Antiviral treatment for human immunodeficiency virus patients co-infected with hepatitis B virus: combined effect for both infections, an obtainable goal?

A large percentage of human immunodeficiency virus (HIV) patients have serological evidence of a past or present hepatitis B virus infection (HBV). Long-term survival is increasing for HIV patients because of highly active antiretroviral therapy. Therefore, the chronic hepatitis B infection may become an important determinant of disease outcome in these co-infected patients. We describe two HIV/HBV co-infected patients who were treated with extended antiviral therapy, initially indicated for the HIV infection. Lamivudine, a suppressor of viral replication in both infections, was one of these antiviral drugs. One patient showed a severe rebound of the HBV after withdrawal of lamivudine, the other patient developed a mutant hepatitis B virus after 18 months of treatment. This mutation was exclusively induced by lamivudine. These patients show that, with improved HIV-related survival, the HBV infection should be monitored carefully, thereby enabling the physician to interfere with therapy when necessary.     

Age and gender-related incidence of chronic renal failure in a French urban area: a prospective epidemiologic study

OBJECTIVE.: To determine the age- and gender-related incidence of chronicrenal failure in a French urban area. METHODS.: Prospective study of adult patients newly identified as havingestablished, chronic renal failure defined by serum creatinine(Scr) 200 µmol/l, with the cooperation of all nephrologyand dialysis units in the Ile de France district (10,660,000inhabitants) during a 1-year period. RESULTS.: 2775 patients (1780 males, 995 females) were referred with Scr200 µmol/l between July 1991 and June 1992, an overallincidence of 260/million population. 847 had advanced renalfailure (Scr 500 µmol/l) and 541 patients (19.5%) were75 years of age. The age-related incidence was 92, 264, 523and 619/million population in the age groups 20–39, 40–59,60–74 and 75 years old, respectively. The annual incidencewas twice as high in males than in females up to 75 years andthree times as high in patients 75 years (1124 vs 356/millionpopulation). Based on the proportion of patients reaching end-stagerenal failure within one year of referral, the minimal estimationof the need for supportive therapy is 81/million/year. CONCLUSIONS.: This epidemiological study in a large French urban area indicatesan incidence of 260 patients per million population annuallyreferred to nephrology units for chronic renal failure definedby Scr 200 µmol/l, with a marked preponderance of malesand a dramatic increase of incidence with age in both genders.     

荆州市乡村卫生室用药情况调查分析

目的：调查分析荆州市乡村卫生室用药情况，为有关部门制定农村医疗卫生政策提供依据。方法：抽样调查荆州市72个乡村卫生室1999—2000年用药情况，采用Microsoft Access2000及Microsoft Excel2000对调查结果进行数据录入、整理和统计处理。结果：荆州市农村用药处于较低水平，2000-1999年用量有一定增长。用药品种以国家基本药物为主，使用率较高的药物主要为抗感染药、解热镇痛抗炎抗痛风药、维生素、消化系统药、呼吸系统药等。结论：荆州市乡村卫生室药物应用基本合理。农村合作医疗政策是切实可行的。     

中国健康志愿者单次静滴甲磺酸加替沙星氯化钠注射液耐受性研究

目的在中国健康成年志愿者中评价单次静滴甲磺酸加替沙星氯化钠注射液的安全性、耐受性.方法根据新药临床试验指导原则设计试验方案,并获得伦理委员会批准.受试者须自愿签署知情同意书.选择48名18～50岁健康成人,经体检及实验室检查均在正常范围内.用区组随机化设计方法,将受试者随机分配至100mg、200mg、300mg、400mg、500mg、600mg、700mg、800mg剂量组中,每组6名,男女各半.观察指标为临床症状体征,实验室指标包括心电图、脑电图、血常规、凝血功能、尿常规、肝功能、肾功能、电解质等.严密观察记录试验期间发生的不良事件.结果各组入选受试者体检及实验室检查各项指标测定值均在正常范围,条件均衡,具较好可比性.给药后体温、呼吸频率、脉搏、血压、血常规、尿常规、肾功能、电解质、心电图、脑电图等未见有临床意义的改变.试验中未见严重的临床不良反应,只发现3例次可能与药物有关的轻度-过性不良反应,分别表现为面部瘙痒、皮疹、GOT或GPT升高.结论健康受试者单次静滴甲磺酸加替沙星氯化钠注射液,最大剂量至800mg,比较安全、耐受性较好.推荐临床使用剂量为400mg/次/日.     

多剂口服甲磺酸加替沙星片药代动力学研究

目的在中国健康成年志愿者中进行多剂口服甲磺酸加替沙星片的药代动力学研究.方法根据GCP原则设计试验方案.选择10名18～40岁健康成人男性,口服甲磺酸加替沙星片每次400mg,每日1次,连续10日.首次给药和第10日给药前及给药后0.083、0.25、0.5、0.75、1.0、1.5、2.0、3.0、4.0、6.0、8.0、12.0、24.0h分别取血;此外每日测定谷浓度和峰浓度.应用高效液相色谱法(HPLC)测定血药浓度,采用3P97软件拟合药代动力学参数.结果受试者口服甲磺酸加替沙星片,体内过程为二房室模型.连续给药10日后AUC0-∞、AUC0-τ值比首次给药显著增加,但第10日给药后AUC0-τ与首次给药后AUC0-∞差异无统计学意义;其余参数Cmax、T1/2β、Vd等差异亦无统计学意义.平均稳态血药浓度Cav为0.844±0.180 mg·L-1,稳态血药浓度-时间曲线下面积AUCss为26.165±4.530mg·h·L-1,累积比为1.354±0.867,波动系数1.685±0.158.受试者给药期间未出现严重不良反应.结论口服甲磺酸加替沙星片,每次400mg,每日1次的给药方案,在人体内可达到有效血浆浓度,且连续给药10日体内未见蓄积.该方案适宜在临床推广应用.     

铜绿假单孢菌生物被膜相关大鼠肺慢性感染免疫逃逸的研究

将藻酸盐-粘液型铜绿假单胞菌接种于免疫抑制大鼠，感染两周后，应用菌落计数法测定大鼠肺内存活菌数，光镜、透射电镜观察大鼠肺部病理改变，ELISA方法测定大鼠外周血IgG抗体，建立了稳定的铜绿假单胞菌生物被膜相关肺慢性感染大鼠模型，探讨铜绿假单胞菌生物被膜相关感染免疫逃逸现象。     

中国健康志愿者单剂静滴甲磺酸加替沙星注射液的药代动力学

目的:研究中国健康成年男性志愿者单剂静滴甲磺酸加替沙星注射液的药代动力学。方法:按药物临床试验管理规范(GCP)指导原则设计试验方案。选择9名受试者分别依次单刘静滴100,200和400mg的甲磺酸加替沙星注射液后,应用HPLC测定血药浓度,采用3P97软件进行数据处理,求出药代动力学参数。结果:受试者分别给药后,药-时曲线符合二房室模型,主要药代动力学参数C_(max)分别为1.10±0.19,2.17±0.33和3.16±0.47mg·L~(-1);t_(1/2)β分别为7.42±1.99,8.41±2.72和8.46±2.83h;AUC_(0-∞)分别为4.45 ±0.71,11.10±1.81和23.03±3.83mg h·L~(-1)。原形药主要经肾排泄,48h尿药累积排泄率分别为(43.08±15.79)％,(51.33±23.69)%和(45.67±18.22)％。结论:9名静滴甲磺酸加替沙星注射液后,药-时曲线符合二房室模型。提示甲磺酸加替沙星在100～400mg剂量内药物体内过程基本呈线性动力学特征而无饱和性,主要排泄途径为肾脏。     

依那普利对2型糖尿病大鼠肠系膜血管内皮细胞的保护作用

目的　糖尿病血管病变的初始原因是血管内皮细胞损害。本研究观察依那普利对糖尿病大鼠肠系膜血管内皮细胞是否有保护作用。方法　大鼠用高脂饮食饲养 4周后 ,ip链佐霉素 30mg·kg- 1诱导 2型糖尿病 ,继续饲以高脂饮食 4周后 ,依那普利组给予依那普利 10mg·kg- 1·d- 1,ig ,连续 4周。采用大鼠离体肠系膜血管灌流技术 ,用去甲肾上腺素 1μmol·L- 1预收缩血管 ,再给予乙酰胆碱 (ACh) 1μmol·L- 1使血管舒张。观察ACh的舒张率来反映内皮细胞功能。结果　糖尿病大鼠肠系膜血管ACh舒张率为 (33±8) % ,较对照组 (79± 8) %明显降低 ,依那普利治疗组血管ACh舒张率为 (5 2± 6 ) % ,较糖尿病组明显改善。用皂素去内皮后 ,三个组肠系膜血管对ACh舒血管的反应性均明显降低 ,三组间无显著性差异。去内皮前后 ,三个组肠系膜血管对硝普钠舒张血管的反应性无显著变化。结论　依那普利对 2型糖尿病大鼠肠系膜血管内皮细胞具有保护作用。     

Induction of carbohydrate‐specific antibodies in HLA‐DR transgenic mice by a synthetic glycopeptide: a potential anti cancer vaccine for human use

Abstract: Over the last few years, anticancer immunotherapy has emerged as a new exciting area for controlling tumors. In particular, vaccination using synthetic tumor‐associated antigens (TAA), such as carbohydrate antigens hold promise for generating a specific antitumor response by targeting the immune system to cancer cells. However, development of synthetic vaccines for human use is hampered by the extreme polymorphism of human leukocyte‐associated antigens (HLA). In order to stimulate a T‐cell dependent anticarbohydrate response, and to bypass the HLA polymorphism of the human population, we designed and synthesized a glycopeptide vaccine containing a cluster of a carbohydrate TAA B‐cell epitope (Tn antigen: α‐GalNAc‐Ser) covalently linked to peptides corresponding to the Pan DR ‘universal’ T‐helper epitope (PADRE) and to a cytotoxic T lymphocyte (CTL) epitope from the carcinoembryonic antigen (CEA). The immunogenicity of the construct was evaluated in outbred mice as well as in HLA transgenic mice (HLA‐DR1, and HLA‐DR4). A strong T‐cell dependent antibody response specific for the Tn antigen was elicited in both outbred and HLA transgenic mice. The antibodies induced by the glycopeptide construct efficiently recognized a human tumor cell line underlying the biological relevance of the response. The rational design and synthesis of the glycopeptide construct presented herein, together with its efficacy to induce antibodies specific for native tumor carbohydrate antigens, demonstrate the potential of a such synthetic molecule as an anticancer vaccine candidate for human use.     

pH and bicarbonate in the ductuli efferentes testis of the rat

The pH and bicarbonate concentrations of luminal fluids in the efferent ducts of the rat were estimated from pH measurements of samples in vitro under conditions of controlled temperature and carbon dioxide tension. The pH of scrotal blood was estimated to be more acidic than systemic blood (mean pH=7.44) at either of the putative scrotal carbon dioxide tensions (5% and 7%, pH, respectively,=7.42 and 7.28). For PCO2 tensions of 5% and 7%, respectively, the data indicated that the pH in the efferent ducts was significantly higher (distal initial zone pH=7.55 or 7.41; coni vasculosi pH=7.66 or 7.51; p < 0.01) than in fluid entering (rete testis fluid, pH=7.34 or 7.20) or leaving the ducts (zone 1a of the epididymal duct 7.26 or 7.11). Bicarbonate concentrations were also significantly higher (p < 0.01) in the efferent ducts (35.4 +/- 4.7 mM, distal initial zone; 45.2 +/- 7.6 mM, coni vasculosi) than in fluids entering (22.9 +/- 3.6 mM) or leaving (20.4 +/- 4.9 mM) the ducts. Estimates of the reabsorption of bicarbonate and fluid indicated that 96% of the testicular output of bicarbonate was reabsorbed in the efferent ducts, but there was also some secretion of bicarbonate into the ducts. It is concluded that luminal pH and bicarbonate levels in the efferent ducts of the rat are high relative to those found in the epididymis where low pH and bicarbonate contributes to sperm quiescence during storage. Nevertheless, the high rate of bicarbonate reabsorption in the efferent ducts is a major contributor to the establishment of the low pH and bicarbonate milieu of the epididymis.