托吡酯与硫必利治疗儿童多发性抽动症的对比分析

目的对比分析托吡酯治疗儿童多发性抽动症（TS）的临床疗效及安全性。方法选择符合DSM—IV-TR诊断标准的多发性抽动症70例,随机分为托吡酯组、硫必利组。托吡酯组采用托吡酯剂量每日2-3mg／kg;硫必利组采用硫必利剂量50～150mg／次,每日2次,维持剂量50～150mg／d。以抽动发作减少次数作为评定疗效,对比分析两组不良反应发生率。结果托吡酯组有效率为85．7％（36／42）,硫必利组有效率为82．1％（23／28）。两组疗效比较差异无显著性（x^2=0．0045,P=0．9466）。托吡酯组总的不良反应发生率35．7％,轻度不良反应（33.3％）,中度不良反应发生率2．4％;硫必利组总的不良反应发生率60．7％,轻度不良反应（35．7％）中重度不良反应发生率25％。两组不良反应比较有显著差异（x^2=4．2311,P=0．0397）。结论托吡酯与硫必利治疗TS同样有效,不良反应托吡酯与硫必利相比明显少而轻。     

托吡酯治疗儿童抽动秽语综合征

目的:观察托吡酯治疗儿童抽动秽语综合征(Tourettesyndrome, TS)的疗效及其不良反应。方法:将96例TS病儿分为治疗组和对照组各48例。治疗组采用托吡酯按0. 5 ~ 1. 5mg·kg-1·d-1,分2 次口服, 对照组采用硫必利100 ~400mg·d-1,分2~3次口服,疗程6mo。治疗期间每月定期门诊复诊。结果:治疗组有效率为87 %,对照组有效率为85 %。2组疗效比较差异无显著意义(P> 0. 05); 2组不良反应率相比有非常显著差异(P <0. 01)。结论:托吡酯与硫必利治疗TS疗效相似,且不良反应较硫必利明显减少,同时可有效减轻合并症状。     

托吡酯治疗小儿难治多发性抽动症18例疗效观察

目的验证托吡酯治疗儿童难治性多发性抽动症的疗效和安全性。方法对18例诊断为难治性多发性抽动症患儿予托吡酯到治疗量,采用YGTSS及副反应量表,于治疗前、治疗后3个月评估其疗效及安全性。结果托吡酯对运动抽动发作控制14例（78％）,发声抽动控制13例（72％）,多动性抽动和发声性抽动的分数均显著降低（P〈0．001）,不良反应少。结论托吡酯治疗多发性抽动疗效肯定副反应轻。     

熄风止动片治疗小儿多发性抽动症肝风内动挟痰证的临床研究

目的初步评价熄风止动片治疗小儿多发性抽动症肝风内动挟痰证的有效性和安全性。方法采用区组随机、双盲、平行对照试验方法。将入选216例患儿分成2组,试验组108例,对照组108例,2组剔除或脱落病例各2、3例。结果熄风止动片与对照药硫必利片对小儿多发性抽动症的总有效率分别为81.48%、83.81%。对于中医症状综合疗效,熄风止动片与硫必利片的总有效率分别为83.02%、83.81%,组间差异均无统计学意义。非劣效检验结果显示,试验组疗效不劣于对照组。两组的中医单项证候及舌脉治疗前后组内比较,差异均有统计学意义。试验组与对照组分别有2、4例不良反应,不良反应发生率为分别为1.85%、3.70%。结论熄风止动片对小儿多发性抽动症肝风内动挟痰证的疗效不劣于对照药疏必利片,并具有良好安全性。     

耳部刮痧、中药颗粒辅助盐酸硫必利片治疗儿童多发性抽动症的临床效果

目的 探讨耳部刮痧、中药颗粒辅助盐酸硫必利片治疗儿童多发性抽动症的临床效果。方法 选取2020年1月至2022年4月厦门市中医院儿科多发性抽动症患儿108例,按照随机数表法分为常规组(n=54)和研究组(n=54)。常规组予以盐酸硫必利片治疗,研究组在常规组基础上予以耳部刮痧+中药颗粒干预,比较两组临床疗效、治疗前后中医证候积分、耶鲁综合抽动严重程度量表(YGTSS)积分及不良反应发生率。结果 研究组治疗总有效率为94.44%,高于常规组的79.63%,差异有统计学意义(P <0.05);治疗3个疗程后,研究组中医证候积分低于常规组,差异有统计学意义(P <0.05);治疗3个疗程后,研究组发声性抽动积分、运动性抽动积分、YGTSS总积分低于常规组,差异有统计学意义(P <0.05);研究组不良反应总发生率为7.41%,与常规组的3.70%比较,差异无统计学意义(P> 0.05)。结论 耳部刮痧、中药颗粒辅助盐酸硫必利片用于儿童多发性抽动症干预的临床效果显著,可改善患儿中医证候,促进症状缓解,且安全性高,值得推广。     

宣氏抽动方治疗学龄前儿童多发性抽动症临床观察

目的观察宣氏抽动方治疗学龄前儿童多发性抽动症的临床疗效。方法选取2015年3月至2016年7月浙江省中医院儿科门诊收治的学龄前抽动症患儿60例,随机分为对照组和治疗组,各30例。对照组予硫必利治疗,治疗组予宣氏抽动方治疗,均以12周为1个疗程,1个疗程后观察2组耶鲁综合抽动严重程度量表(YGTSS)评分的变化。结果与同组治疗前比较,2组抽动总积分均明显降低,差异均有统计学意义(P0.05);治疗后2组抽动总积分组间比较,差异无统计学意义(P0.05)。治疗组总有效率为93.3%,对照组为90.0%,2组比较,差异无统计学意义(P0.05)。结论宣氏抽动方治疗学龄前儿童多发性抽动症疗效满意,与硫必利疗效相当,且未发现其他神经系统及心理、行为障碍性症状。     

抽动宁冲剂治疗儿童多发性抽动症的临床疗效观察

目的观察中药抽动宁冲剂治疗儿童多发性抽动症的临床疗效及不良反应。方法对2004年5月至2007年5月诊治的90例多发性抽动症患儿，用随机、对照方法分成治疗组与对照组。治疗组60例，应用抽动宁冲剂；对照组30例，应用西药硫酸泰必利。结果治疗组总有效率为91．67％，对照组总有效率为90．00％，2组比较差异无统计意义（P〉0．05）。但中药组不良反应低于对照组（P〈0．05）。结论中药抽动宁冲剂治疗多发性抽动症疗效显著，能达到与硫酸泰必利同等疗效，且不良反应低。     

文静汤治疗小儿多发性抽动症30例临床疗效观察

目的观察中药文静汤治疗儿童多发性抽动症的临床疗效及不良反应。方法对2009年7月至2009年12月诊治的60例多发性抽动症患儿,采用随机、对照方法分成治疗组与对照组各30例。治疗组应用文静汤治疗,对照组应用西药泰必利治疗。结果治疗组总有效率为90.0%,对照组总有效率为76.7%,治疗组疗效优于对照组。结论中药文静汤治疗儿童多发性抽动症疗效优于西药泰必利,且无明显副作用,值得在临床推广应用。     

托吡酯联合氟桂利嗪治疗偏头痛的临床疗效分析

目的研究分析托吡酯联合氟桂利嗪在偏头痛临床治疗中的应用价值。选择我院收治的偏头痛患者80例,将其随机分成对照组与研究组,每组40例。对照组单纯使用托吡酯进行治疗,研究组采用托吡酯联合氟桂利嗪给予治疗,比较两组临床治疗效果。结果研究组的治疗总有效率为90.0%,对照组的治疗总有效率为62.5%,两组比较差异有统计学意义(P<0.05)。对照组出现7例不良反应(占比17.5%);研究组出现2例不良反应(占比5%),两组临床不良反应比较差异有统计学意义(P<0.05)。结论与单纯使用托吡酯比较,托吡酯联合氟桂利嗪治疗偏头痛的疗效更显著,不良反应更低,值得推广。     

左乙拉西坦治疗儿童多发性抽动症的疗效分析

目的 研究左乙拉西坦治疗儿童多发性抽动症的临床疗效和不良反应.方法 选择2015年1月至2016年1月郑州市儿童医院神经内科门诊多发性抽动症60例.随机将患儿分为对照组和研究组,每组30例.研究组给予左乙拉西坦,对照组给予硫必利,根据患儿抽动减少情况对治疗效果进行评价,并观察药物不良反应及耐受性,用药剂量个体化.结果 两组经过治疗后总有效率比较,差异不显著(P>0.05).研究组不良反应率低于对照组(P<0.05).结论 左乙拉西坦治疗儿童多发性抽动症的疗效显著,不良反应少,耐受性好,值得推广.     

Affective and Anxiety Disorders and Alcohol and Drug Dependence:

Depression and anxiety frequently coexist in patients with substance use disorders. This clinically-oriented article examiens the relationship between these conditions and emphasizes data showing that substances of abuse can cause signs and symptoms of both depression and anxiety. These substance-related syndromes appear to have a different course and prognosis than uncomplicated, independent anxiety and major depressive disorders, and clinicians should consider the role of alcohol and other drugs in all patients presenting with these complaints. The authors will also outline an approach for diagnosing and managing patients with the combination of a substance use and depressive or anxiety disorder.     

Synthesis and anti-nociceptive and anti-inflammatory effects of gaultherin and its analogs

The synthesis of gaultherin (1) and its analogs was carried out to provide 11 glycosides under phase-transfer catalytic conditions. The activities of all synthesized compounds were evaluated by nitric oxide production inhibitory assay in vitro. Methyl 2-O-(4-O-β-d-galactopyranosyl)-β-d-glucopyranosylbenzoate (5f) showed significantly anti-nociceptive and anti-inflammatory effects by the evaluation in vivo. Structure–activity relationships within these compounds were discussed.     

Modelling and simulation of variability and uncertainty in toxicokinetics and pharmacokinetics

Two important methodological issues within the framework of the variability and uncertainty analysis of toxicokinetic and pharmacokinetic systems are discussed: (i) modelling and simulation of the existing physiologic variability in a population; and (ii) modelling and simulation of variability and uncertainty when there is insufficient or not well defined (e.g. small sample, semiquantitative, qualitative and vague) information available. Physiologically based pharmacokinetic models are especially suited for separating and characterising the physiologic variability from the overall variability and uncertainty in the system. Monte Carlo sampling should draw from multivariate distributions, which reflect all levels of existing dependencies in the intact organism. The population characteristics should be taken into account. A fuzzy simulation approach is proposed to model variability and uncertainty when there is semiquantitative, qualitative and vague information about the model parameters and their statistical distributions cannot be defined reliably.     

成骨细胞的功能与损伤和骨质疏松的防治

骨质疏松是一种全身性骨骼疾病,导致骨折风险增加。成人的骨量通过破骨细胞的骨吸收和成骨细胞的骨形成作用来维持动态平衡,治疗骨质疏松症的理想策略是抑制破骨细胞的骨吸收和/或增强成骨细胞的骨形成功能。目前针对保护成骨细胞及增强其功能的骨质疏松疗法相对较少。因此,本文针对成骨细胞相关功能蛋白、各种细胞损伤机制（内质网应激、氧化应激、机械过载、微小RNA和长链非编码RNA的影响等）及骨质疏松的治疗与预防作一综述,以期为针对增强成骨细胞功能的骨质疏松治疗策略提供新思路。     

Self-stimulation and amphetamine: Tolerance to d and l isomers and cross tolerance to cocaine and methylphenidate

The effects of the d and l isomers of amphetamine on self-stimulation responding were tested following acute and chronic administration. Tolerance and post-drug depression of responding occurred in tests with both isomers, indicating no role for p-hydroxynorephedrine (PHN) which is one of the metabolites of d-amphetamine. In the second experiment, d-amphetamine, methylphenidate and cocaine all produced quantitatively and qualitatively similar effects on self-stimulation responding following acute administration. Following chronic administration of d-amphetamine, animals showed tolerance to all three drugs, indicating cross-tolerance among them. These data are consistent with an hypothesis that tolerance and post-drug depression following chronic amphetamine treatment are the result of decreases in postsynaptic receptor sensitivity, which would lead to a decreased effectiveness of all three drugs, regardless of their pre-synaptic mechanisms.     

益生菌与肿瘤防治

益生菌广泛存在于自然界中,通过维持宿主体内菌群平衡、影响肠屏障功能和调节免疫应答等作用,提高宿主健康水平,被公认为"肠道健康卫士".一些益生菌可以增强机体的免疫功能,抑制致癌物质,影响肿瘤细胞的基因表达,对肿瘤具有拮抗作用.大量研究表明,益生菌在未来的肿瘤防治中有很好的应用和发展前景.     

Acamprosate and naltrexone treatment effects on ethanol and sucrose seeking and intake in ethanol-dependent and nondependent rats

Rationale  Two pharmacotherapies are approved for treating alcohol craving (acamprosate and naltrexone), but both have shown mixed findings in animals and humans. Objectives  The present experiments utilized a “reinforcer blocking” approach (i.e., rats were able to consume ethanol during treatment) to better understand the efficacy of these treatments for ethanol seeking and drinking using ethanol-dependent and nondependent rats. Materials and methods  In “nondependent” experiments, drugs (acamprosate 50, 100, and 200 mg/kg; naltrexone 0.1, 0.3, and 1.0 mg/kg) were administered over 3-week periods prior to operant sessions with a low response requirement to gain access to reinforcers for 20 min. For “dependent” experiments, rats were made dependent in vapor/inhalation chambers. Results  Acamprosate and naltrexone had similar effects on intake in nondependent and dependent rats; neither drug was selective for ethanol over sucrose drinking. In nondependent animals, naltrexone was more efficacious at more doses than acamprosate, and acamprosate’s effects were limited to a dose that also had adverse effects on body weight. Both pharmacotherapies showed more selectivity when examining reinforcer seeking. In nondependent rats, acamprosate and naltrexone had response-attenuating effects in ethanol, but not sucrose, groups. In dependent animals, acamprosate had selective effects limited to a decrease in sucrose seeking. Naltrexone, however, selectively decreased ethanol-seeking in nondependent rats. Conclusions  The naltrexone-induced decreases in seeking suggested a change in incentive motivation which was selective for ethanol in nondependent rats. The “nondependent” paradigm may model early stages of “problem drinking” in humans, and the findings suggest that naltrexone could be a good intervention for this level of alcohol abuse and relapse prevention.     

Antiinfective and encrustation-inhibiting materials--myth and facts

Catheters, urethral and ureteral stents and other urological implants are frequently affected by encrustration and infection due to their permanent contact with urine. Indwelling urinary catheters provide a haven for microorganisms and thus require extensive monitoring. Several surface modification techniques have been proposed to improve the performance of devices including the immobilization of biomolecules, the incorporation of hydrophilic grafts to reduce protein adsorption, the creation of hydrophobic surfaces, the creation of microdomains to regulate cellular and protein adhesion, new polymers and antimicrobial coatings. Physico-chemical explanation to elucidate the mechanism of such encrustation or infection inhibiting materials is still not available. Our series of experiments showed a marked decrease of silver-activity in biological fluids which corresponds with the controversial clinical results obtained with silver coated urinary catheters. Rifampicin/minocycline coated catheters had very low activity against Gram-negative rods, enterococci and Candida spp., the main causing organisms of urinary catheter infection. Surface engineered materials and antimicrobial drug delivery systems will be the next generation of sophisticated urinary catheters and stents, if both efficacy as well as efficiency has been proved clinically.     

Alprazolam and lorazepam single and multiple-dose effects on psychomotor skills and sleep

Summary The effects of alprazolam 0.5 mg and lorazepam 2 mg on cognitive and psychomotor skills were assessed in twelve normal volunteer subjects in a randomised, double-blind, crossover design. Single and multiple dose effects were monitored using a battery of tests comprising critical flicker fusion threshold (CFFT), choice reaction time (CRT), simulated car tracking, and subjective ratings of perceived sedation (LARS) and of sleep behaviour (LSEQ). Compared with placebo baseline scores, treatment with lorazepam 2 mg (both single and multiple doses) resulted in a widespread impairment of CRT, tracking accuracy, and CFFT. Single doses of alprazolam 0.5 mg reduced CFFT with respect to the placebo baseline. Single and multiple dose treatment with both drugs resulted in subjective reports of sedation, a reduction of sleep onset latency, and improved sleep quality. Only lorazepam 2 mg significantly disrupted the integrity of behaviour on waking from sleep. These results suggest important pharmacodynamic differences between the two drugs in the doses used.