血清Hcy、hs-CRP、D-D水平检测在急性脑梗死诊断中的临床价值

目的 探讨血清同型半胱氨酸（Hcy）、超敏C反应蛋白（hs-CRP）、D-二聚体（D-D）水平检测在急性脑梗死诊断中的临床价值。方法 选择我院2018年1月至2019年6月收治的60例急性脑梗死患者作为本次研究入组对象,另选取2018年1月至2019年6月在我院进行体检的结果显示健康的60名健康志愿者作为对照组。比较两组血清Hcy、hs-CRP、D-D水平以及不同梗死面积的急性脑梗死患者血清Hcy、hs-CRP、D-D水平差异。结果 急性脑梗死组和健康对照组血清Hcy、hs-CRP、D-D水平对比,研究组患者经血清检测Hcy、hs-CRP、D-D均高于对照组,组间差异有统计学意义（P <0.05）。急性脑梗死不同梗死面积血清Hcy、hs-CRP、D-D水平对比,大面积梗死患者的血清Hcy、hs-CRP、D-D均高于中、小梗死患者,组间差异有统计学意义（P <0.05）。急性脑梗死不同梗死程度血清Hcy、hs-CRP、D-D水平对比,重度梗死患者的血清Hcy、hs-CRP、D-D均高于轻、中度梗死患者,组间差异有统计学意义（P <0.05）。结论 血清Hcy、hs-CR...     

急性脑梗死患者Hcy ox-LDL D-二聚体的表达水平及意义

目的 分析急性脑梗死（ACI）患者同型半胱氨酸（Hcy）、氧化修饰低密度脂蛋白（ox-LDL）、D-二聚体（D-D）等指标的水平变化及其临床意义。方法 选取2016年6月至2018年6月黄浦区中心医院神经内科收治的53例ACI患者作为研究组，依据病情的严重程度将患者分为重度组、中度组、轻度组，依据梗死灶的大小将患者分为大梗死灶组、中梗死灶组、小梗死灶组；同时选取同期体检人员42例作为对照组，比较不同组别急性脑梗死患者与对照组人群的血清Hcy、ox-LDL、D-D水平差异。结果 研究组患者血清Hcy、ox-LDL、D-D水平均高于对照组（P<0.05）。随着NIHSS评分和梗死灶面积的增加，研究组患者血清Hcy、ox-LDL、D-D水平均增高（P<0.05）。完全型和进展型脑卒中患者血清Hcy、ox-LDL、D-D水平均高于对照组（P<0.05）。进展型患者血清Hcy、ox-LDL、D-D水平均高于完全型（P<0.05）。结论 血清Hcy、ox-LDL、D-D水平与ACI密切相关，三者均可用于ACI的诊断及病情严重程度的评估。     

血浆CysC、Hcy、D-D及hs-CRP检测在急性脑梗死早期诊治中的临床应用

目的探析血浆胱抑素C(CysC)、同型半胱氨酸(Hcy)、超敏C反应蛋白(hs-CRP)、D-二聚体(D-D)检测在急性脑梗死早期诊治中的临床价值。方法选择70例急性脑梗死患者作为观察组,根据急性脑梗死面积不同分为大梗死组(20例)、中梗死组(22例)、小梗死组(28例);同时选择70例健康体检者作为对照组。应用自动化分析仪对两组血浆CysC、Hcy、D-D及hs-CRP进行检测。比较观察组和对照组入院24 h内CysC、Hcy、D-D及hs-CRP水平;比较大梗死组、中梗死组、小梗死组患者入院24 h内、治疗1周后CysC、Hcy、D-D及hs-CRP水平。结果入院24 h内,观察组血浆CysC(1.25±0.44)mg/L、Hcy(22.20±5.71)μmol/L、D-D(2.39±0.54)mg/L、hs-CRP(19.34±2.45)mg/L均高于对照组的(0.81±0.15)mg/L、(10.42±3.85)μmol/L、(0.82±0.38)mg/L、(2.20±1.53)mg/L,差异具有统计学意义(P<0.05)。入院24 h内,大梗死组患者血浆CysC、Hcy、D-D及hs-CRP水平高于中梗死组、小梗死组,中梗死组高于小梗死组,差异具有统计学意义(P<0.05)。治疗1周后,三组患者血浆CysC、Hcy、D-D及hs-CRP水平均低于本组入院24 h内,差异具有统计学意义(P<0.05)。结论在急性脑梗死早期诊治中,通过检测血浆CysC、Hcy、D-D及hs-CRP水平可以对病情进行早期诊断,为临床医生制定治疗方案提供依据,有助于提高患者治疗效果及安全性。     

血清同型半胱氨酸、维生素B12及血尿酸水平与脑梗死的相关性

目的 研究血清同型半胱氨酸(Hcy)、维生素B12及血尿酸(UA)水平与脑梗死的相关性。方法 选取80例脑梗死患者为患病组,另择取同期80名健康体检者为参照组,均行Hcy、维生素B12及UA检测,分析两组检测结果。结果 患病组患者的Hcy、UA水平均高于参照组,维生素B12水平低于参照组,差异均具有统计学意义(P<0.05);经统计,Hcy、UA及维生素B12水平在不同脑梗死程度间差异无统计学意义(P<0.05),其中大面积梗死患者的Hcy、UA指标高于中面积梗死及小面积梗死,维生素B12指标低于中面积梗死及小面积梗死,且中面积梗死Hcy、UA指标高于小面积梗死,维生素B12指标低于小面积梗死,差异具有统计学意义(P<0.05);经过分析,脑梗死严重程度与Hcy、UA呈现正相关(r_spHcy=0.564,r_spUA=0.365,P<0.05),与维生素B12呈现负相关(r_{sp维生素B12}=0.602,P<0.05)。结论 Hcy、维生素B12及UA与脑梗死有直接联系,明确梗死严重程度,为疾病...     

血浆CysC、Hcy、D-D及hs-CRP检测在急性脑梗死早期诊治中的临床应用

目的 分析血浆胱抑素C(CysC)、同型半胱氨酸(Hcy)、D-二聚体(D-D)及超敏C反应蛋白(hs-CRP)检测在急性脑梗死患者早期诊治中的应用价值。方法 选择80例确诊的急性脑梗死患者作为观察组,根据梗死体积不同分为大梗死组(20例)、中梗死组(30例)和小梗死组(30例);选择同期80例健康体检者作为对照组。所有研究对象均检测血浆CysC、Hcy、D-D及hs-CRP水平。比较观察组和对照组血浆CysC、Hcy、D-D及hs-CRP水平;不同梗死体积组血浆CysC、Hcy、D-D及hs-CRP水平。结果 观察组血浆CysC、Hcy、D-D及hs-CRP水平分别为(1.63±0.44)mg/L、(21.28±5.43)μmol/L、(2.36±0.45)mg/L、(18.31±2.26)mg/L,均高于对照组的(0.82±0.15)mg/L、(10.42±3.52)μmol/L、(0.81±0.35)mg/L、(2.21±1.49)mg/L,差异具有统计学意义(P<0.05)。大梗死组血浆CysC、Hcy、D-D及hs-CRP水平高于中梗死组、小梗死组,中梗死组高于小梗死组...     

中老年急性脑梗死患者检测BNP、D-D、CRP的临床意义

目的探讨中老年患者血清中的B型尿钠肽(BNP)、D-二聚体(D-D)、超敏C反应蛋白(CRP)水平的变化,及其在疾病中的意义。方法选择106例急性脑梗死患者、70例健康体检者,测定血清中的BNP、D-D、CRP水平,并对不同梗死面积患者结果进行比较分析。结果大面积梗死组结果高于小面积梗死组。结论急性脑梗死患者BNP、D-D、CRP水平升高的不同,对急性脑梗死病发展的提示有重要临床意义。     

血清CRP、Hcy及FIB检测在急性脑梗死诊断中的应用价值

目的:探讨C反应蛋白(CRP)、同型半胱氨酸(Hcy)及纤维蛋白原(FIB)联合检测对急性脑梗死(ACI)的临床诊断价值。方法:选取2019年3月—2021年2月我院神经内科收治的110例初发ACI患者作为实验组,同期在我院进行健康体检的110例健康体检者作为对照组。将110例实验组患者根据梗死损伤总体积分为小梗死组(53例)、中梗死组(38例)以及大梗死组(19例),根据神经功能恢复程度将其分成预后良好组(74例)以及预后不良组(36例),检测所有研究对象的血清CRP、Hcy以及纤维蛋白原(FIB)水平。结果:实验组血清CRP、Hcy以及FIB水平均高于对照组(P<0.05)。大梗死组患者血清CRP、Hcy以及FIB水平高于小梗死组、中梗死组(P<0.05)。中梗死组患者血清CRP、Hcy以及FIB水平高于小梗死组(P<0.05)。相关性分析结果显示,ACI病情程度与血清CRP、Hcy、FIB水平呈正相关性(P<0.05)。预后良好组患者血清CRP、Hcy以及FIB水平低于预后不良组(P<0.05)。结论:ACI患者血清CRP、Hcy、FIB水平与病情程...     

血清同型半胱氨酸和高敏C反应蛋白与脑梗死相关性的临床研究

目的研究检测急性脑梗死患者血清同型半胱氨酸(Hcy)和高敏C反应蛋白(hs-CRP)水平的临床价值。方法116例急性脑梗死患者(观察组),根据影像学检查结果将患者分为小梗死组42例,中梗死组30例,大梗死组44例;根据神经功能缺损程度评分分为轻型组26例,中型组56例,重型组34例。并选择同期健康体检者110例为对照组,用酶联免疫吸附法检测血清Hcy水平,应用免疫比浊法测定血清hs-CRP水平,并对结果进行比较。结果观察组患者血清Hcy和hs-CRP水平明显高于对照组(P<0.05);小梗死组、中梗死组、大梗死组患者血清Hcy和hs-CRP水平逐渐升高;轻型组、中型组、重型组患者亦逐渐升高,组间两两比较,差异均有统计学意义(P<0.05)。结论 Hcy和hs-CRP水平与患者出现脑梗死的情况密切相关,两者协同检测有助于提高早期诊断准确率,并为评估预后提供参考。     

血清同型半胱氨酸与超敏C反应蛋白与脑梗死的相关性

目的 研究脑梗死患者血清同型半胱氨酸(Hcy)和超敏C反应蛋白(hs-CRP)水平的变化及其与梗死面积的关系.方法 测定52例脑梗死患者和30例正常对照的血清Hcy和hs-CRP含量,并分析两者与脑梗死面积的关系.结果 脑梗死患者血清Hcy、hs-CRP水平明显高于正常对照组(P＜0.01),并且与梗死面积旱正相关(P＜0.05).结论 检测患者血清Hcy和hs-CRP水平的变化对腩梗死的病情判断和疗效评价均具有重要的临床价值.     

急性脑梗死血清Hcy和hs-CRP检测的临床意义

目的 探讨了急性脑梗死患者治疗前后血清同型半胱氨酸（Hcy）和超敏C-反应蛋白（hsCRP）水平的变化及意义。方法应用免疫比浊法和化学发光法对80例急性脑梗死患者进行了血清Hcy和hs-CRP水平检测,并与80名正常健康人作比较。结果在治疗前急性脑梗死患者血清Hcy和hs-CRP水平非常显著地高于正常人组（P〈0．01）,且与梗死灶面积呈正相关（P〈0．05）,经治疗后2周则与正常人组比较无统计学意义（P〉0．05）。结论检测急性脑梗死患者血清Hcy和hs-CRP水平的变化对判断病情和评价疗效均具有雷要的临床价值。     

Susceptibility to erythromycin of anaerobes of the genera Bacteroides, Fusobacterium, Sphaerophorus, Veillonella, Clostridium, Corynebacterium, Peptococcus, Peptostreptococcus

The minimal inhibitory concentrations (MIC) of erythromycin were determined by broth dilution tests for 313 anaerobic strains, most of which were clinical isolates. All the gram-positive anaerobes tested (84 Peptococcaceae, including 21 Peptostreptococcus anaerobius and 15 Peptococcus variabilis; 65 Corynebacterium acnes and 29 Clostridium strains, including 13 C. perfringens) were sensitive (MIC values 0.012 through 3.12 microgram erythromycin/ml); so were 111 cultures of gram-negative anaerobes (52 Bacteroides fragilis, 12 B. thetaiotaomicron, 7 B. vulgatus, 13 B. oralis, 4 B. melaninogenicus, 10 Sphaerophorus necrophorus, 2 Veillonella sp., 11 members of other species). Erythromycin at concentrations of 6.25 through 200.0 microgram/ml was active against 24 strains (1 B. fragilis, 4 Fusobacterium fusiforme, 9 Sph. freundi, 10 Sph. varius). The present results are compared to the limited number of reports existing with regard to the susceptibility of anaerobes to erythromycin.     

Safety assessment of poloxamers 101, 105, 108, 122, 123, 124, 181, 182, 183, 184, 185, 188, 212, 215, 217, 231, 234, 235, 237, 238, 282, 284, 288, 331, 333, 334, 335, 338, 401, 402, 403, and 407, poloxamer 105 benzoate, and poloxamer 182 dibenzoate as used in cosmetics

Poloxamers are polyoxyethlyene, polyoxypropylene block polymers. The impurities of commercial grade Poloxamer 188, as an example, include low-molecular-weight substances (aldehydes and both formic and acetic acids), as well as 1,4-dioxane and residual ethylene oxide and propylene oxide. Most Poloxamers function in cosmetics as surfactants, emulsifying agents, cleansing agents, and/or solubilizing agents, and are used in 141 cosmetic products at concentrations from 0.005% to 20%. Poloxamers injected intravenously in animals are rapidly excreted in the urine, with some accumulation in lung, liver, brain, and kidney tissue. In humans, the plasma concentration of Poloxamer 188 (given intravenously) reached a maximum at 1 h, then reached a steady state. Poloxamers generally were ineffective in wound healing, but were effective in reducing postsurgical adhesions in several test systems. Poloxamers can cause hypercholesterolemia and hypertriglyceridemia in animals, but overall, they are relatively nontoxic to animals, with LD(50) values reported from 5 to 34.6 g/kg. Short-term intravenous doses up to 4 g/kg of Poloxamer 108 produced no change in body weights, but did result in diffuse hepatocellular vacuolization, renal tubular dilation in kidneys, and dose-dependent vacuolization of epithelial cells in the proximal convoluted tubules. A short-term inhalation toxicity study of Poloxamer 101 at 97 mg/m(3) identified slight alveolitis after 2 weeks of exposure, which subsided in the 2-week postexposure observation period. A short-term dermal toxicity study of Poloxamer 184 in rabbits at doses up to 1000 mg/kg produced slight erythema and slight intradermal inflammatory response on histological examination, but no dose-dependent body weight, hematology, blood chemistry, or organ weight changes. A 6-month feeding study in rats and dogs of Poloxamer 188 at exposures up to 5% in the diet produced no adverse effects. Likewise, Poloxamer 331 (tested up to 0.5 g/kg day(-1)), Poloxamer 235 (tested up to 1.0 g/kg day(-1)), and Poloxamer 338 (at 0.2 or 1.0 g/kg day(-1)) produced no adverse effects in dogs. Poloxamer 338 (at 5.0 g/kg day(-1)) produced slight transient diarrhea in dogs. Poloxamer 188 at levels up to 7.5% in diet given to rats in a 2-year feeding study produced diarrhea at 5% and 7.5% levels, a small decrease in growth at the 7.5% level, but no change in survival. Doses up to 0.5 mg/kg day(-1) for 2 years using rats produced yellow discoloration of the serum, high serum alkaline phosphatase activity, and elevated serum glutamicpyruvic transaminase and glutamic-oxalacetic transaminase activities. Poloxamers are minimal ocular irritants, but are not dermal irritants or sensitizers in animals. Data on reproductive and developmental toxicity of Poloxamers were not found. An Ames test did not identify any mutagenic activity of Poloxamer 407, with or without metabolic activation. Several studies have suggested anticarcinogenic effects of Poloxamers. Poloxamers appear to increase the sensitivity to anticancer drugs of multidrug-resistant cancer cells. In clinical testing, Poloxamer 188 increased the hydration of feces when used in combination with a bulk laxative treatment. Compared to controls, one study of angioplasty patients receiving Poloxamer 188 found a reduced myocardial infarct size and a reduced incidence of reinfarction, with no evidence of toxicity, but two other studies found no effect. Poloxamer 188 given to patients suffering from sickle cell disease had decreased pain and decreased hospitilization, compared to controls. Clinical tests of dermal irritation and sensitization were uniformly negative. The Cosmetic Ingredient Review (CIR) Expert Panel stressed that the cosmetic industry should continue to use the necessary purification procedures to keep the levels below established limits for ethylene oxide, propylene oxide, and 1,4-dioxane. The Panel did note the absence of reproductive and developmental toxicity data, but, based on molecular weight and solubility, there should be little skin penetration and any penetration of the skin should be slow. Also, the available data demonstrate that Poloxamers that are introduced into the body via routes other than dermal exposure have a rapid clearance from the body, suggesting that there would be no risk of reproductive and/or developmental toxicity. Overall, the available data do not suggest any concern about carcinogenesis. Although there are gaps in knowledge about product use, the overall information available on the types of products in which these ingredients are used, and at what concentration, indicates a pattern of use. Based on these safety test data and the information that the manufacturing process can be controlled to limit unwanted impurities, the Panel concluded that these Poloxamers are safe as used.     

HPLC法测定抗妇炎胶囊中木兰花碱、黄柏碱、药根碱、巴马汀、小檗碱、槐果碱、苦参碱、氧化槐果碱、槐定碱和氧化苦参碱

目的 采用高效液相色谱（HPLC）法同时测定抗妇炎胶囊中木兰花碱、黄柏碱、药根碱、巴马汀、小檗碱、槐果碱、苦参碱、氧化槐果碱、槐定碱和氧化苦参碱10种活性成分。方法 采用InerSustain AQ-C₁₈色谱柱（250 mm×4.6 mm,5 μm）,流动相A：乙腈–无水乙醇（80∶20）,流动相B：0.1%磷酸溶液,梯度洗脱,检测波长220 nm,体积流量1.0 mL/min,柱温30℃,进样量10 μL。结果 木兰花碱、黄柏碱、药根碱、巴马汀、小檗碱、槐果碱、苦参碱、氧化槐果碱、槐定碱和氧化苦参碱分别在2.69～134.50、1.95～97.50、0.63～31.50、0.86～43.00、11.95～597.50、0.59～29.50、6.08～304.00、4.85～242.50、1.66～83.00、19.79～989.50 μg/mL线性关系良好（r≥0.999 3）;平均回收率分别为99.11%、98.23%、96.95%、97.78%、100.02%、97.21%、99.66%、99.52%、98.81%、100.08%,RSD值分别为1.04%、1.23%、1.37%、1.65%、0.70%、1.28%、0.65%、0.81%、1.11%、0.63%。结论 建立的HPLC法可用于抗妇炎胶囊中10种活性成分的测定,作为抗妇炎胶囊质量控制方法。     

Strength of drug habits: For heroin,morphine, methadone,alcohol, barbiturates,pentobarbital, benzedrine,cocaine, and marijuana

The drug habits for 78 confirmed opiate addicts were studied on eight scales from the Process Association Test of Addiction (PATA) for many drug names. Through cluster analysis eight stages of addiction were defined: “to be clean”, “to learn about drugs”, “to hustle”, “to chip” (also “to be high”), to be psychologically dependent or “to need a shot”, “to be hooked”, “to kick a habit” and “to be in treatment”. Associations stimulated by the words heroin and morphine were very similar over the eight stages of addiction in opiate addicts. The subjects were especially inclined to associate morphine and heroin with the most severe level of addiction, “to be hooked”. Associations to both methadone and cocaine were elevated at the “hooked” stage, but in other respects associations to these drugs were opposite. Thus, associations to cocaine were focused on the stage of psychological dependence and the lower intermediate stage of addiction, “to chip” and “to be high”, whereas associations to methadone suggested a turning away from addiction as indicated by avoidance associations (“to come down” and “to kick a habit”) as well as associations to “treatment” and “to be clean”. Marijuana, Benzedrine, “goofball” (barbiturates) and alcohol habits were prominent at an intermediate stage of addiction (“to chip” and “to be high”). Avoidance associations were common for Benzedrine and “goofballs” (also pentobarbital) but not for marijuana or alcohol. “Hustling” associations were frequent for marijuana but not for alcohol.     

Simultaneous measurement of bupivacaine, etidocaine, lidocaine, meperidine, mepivacaine, and methadone

A gas-liquid chromatographic method for the simultaneous measurement of bupivacaine, etidocaine, lidocaine, meperidine, mepivacaine, and methadone in serum is described. The drugs and the internal standard, prilocaine, are extracted from 1 ml of serum. The procedure involves a two-step extraction and injection of the extract into a gas chromatograph equipped with a 10-ft OV-11 glass column and a nitrogen-phosphorus detector. The temperature gradient program results in a run time of 16 min and retention times for meperidine, prilocaine (internal standard), lidocaine, etidocaine, mepivacaine, methadone, and bupivacaine of 3.8, 5.4, 6.0, 8.7, 11.0, 11.7, and 14.8 min, respectively. Standard curves for all drugs were linear over the 80 to 2,000-ng/ml range and recovery of all components averaged 97 +/- 2% with the lowest detection limit of 10 ng/ml for all drugs except meperidine and methadone, which were 20 ng/ml. The within-day coefficients of variation ranged from 12 to 8% at 500 ng/ml. The day-to-day coefficients of variation of the slope and intercept values ranged from 2 to 0% and 130 to 3%, respectively. Response factors of the nitrogen-specific collector varied with the drug analyzed and resulted in peak area variation at constant offset and attenuation of 30%. This method is intended and adequate for therapeutic monitoring of chronically treated pain patients who are being given various combinations of local anesthetic and/or narcotic agents.     

New antiretroviral drugs: a review of the efficacy,safety, pharmacokinetics,and resistance profile of tipranavir,darunavir, etravirine,rilpivirine, maraviroc,and raltegravir

Background: The introduction and approval of new antiretroviral agents in the US and Canada bring new opportunities and new challenges. Arguably, for the first time ever, clinicians have the drugs necessary to achieve the goal of suppressing HIV RNA to levels less than 50 copies/mL in even the most treatment-experienced patients and in those with extensive drug-limiting resistance mutations. However, the use of these new agents is complicated by many drug–drug interactions and – to some extent – pre-existing mutations. To derive maximum durability from the use of these newer drugs, a thorough understanding of their indications and limitations is critical. Objective: To thoroughly review the six most recently approved or soon-to-be-approved antiretroviral drugs in the US and Canada: tipranavir, darunavir, etravirine, rilpivirine, maraviroc, and raltegravir. Methods: Discussion of the indications for, and pharmacokinetics, resistance profile, activity, toxicity, and clinical trials results of, the six new agents. Results/conclusions: These six new agents have resulted in marked progress towards the goal of being able to provide HIV-infected individuals with the drugs necessary to achieve decades of durable suppression of HIV without substantial toxicity.     

Disposition of fluvastatin, an inhibitor of HMG-COA reductase, in mouse, rat, dog, and monkey

The physiological disposition of fluvastatin, a potent inhibitor of hydroxymethylglutaryl-CoA reductase and thus cholesterol synthesis, has been studied in the mouse, rat, dog, and monkey using 14C- or 3H-labeled drug. Oral doses of fluvastatin were absorbed at a moderate to rapid rate. The extent of absorption was dose-independent and was essentially complete in all four species studied. However, the drug was subject to extensive presystemic hepatic extraction followed by direct excretion via the bile, thus minimizing the systemic burden and yielding high liver/peripheral tissue concentration gradients for fluvastatin and its metabolites. Only at high doses far exceeding the intended human daily dose of ca 0.6 mg kg-1 did fluvastatin bioavailability approach unity, apparently due to saturation of the first-pass effect. Dose-normalized blood levels of fluvastatin and total radioactivity were higher in the dog than in the other species, suggesting a smaller distribution volume in the former. Fluvastatin was partially metabolized before excretion, the extent of metabolism being smallest in the dog and greatest in the mouse. The half-life of intact fluvastatin ranged from 1-2h in the monkey to 4-7h in the dog. Regardless of the dose or dose route, the administered radioactivity was recovered predominantly in feces, with the renal route accounting for less than 8 per cent of the dose. No tissue retention of radioactivity was observed, and material balance was essentially achieved within 96h after dosing.