Psychiatric aspects of murder and attempted murder.

The clinical data and forensic aspects of 28 individuals charged with murder and 10 charged with attempted murder examined over the last 35 years are recorded. The majority of those aged 40 years or over were criminally insane. A positive family history of psychiatric illness was present in the majority of the criminally insane group. Murder and attempted murder in the setting of a stable marriage was almost invariably the result of serious psychiatric illness. After the clearcut cases of schizophrenia and depressive illness were separated there were left a mixed paranoid group and a large group of individuals with severe personality disorders. Of the forensic aspects a case is made for the wider use of "unfitness to plead" in the severely psychotic. The follow-up of cases strongly suggested that those found not guilty on psychiatric grounds were likely to be held for longer periods than those treated as criminals. The author suggests that the public would be better protected if the Crown sought an insanity verdict in some cases rather than oppose it.     

吉非替尼对比GP方案治疗女性晚期非小细胞肺癌的临床研究

目的比较吉非替尼与GP方案（吉西他滨＋顺铂）治疗女性晚期非小细胞肺癌的疗效与毒性。方法80例ⅢB～Ⅳ期从未接受过化疗的女性非小细胞肺癌患者中,吉非替尼组40例,GP组40例。吉非替尼组为吉非替尼250 mg/d;GP组为吉西他滨1 250 mg/m^2,第1、8天,顺铂75 mg/m^2,分为第1～3天,静脉滴注。每3周为1周期,2周期后评价客观疗效及不良反应。结果吉非替尼组和GP组客观有效率分别为37.5%（15/40）和30.0%（12/40）,差异无统计学意义（P〉0.05）;疾病控制率吉非替尼组77.5%（31/40）,GP组47.5%（19/30）,差异有统计学意义（P〈0.05）。吉非替尼组血液学不良反应明显小于GP组,吉非替尼组的不良反应主要为皮疹和腹泻。2组近期疗效差异无统计学意义（P〉0.05）,但不良反应吉非替尼组显著少于GP组（P〈0.05）。结论吉非替尼可作为晚期女性非小细胞肺癌患者的一线治疗药物。     

GP prescribing for HF

Growth hormone (GH) may not be the panacea for aging or the fountain of youth, but it may have a role in cell protection. In this way, it could provide elderly patients with greater independence by protecting against osteoporosis, increasing muscle strength and possibly even reducing cholesterol levels. This was concluded at a symposium on the use of GH for preventing physical frailty in older persons, sponsored by the US National Institute on Aging. The symposium was held at the recent XVth Congress of the International Association of Gerontology in Budapest, Hungary.     

重组人血管内皮抑制素联合GP方案与GP方案在非小细胞肺癌患者中疗效比较的meta分析

目的 比较吉西他滨+顺铂+重组人血管内皮抑制素(GPE)方案与吉西他滨+顺铂(GP)方案在非小细胞肺癌(NSCLC)患者治疗中的有效性和安全性.方法 采用Cochrane系统评价方法,检索Cochrane图书馆、PubMed、Embase、CNKI、万方等数据库中有关GPE方案与GP方案治疗NSCLC的文献,用RevMan5.1软件比较以上2种方案的有效性和安全性. 结果 共纳入文献10篇,分析结果表明:GPE方案在总有效率(RR)和疾病控制率(DCR)上均优于GP方案(分别为P＜0.000 01;P＜0.000 1);这2种方案在血小板减少和恶心呕吐的发生率上无统计学意义(P值分别0.07和0.08);但是,GP方案的白细胞减少发生率高于GPE方案(P＞0.003);而GPE方案的心脏毒性发生率高于GP方案(P=0.02).结论 GPE方案治疗NSCLC的总体效果比GP方案好,可降低白细胞减少的发生率,但也存在一定的心脏毒性.由于纳入的文献质量整体评分不高,上述结论仍需要设计良好的大型临床随机对照试验来验证.