人下呼吸道感染，尤其是院内感染，较安全有效。     

加替沙星治疗下呼吸道感染的临床疗效及安全性分析

目的观察加替沙星注射液治疗下呼吸道感染的疗效及安全性。方法将我院160例下呼吸道感染患者随机分为治疗组及对照组，对照组使用左氧氟沙星，治疗组使用加替沙星，比较两组的疗效、细菌清除率及不良反应。结果治疗组和对照组的总有效率分别为95．0％和93．7％，差异无统计学意义（P〉0．05），但治疗组略高；两组各项指标差异均无统计学意义（P〉0．05）。本组共分离出115例株致病菌，其中治疗组和对照组分离出致病菌分别为58株和57株，治疗组和对照组的细菌清除率分别为91．38％、91．23％，差异无统计学意义（P〉0．05）；治疗组出现5例不良反应，对照组出现6例不良反应，未出现肝、肾损害。结论采用加替沙星治疗下呼吸道感染疗效确切，细菌清除率高、不良反应小，且使用方便、价格便宜，值得推广应用。     

Role of the placenta in the control of the ante-partum surge of prolactin in the rat

A nocturnal surge of prolactin secretion occurs in the dark period preceding parturition in the rat. The aim of this study was to examine the role of the placenta in the control of this prolactin surge. Plasma prolactin and progesterone were measured by radioimmunoassay in serial blood samples collected after surgical removal of conceptuses during late pregnancy, and after intracerebroventricular (i.c.v.) injection of placental lactogen (PL) before the prolactin surge. In intact control animals, prolactin secretion remained low until a nocturnal surge of secretion occurred in the dark period preceding parturition, peaking at 269 +/- 51 (S.E.M.) micrograms/l at 03.00 h on day 21. Progesterone levels fell from greater than 200 nmol/l on day 19 to less than 40 nmol/l by 12.00 h on day 20 of pregnancy. PL levels during late pregnancy were modified by partial or complete removal of conceptuses at 10.00 h on day 19 of pregnancy. Removal of all but one or two conceptuses did not change the normal pattern of prolactin or progesterone secretion. Removal of all conceptuses, however, induced a large nocturnal surge of prolactin secretion, peaking at 211.7 +/- 78 micrograms/l at 03.00 h on day 20, 24 h earlier than the surge in intact animals. Progesterone levels after removal of all conceptuses fell to less than 40 nmol/l by 23.00 h on day 19, approximately 12 h before the decline in intact animals. Maintenance of increased progesterone levels after conceptus removal using silicone tubing implants significantly (P less than 0.05) reduced the peak of the premature prolactin surge to 79.7 +/- 18 micrograms/l at 05.00 h on day 20.(ABSTRACT TRUNCATED AT 250 WORDS)     

On the Role of the Septal Area in the Development of Doca-Salt Hypertension in the Rat

The extensive destruction of forebrain noradrenergic nerve terminals by the intraventricular injection of 250 μg of 6-hydroxy-dopamine prevents the subsequent development of DOCA-salt experimental hypertension in rats while the lesser destruction of noradrenergic nerve terminals produced by 90 μg of 6-hydroxydopa does not. The greatest difference in brain part noradrenaline levels between these two neurotoxins was in the septal area where noradrenaline was less than 15% of controls after 6-hydroxydopamine but was the same as controls after 6-hydroxydopa. The non-specific destruction of the lateral septal area by radiofrequency lesions prevented the subsequent development of DOCA-salt hypertension. The relatively selective destruction of catecholamine nerve terminals in the lateral septal area by the injection of 1 μg 6-hydroxydopamine in 1 μl vehicle also prevented the development of DOCA-salt hypertension. These data suggest that the lateral septal area may be the location of the forebrain catecholaminergic neural activity that is necessary for the development of DOCA-salt experimental hypertension in rats.     

Oxprenolol in the treatment of hypertension in the elderly

Controversy continues to surround the value of drug treatment of hypertension in the elderly. Epidemiologic evidence implicates hypertension as a major risk factor in the precocious development of stroke and coronary heart disease in the elderly subject as clearly as it is implicated in the younger person. The hemodynamic and neuroendocrine profiles of the older patient with essential hypertension are similar to those of younger patients in the stable phase of the disease. However, the arterial ravages induced by many years of sustained hypertension render the circulation of the elderly subject more sensitive to pharmacologic intervention. The benefit-risk ratio of most antihypertensive drugs appears to be inversely related to age. Diuretics reduce the blood pressure at rest but have no influence on the increases in systolic pressure during normal activity; in addition, they carry potentially serious metabolic hazards in the elderly hypertensive patient. Centrally acting drugs likewise lower the blood pressure at rest without influencing the high systolic pressures induced by exercise. They also enhance the tendency to endogenous depression. Adrenergic-neurone blocking drugs and alpha-adrenoceptor antagonists are contraindicated because of the frequency of impaired cardiovascular reflexes in the elderly. The beta-blocking drugs can reduce the risk of coronary and cerebrovascular disease in the older patient with hypertension. They appear to be well tolerated, but because of their impaired metabolic handling in many elderly patients they should probably be used in smaller doses than those prescribed in younger patients. The influence of antihypertensive treatment on cardiovascular morbidity and mortality in the elderly hypertensive patient is not known.     

Tissue Oxygen Demand in Regulation of the Behavior of the Cells in the Vasculature

The control of arteriolar diameters in microvasculature has been in the focus of studies on mechanisms matching oxygen demand and supply at the tissue level. Functionally, important vascular elements include EC, VSMC, and RBC. Integration of these different cell types into functional units aimed at matching tissue oxygen supply with tissue oxygen demand is only achieved when all these cells can respond to the signals of tissue oxygen demand. Many vasoactive agents that serve as signals of tissue oxygen demand have their receptors on all these types of cells (VSMC, EC, and RBC) implying that there can be a coordinated regulation of their behavior by the tissue oxygen demand. Such functions of RBC as oxygen carrying by Hb, rheology, and release of vasoactive agents are considered. Several common extra‐ and intracellular signaling pathways that link tissue oxygen demand with control of VSMC contractility, EC permeability, and RBC functioning are discussed.