直接口腔显微镜诊断粘膜病的前瞻性研究

对于口腔粘膜疾病,常规临床口腔粘膜检查往往不能及时确诊,要确诊需活检作组织学病理检查,而活检部位的选择常带有主观性,不利于病变的检出。迄今为止,尚无一种简单可靠的方法能及时准确地查出粘膜病变性质, 作者根据妇科阴道镜的应用技术试用于口腔粘膜病变的检查,对35例患者作前瞻性研究,患者平均年龄60岁(37～86岁),同时测量病灶的大小并编号。这些患者的粘膜病变已作出各种临床诊断,如粘膜白斑,口腔苔藓或怀疑恶性病变。用蔡氏显微镜,焦距200mm镜头,放大8,12,20倍,镜头前装上     

生物降解型左旋18－甲基炔诺酮微球在大鼠的药代动力学

用放射免疫法研究了左旋１８－甲基炔诺酮（ＬＮＧ）微球和ＬＮＧ微晶在大鼠的药代动力学。大鼠单次ｉｍＬＮＧ微晶３５ｍｇ·ｋｇ－１后４．８８ｈ．血药峰值达６７．６６ｎｍｏｌ·Ｌ－１，ＭＲＴ为１０．１６ｄ，Ｔ＜０．３２ｎｍｏｌ·Ｌ－１为４１．５０ｄ；而单次ｉｍＬＮＧ微球２０．４，４１．１和８３．３ｍｇ·ｋｇ－１后，血药分别于６，４．６７和４．３３ｈ达峰浓度１５．１９，３３．６１和３８．５５ｎｍｏｌ·Ｌ－１，ＭＲＴ分别为６９．２３，６５．１２和６３．２５ｄ，Ｔ＜０．３ｎｍｏｌ·Ｌ－１分别为１６７．８１，１６９．７３和１６７．２３ｄ。可见ＬＮＧ微球在大鼠的ＭＲＴ和Ｔ＜０．３２ｎｍｏｌ·Ｌ－１分别约为ＬＮＧ微晶的６．６和４．２倍，提示该微球具有明显的缓释长效作用，且初始血药峰值明显低于肌注ＬＮＧ微晶。     

盐酸维拉帕米渗透泵片溶出度与人体生物利用度研究

溶出度按Weibull's分布处理得T_d=5.76 h,T₅₀=3.9 h,零级溶出速度常数K_t=9.9450,平均体外溶解时间MDT=5.391 h。测定8名健康受试者,单剂量口服,得C_max=76.2±16.7 ng/ml,T_amx=8.0 h,t_1/2=9.75 h,MRT=19.41 h,MAT=5.34 h,与Knoll公司SR片相比,F_rel=101.71%;与市售普通片相比,F_rel=96.16%。多剂量口服,得C_max=121.47±34.5 ng/ml,T_max=7.14 h。按Loo-Riegelman方程处理表明体内外显著相关。理论值与实测值基本相符。     

奥美拉唑治疗伴消化道症状急性心肌梗死42例

急性心肌梗死（AMI）伴有消化道症状反应了心肌梗死的程度和面积’“,应予重视。我们采用奥美拉吐治疗伴消化道症状的AMI,取得较好效果,现报告如下。1资料与方法l．1病例选择我们于1992年1月～1998年3月收治伴消化道症状的AMI患者42例,均符合WHO制定的诊断标准。消化道症状包括恶心、呕吐、呕逆、腹胀、腹痛、返酸,已发生消化道出血者除外,均排除其它引起消化道症状的疾病（如急、慢性胃炎,消化性溃疡及胆道、胰腺疾患）。随机分为两组。治疗组22例,男17例,女5例,平均年龄（64．2士10．7）岁。梗死部位：广泛前壁6例,前壁2…     

‘GAP’ in radiotherapy services in Australia and New Zealand in 2009

Aim: In this study we estimated (a) the number of linear accelerators required in Australia and New Zealand to achieve a 52.3% treatment rate; (b) the ‘GAP’ between the actual and required number of linear accelerators; c) the number of persons not treated (PNT), premature deaths (PD) and years of life lost (YLL) as a result of the ‘GAP’; and (d) to review the actions being taken by health jurisdictions in Australia and in New Zealand to address the ‘GAP’ and reach the 52.3% treatment rate. Material and Methods: The actual number of fully staffed and operating linear accelerators (A) in Australian and New Zealand was obtained from a survey of radiotherapy facilities in December 2009. The required number of linear accelerators (R) was calculated from the projected cancer incidence figures for 2009 and was based on 1.6 linear accelerators being required per 1000 new cancer patients. The ‘GAP’ in Radiotherapy services (G) was R minus A. The maximum treatment capacity (MTC) was the ratio of A over R multiplied by 52.3%, assuming that all linear accelerators were operating at 100% capacity. As each linear accelerator can treat 331 new patients each year, the number of new cancer PNT is G × 331. The estimated 5-year survival benefit from radiotherapy is 16%, and the average survival for all patients receiving radiotherapy (radical and palliative) is 0.76 year. Hence, the number of PD attributed to the ‘GAP’ is PNT × 16%, and the YLL to cancer is PNT × 0.76. A literature search and local knowledge of health department Radiotherapy Plans in all jurisdictions were used to determine the action being taken to achieve a 52.3% treatment rate. Results: In 2009, the ‘GAP’ was 50 linear accelerators in Australia and the MTC was 38%, the same as it was in 1999, but there has been an increase in PNT each year from 7419 in 1999 to 16 550 in 2009, and PD each year increased from 1187 in 1999 to 2649 in 2009, and YLL each year increased from 5638 in 1999 to 12 585 in 2009. In New Zealand in 2009, the ‘GAP’ was nine linear accelerators and the MTC was 38%. An estimated 3310 persons did not receive radiotherapy in 2009 in New Zealand, and as a result, there were 523 PD and 2266 YLL. The review showed that new and replacement machines were being installed in all jurisdictions in Australia and in New Zealand. Only Victoria and Queensland have a Radiotherapy Plan beyond 2010, but both have underestimated the projected cancer incidence. Conclusion: Urgent action is needed by health departments and governments on both sides of the Tasman to improve access and equity to this essential cancer treatment. There is merit in the Baume Report recommendation of establishing a national body to oversee radiotherapy services in all jurisdictions in Australia. A similar central body should also be considered for New Zealand.     

Repeated dose inhaled budesonide versus placebo in the treatment of croup

OBJECTIVE: To investigate the efficacy and tolerance of 12-hourly dosing with 2 mg 4 mL-1 of inhaled budesonide versus placebo in patients admitted to hospital with moderate/severe croup. METHOD: Eighty-two children hospitalised with croup received either 2 mg 4 mL-1 of budesonide or placebo 12 hourly (maximum four doses) via Ventstream nebuliser in a randomised, double-blind manner. Croup scores were performed at 0, 2, 6, 12, 24, 36 and 48 h from initial nebulisation whilst the patient remained hospitalised. Follow-up assessments were made 1 and 3 days after discharge. RESULTS: Improvement was observed in the budesonide group over the 12-h dosing interval when compared to placebo (P = 0.04). Time to attain a significant clinical improvement was superior in the budesonide group (P = 0.01). Three days after discharge seven of 32 placebo-treated patients and one of 34 budesonide-treated patients had sought further medical follow-up (P = 0.02). CONCLUSION: Twelve-hourly dosing with inhaled budesonide significantly improved symptoms of croup as well as decreased relapse rates when compared with placebo.     

Randomized clinical study comparing Compeed® cold sore patch to acyclovir cream 5% in the treatment of herpes simplex labialis

Background Hydrocolloid technology has been proven effective in treating dermal wounds. A previous study showed that a newly developed thin hydrocolloid patch [Compeed® cold sore patch (CSP)] provided multiple wound‐healing benefits across all stages of a herpes simplex labialis (HSL) outbreak. Methods An assessment of CSP efficacy and safety was conducted in an international, multicentre, assessor‐blinded study, which enrolled 728 subjects with a history of recurrent HSL. Of these, 351 experienced an HSL outbreak and were randomized to use CSP (n = 179) or acyclovir cream 5% (n = 172) at the onset of symptoms until the lesion healed, for a maximum of 10 days. The primary end point was the subject's global assessment of therapy (SGAT; 0–10 scale; 0 = no response, 10 = excellent response). Multiple secondary end points included clinician‐assessed healing time and subject assessment of lesion protection, noticeability and social embarrassment. Results CSP and acyclovir were highly effective (mean SGAT = 7.89 and 8.00, respectively), with no significant difference observed (P = 0.65). The difference in healing times between products was not significant (median, 7.57 days with CSP vs. 7.03 days with acyclovir, P = 0.37). Both treatments were well tolerated. Conclusion CSP using hydrocolloid technology provides an efficacious and safe alternative to topical antivirals in treating HSL as a wound while affording additional immediate benefits of wound protection, discretion and relief of social embarrassment.