敏定偶用于35岁以上妇女的疗效、安全性和周期控制

<正> 口服避孕药在投放市场之初,应用于各种年龄段的妇女。然而资料显示早期使用的高剂量口服避孕药会增加心肌梗塞的发病率;在1975年,美国食品药物管理局(FDA)不建议40岁以上的妇女服用避孕药,对30岁以上的吸烟妇女建议她们要么停止吸烟要么改换避孕方式。随着研究的进一步深入及低剂量口服避孕药的问市,已证实任何年龄的非吸烟     

Negative charge distribution and density on the surface of oxygenated normal and sickle red cells

Negative charges on the external surface of red cells were visualized by colloidal iron hydroxide labelling of 50% of the membrane area after osmotic hemolysis and glutaraldehyde fixation. Counts were made over randomly selected areas on electron micrographs at 350,000 x magnification. Statistical analyses showed that at the 95% level of confidence there was no significant difference between oxygenated normal (AA) and sickle (SS) cells in either the distribution or the density of negative charges.     

Patient expectations of radiology in noninteractive encounters

Open-ended interviews with 107 patients documented specific patient expectations of radiologic procedures during which there was no direct radiologist-patient interaction. Patient expectations could be classified into those related to the facility and those related to interactions with radiology staff. Among facility-related expectations, waiting time far outweighed all other concerns. Interpersonal skills were the predominant expectation of radiology staff. The role of the radiologist in fulfilling patient expectations was less clear. Only 10% of unprompted patients cited the radiologist as a factor in their expectations. When patients were specifically prompted to discuss the radiologist's role, communication skills, accuracy of interpretation, and interpersonal skills were the predominant concerns.     

中药贝母类的研究——ⅩⅦ.贝母鳞叶上表皮显微观察

本文对浙贝母Fritillaria thunbergii Miq.等20种贝母的鳞叶上(内)表皮进行了显微观察,发现种间在表皮细胞形状、大小和垂周壁部位角质栓(cuticular peg)的形状,大小和排列等方面有一定区别,可作为新的鉴别依据。全文除描述外,列出检索表,并附主要特征图。     

抗血吸虫药物硝唑酰化物及其类似物的合成

硝唑眯(Ⅰ)是六十年代发现的抗曼氏及埃及血吸虫药物。对日本血吸虫也有治疗作用,但毒副反应较大,应用受到限制。考虑到药物分子中氨基经酰化后毒性往往降低的一般规律,我们设计合成了一系列硝唑咪酰化物。     

Aged venous thrombi: radioimmunoimaging with fibrin-specific monoclonal antibody

Radioimmunoimaging of fresh canine venous thrombi with a murine monoclonal antibody specific for human and dog fibrin has been reported. Successful imaging of canine deep venous thrombi 1, 3, and 5 days old at the time of antibody injection is reported. Images were positive in all dogs, and the uptake of fibrin-specific antibody was equivalent to that of fresh thrombi.     

Human immunodeficiency virus type 1-infected blood donors: epidemiologic, laboratory, and donation characteristics. The HIV Blood Donor Study Group

Transmission of human immunodeficiency virus type 1 (HIV-1) by homologous blood transfusion in the United States (US) is minimized by the deferral of potential donors who are at risk for HIV-1 infection and by the screening of all donations for HIV-1 antibody. HIV-1-seropositive donors at 20 blood centers were studied for information to be used in evaluating the safety of the US blood supply and making recommendations to increase that safety. From June 1988 to August 1989, 829 (0.04%) of 2,192,000 donors were found to be seropositive; 512 were interviewed. Of 388 seropositive men, 56 percent had had sex with men, 10 percent had used drugs intravenously, 8 percent had had sex with intravenous drug users, and 27 percent had no identified risk. Of 124 seropositive women, 58 percent had had sex with men at risk for HIV (81% of whom used drugs intravenously), 5 percent had used drugs intravenously, and 41 percent had no identified risk. Racial and ethnic minorities made up 68 percent of seropositive donors (black, 38%; Hispanic, 30%) and approximately 14 percent of all donors. The 157 persons with no identified risk had demographic characteristics and serologic test results for syphilis and hepatitis B that were more similar to those of HIV-1-seropositive donors with recognized risk than to those of seronegative donors. Three health care worker-blood donors (from an estimated 93,100 health care worker-donors) had infection that was probably acquired occupationally.(ABSTRACT TRUNCATED AT 250 WORDS)     

Outbreak of carbapenem-resistant Pseudomonas aeruginosa producing SPM-1 metallo-{beta}-lactamase in a teaching hospital in southern Brazil

OBJECTIVES: To describe the first nosocomial outbreak of Pseudomonas aeruginosa producing SPM-1 metallo-beta-lactamase (MBL) in southern Brazil. PATIENTS AND METHODS: From January to October 2004, carbapenem-resistant P. aeruginosa (CRPA) were recovered from hospitalized patients. Mortality, site of infection/colonization, patient location and susceptibility profiles were analysed. A sample of CRPA was screened for MBL production, evaluated for the presence of bla(SPM-1), bla(IMP-1) and bla(VIM-2) genes by PCR and submitted for molecular typing by DNA macrorestriction. RESULTS: A total of 135 CRPA (one isolate per patient) were recovered. Two major antibiotic susceptibility profiles comprised 63.7% of the isolates (susceptibility to polymyxin B and aztreonam, and susceptibility only to polymyxin B). Thirty-five CRPA were screened for MBL production (10 isolates from April, June and July, and 25 from September and October) and 27 (77.1%) proved to be positive for MBL production. Twenty-one of the 24 CRPA tested carried the bla(SPM-1) gene. The mortality of patients with CRPA was 48.1% and no variable was associated with death. Molecular typing revealed the presence of a clone with four related subtypes among the bla(SPM-1)-positive CRPA. CONCLUSIONS: The prevalence of MBL production by CRPA is high and horizontal transmission is a major determinant for the spread of SPM-1 CRPA among patients in this institution. As infection control measures failed to control the spread of CRPA, continuous surveillance for MBL production is warranted.     

应用28通道近红外光谱分析恢复过程中老年期抑郁症患者前额叶的激活特征

目的：认知功能障碍是老年期抑郁症的可逆性症状，试验以认知功能研究为突破口，采用28通道的近红外光谱技术分析处于恢复过程中的老年期抑郁症患者在执行词语流畅性测验时前额叶的激活特点，探讨老年期抑郁症的发病机制。 方法：①分组：患者组为2006～03／12首都医科大学附属北京安定医院收治的12例处于恢复过程中的老年期抑郁症患者，入组时符合DSM-4有关重度和中度抑郁发作或复发的标准诊断，首次发病年龄≥60岁，均服用SSRIs类抗抑郁药物治疗。对照组为12例性别、年龄和教育程度与患者组相匹配的健康志愿者。所有受试者排除脑器质性病变：②试验方法：所有受试者接受近红外光谱测查，在28通道的CW5（TechEnInc．American）NIRS系统上完成。通过近红外光谱系统监测被试者在执行词语流畅性测验任务过程中，前额叶氧合血红蛋白和脱氧血红蛋白浓度的变化，从而反映前额叶认知任务相关的激活效应。采用组块设计的词语流畅性测验作为认知激活任务，任务范式包括词语重复任务和词语流畅性任务两种试验。 结果：24例受试者均进入结果分析。①在健康老年人和处于恢复过程中的老年期抑郁症患者，词语流畅性测验能够激活双侧前额叶．未发现半球单侧化激活效应。②处于恢复过程中的老年期抑郁症患者在词语流畅性测验任务过程中，左侧前额叶激活效应较对照组减弱。③尽管在健康老年人和处于恢复过程中的老年期抑郁症患者，近红外光谱显示了不同的激活模式，但词语流畅性测验的成绩不存在显著性的组间差异（P〉0．05）。 结论：处于恢复过程中的老年期抑郁症患者存在词语流畅性测验相关的功能性左侧前额叶功能减退，微血管功能失调和多巴胺系统异常也许在老年期抑郁症的病理生理学机制中起重要作用。     

Utilization of Subcutaneous Methotrexate in Rheumatoid Arthritis Patients After Failure or Intolerance to Oral Methotrexate: A Multicenter Cohort Study

Introduction

Low-dose weekly methotrexate (MTX) is the mainstay in the therapy of rheumatoid arthritis (RA). It can be given via oral, intramuscular or subcutaneous (SC) route. This study sought to determine the real-world pattern of treatment with SC MTX in Portuguese adult patients with active RA.

Methods

Utilization of Metoject^® in Rheumatoid Arthritis (UMAR) was a non-interventional, cohort multicenter study with retrospective data collection. Eligible patients had active RA, at least 18 years of age, and started SC MTX treatment in 2009 or 2010 after failure or intolerance to oral MTX. Data were collected from patient’s clinical records. Both non-parametric and parametric survival methods were used to obtain a detailed understanding of SC MTX treatment duration.

Result

Fifty patients were included, of which only 9 discontinued SC MTX during the study follow-up period. The probability of discontinuation after 1, 2, and 3 years of treatment of SC MTX treatment is expected to be 6.10%, 8.50%, and 23.20%, respectively. The extrapolated median duration of SC MTX using an exponential model was 106.4 months/8.87 years. Mean dose of SC MTX was 18.36 mg. The reasons for treatment discontinuation were occurrence of adverse events in six patients and lack of efficacy in three.

Conclusion

The long treatment duration of SC MTX highlights its excellent tolerability compared to oral MTX, especially concerning the frequent adverse gastrointestinal events of MTX. Furthermore, long MTX treatment duration provides the opportunity to postpone or even avoid expensive therapies with biologics. The results obtained from the UMAR study provide important information for the utilization and public financing of SC MTX in Portugal.