2007～2009年我院口服心脑血管类中成药用药分析

目的：评价我院口服心脑血管类中成药使用情况,为临床合理用药提供参考。方法：对我院2007～2009年口服心脑血管类中成药的种类、年销售金额、用药频度（DDDs）、日均费用（DDC）等进行统计分析。结果：我院2007～2009年口服心脑血管类中成药呈上升趋势;该类药品以胶囊、片剂及滴丸为首选剂型;排序比值同步性较好。结论：我院口服心脑血管类中成药临床使用基本合理,以新剂型、疗效确切、价格低廉的中成药在临床应用中具有优势,但也存在仍需改进的地方。     

Vascular anomalies: what they are, how to diagnose them, and how to treat them

Vascular anomalies are congenital lesions that most often first present in pediatric patients. Treatment of these lesions is a multidisciplinary team approach, involving several specialties, including diagnostic and interventional radiology, dermatology, general and plastic surgery, otolaryngology, and hematology. Knowing the characteristic findings of vascular anomalies on ultrasound, computed tomography, and magnetic resonance imaging leads to early, accurate diagnosis and therapeutic intervention of these lesions. This article discusses the gross and radiographic appearances and the latest treatment options for vascular anomalies.     

Combining two‐dimensional spatially selective RF excitation,parallel imaging,and UNFOLD for accelerated MR thermometry imaging

MR thermometry can be a very challenging application, as good resolution may be needed along spatial, temporal, and temperature axes. Given that the heated foci produced during thermal therapies are typically much smaller than the anatomy being imaged, much of the imaged field‐of‐view is not actually being heated and may not require temperature monitoring. In this work, many‐fold improvements were obtained in terms of temporal resolution and/or 3D spatial coverage by sacrificing some of the in‐plane spatial coverage. To do so, three fast‐imaging approaches were jointly implemented with a spoiled gradient echo sequence: (1) two‐dimensional spatially selective RF excitation, (2) unaliasing by Fourier encoding the overlaps using the temporal dimension (UNFOLD), and (3) parallel imaging. The sequence was tested during experiments with focused ultrasound heating in ex vivo tissue and a tissue‐mimicking phantom. Temperature maps were estimated from phase‐difference images based on the water proton resonance frequency shift. Results were compared to those obtained from a spoiled gradient echo sequence sequence, using a t‐test. Temporal resolution was increased by 24‐fold, with temperature uncertainty less than 1°C, while maintaining accurate temperature measurements (mean difference between measurements, as observed in gel = 0.1°C ± 0.6; R = 0.98; P > 0.05). Magn Reson Med 66:112–122, 2011. © 2011 Wiley‐Liss, Inc.     

In vitro and in vivo characterization of A-940894: a potent histamine H4 receptor antagonist with anti-inflammatory properties

Background and purpose:

The histamine H₄ receptor is widely expressed in cells of immune origin and has been shown to play a role in a variety of inflammatory processes mediated by histamine. In this report, we describe the in vitro and in vivo anti-inflammatory properties of a potent histamine H₄ receptor antagonist, A-940894 (4-piperazin-1-yl-6,7-dihydro-5H-benzo[6,7]cyclohepta[1,2-d]pyrimidin-2-ylamine).

Experimental approach:

We have analysed the pharmacological profile of A-940894 at mouse native, rat recombinant and human recombinant and native, histamine H₄ receptors by radioligand binding, calcium mobilization, mast cell shape change, eosinophil chemotaxis assays and in the mouse model of zymosan-induced peritonitis.

Key results:

A-940894 potently binds to both human and rat histamine H₄ receptors and exhibits considerably lower affinity for the human histamine H₁, H₂ or H₃ receptors. It potently blocked histamine-evoked calcium mobilization in the fluorometric imaging plate reader assays and inhibited histamine-induced shape change of mouse bone marrow-derived mast cells and chemotaxis of human eosinophils in vitro. In a mouse mast cell-dependent model of zymosan-induced peritonitis, A-940894 significantly blocked neutrophil influx and reduced intraperitoneal prostaglandin D₂ levels. Finally, A-940894 has good pharmacokinetic properties, including half-life and oral bioavailability in rats and mice.

Conclusions and Implications:

These data suggest that A-940894 is a potent and selective histamine H₄ receptor antagonist with pharmacokinetic properties suitable for long-term in vivo testing and could serve as a useful tool for the further characterization of histamine H₄ receptor pharmacology.     

Targeted delivery of doxorubicin to the rat brain at therapeutic levels using MRI-guided focused ultrasound

The clinical application of chemotherapy to brain tumors has been severely limited because antitumor agents are typically unable to penetrate an intact blood-brain barrier (BBB). Although doxorubicin (DOX) has been named as a strong candidate for chemotherapy of the central nervous system (CNS), the BBB often prevents cytotoxic levels from being achieved. In this study, we demonstrate a noninvasive method for the targeted delivery of DOX through the BBB, such that drug levels shown to be therapeutic in human tumors are achieved in the normal rat brain. Using MRI-guided focused ultrasound with preformed microbubbles (Optison) to locally disrupt the BBB and systemic administration of DOX, we achieved DOX concentrations of 886 +/- 327 ng/g tissue in the brain with minimal tissue effects. Tissue DOX concentrations of up to 5,366 +/- 659 ng/g tissue were achieved with higher Optison doses, but with more significant tissue damage. In contrast, DOX accumulation in nontargeted contralateral brain tissue remained significantly lower for all paired samples (p < 0.001). These results suggest that targeted delivery by focused ultrasound may render DOX chemotherapy a viable treatment option against CNS tumors, despite previous accessibility limitations. In addition, MRI signal enhancement in the sonicated region correlated strongly with tissue DOX concentration (r = 0.87), suggesting that contrast-enhanced MRI could perhaps indicate drug penetration during image-guided interventions. Our technique using MRI-guided focused ultrasound to achieve therapeutic levels of DOX in the brain offers a large step forward in the use of chemotherapy to treat patients with CNS malignancies.     

界面固定技术治疗外伤性颈椎不稳

目的介绍界面固定技术治疗外伤性颈椎不稳症。方法应用钛金属制成的空心螺纹多孔的笼状植入物，包括螺纹式笼状固定器（ＴＦＣ）、椎体间融合器（ＢＡＫ）和颈椎空心螺纹状固定器（ＣＨＴＦ），治疗外伤性颈椎不稳症３２例。观察各界面固定技术对颈椎的早期稳定和促进融合作用。结果由钛金属制成的空心螺纹多孔的笼状植入物在获得术后早期固定的同时，后期亦获得骨性融合，避免了取髂骨术并减少手术并发症，可使患者早日康复。结论界面固定技术可以取代传统的植骨融合术治疗外伤性颈椎不稳症。     

妊娠期暴露毒死蜱对子鼠成年后脑组织氧化损伤的研究

目的探讨大鼠妊娠早期暴露有机磷农药毒死蜱对子代鼠成年后大脑氧化损伤与机制。方法在母鼠妊娠后第6天至子鼠出生后第21天给予灌胃染毒,染毒剂量1／50LD50、1／IOOLD50、1／180LD50浓度的CPF和玉米油组。待子鼠长到第8周后处死,处死取脑做匀浆测大脑匀浆中丙二醛（MDA）含量、超氧化物歧化酶（SOD）活力、谷胱甘肽过氧化物酶（GSH—PXD）活力。结果随着染毒剂量的增加,SOD的活力、GSH—PX的活力下降;而MDA的含量增加,并呈现出一定的剂量反应关系。各暴露染毒剂量组的上述指标还与玉米油对照组之间的差异有统计学意义（P〈0．05）。结论妊娠期毒死蜱暴露对8周龄子鼠大脑组织具有神经毒性,其机制可能与毒死蜱暴露至大脑氧化损伤有关。     

早期应用醒脑开窍针法结合康复训练治疗高血压脑出血术后病入疗效观察

目的：观察早期醒脑开窍针法结合康复治疗对高血压脑出血术后病人的临床疗效。方法：将42例高血压脑出血术后患者随机分为治疗组及对照组,治疗组在常规药物治疗基础上,术后314天加醒脑开窍针法及康复治疗,对照组术后单纯予常规药物治疗。评定治疗前后神经功能缺损评分,进行临床疗效评定。比较治疗前后Glasgow昏迷评分（GCS）、简化Fugl-Meyer肢体运动功能评分（FMA）及日常生活活动能力评分（ADL）改良Barthel指数（MBI）等,进行功能评价。结果：早期采用醒脑开窍针法结合康复治疗能明显改善患者的临床疗效及神经功能,临床疗效治疗组总有效率为90.48%,对照组总有效率为52.39%,经统计学处理（P〈0.05）,两组间差异有显著性意义。治疗后治疗组GCS、FMA、BI均有明显改善,与对照组比较,有明显差异（P〈0.05）。结论：早期采用醒脑开窍针法结合康复治疗高血压脑出血术后病人,疗效更好。     

评价骨质状况及骨质疏松症的超声方法

超声方法评价骨质状况及诊断骨质疏松症是近年来医学超声领域内的研究前沿,并已取得了较大的进展。本文将近年来超声纵波评价松质骨和超声轴向传播技术评价皮质骨以及超声诊断质疏松症的研究进展进行综述,在此基础上提出了当前研究中存在的主要问题及努力的方向。