急性CO中毒患者激素干预对血清TNF-α,IL-8水平的影响

1 临床资料选择2002-11/2003-04急性CO中毒患者60(男37,女23)例,年龄15～78(平均40)岁. 常规治疗组给予常压高流量鼻导管吸氧,每日高压氧治疗1次(2ATA下经活瓣式面罩吸入纯氧1 h),脱水减轻脑水肿、改善脑代谢、促进脑细胞功能恢复等治疗;干预治疗组在常规治疗的基础上,地塞米松10 mg iv, 2次/d,分别于病例确诊后即刻(中毒后2 h以内)、12,24和48 h抽取肘静脉血3 mL,采用放免法(试剂盒由北京东亚免疫技术研究所提供),严格按说明书操作检测血清检测TNF-α,IL-8.     

Encouraging physician appropriate prescribing of non-steroidal anti-inflammatory therapies: protocol of a randomized controlled trial [ISRCTN43532635]

BACKGROUND: Traditional non-steroidal anti-inflammatory drugs (NSAIDs) are a widely used class of therapy in the treatment of chronic pain and inflammation. The drugs are effective and can be relatively inexpensive thanks to available generic versions. Unfortunately the traditional NSAIDs are associated with gastrointestinal complications in a small proportion of patients, requiring costly co-therapy with gastro-protective agents. Recently, a new class of non-steroidal anti-inflammatory agents known as coxibs has become available, fashioned to be safer than the traditional NSAIDs but priced considerably higher than the traditional generics. To help physicians choose appropriately and cost-effectively from the expanded number of anti-inflammatory therapies, scientific bodies have issued clinical practice guidelines and third party payers have published restricted reimbursement policies. The objective of this study is to determine whether an educational intervention can prompt physicians to adjust their prescribing in accordance with these expert recommendations. METHODS: This is an ongoing, randomized controlled trial. All primary care physicians in Manitoba, Canada have been randomly assigned to a control group or an intervention study group. The educational intervention being evaluated consists of an audit and feedback mechanism combined with optional participation in a Continuing Medical Education interactive workshop. The primary outcome of the study is the change, from pre-to post-intervention, in physicians' appropriate prescribing of non-steroidal anti-inflammatory therapies for patients requiring chronic treatment. Three classes of non-steroidal anti-inflammatory therapies have been identified: coxib therapy, traditional NSAID monotherapy, and traditional NSAID therapy combined with gastro-protective agents. Appropriate prescribing is defined based on international clinical practice guidelines and the provincial drug reimbursement policy in Manitoba.     

4-O-卤代酰基-4′-去甲基表鬼臼毒素类似物的合成与抗肿瘤活性

为考察4′-去甲表鬼臼毒素C_4位上联结含卤素原子的酯化侧链时对化合物抗肿瘤活性的影响,设计并采用选择性酯化方法合成了9个新的4′-去甲基表鬼臼毒素酯化产物。其中标题化合物在L_(1210)白血病肿瘤细胞与KB细胞的体外生长抑制试验中普遍表现出显著的抑制活性,大部分化合物活性超过依托泊甙。而普通脂酸酯的活性较弱。     

MM3 Development of Drug Use Performance Models as Measures of Patient Care

Results from economic analyses of the effectiveness of new therapeutic innovations determine whether a new product will be reimbursed by a managed care organization or government agency. Often, the results of these economic analyses are presented as formal empirical analyses in scientific journal articles. With the pace of medical innovations submitted for approval on a payers fee schedule or formulary list ever increasing, it is important to convey the results of analysis as effectively and efficiently as possible. In response, interactive computer models have been developed to present the key findings of an economic analysis. Ideally, these models allow a potential buyer to customize a scientific analysis to determine their own reservation price for a new product. The quality and costs of these software applications vary-geatly. Given the resources expended to develop these models and time to produce them, it useful to examine the features of cost-effective "laptop model" design. This workshop will review an inventory of the features of laptop models. Participants will gain an understanding of the development process and costs for developing these models from the conceptual development phase to production of a stand-alone software application. A checklist of critical ingredients for software development will be reviewed with a special focus on role of a multidisciplinary development team and the capital resources required. A review of the discordance between scientists, biomedical manufactrures, software applications developers and potential clients and methods to gain consensus to build the application will be discussed. Examples from Project HOPE's and other firms' software development initiatives will be demonstrated as successful applications currently in use. Participants with a basic knowledge of computer applications, cost-effectiveness methods, and systems analysis will likely gain the most from this workshop.     

Complications of epilepsy and a ruptured pyonephrosis: Radiology to the rescue in the Brooks murder case

A woman and her lover were accused of murdering the woman's husband. Five weeks after fracture/dislocations of both shoulders and a central fracture/dislocation of the right hip were diagnosed the woman's husband died of septicaemia consequent on a ruptured infected hydronephrosis. The shoulder and hip injuries and the ruptured hydronephrosis were attributed to a beating with a blunt instrument. A review of the medical records of the deceased, particularly his radiological examinations, led the authors to conclude that his joint injuries and ruptured kidney were not due to the alleged assault. The joint injuries were the consequence of epileptic seizures and the ruptured kidney was also due to natural causes. These medical opinions provided evidence that led to acquittal of the accused.     

4-(2-酰胺基-2-乙氧羰基)乙硫基-4-脱氧-4′-去甲表鬼臼毒素衍生物的合成与抗肿瘤活性

为考察4′-去甲基表鬼臼毒素4位上取代基结构变化与抗肿瘤活性的关系,设计并合成了23个标题化合物。体外L_(1210)白血病细胞与KB细胞生长抑制试验的结果表明,化合物11,16和18的抗肿瘤活性超过依托泊甙,化合物8的活性与依托泊甙相当。     

Patterns of methane production in a Burmese (Myanmar) population

While up to 50% of Western populations produce methane, this is less than that of rural black Africans and there is no information on methane production in populations from Asian developing countries. Females consistently produce methane more commonly than males, and methane production in children under the age of five years, except in Nigeria, is unusual. Breath methane was sampled in 1426 subjects from Myanmar ranging in age from 1 month to 88 years, with a mean age of 26.2 years. Half (49.8%) of the Myanmar population produced methane, this figure comprising 53% of females and 46% of males sampled. Methane production increases with age and reaches adult levels after 10 years of age. A high prevalence of methane production was found in children under 3 years of age (15.8%). Methane production was absent in 13 solely breast-fed children and increased as other food was introduced into the diet. There was an association of methane production within families and with smoking. The prevalence of methane production increased in male and female smokers, with 75% of smokers producing methane. Methane production was not associated with occupation, education, income, water source, latrine type, previous diarrhoea, antibiotic usage or socio-economic status.