国家免费孕前优生健康检查中病毒筛查的临床意义

目的研究孕前优生健康检查病毒筛查的临床意义。方法对扎赉特旗2012年1月至2014年12月7627例待孕育龄妇女进行免费孕前优生健康检查。采取受检者外周静脉血5 m L通过酶联免疫法,检测弓形虫IgG抗体、IgM抗体;巨细胞病毒IgG抗体、IgM抗体;风疹病毒IgG抗体;梅毒螺旋体;对检查结果进行统计分析。结果 7627例待孕育龄妇女中弓形虫IgG抗体阳性4683例,弓形虫IgM抗体阳性22例。巨细胞病毒IgG抗体阳性1365例,巨细胞病毒IgM抗体阳性15例。风疹病毒IgG抗体阳性502例,梅毒螺旋体阳性24例。结论通过对7627例待孕育龄妇女免费孕前优生健康检查中病毒筛查的检查结果进行分析,对检查结果阳性的待孕育龄妇女进行病毒的防治,从而达到降低出生缺陷率,提高出生人口素质的目的。     

6678例育龄妇女TORCH病原体感染血清学调查

目的了解本地区育龄妇女TORCH包括弓形虫(TOX)、风疹病毒(RV)、巨细胞病毒(CMV)、单纯疱疹病毒(HSV)和其他如乙肝病毒(HBV)、丙肝病毒(HCV)、艾滋病毒(HIV)和梅毒螺旋体(TP)等的感染状况,为本地区孕妇保健提供参考依据。方法应用酶联免疫吸附试验(ELISA)检测6678例标本血清TORCH特异性IgM和IgG。结果被调查育龄妇女血清中TOX IgM阳性105例,阳性率为0.8%;TOX IgG阳性330例,阳性率为4.9%;RV IgM阳性141例,阳性率为2.1%;RV IgG阳性3914例,阳性率为71.3%;CMV IgM阳性42例,阳性率为0.6%;CMV IgG阳性5088例,阳性率为99.4%;HBsAg阳性率为10.75%;HCV阳性率为0.24%;HIV阳性率为0.01%;TP阳性率为0.12%;结论本地区育龄妇女存在TORCH病原体100%感染率,婚前、孕前或孕早期检测并及时预防有利于优生优育。     

育龄妇女TORCH病原体感染血清学调查

目的了解本地区育龄妇女TORCH包括弓形虫（TOX）、风疹病毒（RV）、巨细胞病毒（CMV）、单纯疱疹病毒（HSV）和其他如乙肝病毒（HBV）、丙肝病毒（HCV）、艾滋病毒（HIV）和梅毒螺旋体（TP）等的感染状况,为提高本地区人口素质、加强孕妇保健提供参考依据。方法应用酶联免疫吸附试验（ELISA）和化学发光法分别检测6678例血清标本HbsAg、HCV、HIV、TP和TORCH特异性IgM、IgG。结果 6678例被调查对象中TOX感染率为6.5%;RV感染率为60.7%;CMV感染率为100.0%;HBsAg阳性率为10.75%;HCV阳性率为0.24%;HIV阳性率为0.01%;TP阳性率为0.12%。结论本地区育龄妇女存在TORCH病原体100%感染率,婚前、孕前或孕早期检测并及时预防有利于优生优育,提高人口素质。     

佛山市顺德区首次美沙酮门诊吸毒人群HIV、HBV、HCV和梅毒感染状况调查

目的:了解佛山市顺德区首次美沙酮门诊吸毒人员HIV、HBV、HCV和梅毒感染状况及其危险因素。方法:对2006年1月-2013年12月893名首次进行美沙酮门诊吸毒人员进行HIV、HCV、梅毒抗体及HBV抗原进行检测,同时进行问卷调查。结果:893名吸毒者中HIV抗体、HCV抗体、梅毒抗体、HBV抗原阳性率分别为2.24%(20/893)、69.54%(621/893)、0.90%(8/893)、20.94%(187/893),男性吸毒者血清HIV、HCV、梅毒和HBV的阳性检出率分别为1.75%、70.05%、0.75%、21.30%,女性吸毒者血清HIV、HCV、梅毒和HBV的阳性检出率分别为6.31%、65.26%、2.11%、17.89%,女性HIV阳性率显著高于男性(P<0.05),男性HCV、HBV及梅毒的感染与女性无统计学差异(P>0.05)。多个性伴侣吸毒人群HIV、HCV阳性率显著高于单个性伴侣人群(P<0.05)。其中静脉吸毒者556例,非静脉吸毒者337例,静脉吸毒HCV感染率83.81%,明显高于非静脉吸毒感染率46.0%(P<0.01)。静脉吸毒HIV抗体、梅毒抗体、HBV抗原阳性率分别为2.34%(13/556)、1.08%(6/556)、19.97%(111/556),非静脉吸毒HIV抗体、梅毒抗体、HBV抗原阳性率分别为2.08%(7/337)、0.59%(2/337)、22.55%(76/337),两组比较差别无统计学意义,P值分别为0.80、0.70和0.36。合并感染HCV、HBV病毒者15.34%(137/893),其中静脉吸毒19.60%(109/556),明显高于非静脉吸毒者8.31%(28/337),P值为0.00。结论:佛山市顺德区女性吸毒人员HIV感染率显著高于男性,静脉吸毒人群HCV感染率明显较非静脉吸毒人群高,静脉吸毒者合并HCV、HBV病毒感染率较高,多个性伴侣吸毒人群HIV、HCV感染率高。应采取综合干预措施控制HIV、HBV、HCV在吸毒人群中蔓延。     

孕前及孕期妇女TORCH感染状况调查分析

目的:了解汉川地区孕前及孕早期妇女TORCH感染的情况,探讨育龄妇女TORCH早期监测的意义。方法:对1112例孕前及孕早期妇女弓形虫、风疹病毒、巨细胞病毒以及单纯疱疹病毒的-IgM及-IgG抗体的检测结果进行回顾。结果:1112例受检者4类病原体-IgM阳性率依次为0.36%、0.45%、1.98%、0.45%,近期总感染率3.24%;-IgG阳性率依次为1.08%、76.4%、86.7%、6.03%,既往总感染率为95.2%。结论:TORCH是人类先天性感染的重要因素之一,育龄妇女普遍易感,为提高出生人口素质,对孕前及孕早期妇女进行TORCH感染早期监测,具有重要意义。     

孕妇800例TORCH检测结果分析

目的：了解正常孕产妇TORCH（弓形虫、风疹病毒、巨细胞病毒及单纯疱疹病毒）感染情况,为优生优育提供参考依据。方法：采用酶联免疫吸附（ELISA）法检测800例孕产妇血清中TORCH特异性IgM。结果：弓形虫、风疹病毒、巨细胞病毒、单纯疱疹病毒特异性IgM阳性率分别为0.23%、0.29%、1.15%、0.14%。结论：对孕产妇进行四种病原体感染血清学筛查,在优生优育方面有着重要的临床意义。     

560例孕产妇TORCH监测结果分析

目的检测正常孕产妇TORCH(弓形虫、风疹病毒、巨细胞病毒及单纯疱疹病毒)感染情况,为优生优育提供参考依据。方法采用抗体酶联免疫吸附试验(ELISA)对2009年10月至2010年10月间,在我院行孕前或产前检查的560例妇女进行TOX、RV、CMV、HSV-I、HSV-II检测。结果妊娠期妇女感染弓形虫、风疹病毒、巨细胞、单纯疱疹病毒-I型、单纯疱疹病毒-Ⅱ型的阳性率分别为1.6%(9)、0.53%(3)、0.018%(1)、0.89%(5)、0.53%(3)。结论针对目前妊娠期妇女感染TORCH后无特效治疗状况,对孕产妇进行四种病原体感染血清学筛查,在优生优育方面有着重要的临床意义。     

妊娠期孕妇胎儿间TORCH感染特异性抗体检测分析

目的:了解TORCH感染对该地区不良妊娠的影响.方法:应用酶联免疫吸附试验(ELISA)对102例不良妊娠(不良妊娠组)及106例正常妊娠(对照组)的孕妇进行孕妇胎儿间TORCH感染特异性抗体监测.结果:2组感染率最高者均为巨细胞病毒(CMV),其次为单纯疱疹病I型(HSVI);不良妊娠组CMV、HSV1感染率均高于对照组,差异有统计学意义(P<0.05或P<0.01).2组IgG检出率最高者均为CMV,最低者均为弓形虫(TOX);IgM检出率最高者均为CMV,最低者为风疹疾毒(RV);2组易感率最高者均为TOX,最低者均为CMV.不良妊娠组CMV和HSV1感染率均低于对照组,差异有统计学意义(P<0.05).结论:CMV、HSV1是该地区TORCH感染中对妊娠影响最大的病原体,两者均为性传播疾病,其危害不容忽视.     

某市4860例孕产妇艾滋病、梅毒和乙型肝炎病毒检测与分析

目的探讨当地孕产妇艾滋病、梅毒和乙型肝炎病毒感染情况,为干预阻断措施提供依据。方法对2007至2010年来我院保健的4860例孕产妇抽取静脉血,进行艾滋病病毒抗体筛查(快速试纸条由广西区CDC提供),筛查阳性标本送广西CDC艾滋病确认实验室做确认实验;梅毒抗体使用上海荣盛生物药业有限公司生产的TRUST试剂(RPR)进行检测,阳性使用富士株式会生产的梅毒螺旋体诊断试剂(TPPA)再次进行诊断;用上海荣盛生物药业有限公司生产的乙型肝炎病毒表面抗原诊断试剂以ELISA方法对孕产妇血清乙型肝炎表面抗原进行检测;结果 4860例孕产妇中艾滋病病毒感染23例,感染率为0.47%;梅毒病毒感染38例,感染率为0.78%;乙型肝炎病毒感染413例,感染率为8.49%。结论通过对孕产妇进行艾滋病、梅毒和乙型肝炎病毒相关知识的健康教育和检测,及时给予相应的干预阻断措施和治疗,从而降低围产儿感染率和病死率,提高出生人口素质。     

惠州市孕产妇艾滋病、梅毒、乙型肝炎感染状况分析

目的了解惠州市孕产妇乙型肝炎、梅毒及艾滋病的感染状况,为预防乙型肝炎、梅毒及艾滋病的母婴传播提供科学依据。方法对惠州市范围内到医院产检及分娩的孕产妇进行HIV抗体、HBsAg及梅毒血清学进行检测;HBsAg采用ELISA法;HIV抗体采用免疫印迹法;梅毒筛查（RPR）和特异抗体（TPPA）两项阳性为感染梅毒;对检测结果进行比较分析。结果惠州市孕产妇检测梅毒75315人,阳性81例,阳性率0．11％;HIV抗体检测73331人,阳性4例,阳性率为0．05％。;HBsAg检测78605人,阳性6103例,阳性率7．76％;结论惠州市孕产妇三种传染病的感染率依次为乙型肝炎〉梅毒〉艾滋病;三种传染病的感染状况应引起重视,积极采取阻断母婴传播及综合防治措施。     

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.